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Linder L, Lunardini M, Zimmerman H. Supporting Childhood Bereavement Through School-Based Grief Group. OMEGA-JOURNAL OF DEATH AND DYING 2024; 89:741-758. [PMID: 35357962 DOI: 10.1177/00302228221082756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
With 7.3% of children under the age of 18 experiencing the death of a parent and more who experience a loss of a loved one bereavement is a common experience in the lives of children and youth. The current study sought to evaluate the effectiveness of an 8-week, school-based grief group treatment program in reducing symptoms of grief, dysregulation, and improving social support. A total of 296 children and youth (age 11-18) participated in the grief programming provided by a local hospice agency. With a retention rate of 76% the researchers identified a significant reduction in grief symptomology, frequency of emotion dysregulation, and a significant increase in perceived social support from pre- to post-8-week school-based grief programming. A reduction in intensity of dysregulation was not significant. Implications for school personnel and parental support of children and youth experiencing loss are discussed.
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Affiliation(s)
- Lisa Linder
- San Diego State University, San Diego, CA, USA
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2
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Divakar A, James K, Mayorga A, Michelson KN. Availability of bereavement support following traumatic pediatric death in a large metropolitan area. DEATH STUDIES 2023:1-9. [PMID: 36708153 DOI: 10.1080/07481187.2023.2170492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Following an unexpected pediatric death, survivors undergo unique trauma. Medical examiners (MEs) evaluate most of these deaths. We evaluated the bereavement support available to survivors in the Chicagoland area following a pediatric death. We had two goals: to characterize the available bereavement support options and compare the locations (by zip code) of support groups with the locations (by zip code) in which pediatric ME cases occurred. We identified 48 organizations that provided bereavement support services at 74 locations in the summer and fall of 2020. Locations by zip codes in which the largest number of ME cases occurred did not have support groups. Locations in which more ME cases occurred generally had lower-income populations and a greater proportion of Black or Hispanic residents. Bereavement support following pediatric death is inadequate and unevenly distributed across the Chicagoland area.
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Affiliation(s)
- Annika Divakar
- School of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - K James
- Greater Illinois Pediatric Palliative Care Coalition, Chicago, Illinois, USA
- Missing Pieces, Chicago, Illinois, USA
| | - A Mayorga
- Cook County Medical Examiner's Office, Chicago, Illinois, USA
| | - K N Michelson
- School of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Missing Pieces, Chicago, Illinois, USA
- Critical Care, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
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Cutrer-Párraga EA, Cotton C, Heath MA, Miller EE, Young TA, Wilson SN. Three Sibling Survivors' Perspectives of their Father's Suicide: Implications for Postvention Support. JOURNAL OF CHILD AND FAMILY STUDIES 2022; 31:1838-1858. [PMID: 35611068 PMCID: PMC9120346 DOI: 10.1007/s10826-022-02308-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/27/2022] [Indexed: 06/15/2023]
Abstract
This qualitative case study describes three adult siblings' experiences and their perceptions of support connected with the time before and after their father's suicide. At the time of the suicide, participants were ages 1, 5, and 8 years old. We considered commonalities and disparities among the three survivors' perceptions. We also considered how their reported experiences compared to extant literature on child survivors of parent suicide. Our findings suggest that, although the siblings experienced the same traumatic event, each had unique perceptions of the parent's suicide. Immediately prior to closing each interview, to deescalate from the intense topic of suicide, participants offered their impressions of potentially therapeutic children's books and how bibliotherapy may or may not support surviving children. Participants' perceptions of selected children's picture books offer insights about opening communication and addressing challenges specific to a parent's suicide. Implications for teachers, parents, and school-based mental health professionals are provided. We conclude that postvention must consider and monitor each child's perceptions and provide individualized interventions that encourage open communication and support adaptive coping to navigate the intense grief associated with a parent's suicide.
