Guidelines for Helping Grieving Children

Children Express Grief in Their Own Way 

In previous generations, when grandparents often lived with families, death was a more natural part of a child’s experience and often occurred at home. Children witnessed the aging process and death firsthand.  

Today, however, deaths are more likely to occur in a nursing home or hospital, away from children's eyes and experiences. As a result, the exclusion of death from children’s lives requires us to teach them explicitly about dying and grief.  

Even though psychoanalyst Sigmund Freud's contended in Mourning and Melancholia that young children do not have the capacity to mourn, contemporary research has concluded that children are capable of accepting death and expressing grief, often more intermittently and over longer periods than adults who grieve.[i] But they also approach and process grief differently than adults. 

Grieving helps adults and children heal from their pain, and it is a natural reaction to the death of a loved one. Sometimes, adults who try to protect children from the pain of loss are often trying to protect themselves. Keep these suggestions in mind as children work through grief: 

• Allow children to express grief in their own way and in their own time 
• Do not pressure children to resume their normal activities if they are not ready. 
• Children's feeling may emerge through behavior and play, not through talking and discussing, simply because they are not able to verbalize what they are feeling (e.g., children might laugh or play at a time that feels inappropriate to an adult). 
• Children's normal reactions to death might materialize as “grief bursts” that are followed by play and normal activities.  

Tips for Talking About Death With a Child 

• Keep lines of conversation open: Children need to feel that it is okay to talk about death and grief, and that their feelings of anger, sadness, fear and regret are normal. Adults should let a grieving child know that they are available to listen and help. Hugging and touching help the grieving child feel secure in expressing emotions, providing reassurance of continued love and care. Alan Wolfelt feels that if grieving children are ignored, they may suffer more from the sense of isolation than from the loss itself.[ii] At the same time, adults should respect a child's wishes not to talk about his/her grief. 
• Be aware of what you say and what children do: Children might suppress their grief or perceive unreasonable expectations if they're told such things as "Don’t cry. You need to be strong,” or “You’re the man in the family now,” or “Be a good girl. Your mommy needs your help now more than ever.” Grieving children should not be allowed or expected to take on the adult role of “confidante” or partner of the surviving parent.  
• Share your own feelings with children: Adults who do not hide their own sadness teach children that feelings are OK and there is no shame or loneliness associated with grief. It is also true, however, that adults should not grieve profusely and at length in front of a child, behaviors that might frighten or worry a child.  

Parents might be tempted to “send children away” (to a relative's or friend's house) after a death, either to protect them from painful feelings or because it is difficult to care for them while grieving themselves. Just realize that during the grieving period, children are often most comforted by familiar surroundings and routines, and separation may increase their fears about abandonment. 

The Role of Faith and Religion 

Religion is an important source of strength for many adults and children during the grief process. But remember that children often take things literally; explanations such as “It is God’s will” or “Bonnie is happy in heaven” could be frightening or confusing rather than comforting, particularly if religion has not played a key role in a child’s life. Ask children to explain in their own words what they think has happened, or what they think about death. Allow them to express their religious and spiritual concerns. When they ask about death, turn the question around ("What do you think?") and let them speak freely. 

Sadness 

Grieving children who are sad or depressed deserve ongoing support and attention so that they can express their sadness and work through feelings. Grief therapist Helen Fitzgerald suggests: 

• Art as therapy: Ask the child to draw good and bad memories of the person who has died and share the drawings with others.  
• Photographs as therapy: Ask the child to show photographs of their loved one, describe keepsakes to others and develop a memory scrapbook. 
• Fantasy or what-if therapy: Ask a child who feels despaired about their loss to fantasize how life might look if they were not so sad.  
• Exercise and play therapy: Encourage a depressed child to engage in physical activity or active play. [iii] 

Johnny was very withdrawn and depressed for several months after the death of his mother. Finally, his grief counselor suggested he make a “God box.” He could write down all his sad feelings and put them in the box and God would help him feel better. He wrote a new note almost every day and soon his father noticed that he seemed more cheerful. 

Anger 

Children often find it easier to feel mad than sad or guilty. Anger needs to be expressed, however, so that it doesn't escalate or feed on itself. Adults can help children learn to express anger in constructive ways so that it does not evolve into depression or out-of-control rage.  

