Death, Loss, Divorce

Emotions of Grief and Loss

Shock – feeling numb, denying the truth, expecting them to show up after they’re gone.

Sadness – emptiness, despair, yearning

Guilt – wished you would have said certain things.

Anger – feel the need to blame someone

Fear – feeling anxious, panic attacks

Stages of GriefDenial – “It’s not that bad.”

Anger – “Why is this happening? It’s not fair?”

Bargaining – “I’ll do anything to change things. Just tell me and I’ll do it.”

Depression – “Nothing matters anyway.”

Acceptance – “I think she would want me to move on.”

Initial Parent IntakeWhat is full story?

How long ago was event?

What was the child’s reaction?

Has there been improvement or regression?

Bedwetting? Behavioral Issues?

Does the child talk about the event?

What has been helpful? Harmful?

Divorce

How did kids find out?

What do the kids know?

How is co-parenting?

What is the plan? Court, mediation, etc.

State your position and sign forms if needed

Know timeline so you can be prepared to help kids process

The Squid and the Whale

Working with Grieving Children

Children will come in and out of grief

It’s important not to force the issue

Normalizing feelings is key

Use concrete objects to help children deal with abstract concepts.

Prop-Based Interventions

Working with Grieving AdolescentsExpressive Therapies

Develop a relationship around other things (besides grief)

Help them develop support systems outside of counseling office

Help them find ways to say goodbye

Techniques for Kids

Grief LeafPick out a leaf with 5 pointed edges.

Talk about the 5 feeling stages that we go through when there is a loss.

Using markers, write down each stage of grief: shock, anger, rage, bargaining, sadness, acceptance.

Have child identify where he/she is.

Allow child to take it home.

Moms House/Dads HouseDraw a line down the middle of the page

and label one side “Mom’s House” and the other side “Dad’s House.”

Write down all of the good and bad things about each house. Include rules, routines, etc.

Circle the things that are the same at each house.

Talk about what is different.Identify what would make things better at

each house.

Goodbye Letter

After someone has died allow child to write a letter to that person.

Read the letter aloud, draw pictures and make an envelope.

Connect with parent as to whether the deceased has a specific place for such things.

Before and After Write down how life was before the

divorce or loss or illness.

Draw a picture of how life was before and the feelings felt before.

Write and draw how things have changed since the divorce, loss, illness.

Compare the two pictures and look at what positives and negatives have come as a result.

Techniques with Adolescents

Design a Dad (or Mom)

What would he/she be like?

What would he/she say?

What do you need?

If dad is no longer in the picture, recommend role models outside the home.

EMDR

Eye Movement Desensitization and Reprocessing.

Helps process trauma by moving eyes from left to right for short intervals.

Reframes traumatic event.

Guided Imagery

Example: If in car accident, imagine positive things happening.

“See yourself making a left turn. See it going smoothly. See yourself passing a car where everything goes okay.”

The Rosebush

Relaxation TechniquesDeep breathing during distressing

situations.

Rolling the neck, dropping the shoulders, shutting the eyes.

Bringing in soothing music to practice with.

Relaxation Exercise

Case Study: Complicated Grief7-year-old girl.

Mom - Primary caregiver. Started drinking when girl was 3. Went to rehab at 4 (first trauma).

Got out of rehab - arresting for multiple drunk driving charges. Incarcerated for several months (second trauma). *Doesn’t see mom and at all.

Mom and dad divorce. Mom loses all parental rights (3rd trauma).

Dad begins dating woman. Doesn’t tell kids until he’s going to get married (4th trauma).

After dad tells Mom of new marriage, mom dies of alcohol related issues. Child is 6 (5th trauma).

Sell childhood home (in same area as Mom’s apartment) and move into new house with new mom.

On Mother’s Day yells, “You killed Mommy.”

Comes in for next session acting manic, ADHD symptoms.

Over time, ADHD symptoms did lesson.

However, major changes in child’s appearance (disheveled) and behavior.