Arts and Culture United States Project #5971

The Dougy Center peer grief support groups

by The Dougy Center

Project Report | Jan 29, 2018
Supporting children & teens after a suicide death

By The Dougy Center | Program Staff

Explaining suicide death to a child or teen can feel overwhelming and intimidating. As adults, we often want to protect them from the stigma and shame that can accompany such a death. Here are some tips for talking with children and teens about a suicide death and ways to support them in their grief.

Tell the truth
How do I tell my child or teen? It’s a question we hear a lot. Start with a short, simple explanation of what happened in language children can understand. Let their questions guide what else to share. You do not have to describe in detail what happened (unless they ask, and then you should answer honestly). You might say, “I have very sad news, Mommy died of something called suicide. She shot herself,” or “Your dad died last night, he took too many pills.” Avoid euphemisms such as passed away, went to sleep, crossed over, or lost (as in “we lost her”), as they can confuse children. Even though these discussions can be hard to have, being honest and open is an important first step in helping grieving children. It minimizes the confusion that comes from misinformation, and also keeps children from using their limited energy and inner resources to figure out what happened. Children who are not told the truth often fill in the blanks themselves, sometimes with a story that is worse than what actually happened. In fact, many children and teens come to believe that they somehow caused the death, especially if no one will tell them what happened. News also travels fast, and it is important for children to hear about the death from a caring adult rather than through social media or gossip.

The question "Why?"

“Why?” is often the first question everyone asks after someone dies of suicide. You can support children and teens by explaining there are many factors that can lead someone to die of suicide. A suicide death is not the result of a single event such as a break up, loss of a job, a death, or major disappointment, even though it may seem like that event was the cause of the death. Suicide death is a result of someone experiencing unbearable emotional pain, feeling hopeless about it ever getting better, and thinking death is the only way to stop that pain.

It is not uncommon for a child or teen to feel relief after the death, especially if mental health issues created turmoil. Some may feel the parent abandoned them, or that they were unlovable. Children tend to move quickly from one emotion to another, crying one minute and asking for a snack the next. With powerful emotions like anger and fear, consider finding ways for children to safely express them. Remind children that while it’s okay to have big feelings, “You are really, really angry right now, and that’s okay,” it’s not okay to hurt anyone or anything. “You can be really angry, but you can’t kick me or throw your toys at the dog. You can punch the punching bag or stomp on the bubble wrap.”

WHAT HELPS

Compassionate listening. When children and teens are grieving, people can be quick to offer advice and give opinions. What’s most helpful is to listen without judging, interpreting, advising, or evaluating. It can be tempting to minimize their feelings or convince them to think or feel differently than they do. If it’s a case of misinformation, it’s helpful to provide the correct details, but still allow them to express their take on things. Sometimes the best response is to validate their thoughts and feelings. For example, “You really get uncomfortable when kids at school talk about hating their mom. You wish they knew what it’s like to have a mom die.” Responding in this way helps children and teens trust that you will listen, leaving them more likely to come to you when they’re hurting or needing advice. You don’t have to have all of the answers. There are many questions surrounding a suicide death that do not have answers. It’s okay to say you don’t know.

Routines and consistency. Life is often in upheaval after a suicide death, so it’s helpful to find ways to create predictability. Examples include routines around breakfast, getting to school, after-school, chores, and bedtime. Children may also need some flexibility so they know what to expect, “Bedtime is at 7:30 pm,” but can trust that if they need something different (“Tonight we can read an extra story”), the people in their world will be responsive.

Choices. When someone dies, children can feel powerless and out of control. Giving children choices can help them regain a sense of power and control in their world and trust that they can have a say in their lives. Provide day to day choices that are in line with their developmental level. For example: “Would you like hot or cold cereal for breakfast?” “I need help with dinner, would you like to set the table or clear the dishes?” “The trash needs to go out today, would you rather take it out this morning or after school?” It’s also important to let children and teens make choices about issues directly related to the death and their grief. Examples include asking children and teens if they want to help with sorting the belongings of the person who died (and which items they would like to keep) and how they want to acknowledge significant days such as holidays, birthdays, and the anniversary of the death.

Space for play and creativity. Children and teens often turn to play, movement, and creativity to express themselves and make sense of their situation. Consider offering opportunities for playing with dolls and puppets; creating art of all kinds (remember the process is more important than the product); and writing, journaling, and making videos. Big energy play like running, punching a bag, shooting hoops, pounding on a drum, and sports can be safe ways to express strong emotions, as can playing an instrument, writing songs, or simply listening to music.

