For the first time in history, key federal health agencies will report what activities, if any, they are doing to advance bereavement care.Photo by Bob Bowie on Unsplash
As Congress shut its doors and fears of COVID-19 swept the nation, a small group of families and professionals worked tirelessly to advance our nation’s bereavement care system. We know that lack of high-quality, consistent bereavement care is an invisible public health crisis. It touches nearly every doorstep in America. In the wake of overdose deaths, suicides, and mass casualty events and now COVID-19, our nation’s response must consist of more than thoughts and prayers.
Bereavement and its implications on families are not part of our nation’s public health dialogue, or children and families or racial equity.
We can do better.
Bereavement care in America is broken. There are limited tools, few qualified professionals and even fewer protective policies. For nearly ten years, Congress has failed to protect to bereaved parents from being fired.
Late Wednesday, Rep. Lloyd Doggett’s (D-TX-35) office said he would lead the effort to direct key federal health agencies to report activities, if any, they are conducting to advance bereavement care. His commitment grew from listening to a mother whose 19-year old son, Ellis, was killed by a drunk driver. Our small team now had 48-hours to deliver five Congressional members to support the amendment — a tall order for a team with no lobbying firm, no established relationships and a global pandemic in our midst.
Fast and furiously we sent emails to Republican and Democratic members overnight. As offices opened, a mother who lost her 24-year old son, Alex, to addiction called Rep. Lisa Blunt Rochester (D-DE). When the receptionist said, “how can I help you today?” She replied, “I want to talk about my dead son.” She was patched to the chief of staff. We had our first signatory. Less than 32 hours left.
And so, it began. The CEO of Good Grief, a New Jersey nonprofit bereavement center serving 900 children and families monthly, recruited our second, Rep. Andy Kim (D-NJ-3). 28 hours left. Shortly thereafter, with the engagement of the president for the Association for Death Education and Counseling, Rep. Nita Lowey (D-NY-17), chairwoman of the House Appropriations Committee, supported the inclusion of the language. As did Rep. Rosa DeLauro (D-CT-3), chairwoman of the subcommittee on health appropriations, and other appropriators.
Then, the leader of a coalition supporting parents who have lost a child at any age, brought Rep. Jan Schakowsky (D-IL-9) on board. Minutes later, a mother contacted Rep. Peter Welch (VT-D) and talked about life after her 25-year son, Kevin, was killed by a train. Four down, one to go. 27 hours remaining. Four hours later, Rep. Deb Haaland (D-NM-1) joined, followed by Rep. Kathleen Rice (D-NY-4), Rep. Josh Gottheimer (D-NJ-5) and Rep. Danny Davis (D-IL-7). Eight signatures with eight hours remaining.
We had done it; at least in the House. For the first time in history, key federal health agencies will report what activities, if any, they are taking to stem declines in health and wellbeing among bereaved families, as well as what tools and resources are available to professionals.
We believe that every member of Congress — and the Administration — should support every American’s access to quality, tailored bereavement care. Whether it’s the urban mother who loses her son to homicide or the rural family who loses their aging father to suicide. Where professionals have the tools, resources and research to respond, support and continue serving our nation’s bereaved families. It is not a partisan issue; this is an American issue.
Bereavement touches all of our doorsteps, regardless of geography, race, religion or wealth. As a modern society, families no longer have to slog through their losses alone. Imagine a tomorrow where individuals, families and communities have the resources, policies and programs in place to facilitate healthy coping, to get us back to work, to contribute back to society.
We are dedicated to making the world a more livable place for bereaved families. We hope you will join us because someday this will likely be your story too.
For too long, too many have considered bereavement as simply a mental health issue. When a family member or loved one dies, those grieving experience a deep sadness as their lives are changed fundamentally forever. Conventional wisdom tells us a bereaved individual or family will eventually “get over it,” “find closure” and “move on.” But, those commonly held myths are far from the truth.
Research continues to show that a loved one’s death isn’t something that we just “come to terms” with. Researchers tell us that bereavement grief makes us more prone to cognitive decline, disease and premature death. It can lead to financial loss. And it can tear families apart.
