1. SUPPORTING GRIEVING STUDENTS IN THE RECOVERY PHASE OF TREATMENT Lauren W. Schneider, LCSW Clinical Director of Children’s Programs OUR HOUSE Grief Support Center 1663 Sawtelle Blvd., #300 Los Angeles, CA 90025 (310) 473-1511 www.ourhouse-grief.org

2. 4 GOALS WHEN SUPPORTING GRIEVING CHILDREN Correspond to JW Worden, PhD’s Task Model for understanding grief. Grief Counseling & Grief Therapy (2009) Children & Grief (1996)

3. 4 GOALS WHEN SUPPORTING GRIEVING CHILDREN (CONT.’) 1.To assist them with accepting and understanding the reality that their loved one has died 2.To support them while they experience the thoughts and feelings associated with grief 3.To help them adjust to their new normal and help them get their needs met in a world without their loved one 4.To provide guidance as the child finds ways to honor their loved one’s memory and to maintain the positive connection with the deceased

4. FIRST GOAL: TO ASSIST THEM WITH ACCEPTING AND UNDERSTANDING THE REALITY THAT THEIR LOVED ONE HAS DIED 1.Child’s ability to achieve goal dependent on three factors 2.What can you do before the child returns to school? 3.Bottom line: Empower the child so he can talk about what happened

5. TODDLERS (UNTIL AGE 4 OR 5) 1. Magical Thinkers 2. Ego-centric 3. Cognitively unable to understand death related concepts: a. Irreversibility b. Unpredictable c. Universality d. Causality e. Non-functionality

6. SCHOOL AGED ( 6-10 YEARS) 1. Concrete thinkers (Piaget) 2. Understand permanence 3. Lack language to express grief verbally 4. “Short sadness span” (Nancy Boyd Webb)

7. PRE-ADOLESCENTS AND TEENS 1.Lack cognitive and emotional maturity to process grief like adults 2. Magical thinkers

8. TEENS (CONT’) 1. Identity vs. Role Confusion (Erickson) 2. Separation-Individuation process impacted

9. HELPING CHILD WITH FIRST GOAL 1.Primary Intervention is use of language 2.Avoid Euphemisms or platitudes “Death is when a person’s body stops working and they no longer breathe, think or feel anything and we will never see them alive again”

10. CAUSES OF DEATH AT CAMP ERIN, AUGUST 2014 83 Grieving Children: Illness: 66% Homicide: 12% Suicide: 8% Overdose: 3%

11. DEFINITION OF SUICIDE Suicide is when someone ends their own life.

12. EXPLAINING SUICIDE TO CHILDREN 1.Define Suicide in simple terms 2.Give honest, age appropriate information about what actually caused the death 3.Answer questions honestly or by saying “I wish I could answer that question”. 4.Ask children to identify who they would go to for help if they ever felt so depressed they wanted to die

13. DEFINITION OF HOMICIDE “Homicide is when someone ends someone else's life”

14. SUBSTANCE RELATED DEATHS 1.Complications of Alcoholism 2.Liver Failure 3.Took too much medicine 4.Overdose

16. GOAL #1 ACTIVITIES 1.Read Books: When Dinosaurs Die; Brave Bart; My Memory Book for Grieving Children 2.Help them construct their narrative: a. Write or Draw about the day of death b. Write or Draw about the day of the funeral or memorial service c. Draw where your person is now? d. The 5 Senses –see, hear, taste, smell, touch

17. WHAT HAPPENED TO YOUR PERSON?

19. Where is your person now?

21. DRAW THE DAY OF THE FUNERAL

22. DRAW WHAT HAPPENED ON THE DAY OF THE DEATH

23. GOAL #2: TO SUPPORT THE CHILDREN WHILE THEY EXPERIENCE THE FEELINGS AND THOUGHTS ASSOCIATED WITH GRIEF I Typical Grief Reactions A. SADNESS B. ANGER C. FEAR D. RELIEF OR HAPPINESS E. GUILT

24. GOAL #2 ACTIVITIES 1. Activities designed to help them express their feelings and quantify them. a. Feelings Pie b. Feelings Ball c. Angry Bags d. Feelings Jenga e. Feelings Charades

26. FEELINGS SOUP 26

27. GOAL #3: TO HELP THEM ADJUST TO THEIR NEW NORMAL AND HELP THEM GET THEIR NEEDS MET IN A WORLD WITHOUT THEIR LOVED ONE. A. Teach coping strategies B.Prepare child for special days C.Assist with secondary losses as needed

28. COPING STRATEGIES: 1. Breathing Techniques 2. Visualization 3. Releases emotions through movement 4. Comforting self with music, journaling, pets, etc.

31. GOAL #4: TO PROVIDE GUIDANCE AS THE CHILD FINDS WAYS TO HONOR THEIR LOVED ONE’S MEMORY AND TO MAINTAIN THE POSITIVE CONNECTION WITH THE DECEASED 1. Engage in on-going rituals 2. Become more future oriented over time 3.Good News: Kids are resilient

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34. GOAL #4 ACTIVITIES

35. REMEMBERING DOESN’T HAVE TO HURT!

36. BEST PREDICTORS OF POSITIVE OUTCOME 1. How well the surviving parent or other family members adjust to life without the deceased 2.Consistent limit setting 3.Presence of similarly bereaved peers

37. NO SUCH THING AS “CLOSURE”!