89
Helping Grieving Students: Resources for School-Based Professionals Dr. Carolyn H. Suppa Licensed Psychologist School Counselor K-12 Coordinator, Human Services Cluster WVDE [email protected]

Helping Grieving Students: Resources for School-Based Professionals Dr. Carolyn H. Suppa Licensed Psychologist School Counselor K-12 Coordinator, Human

Embed Size (px)

Citation preview

Helping Grieving Students:

Resources for School-Based Professionals

Dr. Carolyn H. SuppaLicensed PsychologistSchool Counselor K-12

Coordinator, Human Services ClusterWVDE

[email protected]

The 3R's of School Crises and Disasters: Readiness, Response, and Recovery

A way to think about your school's level of preparednessis to measure what you have done to address the 3R's of School Crises and Disasters.

• Readiness: Readiness is the level at which a school is prepared to respond to a crisis or to an emergency if the crisis or disaster were to happen today.

• Response: Response is the sum total of the school's resources and skills to take decisive and effective action when a crisis situation has occurred.

• Recovery: Recovery is the process of restoring the social and emotional equilibrium of the school community.

4-step model found in some research:

• Mitigation• Preparedness• Response• Recovery

Mitigation Mitigation is the action(s)

schools and districts take to eliminate or reduce the loss of life and property damage related to an event(s) that cannot be prevented

Session Objectives

To focus on resources for counselors to:• Evaluate and assist with school READINESS

programs• Assist in the development of school RESPONSE

strategies • Develop personal toolbox of RECOVERY

strategies/resources related to grief reactions

READINESS• Because schools vary widely in their geographic locations, physical grounds,

student body, number of teachers and staff, and available resources, each should craft strategies that match its own needs.

• For all schools, cooperation among school staff, community resources, and mental health providers is the most important element of a successful readiness, response, and recovery process.

• During the Readiness Phase, the school must establish effective relationships with law enforcement, emergency responders, health and mental health community agencies, and local religious institutions. With solid preparation and dedicated partnership, recovery, while always challenging, can be promoted effectively.

• The first step in creating relationships is to reach out to partners in the community.

Each county school system is required to have a crisis management plan in place under the federal Safe Schools Act. The WVDE is encouraging all West Virginia schools to review their crisis management plans and will provide technical assistance related to such plans. These plans are customized to each county school system and explore items such as school security and actions to take in the case of a bomb threat or an intruder entering the building. (WVDE, 10/11/07)

The county plan must encompass the needs of the entire county and be reviewed and revised regularly. Additionally there must be a school-specific plan for each school. The county is strongly encouraged to keep all plans from every school within the county office.

http://www.connectlive.com/events/edschoolsafety/

http://www.connectlive.com/events/depteduphilly0207/ (OSDFS Emergency Management Webcasts)

Current Status of School Emergency Management Plans

Most schools and school districts have emergency management plans; however, the plans are not always:

• Comprehensive• Practiced regularly• Coordinated with the community• Always discussed with families, staff, and students• Based upon sound factual data and circumstances • Regularly updated or …• Used!

Key Components of School Emergency Management Plans

The goal is for all school districts and schools to have emergency management plans that:

• Address all phases of emergency management• Are developed collaboratively with community

partners• Are based upon sound data and information• Are practiced on a regular basis• Are continually reviewed and updated• Are living documents• Include command structure• Are tailored to conditions of individual schools• Take an “all hazards” approach

All-Hazards Approach

• Natural – Earthquakes, tornados, floods• Technological – Power outages, nearby nuclear

plant• Infrastructure – Roads and bridges, utilities • Nonstructural – Portable room dividers,

bookshelves, suspended ceilings and light fixtures• Man-made – Hazardous materials release, terrorism• Biological – Pandemic flu, contaminated food• Physical well-being – broken bones on playground,

suicide• Student culture and climate – bullying, drugs,

violent behavior

There are many resources for not only developing a school readiness program but also for assessing its effectiveness. This is just one review plan offered by, John Dudley, the author of the book When Grief Visits School: Organizing a Successful Response.http://www.schoolcrisis.org/publication.htm

FREE* CRISIS PLAN REVIEW

As the old saying goes, "People don't plan to fail, they fail to plan." Most schools have a plan to assist students, staff, and parents during times of crisis. But when was the last time you had your school crisis plan reviewed? Is it up to date on the latest techniques to deal with the media, students, staff and parents?

