Childhood Traumatic Grief Research Articles

Childhood traumatic grief counselling: A South African case study

This study explored the efficacy of a culturally adapted childhood traumatic grief counselling treatment with a 6-year- old South African male child who lost his mother to accidental electrocution. Based on data analysis of his case file, we discerned five themes to characterise his recovery: (i) gradual exposure to trauma memory; (ii) strengthening the child-caregiver relationship; (iii) self-managing trauma emotions; (iv) trauma narrative competencies; and (v) grief symptoms recognition and expression. Findings support the efficacy of a culturally adapted childhood traumatic grief treatment intervention with a young South African child.

Trauma-Focused Cognitive Behavioral Therapy for Childhood Traumatic Separation.

In light of the current U.S. family separation crisis, there is growing attention to Childhood Traumatic Separation, defined here as a significant traumatic stress reaction to a familial separation that the child experiences as traumatic. When living in a family setting, Childhood Traumatic Separation may interfere with the child's relationships with the current caregiver(s). Effective treatments for Childhood Traumatic Grief can be modified to address Childhood Traumatic Separation. This article describes current applications of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for Childhood Traumatic Separation. Using two composite clinical cases, TF-CBT applications for Childhood Traumatic Separation are described. These include: (1) implementing the safety component first; (2) tailoring coping skills to address the uncertainty of Childhood Traumatic Separation; (3) integrating past traumas into trauma narration and processing of the traumatic familial separation; (4) providing Childhood Traumatic Separation-focused components to address challenges of committing to new relationships while retaining connections to the separated parent; and (5) addressing role changes. These modifications have been implemented for many youth with Childhood Traumatic Separation and have anecdotally resulted in positive outcomes. Research is needed to document their effectiveness. The above practical strategies can be incorporated into TF-CBT to effectively treat children with Traumatic Separation. Practical strategies include starting with safety strategies; tailoring skills components to address the ongoing uncertainty of traumatic separation; integrating past traumas into trauma narration and processing of traumatic separation; providing traumatic separation-focused components to balance the challenges of committing to new relationships with retaining connections to the separation parent; and addressing role changes. Through these strategies therapists can successfully apply TF-CBT for Childhood Traumatic Separation.

The Whispers by Greg Howard

Reviewed by: The Whispers by Greg Howard Karen Coats Howard, Greg The Whispers. Putnam, 2019 [256p] Trade ed. ISBN 978-0-525-51749-8 $16.99 E-book ed. ISBN 978-0-525-51750-4 $9.99 Reviewed from galleys R Gr. 4-7 Eleven-year-old Riley wants to kiss boys, and he feels that might have something to do with why his mother left. Although a chubby policeman that he calls Frank keeps questioning him about the last time he saw his mother, Riley doesn’t trust him to help; instead, he believes that he has to find her on his own. He turns to the Whispers—creatures from a local legend that entice people into the woods and reveal secrets. A camping trip with his best friend and his dog looks to be the best night of his life when the boy he’s crushing on joins them and then becomes the worst night of his life when Riley finally has to face the truth he’s been avoiding about his mom’s disappearance. Riley’s determination to keep his hope alive results in a mystery that seems almost plausible before it becomes heartbreakingly poignant in the reveal. His introduction of Frank (his therapist) as a policeman, his memory of a mysterious white car (a hearse) outside the house on the day of her “disappearance,” and his invocation of someone named Kenny from Kentucky as a possible factor all suggest a crime to be solved. The last, however, makes even more psychological sense when readers learn that his mom caught Riley and Kenny kissing, and that Riley believes the careless words he overheard from a church lady that it would “kill Mama if she found out” that Riley was gay. Riley blends southern folklore and TV-inspired crime drama to craft a story that protects him [End Page 209] from a truth he can’t acknowledge, making this an inspired and sensitive portrait of childhood traumatic grief. Copyright © 2019 The Board of Trustees of the University of Illinois

Building Resilience Among Orphaned and Vulnerable Children Through the Memory Book Intervention.

Children who are orphaned and vulnerable due to poverty, war, or disease (HIV/AIDS) may experience childhood traumatic grief. A qualitative phenomenological approach was implemented to explore and compare the lived experiences of orphaned children, adolescents, and caregivers who had used the Memory Book intervention at six children's homes in India, Kenya, and South Africa. Study findings revealed similar themes between the countries, with primary themes of identity and relationships, and secondary themes of coping, hope, and emotion. Findings suggest the value of Memory Book resources to encourage the preservation of a child's story and grief recovery that can be used for any child facing recovery from difficult life events.

