Parent Grief 1–13 Months After Death in Neonatal and Pediatric Intensive Care Units

Objective. Describe changes in mothers’ and fathers’ grief from 1 to 13 months after infant or child neonatal or pediatric intensive care unit death and identify factors related to their grief.

Methods. Mothers (n = 130) and fathers (n = 52) of 140 children (newborn–18 years) completed the Hogan Grief Reaction Checklist at 1, 3, 6, and 13 months postdeath.

Results. Grief decreased from 3 to 13 months for mothers and from 3 to 6 months for fathers. Grief was more intense for mothers of deceased adolescents and mothers whose children were declared brain dead.

Conclusion. Mothers’ and fathers’ grief intensity may not coincide, resulting in different needs during the 13 months after infant or child death.     

Complicated Grief: An Evolving Theoretical Landscape

The bereavement literature has proliferated in recent decades, generating a shift from conceptualizing grief as a stepwise, uniform process to an idiosyncratic experience that varies among individuals. Among the most notable developments is the empirical exploration of complicated grief—a protracted, debilitating, sometimes life‐threatening response to the death of a loved one—and the testing of novel interventions to treat it. This article provides counselors with recommendations for identifying and treating complicated grief.     

Reactions following the sudden death of a classmate

Findings from a study of adolescents grief reactions following the sudden death of a friend and a classmate are presented. The group (26 classmates) was followed up after one and nine months. Interviews and a questionnaire including the Imapact of Event Scale and the Hogan Grief Inventory were used. The general grief scores on the Hogan Grief Inventory indicated that the grief level was similar to that of adolescents who had lost siblings. The scores on the Impact of Event Scale showed a descline in distress level from 1 to 9 months. However, after 9 months about 1/5 of the students still scored above a clinical cut-off point indicating post-traumatic stress levels. Recommendations for improving help following such events are presented.     

Field Trial of a Complicated Grief Psychosocial Program for Adolescents in Occupied Palestine

The current study evaluated the new “Children and Grief” program for Palestinian adolescents (n = 158), aged 10–18, referred to counselors for complicated grief. A mixed methods quasi-experimental design involved non-randomized intervention group (n = 79), waitlist (n = 79), and measures of program fidelity and cost. Traumatic loss was identified from case files. Standardized measures assessed complicated grief, posttraumatic stress, and depression at pre and post-test. Interviews of 9 adolescents and 9 presenters explored subjective experience of program delivery. Analysis involved multivariate analysis of variance (MANOVA) and quasi-qualitative analysis of interviews. A large effect size was found for reduced complicated grief. Randomized control trials, longitudinal research, and studies that explore the impact of martyrdom on coping with grief are needed.     

Teacher Perspectives on Grief Among Children with Intellectual Disabilities

The death of a parent can have a profound impact on a child. However, little is known about how children with intellectual disabilities demonstrate grief or how teachers respond to student grief. Constructivist grounded theory methods were used to analyze data collected from five special education teachers of elementary students with intellectual disabilities. Categories related to grieving, loss, support, coping, and emotion were found. Teachers reported a range of grieving behaviors displayed by children with intellectual disabilities in the classroom and used various strategies to provide support. Grief in surviving caregivers and assistance from other school personnel were also described. The need for additional training of teachers and counselors about grief in children with intellectual disabilities is highlighted.     

From Mourning to Action: African American Women's Grief,Pain, and Activism

The Movement for Black Lives has brought particular attention to the experience of grief in the lives of African American mothers and its use in their advocacy for social reform. Grief-inspired activism is historically significant in the African American community. By highlighting the historical connections between Mamie Bradley Till and present-day African American mothers’ grief over their deceased children, we will discuss the role of grief and mourning in the lives of African American mothers and the way in which their grief is pivotal in shaping their involvement in social justice movements. Furthermore, we will provide suggestions on how to promote social activism among African American mothers.     