As a service to schools, Dr. Dudley has volunteered to review and critique your school crisis plan FREE. Simply send a copy of your crisis plan to:

Crisis Management7320 South 96th CourtLincoln, NE 68526

* Please enclose $15 for return shipping and handling.

SCOPE OF EVENTMajor School-wide crisis (e.g., major earthquake, fire in building, sniper on campus)

Small Group Crisis (e.g., minor tremor, fire in community, suicide

Individual Crisis (e.g., student confides plan to hurt self/others)

During the Emergency

PHASES FOR WHICH TO PLAN

Immediate Aftermath

Days/Weeks Following

Prevention in the Future

RESPONSE AND RECOVERY

RESPONSE

Response is the sum total of the school's resources and skills to take decisive and effective action when a

crisis situation has occurred.

A Response Resource Aid: Responding to Crisis at a School is available from:

The UCLA School Mental Health Project

http://smhp.psych.ucla.edu

RECOVERY

The Recovery phase is designed to assist students, staff and their families in the healing process and to restore educational operations in schools.

The key components of recovery are:• Physical/structural• Business/fiscal• Academic• Psychological/emotional

Crisis Response, Recovery and Prevention Intervention Outcomes

1. Crisis Team Response and Aftermath Intervention

2. School Environment Changes and School Safety Strategies

3. Curriculum Approaches to Preventing Crisis Events (Personal and Social)

a. Violence Prevention b. Suicide Prevention c. Physical/Sexual Abuse Prevention

Types of Crisis Aftermath Reactions

• Reactions regarding Suicide• Reactions to Disaster• Reactions to Violence and Trauma• Grief Reactions

How do these types of aftermath reactions differ?

And, more specifically to our session, what is the difference

between grief and trauma reactions?

Disaster Reactions

• Sense of unreality• Panic/feeling out of control • Anxiety/uncertainty • Disorientation • Despair • Anger • Generosity toward others • Cooperation/team work

Suicide: A Whole Other Session!http://www.google.com/search?

q=wv+youth+suicide+rate&sourceid=ie7&rls=com.microsoft:en-us:IE-SearchBox&ie=&oe=

(Good PowerPoint)

But please remember three things:1. WV’s suicide rates for all ages are among

the highest in the country.2. More students seriously consider suicide

than most people want to think. (Take it all seriously.)

3. Talking about suicide doesn’t make it happen. (Know and teach the signs.)

Violence and Trauma Reactions

• http://www.tlcinst.org/griefandtrauma.html (The National Institute for Trauma and Loss in

Children)• http://www.challiance.org/vov/publications/C

ommon%20Reactions%20brochure.pdf (general brochure)

About Grief Reactions

There are a minimum of fifteen different terms describing grief, and mourning.

Further complicating our understanding of grief and mourning is the concept of trauma.

http://www.tlcinst.org/griefandtrauma.html

Grief Terms

Normal Grief Bereavement

Neurotic Grief Traditional Mourning

Inhibited Grief Distorted Mourning

Acute Grief Psychoanalytical Mourning

Morbid Grief Unanticipated Mourning

Complicated Grief Chronic Mourning

Pathological Grief Complicated MourningTraumatic Grief Traumatic Mourning

Grief and Trauma:The Confusion - The Difference

As our understanding of trauma has improved, new terminology has emerged to describe new findings in the field of grief and trauma -- yet older terminology lingers.