Remember the person who died. Remember and talk about how the person lived rather than just about how they died. Their life was unique and important. After a suicide death, people often avoid talking about the person who died because they don’t know what to say. You can help by sharing pictures, stories, and details about the person’s life: “Your daddy really liked going fishing with you,” or “Your mom was a great cook, I know you loved her pancakes.” Sometimes just remembering to say the person’s name can be very meaningful to children and teens.

Be aware of words. When talking about a suicide death the words you use matter. There are some ways of talking about it that can add to the shame and stigma surrounding suicide. For example, consider avoiding the phrase “committed suicide.” Committed is a word associated with criminal behavior (“He committed a felony”). Instead, try saying “he died by suicide” or “she killed herself.” Using this language decreases stigma and judgment by talking about suicide the way we would any other type of death (“She died of cancer”). Another challenging phrase is “successfully completed suicide.” Remembering someone for being successful or unsuccessful at killing themselves adds to stigma. Negative comments such as, “That was such a selfish act,” “He was so crazy, no wonder he killed himself,” and “What a cowardly way to go,” are not helpful. If questions come up, you can ask, “You’re wondering if Daddy was being selfish. What do you think?” You can then add something to help them better understand how intense emotional pain can lead people to feel hopeless and think death is the only option to stop the pain they are in.

Find sources of support for yourself. If you are parenting or supporting a grieving child, one of the best ways to help is to ensure that you are taking care of yourself. This doesn’t mean hiding your grief from children and teens. Rather, it means ensuring that you have people and activities in your life that are sources of comfort and inspiration. By accessing support, you model for your children ways to take care of themselves, and you reassure them that you will have the energy and presence to be there for them. A great place to start is the American Foundation for Suicide Prevention.

These are just a few tips for supporting children and teens after a suicide death. Grief is unique to each person and every family, so adapt these suggestions as needed.

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Sep 29, 2017
Helping the Grieving Teen

By The Dougy Center | Staff

mom and teen

If you know a teen who has experienced a death, you might be wondering, “How can I help?” Here are a some tips to keep in mind. In general, if you find yourself unsure of what to do or say, remember to take your cues from the teen. It’s likely that they know, or will be able to figure out, what they need. Your willingness to listen to their concerns and questions, as well as be present with their thoughts and feelings, creates a foundation of safety, trust, and support.

Be open and honest about the death. One of the first questions adults have after a death is, “How and when do I tell my teenagers?” There is no magical ‘right time’ to share the news of someone’s death, but in general we recommend telling them as soon as possible, so that they hear it from someone they trust rather than from other teens or through social media. Find a safe, comfortable place and start with a short, but honest, explanation about the death. Even though teens are better able to grasp the concept of death than younger children, it’s still good to avoid euphemisms such as passed away, went to sleep, crossed over, or lost. Taking in such big news can be confusing, so using the words dead or died can help teens comprehend what happened. You might say something like this: ”Honey, I have very sad news. Dad died today. He had a heart attack.” Let their questions guide what else to share.

Allow for questions. Teens may have a lot of curiosity about the details of what happened. Let them know it’s okay to ask and that there are no wrong questions. If your teen asks something you don’t know the answer to, tell them what you can do to find out, acknowledging that some questions may not have answers. Sometimes teens hesitate to ask questions or talk about the person who died because they worry the adults they are closest to will get upset or cry. This doesn’t mean you should hide your feelings, but it is helpful to let them know ahead of time that it’s okay to talk about the person, even if your strong emotions come up. Reassure them that you will be okay and that there are people you can go to for support. Another option is to work with your teen to identify a trusted adult - family friend, relative, coach, mentor - they are comfortable going to with questions and concerns.

Listen. When a teen is grieving, people can be quick to offer advice and give opinions. What’s most helpful is to listen without judging, interpreting, advising, or evaluating. It can be tempting to minimize their feelings, or convince them to think or feel differently than they do. If it’s a case of misinformation, it’s helpful to provide the correct details, but still allow teens to express their take on things. Sometimes the best response is to repeat what you hear them say -- called “reflecting” -- so that they know they have been heard. For example, “You really get uncomfortable when kids at school talk about hating their dad. You wish they knew what it’s like to have a dad die.” Doing this helps teens trust that you will listen, leaving them more likely to come to you when they’re hurting or needing advice.

Be open to different ways of grieving. Grief is as unique as we are. Teens can have a wide range of reactions and ways of expressing their grief. Teens tend to be hard on themselves, whether for crying, not crying, being strong, being a “mess,” thinking about the person, or not thinking about the person. There is no right or wrong way to grieve. Each grief experience is unique. You can help teens (and yourself) by letting them know all of their reactions are okay and supporting them to discover what works best for them, as long as their behavior does not hurt themselves or others.

