i. Children experiencing grief and loss

PROJECT EVIDENCE for Prevention of Mental Disorders. The project coordinator is Dr Allan Mawdsley. The version can be amended by consent. If you wish to contribute to the project, please email admin@mhyfvic.org

[2] Selective Programs are indicated for situations where subjects are at high risk of developing mental disorders unless there is preventive intervention.

[2 b] Psychological factors

i Children experiencing grief and loss
ii Children with disruptive behaviours

[2 b i ] Children experiencing grief and loss

The “Emerging Minds” website provides sensible commentaries on understanding and supporting pre-school and primary school aged children experiencing grief and loss. Those commentaries are combined here to minimise duplication. The final advice about persistent symptomatology is for consultation with the family General Practitioner; we would suggest discussion about referral to a psychologist.

What are grief and loss?

Children experience grief and loss as a normal part of life. Loss is when something ends (you or your child has ‘lost’ something or someone). Loss can mean the death of a family member or friend, or member of the community. It can mean the loss of a pet, or a relationship (e.g. divorce or separation) or even moving to a new house. It can be a psychological loss as well, such as the loss of feeling safe (e.g. due to bushfires or floods, or experiences of violence).

Grief is the emotional response to these types of losses, and may include feelings of anger, sadness, or anxiety. Grief, and the emotions that accompany it are a natural though difficult process.
A child’s experience of grief will partly depend on how fully they can understand the nature of the loss, such as the finality of a death, or the impacts of losing a home in a disaster.

How children react also depends on:

• the level of disruption there is to their lives and environment
• the way other family members are coping, and how they are able to respond to the child and their questions
• if someone has died: how close the child felt to that person, and how involved they were in the child’s life and care
• the child’s other experiences of loss or adversity.

Responses to grief and loss

Preschool-age children can’t really understand the finality of death and may think that the person will return. They will often think that death is temporary and reversible. They may keep asking when their loved one will come back or where they have gone. They may even want to go out looking for the person who has died. Children of this age take what you tell them literally, so it is important to think about how you explain the death.

The effects of grief at this age are mainly behavioural and may include:

• withdrawing – not wanting to play with friends
• regression – going back for a short time to behaviours used at a younger age self-soothing – such as thumb-sucking, using dummies, rocking, etc.
• crying
• asking repetitive questions – often about where the person is, when they are coming back, and how they died
• anger – including defiance, acting out, aggression or temper tantrums
• separation anxiety – being clingy and difficult to settle, or calm, as they fear being separated and abandoned by those who care for them.

These reactions all show the child’s need for comfort, particularly following the death of a parent or someone else they were very close to.

As children enter primary school (at 5-6 years of age) many do not yet understand the finality of death. By the age of 8, children have usually shifted to an understanding that death is permanent. This may lead children to feel more anxious that they themselves may die, or that other loved ones may die. However, primary school children still have a limited ability to express themselves through language and may show their feelings of grief through their behaviour and play.

Primary school-age children may:

• frequently ask questions such as, “where is (the person who died)?” and “when are they coming home?
• feel that the loss is somehow their fault
• withdraw from friends and family
• act out or misbehave or show some aggression
• not perform as well as usual at school
• have difficulties concentrating.

These reactions all show the child’s need for comfort, particularly with the death of a parent or someone else they were very close to.

How to support a child experiencing grief or loss

• Recognize that they are feeling sad too, even though their behaviour may not always make this clear.
• Remember, children’s moods can change very quickly. They may be extremely sad one moment and be running off to play the next – this doesn’t mean they are not still upset.
• Try to maintain normal routines to the best of your ability.
• Allow them to ask questions. Provide simple, clear and honest answers.
• Assure them that it was not their fault that the person died.
• Don’t be alarmed if children’s play includes scenarios of death as they process their grief.
• Make yourself available for hugs or chats when they are feeling worried or uncertain.
• Acknowledge that grief may be the reason for their change in behaviour.
• Provide information about ‘normal’ grief – how it comes and goes and can bring strong feelings but will ease over time.
• Make sure that they feel valued and cared for.
• Ensure that they are supported at home and at school.
• Help them to understand that life will go on; they are strong and will get through this time; and that help is there if they need it.

How should I talk to my child about death?

• Preschool-age children may see death as a temporary, reversible state. Let them know that the person’s life is over now, and they will not be able to visit them anymore.
• Gently explain that the person’s body doesn’t work well enough for them to live in it, like they used to
• Provide school-age children with simple, concrete answers to their questions rather than complex scientific or philosophical explanations.
• Acknowledge feelings of confusion or uncertainty as normal responses when something happens that we don’t want or understand.
• Validate the sadness or other feelings your child expresses, encouraging them to come to you if they need a hug or want to talk about the person they are missing.

The majority of children are resilient and with the right support they will work through the grief and loss and be OK. However, if these emotions and feelings are persisting and causing you concern, you should seek additional support from your GP.

Last updated 6/3/2020

POLICIES for Prevention of Mental Disorders

[2] Selective Programs

a) Biological factors

i Post-natal depression
ii Children with chronic illnesses
iii Children with learning difficulties

b) Psychological factors

i Children experiencing grief and loss
ii Children with disruptive behaviours

c) Social factors

i Indigenous families
ii Immigrant families
iii Children involved with bullying
iv Children in out-of-home care

[2 b i ] Psychological factors: Children experiencing grief and loss

MHYFVic advocates implementing the approaches outlined by “Emerging Minds” as reported in Project Evidence PE2b i followed by referral to a clinical psychologist in the event of persistent symptomatology.

MHYFVic advocates Government support for Headspace, Lifeline and Beyond Blue as public assistance agencies helping individuals experiencing grief and loss and other crises minimise the likelihood of worsening mental illness.

Last updated 6/3/2020

BEST PRACTICE MODELS for Prevention of Mental Disorders

[2] Selective Programs

a) Biological factors

i Post-natal depression
ii Children with chronic illnesses
iii Children with learning difficulties

b) Psychological factors

i Children experiencing grief and loss
ii Children with disruptive behaviours

c) Social factors

i Indigenous families
ii Immigrant families
iii Children involved with bullying
iv Children in out-of-home care

[2 b i ] Psychological factors: Children experiencing grief and loss

Best Practice management of children experiencing grief and loss involves following the approaches outlined by “Emerging Minds” as paraphrased in Project Evidence PE2b i to be followed by discussion with the family General Practitioner including potential referral to a clinical psychologist in the event of persistent symptomatology.

Last updated 6/3/2020