Terms are used interchangeably sometimes appropriately but also, at times, inappropriately. The meaning of some of the older terms can be narrowly and vaguely defined. This transition between old and new can be confusing at times.

The questions many now ask are:

• “What is the difference between grief and bereavement and grief and trauma?

• What is the difference between Traumatic Grief and PTSD?

• What are the disorders most often associated with ongoing Traumatic Grief?”

Grief and Bereavement

Grief and bereavement are terms often used interchangeably when in fact there is one major difference between the two.

Bereavement is reserved specifically for the

response to the death of a significant other whereas, grief can be the result of incidents of loss not involving death such as loss of job, loss of a limb, loss of status, etc.

The definition of Bereavement and its criteria has remained one of the more constant classifications. However, criteria related to other than normal bereavement and criteria related to mourning has changed considerably.

Traumatic Grief is now becoming the term of choice over other terms used in the past to define other than normal bereavement.

Why the term “Traumatic Grief?”The classification of Traumatic Grief accomplishes several objectives as

follows:

• Avoids confusion with previous terminology such as pathological grief, neurotic or morbid grief, complicated grief, etc.

• Succinctly defines a mourning process that can be traumatic without being triggered by a traumatic death.

• Delineates traumatic grief from PTSD which can coexist with traumatic grief.

• Requires that criteria be present for two months thereby giving individuals time to process traumatic aspects of the actual death prior to moving too quickly in assigning their reactions/responses as problematic.

Posttraumatic Stress Disorder has also become a more familiar classification which is now evaluated for its presence following death of a traumatic nature.

PTSD and Traumatic Grief do share common reactions yet each classification stands alone. At the same time both classifications can coexist with or without additional disorders.

Bereavement and Mourning

Bereavement and mourning are also sometimes used interchangeably when in fact a distinct difference also exists between these two classifications.

Bereavement identifies the specific reactions experienced following the death of a significant other whereas, mourning speaks to the way the individual displays his/her grief.

Complicated Mourning & Pathological Grief

Complicated Mourning and Pathological Grief both refer to a description of the normal mourning process that leads to chronic or ongoing mourning. Psycho-analytically, mourning refers to the conscious and unconscious processes and behavior related to:

a) development of new tiesb) adapting to the loss (the internal process of redefining one’s view of self and the world) andc) adaptation to the loss (the external process of relating to the world, people, one’s roles, responsibilities etc.)

It has been in this area of complicated mourning and pathological grief that numerous terms came into existence to further clarify different factors of complicated mourning or pathological grief. As stated previously many of these terms were narrowly defined and no longer considered current.

GRIEF RECOVERY

WVDE Web Grief Resources

• http://wvde.state.wv.us/counselors/documents/grief_resources_what_to_say.pdf

• wvde.state.wv.us/counselors/documents/Divorce9-122.doc

• http://wvde.state.wv.us/counselors/group-lessons.html “Let’s talk about these. I have issues with the concepts of stages and closure.”

Coping with Death

Important qualities for assistance include:

• Courage to acknowledge the loss• Willingness to talk; “Keep the door open”• Good listening skills• Ability to empathize• Offer ongoing care and support• Regular, healthy routines and structures• Boundaries, limits, and accountability• Spiritual perspective/insight

COPE Model Problem-Solving Motivational Approach

• Creativity – to overcome obstacles, manage problems and to see problems and solutions in a new way

• Optimism – to face other’s expectations re the problem-solving process; need realistic optimism to recognize seriousness of problem yet see that solutions are possible

• Planning – to implement treatment goals and objectives and address the emotional challenges associated with tasks

• Expert Information – to encourage a sense of control and confidence when managing physical and emotional problems due to loss

(adapted from Houts, 1996)

Six Basic Concepts of Grief

• Grief is a natural reaction to change, loss, or death.

• Each person’s grieving experience is unique.

• There are no “right” or “wrong” ways to grieve.

• All individuals walk through the grieving process in theirown timeframes and in their own ways.

