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Section 3
Adolescent Grief

CEU Question 3 | CEU Test| Table of Contents | Grief
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On the last track we discussed how grief reflects stages of development.  The three stages of development we discussed are ages two to six, ages six to nine, and ages ten to thirteen.  We also discussed the three key concepts of death as put forth by Dr. David Schonfeld.  The three key concepts of death are "nonfunctionality" of the body, death is final and death is universal.  

On this track we will continue to discuss how grief reflects stages of development.  We will discuss the adolescent stage of development.  The three phases of adolescence we will discuss are early adolescence, middle adolescence, and late adolescence. 

As you know, adolescence is a turbulent stage of development.  I have heard many parents of adolescents ask, "Are these strange actions and bad attitudes a sign of adolescence or is it grief?" 

Having treated bereaved teens yourself, and perhaps had experience with non-bereaved teens, do you agree with the following statements?  Adolescence itself is a stage of life filled with losses.  Therefore, to a certain extent, all teens are dealing with grief, and adolescence itself is a period of mourning

This loss was defined by professor of human development Lloyd D. Noppe as "the loss of parent-child attachment relationship."  Therefore, when parents ask about the cause of an adolescent’s behavior, I encourage those parents to instead ask, "How will the loss affect the child’s development?"  Clearly,  the phase of adolescence in which a child experiences a death may affect the developmental issues related to that phase.

Teenagers are fascinated with death and often spend time fantasizing about their own deaths.  They wonder who would come to their funerals, how bad everyone would feel, and what rituals would take place.  Even at this advanced age, however, teens still are not really in touch with the finality of death or the impossibility of enjoying their own funerals. 

Teenagers have death romanticized for them in cultural ways such as music or books like Romeo and Juliet.   They may even find themselves challenging death by driving recklessly, experimenting with drugs, or other risks and dangerous activities.

#1 Early Adolescence
As you know, early adolescence generally falls between ages eleven and fourteen.  Matt was searching for his identity.  Therefore, Matt was in the phase of early adolescence and began to withdraw from his parents.  Matt’s parents felt that they had been removed from the position of role models.  

In the normal stages of development, teens replace their parents with other role models.  Instead, Matt’s grief prevented him from having a replacement role model.  Sheila, who had lost her youngest son to leukemia, had children in all three phases of adolescence.  Sheila’s son Matt was 13. 

Sheila stated, "Matt used to think the world of his father.  Roger was Matt’s hero.  Now Matt pretty much ignores his dad.  He has no one else to look up to and doesn’t talk to his friends anymore."  Clearly, the lack of a role model can have a negative impact on development. 

Think of your Matt.  Could the loss of a family member cause him or her to withdraw from friends or family? At the end of this track, we will discuss a technique which helps define role models for grieving adolescents.

#2 Middle Adolescence
As you may know, middle adolescence falls between ages fourteen to seventeen.  Coinciding with high school years, I have found the teen’s search for personal identity grows stronger.  Sheila’s son Andrew was 15.  

Sheila stated, "Andrew’s pretty hard to deal with.  He used to just ignore us like Matt, but now Andrew actively pushes us away.  Nothing we do is right."  In my experience this is normal behavior for a teen in the phase of middle adolescence. 

However, as a teen rejects his or her family’s values, he or she should be forming their own values.  The grief resulting from a profound loss may prevent teens in the phase of middle adolescence from forming personal values.  I have found that fear and anger can prevent teens from forming personal values in the phase of middle adolescence. 

Have you had experience with other issues relating to development during middle adolescence which may be affected by grief?

#3 Late Adolescence
Clearly, late adolescence represents the ages seventeen to twenty-one.  I have found that development in this stage can be impeded by grief in a very profound way.  Late adolescence is the phase in which teens go to college or begin careers.  Depression may result from grief, preventing the teen from maintaining the self esteem and sense of worth necessary to enter adult life. 

For example, Sheila’s son Paul, age 20, dropped out of college just three weeks after losing his younger brother to leukemia.  Paul stated, "Man, I just don’t feel like there’s any hope for me.  Why should there be?  I mean, I don’t deserve a good life while my little bro rots in the ground." 