What’s more, federal policies and programs can compound the experience, further victimizing mourning Americans who need more than our thoughts, prayers and casseroles.
For example, of the two million bereaved children in the United States, Social Security Income is not reaching all children leaving those in need with lower levels of economic wellbeing and educational attainment. Or, for example, two fathers Barry Kluger and Kelly Farley have advocated for nearly a decade to protect newly bereaved parents from being fired from their jobs. Imagine losing your child, then your job.
Over the last three weeks, Evermore has been calling Congressional offices, meeting with staff and sending materials to dozens of staffers. And here’s the good news: Capitol Hill is listening, and lawmakers are beginning to understand that bereavement isn’t just a mental health issue, but an issue — and an American issue — that demands serious attention. The question is: will they act?
As deaths from suicide, overdoses and mass casualty events increase, members see how bereavement and the lack of a public health response is impacting their own communities. These discussions come as lawmakers consider appropriations bills and updates to the Family and Medical Leave Act, which currently does not provide time off for workers after a child’s death.
Here’s where Evermore is making big strides in bereavement care.
Appropriations committees address bereavement
In appropriations committees in both the House and Senate, spending bill proposals recommend that the U.S. Department of Health and Human Services seek information from its agencies about their bereavement care activities. Those agencies include the National Institutes of Health, the Centers for Disease Control and Prevention and the Substance Abuse and Mental Health Services Administration, for example.
According to the proposal, the agencies would be tasked with examining their own activities to advance bereavement care for families, including risk factors for survivors and whether policies and programs in place help or hinder coping and processing. Agencies would also be charged with documenting what resources they are providing to the professional community as well.
If approved, it would be the first time the agencies have studied how they address the bereaved and could pave the way for future spending bills that fund new efforts to support those who are grieving.
FMLA expansion could come
Congress hasn’t built upon the Family and Medical Leave Act since it was passed in 1993, and that’s led to many workers not having the right to take unpaid leave or unable to afford unpaid leave when it is available. For many grieving parents, in particular, the law doesn’t carve out an opportunity for them to take time off without fear of losing their job.
But that may be about to change. In February, the House Education and Labor Subcommittee on Workforce Protections held a hearing to talk about FMLA expansion, including bereavement care. In her opening remarks, Rep. Alma Adams, a Democrat from North Carolina, talked about the number of cases where the act does not cover workers who need to take leave, specifically calling out “family members taking time to grieve a child’s death.”
Research continues to show that the death of a child is one of the most severe and prolonged trauma that anyone can experience, which is why it is critical for Congress to recognize child death as an eligible event for FMLA job protection.
Evermore is having an impact here too. We submitted a statement for the record on the importance of including a child death as an eligible event for FMLA.
Our request is three-pronged.
We want the U.S. Department of Labor to conduct a survey on bereavement leave for all employers with more than 50 employees.
We’d like the FMLA to be expanded to include a child’s death as an eligible event, so parents have time to mourn.
And we’re asking Congress to increase the age of a child to 26 in the law to make it parallel with the Affordable Care Act and tax law.
“As a modern society, we should no longer have to slog through death alone with few resources,” Mulheron said. “We can reimagine a tomorrow where people have the support they need in their own communities — whether urban or frontier America — and where professionals have robust supports, resources and benefits to move this work forward.”
Added Mulheron: “There’s still plenty of work to do, but this is a shared human experience, and people know that. We’re thrilled that offices are listening.”
As another decade comes to a close and Evermore marks its fifth year working to improve bereavement care in the United States, we have reason to celebrate 2019.
Here at Evermore, we made big strides toward building our team and raising awareness about the need to support grieving parents. Meanwhile, across the country, new initiatives and research moved forward the conversation about how to support the bereaved.
Evermore in 2019: Advocacy and awareness
Julie Kaplow, PhD, ABPP (left)
Wendy Lichtenthal, Phd
We were thrilled to add two renowned experts on grief and bereavement to our Scientific Advisory Council. Wendy Lichtenthal is director of the Bereavement Clinic at Memorial Sloan Kettering Cancer Center. Julie Kaplow serves as director of the Trauma and Grief Center at Texas Children’s Hospital.