• Grief comes in waves—times of great intensity followedby times of relief. There is no reasoning or pattern andit can hit with little warning.

• Grieving never ends. It is something the personwill not permanently “get over.”

Integration vs. Recovery, Closure, Etc.

• Resolution (Not so much)• Recovery (Not so much)• Completion (Not so much)• Closure (Not so much)• Instead consider using . . .

– Adaptation– Accommodation

or– ** Integration

(Current Preference in Literature)

Helping Grieving Children at Schoolby Alan D. Wolfelt, Ph.D.

Dr. Alan D. Wolfelt is a noted author, educator and practicing grief counselor. He serves as Director of the Center for Loss and Life Transition in Fort Collins, Colorado and presents dozens of grief-related workshops each year across North America. Among his books are Healing Your Grieving Heart: 100 Practical Ideas and The Healing Your Grieving Heart Journal for Teens. For more information, write or call The Center for Loss and Life Transition, 3735 Broken Bow Road, Fort Collins, Colorado 80526, (970) 226-6050 or visit their website, www.centerforloss.com.

Learn About Grief

To help your students cope with death and grief, you must continually enhance your own knowledge of childhood grief. While we will never evolve to a point of knowing "everything there is to know about death," we can always strive to broaden our understanding and degree of helpfulness. Take advantage of resources and training opportunities as they become available.

Another part of learning about grief involves exploring your assumptions about life and death. Think about your own personal losses. Who close to you has died? What did their deaths mean to you? Were you a child when someone you loved died? If so, how did you feel? How did the important adults in your life-including teachers and counselors-help you with your feelings of grief? Thinking about these issues will help you better help your students.

Adult Reactions to Grief and Loss

• Denial• Difficulty findingconsolation• Irritability and moodswings• Sleep difficulties• Change in eating habits• Low motivation• Difficulty problem solving• Fear of being alone• Use of substances tomedicate• Vulnerable immunesystem• Other reactions?

Important Points re Grieving Children & Youth

• They tend to go in and out of grief reactions.• Their developmental stage will influence their reactions.• All cannot talk openly about their loss and feelings.• They may not seem to be affected at all (external vs. internal responses or “survival mode”).• Play is one way in particular they make sense of the changes in their world.• It is not unusual for them to experience physical reactions.• They need to grieve any significant loss/change/death at all developmental stages for healthy resolution.

What are the differences between these two lists?

Child/Adult Grief

Guidelines for Helping Grieving Children

Be a good observer. A bereaved child's behavior can be very telling about her emotions.

Listen. Let each child teach you what grief is like for him. And don't rush in with explanations. Usually it's more helpful to ask exploring questions than to supply cookie-cutter answers.

Be patient. Children's grief isn't typically obvious and immediate.

Be honest. Don't lie to children about death. They need to know that it's permanent and irreversible. Don't use euphemisms that cloud these facts. Use simple and direct language.

Be available. Bereaved children need to know that they can count on the adults in their lives to listen to them, support them and love them.

Common Mistakes WhenDealing with Death

Words and actions to avoid

• Acting as if nothing has happened

• Suggesting the person has grieved long enough

• Indicating they should “get over it” and move on

• Expecting business as usual when it comes to school/ work performance

Please don’t ever say:

• “It could be worse…”• “I know how you feel…”• “You’ll be stronger because

of this…”• Any cliché of grief – See:http://onlineministries.creighton.edu/CollaborativeMinistry/Grief/avoid-cliches.htmlhttp://www.amazon.com/Know-Just-How-You-Feel/dp/0961463619

Talking to Children about Death

As a counselor, you should be good at talking to children. You know that they respond better, for example, when you get down on their level and maintain eye contact. You ask open-ended questions to solicit their thoughts and feelings. Without talking down to them, you use language that they understand.

Actually, what grieving children need most is for someone to listen to and understand them-not to talk at them. Instead of worrying about what to say, try to create opportunities for your bereaved student to talk to you about the death.