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Affiliation(s)
- Elizabeth A. Cutrer-Párraga
- Counseling Psychology & Special Education, McKay School of Education, 340 MCKB, Brigham Young University, Provo, UT 84602 USA
| | - Caitlin Cotton
- Spectrum Academy, 867 S 800 W, Pleasant Grove, UT 84062 USA
| | - Melissa A. Heath
- Counseling Psychology & Special Education, McKay School of Education, 340 MCKB, Brigham Young University, Provo, UT 84602 USA
| | - Erica E. Miller
- Counseling Psychology & Special Education, McKay School of Education, 340 MCKB, Brigham Young University, Provo, UT 84602 USA
| | - Terrell A. Young
- Teacher Education, McKay School of Education, 205-F MCKB, Brigham Young University, Provo, UT 84602 USA
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Ridley A, Revet A, Raynaud JP, Bui E, Suc A. Description and evaluation of a French grief workshop for children and adolescents bereaved of a sibling or parent. BMC Palliat Care 2021; 20:159. [PMID: 34649560 PMCID: PMC8518298 DOI: 10.1186/s12904-021-00861-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 09/24/2021] [Indexed: 12/04/2022] Open
Abstract
Background Childhood bereavement is common, and is associated with elevated symptoms of grief with distress and impairment. However, few developmentally appropriate interventions to support grieving children are available to date. In Toulouse, France we developed an innovative four-session group intervention to support grieving families and evaluated its feasibility and acceptability. Methods The workshop consists of four sessions over 4 months, open to children bereaved of a sibling or parent, and co-facilitated by two mental health professionals. After an intake assessment, children were placed into closed groups according to age and relation to the deceased. The session content was balanced between creative activities and grief-related discussions. Overall satisfaction was evaluated in March-April of 2020 by an 8-question online survey of children and parents having participated between 2011 and 2019. Freeform commentaries were analysed using the thematic synthesis process. Results Of the 230 emails sent in March 2020, 46 children and 81 parents agreed to participate (55% response rate). The families reported an overall high level of satisfaction regarding the intervention that was rated as good to excellent. A majority of respondents considered their participation in the workshop helpful and in accordance with their expectations. Most would recommend the workshop to a friend, and would participate again in the group if needed. The group intervention helped reduce social isolation, facilitated grief expression, and supported the creation of a sense of community among bereaved families. Conclusions Encouraging community and mutual support among grieving families is fundamental in bereavement care. Our four-session workshop held over 4 months and led by mental health professionals aimed to help reduce social isolation and foster coping skills through artistic creation and group discussion. Our results highlight the potential need for family bereavement support over a longer period and a provision of a variety of services. Our intervention model is feasible for families, and further studies examining its efficacy are warranted.
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Affiliation(s)
- Ashley Ridley
- Department of Paediatric Palliative Care, Toulouse University Hospital, Toulouse, France
| | - Alexis Revet
- Department of Child and Adolescent Psychiatry, Toulouse University Hospital, Toulouse, France.,Centre for Epidemiology and Population Research, University of Toulouse, Inserm, UPS, Toulouse, France
| | - Jean-Philippe Raynaud
- Department of Child and Adolescent Psychiatry, Toulouse University Hospital, Toulouse, France.,Centre for Epidemiology and Population Research, University of Toulouse, Inserm, UPS, Toulouse, France
| | - Eric Bui
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,University of Caen Normandy & Caen University Hospital, Caen, France
| | - Agnès Suc
- Department of Paediatric Palliative Care, Toulouse University Hospital, Toulouse, France.
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Goldberg JM, Duplechain AC, Fraser CE, Boles JC. An Interdisciplinary Hospital-Based Committee to Improve Pediatric Bereavement Care. Hosp Pediatr 2021; 11:1287-1294. [PMID: 34599017 DOI: 10.1542/hpeds.2021-005964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Although frequently overshadowed by adult mortality rates and bereavement care needs, the death of a child can significantly jeopardize the physical, psychosocial, and emotional health of surviving parents, caregivers, and family members. Unfortunately, researchers have only recently begun to explore the trajectory of pediatric bereavement care needs. As an ongoing public health concern, health care institutions and related organizations must partner with interdisciplinary care providers and bereaved families to design effective and sustainable bereavement supports in their communities. Therefore, the purpose of this article is to describe the development and accomplishments of an interdisciplinary bereavement committee at a children's hospital within an academic medical center. By relying on available empirical evidence and close collaboration with bereaved parent members, this effort has generated sizeable practice improvements and new service offerings within the organization, local community, and the individual patients and families the institution serves.