At the same time, our burgeoning advocacy network began to focus on three priorities as we seek to push the needle forward on new policies and supports for those who are grieving. The advocacy network is working to:
Increase research funding so we can better understand who is impacted and how to help.
Grow family support programs across the country to meet families where they are, regardless of race, income or geography.
Boost funding for professional education, development and support to ensure a more qualified, skilled workforce; bolster coping skills; and decrease high rates of suicide among these professionals who respond to traumatic events, like bereavement.
We also were laser focused on raising the national conversation about grief and bereavement. In November, in fact, the Wall Street Journal published Evermore Executive Director Joyal Mulheron’s letter to the editor about the need for companies to better accommodate grief.
“Job protection for bereaved parents seems reasonable,” she wrote in response to a story about how employees juggle work after a loved one dies. But, she pointed out, it’s not considered a qualifying event that allows for leave under the Family and Medical Leave Act.
As we work hard to improve the lives of those who are grieving, we’ve also been pleased to play even a small role in efforts around the country and world to help families cope with a death.
Bereavement Care in 2019: New support, vital research
As we focused on our own work at Evermore this past year, we also were thrilled to witness these notable steps forward in bereavement care that will only support our work to continue to push for more assistance for those who are grieving.
Bea’s Law passed in Seattle
In June, the Seattle City Council passed Bea’s Law, which extends paid family care leave benefits to city employees when their child dies. It is very likely the first paid bereavement law in the nation and a model for lawmakers elsewhere.
The ordinance is named after a city employee’s infant daughter, who died just 36 hours after being born. Bea’s mother was only able to take time off after her daughter’s death by borrowing paid leave from her co-workers. She brought the issue to the attention of city leaders, who made the bold move to make a change.
“Bea’s parents Rachel and Erin are honoring their daughter in such a powerful way. On behalf of bereaved parents everywhere, I thank them and Seattle’s City Council for drafting and passing a landmark law that can be an example for elected leaders across the nation,” Mulheron said at the time.
CuddleCot featured in New Amsterdam
In November, “New Amsterdam,” NBC’s popular hospital drama, showcased a product that’s changing the care system for stillbirth families — the CuddleCot. Developed by Flexmort, which is based in England, the CuddleCot has been on the market for about seven years. The device, which is small enough to fit inside a bassinet, works by continually pumping and cooling water underneath a body. The movement of the water and the cooling process drags away heat from the body, slowing down any change. It gives parents more time with their stillborn baby.
In an interview with Evermore, Steve Huggins, Flexmort’s commercial director and CuddleCot’s co-inventor, said he was thrilled for the opportunity to showcase what’s possible for parents grieving a stillbirth on TV.
“We are always pleased when the subject of stillborn is tackled in a TV show as it starts people talking about what unfortunately does happen,” Huggins told us. “We thought that the show dealt extremely well with the subject and showed how important it is that the mother has the choice to have time with the baby. Something like this really does let people know that this is totally acceptable and the options are readily available.”
FMLA bill wins bipartisan support
For years, two fathers — Kelly Farley and Barry Kluger — have been pushing lawmakers to approve the Sarah Grace-Farley-Kluger Act, which would update the Family and Medical Leave Act and allow parents to qualify for unpaid leave when a child, who is under the age of 18, dies. In February, for the first time in eight years since the bill’s original introduction, it received bipartisan support from both the U.S. House and the U.S. Senate.
Few want to dwell on death and dying, especially when a child is involved. Sadly, the funding and research required to study the impacts of death and grief on the living has been slow to come. But that’s starting to change. In the last year, researchers shed some important insights on death and grief and there’s more to come in 2020.
Research published in the October issue of Social Science & Medicine found that the death of a child has “lasting impacts” on parents. In fact, bereaved parents had a 32% higher rate of mortality than non-bereaved parents, according to the report.
