Academic journal article Journal of Mental Health Counseling

Promoting the Adjustment of Parentally Bereaved Children

Academic journal article Journal of Mental Health Counseling

Promoting the Adjustment of Parentally Bereaved Children

Article excerpt

The death of a parent is' one of the most stressful life events to encounter during childhood. Given its detrimental impact on psychological development, a better understanding of outcomes associated with childhood bereavement and factors that affect these outcomes is necessary. The adjustment of bereaved children is linked to such factors as age of the child, sex of child and parent, circumstances of parent death, and the adjustment of the surviving caregiver. In this article I highlight considerations that may increase children's positive adjustment to parental death and also discuss specific treatment recommendations.

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About 2.5 million (3.5%) of children in the United States will lose a parent before the age of 18 (Social Security Administration, 2000). Parental death has been found to have an impact on both short- and long-term psychological adjustment, and ensuing psychological difficulties can be largely attributed to the quality of care children receive after the loss (Tremblay & Israel, 1998). Although most children who experience the death of a parent are thought to adequately adjust within one year (Worden & Silverman, 1996), a number of them experience significant depressive symptoms, social withdrawal, and academic difficulties long after the death (Cerel, Fristad, Veducci, Weller, & Weller, 2006). Improving the psychological adjustment of children who have lost parents is an important goal for counselors because parental death affects so many aspects of children's lives and functioning (Wolchik, Tein, Sandler, & Ayers, 2006).

Mental health difficulties following the loss of a parent are a function of both individual and family variables and environmental processes (Lin et al., 2004). Parental death is a traumatic event for children not only because of the actual loss of the parent but also due to the changes it causes in multiple domains of children's lives. Most researchers conceptualize parental death as a series of stressors related to a decrease in economic resources, change in residence, less contact with friends and neighbors, increased responsibilities, and loss of time with the surviving caregiver (Wolchik, Ma, Tein, Sandler, & Ayers, 2008). Parental death may also introduce stressors that limit the surviving caregiver's ability to provide a stable environment, consistent discipline, adequate warmth and support, and open communication with the child (Wolchik et al., 2006).

As a result of the bereavement, children may develop a variety of mental or physical complications. Bereavement in children has been associated with more frequent anxious and disruptive behaviors consistent with depression and conduct disorder (Thompson, Kaslow, Kingree, King, Bryant, & Rey, 1998).

Skinner and Wellborn (1994, 1997) suggest that parental death threatens the ability of children to meet needs for relatedness, competence, and autonomy. Further, stressors that accompany the loss of a parent may hinder satisfaction of the basic needs of positive self-worth, social relatedness, and control (Sandier, 2001). Sandler suggests that fulfillment of these basic needs is likely to promote a child's process of redefining and reintegrating oneself into a life without the physical presence of the person who has died. As a child navigates the grieving process and reintegration occurs, painful feelings decrease and recurring thoughts about the deceased are less intrusive and dominant (Shear & Shair, 2005).

The death of a parent is not an isolated trauma for children: parentally bereaved children re-experience aspects of the loss throughout their life (National Cancer Institute, 2008). The long-term effects from parental death are an important consideration for counselors. Adults who were parentally bereaved as children may present with issues that are not directly linked to but have been influenced by their loss. The Harvard Child Bereavement Study (Silverman & Worden, 1992; Worden & Silverman, 1993, 1996) documented how parental death can have a continuing impact on adult survivors. …

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