96 Grief and Loss Across the Lifespan
Dunning (2006) provides many excellent examples of how social workers
can work with children around their misconceptions and fears. She emphasizes
that simple reassurances seldom have positive impact. Children instead ben-
efit from struggling with expressing their fears and understandings; later, play
can be used to help children discover their own reassurances. For example, in
playing nurse and mother (with the child as the mother who was the healthy
parent), the child was able to state her fear that no one would be able to care
for the child after the father’s death. The “nurse” and “mother” then worked
together to develop a list of all the people who could help the child, something
that provided much reassurance for the child as she played her role of mother.
Still another intervention is to work with children using mindfulness
techniques. As with mindfulness-based stress reduction and other mindful-
ness approaches, the emphasis with children and adolescents is on an atti-
tude of nonjudgmental, patient awareness, sustained and directed attention,
and intentional use of the awareness and attention in directed practice (Burke,
2010). In a systematic review, Burke (2010) found that most studies of mind-
fulness with elementary school children have focused on feasibility and
acceptance rather than efficacy. Promising results with anxiety and somati-
cizing behaviors indicate that mindfulness skills may be helpful in working
with bereaved children. Resources for mindfulness in children include: www
.susankaisergreenland.com/content/inner-kids-level-1-training-for-the-2013-
14-school-year.html; marc.ucla.edu/body.cfm?id=27; and http://www.mindfulliv-
ingprograms.com/links.php.LOSS OF AN INDIVIDUAL OF ELEMENTARY SCHOOL-AGE AS EXPERIENCED
BY OTHERS
Parents’ Loss of a Child
When children in elementary school die, the parents and family are most
directly affected. Parents are responsible for the well-being of their children
and therefore often have extreme levels of guilt about the death of a child.
Rando (1993) asserts that loss of a child consistently correlates with compli-
cated parental grief. The assumptive world is violated when a child dies before
a parent and this leads to a heightened sense of vulnerability.
For parents living through the process of their child’s death, the tension
between holding on to their child and wanting the child relieved of suffer-
ing becomes unbearable at times. Parents cope by focusing on action. These
actions have been categorized as piloting, providing, protecting, and preserv-
ing (Price, Jordan, Prior, & Parkes, 2011). Piloting involves directing the child’s
care and treatment decisions while providing involves actual parental care of
the child. Protecting the child from knowledge of the illness, caregivers they
perceived as less competent, and other real or perceived threats, was prob-
lematic: efforts to “protect” in these ways led to communication failures and
anxiety. Preserving the family, both during the child’s illness and after the
child’s death, includes preserving the child’s place within the family (Price
et al., 2011). This implies that helping parents find ways to take constructive
action can assist them to cope during a child’s course of dying.