Children and Terrorism and commentaries

Children and Terrorism and commentaries

Traumatic grief in young people in Sub-Saharan Africa: a scoping review

Aim: To identify relevant and pertinent themes and interventions within the literature relating to childhood traumatic grief, in order to provide a sound background of evidence for further research and service development. Background: Childhood traumatic grief is caused when a significant person in a child’s life dies under circumstances that they perceive to be traumatic. This can leave a child unable to return to the same level of physical and emotional functioning that he or she had prior to the death occurring. In Sub-Saharan Africa, there is an increased risk for childhood traumatic grief due to a high prevalence of orphanhood, environmental stressors, stigma, and abuse. This can have detrimental effects upon mental health. Methods: The review followed the York methodology: identifying the purpose and agreeing on the strategy beforehand; identifying relevant sources/studies; selecting the studies; charting the data; and collating, summarizing, and reporting results. Results and discussion: Interventions identified to prevent and/or manage traumatic grief included narrative exposure therapy, psychotherapy, mentoring, peer-group support, psychosocial support, a grief and loss therapy session, and memory boxes. Mental health remains neglected within service and policy development as well as in global health spending. The average amount expended on mental health services per person per year in low-income countries is less than $0.25. Only 36% of people in low income countries are covered by a mental health policy, compared with 92% in high income countries. Limitations: The sixth stage of the York methodology was omitted. Only papers written in English were included in the review. Conclusion: Childhood traumatic grief in young people is an important issue within SubSaharan Africa and has relevance to the global mental health agenda.

Beyond Community Violence: Loss and Traumatic Grief in African American Elementary School Children

The current study examined loss and childhood traumatic grief (CTG) in a sample of 403 African American school children in grades 6–8. Three out of four of these children reported the death of a close family member or friend, with deaths more than twice as likely to occur from illness and disease as from violence. Almost one-quarter of the children reporting a loss from any source scored in the severe traumatic grief range. After statistically controlling for witnessing violence, victimization and family violence, CTG was a significant contributor to PTSD, internalizing behavior problems, depression and poor academic achievement for girls, and particularly so for boys for whom it also predicted acting out. These data indicate that loss and traumatic grief are pervasive in the lives of these inner-city children who appear to be more affected by these events than the often-studied exposure to community violence.

Trauma-Focused Cognitive Behavioral Therapy Applied to Childhood Traumatic Grief in the Aftermath of a Motor-Vehicle Accident

Symptoms of posttraumatic stress, depression, and unresolved grief can appear in children and adolescents following the witnessing or experiencing of a traumatic event and respond with intense fear, helplessness, or horror. Those who lose a loved one in a traumatic manner can develop childhood traumatic grief (CTG), where typical grieving is hindered by trauma symptoms, causing significant impairment in daily functioning, relationships, and academic pursuits. The following is a case study describing a trauma-focused cognitive behavioral approach to treat posttraumatic stress disorder and CTG in a 16-year-old driver of a motor vehicle accident in which his peer was killed. A graduate student clinician provided treatment under supervision within the context of a school mental health program. The results of the intervention were associated with significant reductions in symptoms and impairments in daily living. The implications of these data and recommendations for clinicians treating CTG are provided.

Healing Components of a Bereavement Camp: Children and Adolescents Give Voice to Their Experiences

This qualitative study is the follow-up to a quantitative controlled study which showed a decrease in childhood traumatic grief and posttraumatic stress disorder symptoms in parentally bereaved children participating in a bereavement camp. The purpose of this study was to identify the healing components of this camp model. Semi-structured interviews with 19 children and 13 parents/guardians were conducted 3 to 9 months after participation in the bereavement camp. Therapeutic Interventions and Traditional Camp Activities emerged as themes. The themes are discussed in relation to previous research as are limitations of the study and the implications for theory, practice, and future research.

Supporting children with traumatic grief: What educators need to know

Following traumatic deaths children may develop Childhood Traumatic Grief (CTG), a condition in which trauma symptoms interfere with adaptive child grieving. Educators have an important role in supporting children who have CTG. Key contributions that educators can make are to (a) recognize CTG symptoms in school settings; (b) refer children for mental health evaluations when appropriate; (c) recognize reminders that trigger trauma symptoms and identify ways to manage these triggers and responses in school settings; (d) support CTG treatments in school by reinforcing children’s use of stress-management strategies; (e) respect confidentiality; (f) recognize the importance of cultural issues in CTG; and (g) maintain good communication with parents and other helping professionals.