And in June, research in the Journal of the American Medical Association noted a 30% spike in suicides in the United States, including troublesome increases among adolescents, in particular.
As we carry forward into a new decade, these data points will only help us as we continue to push for better policies, more support and increased visibility into an issue that touches us all.
As we look toward the next five years, we hope you will consider joining our movement, sharing our work or volunteering in your communities. To bring bereavement care to America, it will take every last one of us.
In one study grieving parents ranked support groups and psychics as the most helpful in coping with their grief. Photo courtesy of Yeshi Kangrang.
An expert on grief says bereaved parents shouldn’t discount the benefits
One of the most difficult aspects of dealing with the death of a loved one is its finality. Surviving family members may have great difficulty accepting the fact that they will never speak with their loved one again.
Consequently, some bereaved individuals decide to contact a medium. Mediums claim that they can receive messages from deceased loved ones, and act as a channel between people who have died and loved ones who are still alive.
It’s easy to make fun of those who claim to talk to the dead and the people who call on them. Comedian John Oliver laid out plenty of reasons in his February 2019 segment on “Last Week Tonight with John Oliver.”
Mediums may appear to make wild — or slightly educated — guesses. In one case aired on NBC’s Today show a medium suggested that fishing was an important hobby for former NBC anchor Matt Lauer. Oliver later revealed that information was easy to find with a simple Google search looking for information about Lauer and his deceased father.
And they can be wrong — and hurtful. While in captivity, Amanda Berry, a teen who was kidnapped and helped captive for a decade, watched in horror as a psychic on The Montel Williams Show told her mother that she was dead. Williams later apologized, but Berry’s mother died believing her daughter was no longer living.
In this 20-minute segment, Oliver says mediums are simply “ventriloquizing the dead” and part of a “vast underworld of unscrupulous vultures.”
Camille Wortman, Emeritus Professor of Psychology at Stony Brook University, agrees that the world of psychics and mediums is rife with con artists.
But in her decades-long work with grieving people, she sees another side to the story. A study, which backs up her own experience working with the bereaved, shows that mediums and psychics also can help grieving people — even more than therapists, grief counselors and clergy.
Wortman believes that destigmatizing the topic of visiting with mediums could help bereaved parents recognize that even just one or two sessions could play a big role in their healing.
Wortman considers herself a John Oliver fan. But, she said, “for the sake of entertainment, he put material out there that can be very damaging.”
‘I can’t wait to tell you. I went to a medium’
Wortman is a longtime expert on grief and bereavement with a special focus on how people react to the sudden and traumatic death of a loved one. Her interest in the grief process started, she said, at the age of four when her father died.
Bereavement expert Camille Wortman says her experience with parents left her very interested in grief and very driven to understand more.
“Nobody ever talked about it. Nobody dealt with it on an overt level,” she said. “It left me very interested and very driven to understand more.”
Much of Wortman’s work has been with bereaved parents. And, in her work, she began to notice that many of them visited with a medium. Wortman had no feelings or beliefs about mediums, but the parents talked of very positive outcomes.
Consider the case of Joan, a friend of Wortman’s. Joan’s college-aged son, David, was murdered on his way home from soccer practice. Wortman was there to help her during those early days, connecting her with a therapist. But the mother’s pain was still raw, even a couple of years later.
Wortman, however, noticed a big change one day during a phone call. “For the first time, Joan’s voice sounded different,” she said. “There was a little bit of an upnote to her voice. I wondered what was going on. She said, ‘Camille, I can’t wait to tell you. I went to a medium.’”
Joan told Wortman that during the session, the medium immediately said David wanted to see his wallet, which only Joan knew she’d been carrying in her purse since the day he died. Among other details, the medium also knew that David had a tattoo on his foot with two wings and that his favorite food was sauerkraut.
And, finally, as the session wrapped up, the medium told her David wanted to tell her one more thing: “‘Don’t worry. You’ll always be my number one girl.” It was something David would tell his mom before he’d go on a date.
“This encounter with the medium jump-started her healing, which was going nowhere,” Wortman said. “And she is gradually moving in a positive direction in terms of moving forward with her life. I’ve noticed that of many parents.”
