Decreasing the Risk of Complicated Bereavement and Future Psychiatric Disorders in Children

Journal of Child and Adolescent Psychiatric Nursing, Apr-Jun 2005 by Kirwin, Kathleen M, Hamrin, Vanya

Decreasing the risk of complicated bereavement and future psychiatric disorders in children. This literature will determine what major factors influence a child's response to death and to understand how children react to the death of a parent at different developmental stages. It will evaluate the following: a) What are children's emotional responses to the death of a parent? b) How can a surviving parent help the grieving child complete the tasks of grieving? c) What skills are important for a parent to learn in order to help the grieving child through the tasks of grieving and d) How can mental health providers help the grieving family and the grieving child? Relevant literature from child psychiatry, child psychology, and nursing. The death of a parent is a major stressful event for children and their families. This traumatic event can bring serious psychological and social distress to bereaved children and their families. Children who are not supported in the early phases of grieving can develop serious emotional and behavioral problems that can lead to the development of some major psychiatric disorders. Providing early prevention support programs for surviving parents and bereaved children can help both the parents and the children adapt to their losses. These structured programs can decrease the risk of complicated grief in bereaved families. More research studies are needed to validate the effectiveness of these early prevention program interventions. Children and adolescent grief, attachment, and parental loss

This paper investigates how the death of a parent is a risk factor in developing future psychiatric disorders in children and adults. This paper also covers the current methods of assessment for children at high risk for developing complicated grief, as well as reviews the current successful interventions from published journal articles and published books on loss and the grief process.

Demographics

According to the 1989 United States Bureau of Census, approximately 1.5 million children live in a single-parent home because the other parent is dead (as cited in Silverman & Worden, 1992). Steen (1998) accurately predicted that during 1999 in the United States, it was possible that one or two of every 10 American adults will suffer a death of a family member. This statistic leads to the fact that there are more than 15 million widowed adults in this country. The number of American children under the age of 15, who will suffer from the loss of a parent or both parents, is one out of every 20 (Steen, 1998).

The death of a parent is considered one of the most significant and stressful events for children and their families. When a parent dies, it affects each member of the family and the family as a whole. How the surviving parent copes with the loss of their partner affects how their children work through the tasks of grieving. Bereaved parents may have difficulty dealing with their feelings and grief issues, which will impair their ability to parent their children. These children may then have to deal with major psychiatric problems and social dysfunction in their childhood and possibly throughout their adult lives. The death of a parent affects a child's self-concept, health, social, and economic circumstances (Steen, 1998).

Currently, the need for mental health providers to understand the grief process has increased as a result of the terrorist events on September 11, 2001. The people of the United States of America and many other countries suffered a great loss of lives in New York, Washington D. C., and Pennsylvania. Thousands of civilians, military personnel, and rescue workers were killed through acts of terrorism. Many of them left behind children who are now grieving the loss of their mother, father or both parents. The number of children who lost a parent or parents, varies between 10,000 to 15,000. It has been established that 4,000 qualify as orphans under the Twin Towers Orphan Fund. There are 1,500 children left by the 700 missing Cantor Fitzgerald employees alone (The Avalon Project at Yale Law School, September 11, 2001: Attack on America, Congressional Record House Children Who Lost A Parent or Guardian on September 11, 2001, Must be Provided for; October 30, 2001). We all need to understand that all children who have lost a parent to death suffer in many ways and may need mental health services. September 11 has highlighted for us that it is important that mental health professionals understand how children grieve.

Psychiatric Sequela in Adulthood of Unresolved Grief during Childhood

Studies confirm that adults who were unable to move through the tasks of grieving as children are at significant risk for developing depression and anxiety (Saler & Skoinick, 1992; Mireault & Bond, 1992). Saler & Skoinick (1992) looked at adults who, in their childhood, experienced the death of a parent. In this study, they were looking at the following effects: the quality of parenting by the surviving parent after the other parent's death and the type of home environment that was present after the parent's death.