New Pieces of Gone

1. New Pieces of Gone Grief & Loss Issues for Kids in Group Homes

2. 14� From Head to Heart

3. WHAT IS GRIEF? A Process

4. The Grief Process Normal natural process Response to significant loss Irrational confusion of contradictory feelings Occurs with every loss Cumulative: grows over time Not a disease one recovers from

5. New Pieces of Gone Grief & Loss Issues for Kids in Group Homes

6. 14� From Head to Heart

7. WHAT IS GRIEF? A Process

8. The Grief Process Normal natural process Response to significant loss Irrational confusion of contradictory feelings Occurs with every loss Cumulative: grows over time Not a disease one recovers from

9. Child Grief and Adult Grief

10. Grief Intensity Differs From Person to Person Culture to Culture Time to Time with same person

11. The Grief Response Never wholly resolved How we integrate loss experience as part of self Living, dynamic, evolving, unpredictable Loss of something/someone no longer there Variety of physical and emotional reactions Ebb & flow of emotions over time Changes reality and perception

12. Grief & Loss Differences L O S S Traumatic as death Subjective Process loss & realize endurance Awareness of survival G r i e f Similar for any significant loss Unfinished grief over losses triggers other losses Provides coping skills

13. Child Grief and Adult Grief

14. WHAT IS LOSS? A Process

15. The Loss Process Grief is universal response to loss Those who confront loss deal with it better than those who don�t Sudden, gradual or prolonged Predictable or unexpected Tragic or benign Complete, partial, or unending

16. Individual Experiences of Loss Sadness Guilt Anger Sense of Abandonment

17. Categories of Loss

18. Loss is Also Single, multiple, cumulative Tangible or intangible Symbolic or personal

19. Five Stages of Grief Shock Anger Not clear or consecutive Bargaining Depression Integration

20. Children�s Losses �Another piece of gone.� *

21. Loss is Different for Kids Limited ability to verbalize feelings May be feeling sad but have no words Don�t like to be different from peers Need individual time for expression *

22. How is it different for kids? Relates to cognitive and development level No comprehension of irreversibility until 9 Short �sadness� span Limited ability to tolerate pain of loss *

23. Where Does Grief Go? Child�s grief response may last a long time Can only express a little at a time Takes longer than adult loss recovery Crying doesn�t help *

24. Developmental Losses Leave behind one stage for another Arrival of siblings Starting or ending school Losing childhood Children start school Empty nest Midlife Retirement *

25. Repressed feelings come out over years in behaviors *

26. Assessment of Child in Loss To what extent is loss disabling How long is child in shock state Nightmares & sleep disorders Difficulty concentrating in school School performance changes Differences in relationships *

27. Get Help from Mental Health Professional When: Symptoms appear in extreme Symptoms predominate child�s life Symptoms interfere with normal development *

28. Anticipated or Sudden Loss Anticipated Loss Child may not understand outcome Something is very different Sudden Loss Leads to PTSD Needs to be addressed Causes fright, agitation, nervousness Terrifying nightmares Numbing Simultaneous withdrawal & agitation *

29. Unresolved Grief Affects Body: through illness & depression Behaviors *

30. Primary Needs of Children Facing Loss Adequate Information Fears & Anxieties Addressed Clear Consistent Limits Gently Maintained *

31. Primary Needs of Children Facing Loss Reassurance Help in acknowledging loss Help integrating loss Help to identify & express feelings *

32. Needs of Children in Loss Involvement & inclusion Permission to grieve and feel the loss and let it go Opportunities to remember *

33. Emotional & Behavioral Problems Normal & expected reactions to grief & loss Difficulty in discussing situation Aggressive behavior including property damage *

34. Emotional & Behavioral Problems Clinging to caregivers School phobia Prolonged physical ailments Prolonged sleeping disorders *

35. Emotional & Behavioral Problems Eating disorders Social Withdrawal School difficulty or reversal Self-blame or guilt *

36. Self destructive acting out behavior or expression of desire to die Can help express feelings Provoke punishment and feel more in control Alienate others to prevent future loss Distract from pain *

37. Process of Healing Loss & Grief

38. Become aware of feelings and reality of loss Take responsibility in healing process Talk about pain Communicate feelings & needs Action in direction of new life Vision of greater meaning Embrace others experiencing loss Lending and receiving support *

39. Worden�s 4 Tasks of Grief Accepting the reality of loss � denial prolongs grief Accepting grief as painful � explore to transform Adjusting to unfamiliar environment Withdrawing emotional energy from past life and reinvesting in new � loyalty to old life can produce guilt *

40. Where have people lost attachment? Could this help identify their loss? How can they be reattached? What are the resources available for them? *

41. The Seven Essential Attachments From: Persons in Distress by Norris Hansel, M.D. (Harvard School of Medicine) *

42. To Supplies of Food, Oxygen and Information Adversely impacted by: Institutionalization Isolation Poverty Health issues *

43. To Persons with Opportunity for Repeated Contacts Adversely affected by: Living alone Institutions Migration Death Health loss *

44. To Identity � knowing how to describe beliefs and self Adverse affects from: Placement in a strange setting Where person�s past identity, experience, aspirations are unknown *

45. To Groups � Work, Play, Social, Religious, Kin: Solidarity Impacts attachment: Living alone Institutions Migration Performance crisis *

46. To Roles � Presence of skills, opportunity to perform roles, self-esteem & dignity Impacted by: Unemployment Poverty Social upheaval Migration Institutionalization *

47. To Cash Economy � Purchasing Power, Financial Security Impacted by: Poverty Loss of Family Migration *

48. To System of Meaning � Regular Rituals that Mean Life is Good Impacted by: Placement in unfamiliar settings Loss of usual surroundings-bad or good Performance failure Isolation *

49. Ask these questions about Childhood Grief Describe what you remember of your first loss What are the main losses in your life? How were you treated? How old were you? What were your feelings then? How do you feel now? Is this finished or unfinished business? -33-

50. Sharon R. TaylorM.S.W., Ph.D. drsharontaylor@aol.com