Grief and Loss Across the Lifespan, Second Edition

5 Tweens and Teens 139

humor as a coping defense and are very accepting of Sophie’s disabilities.
Despite several years on the wait-list, the availability of a bed for Sophie was a
shock for the family. Sophie had been an integral part of family life for 16 years
and her transition to a residential facility was difficult to accept. In addition,
Sophie’s older sibling was leaving for college in the fall, so there were addi-
tional and significant changes in this family’s structure. This family was deal-
ing with multiple losses.
When they decide to place their child in an RCF, families must deal
with loss of control and guilt. Institutional care is defined by interactions
with many caregivers, a need to adhere to strict schedules and regimens,
and all that goes along with sharing a room with one or two other people.
Immediately after admission, many families struggle with remorse and
doubt. For this family, additional stressors included their oldest child going
away to college. Sharon was losing two children at nearly the same time!
Worries about Sophie, their “child with disabilities,” leaving for residential
placement and its attendant restrictions were an ironic counterpart to their
concerns about their “child without disabilities” leaving for college and its
sudden freedom and independence. For families accustomed to overseeing
and managing much of their children’s day-to-day needs, such adjustment
is quite challenging.

Interventions

Social workers assisting children and families through RCF placement should
keep in mind that (regardless of time spent on the wait-list) it is always a
shock and a traumatic event for the family when placement is finally offered.
Families should be educated about the team approach and be apprised of the
need for a “settling-in” period. Some recommendations to help the initial tran-
sition process to placement in an RCF include:

1. Coordinate at least one preadmission meeting with the family and child
   including a comprehensive team assessment of the child’s residential care
   needs.


2. Coordinate a postadmission meeting shortly following residential admis-
   sion to check in with family and team about any emerging adjustment
   issues.


3. Prioritize consistency in caregivers and routine as much as is possible given
   the realities of working with staff on several shifts.


4. Include the family and child as part of the treatment team for planning/goal
   setting and problem-solving purposes.


5. Offer the family the opportunity for peer support. Provide a contact list of
   other families who would be willing to mentor the new family and help
   them navigate various issues that may be encountered in adjusting to the
   placement.


6. Develop rapport with family members through provision of updated
   reports on progress, interfacing with community agencies on their behalf,
   and assisting the child to maintain contact with them through Skype and
   assisted phone calls. This is even more important for families who are not
   able to visit on a regular basis.