Approach to bereavement support for children
Providing bereavement support for children requires both sensitivity and understanding of the psychosocial, cultural and spiritual background of the family unit to which a child belongs; follow the principles of Talking about death and dying with children.
After a person has died, providing children with an understanding of the death minimises the potential for confusion and misattribution. Clear language is important to avoid confusion and worry (eg use the word ‘dead’, rather than ‘lost’ or a ‘long sleep’). Parents can help to clarify concerns related to an incomplete understanding of death (eg ‘Is it my fault?’, ‘Will it happen to me?’, ‘Who will take care of me?’) and openly discuss their child’s fears and concerns. Advise parents to continue with normal routines and discipline as much as possible; children in distress need the reassurance of structure and limits.
Allow children to search for the dead person if they wish to—physically searching in places previously frequented by the person is a way of testing and affirming reality. Parents (and significant carers) should express sadness openly with children and may want to share age-appropriate books about grief and loss with them. They should allocate special time for the child each day (this does not necessarily need to be for talking) and allow time for the child to play with peers, affirming that it is acceptable to have fun. Some children may express their feelings through play, music or art, and may benefit from play-based, music or art therapy. It may be helpful to recruit family, friends or teachers to help, and to inform the child’s school or kindergarten about the death.
Parents (or significant carers) can help children create memories of the deceased, eg stories, photos, drawings. Adjusting to the death does not necessarily require letting go, and bereaved children (and adults) often maintain a connection with the dead person by constructing a new relationship that is maintained by reminiscing, treasuring belongings, and writing to or talking about the deceased. This process is referred to as ‘continuing bonds’.
Parents who feel unable to adequately attend to their child while they are grieving may delegate this responsibility to another trusted adult.
Most children adjust to the death of someone close without the need for counselling. Features that may require intervention are outlined in Features requiring intervention in bereaved children. If these are present, consider referring the child to a specialist centre for counselling. As with adults, there are a number of options:
- specialist children’s bereavement counsellors
- specialist paediatric palliative care services or hospices usually offer bereavement follow-up, often based on a risk assessment; they may accept referrals from other sources
- community-based organisations offering group programs
- child and youth mental health professionals.
Request for support is usually from parents, significant others or teachers who may observe changes in a child’s demeanour, behaviour, social interaction or educational performance.
For specific information on supporting a child whose sibling has died, see Bereavement support for siblings of children who have died.