A Guide to Children's Bereavement Counselling

The loss of a loved one is a profound and life-altering experience, particularly for children who may struggle to comprehend and cope with their emotions. Children’s bereavement counselling is a critical resource that offers tailored support, helping young people navigate the complex and often overwhelming journey of grief.

This guide seeks to provide an understanding of the unique challenges children face during bereavement, offering insights into how counselling can help them process their loss and find a path forward.

Their age and cognitive development often influence a child’s reactions to loss. Young children, particularly those under five, may not fully grasp the permanence of death and might believe that the deceased person will return. As children grow older, their understanding deepens, but this can also bring about more complex emotions, such as anger, guilt, or anxiety. Adolescents, on the other hand, might struggle with feelings of isolation, fearing that no one else understands what they are going through.

One of the most significant challenges in supporting grieving children is the common misconception that they are “too young to understand” or that they will “get over it” quickly. Such beliefs can lead to a lack of necessary emotional support, potentially causing long-term psychological issues. Adults must recognise that children do grieve, and they require just as much, if not more, support as adults during these times.

One of the key components of children’s bereavement counselling is the emotional support it offers. Children need to know that it is okay to feel sad, angry, or confused and that there is no “right” way to grieve. Counsellors work to validate these feelings, helping children to understand that their emotions are a normal part of the grieving process.

Different approaches can be used in children’s bereavement counselling, depending on the child’s age, personality, and circumstances. For younger children, play therapy or art therapy can be particularly effective, as these methods allow them to express their emotions in a non-verbal way. Older children and adolescents might benefit from more traditional talk therapy, where they can explore their feelings and experiences in a structured environment.

It is also important to consider the role of the family in the grieving process. Family counselling can be a valuable tool, offering support not only to the child but also to parents and siblings who are grieving. This holistic approach helps to ensure that the entire family system is supported, creating a stronger foundation for everyone to heal.

Identifying When a Child Needs Bereavement Support

Not all children will require professional bereavement counselling, but it is important for parents and caregivers to be aware of the signs that indicate a child may need additional support. These signs can be physical, emotional, or behavioural and may not always be immediately apparent.

Physical signs of grief in children can include changes in appetite, sleep disturbances, and complaints of physical pain, such as headaches or stomach aches. Emotionally, children might exhibit signs of sadness, anxiety, or anger that seem disproportionate or out of character. Behaviourally, a grieving child might become withdrawn, exhibit regressive behaviours (such as bedwetting or thumb-sucking), or display changes in academic performance or social interactions.

One of the challenges in identifying grief in children is that they may initially appear to cope well, only to show signs of distress later on. This delayed reaction can make it difficult for parents and caregivers to connect the child’s behaviour to their grief. It is also important to recognise that unresolved grief can have a long-term impact on a child’s development, potentially leading to issues such as depression, anxiety, or difficulties in forming relationships.

Parents and caregivers should trust their instincts when it comes to their child’s well-being. If something seems off, or if a child is struggling to return to their usual routines and activities, it may be time to seek professional support. Early intervention can be key in helping children process their grief in a healthy and constructive way.

How Children Cope with and Show Grief: Age-Specific Responses

Ages 3-5 Years: Young children struggle to grasp the permanence of death, often asking when the deceased will return. Their grief may appear as increased clinginess, fear of separation, or regression to earlier behaviours like bedwetting. They might express distress through play or fantasy, acting out scenarios that reflect their anxieties.

Parental Approach:
Parents should offer clear, simple explanations, avoiding confusing euphemisms. Reassuring the child about their safety and encouraging expression through play can help them process their emotions.

Ages 6-8 Years: Children start to understand the finality of death but may struggle with its universality. Their grief often manifests as anxiety, fear, or anger, and they may worry about their own health or that of others. Behavioural changes like withdrawal or irritability are common, and physical symptoms such as headaches may also occur.

Parental Approach:
Maintaining open communication is key. Parents should correct any misconceptions the child has and provide reassurance. Establishing routines can help the child feel more secure during this time.

Ages 9-11 Years: Children’s understanding of death becomes more sophisticated, leading to more complex emotions. They may experience delayed grief, where emotional responses are postponed until they feel safe to express them. Feelings of guilt or responsibility can arise, and children may become preoccupied with details of the death.