• Let them vent anger physically: Allow children to dissipate anger by running, exercising, scribbling on paper, ripping paper, singing or sculpting clay. 
• Ask questions when anger is not peaking. Wait until anger's intensity has waned too ask children about their anger. Ask open-ended questions, such as “What usually leads to your feeling angry?” “How does your body tell you that you are becoming angry?” Examining anger this way can diminish the intensity of the emotion and give the child a sense of control by learning what triggers an angry response. 
• Let the child come up solutions for dealing with anger. Ask the child what he/she thinks are more appropriate ways of responding to angry feelings—but remember that adults are responsible for setting limits with an angry, bereaved child who is acting out (e.g., “It’s not OK to hit me but you can hit this pillow instead").  Maintaining household rules and chores increases a sense of normalcy and security for a grieving child. 

Stephen had been very close to his grandfather. When his grandfather died, Stephen's parents noticed he began bullying his younger siblings and picking fights at school. They called his football coach who suggested that Stephen might “work out” some of his aggression by staying after practice and “ramming” the dummy players. After two weeks of “extra” practices, Stephen was much less aggressive with other children. 

Guilt and Regrets 

Some children have regrets about certain aspects of their relationship with the person who has died. They might regret things that did not happen or were not said while they had the time. Examples might be: “I never told my mother I loved her,” “I lied to my father and never told him the truth,” “I was mad at my mom the day she died,” “I didn’t have a chance to say goodbye.” 

Fitzgerald describes useful techniques to help children work through feelings of guilt and regret. 

• Write a letter to a loved one: Ask the child to describe the "unfinished business" that worries them, or to write a note about why he or she feels guilty. Tie the note to a helium balloon and release it into the sky, or burn it in a bonfire and let the smoke and ashes rise to the sky. 
• Use art to work through guilt and regrets:  Children who cannot yet write can draw pictures about their worries, regrets or built. For younger children, puppet play can help them work through feelings, too. [iv] 

 

After her mother’s death, Emily’s father noticed that she seemed very preoccupied and unable to focus on her schoolwork. After several months, he referred her to the school counselor who had experience in working with bereaved children. When she suggested Emily write letters to her mother, Emily seemed relieved to be able to communicate with her mother in this way. Emily then asked the counselor to read the letters. They were full of ways that Emily believed she could have prevented her mother’s death. After the counselor read several of these letters and educated Emily on the nature of her mother’s serious illness, Emily began to relax and was able to focus on her school work again. 

Fears 

It is important to help fearful children identify specifically what scares them, and then to address each fear individually. Children who are fearful generally need repetitive reassurance that they will be OK. A parent or other significant adult should spend alone time and focused time with a grieving child, reassuring them that they are special and loved. 

Both of Anwar’s siblings had been killed in an automobile accident. Anwar was terrified of riding in a car for months after their death, and was also afraid that someone else close to him would die. His parents and family provided a great deal of love and support during this time. His father decided to help him confront his fear of riding in the car by taking incremental steps. First they sat in the car for a long time as Anwar expressed sorrow about his loss and anger at the driver who caused the accident. Later, his father backed out of the driveway, reassuring Anwar that he was safe. The next day he drove down the street, assuring Anwar about how accomplished a passenger he was. Soon Anwar was able to ride in a car again without fear. 

Physical Complaints 

Grief can manifest itself physically in children, perhaps as headaches or stomach aches. When a grieving child routinely complains of physical symptoms, gently ask what other feelings he/she may be having. Even if children do not disclose their emotions right away, they might begin to make the connection between emotions and how their body is reacting. 

If a child's physical complaints mirror those of the deceased, remind the child in words he or she can understand why the death happened. A visit to the pediatrician may also be advised, so the child can be reassured by a doctor that nothing is wrong. 

Jose complained of headaches for weeks after his father’s death. He was the oldest son and felt he had to be “strong” for his other siblings and for his mother, so he expressed very little emotion. Two months after his father’s death, his uncle asked Jose if he wanted to visit the cemetery. When they approached the grave Jose began to cry as they approached the grave. He and his uncle spent several hours while Jose talked to his father and reminisced with his uncle. After that, Jose no longer complained of headaches. 

