According to a study conducted by Peter's Place, a bereavement support center for children, teens and their families in southeastern PA, school counselors are the number one source of referrals, at 37%, for child/teen bereavement services.  The second largest source of referrals is bereavement support providers at 17%.  School Counselors and staff have three important roles to play in supporting bereaved students and their families:

   1.   Recognizing (not solving) grief. 
   2.   Identifying when a grieving/bereaved student needs additional support.  
   3.   Referring your students and their families to bereavement support services. 

Recognizing Grief

If you know that a student has experienced the death of a family member or friend, then you know that the student is grieving, even if there are no outward indicators.
Hiding Grief - Mimi Mahon

If the student's records indicate that there was a death in the family or of someone significant in the student's life, then you know that the student is continuing to adapt to that person's death no matter how long ago the death took place and no matter whether there are any outward indicators.  This continual adaptation process is bereavement.  If a student yells at a classmate on April 12th and you see in his file that his mom died two years ago on or about April 12th, you know that his behavior is connected to his bereavement process. 

Support on the Anniversary of a Mother's Death - Alexis D.
Delayed Grief Responses - Hope Edelman

What if you do not have any information about whether there has been a death in the student's life?  How can you recognize grief? 

• ANY change (downward or upward) in behavior that you can not connect to a cause in the student's life should prompt you to ask whether the student has experienced a significant loss in their lives in the last couple of years.
• ANY unusual behavior (behaviors that you do not typically see in other students in the same age/maturity range).
• ANY reference made by the student to the death of someone they knew (family member, friend, neighbor, etc.).

What are some indications that a student might be grieving? 

The lists below for elementary and middle/high school aged students are intended to illustrate different indicators; they are not intended to be exhaustive.  Note that some of these indicators will be present regardless of the student's age or grade

Elementary School

• Not engaging in eye contact
• Lack of energy
• Lack of joy
• Lack of play
• Overly sensitive
• Seems angry - sometimes it is easier to be angry than to feel hurt
• Change in appetite
• Change in sleep patterns-if the student's guardian shares this with you
• Talking about death
• Student seems sad for no identifiable reason
• Increased absenteeism or lateness
• Increased visits to the school nurse

Middle/High School

• Self destructive behavior
• Drug abuse - beginning or increasing
• Increased inappropriate sexual activity
• Change in friends
• Withdrawal
• Hyper activity
• Ongoing expression (in writings, drawings or conversations) of death, dark or depressing themes
• Change in physical appearance, including clothes, make-up, hair
• Irregular class attendance
• Increased physical complaints

What other behaviors, thoughts and feelings have you seen in your students that helped you to realize that a student was having a grief/bereavement response?  Please share them with us.  

 I have observed over the 20 + years that I have been a school counselor, that elementary school aged and pre-adolescent students sometimes act out when they have suffered the loss of a loved one...Yes, there is anger, but if you take that a step further... they act out that anger, with words, by sometimes hitting (or otherwise physically hurting) their peers. For school counselors, a real tip-off is when a student, who was previously well-behaved, starts receiving numerous discipline reports. Thank you for the work of your organization. It is a wonderful resource!  B.H. Arkansas  

Asking Caring Questions and Listening to the Responses:

When you see a behavior that concerns you, take two steps:

   1.   Acknowledge what you have seen to yourself - this helps to bring the issue into focus rather than remain in the corners of your thoughts, and
   2.   Check it out with the student - You can say, "I've noticed some changes and I am wondering how you are doing..."  Questions like "What is wrong?" or "What is the matter with you?" should be avoided as they assume something is wrong and tend to put people on the defensive rather than facilitate genuine communication.

Being a good listener is one of the most important ways you can support any grieving child/teen.  Be honest about when you can be a good listener and when you can not (sometimes the school day schedule and your job responsibilities require you to cut short conversations).  A good listener is some one who:

• Is honest about their own ability to simply listen - you will do a child/teen more harm than good if you pretend to be a good listener.
• Understands that the role of a good listener (which is different than the role of teacher) is to simply listen with empathy not sympathy. Most children/teens will shut down communications with overly sympathetic people.
• Refrains from judging what a child/teen is sharing, knowing that the child/teen is doing the best they can with what they currently know and have.  Remember that every one grieves differently.
• Understands that there is rarely a need to fix anything - grieving children, teens and adults are not broken people; they are people who are hurting.  This hurt is a necessary and healthy part of the grieving process.  What they need is a safe harbor to share some of their pain.  Good listeners are among the safest harbors.

