Bereaved families and children often require and benefit from support – however, the support that is helpful varies from case to case. Professor Jacqueline Barnes’ research  examines the reasons and factors that influence a family’s decision to either seek or not seek support.
The impact of bereavement on children and families
Bereavement can have a personal, emotional and social impact. The egocentric nature and limited cognitive development of children can lead to younger children perceiving the death to be their responsibility.
Cognitive limitation and anxiety developed as a result of the loss may also see children begin to associate locations and circumstances, such as hospitals, or driving a car, as associated with death, if these were factors in a bereavement. Children may also become increasingly anxious about health concerns.
Emotional and social problems generally fall under two categories: externalising and internalising issues. Externalising challenges include anger and aggression, whereas internalising factors are often harder to detect, and include depression, anxiety and guilt.
Bereaved children and young people can also sometimes feel that they are isolated from their peers, who may not have experience in talking about bereavement, and cases of bullying after a bereavement can arise. Poor home communication may also become an issue, if family members are unwilling to discuss the bereavement or do not address distress and emotions.
Why do parents and carers seek support?
Research undertaken by Professor Barnes found the following reasons were common for support being sought:
Parents and carers were found to appreciate the reassurance provided by external care. Seeking support allows family members to be certain that they are doing the correct thing, and offering the best possible support.
By discussing their challenging emotions with an external care provider, parents were able to discuss issues they felt were too difficult to communicate with their children. Counselling and support groups provide a safe environment, and also offer an outlet for children who may be unwilling to share their feelings with parents or carers, particularly if they fear that this may upset them.
Some respondents stated that their individual grief was preventing their ability to provide support for all of their children’s needs – counselling was able to ‘bridge this gap’.
Research identified that externalising problems, such as anger, behavioural problems and aggression, were the most likely cause for parents to put forward their children for counselling.
Internalising problems such as depression or anxiety were less well detected by parents. It is possible that some children are not offered support when they require it, as the grief they are experiencing is kept hidden from parents and carers.
Why did some parents not seek help?
Children showed no overt signs of distress. Research has found that internalised responses to grief are often less likely to be detected than externalised reactions.
Some respondents were concerned that counselling sessions might lead to their children becoming distressed, and held an attitude that ‘the less we talk about it the better’.
Negative preconceptions about support and concern that it might highlight parental
A fear of a loss of control and authority.
The value of group support
Whilst Professor Barnes’ research has highlighted some negative experiences with schools. Group and peer support for children was found to be very beneficial. It is important for schools to ensure that bereaved children are not left isolated, and that the environment is stable and supportive.
It is also crucial for schools to ensure that information is distributed sensitively and accurately, both to prevent rumours from spreading, and also to ensure that teachers and parents are aware of any delicate issues. Schools should be aware of the potential for other students to become jealous of the increased attention a bereaved pupil may receive.
Peer support was identified as being very beneficial and helpful for children. Research has found that children may feel more comfortable in this setting, and more willing to open up and discuss their feelings.
This environment can be useful in helping children to overcome feelings that they are different to their peers, and attitudes that ‘I am the only person this has ever happened to’. It is important however, for any significant information to be passed on to parents, and family communication to be encouraged.
Activities that are useful:
Throwing mud can be a good way of releasing tension
Anger walls provide a safe environment for children to express anger and frustration
Producing memory boxes and items to help celebrate a bereaved person’s life
What support was able to offer:
For parents and children, being able to share their experiences was found to be the most beneficial element of support
For children, support was found to enable them to feel more confident and comfortable in expressing their feelings, keep a positive memory alive and communicate more freely with their family.
 Barnes, J. et al. 2007. Are we getting it right? Parents’ Perceptions of Hospice Child Bereavement Support Services. Palliative Medicine. [Online]. 21 (5), pp. 401-407. [Accessed 07/07/2016]. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17901099