Attachment serves add a biological basis for all forms of grief.
4% of children lose parent before 18
Interventions need to be carefully targeted, but evidence base is poor.
The assumption that bereavement is bad has hampered progress; many children are very resilient. 2/3 do well after loss of a parent.
Bereavement a potent trigger to attachment system. (See slides)
The stages of grief narrative remains dominant, but isn’t the whole truth. More useful is an oscillation between loss orientated and restoration orientated activities.
Continuing bonds model (Silverman) rejects the idea that the end point of grief is to break the bonds with the dead person. Accommodates children’s grief in an uncritical and helpful way.
Meaning making a important part of the cognitive work of grief. A punctuation (saying goodbye) can be helpful.
Lack of evidence but experience suggests that children have a distinct individual path through grief
Trauma can interfere with grief process as person revisits traumatic memories. Triggers can be quite trivial.
Details matter in making sense.
Viewing the body can be helpful if the child chooses. Choices need to be given in a neutral way.
Peer groups can be prepared to deal with a bereaved child.
Two broad types of complicated grief in children
Traumatic and delayed or inhibited
Seems to be quite a bit of somatisation after inhibited grief, all aberrant behaviors can be linked to grief.
Assessment and understanding should include consideration of family relationships.
Disenfranchised grief, not accepted by others or self, can come out in physical symptoms.
Slides will be posted shortly.