Contemporary Advancements in Childhood Bereavement

The field of juvenile and adolescent bereavement has seen significant advances within the past five years. In particular, the diverse array of approaches that authors have taken has allowed the discipline to expand in many different directions simultaneously. Some authors, such as William Steele and Cathy Malchiodi, have reviewed the existing treatments typically performed by caregivers and therapists. By contrast, writers like Brenda Mallon have enumerated alternative methods of grief counseling such as dream therapy and spiritual exercises. Also, contemporary texts within the field of juvenile bereavement can differ radically in their intended audience. While Julia Sorensen’s work Overcoming Loss: Activities and Stories to Help Transform Children’s Grief and Loss presents many activities intended for children, while Tina Maschi and Derek Brown’s essay “Professional Self-Care and Prevention of Secondary Trauma” is directed towards the wellbeing and performance of caregivers themselves. Ultimately, the largest problem in the field of contemporary juvenile bereavement is how to engage young people in a way that is clear, respectful, and supportive. Nearly every author within this dialogue has attempted to address this issue in alternative ways, through a diverse range of modes.

William Steele and Cathy Malchiodi’s 2012 book Trauma-Informed Practices with Children and Adolescents discusses the effects of trauma upon children and enumerates some psychological treatments that might mitigate the mental impacts of trauma. Both Steele and Malchiodi have experience working with the National Institute for Trauma and Loss in Children. They begin by defining trauma as a severe form of grief, in which the predominant emotions affecting the patient are those of profound terror and powerlessness (Steele, 2012, p. 10). These experiences, which may culminate in the condition of Post-Traumatic Stress Disorder (PTSD), typically dramatically shape the personal development of young people’s identities and can often lead to aggressive or even violent behavior patterns. Therefore, according to Steele and Malchiodi, the central goal of Trauma-Informed treatment is to turn unstable, frequently destructive traumatic reactions into more manageable and healthy processes of grieving. The methods of psychological transition suggested, which include providing sensory treatments, establishing safe environments, and developing healthy relationships, are informed by both the authors’ personal experiences with young trauma survivors and also contemporary neuroscientific findings. For example, when discussing the critical role of developmental neuroscience in the practice of caregiving, the authors site B. D. Perry’s 2006 article “Applying principles of neurodevelopment to clinical work with maltreated and traumatized children” (Steele, 2012, p. 51). Because of this strong use of existing evidence, Steele and Malchiodi’s prescriptions for treating traumatized children are presented in a very persuasive manner. Of the three treatment methods suggested in this volume, the discussion of sensory interventions is clearer and more articulate than the discourse surrounding safe spaces and enacting effective relationships – primarily because this former method is the most tangible and the least abstract mode of intervention. Admittedly, because the text is mainly a prescriptive guide meant for practical use by counselors, contrary positions are largely overlooked. Nevertheless, the breadth of materials presented in Trauma-Informed Practices with Children and Adolescents participates in the discourse surrounding childhood loss and grief in a manner that is relatively even-handed and unbiased. Understanding when neurotypical grief crosses the threshold and becomes an unhealthy reaction of trauma is an important contribution to the field of developmental bereavement, and therefore William Steele and Cathy Malchiodi’s constitutes a significant contribution to the existing canon of literature

Brenda Mallon, in her work Working with Bereaved Children and Young People, analyzes different methods of grief counseling and discusses the benefits and drawbacks of specific approaches. In particular, she examines the efficacy of approaches such as a) individualized counseling, b) school-based support, c) creative approaches, d) dream-based treatment, and e) spiritual discussions. While both William Steele and Julia Sorenson’s works discuss the possibility for creative, sensory-based treatment, and Tina Maschi & Derek Brown’s article discusses individual and group-based counseling, Mallon’s book is one of the first in the field of child bereavement to discuss the importance of dream and spiritual interventions. The text supports its recommended interventions by referencing existing texts in the field, such as Kelly Bulkely’s 1995 work Spiritual Dreaming: A Cross-cultural and Historical Journey, and J.D. Emblen’s 1992 article “Religion and spirituality defined according to current use in nursing literature” (Mallon 2008, 95 & 107). These chapters, which argue in favor of traditionally discounted methods of psychological intervention, add new methods of treatment that caregivers can practice to aid grieving children. Also, Mallon readily accepts critiques of her position, and never claims definitive certainty. Rather, she suggests the potential for aid that these methods can provide - particularly when used in conjunction with more traditional exercises. Brenda Mallon, herself an experienced practitioner of dream therapy, combines existing empirical findings with her own first-hand experience to lend authority to her claims. Therefore, her work, by providing an objective and impartial account of emerging tools, is a substantial contribution to the field of child bereavement.

