Supporting a Nine-Year-Old through the Loss of a Parent: A Comprehensive Guide

Understanding Grief in Children

Kids grieve differently and may show signs of sadness and joy in rapid succession. Their changeable moods do not mean that they are not sad or that they have finished grieving. Children cope differently than adults, and playing can be a defense mechanism to prevent them from becoming overwhelmed. It is also normal to feel depressed, guilty, anxious, or angry at the person who has died or at someone else entirely.

Encouraging Emotional Expression

It's good for kids to express whatever emotions they are feeling. Encourage them to talk about how they feel and use creative outlets like writing, drawing, or playing. Provide resources such as children’s bereavement programs if available in your area.

Therapeutic Approach: Cognitive Behavioral Therapy

Therapy for child grief, often involving cognitive behavioral techniques, aims to help children and their parents process their emotions. Cognitive behavioral therapy (CBT) is a practical and evidence-based approach. It emphasizes relaxation and meditation for the child and the adult, teaching exercises to identify and modulate feelings using cognitive techniques such as thought stopping, positive self-talk, reviewing safety plans, enhancing social skills, and problem-solving for dealing with triggers.

The cognitive triangle, a tool used in CBT, can be very helpful. It helps children and adults understand the relationship between thoughts, emotions, and behaviors. This model is user-friendly and familiar to practitioners of CBT. The therapy process involves:

Constructing a trauma narrative: A list of books is provided for children to use in this work. Starting with neutral and happy information, the child writes or dictates a “book” that describes the family history, including the trauma. Both words and pictures may be employed. Re-reading this narrative, the child must then add the associated feelings, culminating in the event description and processing all aspects of it, even the worst moment. Relaxation and distraction techniques are employed during this process. Parental narrative and desensitization: The parent constructs his or her own narrative. The parent is then exposed to the child’s narrative, desensitizing them to their fear of hearing the child’s experience and allowing communication that has been blocked prior to this step. Cognitive restructuring: As therapy progresses, these narratives are used to expose dysfunctional thoughts and cognitive restructuring can proceed for the child and the adult. Homework is used to uncover more dysfunctional cognitions and generate substitute thoughts. Concrete situations that are avoided can then be approached by gradual exposure. Conjoint sessions: Formerly forbidden questions from both the child and the adult can be explored in these sessions. This helps in understanding what has been lost and processing troubling aspects of the relationship that no longer have to be dealt with. Ambivalence is resolved, and rifts at the time of death are unearthed and healed. Memorialization and new experiences: Methods of memorializing the deceased are described to promote and encourage happy, positive memories. As the therapy moves to a close, the child and their parent are encouraged to move away from what they have lost and towards new experiences and relationships. The therapy is terminated with a celebration, as well as planning for any triggers that could be anticipated in the near and distant future.

Conclusion

This practical book outlines the therapy in a way that makes it accessible and easy to understand. It inspires the reader to seek experiential training and provides many good practical examples and a trouble-shooting section in each chapter. Handouts for patients and an excellent reference section complete the book. The authors' impressive breadth of knowledge and experience makes this book valuable for any professional who might find families with traumatic experiences in their practice. I strongly recommend it to my colleagues.