Know that grief affects teens on many levels. Grief is a holistic experience that can impact how a teen thinks, feels, and behaves. The death of a family member or friend can be physically, emotionally, and cognitively exhausting, leaving teens with little energy leftover. Some teens have trouble sleeping, especially in the first few weeks or months after the death. Lack of sleep can lead to short tempers, mood swings, and impatience. You can help your teen by modeling good self-care around sleep, food, staying hydrated, and exercise. Grief can also make everyone forgetful, so your teen may need extra reminders about chores and plans. If your teen experiences difficulty concentrating in class or completing homework, reach out to their teachers to discuss ways to help your teen feel supported and successful in school.

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Jun 29, 2017
When a family member has an advanced serious illness

By Rebecca Hobbs-Lawrence | Pathways Program & Grief Services Coordinator

Explaining that someone has a life-limiting illness to a child or teenager can feel overwhelming and daunting. These tips may help you have that hard conversation and know better how to support your child during the challenges of living with a family member who has an advanced serious illness.

Begin the Conversation. Giving children difficult news is not an easy task, though your child will likely have already sensed that something has shifted within the family. Knowing that it will painful for a child to hear that a pparent or other family member has an illness that they may ultimately die from often leads caregivers to wait for the "right" time to share challenging, life-altering news. However, rarely is there a "perfect time" to have these conversations with children. Waiting can lead to hurtful edxchanges that provide too little information and that comes too late in the illness for children to best cope and be included in the experience. The "perfect time" then, is the one that is created by you which leaves ample space for questions, reactions, and clarification.

Use open, honest, and clear communication. Be honest and give clearaccurate information. Euphemisms like " not getting better", "won't be her much longer", or "passing on" can be confusing. Use the words "will die from" or "dying" when speaking to children and teens. If the only thing a child has been told is that the family member is "sick", they can become fearful or anxious about being sick wuith a cold or a flu. Name the disease. Young children need basic, concrete information regarding the illness, what will happen in the immediate future, and specifics about how their care and routine will be maintained. Adolescents and teens appreciate having more detailed information, especially as the family member's health declines. Being open in your communicationmodels for your children their ability to also be open and creates a level of trust with your child as they realize you will tell them the truth, even when it is really hard.

Validate feelings and thoughts. It is important to listen to a child's responses without interrupting or minimizing fears. Validate the experience your child is sharing with you. Tell them that is normal to have many different feelings and thoughts when someone in the family has an advanced serious illness. Children often worry that they can catch the disease, or that they either caused or in some way contributed to their family members lifelimiting illness. Reassure your child by being clear that their family member's illness is not contagious nor did they cause it. An adult can also validate the experience of a child by sharing similar feelings/thoughts, affirmaing that each reaction is normal, and giving them permission to express those feelings and thoughts.

Communicate often. Make time to have check-ins with your child. Use this time to inform your child when there is new information regarding the illness, treatment and procedures, changes in appearance or functioning of the person, or changes in routines. Ask your child if there are questions, concerns, or thoughts they would be willing to share with you. Even if there is no update, just carving out the time to share openly will reaffirm the message that you care. Communicating often with your child will build trust and help prepare for what is ahead.

Model being okay with not knowing. Be honest if you don’t have an answer. It’s okay to not know. Appreciate your child’s question then assure them that you will tell them if and when you have an answer. Validate that it’s important to ask questions even when no answers are to be had. Much in life is unknown to us and that is certainly true when a family member is living with a life-limiting illness. Being able to ask questions and be patient in the unknown is an important life skill. Provide structure and routine. Life is constantly changing and often seems very unstable when a family member has an advanced serious illness. Providing structure with flexibility will help a child regain some sense of safety and control. Predictable morning and night time routines provide consistent bookends that will support your child in starting and ending their day. Additional important routines to consider are consistent childcare when you’re unavailable, planned time-limited hospital visits, continued participation in school/sports activities, and spending time with friends.

Provide time to be a kid/teen. It’s important for your child to spend time with and play with their peers. This invaluable time provides your child some normalcy, a physical outlet, social connection and can be a supportive coping strategy when your child is overwhelmed with all the other changes that are occurring at this time. Kid/teen time gives your child a brief but much needed reprieve from the worries and burdens they are carrying.

Advocate for your child. Inform your child’s teacher or school counselor about what is happening at home, how your child has been responding, and any fears or anxieties your child has that may be expressed at school. Many teachers and school counselors have little if any training on supporting grieving kids. It may be helpful to provide school staff with literature and resources so they can best support your child. Look to your palliative and hospice care staff, child’s pediatrician, hospital social workers, and support organizations like The Dougy Center for helpful information to give to your child’s school.

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