trauma and loss for relative caregiving families brookdale foundation rapp webchat march 14, 2012...
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Trauma and Loss for Relative Caregiving Families
Brookdale Foundation
RAPP Webchat
March 14, 2012
Deborah Langosch, PhD, LCSWJewish Board of Family and Children’s Services
New York City
(c) JBFCS, CTPI, 3-14-12
Webchat Content
• Principles and concepts about trauma and loss• Effective interventions and models • Enhancing the emotional well-being of
kinship families
(c) JBFCS, CTPI, 3-14-12
Transitions for Caregivers•Role and boundary issues
•Quality of relationship with parent
•Sacrifices
•Ambivalence
•Rewards
•Family dynamics
•No nine month prep time!
©jbfcs, ctpi, d.langosch, 2010
(c) JBFCS, CTPI, 3-14-12
The Grandchild’s Experience•Loss of parent/s and or siblings•Numerous changes and separation issues•Loyalty issues•Worries about permanency•Ensuing Feelings•Behavioral Expression•Developmental Differences•Perceptions based on learning, emotional and physical challenges
(c) JBFCS, CTPI, 3-14-12
Loss and Trauma
All kinship families have experienced loss, but there are many different types such as:
•Separations•Trauma•Death•Ambiguous Loss (Pauline Boss, 2004)•Loss of dreams, hopes and ideals•Multiple and complex losses•Stigmatized loss
All of these circumstances can profoundly effect kinship families. (c) JBFCS, CTPI, 3-14-12
The Grieving Process
•Children and adults mourn differently.
•Loss of an adult child vs. the loss of a parent.
•Must grieve to recover from loss. Blocked grief = blocked recovery.
•Impact of repeated traumatic loss.
•Risk of increased depression, complicated and or prolonged bereavement.
(c) JBFCS, CTPI, 3-14-12
Tension between Caregiving and Grieving
How do caregivers attend to their own feelings while raising their grandchildren?
•Adaptive Coping•Stiff upper lip/ John Wayne Stance•Finding time to grieve•Putting their own needs on hold•Fears of opening up the flood gates•Complicated coping
(c) JBFCS, CTPI, 3-14-12
Family Secrets• Meaning/reason for secrets
– Wish to protect the child– Worry about disclosure
• Kids are quick to pick up on secrets
• Effect on them– Fears and fantasies– Disruption of trust
• Am I ready to talk about this?• Considering what child can hear
and what’s age appropriate(c) JBFCS, CTPI, 3-14-12
Interventions: The Three C’sAdapted from Memorial Sloan-Kettering Cancer Center
Childhood Bereavement Project
•Open Communication: Age appropriate and in pediatric doses
•Consistency: Need for predictability and safety
•Competency: Supporting the caregivers ability to competently help their grandchild
(c) JBFCS, CTPI, 3-14-12
Treatment for Traumatic Loss
• Need to attend to dysregulation before doing grief work
• Teaching skills that include: feeling identification; relaxation techniques; and connections to feelings, thoughts and behaviors
• Then it’s safer to proceed with more gradual exposure to the loss
(c) JBFCS, CTPI, 3-14-12
Kids didn’t like it when adults said….
• “I know how you feel.”• “It’s been over four months now,
you should be over it.”• “You shouldn’t be this angry. Being
angry won’t bring your brother back.”
• “You’ll get over it in time.”
Adapted from Fernside Online-Resources for Educators –www.fernside.org
(c) JBFCS, CTPI, 3-14-12
Kids preferred it when adults said…
• “I’m sorry that Chris died.”• “I know it’s hard. It’s okay to cry.”• “I can’t know how you feel, but I
want to help you in any way that I can.”
• “I’m ready to listen when you’re ready to talk.”
Adapted from Fernside Online-Resources for Educators –www.fernside.org
(c) JBFCS, CTPI, 3-14-12
Helpful Techniques
•Creating a safe place
•Use of cognitive behavioral therapy esp. for traumatic loss
•Expressive art therapies, such as art,poetry,music, drama, writing
•Destigmatizing counseling or therapy
(c) JBFCS, CTPI, 3-14-12
How Can We Help?
•Psycho-education: Helping caregivers understand how children react and their behavior as indicators•Providing support•Utilizing a strength and resiliency model•Linking families to services•Information and referral•Advocacy•Empowerment
(c) JBFCS, CTPI, 3-14-12
Services
• Evaluating the need for services
• Overcoming the stigma of getting help
• Cultural considerations
• Accessing resources
• Medicare and Medicaid availability for psychotherapy
(c) JBFCS, CTPI, 3-14-12
Strength Model• Resiliency
• Developing adaptive coping
• Stress reduction/management skills
• Role of spirituality as a sustaining force
• Value of support groups
• Expanding support networks
• Self-care
(c) JBFCS, CTPI, 3-14-12
Best Practice Models
•Brookdale RAPP grants
•Loss and Bereavement Programs
•The Ties that Bind
•Collaborative Approaches
(c) JBFCS, CTPI, 3-14-12
Deborah Langosch, PhD, LCSW
Jewish Board of Family and Children’s ServicesNew York City212-632-4760
Project Director, Kinship Care Program
Chairperson, Brooklyn Grandparents’ Coalition
Co-Chair, NYC Kincare Task Force
Clinical Coordinator, Loss and Bereavement Program(c) JBFCS, CTPI, 3-14-12