Child Psychology and Psychiatry

95

---

Children bereaved by parent or sibling death
Table 16.1
Bereaved children: assessing the need for support and intervention.
Time
Context
Post-death
Implications for Management
Monitor
Advise/consult
Consider
with professional
referral if:
Pre-death
Children
:
Developmental level
If learning
disabilities
Liaise with school
Understanding of death
Temperament
Relationship with deceased
If problematic
Prior history of loss/divorce/
separations/death
Yes
Prior disturbance/disorder
Yes
Family
:
Patterns of communication
Organization
Role differentiation
Quality of family relationships
If poor/prior
disturbance
Prior parental mental health
difficulties
Yes
Culture/religion/community
:
Beliefs
— meaning of life/death/
afterlife
— relationships with the dead
— roles of adults/children/
family
Behaviour
— culturally appropriate rites/
rituals
— culturally appropriate
expressions of grief
Practical
obstacles/
community
support
Consider support
from/liaison with
cultural community
Death occurs
Nature/circumstances of death
:
Traumatic, murder, suicide
Yes
Presence of child
Information provided
Adults available to child
Degree of preparation/
support available
96

---

Attachment and separation
Table 16.1
(
continued
)
Time
Context
Post-death
Implications for Management
Monitor
Advise/consult
Consider
with professional
referral if:
Immediate
aftermath
Children
:
Impact upon routines/practical care
Suitability of substitute care
Yes
If unsuitable
over longer term
Involvement in rites/rituals
If requested
Expression of grief tolerated
Opportunities to gain understanding
Family
:
Explanations given to child
Psycho-education on
grief if requested
Availability of practical/emotional
support for all family members
Support for expression of grief and
distress
Extent to which able to appreciate
children’s needs
Extended family:
involvement with child
conflict around death/
aftermath
Yes