The use of religion in coping with grief among bereaved Malay Muslim parents

The purpose of this study is to explore the influence of religion on bereaved parents after the death of a child. Literature had attempted to understand how religiosity may influence parental grief both in positive and negative ways. However, this area is scarcely explored in the Malaysian context. This qualitative study involved 11 bereaved parents who lost their children due to accidents (n?=?9) and homicide (n?=?2). Open-ended questions that focused on the importance, activities, and role of religion in the grieving process among Malay parents were asked. According to the thematic analysis, some of the main themes found were that the bereaved parents described religion as a beneficial mechanism in helping them to adapt with their losses through various responses that indicated the perception that religion as a guidance. However, other than the positive impact, religiosity can also lead the bereaved parents to experience negative effects of using religion as a coping strategy. The influence of culture is prevalent in the current study as the theme of mystical belief and paranormal experiences were also reported. This study provides some professional implication from the possible use of religion in intervention.     

Building Self-Efficacy Through Women-Centered Ropes Course Experiences

This paper describes our experiences as facilitators in adventure-based ropes course training. It summarizes experiences with different groups that raise rich and complex issues about the use of adventure-based learning for personal growth and professional development. These groups include women executives, women living in public housing who have formed a women's resource group, adolescent women in treatment, adolescents from currently diverse backgrounds, graduate students, and women who have been sexually abused. These groups reflect the diversity of female participants who have engaged in ropes course training. Although participants are diverse, deep commonalities exist in the kinds of issues they are addressing in ropes course programs. Positive changes in women's abilities to take risks, practice assertive leadership, solve problems effectively, and feel more competent in general, can result from participation in a ropes course experience. In this article, the reader will see how one fixed ropes course element can be used to create a variety of metaphors for diverse groups of participants.     

Cross-Lagged Analyses of Prolonged Grief and Depression Symptoms With Insomnia Symptoms

Prolonged grief disorder, characterized by severe, persistent and disabling grief, has recently been added to the DSM-5-TR and ICD-11. Treatment for prolonged grief symptoms shows limited effectiveness. It has been suggested that prolonged grief symptoms exacerbate insomnia symptoms, whereas insomnia symptoms, in turn, may fuel prolonged grief symptoms. To help clarify if treating sleep disturbances may be a viable treatment option for prolonged grief disorder, we examined the proposed reciprocal relationship between symptoms of prolonged grief and insomnia. On three time points across 6-month intervals, 343 bereaved adults (88% female) completed questionnaires to assess prolonged grief, depression, and insomnia symptoms. We applied random intercept cross-lagged panel models (RICLPMs) to assess reciprocal within-person effects between prolonged grief and insomnia symptoms and, as a secondary aim, between depression and insomnia symptoms. Changes in insomnia symptoms predicted changes in prolonged grief symptoms but not vice versa. Additionally, changes in depression and insomnia symptoms showed a reciprocal relationship. Our results suggest that targeting insomnia symptoms after bereavement is a viable option for improving current treatments for prolonged grief disorder.     

The Healing of Nations

Based on the apparent transgenerational traumas experienced by clients of two psychoanalysts working in the Balkans region over a four-year period, from 2012 to 2016, this article presents an understanding of recovery from war trauma at the national and cultural levels in terms of individual grief models. As examples of unresolved transgenerational grief, the experiences of the Jasenovac children in concentration camps in Croatia during the Second World War are cited. The presented models can be applied to promote healing, and the need for monuments to aid the mourning process is emphasized.     

Siblings after suicide--"the forgotten bereaved"

There is scarce research on "the forgotten bereaved"--the children and adolescents who lose a sibling by suicide. In this paper we explore their psychosocial situation and needs for assistance through a Norwegian nationwide study. The results show that particularly younger bereaved siblings are suffering from posttraumatic and grief reactions, depression, and anxiety. Most of the difficulties are not individual, but rather relational and social in nature, and largely contextually dependent. Necessary help is impeded due to the extraordinary experience leaving the siblings outside the circle of friends and parental grief community. A systematic outreach help program is presented.     

Grief Counseling: An Investigation of Counselors' Training,Experience, and Competencies

Grief is prevalent in counseling, but little is known about the current status of counselors’ preparation and competencies to provide effective care. This exploratory study surveyed counselors (N= 369) on grief training, personal and professional experiences with grief, and grief counseling competence. Multiple regression analyses found training and experience were statistically significant predictors of competence. The strong relationship between variables suggests these concepts may be understood as synonymous. Implications for training, practice, and research are discussed.     