Like saying…

Grieving is a natural human response. It is experienced by all human beings some time during our lifetimes. It is a topic we often don’t feel comfortable talking openly about or know how to deal with effectively. But it is an issue that many of have experienced in one way or another.

Some Cold, Hard Facts• By the time children complete high school, most will

experience the death of a family member or friend with 5% of children experiencing the death of a parent by 16 years of age.

• Nearly 40% will have experienced the death of a peer.

• 20% will have witnessed the death of someone.

www. cincinnatichildrens.org/school-crisis

Cincinnati Children's Hospital Medical Center 3333 Burnet Avenue, Cincinnati, Ohio 45229-3039 513-636-4200 | 1-800-344-2462 | TTY: 513-636-4900

School is a Place for Support

You are important to your students. From you they learn not only facts and figures, but behaviors and emotions. They also rely on you for support during the seven or so hours they are in your care each day. In many ways, you are not only their teacher or counselor, but their authority figure, role model friend and confidant during the school day.

So, school isn't just a place for book learning. It's a home away from home, a place for students to share their lives with others. When a student is grieving, he needs to share his new and scary feelings. He needs to know that like home, school will be a stable and loving refuge.

Teach What You Learn to Students

Don't wait until a student's parents are killed in a car accident to teach your class about death and grief. Make lesson plans that incorporate these important topics into the curriculum. And use natural, everyday encounters with death-a run-over squirrel, a car accident that made local headlines-to talk about your students' fears and concerns.

Remember the concepts of the "teachable moment" and "created moment." The teachable moment occurs when an opportunity to teach children about life and death arises through events happening around them. A baby is born; a classmate's grandfather dies. When these events occur, make positive use of them by talking openly about them. The created moment means not waiting for "one big tell all" about death but working to create regular opportunities to teach children about death.

Children who have already been acquainted with the naturalness and permanence of death are more likely to grieve in healthy ways when someone they love dies.

Acting-Out in the Grieving Child

Many children express the pain of grief by acting-out. This behavior usually varies depending on the child's age and developmental level. The child may become unusually loud and noisy, have a temper outburst, start fights with other children, defy authority, or simply rebel against everything. Other examples of acting-out behavior include getting poor grades or assuming a general attitude that says, "I don't care about anything." Older children may even run away from home.

Underlying a grieving child's misbehavior are feelings of insecurity, abandonment and low self-esteem. This basic recognition is the essence of artfully helping during this difficult time. My experience as a grief counselor has shown me that probably the two greatest needs of a bereaved child are for affection and a sense of security. Appropriate limit-setting and discipline, then, should attempt to meet these essential needs. We must let bereaved children know that we care about them despite their present behavior.

Adult modeling and setting reasonable boundaries help bereaved children develop their internal controls while at the same time providing children the opportunity to make painful mistakes. As we all know, discovering we make mistakes as we grow up is an important lesson.

When a Classmate Dies

We think that children aren't supposed to die. But the reality is, sometimes children do die. When a classmate dies, the other children will be profoundly impacted. They will probably feel a deep sense of loss and sadness, especially those who were among the classmate's close friends. Many will be curious. They will want to know what happened to Bobby and why. Some of the children will be afraid. When a classmate dies, children begin to understand that they, too, could die young. Other normal feelings include shock, anger and even relief.

Because the death was part of the children's school lives, you will be the primary caregiver your students will look to for help with their grief. The first school day after the death, spend some class time explaining what happened. Remember to use simple, concrete language and honestly answer their questions. Model your own feelings. If you want to cry, cry-without apologizing for it. Later in the day you might have the children make drawings or write letters to give to the dead student's parents.

Send a note home with students informing parents about the death. With parental permission, you might also arrange for interested students to attend the funeral. And don't forget, grief is a process, not an event. In the weeks and months to come, you will need to provide ongoing opportunities for your students to express their grief.

