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December 1, 2017
Vol. 75
No. 4

Helping Students Grieve

Social-emotional learning
Engagement
The 3rd graders were reading Because of Winn Dixie by Kate DiCamillo. The students found much in common with the book's protagonist, Opal, whose mother left the family when Opal was three years old. In a carefully facilitated discussion, one student quietly told her teacher and classmates, "My mama left me, too." The sadness in this comment, and the teacher's ability to make a space in the classroom for speaking about loss, sparked a flood of stories from other students who spoke about the death of parents, siblings, or grandparents; experiences of divorce and separation; the car accident that took the life of a beloved pet; having a best friend move away.

Students Face a Variety of Losses

Educators regularly come face-to-face with the tragedies and emotions their students experience. Statistics show that children are dealing with more loss than ever before, especially due to increases in divorce and job-related migration.
Common disruptions in the relational fabric of a young person's life can affect students' social and emotional well-being and have implications for learning (Mauk, 2011). In this article, I outline the social, emotional, academic, and behavioral consequences that often follow significant loss for children and adolescents, and what schools can do to assist grieving students.
First, let's look at the kind of losses our students know. The death of a family member, divorce and separation, the loss of community and cultural ties experienced by immigrant and refugee children, ruptures in peer relationships, moving or changing schools, and the unpredictability and disconnection that comes with parental mental illness and addiction are a few of the losses children experience. Approximately two million children experience the death of one or both parents by the age of 18. Children and adolescents who lose a parent might struggle in ways that resemble clinical depression, even when bereavement is "uncomplicated." And the risk of serious mental health problems is greater when children experience a loss in violent conditions or alongside other life-altering conditions, such as domestic violence or poverty (Mannarino & Cohen, 2011).

An "Endemic Lack of Training"

In a 2012 survey, the American Federation of Teachers found that 92 percent of school staff members surveyed agreed that childhood loss and grief is a serious problem that requires more focus and resources to prevent mental health problems with potentially serious consequences. Yet only 7 percent of the educators surveyed had received training in identifying vulnerable students and how to respond. The report concluded that there was an "endemic lack of training," but an "overwhelming interest" among educators in doing more for grieving students.
Without proper training, educators are cautious. They want to avoid doing harm by bringing painful stories into the classroom. In an interview with Scholastic Teacher, pediatrician David Schonfeld noted that while we might fear we will say the "wrong" thing, saying nothing "communicates to children that you are unaware or unconcerned about their loss, or that you are unable or unwilling to help them" (Borris, 2015, p. 42). When educators have information about the emotions that accompany grief, support from their administrators, and strategies on how to respond, they can help grieving students—who are often ready to be guided into these tender places.

The Complex Terrain of Grief and Coping

Trauma often accompanies the losses students navigate, especially when the loss is sudden or violent. But trauma, with the accompanying deeply disturbing fear and hypervigilance, can be present even when the loss is anticipated. Children frequently believe they caused something bad to happen, or that they failed to do something that could have prevented the loss.
Losses can multiply. Death and divorce are often preceded by a period of instability, followed by significant disruption in a child's life, such as having to move away. For some children, the worry about who will take care of them is very real. Parents who lose a partner, a child, or close family member are often bearing so much pain that they aren't able to be fully available for their children. And frequently, children "protect" their parent by not revealing their level of distress.
The intensity or range of feelings a child experiences, how that child thinks and acts, and even the length of grieving time are influenced by circumstances, such as age and development, how the loss happened, the relationships that children had, previous losses, resources the student and family have available, and personal resilience (Webb, 2011). Regret, guilt, anger, fear, and pain can surface and become hard to manage.

Gabriella's Story

Gabriella's brother died of a brain tumor when she was 13 and he was 10. Members of her church and some school staff and friends attended the funeral, and the support they offered was comforting. Afterwards, home felt eerily quiet without the daily visits to the hospital, phone calls with medical providers, and communication with extended family members. Gabriella knew her parents were distraught and exhausted, but she desperately wished they could assure her that everything would be OK. The gnawing sense that things would never be OK sometimes overwhelmed her. She often wished she had been nicer to her brother and regretted not saying how much she loved him.

At first, when Gabriella returned to school, everyone seemed to treat her differently but, soon, everyone just kept moving along as though nothing happened. In her life, everything had changed. She was uncomfortable when someone mentioned her brother's death but, simultaneously, felt desperate for someone to talk to. She tried to keep up with her school work and after-school activities, but three months after her brother's death, she began to be sick more often, missing days at school. Gabriella had trouble concentrating and wasn't turning in homework. She even decided to drop favorite activities and didn't sign up for spring sports.

Gabriella had always struggled to express herself (in fact, she'd envied her brother's ease with words). Now when someone asked her how she was doing, she'd just say, "All right." She didn't know how to speak about the chaos she felt inside.

Note: Names and circumstances have been changed to protect confidentiality.

