Foster Care Training Module

Foster Care Training Module Loss and Grief for Children in Care By Liz Crowe and Dr Judith Murray

Something to keep in mind • Loss and Grief as a topic can raise issues for us that we were not aware of. • If this talk raises emotions and issues for you, you are not alone • Grieving is a normal, natural process • It is really important that we are aware of our own loss and grief experiences before we try to work with or help others © Dr Judith Murray and Liz Crowe, The University of Queensland

Something to keep in mind • Loss and grief never completely ‘goes away’, it is an ongoing journey • Loss and Grief experiences become a part of our life story and therefore a part of who we are • Our own grief and loss experience will greatly influence how we deal with others in their loss © Dr Judith Murray and Liz Crowe, The University of Queensland

Before we get started • Foster care parents do not need to become specialized loss and grief 'counsellors' for children. • As Foster care parents you already have skills and knowledge. The most valuable resource you have is the relationship that you have with your foster child • The aim of the workshop is to give you some tools to recognise and assist children who are facing loss and grief. © Dr Judith Murray and Liz Crowe, The University of Queensland

Session One LOSS AND CHILDREN © Dr Judith Murray and Liz Crowe, The University of Queensland

Definitions of Loss What is loss? Loss is produced by an event which is perceived to be negative by the individuals involved and results in long-term changes to one’s social situations, relationships, or thinking. Miller & Omarzu (1998) (p. 12) © Dr Judith Murray and Liz Crowe, The University of Queensland

Definitions of Loss In other words: • Loss is any situation that happens that we don’t like or feel comfortable about. Loss changes the way things were and forces us to live differently. • Loss is a lot more than death, yet death is usually the only loss that gets us attention and sympathy. © Dr Judith Murray and Liz Crowe, The University of Queensland

Activity One • So we can start thinking about loss for children in care I would like people to just raise their hand if they have ever had any of these experiences. • Have you ever had to stay at someone else’s house: • Hated the pillow • Found the room really smelt differently • Couldn’t find the toilet in the middle of the night • Were still really hungry after you just ate • Hated the food • Wanted to turn a light on or off but were too scared to ask?. This is what a new fosterplacement may be like for kids. © Dr Judith Murray and Liz Crowe, The University of Queensland

Facts about children and loss • Children feel pain, sorrow and sadness. • You cannot ‘protect’ children from loss by simply not talking or reminding them about the issues or events • Babies, Children and Young people do not forget what has been lost no matter how much time passes. Though their understanding of the loss will change © Dr Judith Murray and Liz Crowe, The University of Queensland

How will loss affect children? • The Way the loss affects a child depends on: • What the loss was • The meaning of the loss for the child • What is the relationship to the lost object and what opportunity the child has to replace it • The Developmental level of the child • The Individual Personality of the child • Gender • The circumstances in which the loss occurred – was it expected or sudden? • Adults handling of the situation © Dr Judith Murray and Liz Crowe, The University of Queensland

What may affect the sense of loss of children in care? • The level of trauma attached to the loss • Depends on the significance of the people they have been separated from • Whether the separation is temporary or permanent OR how great the level of uncertainty around this issue is? • How well they know the people and place they have gone, eg. moved in with unknown foster parents vs relatives or friends • Previous life experiences • Support available • How the separation and placement is explained to the child © Dr Judith Murray and Liz Crowe, The University of Queensland

What do we know about loss and children? • Loss is a very personal and intimate experience for an individual • Only a child can decide what has been a loss experience for them. Their loss may not be what adults would expect. • Eg: A child who has been removed from the family home may be more sad about leaving the cat then their parents • Eg: A child who has been severely abused by their family may still want to live in that home and love their family very much. © Dr Judith Murray and Liz Crowe, The University of Queensland

What do we know about loss? • Dealing with loss is a very individual and at times a very lonely experience • Eg. Children in care may find it difficult to relate to other kids at school, children in care may feel they can trust no one with their fears and sadness • Losses rarely happen on their own • Eg. Mummy’s boyfriend hit me and I told my teacher, now I live somewhere else, go to a different school and Mummy is so angry at me she doesn’t talk to me anymore © Dr Judith Murray and Liz Crowe, The University of Queensland

