ive 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 (Sandler, 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.
The treatment of childhood grief presents unique challenges for both counselors and family members because the nature of the grieving process is different for children than for adults. Children understand grief differently than adults because their cognitive ability to grasp and cope with loss is still developing (Schoeman & Kreitzman, 1997); they do not react to loss in the same ways as adults (O'Toole & Cory, 1998). With limited capacity for abstract thinking, children may not fully comprehend the concept of death or understand the permanence of the loss; thus, they may not display their feelings as openly as adults.
Although the death of a loved one causes emotional trauma for children, their grief reactions may differ from the emotional responses typically seen with adults. The primary difference is that intense emotional and behavioral expressions are not continuous in children (Corr, Nable, & Corr, 1997). Rather, their grief reactions may appear more intermittent and brief than those of adults, yet the grief usually lasts longer than its behavioral expression (Fitzgerald, 1992; O 'Toole & Cory, 1998). Families often incorrectly interpret this behavior to mean the child does not really understand the loss or has already gotten over the death.
Grief reactions are intermittent because children cannot thoroughly explore all their thoughts and feelings rationally as adults can (Corr et al., 1997). A variety of emotional reactions can be expected from a grieving child, among them numbness, disbelief, yearning, anguish, anger, and guilt (Lampton & Cremeans, 2002). Children often have difficulty articulating their feelings about grief; thus, it is through their behavior that they may evince strong feelings of anger and fear of abandonment or death (O'Toole & Cory, 1998). Rather than outwardly expressed emotions and withdrawal from daily activities, grief reactions in children may manifest in psychosomatic symptoms, temper tantrums, academic failure, and other seemingly unrelated behaviors.
Bereaved children also tend not to withdraw into preoccupation with thoughts of the deceased person as adults can; instead they often immerse themselves in activities and games as a way of working out their feelings and anxieties (Corr et al., 1997; O'Toole & Cory, 1998). Play, drama, art, school work, and stories also give them opportunities to express feelings (Goldman, 1998).
Although loss is a highly individualized experience, children's grief reactions may be influenced by their age, personality, stage of development, previous experiences with death, type of relationship with the deceased, environment, the cause of death, patterns of 