Traumatic Loss in Children and Adolescents

Although different types of childhood trauma have many common characteristics and mental health outcomes, traumatic loss in children and adolescents has a number of distinctive features. Most importantly, youth who experience a traumatic loss may develop childhood traumatic grief (CTG), which is the encroachment of trauma symptoms on the grieving process and prevents the child from negotiating the typical steps associated with normal bereavement. This article discusses the distinctive features of CTG, how it is different from normal bereavement, how this condition is assessed, and promising treatments for children who experience a traumatic loss.

Trauma-Focused CBT for Traumatic Grief in Military Children

Although military children are typically as resilient as the general child population, the ongoing conflict has exposed military children to unusual stressors such as repeated deployment, severe injury, or the death of a parent or sibling. U.S. forces have experienced more than 5,600 casualties during Operation Iraqi Freedom and Operation Enduring Freedom, with growing numbers of suicides among Service members. These deaths have affected thousands of military children. Most bereaved military children experience adaptive grief characterized by deep sadness, longing for the deceased person, and being comforted by positive memories of the deceased. A smaller number of military children develop childhood traumatic grief, characterized by trauma symptoms that interfere with adaptive grieving. Children with traumatic grief get “stuck” on the traumatic aspects of the death such as picturing the imagined or real details of the death; imagining the pain their loved one experienced in the moments before dying; wishing for revenge; and becoming angry at those who do not understand or share the child’s thoughts and feelings about the death. These children avoid reminders of the deceased person. Trauma-focused cognitive behavioral therapy (TF-CBT) is an evidence-based treatment for children with trauma symptoms including those with traumatic grief. TF-CBT may be particularly suitable for military families. This article describes the clinical application of TF-CBT for traumatic grief in military children.

Implementing Trauma-Focused CBT With Fidelity and Flexibility: A Family Case Study

Effective approaches for the treatment of childhood posttraumatic stress disorder and traumatic grief are needed given the prevalence of trauma and its impact on children's lives. To effectively treat posttraumatic stress disorder in children, evidence-based practices should be implemented with flexibility and responsiveness to culture, developmental level, and the specific needs of the family. This case study illustrates flexibility with fidelity in the use of a manualized treatment, describing the implementation of Trauma Focused-Cognitive Behavior Therapy with three traumatized family members—a caregiver and two children. Particular attention is paid to the use of creative strategies to tailor interventions to the individual clients while maintaining fidelity to the principles and components of this evidence-based treatment.

The Prevalence of Childhood Traumatic Grief—A Comparison of Violent/Sudden and Expected Loss

The purpose of this study was to examine the prevalence of childhood traumatic grief (CTG) and posttraumatic stress disorder (PTSD) symptoms in parentally bereaved children and compare scores between those who had lost a parent to a sudden/violent death and those who had lost a parent to an expected death. A sample of 158 parentally bereaved children ages 7-16 completed the Extended Grief Inventory (EGI); 127 of those also completed the UCLA PTSD Index. A large number of children were experiencing CTG symptoms at moderate and severe levels. There was no significant difference in EGI or UCLA PTSD Index scores between the two types of losses. Findings are discussed in relation to trauma theory, research on parentally bereaved children and implications for practice.

Childhood Traumatic Grief: A Multi-Site Empirical Examination of the Construct and its Correlates

This study evaluated the construct of childhood traumatic grief (CTG) and its correlates through a multi-site assessment of 132 bereaved children and adolescents. Youth completed a new measure of the characteristics, attributions, and reactions to exposure to death (CARED), as well as measures of CTG, posttraumatic stress disorder (PTSD), depression, and anger. CTG was distinct from but highly correlated with PTSD, depression, and, to a lesser degree, anger. In contrast to a recent study of complicated grief, CTG severity was significantly associated with the degree to which the death was viewed as traumatic. CTG was also associated with caregivers' emotional reaction at the time of the death and caregivers' current sadness. Clinical implications and recommendations for future research are discussed.

Efficacy of a Camp-Based Intervention for Childhood Traumatic Grief

Objective: This study examined the efficacy of a short-term, camp-based, trauma-focused grief intervention in reducing traumatic grief and posttraumatic stress disorder symptoms in parentally bereaved children. Method: For this nonequivalent comparison group study, 100 children were split into two groups, with one group serving as the immediate treatment group and the second group serving as the delayed treatment group. Results: The results were analyzed using chi-square, independent samples t tests, multiple and logistic regression and showed this short-term intervention to be followed by reduced traumatic grief and posttraumatic stress disorder symptoms. Conclusions: The results are discussed in relation to current research on and practice with bereaved children as well as implications for future research.