Getting Extra Help for the Bereaved Student

When a student seems to be having a particularly hard time dealing with grief, help him get extra help. Explore the full spectrum of helping services in your community. Hospice bereavement programs, church groups and private therapists are appropriate resources for some young people, while others may just need a little more time and attention from their parents or other caring adults.

If you decide that individual counseling outside the realm of school counseling might be able to help the bereaved student, try to find a counselor who specializes in bereavement counseling and has experience working with children. Scan your Yellow Pages for counselors citing grief or bereavement as a specialty. Another credential to look for is certification from the Association for Death Education and Counseling.

Behavioral Responses of the Grieving Child/Youth

• Disruptive behaviors, noisy outbursts• Aggressive behaviors, frequent fighting• Non-compliance to requests• Increase in risk-taking or unsafe behaviors• Isolation or withdrawal• Regressive behaviors to a time when things felt more safeand in control• High need for attention• A need to check in with parent/significantother

Academic Responses of the Grieving Child/Youth

• Inability to focus or concentrate• Failing or declining grades• Incomplete or poor quality of work• Increased absence or reluctance to go to school• Forgetful, memory loss• Over achievement, trying to be perfect• Inattentiveness• Daydreaming

Emotional Responses of the Grieving Child/Youth

• Insecurity, issues of abandonment, safety concerns• Concern over being treated differently from others• Fear, guilt, anger, regret, sadness, confusion• “I don’t care” attitude• Depression, hopelessness, intense sadness• Overly sensitive, frequently tearful, irritable• Appears unaffected by change/loss/death• Preoccupation, wanting details• Recurring thoughts of death, suicide

Social Responses of the Grieving Child/Youth

• Withdrawal from friends and family• Withdrawal from activities and sports• Use of alcohol and other drugs• Changes in relationships with teachers and peers• Changes in family roles• Wanting to be physically close to safe adult• Sexual acting out• Stealing, shoplifting• Difficulty being in a group or crowd

Physical Responses of the Grieving Child/Youth

• Stomachaches, headaches, heartaches• Frequent accidents or injuries• Nightmares, dreams, or sleep difficulties• Loss of appetite or increased eating• Low energy, weakness• Nausea, upset stomach, hives, rashes, etc.• Increased illnesses, low resistance• Rapid heartbeat

Spiritual Responses of the Grieving Child/Youth

• Anger at God or Higher Power• Questions of “Why me?” and “Why now?”• Questions about meaning of life• Confusion• Feelings of being alone in the universe• Doubting or questioning current beliefs• Sense of meaninglessness about the future• Changes in values, questioning what is important

Another important consideration in helping children live through grief is the developmental stage of the child. It's important to note that a grieving child's developmental stage may lag behind his chronological age. Regression is expected and developmental accomplishments take longer to achieve.

Developmental Responses:

INFANTS & TODDLERS• Intuitive sense

something serious has happened

• General anxiety• Crying• Sleeplessness• Excessive sleeping• Stomach problems• Clinging, needing to be

held

• Separation anxiety• Biting• Throwing things• Regression through

baby talk, bed wetting• Irritability• Temper tantrums• Clumsiness

Developmental Responses:PRESCHOOL CHILDREN

• See change/loss/death as abandonment

• Changes in eating and sleeping patterns

• Wanting to be dressed or fed

• Thumb sucking• Baby talk

• Wanting a bottle• Bed wetting• General irritability• Concerns about safety

and abandonment• General confusion

Developmental Responses:

ELEMENTARY SCHOOL CHILDREN

• Begin questioning how things will be same or

different• Want to see change/loss/ death as reversible but

also beginning to understand that it is final• Regression• Fighting, anger

• Difficulty paying attention and concentrating• Daydreaming• Not completing homework

assignments• Sleepiness• Withdrawal

Developmental Responses:MIDDLE SCHOOL CHILDREN

• Experience range of emotions impacted by physical/hormonal development

• Comprehend change/loss/death as final and unavoidable

• Feelings of helplessness and hopelessness may increase risk-taking behaviors

• Argumentative, anger, fighting

• Withdrawal, sullenness

• Need healthy physical outlets

• Lack of concentration• Risk-taking behaviors

(alcohol/drugs, sexual acting

out, stealing)• Unpredictable ups and

downs or moodiness• Erratic, inconsistent

reactions

Developmental Responses:

