interaction and communication within the family, stability of family life after the loss, how the needs for sustained care are met, availability of opportunities to share and express feelings and memories, parental styles of coping with stress, and the availability of consistent relationships with other adults (DeSpelder & Strickland, 1996; Fitzgerald, 1992).
Tasks of Grieving
Although children must work through the same tasks in the bereavement process as adults, the progression differs depending on the child's developmental stage (Schoeman & Kreitzman, 1997). Although several researchers have proposed tasks and stages of grief, I will highlight just one model that has wide acceptance and has been specifically applied to children's grief. Worden and Silverman (1996) assert that the normative grieving process for children incorporates specific tasks associated with common responses to loss over time. In their model, children must complete four tasks in order to experience reintegration and adaptation to the loss.
The first is to accept the reality and permanence of the loss. To accomplish this, children need accurate information about the death so they can avoid "magical thinking" or filling in the gaps with misinformation (Lampton & Cremeans, 2002). Emotional recognition and acceptance of the loss are very difficult; the process involves full recognition that the lost one will not return.
Next, children must experience the pain and the emotional aspects of the loss. Intense emotions of sadness, despair, anger, guilt, fear, loneliness, shame, and jealousy may all be part of this experience. Initially, these painful feelings may be constant. Later, they may become sporadic or intermittent, but they can surface at unexpected times, causing the child to feel out of control. Eventually, these feelings become less frequent and may be experienced mostly during anniversaries of the loss, holidays, and special events (e.g., the birthday of the lost one).
The third task is adjusting to life without the loved one. How difficult this will be depends on what the relationship between the child and lost parent was and the amount of disruption in daily life the child experiences due to the loss. The opportunity for a child's personal growth is perhaps most clearly seen in this part of the grief work.
Finally, the child must convert the relationship with the deceased from one based on continuing interactions to one based on memories. Children gradually withdraw emotional energy from the loved one and focus on establishing new relationships with others. The work of this task has been described as being able to say a final farewell to the dead person. This does not mean giving up memories; rather, this farewell releases a central attachment to the dead person so that more room and energy are available for engaging in life in the present.
Ultimately, the process outlined in this model is characterized by reconciliation, which is defined as the "process that occurs as the bereaved child works to integrate the new reality of moving forward in life without the physical presence of the person who died" (Cohen, Mannarino, Greenberg, Padlo, & Shipley, 2002, p. 309). Although most children are able to cope with the normative grieving process without complications (Boelen, van den Hout, & van den Bout, 2006; Bonanno, 2004), some who cannot successfully address these tasks may suffer complicated grief.
PARENTAL BEREAVEMENT IN CHILDHOOD
A review of the literature consistently indicates that bereavement in children is significantly related to depressive symptoms, withdrawal, and academic problems (Wolchik et al., 2006). Parental death involves a series of stressors that may affect numerous aspects of the life and functioning of children, such as a decrease in economic resources, changes in residence, loss of contact with peers, increased expectations and responsibilities, loss of time with the surviving parent, and a change in caretakers and the family system (Wolchik et al., 2006). As a result, bereaved youth report more depressive, anxious, and dis