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    Childhood Traumatic Grief

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    Child and Family Institute
    The concept of Childhood traumatic Grief involves a condition where a child’s trauma symptoms surrounding the loss of a parent prevent the child from processing his or her grief. The loss can be either what is objectively described as a traumatic death, such as a death caused by suicide, homicide, or accident, or a loss caused by what is subjectively interpreted by the child as a traumatic experience.

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    Childhood Traumatic Grief

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    Child and Family Institute
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    The concept of Childhood traumatic Grief involves a condition where a child’s trauma symptoms surrounding the loss of a parent prevent the child from processing his or her grief. The loss can be either what is objectively described as a traumatic death, such as a death caused by suicide, homicide, or accident, or a loss caused by what is subjectively interpreted by the child as a traumatic experience.

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    The concept of Childhood traumatic Grief involves a condition where a child’s trauma symptoms surrounding the loss of a parent prevent the child from processing his or her grief. The loss can be either what is objectively described as a traumatic death, such as a death caused by suicide, homicide, or accident, or a loss caused by what is subjectively interpreted by the child as a traumatic experience.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    323 views23 pages

    Childhood Traumatic Grief

    Uploaded by

    Child and Family Institute
    The concept of Childhood traumatic Grief involves a condition where a child’s trauma symptoms surrounding the loss of a parent prevent the child from processing his or her grief. The loss can be either what is objectively described as a traumatic death, such as a death caused by suicide, homicide, or accident, or a loss caused by what is subjectively interpreted by the child as a traumatic experience.

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    The document discusses developmental perspectives on grief from infancy through adolescence, variables that influence a youth's grief reactions, symptoms of childhood traumatic grief, and interventions for assessment and treatment.

    The document discusses that infants and toddlers have no cognitive understanding of death and may expect the deceased to return. Preschoolers begin to understand death is permanent but may not believe it is universal. School-aged children understand death is final but may feel anxiety, depression, anger, and guilt. Adolescents have increasing capacity for abstract reasoning about death and complexity of loss.

    The document mentions that child variables, environmental variables, attachment to caregivers, and support outside the family can influence a youth's grief reactions. The nature of the loss, such as a traumatic or sudden death, can also impact grief experiences.

    Rania Attia M.D.

    Grand Rounds 5/29/13

    Topic Relevance

    Terminology
    Developmental Perspective on Grief Variables Symptoms of Childhood Traumatic Grief Assessment Treatment

    Researches have documented higher levels of trauma symptoms with concurrent grief reactions in youth exposed to war, violence and terrorism. 5% of children age 15 and younger have lost one or both parents (Steen, 1998) Slightly more than half (51.9%) had experienced the sudden unexpected death of a close relative or friend by age 21 Childhood bereavement from parental death is associated with increased psychiatric problems in the first 2 years after death

    Cerel et al 2006; Breslau et al 2004; Weller et al., 1991; Worden and Silverman, 1996; mentalhelp.net; Pfefferbaum, Call,et al., 2001; Pfefferbaum, Nixon, et al., 1999

    Bereavement Grief Complicated Grief and Prolonged grief-DSM V

    Persistent Complex Bereavement disorder


    Childhood Traumatic Grief
    Nader et al 2011; Storebe et al 2001

    Infants and Toddlers


    No Cognitive

    Preschoolers
    Death is temporary and

    understanding of death Expect Person to return Sleep Disturbance Eating Pattern Changes Fussiness Bowel and Bladder Disturbance Difficulty being comforted

    reversible Death is sleeping Magical thinking Regressive behavior Re-enact death via play Aggression

    Nader et al 2011, Cohen et al 2002

    School Age
    Begin to understand that

    Preadolescent
    Death is final and

    death is permanent May not believe that death is universal Anxiety Depression and Anger Somatic complaints Fear the safety of loved ones

    Nader et al 2011, Cohen et al 2002

    irreversible Curiosity about death Interest in religious or cultural aspects of death Guilt Fear dying Feel different from other kids

