Understanding Grief and Loss. Provided by Alabama Pre/Post Adoption Connections

Transcription

1 Understanding Grief and Loss Provided by Alabama Pre/Post Adoption Connections

2 Agenda Introduce Grief and Loss Stages of grief and the manifestation of grief in children Ways to facilitate the grief process What parents can do to help What happens if child does not grieve

3 Loss and Managing Loss Grief is a result of loss Grief is the process of recovery from loss Adoption and Foster Care create a situation in which an adult or child experiences loss and subsequent grief

4 All children in adopted and foster families experience loss. "Adoption Loss is the only trauma in the world where the victims are expected by the whole of society to be grateful" The Reverend Keith C. Griffith, MBE

5 Two Types of Loss Maturational- experienced by everyone through the course of human development Moving from childhood dependence to adult independence Rites of passage ( marriage, death, parenthood,) Situational out the normal experience and can interrupt human development Moving Changing jobs Abuse and neglect and resulting separation from birth families Divorce

6 Managing the Two Types of Loss and Resulting Grief Maturational : role models influence how we manage and resolve this grief. Situational : many factors influence the management of this type of loss, which is often difficult to resolve. Parenting attitudes Parenting style Support system Child s innate temperament

7 Situational Losses Experienced by Foster and Adoptive Children Loss of relationship (usually people and animals); Loss of objects that give comfort (toys, blankets, clothing); Loss of familiar environment; Loss of self identity (roles within the family, including child taking care of other children) Loss of familiar habits,routine and traditions; ways of being and doing that define them uniquely

8 Elements that Influence a Foster or Adopted Child's Experience of Loss Reason for move. Why was the child removed from the home or placed for adoption? Abuse? Neglect? Drug/Alcohol abuse? Age. How old was the child at the time of the placement - not only chronologically but developmentaly and emotionally? Timeline of move. Did the placement happen after many visits or suddenly? The trauma of moving into a foster home after being removed from his/her birth home by the police is going to have more of an effect on a child than the planned move from a foster home into an adoptive home. Support. Level of support and understanding given to the child. An understanding foster/adoptive parent who is open to talking about the child's losses and listening to the child's feelings will help the overall grieving process.

9 The Grief Process

10 *these stages were developed to apply to the adult grieving process Traditional Model of Adult Stages of Grief as Described by Kubler Ross Denial-shock Anger Bargaining Depression Acceptance

11 Stages of Grief Are More Disorganized in Children Children are less verbal and communicate thru their behaviors. Children do not understand their behavior is an expression of grief. And are likely to say I don t know when asked WHY they are acting out. Children may not have acting out behaviors when they are in SHOCK, and the acting out behaviors may come later in the placement. There are no predictable time lines for a child to go thru the stages of grief. Also children may revisit different stages at different times, in a disorganized way.

12 Feelings/Behaviors associated with child grief and how you can help.

13 Feelings in Denial Stage My family will be here soon to pick me up. Disbelief Defensiveness Numbness Feeling of unreality Shock Panic

14 Behaviors in the Denial Stage Cooperative/compliant (people pleasing-happy go lucky) Quiet/withdrawn Fatigue Sleep changes Automatic behavior (soldiering on) Asking when they are going home Fantasizing about a rescue or resolution Refusal to unpack or settle in Lying to self and others Regressive behaviors ( bedwetting, thumb sucking, baby talk) *during the first phase of placement children may behave well because they are in shock (honeymoon stage)

15 How to Help a Child in Denial Acknowledge the loss and let the child know its ok to talk about it when they are ready. Make yourself available to the child Answer the child s questions honestly, in a way that will not create alarm/resentment Reinforce the security and safety of the child s new environment Show empathy to the child s loss of the parent Provide consistent nurturing in this new family setting

16 Feelings in the Anger Stage I I hate social workers, they don t t understand anything about my family Defiance Disrespect Fighting Apathy Hyperactivity Poor school performance/lack of concentration Regressive behaviors ( bedwetting, baby talk, thumb sucking) Reverting to the chaos of their life experience Tantrums behaviors designed to shock

17 Behaviors in the Anger Stage Defiance Disrespect Fighting Apathy Hyperactivity Poor school performance/lack of concentration Regressive behaviors ( bedwetting, baby talk, thumb sucking) Reverting to the chaos of their life experience Tantrums behaviors designed to shock

18 How to Help a Child Who is Angry Acknowledge the child s anger Validate the child s right to be angry Help a child to be in control of something positive Provide appropriate outlets to redirect negative behaviors LOOK for and praise positive behaviors

