Author: Howarth, Robyn A
Date published: January 1, 2011
About 2.5 million (3.5%) of children in the United States will lose a parent before the age of 1 8 (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 (Cerei, Fristad, Veducci, Weiler, & 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 (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 adu