What do we know about loss? • Children who experience loss remain a child all the same. Eg: Children don’t mature, think or become like adults just because of their experience Also no matter how obvious is the loss, never forget the child is still a child with other aspects to who they are. Try to not lose sight of the child inside amidst the chaos including the ‘magic’ of the child and the need for limits • Children are not illogical Eg: Children try to make sense of what is happening to them based on past experiences. “Police take away bad people. If a policeman takes me away from my family it is because I am a baddie” © Dr Judith Murray and Liz Crowe, The University of Queensland

What do we know about loss? • Loss becomes a part of us from the time we are born. Our loss history will become a part of who we are. Children in care are almost ‘trained’ to be guarded about new people and situations, they may find it hard to trust, attach, connect or love people as a result. • Children in care face many, ongoing losses. Children in care face many losses. The long-term effect of this may be obvious mental health and behaviour problems © Dr Judith Murray and Liz Crowe, The University of Queensland

Loss is a part of life There are many ‘normal’ losses that all children may encounter. Children in care will have to cope with ‘normal’ losses as well as other significant losses © Dr Judith Murray and Liz Crowe, The University of Queensland

Losses that any child may face • Developmental losses and changes • Weaning • Loss of a ‘comforter’, eg. sucking your thumb, bottle, dummy, lambie • Going from kindy to preschool and then primary to secondary school • Physical changes, eg. changes in the body at puberty, getting too big to be picked up © Dr Judith Murray and Liz Crowe, The University of Queensland

Losses that any child may face • General losses • Death of a family member, friend, teacher • Car accidents • Victims of crime – stealing, assault • Loss of a pet – death or runaway • Moving house • Favourite toys get broken or lost • Finding out Santa is not real • Failing school • Being ‘dumped’ by a boy/girlfriend • Being rejected at school © Dr Judith Murray and Liz Crowe, The University of Queensland

Session Two LOSS AND THE CHILD IN CARE © Dr Judith Murray and Liz Crowe, The University of Queensland

Activity Two • Break into groups • You have two tasks: • Write down what losses you think children in care have faced. • Write down what losses you think foster care families face when they take a child into their care. © Dr Judith Murray and Liz Crowe, The University of Queensland

“The foster care child is like a refugee, they are often travelling away from a situation of untold trauma, attempting to re-establish their lives in foreign places.” McIntosh (2003) p16 © Dr Judith Murray and Liz Crowe, The University of Queensland

Specific Losses for Children in Care • Loss of being with their Birth Parents and siblings • Loss of attachment to a primary carer • Loss of the ‘perfect’, ‘normal’ family • Being cut off from grandparents, cousins etc • Losing their own home, their own room and their own ‘things’ • Possible poverty © Dr Judith Murray and Liz Crowe, The University of Queensland

Specific Losses for Children in Care • Moved away from familiar streets, neighbourhoods & communities • Frequently moved into new Daycare/ Kindy / School • Removed from Friends • Not being able to have their Pets • Feel they have no home, no fixed address • Loss of educational opportunities © Dr Judith Murray and Liz Crowe, The University of Queensland

Specific Losses for Children in Care • Loss of participating in extracurricular activities, or no opportunity to do so • Fears about the future and leaving the care of foster care parents and the Department. • Little choice or consultation about decisions for their own lives • Feelings of no stability, everything is uncertain from day to day © Dr Judith Murray and Liz Crowe, The University of Queensland

Specific Losses for Children in Care • Loss of control and power, not only about what is happening to them but loss of control over their own behaviour is common. • Loss of identity and belonging • Loss of ‘life story’, what do you tell people about who you are and where you live? • Loss of identity © Dr Judith Murray and Liz Crowe, The University of Queensland

Specific Losses for Children in Care • Loss of being able to remember all the places you have lived, no one to recall when you first walked, lost a tooth or in who’s house it even happened • No history, no photos or special memories, no kept birthday cards or mementos etc • Loss of privacy – having everything you do recorded and discussed by many © Dr Judith Murray and Liz Crowe, The University of Queensland