Wortman said she’s heard many stories like Joan’s. “The one thing I am struck by is what a powerful effect it has and how immediate those effects are,” she said.
What the research says
Research backs up Wortman’s discussions with Joan and other grieving parents. A 2012 study, described in the book “Devastating Losses: How Parents Cope With the Death of a Child to Suicide or Drugs,” found that grieving parents ranked support groups and psychics as the most helpful in their grief, followed by grief counselors; psychologists, social workers and psychiatrists, and members of the clergy.
In the study, about 30 percent of parents visited with psychics during the first four years after their child died.
Another 2014 study also found that grieving people reported lower levels of grief after a reading when compared to a visit with a mental health professional.
Wortman surmises that a conversation with a medium can be helpful because it addresses an underlying worry for a grieving parent that a traditional therapist can’t address: Is their child really gone?
“It conveys that their child still exists in some form,” she said. “That’s terribly important. And it conveys that the child is OK. The child is not hurting, not calling out for them. This enables them to put more attention on other important aspects of their life, such as their marriage, their other children, and their job.”
If you’re considering consulting with a medium after the death of a child, Wortman has some tips.
Ask around
If you know other bereaved parents who have had an experience with a medium, talk to them about it, she said. Learn about how a reading may have helped or hurt.
Don’t fall for a scam
Don’t fall for somebody who is out to simply get your money. “Give it full consideration, but be careful how you go about it,” she said.
Some therapists are critical of mediums, but others see the benefits, Wortman said. “Certainly, we need a therapist who does not sit in judgment of mediums and who can have empathy for the reasons a person might go to a medium and can help the person understand the impact of it,” Wortman said.
“They can help you process it,” she said. “And that’s really terribly important.”
47% of surveyed kids under age 18 believe their life will be harder than it will be for other people. Photo by Chinh Le Duc on Unsplash.
Evermore’s next few stories will have a “Back to School” theme focusing on both younger children and college-aged students. We are giving focus to siblings who have suffered the death of a brother or sister. Returning to school without their siblings can be painful reminder. Being with caring adults and peers who share their experience is extremely important. Bereaved parents are often so devastated by the death of their child, they can’t be there for their surviving children in the way they want to and need to be.
For centuries, children have grieved the death of a relative or friend. But, even just a couple of decades ago, there wasn’t really a field called “child bereavement” or a central organization to support the groups and individuals across the country who do the hard work to help kids in mourning.
To fill in the gaps, the National Alliance for Grieving Children formed nearly 25 years ago to create a network of people who provide services for kids who need them. And, today, the alliance’s membership has grown to 1,100. They include representatives from bereavement centers and hospices, along with social workers, child life specialists, school employees and others.
Vicki Jay, the alliance’s chief executive officer, said the lag to launch a bigger effort to support grieving children boils down, in part, to people’s discomfort with the topic.
“There are two natural things in life — birth and death,” Jay said. “We do everything in the world we can to plan for, anticipate and celebrate birth. And we, as a society, are not so eager to talk about the second topic. As a society, we haven’t done a lot of good work through the years of recognizing the importance of supporting people through that process.”
Vicki Jay, Chief Executive Officer.
What’s more, grieving children make adults uncomfortable. “We want to think kids are resilient,” she said. “They’ll be OK, and they’ll bounce back.”
In reality, she said, adults just don’t know what to do about kids who have experienced a death. “It’s easier to think that kids will be OK than trying to figure out how to help them,” Jay said. “Putting kids and grief in the same sentence makes a lot of people uncomfortable.”
But that’s what Jay and others at the alliance do on a daily basis. And their work has helped to uncover statistics that show that bereaved kids need help. Along with local grief support centers and the New York Life Foundation, the alliance conducted a national poll of 531 grieving children and teenagers, ages 18 and under, who were mourning the death of a parent or sibling.
The results, according to the alliance’s website, uncovered some sad realities:
86% of respondents said that they wish they had more time with their loved one, with 69% saying that they wish they could talk to their loved one, just one more time.