According to the American Academy of Child and Adolescent Psychiatry (2013), children devise particular behaviors as a way to cope with grief. They may cling to adults, ask persistent questions, not want to be alone, act or talk younger than they are, show a desperate wish to talk to the person that died, act or speak like the deceased or missing person, or show careless or risky behavior. Students of all ages may show physical signs of distress like heaviness in the chest, stomach pain or nausea, headaches, loss of appetite, sleep problems, nightmares, persistent tiredness, or restlessness. Cognitive troubles—like forgetting or having difficulty concentrating—and emotions like loneliness (or wanting to be left alone), and intermittent intense pangs of grief are common. There may also be a sense of precarious instability or fear that another tragedy is about to happen.

Identify Vulnerable Students

Feelings, behaviors, and symptoms can come and go. There may be good days and bad, and an on-and-off sense of being "stuck" in grief. Sometimes children and adolescents show remarkable resilience at first, and then the ordinary tasks of life become unbearable months later. The American Academy of Child and Adolescent Psychiatry (2013) outlined warning signs that indicate the need for increased mental health intervention:
▪ Persistence or intensification of any of the symptoms named above.
▪ An extended period of listlessness in which the student loses interest in daily activities.
▪ Statements of wanting to join the dead person.
▪ Withdrawal from friends and family members.
▪ A sharp drop in school performance or refusal to attend school.
▪ Increased risk-taking behavior.
As with any risk to mental health, some factors place students at higher risk of "childhood traumatic grief," (Mannarino & Cohen, 2011). Students who start out with a weak safety net or those with difficulty socializing with peers will need increased support. Higher risk students will also include those who have extra stressors at home, such as substance abuse, homelessness, poverty, parental depression, uncertain immigration status, previous traumas or violence in the home or neighborhood, and stigma associated with the cause of death.
To respond effectively, we need to keep in mind the particular needs of students with disabilities, students in foster care, military families, and families who experience prejudice based on various "differences." The ideal scenario would be to identify students at risk before a loss occurs and then help them to build resilience by strengthening their social and personal assets. This goes a long way in preventing prolonged and debilitating disturbance.

How to Create a Safe Harbor

Our aim should be to hold a space open for grief and become a calm witness to the student's suffering. There is no "best" or "normal" way to grieve. There are, however, many ways we can help children and adolescents work through their own unique processes so grieving does not become a serious long-term mental health issue. For example, if a student doesn't want to talk one-to-one, facilitate group support; if a student prefers activity, physical education, sports, art classes, or service projects can be intentionally designed to help a struggling student.
Consider cultural traditions and norms in each of the strategies listed below. Our manner of speaking and acting—and what we might look for in the child's way of grieving and coping—will depend in part on the cultural context of the child's life. And interventions and resources, such as books and handouts, should always reflect the diversity in our schools.

Whole-School Strategies

Let's look at how whole-school and one-to-one strategies can help children cope with loss.

Build a Library of Resources

Books and other media on topics of loss and grief should be visible and available to students, staff, and parents. Several organizations offer lists of vetted books that pertain to loss. Some supply suggestions for how to bring up these issues respectfully, stimulate discussions, lead activities focused on loss, or just respond in ways that help a grieving student. The National Association for the Education of Young Children has an excellent list of picture books on death and dying. What's Your Grief, a website run by two mental health professionals with decades of experience in grief counseling, has a blog that highlights resources to be shared with students, such as "grief journals" or workbooks that help young kids get through loss. Other groups that share book lists and resources are the National Association of School Psychologists and the Safe Crossings Foundation.

Structure Communication Across Roles—and Partner with the Community

Create protocols for how adults with different roles in the school community can collaborate with one another on behalf of students who are grieving. Teachers, school nurses, administrators, and school counselors should consult with one another when a student experiences a significant loss, so they can identify vulnerable students and offer a preventive response—or, if necessary, a more urgent mental health intervention.
Community mental health agencies, spiritual communities, and hospice agencies all have professional staff who are invested in our students' well-being, so partnering with such a group expands the help we can give. When partnerships form, it's key to introduce community partners to all school staff and explain their role. Strong community alliances enable schools to make appropriate referrals and bring therapeutic expertise into the school to provide services to students in need.
Such professionals can also provide professional development on dealing with grief, which should be offered to school staff annually. Invite everyone to participate—teachers' aides, administrative assistants, custodians, librarians, coaches, and cafeteria staff.

Develop Bereavement Groups

At first, students might be reluctant to attend a bereavement group. But, over time, bereavement groups, if run well, can become a welcome way for students to meet with other students who have experienced a painful loss. Groups can be co-led by school counselors and a community partner. Enlisting the help of an older student who has been through a healthy grieving process can be very effective.
For example, one school brings together older and younger students in mentoring pairs and in groups. Sometimes mentoring matches are made because both the older and younger student each experienced a significant loss. Teen mentors played a significant role by helping younger students feel less alone with their suffering. Older students can lead group activities, such as experiential challenges like rock climbing, to build a sense of connection, competence, and courage.