Specific Losses for Children in Care • Loss of safety • Loss of the world they once knew • Loss of innocence • Loss of trust • Loss of hope that relationships and a home can last for them • Loss of ‘normal’ childhood and childhood experiences. THIS LIST IS ENDLESS! © Dr Judith Murray and Liz Crowe, The University of Queensland

Loss Messages • Loss has the potential to either cause: • GROWTH or • DETERIORATION • Children can experience growth when they are able to make sense and work through loss. • Children in care may find it difficult to ‘grow’ from loss as they also have so much pain and fear to deal with and when their environment is potentially damaging, new or constantly changing. © Dr Judith Murray and Liz Crowe, The University of Queensland

The Negative Messages of Loss • What sort of messages do these ongoing losses give to the child in care? • I am no good • Bad things always happen to me because I am bad • I am not wanted by anyone • Life sucks • If your parents can’t love you who can? • There is no point in going to school because I will never become anything If these are the messages kids hear,we can see what drives their behaviour! © Dr Judith Murray and Liz Crowe, The University of Queensland

The Importance of Positive Messages • How do we give children positive messages so they can take these into the future? • You are important to us • We are glad you are here and want you to stay • We want you to feel safe and secure • What happens to you matters • We have to be respectful of every child’s loss experience. We have to remember that loss can create who children are. © Dr Judith Murray and Liz Crowe, The University of Queensland

The Reality of the Loss • All foster children grieve what they have lost no matter how superior the foster care placement might be. • After a time foster children may come to idealise the home and parents (natural or foster parents) they left behind simply because of the accumulated losses that have followed. This may fill them with anger, longing and regret. © Dr Judith Murray and Liz Crowe, The University of Queensland

Loss forFoster Families © Dr Judith Murray and Liz Crowe, The University of Queensland

Loss and Grief for the Foster Carers • Foster Parents often ‘carry the grief’ of everyone involved • The grief of the parents whose child they are caring for • The grief of the child in their care • Loss of their own family life • Concerns for their own children • Their own grief upon losing a child to reunification with family or other placement • And the grief of other family members as a foster child leaves. Edelstein (2001) © Dr Judith Murray and Liz Crowe, The University of Queensland

Loss and Grief for the Foster Carers • Loss of Innocence: horrific stories of abuse • Loss of faith in people: all people are not good, people can hurt and fail to protect children • Loss of time: due to demands of a new child • Loss of knowing what’s happening in their own lives: foster kids come and go, biological parents ring, the Dept visits • Loss of own family routine, life, hobbies • Loss of time for their own children • Loss of foster child: when they leave the foster family © Dr Judith Murray and Liz Crowe, The University of Queensland

Loss and Grief for the Foster Carers • It can be hard for Foster Families to know what they have lost when: • Often the relationship with the foster child who is leaving has been challenging and hard work • They feel they are not allowed to be sad • They are so busy still caring for other kids and a household • Given they still have to worry about the wellbeing of everyone else in the house. (Edelstein 2004) © Dr Judith Murray and Liz Crowe, The University of Queensland

What is Grief? What Does Grief Look Like InChildren And Adolescents? © Dr Judith Murray and Liz Crowe, The University of Queensland

What is Grief? • Grief is the emotional, physical and behavioural reaction to loss. • Emotional: sadness, tears, anger, helplessness, guilt and despair • Physical : headaches, appetite changes or sleep disturbances etc. • Behavioural: lashing out in anger, withdrawing into silence and isolation, taking risks © Dr Judith Murray and Liz Crowe, The University of Queensland

Common Grief Reactionsin Children Important to note there is a wide variation in children’s reactions! © Dr Judith Murray and Liz Crowe, The University of Queensland

Immediate Grief Reactions • Shock and Disbelief • Distress and Protest • Apathy – not sure if they care • Continue as if nothing has happened – no obvious reaction © Dr Judith Murray and Liz Crowe, The University of Queensland

Anxiety Sleep Difficulties Sadness and Longing Anger and Acting out behaviour Guilt, blaming self School Problems/ Refusal Physical Complaints (sick) Bedwetting Fear of sleep and dark Clinging to Parents and Family Vivid Memories Grief Reactions following the loss © Dr Judith Murray and Liz Crowe, The University of Queensland

