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On the last track we discussed the final two challenges of a grieving child. The fourth and fifth challenges we discussed were staying connected and resuming childhood.
On the next two tracks we will discuss complicated mourning. As you are aware, when normal grief gets distorted or breaks down and affects children negatively it is referred to as complicated mourning. Aspects of this concept that I will describe on the next two tracks are risk factors of complicated mourning and signs of complicated mourning.
On this track we will discuss risk factors of complicated mourning. As you likely know, many children can fall into a pattern of complicated mourning. However, in my practice I have noticed that some children run a much greater risk. Therefore I will describe six risk factors of complicated mourning.
They are traumatic deaths, the caretaker is not functioning well, the child had a love-hate relationship with the deceased, the child experienced multiple losses, the deceased had an extensive illness, and the child has other mental health issues. As I list the six risk factors of complicated mourning, you can use the information as a checklist to evaluate your clients.
#1 Traumatic Deaths
Conversely, children who do not receive any information about the traumatic event may use their imagination to supply the missing information. As we discussed in track 1, a child’s imagination may be more frightening than reality.
#2 The Caretaker Is Not Functioning Well
#3 Love-Hate Relationships
Clearly, these problems can leave a child with mixed feelings. When grieving children struggle with mixed emotions such as love and hate, they are at risk for complicated mourning. However, in my practice I have seen less severe family conflicts like divorce or normal teen struggles put children at risk for complicated mourning.
#4 Multiple Losses
First, as you know, children process losses repeatedly as they pass through the different stages of development. Therefore, children who experience multiple losses, may experience an increase in grief over time.
Second, multiple losses can negatively impact a child’s view of the world and encourage unhealthy coping skills. For example, Christine turned 4 a few months after her older brother died in a bicycle collision with a car. Six months later, her younger brother died from meningitis. After three years of grieving, Christine’s parents decided to have another child. They worried about Christine’s reaction, but were relieved that she continued her life as normal after the baby was born.
Several months later, however, they realized that Christine hardly acknowledged the baby. Christine never talked to or played with the baby. She only helped when specifically asked to help by her parents. When I treated Christine, I asked her why she refused to acknowledge her baby brother. Christine stated, "Why should I? He’s just going to die anyway."
Think of your Christine. Has she or he developed problematic coping skills as a result of experiencing multiple losses? Later in this course, we will discuss a technique which is useful in developing more productive coping skills in children.
#5 Extensive Illness
#6 Other Mental health Issues
Have you had experience... counseling a child who contends with depression, anxiety, ADD/ADHD, or another mental health issue? If so then you are already aware of how these grieving children may be at risk for complicated mourning.
Do you agree that loss can divert the internal coping resources of a child with mental health issues to grief. This diversion of resources may allow pre-existing mental health issues to get worse. Even if the child has already completed therapy for an ongoing mental health concern, extra therapy work may provide the additional support needed. If you counseled a grieving child with mental health issues, how would you interact with other therapists involved with the child?
On this track we have discussed risk factors of complicated mourning. I have identified six risk factors of complicated mourning. They are traumatic deaths, the caretaker is not functioning well, the child had a love-hate relationship with the deceased, the child experienced multiple losses, the deceased had an extensive illness, and the child has other mental health issues.
On the next track we will discuss six signs of complicated mourning. The six signs of complicated mourning that we will discuss are continuous hyperactivity, ongoing and significant changes in performance, persistent regression, ongoing depression, self-destructive behavior and chronic anger.
Peer-Reviewed Journal Article References:
Grassetti, S. N., Williamson, A. A., Herres, J., Kobak, R., Layne, C. M., Kaplow, J. B., & Pynoos, R. S. (2018). Evaluating referral, screening, and assessment procedures for middle school trauma/grief-focused treatment groups. School Psychology Quarterly, 33(1), 10–20.
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