"When someone has died..." - Mimi Mahon

From a Surviving Father - "You try to talk to them..." - Charlie C.

From a Surviving Father - "Being 6 years old..." - Charlie C.

From a Grieving Child - "Sometimes I just don't feel like talking..." - Jacki W.

From a Grieving Teen - "Well, a dad..." - Alexis D.

"For a surviving father, caregiver..." - Laura Munts

School Counselor/Staff Book Resources:

To request copies of Mommy's Light's bereavement education materials, including our DVD "When a Mother Dies...Breaking Down the Walls of Silence," and our Warning Signs Brochure, click Request Information Form.  Click here for a printer friendly copy of the Warning Signs Brochure.

The following books are available for purchase at http://www.griefstore.com/. 

When Death Impacts Your School by The Dougy Center...$9.95
A valuable resource for school personnel who are faced with a death or tragedy in their school community. This guidebook includes suggestions for how schools can help students-by addressing concerns, organizing memorials and offering support. It also includes instructions for developing a school intervention plan after a death, how to address issues related to suicide and violence and how to know when outside help is needed.

Helping the Grieving Student by The Dougy Center...$10.00
At some point, every teacher will encounter a student who has been affected by a death. This guidebook is an essential resource for elementary, middle and high school teachers, offering practical tips and information for how to respond to a death.

Helping Children Cope by The Dougy Center...$10.00
Provides a comprehensive, easy-to-read overview of issues facing grieving children, and ways to help them. Based on The Dougy Center's work with children, teens and families, this guidebook contains information on a child's understanding of death, relevant developmental issues, how to explain death to children, how to know when to get professional help, and much more. For parents, teachers, social workers, counselors, youth workers or anyone who knows a grieving child and wants to help.

Class in Room 44 by Centering Corporation...$6.95
For elementary school children. We share feelings when Tony, leaving early for vacation, is killed. The class talks about anger, guilt, remembering and saying goodbye. Helps explain all the different feeling when a classmate dies and encourages open discussion.

Grief Comes to Class by Centering Corporation...$6.95
The purpose of this book is to assist school personnel, primarily the classroom teacher, in being a positive, significant caregiver for the bereaved students. This book is also meant to aid parents of grieving students and to provide help for the student as he/she re-enters the school environment following the death experience.

Healing a Child's Heart by Alan Wolfelt...$12.00
A child you know is grieving. But how can you help? This book offers 100 practical, kid-friendly ideas for helping children mourn well so they can grow to live well and love well again. Turn to any page and seize the day by supporting this child today, right now, right this minute. A concise, easy-to-use resource for parents, aunts and uncles, grandparents, teachers, coaches--and a good refresher for professional caregivers.

For additional books/DVDs, see Resources. 

Needing Additional Support 

Once you have determined that a student is experiencing grief/bereavement responses, what do you do with this information?

Know that your genuine caring presence, whether through your words or demeanor, may be very supportive.  If a student is hurting, even if you don't know the cause, let them know you are there and that you care. 

Grief is Painful - Mimi Mahon

What to Say to A Grieving Child/Teen - Mimi Mahon

What to Say to A Grieving Child/Teen - Darcie Sims

How To Support a Grieving Child/Teen - Alexis D.

How to Support a Grieving Child/Teen - Laura Munts

What to Say to A Grieving Child/Teen - Darcie Sims

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• Some bereaved students will have the resources they need to support them; others may need additional support. How do you determine whether the student is exhibiting behaviors that indicate he/she may need additional support? See Is Additional Help Needed below.
• If you determine that additional help may be required, see Providing Bereavement Support Referrals below.

Is Additional Help Needed?

How can you tell whether the student needs additional bereavement support services?

Warning Signs - Mimi Mahon

RED FLAGS - Signs that a grieving child/teen needs immediate help

Some behaviors in grieving children/teens are red flags, or emergencies.  Immediate help is needed if a student is:

• Hurting himself
• Hurting someone else
• Damaging property

Hurting one's self or someone else includes:

• Self injury
• Having more "accidents" or getting hurt more than usual
• Saying that she wants to die
• Threatening to hurt someone else
• Treating other people badly, so much so that she is losing friends

If the student is exhibiting any of these behaviors, immediately contact the student's parent/guardian and be prepared to make bereavement support referrals. 