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Affiliation(s)
- Jessica M Goldberg
- Patient- and Family-Centered Care, Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, Tennessee
| | - Anne C Duplechain
- Patient- and Family-Centered Care, Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, Tennessee
| | - Camille E Fraser
- Patient- and Family-Centered Care, Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, Tennessee
| | - Jessika C Boles
- Patient- and Family-Centered Care, Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, Tennessee .,Department of Psychology and Human Development, Peabody College Vanderbilt University, Nashville, Tennessee
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Laabar TD, Saunders C, Auret K, Johnson CE. Palliative care needs among patients with advanced illnesses in Bhutan. BMC Palliat Care 2021; 20:8. [PMID: 33422058 PMCID: PMC7797114 DOI: 10.1186/s12904-020-00697-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 12/15/2020] [Indexed: 02/08/2023] Open
Abstract
Background Palliative care improves the quality of lives of patients and families affected by advanced illnesses through the prevention and relief of suffering. While palliative care is well established in developed countries, it is inadequate or non-existent in most developing countries. Palliative care is an emerging concept in Bhutan, a tiny Himalayan Kingdom. A small community palliative care service is available in the national referral hospital with three dedicated inpatient palliative care beds. This study explored the needs for palliative care among patients diagnosed with advanced illnesses and is a component of a larger project aimed to inform a suitable palliative care model for the country. Methods This is a cross-sectional descriptive study. A survey, using a structured questionnaire including the EORTC QLQ-C30, was carried out among patients with advanced illness in hospitals, primary care units and communities across the country. Purposeful and snowball sampling strategies were used to recruit study participants. Results Seventy (76%), out of 93 eligible patients, agreed to participate in the survey. Participants reported low to moderate scores on physical, role, emotional, cognitive and social functioning, a moderate score for the global health/ quality of life scale and moderately high (worse) scores in symptoms including fatigue, pain, insomnia, loss of appetite and the financial impact from the disease. Conclusions The symptom burden experienced by patients affected by advanced illnesses demonstrates the need for palliative care in Bhutan. These findings will help inform the development of a public health-focused palliative care model, modified to the Bhutanese context, as recommended by the World Health Organization.
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Affiliation(s)
- Tara Devi Laabar
- Medical School, The University of Western Australia, 35 Stirling Highway, 6009, Perth, Western Australia, Australia. .,Department of Nursing, Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan.
| | - Christobel Saunders
- Medical School, Surgery Division, The University of Western Australia, 35 Stirling Highway, 6009, Perth, Western Australia, Australia
| | - Kirsten Auret
- Rural Clinical School of Western Australia, The University of Western Australia, Science Building M701, 35 Stirling Terrace, 6330, Albany, Western Australia, Australia
| | - Claire E Johnson
- Medical School, The University of Western Australia, 35 Stirling Highway, 6009, Perth, Western Australia, Australia.,Monash Nursing and Midwifery, Monash University, 10 Chancellors Walk, Wellington Road, 3800, Clayton, Victoria, Australia.,Australian Health Services Research Institute (AHSRI), University of Wollongong, Building 234, Innovation Campus, 2522, Sydney, NSW, Australia
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Ridley A, Frache S. Bereavement care interventions for children under the age of 18 following the death of a sibling: a systematic review. Palliat Med 2020; 34:1340-1350. [PMID: 32807009 DOI: 10.1177/0269216320947951] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Childhood bereavement after sibling death is common, but often unrecognized. The psychosomatic and socioeconomic outcomes of bereaved children can be compromised if appropriate care is unavailable during the formative years leading into adulthood. AIM This review aims to describe the methods, structures and procedures of bereavement care for children and adolescents after the loss of a sibling, and the impact on the families benefiting from these interventions. DESIGN A systematic review without restriction on study design was conducted. DATA SOURCES Four databases (MEDLINE, PsycINFO, EMBASE, Cochrane Library) were searched for articles published from 2000 to 2019. The search was conducted according to PRISMA guidelines and the protocol is registered on PROSPERO under number CRD42019124675. Articles were assessed against eligibility criteria by both authors, and quality was appraised using CASP checklists and NHMRC grading guidelines. RESULTS Twenty-three studies met inclusion criteria. Bereavement care was most often accessed by children ages 6-18 who lost a sibling to cancer 6-12 months prior. The interventions were typically group sessions or weekend camps, run predominantly by unpaid staff from a variety of backgrounds. Some staff members received priori specific training. Grief education is taught through mediated discussion and bereavement-centered activities balanced with playful and relaxed activities. Several services have effectuated evaluations of their interventions, and preliminary results show a positive effect for families. CONCLUSION Existing literature most likely gives an incomplete picture of appropriate childhood bereavement care, and many interventions possibly remain unpublished or published in other non-scientific sources. An effective response to childhood grief would involve collaboration between medical resources and community services, reinforced through the development of outreach and training programs.
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Griffiths N, Mazzucchelli TG, Skinner S, Kane RT, Breen LJ. A pilot study of a new bereavement program for children: Lionheart Camp for Kids. DEATH STUDIES 2019; 46:780-790. [PMID: 31858883 DOI: 10.1080/07481187.2019.1702121] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
We assessed the acceptability and effectiveness of a new childhood bereavement service known as Lionheart Camp for Kids. Using a pre-post-follow-up design, data pertaining to 12 bereaved children (aged 5-12 years) and their primary caregivers were obtained. Results showed that caregivers reported decreases in children's peer relationship problems, improvements in parental consistency, and reductions in coercive parenting, and there was a trend toward lower self-reported grief by the children. Caregivers were highly satisfied with the program. There is a need for a wait-list or randomized controlled trial over a longer time period to determine the full benefits of the camp.