    Adolescent:
    Increasing capacity for abstract reasoning and

    understanding complexity of death Existential life crisis Invincible Resent results of loss (demands on family) Sadness and loneliness Reject adults Normal mood swings=exacerbate grief Idealize deceased and demonize survivor

    Nader et al 2011, Cohen et al 2002

    Multiple factors influence a youths grief reactions

    Child Variables
    Environmental Variables Attachment to caregivers Support outside of the family

    Brown et al.,2008; Crenshaw, 2007; Webb, 2002; Nader et al 2011; Salinder et al 2004

    Nature of the loss will increase the chances of having a Traumatic Grief

    experience.

    Youth exposed to the same type of loss may have different reactions, and youth

    exposed to different types of loss may have similar reactions

    Loss of parent from terminal illness can also be considered traumatic


    No Clear Consensus

    Shapiro, 2008; Nader et al, 2011

    Reconciliation is a term used to describe the

    process of the child adjusting to and accepting the reality of life without the loved one and reinvolving oneself in the activities of living

    Wolfelt 1996; Worden, 1996

    1. Accept 2. Experience pain 3. Adjust to new identity 4. New Relationships 5. Convert to memory 6. Find Meaning

    7. Supportive adult
    Worden Et al 1996; mom-psych.com; Goodman 2004

    Childhood traumatic grief (CTG) refers to a condition

    in which a child or adolescent has lost a loved one in circumstances that are objectively or subjectively traumatic and in which trauma symptoms impinge on the child's ability to negotiate the normal grieving process.

    Cohen et al 2004/2007; Brown Goodman 2005

    Trauma Reminders---avoidance/numbing Loss reminders--avoidance/numbing Change reminders-avoidance/numbing

    Pynos et al 1992; Cohen et al 2001;

    Avoidance Identification Over identification Exaggerated self blaming and guilt

    Pynos et al 1990, Nader 1997, Cohen 2001

    Death of loved one perceived as traumatic Presence of significant PTSD symptoms Impingement on childs ability to complete bereavement

    Pynos et al 1990, Nader 1997, Cohen 2001

    Children may grieve throughout their development Only their persistence and intensity may distinguish them

    from normal reactions.

    Cohen et al 2007; Layne et al 2001

    What is the childs current and previous functioning? The death Childs PTSD symptoms Variety of measures under exploration i.e. EGI-Extended

    Grief Inventory

    Cohen et al 2007; Layne et al 2001

    Studies: Cohen and Mannarino 2004

    Layne et al 2001
    Saltzman and Pynoos et al 2001

    Salloum and Vincent 2001 Pfeffer and colleagues 2002

    Cohen 2004; 2011; Layne 2001; Saltzman 2001

    Trauma-Focused Interventions

    Affective expression skills Stress management skills Cognitive triangle Creating the child's trauma narrative Cognitive processing Joint parent-child sessions Talking about death; psychoeducation Mourning the loss Addressing ambivalent feelings about the deceased Preserving positive memories Redefining the relationship Committing to other relationships Making meaning of the traumatic loss Joint parent-child sessions

    Grief-Focused Interventions

    Cohen et al 2004

    Trauma Focused Interventions:


    Affective Expression Skills Stress management skills Using Cognitive triangle Trauma narrative Cognitive processing Joint parent-child sessions

    Cohen et al 2004

    Grief Focused Components Talking about death Mourning the loss Addressing ambivalent feelings about the deceased Preserving positive memories Redefining the relationship Committing to other relationships Making meaning of the traumatic loss Joint parent-child sessions
    Cohen et al 2004; Brown 2003

    CTG: Trauma + Grief Death and loss increases risk of mental Health

    Disorders Developmental level complicates expression of grief Reconciliation and Mourning Variables to grief expression Assessment CTG studies are limited- current literatures suggests that TFCBT with Trauma and Grief Modules

    Acknowledge:

    Paden Bhutia M.D.


    Wendy Klapper Phd

    vanessafadeff.com

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