75% say the pervading emotion they currently feel is sadness, with feeling angry, alone, overwhelmed and worried being top other emotions.
73% said that they think about their loved one every day.
47% believe their life will be harder than it will be for other people.
46% cannot believe it is true.
Children also report trouble sleeping and concentrating on school work and that they’ve acted in ways that might not be healthy, according to the survey.
“When there is a death, I, as an adult, have a need to do something,” Jay said. “I call somebody. I cry. I pray. I research. I reach out. I make a casserole. I do something. And kids have that same need. Their tools are just different. We need to give them something to do that allows them to take that inside expression that they have and express it outwardly. … Our goal with kids is to give them the tools to get that inside stuff out.”
To help grieving kids, the alliance provides educational opportunities for the professionals who work with them and also connects children with services around the country. And, each November, it holds a National Childhood Bereavement Awareness Month to raise awareness about the needs of bereaved children.
Megan Lopez, National Program Director.
Jay, along with Megan Lopez, the alliance’s national program director, shared some tips for adults who are caring for grieving kids to help them understand their emotions. Here’s what they suggest.
#1 Talk about hard things
Adults often want to protect a child from hurtful or difficult-to-understand situations. But, when they do that, Jay said, they miss out on opportunities to have important talks about life and death. “We have multiple opportunities to help kids understand life and death and grief, and we need to capitalize on those,” she said. When those conversations take place, she said, you’re empowering them with information and knowledge.
#2 Expect unexpected reactions
Sobbing, deep sadness, exhaustion, changes in appetite and trouble sleeping are considered common reactions to grief. But, for kids, sometimes they just want to play or go back to school. “It doesn’t mean they’re not grieving,” Lopez said. “It means they’re a kid.”
#3 Look for change
Kids react to grief in any number of ways. “It looks like change for them,” Lopez said. “Maybe they were a very outgoing child before and now they’ve become more introverted. Maybe they were struggling with school and now they are really overachieving.”
What you’re looking for, she said, are changes to their typical behavior at home and school.
#4 Help them open up
It can be as simple as coloring a picture or playing with play dough together, Jay said. At night, she suggests, ask them what the best and worst thing is about their life. Find out what they’re excited and worried about.
Expect questions to come up months or years after the death as kids navigate through different developmental stages. “Give them multiple opportunities and modalities to help them express what’s inside and ask questions,” Jay said.
#5 Give them a safe space
Parents, of course, will want to ensure that children know they can go to them with questions. But adults also are grieving a loss. Lopez recommends providing other sources, who might be more removed from the family’s pain, where children can talk about their feelings. It might be a support group or with trusted friends.
“It’s about meeting the child where they are,” Lopez said. “Not giving them more information than they are ready to process, but being willing to keep having conversations. It’s not one and done.”
Julie Kaplow, on the left, serves as the Director of the Trauma and Grief Center in Houston, Texas, will be launching the Handle with Care program for children who have witnessed a death.
In August we are focusing on “Back to School” at Evermore. We are giving focus to siblings who have suffered the death of a brother or sister. Returning to school without their siblings can be painful reminder. Being with caring adults and peers who share their experience is extremely important. Bereaved parents are often so devastated by the death of their child, they can’t be there for their surviving children in the way they want to and need to be.
The research makes it clear: For children, bereavement is one of the top reasons they are clinically referred. It’s among the “most distressing life events” for children and adults. What’s more, children who are mourning the death of a family member or friend have a higher risk for depression, substance abuse and other mental or behavioral health problems later in life.
Researcher Julie Kaplow, along with other experts, spell out these facts in a 2018 report that considers a tool used to assess bereavement in youth. The death of a parent, sibling or other relative or friend is a setback for any child, but some children develop unhealthy strategies to cope with the loss. There aren’t enough tools, especially for youth, that clinicians and counselors can use to evaluate whether a child could use extra support.
“We need assessment tools that tell us that this kid is not grieving in a way that’s healthy and we need to find some help,” said Kaplow, considered one of the nation’s top experts and thought leaders on grief and children.