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Affiliation(s)
| | | | - Shelly Skinner
- Lionheart Camps for Kids, Perth, Australia
- Perth Children's Hospital, Perth, Australia
| | - Robert T Kane
- School of Psychology, Curtin University, Perth, Australia
| | - Lauren J Breen
- School of Psychology, Curtin University, Perth, Australia
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Dyregrov A, Dyregrov K, Pereira M, Kristensen P, Johnsen I. Early intervention for bereaved children: What mental health professionals think. DEATH STUDIES 2018; 44:201-209. [PMID: 30556790 DOI: 10.1080/07481187.2018.1531086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
People rarely specify what "early intervention" following bereavement means, so we explored the views of experienced professionals working primarily with bereaved children. In an anonymous online survey, 84 mental health professionals answered questions about the content and timeframe of early intervention. The types of interventions varied, but conversation and support were most frequent. Most considered early intervention to mean before or during the first month following the loss. Although meta-analyses show little benefit of early intervention, professionals disagree and see the need to tailor interventions to the type of death, the situation of the family, and the intensity of reactions.
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Affiliation(s)
- Atle Dyregrov
- Center for Crisis Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Kari Dyregrov
- Center for Crisis Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Mariana Pereira
- Center for Crisis Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Pål Kristensen
- Center for Crisis Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Iren Johnsen
- Center for Crisis Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
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Thienprayoon R, Alessandrini E, Frimpong-Manso M, Grossoehme D. Defining Provider-Prioritized Domains of Quality in Pediatric Home-Based Hospice and Palliative Care: A Study of the Ohio Pediatric Palliative Care and End-of-Life Network. J Palliat Med 2018; 21:1414-1435. [PMID: 29957100 DOI: 10.1089/jpm.2018.0056] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND In 2017, the Ohio Pediatric Palliative Care and End-of-Life Network (OPPEN) published nine domains of high-quality care for pediatric home-based hospice and palliative care (HBHPC). Eight domains established by the National Consensus Project (NCP) were validated for pediatric HBHPC, and a ninth domain of "Continuity and Coordination of Care" was added. OBJECTIVE The aim of this study was to establish definition criteria for each of these domains. DESIGN AND SETTING Using a modified Delphi technique, providers from the OPPEN were surveyed regarding definitions drawn from the NCP domain criteria. For the ninth domain, new definition criteria were generated de novo based on qualitative responses. RESULTS Definition criteria were established for the nine domains of quality in HBHPC previously identified. In the course of analysis, Bereavement Care was established as a 10th domain of quality, and definition criteria generated. CONCLUSIONS This is the first study to define domains of quality for pediatric HBHPC, and the second to leverage the infrastructure of a pediatric HPC statewide consortium toward this work. Future studies are needed to establish parent and patient-prioritized domains of quality in pediatric HBHPC, and to map indicators validated in pediatrics to these domains.
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Affiliation(s)
- Rachel Thienprayoon
- 1 Department of Anesthesiology (Palliative Care), Cincinnati Children's Hospital Medical Center , Cincinnati, Ohio
| | - Evaline Alessandrini
- 2 Department of Pediatrics, Cincinnati Children's Hospital Medical Center , Cincinnati, Ohio.,3 University of Cincinnati Health , Cincinnati, Ohio
| | - Millicent Frimpong-Manso
- 1 Department of Anesthesiology (Palliative Care), Cincinnati Children's Hospital Medical Center , Cincinnati, Ohio
| | - Daniel Grossoehme
- 4 Department of Pediatrics, Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center , Cincinnati, Ohio
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Griese B, Burns M, Farro SA. Pathfinders: Promoting healthy adjustment in bereaved children and families. DEATH STUDIES 2018; 42:134-142. [PMID: 29313796 DOI: 10.1080/07481187.2017.1370416] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Pathfinders is a 10-session program developed in a community setting to creatively address the diverse needs of bereaved children and families, prevent complications of grief and trauma, and promote healthy adaptation. It is an accessible, grief-focused and trauma-informed family systems model that is theory-driven, research-informed, and grounded in practice-based evidence. Pathfinders incorporates principles central to narrative approaches, with a focus on restorative processes for helping children and families stay on track developmentally. This article outlines the structure, process, and content of Pathfinders, including examples of creative interventions used within the program.
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Affiliation(s)
- Brook Griese
- a Judi's House and JAG Institute for Grieving Children and Families , Denver , CO , USA
| | - Michaeleen Burns
- a Judi's House and JAG Institute for Grieving Children and Families , Denver , CO , USA
| | - Samantha A Farro
- a Judi's House and JAG Institute for Grieving Children and Families , Denver , CO , USA
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