Have you had experience counseling a teen in late adolescence whose inability to deal with grief prevented him or her from functioning as an adult?

Technique: New Hero  
To help Paul overcome his depressed feelings, I asked him to help his 13 year old brother Matt.  Matt had disregarded his father as a role model.  Matt’s grieving process prevented him from replacing Roger with another role model.  This was impeding Matt’s development.  Paul was willing to help me implement the "New Hero" technique. 

1. Alert to the Signs and Signals
First, I explained to Paul different ways he could be alert to the signs and signals Matt gave to let his family know he was in need of a role model.  For example, Paul realized Matt’s quality of work in school was declining.  Paul also noticed that Matt was neglecting relationships with his friends. 

2. Lines of Communications Open
Second, Paul did his best to keep the lines of communications open for Matt.  Paul kept the lines of communications open by expressing interest in Matt’s life and by respecting his individuality.  Paul stated, "I remember when I was Matt’s age.  It seemed like nobody cared what I was doing unless they wanted to stop me.  I knew I could relate to Matt and help him feel less like an alien and more like a normal kid."

3. Help Discover New Role Models
In addition to being alert to signs and signals and keeping lines of communication open, the third step in the "New Hero" technique is to help discover new role models.  I explained to Paul that Matt’s new role model could be remote, like a novelist, or more near at hand, like a teacher or coach.  Paul stated, "I tried to help Matt find a new hero.  He said he already had one.  When I asked who, he said it was me.  Man, I never knew I could mean so much to him.  I’m going to do everything I can to be a good role model." 

Think of your Paul.  Have you had experience counseling families who have the ability to help each other through the grieving process?

On this track and the last track we have discussed how grief reflects stages of development.  On this track we have discussed three phases of adolescence.  The three phases of adolescence we have discussed are early adolescence, middle adolescence, and late adolescence. 

On the next track we will discuss the responsibilities of therapists regarding clients grieving the death of children from SIDS.  We will also discuss the 6 common features of filicide.  The 6 common features of filicide are first children, aged less than 7 months, suffering from seizures or apnea, recent hospital discharge, time of death, and mothers who smoke.

Peer-Reviewed Journal Article References:
Allen, B., Oseni, A., & Allen, K. E. (2012). The evidence-based treatment of chronic posttraumatic stress disorder and traumatic grief in an adolescent: A case study. Psychological Trauma: Theory, Research, Practice, and Policy, 4(6), 631–639. 

Bellet, B. W., LeBlanc, N. J., Nizzi, M.-C., Carter, M. L., van der Does, F. H. S., Peters, J., Robinaugh, D. J., & McNally, R. J. (2020). Identity confusion in complicated grief: A closer look. Journal of Abnormal Psychology, 129(4), 397–407.

Domino, J. L., Whiteman, S. E., Davis, M. T., Witte, T. K., & Weathers, F. W. (2020). Sudden unexpected death as a traumatic stressor: The impact of the DSM–5 revision of Criterion A for posttraumatic stress disorder. Traumatology. Advance online publication. 

Goetter, E. M., Mauro, C. M., Qiu, X., Skritskaya, N. A., Reynolds, C. F. III, Zisook, S., Shear, M. K., & Simon, N. M. (2018). Treatment expectancy and working alliance in pharmacotherapy as predictors of outcomes in complicated grief. Journal of Consulting and Clinical Psychology, 86(4), 367–371.

Sandler, I. N., Ma, Y., Tein, J.-Y., Ayers, T. S., Wolchik, S., Kennedy, C., & Millsap, R. (2010). Long-term effects of the family bereavement program on multiple indicators of grief in parentally bereaved children and adolescents. Journal of Consulting and Clinical Psychology, 78(2), 131–143. 

Thompson, A. L. (2017). The clinical challenge of adolescent grief: Comment on Zakreski (2017). Clinical Practice in Pediatric Psychology, 5(3), 282–284.

Online Continuing Education QUESTION 3
What are the three phases of adolescence? To select and enter your answer go to CEU Test.

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