19 Feelings in the Bargaining Stage If I m I m allowed to go home, I ll I be the best kid. I ll I clean the house and get good grades Desire for control Unrealistic expectations/hope Guilt Blaming Anxiety

20 Behaviors in the Bargaining Stage Over-compliance (perfect child syndrome) Irrational thinking /wishful thinking Fantasizing Manipulating Obsessive behaviors Unexplained behaviors based on child s distorted thinking

21 How to help the Bargaining Child Acknowledge feelings of powerlessness, but reassure the child he/she will be safe. Reinforce the idea that adult problems are not the child s fault, and that he/she is not responsible for fixing the problem Try to identify the bargains the child is making (i.e. If I fail school, they ll send me back to my birth family) and redirect those Empathize with the child s grief about things not going the way he/she wants them to go Remind the child that he/she will have more control over things when older, but until then he/she should try to be a kid.

22 Feelings in the Depression Stage Sad/feeling empty Hopelessness Lonely/isolated Loss of interest Low self esteem Who is going to take care of me? I I want to feel wanted. Lack of regard for others Loss of faith

23 Behaviors During the Depression Stage Listlessness/Fatigue Flat Affect Withdrawal Somatic complaints Changes in sleeping and eating patterns Poor grades Suicidal ideation, expression, or attempt Self-injurious behaviors (substance use, cutting, sexual acting out/promiscuity, etc.)

24 How to Help Children in the Depression Stage Express genuine unwillingness to give up on them Continue inviting child to engage with family and in positive activities Validate child s feelings, but offer support and encourage positive thinking Don t take things personally Seek professional help if necessary to determine if this is part of the grief process or an indication of another disorder.

25 Feelings in the Acceptance Stage I m m in this home it it s s not my home, but I m I m safe. I I may never meet my birth family, but I have a forever family. Belonging Resolved to the current situation Able to cope with the pain of loss Hopeful for the future Returning sense of strength and motivation Positive self-worth/self-esteem Emerging sense of peace about the past

26 Behaviors in the Acceptance Stage Re-engagement in positive activities Healthy sleeping and eating routines Responsiveness to the family system and leadership of parents (structure, rules, etc.) Interest in creating and maintaining positive relationships Playfulness Making efforts to improve (school, sports, etc.) Seeking comfort in new attachment figures Use of healthy coping skills

27 How to Support Child s Acceptance Validate the child s journey Give child permission and opportunity to enjoy themselves Continue to provide the parental guidance and structure that the child needs Build upon the child s accomplishment to encourage confidence in meeting new challenges.

28 What Happens if a Child is Unable to Grieve? May develop extreme anger and control problems Might not learn to trust Might lack ability to give and receive affection

29 Obstacles to Facilitation of Grief Process Being told how they should or shouldn t feel Parent/Caregiver taking things personally Loss not being acknowledged Telling the child You must be strong and get on with life Setting time frames Repetitive losses

30 Things to Remember Parent s mindset must be unconditional and not reactive Children may revisit stages of grief when triggered by things such as birthdays, anniversaries, holidays, court dates, visits, season changes, etc. Children need permission to remember lost loved ones (pictures, life books, mementos, rituals). Each child s ability to be resilient is unique to the child and each child grieves differently.

31 Remember: Parents Grief May Be Infertility Issues Triggered Too..... Foster child reunited with birth family Heartache for the grieving child Past loss of their own loved ones Divorce or failed relationships Previous trauma Problems with family of origin

32 Especially for Foster Parents Be clear in your intentions about fostering and supporting permanency for the child Grief will occur/you may experience the stages of grief when the placement ends It is important to connect with the child while preparing for the reality that the child may move on. Do not talk in front of the child about your concerns about reunification You can be a positive role model for coping with loss for your child

33 How to Take Care of Yourself When Supporting a Grieving Child Don t take the grief personally Be willing to reframe the child s behaviors in terms of dealing with his/her loss Develop your own support system of trusted people to help separate your own feelings from the child s Address your own grief triggers with professional support if needed.

34 What Have We Learned Identified two types of loss (maturational & situational) Explanation of how children experience the stages of grief, their feelings, their behaviors Discussed how parents can help children in these stages Emphasized need for parental self care, fostering or adopting

35 References Adopting the Hurt Child by Dr. Gregory Keck and Regina Kupecky Institute for Attachment and Child Development in Colorado When Children Grieve by John W. James and Russell Friedman Helping Children Cope with Separation and Loss by Claudia Jewett Jarratt

36 Where to Get More Information Where to Get More Information Books Trainings Institute for Attachment and Bonding Attachment and Bonding Center of Ohio Attachment and Bonding Center of Atlanta Center for Attachment and Family Development APAC