Julia Sorensen’s 2008 work Overcoming Loss: Activities and Stories to Help Transform Children’s Grief and Loss, enumerates several exercises that parents, teachers, and counselors might use to help young people manage and confront their own emotions of grief. Because of the engaging nature of these activities, they might be said to constitute what Steele and Malchiodi later call ‘sensory treatments’. In the introduction to the text, Sorensen discusses the separate intellectual disciplines whose work has culminated in the creation of the included exercises: “The book draws on, and integrates, the best of approaches: social-emotional learning, emotional EQ, Developmental Approaches, Expressive Therapy, and Cognitive Behavioral Therapy” (p. 9). Because the work is intended primarily for child audiences, it does not provide contradictory views, nor supply empirical evidence to definitively show the efficacy of its exercises. However, Sorensen’s book positively contributes to the discourse surrounding juvenile and adolescent bereavement by providing materials that can engage with young people themselves. This text practically implements much of the existing theory in the field to help stimulate experiences of introspection and healing. Therefore, despite a slight deficiency in objective substantiation, Sorensen’s work is nonetheless an important contribution to the discipline of child grief counseling.

The 2010 third edition of Nancy Boyd Webb’s collection Helping Bereaved Children, was co-written by twenty co-authors. The majority of these contributors have backgrounds either in the field of developmental psychology or professional social work. The fifth section of the work, which was created specifically for the publication of the work’s third edition, discusses how counselors, parents, and teachers can be aided in providing grief therapy. The first chapter in this segment – “Professional Self-Care and Prevention of Secondary Trauma” – was written by authors Tina Maschi, Ph.D., LCSW, and Derek Brown, MSW, both of whom have had extensive study and practice in the field of social work. In this segment, the authors support their findings by drawing upon empirical studies conducted in major psychological publications such as those of the American Psychiatric Association, The Asian Journal of Psychiatry, and The Review of General Psychology (Webb, 2010, p. 371). Maschi and Brown’s arguments in this piece are threefold: a) the stresses of working with bereaved children can lay a heavy toll on counselors and social workers; b) these psychological maladies, such as burnout, secondary traumatic stress, compassion fatigue, and vicarious trauma, can be definitely assessed and determined by looking for the presence of a finite number of symptoms; and c) practices such as yogic meditation, social and interpersonal interventions, and accelerated recovery programs can help remove the stresses of helping with childhood bereavement and ultimately make caregivers more capable of providing necessary aid. The first of these arguments – that caring for grieving children can have a detrimental impact upon social workers, is supported by numerous psychological findings and is cited as being such a widespread phenomenon that few disagree with such a finding. The second thesis, which suggests that the presence of psychological stress in counselors can be definitively ascertained through triage, is more controversial and open to contestation. Nevertheless, the abundance of psychometric tools that Maschi and Brown provide – such as the Professional Quality of Life Scale (ProQOL), the Secondary Traumatic Stress of Life Scale (STSS), and the Trauma and Attachment Belief Scale (TABS) give enough credence to the idea of qualitative assessment to make this a plausible thesis. However, the third argument suggested in the piece – that certain self-care and intervention measures can counteract the detrimental effects of secondhand bereavement – is much less supported than either of the earlier two claims. ‘Self-care’ is defined in a manner that is vague enough to encompass a broad swath of activities, and the authors do not provide enough evidence to demonstrate the effects and efficacy of particular supportive methods. This oversight is compounded by the glaring lack of contrary or conflicting opinions, which might challenge the positions advanced in this last thesis. Nevertheless, the Tina Masachi and Derek Brown’s piece is a significant contribution to the subject of child grief support, by expanding the discourse of caregiving to include not simply the wellbeing of the child, but also the mental health of the social workers or counselors who provide much-needed aid.

Moving forward within the field of juvenile bereavement, more work is required to empirically assess the efficacy of specific treatment practices. The abundance of theories regarding child-centered activities, individual creative engagement, alternative practices, and caregiver training highlights the dearth of neurological and psychological evidence within this field. Nonetheless, the work being conducted by authors like William Steele, Cathy Malchiodi, Julia Sorensen, Brenda Mallon, Tina Maschi and Derek Brown make the field of juvenile and adolescent bereavement therapy an exciting and rapidly changing field of intellectual and social engagement.

References

Mallon, Brenda. Working with Bereaved Children and Young People. London: SAGE, 2011. Print.

Sorensen, Julia. Overcoming Loss: Activities and Stories to Help Transform Children's Grief and Loss. London: Jessica Kingsley, 2008. Print.

Steele, William, and Cathy A. Malchiodi. Trauma-informed Practices with Children and Adolescents. New York: Routledge, 2012. Print.

Webb, Nancy Boyd. Helping Bereaved Children: A Handbook for Practitioners. New York: Guilford, 2010. Print.