Click here for a list of on-line resources and bereavement support services for Delaware Valley.  Note that The Dougy Center web site, http://www.grievingchild.org/, lists child/teen bereavement support centers across the United States.

YELLOW FLAGS - Signs that a grieving child/teen might need more support

A yellow flag is just like a yellow light: it means caution.  Note that some of the Yellow Flags below may only be noticeable outside of the school environment.  As a school counselor/staff, you may, however, become aware of these Yellow Flags through what the student's parent/guardian, teachers or friends share with you.  Help may be needed if a student:

• Asks for help: The student indicates he wants additional help.
• Never speaks about the person who died: The student chooses never to talk about the person who died, even when others bring it up.  The student perceives that she has no one with whom to speak.
• Expresses excessive anger: When someone dies, children/teens (and adults) often feel angry and/or frustrated.  That's okay and healthy. Too much anger or frustration, however, can cause a child/teen to feel overwhelmed or out of control, and that can be unhealthy.
• Has physical symptoms that do not have an obvious physical cause: Children/teens who are grieving, like adults, might have physical symptoms, such as headaches or stomach aches.  This is normal. If these symptoms persist, the student's parent/guardian should be encouraged to take him to his health care provider.  If nothing physical is found to be wrong, and the student continues to have physical symptoms, the parent/guardian should be encourage to consider getting additional help for the student.
• Significantly changes social interactions: Some children/teens do not interact with friends and family as they did before the death.  A period of withdrawal is normal and healthy.  If the withdrawal persists and the student does not resume some activities outside of school, talk with her.  This isolation may be a sign of needing additional help.
• Has dramatic changes in academic performance: Many students' grades change during the year in which the death occurs.  If the grade changes (downward or upward) continue into the following academic year, or other changes in performance continue for months, consider that the student might benefit from more help.  Note: If a student's grades improve dramatically, you may have difficulty convincing the student's parent/guardian that this may be a "yellow flag" indicating bereavement support might be needed because good grades are usually taken as a sign that things are "going well."  See Is overachieving below.
• Is overachieving: We tend not to recognize a dramatic increase in performance or participation as a sign of grief because it looks like things are "going well."  Significant changes occur for a reason.  It's important to try to understand the reasons for any dramatic change, regardless of whether it is perceived as positive or negative.
• Guilt: Almost all children/teens feel guilt or regret about something related to the death.  "I didn't get to say goodbye."  "We had a huge fight."  Many children/teens need information about why the death was not their fault.  Guilt is the one emotion it's important to ask about: "Most children feel guilt about something related to their mom's death.  Do you?"
• Fear and worry: New fears often emerge after a death.  A student might be afraid that someone else will die, or worry that he will get sick, or be left alone.  When fear and worry keep a student from doing what she wants to do, she might benefit from other help.
• Anxiety: Most children/teens will be anxious after someone dies.  For many, the anxiety decreases within months.  For some, anxiety persists, causing behavioral changes, and might interfere with a student's interactions with others.

How To Get More Help For A Grieving Student?

Invite the student to participate in bereavement support programs that are available in your school, if any.  Share your concerns, based on very specific observations of the types of behaviors listed under Red and Yellow Flags above, that the student may need more help with the student's parent/guardian. 

Click here for a printer friendly Warning Signs brochure

Providing Bereavement Support Referrals 

Become familiar with child/teen bereavement support in your area and on line.  Refer your students and their families to these resources, including Mommy's Light's free Tradition Fulfillment_sm Services and Bereavement Education Materials. 

Click here for a list of on-line resources and bereavement support services for Delaware Valley.  Note that The Dougy Center web site, http://www.grievingchild.org/, lists child/teen bereavement support centers across the United States.

There are professionals who can help, including counselors, psychologists, psychiatrists and social workers.  Health care providers or counselors may be able to provide you with referrals for professionals who specialize in childhood and teen bereavement.  Often the best referrals are from families who have benefited from bereavement counseling.  Share all the resources you know about with the student directly, if age appropriate, and with the student's family.

What to Look For in a Bereavement Professional - share this information with the student's parent/guardian:

• Ask about the professional's specific education and experience with bereaved children and teens.
• Ask how many bereaved children/teens the professional has treated.
• Ask what format the bereavement support will take (group or individual) and how often and how long each session will run.

Any professional who tells or encourages a child/teen to "get over the death" or to "grow up" is unlikely to help a bereaved child/teen.
For a list of book/DVD resources, see Resources.