HIGH SCHOOL YOUTH• Appear to use “adult”

approaches to problem solving and abstract thinking to deal with grief

• May struggle with their vulnerability because they want very much to be independent

• May assume responsibility for family

• Withdrawal from adults

• Angry outbursts• Increased risk-taking

behavior• Pushing the limits of rules• Lack of concentration,

inability to focus• Hanging out with friends• “Sad” or “strong” face• Sleepiness, exhaustion

How To Help: Infants and Toddlers

• Lots of holding, additional nurturing, and physical contact• Consistent routine, including regular meal and bed times• Rules and limits which are concrete and specific• Short, truthful statements about what happened• Making time for play, both physical and imaginative

How to Help: Preschoolers• Use simple and honest

answers• Be prepared to answer

same questions over and over again

• Include child in rituals around loss/death

• Support child in his/her play• Allow for anger and physical

expression• Maintain consistent

structure and routines

• Allow to act younger for a while

• Hold, nurture, and give lots of physical attention

• Encourage/allow fun and happy times

• Have books available• Model by sharing

personal anecdotes as appropriate

How To Help: Elementary School Child

• Answer questions as clearly and accurately as possible

• Provide creative outlets (art, music, journal, etc.)

• Help identify and use support systems

• Work with student around academic workload

• Encourage taking breaks and some time alone

• Allow for expression of feelings and emotions

• Maintain routines and structure but allow for

flexibility• Give choices whenever

possible• Share that you care and are

thinking about them• Create “safe space” for child to go to as needed

How To Help: Secondary School Youth

• Expect and accept mood swings• Provide supportive environment where

student can share, when needed• Anticipate increased physical concerns,

illness, body aches, pains• Allow to choose with whom and how s/he

gets support• Encourage participation in support group• Allow flexibility in completing school work

STAGES, PHASES, TASKS, PROCESSES, REACTIONS…

Approaches to Grief Counseling1. Stages and Phases – describes predictable, orderly

patterns of responses (Bowlby, Parkes, Kubler-Ross) 2. Tasks – describes grief as a process of tasks to be

completed rather than a state such as a stage or phase (Worden, Doka)

3. Dual Process – describes a dynamic alternation between focusing on the loss (Loss Orientation) and avoiding focus on the loss (Restoration Orientation) (Stroebe & Schut)

4. Continuing Bonds – challenges the need to break the bonds with the past and supports a continuing bond with the past that is compatible with other new and continuing relationships (Klass et al)

5. Family Oriented – views loss reactions from a systems approach (Bowen, McGoldrick,Shapiro, Rolland)

Editorial – “Beware the 5 Stages of Grief”TLC Group

(major point – tasks more flexible)

http://home.windstream.net/overbeck/grfbrf13.html

FOUR PHASES OF GRIEF• Numbness – This is the phase immediately following a loss. The grieving

person feels numb, which is a defense mechanism that allows them to survive emotionally.

• Searching and Yearning – This can also be referred to as pining and is characterized by the grieving person longing or yearning for the deceased to return. Many emotions are expressed during this time and may include weeping, anger, anxiety, and confusion.

• Disorganization and Despair – The grieving person now desired to withdraw and disengage from others and activities they regularly enjoyed. Feelings of pining and yearning become less intense while periods of apathy, meaning an absence of emotion, and despair increase.

• Reorganization and Recovery – In this final phase, the grieving person begins to return to a new state of “normal”. Weight loss experienced during intense grieving may be regained, energy levels increase, and an interest to return to activities of enjoyment returns. Grief never ends but thoughts of sadness and despair are diminished while positive memories of the deceased take over.