Less Common Grief Reactions • Intrusive and Vivid Nightmares • Regressive Behaviours • Social Isolation • Fantasies • Personality Changes • Pessimism about the future Dyregrov (1990) © Dr Judith Murray and Liz Crowe, The University of Queensland

Loss, Grief and Children • One of the biggest barriers for children and young people experiencing loss and grief is they may not have the language skills and words to tell us how they feel • Children may not have the emotional knowledge or experience to tie their feelings to words and behaviours. • Children are limited by their life experiences and their maturity in how they interpret what is happening © Dr Judith Murray and Liz Crowe, The University of Queensland

Grieving is a normal, natural process • Important to remember that grief is a normal and natural reaction to a loss • Going through grief helps anyone move from a state of significant disorganisation to a position of being able to move on with life • Children cope with grief differently to adults particularly in terms of self protection and their need to protect others (Baker, Sedney & Gross, 1992) © Dr Judith Murray and Liz Crowe, The University of Queensland

Grief Theories • Grieving then is this process of healing that can take time. We all know the experience intimately and many theorists have tried to put together models to explain it. Hence there have been many theories of grief and loss. Each tells a little more of the story of grief but none is definitive- there is no one theory of grief. Rather, by taking them together we start to piece together the complex human experience that each of us knows so intimately because we have lived it. • Many of us have heard of the grief theorist Kubler-Ross with her belief that grief happens in STAGES • Denial and Isolation • Anger • Bargaining • Depression • Acceptance © Dr Judith Murray and Liz Crowe, The University of Queensland

Grief Theories • While Kubler Ross had some good ideas we now know that: • Grief does not happen in clear, cut stages. It may come and go during our life • Grief and Loss becomes a part of who we are and our life story • Grief and Loss impacts our development, our relationships and how we look at the world. • Only looking at ‘stages’ of grief stops us from seeing how a child’s life experiences, their personality and the environment in which they live is affecting them. © Dr Judith Murray and Liz Crowe, The University of Queensland

How can we tell if a child is grieving? What to look for: • Children’s behaviour and actions may be the best clues to tell us how a child is feeling. • We need to look for changes in the child’s total behaviour rather than a change in a single behaviour • Remember that the intensity of outward behaviour is not always a true sign as to the trouble going on inside. © Dr Judith Murray and Liz Crowe, The University of Queensland

How can we tell if a child is grieving? What to look for: • The same behaviours may just be part of ‘normal’ development and have nothing to do with the loss • The behaviours may not be that different to what the child is normally like so it may be easy to miss the distress • Grief reactions for children can come and go. This is normal and not a measure of grief. Just because there is no signs of grief does not mean they are not grieving • Children may not know what they need or what is wrong so they cannot ask for help © Dr Judith Murray and Liz Crowe, The University of Queensland

Trauma, Loss and Grief – an important connection • Many children in care have suffered trauma. • Physical and sexual abuse is seen as a serious emotional trauma. • Babies and children can experience trauma even if they cannot talk • Trauma makes children more vulnerable to psychiatric disorders • Trauma causes FEAR © Dr Judith Murray and Liz Crowe, The University of Queensland

Trauma, Loss and Grief – an important connection • Many children in care are scared as well as sad • Children can often re-experience trauma. This is out of their control and is called a ‘flashback’ • When children have ‘flashbacks’ their brains become very active and they are physically unable to speak. It becomes a “speechless terror” © Dr Judith Murray and Liz Crowe, The University of Queensland

Trauma, Loss and Grief – an important connection • Babies, children and young people often find it hard to tell us what has happened after a ‘flashback’ • Re-traumatisation can present as outbursts of anger, temper, irritability, poor concentration, being ‘out of control’, or as withdrawal, isolation, silence etc. • Children coping with trauma may have no energy for anybody or anything else • Trauma can stop a child from being able to grieve their losses and move on in life. © Dr Judith Murray and Liz Crowe, The University of Queensland

Foster Care Training Module