The Effects of Parental Bereavement in Childhood Essay
The aim of this study is to present a general overview of the evidence base in relation to the effects of parental bereavement in childhood. The primary focus is upon research conducted during the past ten years, the available commentary and key theoretical ideas on the topic, notably from Bowlby (1969; 1980), Parkes (1986) and Worden (2003) together with an outline of the contemporary information and guidelines available for those directly involved with this phenomenon, particularly parents and children.
An overview of the research suggests that there areconflicting findings, particularly in terms of the nature and extent ofpsychological difficulties, such as depression, that may present inlater life. Two clear messages seem to emerge. The Effects of Parental Bereavement in Childhood Essay. Firstly, a significantnumber of studies indicate that further research is needed into theinfluence of variables that potentially mediate, or facilitate, theoutcome for the bereaved child, such as the child’s personality traits,family and school factors and other life events. Secondly, thereseems to be a need for more longitudinal studies in this area andstudies which ask similar questions and adopt similar research designand methodology, particularly in the qualitative field, so that usefulcomparisons may be made between different findings.
Chapter One
Introduction
The purpose of this literature review is to explore the evidence basein relation to the effects of parental bereavement in childhood. Theresearch and commentary on this topic is useful in terms of social workpractice because it offers much insight into the experiences and needsof children who have lost a parent. Furthermore, the evidence includesmuch background theoretical material regarding issues of attachment,loss, grief and the making and breaking of affectional bonds forchildren, offering useful insights for those working with children inneed.
ORDER A PLAGIARISM-FREE PAPER NOW
The death of a parent in childhood, by definition, is oftenpremature and unexpected. It is an event commonly understood tointerfere with the normal process of growing up. As the research andcommentary in this field demonstrates, the child’s life is shaken fromits very foundations and the confidence the child has developed thusfar in the world around them and within themselves has effectively beendestroyed (Brown, 1999). This review offers a general overview of thecurrent literature relating to parental death in childhood to include arange of research studies undertaken within the last ten years,commentary by theorists and writers on the topic such as Bowlby (1969;1980) and Parkes (1986) underpinning much of the research and aselection of the advice, information and guidelines available onchildhood bereavement and offered to interested parties such asparents, service providers and the children themselves.
This review differs from other reviews on the topic. Firstly, itconstitutes the most recent review of its kind, the latest review beingthat undertaken by Dowdney (2000), at least as far as can be determinedgiven the limitations on time available to search for such reviews. Secondly, this review includes an up-to-date indication of thepractical and accessible guidance and information available tointerested parties on child bereavement which is not present in otherreviews, such as that by Dowdney (2000).The Effects of Parental Bereavement in Childhood Essay. The choice of research papersto include in the review was determined by the availability of the fulltext of the articles found and the relevance of the subject studied tothis specific topic. Three further considerations were firstly, thatthe research discussed in detail would be contemporaneous, that iswithin a time span of the past ten years – although earlier research isreferred to within the review, where this was adjudged to besufficiently influential and relevant to the issue under discussion.
The second rationale, felt by the review author to be important, wasthat the research used would be that which was presented in a coherent,understandable and accessible way. Connected to this was the thirdimportant consideration, in that research material was selectedaccording to its validity and standing within the academic community. This was determined by the extent to which the researchers hadexplained their research design, methodology and analysis and whetherthe material had been cited by other well-established investigators inthe field.
Decisions about how the review was to be organised, in terms ofgrouping the material, proved to be quite a difficult task due to thewide range of specific research aims and approaches found within thisfield. It must be stressed that the following four chapters representonly one way in which this material could be organised since there aremany issues and themes which tend to cut across all the studies,defying any rigid categorisation. Nevertheless, having considered allthe material, the chapter contents reflect the major themes to emergefrom the available literature from the past ten years. Two appendicesare included at the end of the review which outline the searchingstrategy used and its outcome, and the major themes emerging from thereview.
Chapter Two
Models of healthy mourning and the developmental perspective
The death of a parent, and indeed any other significant figure, isunderstood as a very stressful experience for children. Worden (2003)notes the considerable controversy over some decades concerning theextent to which children are considered capable of mourning. He citesWolfenstein (1966) who suggested that children could not mourn untilthey have achieved full psychological differentiation within a fullyformed identity occurring at the end of adolescence. Others, hesuggests, such as Furman and colleagues (1974) and John Bowlby (1960),cite the age of capacity for mourning as much younger, at 3 years ofage and 6 months respectively (Worden, 2003). Worden himself assertsthat children do mourn and that the issue is rather that we need tofind a model of mourning that is appropriate for children themselves,rather than trying to fit children’s experiences into an adult model.
