Dr Joanne Robinson Chartered Clinical P sychologist DClinPsychol CPsychol One eye sees the other feels Paul Klee BereavementGrief Is a normal process Persistent and prolonged ID: 173065
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Bereavement, Loss & critical illness
Dr Joanne Robinson, Chartered Clinical PsychologistDClinPsychol., CPsychol.Slide2
“One eye sees, the other feels”
Paul KleeSlide3
Bereavement/Grief
Is a normal processPersistent and prolongedLeads to a change in emotions, behaviours, and beliefs about self, others and the worldTraumatic Grief: leads to actual shifts in the structure of self – can become fragmentedExperiencing possible detachment, dissociationExpressions of Grief: emotional shock, regression, explosive emotions, repetitive questions, feelings of guilt/self-blameSlide4
Bereavement/Grief
1 in 5 will experience death of someone close to them by the time they are 18 years old1 in every 1500 secondary school students dies each yearEvery 22 minutes a child in Britain is bereaved of a parentApproximately 2 children under 16 years old are bereaved of a parent every hour in the UK1 out of every 20 children aged 15 years and younger will suffer the loss of one or both parents
6% of 5-16 year olds will have experienced death of a close friend of the familySlide5
loss
Loss of…Role due to disability, mental health and illnessFamily separation due to war, terror, divorce, adoption/fosteringHospitalisation (chronic & terminal health conditions)Friends due to house moves, deathPetsSlide6
Models of Grief
Kübler-Ross: 5 emotional stages of Grief (1969)Denial AngerBargaining
DepressionAcceptanceNot a linear model.
E.g. Parents Divorce
“mum & dad will stay together”
“I hate Mum for leaving us”
“If I tidy my bedroom maybe Mum won’t leave Dad”
“I feel sad. I can’t be bothered to go out”
“I guess it’s happening. Maybe I can still see Mum at weekends”Slide7
Model of Meaning Reconstruction Pathways in Response to the Loss of a Loved One (Gillies &
Neimeyer
, 2006)Slide8
Critical illness
“a disease state that has symptoms with a protracted course and involvement of one or more organ systems (e.g. brain, heath, lung, blood) and may impact health status or psychological functioning, and lasts three months or longer”Adaption to illness is defined as “the psychological functioning and personal adjustment of children and adolescents who suffer from chronic illness”Slide9
Critical illness
Average age of Young Carer = 12 years old (Barnardos)2001 Census identified 175,000 Young Carers in UK2011 Census identified 178,00055% increase in 8-9 year olds83% increase in 5-7 year olds
April 2015: Social Worker from Local Authority must carry out a Young Carer’s Needs Assessment to decide what kind of help the child and family need, if they request this.Slide10
Critical illness
ContinuumThose that activity seek more information vs those that ‘switch off’ (Green, 2007)Those who adopt an active coping style – manage hospital admissions for surgery better (Schultheis,
Petersn and Selby, 1987)Slide11
Critical illness
Missing School : appointments, tiredness, physical difficultiesDifficulties with peers e.g. physically joining in, absences, disrupted friendshipsSpecific Learning Difficulties Being ‘normal’ vs sense of differenceImportance of family
Access to Education for children and Young People with Medical Needs (2001): need to achieve a balance between continuing education and making allowances.Slide12
Critical illness
Day to day responsibilitiesStruggling educationallyCoping with medical procedures & symptomsEstablishing relationships with medical professionalsOften bullied for being different or labelled as “ill”Isolated (separation from family & friends)
Non-ill siblings taking on additional roles Afraid to ask for helpSlide13
Coping with grief/loss
Different to AdultsAct out & Complain of Physical DiscomfortConflict in perception of selfIndependence – a barrier?Create tensionSlide14
“All learning has an emotional base”
PlatoSlide15
Coping
What opportunities have been available to the child or young person to express their views and how have they used this opportunity?Constantly changing cognitive and behaviour efforts to manage internal and external demandsSlide16
No One needs to be a victim of their biography.
George Kelly, 1955Bereavement, Loss or critical illness does not need to define you.Slide17
Establishing safety
©Therapeutic Aims (Pocket Health Series, Robinson, 2014)Slide18
Establishing a common Language
“Happiness can be found even in the darkest of times; when one only remembers to turn on the light”
“Nameless forebodings crept upon him as he sat there in the dark: he tried to resist them, push them away, yet they came at him relentlessly. Neither can live while the other survives”Slide19
BIBLIOTHErapy
Tom Ravenette, Educational Psychologist: routinely used stories with young people to establish similarity and difference to the young person’s own situation. Through discussion of characters young people are able to “ integrate concepts elicited and find personal meaning to their grief, increasing their understanding of self in relation to others and the world” (Robinson, 2012)
Tell me about the story in your own words..
Would you change anything in the story? If so, what would you change?How would you have liked the story to have ended?Which character are you drawn to the most? Are they like you in anyway? Is so, in what way? How are they different?Slide20
What stories/films do you know?Slide21
Helping young people
Equipping young people with the skills to cope with adverse life eventsAllow young people to tell their storyBe a good listenerDon’t make assumptionsGrieving is a processDon’t lieEncourage questions
Let Young People know you really want to understand themWill need long-lasting supportSlide22
Helping young people
Make connectionsHelping othersMaintain routineTake breaksSelf careSet reasonable goalsNurture positive self view
Keep perspectiveOpportunities for self discoveryAcceptance of changeSlide23
resiliency
“the human capacity to face, overcome and ultimately be strengthened by life's adversities and challenges”Meaning MakingStrengths-focusedPromote connectednessBecome better observersModel emotional regulationSlide24
Professional wellbeing
Impact on StaffProQol – 30 items self report measure - Questions about you and your current work situation - Honest reflection of how frequently you experience these in the last
30 daysSlide25
Resources
The Children’s Society childrenssocitey.org.ukBarnardos barnardos.org.ukCRUSE cruse.org.uk
Grief Encounter griefencounter.org.uk
National Association of School Psychologists: Helping Children cope with loss, death and grief. Tips for Teachers and Parents (2003) www.nasponline.orgSlide26
Thank you For listening & Participating!
My email address: info@drjoannerobinson.co.uk