Parental Approach:
Parents should encourage discussions about the death, reassuring the child that their feelings are normal. Creative outlets, like journaling or drawing, can be helpful in processing emotions.

Ages 12-14 Years: Early adolescents face a challenging time for grief, coinciding with significant cognitive and social changes. They may distance themselves from parents, seeking support from peers, yet feel isolated in their grief. Discussions about the death may be avoided, leading to increased anxiety or depression.

Parental Approach:
Respect the adolescent’s need for privacy while remaining available for discussions. Address any misunderstandings and provide accurate information to alleviate fears. Encouraging engagement in enjoyable activities and maintaining routines can offer stability.

Ages 15-17 Years: Older adolescents understand death’s implications and may experience anticipatory grief. They often hide their emotions to avoid burdening others, leading to a range of feelings from frustration to deep sadness. Relationships may become strained as they navigate grief alongside normal adolescent challenges.

Parental Approach:
Offer empathetic support without intruding, allowing the adolescent to grieve in their own way. Open discussions about death and existential concerns can help them process their grief. Be alert to signs of depression or anxiety and seek professional help if needed.

Individual Counselling: One-on-one counselling sessions provide a safe and confidential space for children to explore their feelings and experiences. This type of support is particularly beneficial for children who may not feel comfortable expressing their emotions in a group setting. Counsellors can tailor their approach to meet the specific needs of the child, using techniques such as play therapy, cognitive behavioural therapy, or narrative therapy.

Group Therapy and Peer Support Programmes: Group therapy can be a powerful way for children to connect with others who are going through similar experiences. These sessions offer a sense of community and shared understanding, helping children to feel less isolated in their grief. Peer support programmes, which may include activities such as camps or workshops, can also provide valuable opportunities for children to express their emotions in a supportive and empathetic environment.

Creative Therapies: Creative therapies, such as art, music, and play therapy, are particularly effective for younger children who may struggle to articulate their feelings verbally. These therapies allow children to express their emotions through creative mediums, helping them to process their grief in a non-threatening way. For example, a child might create a memory box filled with items that remind them of their loved one, or they might draw pictures that represent their feelings.

Family Counselling: Family counselling sessions involve the entire family in the grieving process, providing a space for everyone to share their feelings and support one another. This type of counselling can be particularly helpful in situations where the family is struggling to communicate about the loss, or where there are differing reactions to the grief. Family counselling helps to strengthen the family unit, ensuring that everyone is supported and that the child’s needs are met within the context of the family system.

Bereavement Counselling for Children with Parents in Hospices

The situation becomes even more complex when a child is dealing with the imminent loss of a parent who is in hospice care. Bereavement counselling in these cases often begins before the loss, helping the child to prepare for what lies ahead.

Pre-Bereavement Support: Pre-bereavement counselling is focused on preparing the child for the loss, providing age-appropriate explanations of what is happening and involving them in the care process where appropriate. Early intervention is crucial in helping the child to understand the situation and begin processing their emotions before the loss occurs. This might involve open and honest discussions about the parent’s condition, hospice visits, and memory-making activities.

Addressing Anticipatory Grief: Anticipatory grief refers to the emotions that children experience in anticipation of the loss of a loved one. This type of grief can be particularly challenging, as it involves a mix of hope and fear, as well as a sense of impending loss. Counsellors can help children to navigate these emotions, providing support as they come to terms with what is happening and helping them to maintain a sense of normalcy during this difficult time.

Memory-Making and Preparing for the Final Days: Creating lasting memories can be a comforting way for children to feel connected to their parents during their final days. This might involve activities such as creating scrapbooks, recording messages, or simply spending quality time together. These memories can provide a source of comfort for the child after the parent has passed away, helping them to remember the positive aspects of their relationship.

Continuity of Care: Bereavement counselling should not end when the parent passes away. It is important to continue providing support to the child as they move through the different stages of grief. This might involve transitioning from pre-bereavement to bereavement counselling, as well as providing ongoing support as the child grows and their understanding of the loss evolves. Grief can resurface at different developmental stages, and children may need additional support as they encounter new challenges related to their loss.

It’s also important to note how as with children, each person’s reaction and way of dealing with their own grief or illness is different, and to be ready to anticipate this. Our child counsellor recounts how two mothers with the same prognosis handled breaking the news to their children – one with anger and another with practicality and putting plans in place. This affects how the child will perceive not only the news but also their understanding of the situation. Again, no one approach is right or wrong, it needs to be holistic, empathic and taken case by case.