Parkes (1986) and Worden (2003) have emphasised that mourning thedeath of a significant figure is characterised by a series of tasks tobe undertaken by the bereaved person over a period of time that isessentially unique to each individual. These tasks are summarised byBrown (1999) as “accepting the reality of the loss, experiencing thepain of grief, adjusting to a new environment and investing in newrelationships” (p.1). Brown (1999) points out that there are manyfactors which influence bereavement for children including “their age,level of cognitive understanding and the relationship which they hadwith the person who died” (p.18). She describes how these factors willimpact upon the child’s emotional and behavioural responses to theirloss.
John Bowlby, in his studies of attachment, loss and separation andaccompanying anxiety responses in children, asserted that bereavedchildren who had experienced secure relationships prior to the death,were more likely to achieve a healthy resolution to their loss (1969;1980). Furthermore, in his analysis of children’s responses to thedeath of a parent, Bowlby seems to place the responsibility for ahealthy resolution firmly with the significant adults around thechild. He suggests, for example, that the child is likely to behindered in his or her grieving process because the adults themselvesare often “unable to bear the pain of mourning – perhaps that of theirown mourning, certainly that of their child’s, and especially that ofmourning together” (Bowlby, 1980, p.272).The Effects of Parental Bereavement in Childhood Essay.
Bowlby identified three key stages in the achievement of healthyresolution of childhood grief. Firstly, children need to be givenhonest and open information about the death, and to have theirquestions answered. Secondly, they need to be aware of adults’responses to the loss and to be actively involved in the ritualssurrounding the death. Thirdly, they need a secure, continuedrelationship with a known and trusted adult (Bowlby, 1969; 1980). Bowlby’s observations are given prominence here because they haveunderpinned much of the later work on childhood bereavement. Brown(1999), for example, outlines research evidence which emphasises thatthe most effective way to help bereaved children is to work with thefamily. She notes, also, that “children adapting to grief need bothcognitive and emotional understanding of what has happened” (Brown,1999, p. 18). Worden (2003) echoes this observation, pointing out thata certain level of cognitive development is required to fullyunderstand and integrate the concept of death. He cites some of themajor cognitive concepts to be mastered as “(1) time, includingforever; (2) transformation; (3) irreversibility; (4) causality; and(5) concrete operation” (Worden, 2003, p.160).
Worden (2003) describes the Harvard Child Bereavement Study whichhe, along with his colleague, Dr. Silverman, conducted in the early1990s with a total of 70 families, including 125 school-age children,over a two-year period following the death of one parent. Thenon-clinical sample of families was drawn from communities of varyingdemography and compared with a matched control group of non-bereavedfamilies. The researchers interviewed the children and survivingparents with the aim of studying the ‘natural course of bereavement’for the children (Worden, 2003, p.160). Worden lists ten of the keyfindings from this survey study, the first of which is that “mostbereaved children (80%) were coping well by the first and secondanniversaries” (2003, p.160). The differences between the bereavedchildren (20%) who were not coping well and their control counterpartswere greater at two years than at one year, indicating that there was adelayed effect of the loss on these children, as pointed out by Worden(2003). This finding implies that children’s grief is developmental,fitting with the idea that the quality of children’s grief will changeover time, in line with their increasing mastery of the cognitiveconcepts mentioned earlier.
The Harvard Child Bereavement research is cited as significant by anumber of commentators. Monroe (2001), for example, suggested thatthis study “is probably the most important research study on childrenand bereavement to date” (p.76). Monroe describes how children are aptto return to issues concerning bereavement and loss repeatedly overtime, especially at times of transition in their lives, as theirunderstanding develops and their questions change. Other key findingsfrom the research include the importance of active coping, cohesion andgood, open communication about the dead parent within the families. The most powerful predictor of a child’s adjustment to the loss ofparent was stated as “the functioning level of the surviving parent. Children with a poorly functioning parent showed more anxiety anddepression as well as sleep and health problems” (Worden, 2003,p.161). This observation takes us back to Bowlby’s assertion that aprime task in helping a child to overcome difficulties in the grievingprocess is “to provide the surviving parent with a supportiverelationship” (1980, p.273), and this is a recurrent theme to which wereturn, especially in Chapter Five.
A recent study conducted by Hurd (2004) contrasts with the Harvardresearch in many ways. Hurd employs a qualitative, single case-studyapproach in order to investigate the ‘grief work’ of a 14-year old girlwhom he names ‘Debbie’. He describes his use of the interview method,audio-taping and transcribing all interviews into verbatim texts. Themode of data analysis used was the constant comparison method in whicheach interview session was coded for concepts, categories and majorthemes. Hurd describes his role as “an engaged but dispassionatelistener committed to faithfully reporting and explicating (Debbie’s)bereavement experience and its meaning to her” (2004, p.342). Datavalidity was established via interviews with Debbie’s mother andbrother to confirm factual accuracy. This differs from the surveymethod employed by the Harvard study in that it can produce therichness and complexity of individual experience in a way that theformer cannot. However, on the other hand, its limit to a single studycannot offer the kind of general overview of experiences within alarger population that the survey method allows.