An Interpersonal Neurobiological-Informed Treatment Model for Childhood Traumatic Grief

This article expands an earlier model of the tasks of grieving (1990, [1995], [2001]) by building on science based findings derived from research in attachment theory, neuroscience, interpersonal neurobiology, and childhood traumatic grief (CTG). The proposed treatment model is a prescriptive approach that spells out specific tasks to be undertaken by children suffering traumatic grief under the direction of a therapist who is trained in trauma-informed therapy approaches and draws heavily on the empirically derived childhood traumatic grief treatment model developed by Cohen and Mannarino (2004; Cohen, Mannarino, & Deblinger, 2006). This model expands on their work by proposing specific tasks that are informed by attachment theory research and the interpersonal neurobiological research (Schore, 2003a, 2003b; Siegel, 1999). Particular emphasis is placed on developing a coherent and meaningful narrative since this has been found as a crucial factor in recovery from trauma in attachment research (Siegel, 1999; Siegel & Hartzell, 2003).

A Pilot Study of Modified Cognitive-Behavioral Therapy for Childhood Traumatic Grief (CBT-CTG)

This pilot study evaluated outcomes for a modified 12-session protocol of cognitive-behavioral therapy for childhood traumatic grief (CBT-CTG) conducted between March 2004 and October 2005. CTG is an emerging condition characterized by a combination of posttraumatic stress and unresolved grief symptoms. This two-module treatment model consisting of sequential trauma- and grief-focused components was shortened from a previously presented 16-session protocol. Thirty-nine children ages 6 to 17 years old with CTG and their parents received the modified 12-session protocol of CBT-CTG. CTG and posttraumatic stress disorder (PTSD) symptoms were assessed at pretreatment, after the trauma-focused module, and after the grief-focused module (at posttreatment). Child depression, anxiety, and behavioral symptoms, as well as parental depression and PTSD symptoms, were assessed at pre- and posttreatment. Children reported significant improvement in CTG, PTSD, depression, and anxiety, and parents reported significant improvement in children's PTSD, internalizing and total behavior problems, and their personal PTSD symptoms. Although PTSD significantly improved only during the trauma-focused module of treatment, CTG improved significantly during both trauma- and grief-focused modules of treatment. Child satisfaction and parent satisfaction for this treatment protocol were also high. These findings suggest that the shortened CBT-CTG protocol, which is similar in the number of sessions to what many community child bereavement programs offer, may be acceptable and efficacious for this population. The CBT-CTG model requires further evaluation in randomized, controlled treatment trials.

Psychosocial Interventions for Maltreated and Violence‐Exposed Children

Child sexual, physical, and emotional abuse as well as child neglect and domestic violence, community violence, and Childhood Traumatic Grief may result in significant and long‐lasting emotional and behavioral difficulties. This article reviews randomized controlled studies that have assessed child mental health outcomes for maltreated and violence‐exposed children. Key points of this review include the following: (1) maltreated and violence‐exposed children typically experience more than one of these types of traumas; (2) effective psychosocial treatments are available to address Posttraumatic Stress Disorder (PTSD), depression, anxiety, and behavioral problems in these children; (3) it is likely that treatments which effectively reduce mental health symptoms in children exposed to one type of child maltreatment or violence exposure will also be effective for other or multiple types; and (4) mental health outcomes are not the only important outcomes to address in future treatment or intervention efforts. These future directions for treatment intervention research are addressed.

Clinical Tools to Facilitate Treatment of Childhood Traumatic Grief

Cohen and Mannarino (2004) define childhood traumatic grief (CTG) as “a condition in which trauma symptoms impinge on children's ability to negotiate the normal grieving process” (p. 819). Brown and Goodman (2005) add further clarification, “According to our current understanding of CTG and normal grief, thoughts and images of a traumatic nature are so terrifying, horrific, and anxiety provoking that they cause the child to avoid and shut out these thoughts and images that would be comforting reminders of the person who died. In contrast, a child who does not have intrusive reminders, or who did not experience the death as traumatic, is able to access the person in memory in a manner that is positive and beneficial to integrating the death in his or her total life experience” (pp. 255, 257). The distressing and intrusive images, reminders, and thoughts of the traumatic circumstances of the death, along with the physiological hyperarousal associated with such re-experiencing, prevent the child from proceeding in a healthy way with the grieving process. In addition, while such children are ordinarily excluded from studies of empirically validated treatment studies because of severity and co-morbidity of their conditions, clinicians often see youngsters where traumatic death has been superimposed on a history of multiple losses and in some cases socio-cultural trauma and/or major psychiatric disorders in the child or family. The projective drawing and storytelling strategies and the evocative technique described in this article are intended to offer clinicians additional tools to deal with such seriously impacted youth so that the trauma work can be approached in the relative safety of symbolism and metaphor prior to directly confronting the trauma events.