Tasks of Mourning (Worden & Doka)• To accept the reality of the loss• To experience the pain of grief• To adjust to a new environment that

does not include what has been lost• To emotionally relocate the loss and to

develop a new sense of identity (Worden)

• To rebuild faith, beliefs and values that are tested by loss (Doka)

Tasks of Grief for Children

• Understanding – Accepting that the loss is real

• Grieving – Working through the feelings (the mourning after)

• Commemorating – Formal or informal acts, celebrations, rituals,

remembrances that mark the loss

• Moving on (Integrating) – Engaging in life again; often requires permission

(Fox, ’85)

Counseling Intervention: Assess and Address

• Assess student’s accomplishment of taskshttp://www.integraonline.org/assessments/grief_depression_inventory.pdf The Grief Assessment and Intervention Workbook: A

Strengths Perspective [Paperback] Elizabeth Pomeroy (Author), Renee Garcia (Author)

• Address the gaps through group guidance/counseling and individual interventions

Grief Counseling Homework Planner [Paperback]Phil Rich (Author)

PHILOSOPHY OF GRIEF SUPPORT GROUP CURRICULUM (Lehmann)

• Children placed in groups with same-age peers• Grief approached through fun activities• Activities involve various media for expression• Provide tools for outside of group• Format of group stays same each group to provide

needed structure• Topics alternate between “head” and “heart”

Grief Support Group Curriculum : Facilitator's Handbook (editions for all age levels)

OTHER CURRICULA

• Growing Through Grief: A K-12 Curriculum to Help Young People Through All Kinds of Loss, Donna R. O’Toole http://www.amazon.com/Growing-Through-Grief-Curriculum-People/dp/1878321005

• Grief Curriculum: Helping Children Grieving the Loss of a Parent or Loved One www.baylor.edu/content/services/document.php/92050.doc

• Students Sharing Feelings of Grief: An Elementary Curriculum on Loss http://digitalcommons.uri.edu/cgi/viewcontent.cgi?article=1048

• Childhood Traumatic Grief Curriculum Guide with CD-ROM

http://store.samhsa.gov/product/Childhood-Traumatic-Grief-Curriculum-Guide-with-CD-ROM/SMA-4303

• Children’s Grief Education Association http://childgrief.org/childgrief.htm

BIBLIOTHERAPY

• http://education.qld.gov.au/library/resource/currtopics/grief-bk.html (book list)

• Bibliotherapy for Bereaved Children: Healing Reading [Paperback] Eileen Jones (Author)

• Using Literature to Help Troubled Teenagers Cope with End-of-Life Issues (The Greenwood Press Using Literature to Help Troubled Teenagers Series) [Hardcover] Janet Allen (Author)

OTHER RESOURCES

• U.S. Department of Education Emergency Planning Web site: www.ed.gov/emergencyplan

• Practical Information on Crisis Planning Guide: http://www.ed.gov/admins/lead/safety/emergencyplan/crisisplanning.pdf

• Emergency Response and Crisis Management Web cast: http://www.kidzonline.org/ercm/

• http://griefconnect.com/Documents/When%20Grief%20Comes%20to%20School.pdf

OTHER RESOURCES, CONT’D.

• Emergency Response and Crisis Management (ERCM) Technical Assistance (TA) Center : www.ercm.org

• Presentations from previous ERCM training events• Technical Assistance Request form• ERCMExpressNewsletters• Emergency Management for Schools Training events• Operation: Military Kids Training & Resource

Manual http://www.k12.wa.us/OperationMilitaryKids/TrainingManual/Prechapter_Final.pdf

You can count on grief to:• Increase vulnerability• Stress relationships• Re-define priorities• Create change• Strengthen compassion• Increase awareness (physically, mentally,

emotionally, socially, spiritually)• Define past and open new doors to future• Take time to resolve