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Children in Families Affected by Illness and Death

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by

Asma AlGhurair

on 15 June 2014

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Transcript of Children in Families Affected by Illness and Death

Children in Families Affected by Illness and Death
By Asma M. AlGhurair and Fatma A. AlMahamood

The Case Of Sabrina
Family information:
Child Client: Sabrina Rossi, Age 5 ¾, Completing kindergarten.

Mother: Lida Rossi, Ages 46, Psychologist (Unemployed).

Father: Dan Rossi, Age 40, Editor at publishing house.

Half Brother: John Sand, age 18, unemployed; Former collage student.

Paternal Grandparents: In 70's, living nearby.

Paternal Aunt: Carol, age 44, living nearby.

Cousins: Carol's children, Katie and Greg, ages 10 and 4.

Other family members living out of state
Background Information
Mrs. Rossi had been married before.

He died from a heart attack at age 45 when john was 14; he has suffered from depression and alcoholism.

She was separated from him when john was 2 ½. Neither she nor John contacted him since the separation.

Mr. and Mrs. Rossi have been married 8 years.

They come from different backgrounds.
Presenting The Problem
Mrs. Rossi requested help for her family because she was facing major surgery.

Large tumor that need to be removed.

There was a lot of tension because Mr. Rossi was angry with john, because he was unemployed.

John overdoses on cocaine 6 months ago and dropped out of college.

Mrs. Rossi has been trying to put her family in order before going to the hospital.
Intervention
In the sessions, they talked about the chores everyone will do when Mrs. Rossi comes back from the hospital.

But John seemed reluctant to do the chores because he might be asleep.

Sabrina's kindergarten teacher commented about her that she is "Spaciness" and unable to concentrate.

They also planed later on sessions with the family.
Mother-Child Sessions
They told Sabrina that her mother is going to the hospital next week.

She said that she is "Mad" because she will stay at her grandmother's and its dark there.
She was asked to draw a picture. but declined to explain the picture.
8 Months Later
Mr. Rossi was supportive of his wife.
Mrs. Rossi recovered well and making plans to resume her professional career.
John got a job and plans to move out and go to school next semester.
Sabrina was doing well and she drew her person as a princess.
Issues in Sibling Death
1- Creates sense of vulnerability in the siblings.

2- Grieving parents doesn't give their parental function the surviving siblings.

3- The child's reaction depends on how successfully the parents get back to do their patently functions.

4- The child's developmental levels has important effect on his or her grief response. (Ex: ambivalent, hostile and guilty)

5- Death of a family member requires role realignments and reorganization.
Update 8 years Later
Developmental influences on children’s understanding of death
The child’s understanding of death
The extent of the child’s understanding of death
What should be done when a child suffers a loss

The Case of Sabrina 6½
What stage is Sabrina in?
What was her understanding of her brother’s death?
The effect of her belief on her understanding.

The Tripartite Assessment of The Bereaved Child
What is Bereaved?
What is the method used in “The tripartite assessment of the bereaved child”
Three factors to be considered when a child suffers a loss of a loved one
Individual factors
1- Age/Innate Factors
Developmental stage
Cognitive level
Temperamental Characteristics
2- Past coping/Adjustments
Home
School
Interpersonal/peers
Hobbies/interests
3- Global Assessment of Functioning (DSM-VI-TR)
4- Medical history
5- Past experience with death/loss
Past experience with death/loss could impact the child’s response

Example:
Death-related factors
Anticipated/sudden
“Timeless” of death/prevent ability
Degree of pain
Presence at violence/trauma
Element of stigma

1- Type of death
2- Contact with Deceased
Present at death
Viewed dead body
Attended ceremonies
Visited grave

3- Expression of “Goodbye”
4- Relationship to deceased: Meaning of loss
5- Grief Reaction
The violence/trauma may affect the child’s and the family.
Example:
Factors in Support System
What are the different form in the tripartite assessment of the bereaved child
What does each form eases?

Relating The Tripartite Assessment of The Bereaved Child to Sabrina
Sabrina and her school
Sabrina’s change in behavior
Is it normal?
Relating The Tripartite Assessment of The Bereaved Child to Sabrina
1- Nuclear Family: Grief Reaction
2- Extended Family: Grief Reaction
3- School: Recognition of Bereavement
4- Religious Affiliations
Membership/participation
Beliefs about death
5- Cultural affiliations
Typical beliefs about death
Extent of child inclusion
Sabrina's Intervention
Conclusion
Selected helping intervention for bereaved children
What is the goal?
The parents confusion regarding their child’s behavior.
Play Approaches
Why do counselor use play therapy?
What is the method used and what is the purpose?

Play Materials
What are some of the effective materials?
Example: Clay
How is the material is chosen?
Were is the focus in play therapy techniques?

Individual, Family, and Group Approaches
Should the counselor focus on the child alone?
What is the reason behind the counselor attending funerals and family gatherings after a death of a loved one?
Does play therapy include parents?
When does the counselor prefers a grief support group?
Are there schools with bereavement groups and why?

What kind of emotion do children experience and how to console them?
Does the process of consoling a child depend on anything?
Play therapy recap
Play therapy’s goal
Sabrina and Mr. Rossi were starting to move on after a year.
Sabrina was doing well in school, had friends and participated in school activities.
few years later Mr. Rossi Started dating, and Sabrina was "It's OK"
But both Sabrina and Mr. Rossi where "Super Sensitive" about someone being late or not knowing where the other is.
Initial Intervention
Sabrina’s First Session
Individual Sessions with Sabrina
Sessions with Sabrina and Her Father
Sessions with Sabrina and Her Mother- 4 Months After John’s death
The Body Map Of Feelings
Full transcript