Current Issues in Children’s Bereavement Support

The field of children’s bereavement support is constantly evolving, with new challenges and opportunities emerging in response to societal changes. One of the most significant developments in recent years has been the increased use of technology in providing remote counselling services. While this can offer greater accessibility for some families, it also presents challenges in terms of maintaining the personal connection that is so crucial in bereavement support.

Culturally sensitive approaches are also becoming increasingly important in children’s bereavement support. It is essential to recognise that grief is experienced differently across cultures, and that counselling approaches need to be tailored to reflect these differences. This might involve understanding cultural beliefs about death and the afterlife, as well as being aware of different mourning practices.

There is also a growing recognition of the need for bereavement training for educators. Schools play a key role in supporting grieving children, and teachers and school counsellors must be equipped with the skills and knowledge they need to provide effective support. Grief-informed practices, which take into account the impact of loss on a child’s learning and behaviour, can help create a supportive school environment that fosters healing.

Additionally, the importance of supporting the entire family system in children’s bereavement counselling cannot be overstated. Families often experience grief as a unit, with each member’s emotions influencing the others. Counsellors who work with bereaved children must consider the family’s dynamics and provide support that addresses the needs of all family members, not just the child.

Insights from Hospice Care

Hospice care offers a unique perspective on children’s bereavement support, particularly when a child is coping with the impending loss of a parent. The compassionate, individualised, and holistic care provided by hospices like Hospice in the Weald ensures that both the patient and their family receive the support they need during this challenging time.

One of the key aspects of hospice care is its focus on making the time remaining, as fulfilled, dignified, and comfortable as possible for the patient and their family. This approach extends to bereavement support, where the hospice’s counselling and support services work closely with the family to provide emotional and spiritual care tailored to their needs.

For young children, separation from their main caregiver can be particularly distressing, and hospice staff are trained to help children understand and cope with these feelings. Communication about the illness, presented in an age-appropriate manner, is essential. For example, children aged 3-5 may struggle to understand the significance of events and often focus on visible signs of illness, such as hair loss or changes in mobility. Providing information in a form they can understand, such as through play or storytelling, helps them process what is happening without overwhelming them.

As children grow older, their ability to understand and process grief evolves. Children aged 9-11, for instance, may welcome the opportunity to talk about what is happening but might not share their emotional reactions readily. It’s important to provide these children with opportunities to express themselves, whether through talking, creative activities or simply spending time with them in a supportive environment.

Adolescents, on the other hand, may require a different approach. They might be more inclined to seek information on their own or rely on trusted adults outside the family, such as teachers or counsellors, to discuss their feelings. For this age group, offering detailed information about the illness and encouraging open discussions can help them navigate their complex emotions.

Finding the Right Bereavement Counselling for Your Child

Choosing the right bereavement counsellor for your child is a critical step in ensuring they receive the support they need. It’s important to find a qualified counsellor who specialises in working with children and understands the unique challenges they face in processing grief.

When selecting a counsellor, consider their experience and approach to working with children. A good counsellor will take the time to build a rapport with your child, making them feel comfortable and safe. They should also be able to offer a range of therapeutic options, from individual counselling to group sessions and creative therapies, depending on what your child responds to best.

Parental involvement in the counselling process is also crucial. While it’s important to give your child the space to express their emotions independently, being involved in the process can help you better understand what your child is going through and how you can support them at home. Many counsellors will work with parents to provide guidance on how to talk to their child about the loss and how to help them cope with their emotions.

In the UK, there are numerous resources available for child bereavement support. Organisations like Hospice in the Weald, offering children’s hospice services in Kent, and Winston’s Wish provide a wealth of information and services to help families navigate the challenges of grief. Whether you’re looking for counselling, educational materials, or simply someone to talk to, these organisations can provide the support you need during this difficult time.

Closing Thoughts

If you notice signs of unresolved grief in your child, don’t hesitate to seek professional help. Early intervention can be key in helping your child heal and develop the resilience they need to cope with future challenges. Remember, you’re not alone – there are many resources available to support you and your child through this difficult time. Reach out to us at Hospice in the Weald to find the help and guidance you need.