Special Consideration - Death of a Parent or Significant Adult 

The death of a parent is particularly hard for a child, because children depend upon parents for survival and stability. Phyllis Silverman believes that a child's deeply felt loss, how they talk about their deceased parent or significant adult, and the deceased parent's place in their life can be even more critical than their age-specific understanding of death.[v] A parent's death can also be more difficult if it was sudden OR if the child lacks a solid replacement figure. [vi] 

Some children fantasize that their parent will return; others wish to die so they can be reunited with their deceased parent. Usually this is a fleeting desire rather than true suicidal ideation. The child should, however, be questioned more deeply to explore whether they have a specific plan or means available to carry out their wishes. 

Children also will accommodate and adapt to a parent's death throughout his or her life. They will revisit the meaning of their parent’s death at different developmental stages or experience the loss differently at events such as graduation, marriage and the birth of a child. 

Some bereaved children idealize the parent or significant adult as a way to keep pleasant, comforting memories alive. This can be helpful unless it gets in the way of the child expressing angry feelings or confronting “unfinished business” in the relationship. The surviving parent should allow the idealization of the deceased parent and reassure the child of his or her love, care and support.  

Sources

[i] Charles A. Corr; “What Do We Know About Grieving Children and Adolescents?”, in Kenneth J. Doka, editor, Children, Adolescents and Loss: Living With Grief (Washington: Hospice Foundation of America, 2000), p.28. 

[ii] Alan D. Wolfelt, PhD. A Child’s View of Grief (Service Corporation International, 1990) page 17. 

[iii] Helen Fitzgerald, The Grieving Child (New York: Simon & Schuster, 1992), p. 

[iv] Helen Fitzgerald, The Grieving Child (New York: Simon & Schuster, 1992), p.122-126. 

[v] Phyllis SR. Silverman, “When Parents Die,” in Kenneth J.Doka, editor, Children, Adolescents and Loss: Living with Grief (Washington: Hospice Foundation of America, 2000), p. 221. 

[vi] Atle Dyregrov, Grief in Children: A Handbook for Adults (London: Jessica Kingsley Publishers, 1990), p.31. 

References 

Bolby, John (1980). Attachment and Loss: Loss-Sadness and Depression-Volume III. New York: Basic Books. 

Cline, Karen D. et.al. (1988). A Family Guide to Helping Children Cope. California: American Cancer Society. 

Doka, Kenneth J., editor. (2000). Children, Adolescents and Loss: Living with Grief. Washington: Hospice Foundation of America. 

Doka, Kenneth J., editor. (1995). Children Mourning, Mourning Children. Washington: Hospice Foundation of America. 

Dyregrov, Atle. (1990). Grief in Children: A Handbook for Adults. London: Jessica Kingsley Publishers. 

Fitzgerald, Helen. (1992). The Grieving Child. New York: Simon & Schuster. 

Grollman, Earl. (1985). Bereaved Children and Teens: A Support Guide for Parents and Professionals. Boston: Beacon Press. 

Huntley, Theresa. (1991). Helping Children Grieve. Augsburg: Augsburg Fortress. 

Kroen, William C. (1996). Helping Children Cope with the Loss of a Loved One. Minneapolis: Free Spirit Publishing, Inc. 

Osterweis, Marian; Solomon, Frederic; & Green, Morris, editors. (1984). Bereavement: Reactions, Consequences and Cure. Washington: National Academy Press. 

Pennells, Sr. Margaret & Smith, Susan C. (1995). The Forgotten Mourners: Guidelines for Working with Bereaved Children. London: Jessica Kingsley Publishers. 

Wolfelt, Alan. (1983). Helping Children Cope with Grief. Bristol: Accelerated Development. 

Wolfelt, Alan. (1990). A Child’s View of Grief: A Guide for Caring Adults. Service Corporation International. 

Worden, J. William. (2001). Children and Grief: When a Parent Dies. New York: Guilford Publications. 

Resources for Grieving Children 

Books

Buscaliglia, Leo. (1982). The Fall of Freddie the Leaf. Holt, Rinehart and Winston. 

Fassler, Joan. (1971). My Grandpa Died Today. New York: Behavioral Publications Co. 

Krementz, J. (1991). How it Feels when a Parent Dies. Knopf. 

Viorst, Judith. (1972). The Tenth Good Thing About Barney. New York: Atheneum 

Websites 

www.centerforloss.com

www.griefnet.org