Make Loss a Whole-School Concern

Educators throughout the school can integrate lessons on death and dying into the curriculum. Social studies classes can learn about the way different cultures and religions understand death. Advisories and health classes are ideal locations for "wellness modules" that deal with grieving and other social-emotional health issues.
In one K–8 school, students designed small pieces of cloth in an art class and wrote sentences beginning with "I miss" or "I hope" on the squares. Students gathered outside to read their statements and hang their work on a wooden trellis. The pervasiveness of loss of one kind or another was evident as each student spoke about losses and hopes ("I hope my grandpa gets better." "I miss my dog. He was my best friend").
Such strategies can be especially healing when a loss has affected the whole school or community: When death touches the whole school, people grieve both privately and publicly. We can anticipate grief responses from staff and students who were close to the person—or people—who died but, frequently, students who were not close will also be deeply affected because the death triggers emotions from other losses. We must be fair and consistent in how we respond to each death. Circumstances vary, and there may be reasons for responding to deaths in differing ways (such as a violent death compared with a death from cancer), but students will be sensitive to the ways people speak about and respond to the death of a student or staff person. In one school, for example, some students were angry when an assembly was held for one student but not another. Decisions about assemblies, memorial sites, and school announcements must be made with no moral judgment, in a way that respectfully and equally honors each life. It will be important for students to understand the reasons for differing responses (for example, "We must honor the wishes of the family to maintain privacy around their son's death.") In many circumstances, it's good to involve students in decisions about how to memorialize a classmate or teacher.

Classroom and One-to-One Interventions

The best interventions that help a student cope with—or heal from—a death let that student know it's OK to talk about loss and to either affirm their emotions or accept their choice not to talk. Students are quick to pick up on the imagined or real caution of others who don't want to talk about death, and they comply by hiding their feelings and, consequently, become more isolated. Conveying, "I know this is very hard, and I am here for you if you want to talk," can ease things even if the student doesn't come to talk. And when a student wants to talk, our most essential role is to listen.
It's important, too, to keep lines of communication open with families and share ideas. Many parents are eager for ideas and support as they learn to navigate their own grief and search for ways to help their children. Parents also offer important information about their child.
Other strategies that help reach one student at time include the following:

Read and Discuss

Classroom discussions about grief-related readings help build community and lessen the sense of isolation. With interactive journaling on questions relevant to the reading, teachers can express caring thoughts and encouragement privately to students. In their journals, students may share what they are experiencing in a deeper, fuller way, and they appreciate compassionate, brief responses that acknowledge their loss outright. In teachers' written responses to students' journal entries, it's effective to communicate openly and without assumptions, with sincere interest in the bereaved child's unique experience. Students will grieve on their own timeline, however. It's wise to follow their lead.

Cultivate Go-to People

A mentor-rich environment in school will give students access to a trusted adult or older student to go to when they need to talk. Educators in a variety of roles are often willing to become that "go-to" person. The best matches are made with student input on who they would be most likely to go to for support. Near-peer and adult mentors need training and regular, consultative check-ins on how matches have worked out. Emphasize listening, expressing care appropriately, and knowing when to refer.
In middle and high school grades, peers are a terrific but underutilized resource. Friends often want to help, but are unsure what to say or do. With information and coaching, friends can be a significant source of comfort for grieving students.

Build Resilience

When we listen for resilience, we pay attention to children and adolescents' self-preserving strategies. What are they drawing strength from? What do they find helpful or unhelpful, and why? Often, behaviors that seem counterproductive are aimed at achieving something important. To foster resilience, talk with students about what they hope their actions will do for them—and if those actions are problematic, help students find alternative ways of achieving that goal.
It's important for adults to foster our own resilience as well. Being present for struggling students takes a toll, especially when the losses of our students trigger painful losses of our own. We need to be generous with our own self-care and get help when we need it.
Perhaps the most important—and relatively simple—strategy is to check-in regularly: Above all else, grieving children need to know that someone sees them and knows they are suffering. For a long time after a loss, important life events, such as graduations, proms, and special accomplishments, are especially poignant when a friend, parent, or sibling is missing from these events. Expressions of care recognize that the loss matters.
References

American Academy of Child and Adolescent Psychiatry. (2013). Facts for families: Grief and children, Number 8.

American Federation of Teachers. (2012). Supporting the grieving student.

Borris, C. (2015). Coping with grief in the classroom. Scholastic Teacher, 42–43.

Mannarino, A. P., & Cohen, J. A. (2011). Traumatic loss in children and adolescents. Journal of Child and Adolescent Trauma, 4(1), 22–33.

Mauk, G. W. (2011). Loss-oriented support for students (LOSS): Companioning the journey from yesterday's sorrow to tomorrow's hope. The Clearing House, 84(3), 104–108.

Webb, N. B. (2011). Play therapy for bereaved children: Adapting strategies to community, school, and home settings. School Psychology International, 32(2), 132–143.

Donna Marie San Antonio is associate professor of counseling and psychology at Lesley University. She has previously taught middle school and been a school counselor. She is a consultant with schools and community programs, addressing social and emotional supports for children and youth.

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