ADHD and Grief: Diagnosis and Differentiation at One Federally Qualified Health Center

Family physicians provide medical care including diagnosis for children experiencing loss and grief. The cognitive impact of loss includes poor attention and concentration, suggestive of attention deficit hyperactivity disorder (ADHD). Our study examined this phenomenon in a community health center (CHC) utilizing physicians’ surveys and a medical record audit of 378 children diagnosed with ADHD during a three-year period. Results identified ambiguous loss and trauma resulting from family instability, absent parent, domestic violence, abuse, and foster care, often unrecognized by physicians as producing grief accompanied by attention and concentration problems. Findings suggest exploration of repeated ambiguous losses in children with ADHD.     

Psychometric Properties of the Grief Cognitions Questionnaire for Children (GCQ-C)

Negative thinking is seen as an important mediating factor in the development of prolonged grief disorder (PGD), a syndrome encompassing debilitating symptoms of grief. No measure of specific grief related cognitions is available yet. Based on an adult measure of negative thinking in adults we developed a questionnaire for children, the Grief Cognitions Questionnaire for Children (GCQ-C). This study investigated several psychometric properties of the GCQ-C. Both reliability and validity were investigated in this study, in which hundred fifty-one children and adolescents (aged 8–18 years) participated. Findings showed that items of the GCQ-C represented one underlying dimension. Furthermore, the internal consistency and temporal stability were found to be adequate. Third, the findings supported the concurrent validity (e.g., significant positive correlations with self-report indices of PGD, depression and posttraumatic stress disorder), convergent and divergent validity of the GCQ-C. This study provides further evidence for the importance of negative thinking in PGD in children and adolescents.     

Spirituality and Loss: Approaches for Counseling Grieving Adolescents

The death of a loved one has serious implications for adolescent growth and development. The authors review relevant research on the grief process and spirituality in adolescence, and they give a rationale for integrating spirituality into adolescent grief work. By way of a case illustration, they draw implications for counselors’ use of spirituality in addressing adolescent grief.     

Cognitive-Behavioral Therapy for Prolonged Grief in Children: Feasibility and Multiple Baseline Study

There is growing recognition of a syndrome of disturbed grief referred to as prolonged grief disorder (PGD). Although mostly studied in adults, clinically significant PGD symptoms have also been observed in children and adolescents. To date, no effective treatment for childhood PGD yet exists. We developed a 9-session cognitive-behavioral treatment for childhood PGD, combined with 5 sessions of parental counseling. In the present article, the content of this treatment is described. We also describe findings of a multiple baseline study among 6 bereaved children and adolescents. This study showed that the intervention coincided with reductions in symptoms of PGD and other self-rated and parent-rated symptoms. All participating children and parents gave favorable scores to the satisfaction about each session, the contact with their therapist, and the information they received, attesting to the feasibility of this treatment approach.     

The Application of Self Psychology to Therapeutic Camps

Abstract

Camp programs provide children and adolescents with vital opportunities to grow and are recognized as effective social work interventions. Children and adolescents with learning disabilities (LD) are at risk to experience psychosocial difficulties, which may result in difficulty attending regular camps. Self psychology can increase our understanding of these children's camp experiences, because of its focus on the individual's subjectivity and interactions throughout the lifespan and in therapeutic relationships. This paper extends the application of self psychology to therapeutic summer camps with children who have learning disabilities, illustrated through examples. The paper concludes with practice principles.     

Grief in two guises: ‘Mourning and melancholia’ revisited

¹ 1. A version of this paper was given at the Institute of Psychoanalysis Conference: ‘Mourning and Melancholia through the Life Cycle’, London, 1998. This paper is a re-reading of Freud’s classic paper. The themes of mourning and melancholia are viewed in relation to children and adolescents with illustrations from case histories. Mourning is interpreted in a broader sense: not only as grief (both expectable and traumatic) but as a response to the developmental process itself as phases of childhood are shed and an emerging newer identity is assumed. The author argues that Freud’s paper left the way open to make a number of further distinctions of the processes involved within melancholia.