Recent commentators, such as Jacobs (1999) and Stroebe et al(2001), contribute to an ongoing debate that questions the perceptionof grief reaction as a psychiatric disorder, and therefore as somethingthat can be diagnosed and cured, rather than a natural response to theway that the death of a significant ‘other’ can change a person’sworld. Stroebe et al (2001), for example, have stressed the potentialfor healthy mourning during childhood after a parental death. Hurd,also, acknowledges the work of Bowlby (1980), stating that “depressionas an outcome of a childhood bereavement experience was no longerconsidered as inevitable” (2004, p.341). He also links this shift withan emergent contemporaneous interest in resilience in the lives ofat-risk children in this field, noting that there is, to date, verylittle research evidence on resilience in parentally bereavedchildren.
From his single case study, Hurd concluded that Debbie was a stable andhappy 14 year old who had coped well with the loss of a much-lovedfather without having developed depression or other psychologicaldisorder. He notes the environmental factors deemed by Bowlby (1980)to be crucial for healthy mourning, as outlined above, and that thepositive presence of these in his analysis could help to explainDebbie’s success in coping. Hurd summarises by suggesting that “theinternal and external protective factors were in place for Debbie tobecome a resilient adolescent able to experience healthy mourning andto develop her identity relatively unscathed by the psychological andemotional trauma that often accompanies a major loss” (2004, p.351). Hurd ultimately calls for more single-case reports and large populationstudies enrich the knowledge base on resilience and suggest newdirections.
Chapter Three
Anticipated versus sudden parental death
Many commentators have made a distinction between anticipated andsudden death in terms of the nature of grief responses. There seem tobe few studies which focus specifically upon childhood bereavement inthis respect, and where they do so they tend to be situated within thecontext of high-profile, public events such as the violence stemmingfrom the troubles in Northern Ireland, the September 11 attack on theWorld Trade Centre in New York and the genocide in Rwanda. Suchstudies, nevertheless, enhance our understanding of the specific impactof traumatic parental death upon children. Christ (2005) highlightshow the sheer numbers of parentally bereaved children following the 11September 2001 attack in New York prompted a range of novel groupinterventions with children and their surviving parents using ritualsand activities. These initiatives were centred upon the reconciliationprocesses of children at different cognitive and emotional levels,especially in the months following the death.
Grace (2005) reviews the research into the relationship betweengrief and trauma responses in children. She notes that whilst earlierinvestigators stressed the need for the child to resolve the symptomsof trauma, where present, prior to being able to process bereavementissues successfully, more recent research suggests that “the presenceof symptoms of trauma may not interfere with the child’s ability togrieve” (Christ, 2005, p.101).The Effects of Parental Bereavement in Childhood Essay. She cites evidence from her own workwith families of New York fire fighters who died which showed thatsymptoms associated with bereavement and trauma in children were oftenintertwined, suggesting that the two need to be addressedsimultaneously.
ORDER A PLAGIARISM-FREE PAPER NOW
Donnelly and Connon (2003) presented the findings from the childbereavement project group for the Social Services Trauma Advisory Panelin Belfast. They note that traumatic bereavement varies in nature andintensity as children grow and can also lead to the development of posttraumatic stress disorder and depression. Their research alsoidentified a number of children who were able to make use of bothsocial support and their internal resources to achieve understandingand cope with their grief without developing overwhelming symptoms orrequiring external interventions. Whilst acknowledging the usefulnessof resilience theory, emphasising the ability of children to cope wellwithout intervention, and other insights from research studies,Donnelly and Connon maintain that “our current understanding oftraumatic bereavement underestimates the negative symptoms suffered bychildren” (2003, p.3). They suggest that many researchers have reliedon assessing behaviours that “do not accurately reflect the true rangeof children’s reactions” (2003, p.3).
Donnelly and Connon (2003), similarly to previously citedresearchers, acknowledge Bowlby’s assertion of the loss of a parent, orprimary care giver, as one of the most influential events in a child’slife, requiring radical adjustment to the child’s daily routinealongside the establishment, or reinforcement, of a secure relationshipwith a trusted adult (Bowlby, 1980). They highlight the effects oftrauma on children, initial reactions depending upon the child’s levelof exposure to the event, varying from hearing about it second-hand towitnessing, or being personally threatened by, the traumatic eventitself. They point out that the impact of trauma upon children can beso strong that emotions and thoughts about the event can remain vividfor years after the event and the threat have passed. Donnelly andConnon cite research by Terr (1991) which postulates traumaticbereavement as a particularly complicated process whereby “the normalmourning rituals and social support which facilitate the resolution ofnon-traumatic bereavement are often not enough to overcome distresscaused by traumatic loss”(2003, p.5). They go on to stress that “iftrauma remains unresolved, or isn’t fully understood by children, itinterferes with the normal grief process, engenders secondarydifficulties, and increases the period of distress” (Donnelly andConnon, 2003, p.5). The Effects of Parental Bereavement in Childhood Essay.