In her many jobs, Kaplow’s work to develop those assessments is part of a multi-pronged approach that she and other researchers are tackling to support traumatized and bereaved children.
Kaplow is director of Texas Children’s Hospital’s Trauma and Grief Center, a Substance Abuse and Mental Health Services Administration-funded center that’s part of the National Child Traumatic Stress Network. The network, which includes 100 sites across the country, aims to raise the standard of care and bolster access to services for traumatized children and their families. The center at Texas Children’s is the only one to focus specifically on grief and bereavement.
Kaplow also serves as chief of psychology at the Houston hospital where she oversees 60 clinical psychologists. And, she is vice chairman for behavioral health at Baylor College of Medicine where she supervises behavioral health initiatives.
Healthy, unhealthy coping
Death is hardly a new topic, but grief and how we cope with it is a newer field of research, especially as it pertains to bereaved children.
“It’s controversial to talk about grief as a psychological problem given that bereavement is a natural part of life,” Kaplow said. “We know that everyone will have to experience a death at some point. We don’t want to pathologize normal grieving. I think there’s been such a push in that direction that it’s been at the expense of recognizing that there are some kids who really do get stuck and who really do need an additional level of support. I think that is what’s hindered the field.”
There are plenty of factors that can help to determine how a child will cope with a death over time, Kaplow said.
“What we know is if children are brought up in a healthy, happy environment, and if somebody dies, those kids, most of the time, will end up still continuing to lead happy, healthy lives,” she said.
“Kids who already bring with them other adverse experiences or a lack of parental support, even before the death, can have more trouble. So can children whose loved one died by homicide or suicide or who are living in poverty or in neighborhoods where violence is the norm,” Kaplow said.
“Maladaptive grieving can manifest in a number of different ways, and that depends on the developmental stage of the child,” she said.
A younger child may exhibit more clinginess, separation anxiety, a new onset of fears or developmental delays. A teenager might get involved in more risk-taking behaviors or even consider suicide. “And that can be either wanting to reunite with the person who died, if that’s part of their belief system, … or just not caring about life anymore,” Kaplow said.
Better treatments
To help those kids, Kaplow and her colleagues have developed evidence-based treatments that are designed to support traumatized or grieving children.
Trauma and Grief Component Therapy can be tailored to an individual child’s specific needs. A child mourning a loved one will benefit from the modules designed for grieving kids. Another child, who has been abused or witnessed violence, but hasn’t experienced a death, can benefit from the trauma modules.
The Trauma and Grief Center’s goal is to raise awareness about the adaptive side of grief, while also helping to identify bereaved youth who may need a higher level of support.
Multidimensional Grief Therapy is for kids who have experienced a death and are struggling. “It’s designed to address the different bereavement-related challenges kids may have,” she said.
Now, Kaplow and her colleagues are training others to provide these therapies to the kids who need them.
Targeting schools
There is much more work to do, of course, to help communities and clinicians assist kids who are mourning. And schools, said Kaplow, where children spend so much of their time, are an obvious place to start.
In the next six months, Kaplow plans to launch the Handle with Care program in Houston. Already in West Virginia and San Antonio, the program provides a way for police to alert school principals when a child has witnessed a death. From there, the child’s teacher can monitor them for post traumatic stress disorder and refer them to the school counselor, if needed.
Another major initiative is to ensure that school-based clinicians and teachers are trained to identify PTSD symptoms and children who are not coping well with their grief.
“Bereavement has been one of those sleeper traumas that not a lot of schools have paid close attention to,” Kaplow said. “What we’re finding is that bereavement is the №1 predictor of school failure above and beyond any other form of trauma and that includes sexual abuse, physical abuse and witnessing domestic violence.”
“Knowing bereavement is the most prevalent form of trauma, we definitely need to be helping teachers to ask questions and be more direct about inquiring about a recent loss,” she said. “We know that it’s uncomfortable for people. We don’t want to bring it up. But we also know it’s never harmful to inquire about how a child is coping after a death.”
