ABSTRACT
Psychological consultation to children and families where the child’s adjustment to bereavement or a life-threatening condition is the central concern, is examined in this chapter. Bereavement is an inevitable part of the lifecycle. During childhood and adolescence most children experience the death of a family member or friend and manage the process of grieving satisfactorily. However, in some circumstances bereavement impairs the child’s adjustment to a marked degree or the youngster’s grief reactions do not conform to the expectations of significant members of their social network, particularly their parents (Black, 2000, 2002; Corr & Balk, 1996; Kissane & Block, 2002; Smith & Pennell, 1996; Stroebe, Hansson, Stroebe & Schut, 2001; Walsh & McGoldrick, 2004; Webb, 2002; Worden, 2002). Such expectations may be coloured by the parents’ or network members’ own grief reactions and also by popular misconceptions about grief propagated by the media. Thus, both the child’s behavioural reactions following bereavement and expectations of significant others may prompt a referral for psychological consultation. An example of such a routine referral is presented in Box 24.1. Children may also be referred for psychological consultation when they have been diagnosed as having a life-threatening illness or injury (Abu-Saad, 2001; Black, 1994; Hurwitz, Duncan & Wolfe, 2004). Children’s adjustment to bereavement or life-threatening medical conditions is in part dependent on their understanding of the concept of death. This chapter begins, therefore, with a discussion of the development, through childhood and adolescence, of the concept of death. This is followed by a description of grief processes, a review of theoretical explanations for these processes and a summary of the available evidence on types of grief reactions. A framework for conceptualizing the wide variety of factors that influence grief reactions is then given. The assessment and management of cases where grief is a central issue is then presented.
