By Catherine L. Thorington
Liberty University Psychology Student

Helping Bereaved Children edited by Nancy Boyd Webb is a book written as a tool for Thantologisits, psychologists, clergy and social workers who specialize in grief counseling of children. Webb is a clinical social worker whose specialty is play therapy. She is professor on the faculty of Fordham University and is the editor of The Guilford Press book series Social Work Practice with Children and Families (Webb).Among her many other tasks and publications Webb has written several books and produced a video entitled Techniques of Play Therapy (Webb) for professionals that work in the fields of child development and grief therapy. After working with children for many years Nancy Boyd Webb discovered that there was a lack of resources to help professionals in the growing field of child grief. Helping Bereaved Children is a resource that parents social workers teachers’ laymen and professionals can use to develop skills such as play therapy when working with children who have experienced a loss. Webb uses case studies, her own other therapists that contributed to this book as examples to teach professionals how to use and implement play therapy when working with a grieving child. 

Helping Bereaved Children is divided into four parts the introduction which defines and explains how to recognize grief in children. Chapter two covers Assessment and cognitive development of the child using Piaget’s cognitive theory as a guideline for the developmentally age related process of bereavement. Death in the Family chapters three through seven cover the loss of parents grandparents siblings complicated grief suicide and violent death such as murder. Part three chapters eight nine and ten discusses death in schools and community and the treatment of children who experience these tragedies. Part four gives examples of interventions using case studies from Webb and four other contributing therapists. Part four discusses a relatively new aspect to grief helping children recover from terrorism.

Part one chapters one and two are guide lines for defining grief in children and how to assess whether or not a child has reached the point of intervention.  According to Webb most children do not reach the developmental ability to understand and comprehend the permanence of death until around the ages of seven to eleven years of old. Referring to Piaget’s Cognitive Development theory children develop cognitively in three distinct and overlapping stages, Preoperational, Latency and Prebubertal.

The preoperational stage is also called the stage of magical thinking and occurs between the ages of two and seven years. Children in this stage of cognitive development believe that their thoughts or emotions cause the death of a loved one.  It is very difficult for a child of this age to understand that death not permanent and that they did not cause the death by having a mean thought. Many times children will think that by being good they can bring their loved one back to life or make them wake up. This is why we as adults should not tell young children that Grandma has gone to sleep. Sleep is temporary and children understand that people wake up. Working with children in this stage of development is very challenging because they often lack verbal skills to communicate what they are feeling and remembering. Toys placed in a room in various places where a child can explore are one tool that is used. If a child has been witness to a violent crime such as a murder suicide of a parent. Placing toys that are repersentive of the event within the child’s range will give the child encouragement to re-enact the event. Giving them crayons or makers and paper to draw with and asking them to make a picture of what happened is also very effective. Another interesting tool is that of finger paint especially if a child was witness to the murder of a parent and then clung to the body of the dying parent. The child will paint their body with the “blood “as a way of accepting the death and separation. The paint washes off easily when the child is done playing and is symbolic of washing off the blood.

Latency also known as Concrete Operational stage of cognitive development occurs between the ages of seven and eleven. Children at this stage in mental development start to comprehend and understand the permanence of death. They also have begun to think in the abstract and can reason for themselves what it means to die though death still seems futuristic and not applicable to their lives. The challenge for therapists working with children of this cognitive stage is getting them to open up and talk about the loss. The seven to eleven year old has a very low tolerance for emotional pain and will avoid talking about the event .Parents will see clues that grief is active and can spot problems by observing behaviors such as loss of appetite nightmares disinterest in pervious activities that brought joy or pleasure before the death. Webb has found that playing board or card games with this age is very effective and presents a safe way for them to express their grief. The Story Telling game is one such game that is recommended .The game consist of story cards and settings such as rooms in the home community scenes, grocery store school police station fire department and a few blank cards that the child can chose to alter to his or her situation.

By the ages of nine to twelve years children are able to think and reason in more logical terms and understand that death can happen to anyone at any age and is permanent this is called the Perpubertal  stage  or Formal  Operational stage of cognitive development. By this time children are receptive to talk therapy and yet still young enough to prefer board and card games. Children this age are more vulnerable to depression and suicide after the death of a loved one.

Bereavement as defined in the text by Wolfelt (1983 .p28)”Grief is a process rather than a specific emotion like fear or sadness; it can be expressed by a variety of thoughts and emotions and behaviors.” It is also the loss or absence or termination of a significant relationship .Children grief differently than adults due to their cognitive development and immaturity.  These are the five guidelines that Webb uses to explain the difference between children’s grieving processes and that of adults. Children do not lack verbal and mental skills to express their anguish over the loss of a loved one, nor do they have the same tolerance for emotional pain as adults. Children are also more aware of being different than their peers and do not want that difference to be made known especially in the case of a parent dying. The majority of a Childs life especially in early to middle childhood is spent learning through play. For that reason children can appear to not be grieving by the adult care givers in their lives. Play therapy works best with children by allowing them to express their grief through drawings role play and re-enactments of events leading up to and after the death and burial of a loved one.

When evaluating a child who may be in crisis there are several areas to consider; cognitive and developmental age adjustment medical history environment past experience with death type of death and relationship to deceased. Cultural environments as well as religious affiliation and or belief systems are also considered.

For some people the grieving process can last a life time depending upon the relationship of the deceased to the child and the manner in which they died.  Such as a parent or sibling who dies at a young age or the age of the surviving child. There are milestones that all of us want to share with our families such as graduating from high school or college getting married and the birth of a child. It is important to understand that grief is personal and individual and that there is no correct or incorrect way to remember our loved ones.

I would highly recommend Helping Bereaved Children to anyone going into the fields of psychology sociology social work education and child development. As I was reading this book I could look back at my own life and my personal losses and those of my children and see that we grieved in a healthy manner. I now have technical words for the grief work that my children did and can see that for their ages developmentally they were on target. This book will become a useful resource that I refer back to over the years. Play therapy makes sense it was interesting to read the case studies and see how well it works even with very young children. Several of the children were followed up on many years latter to check their progress. All of them were doing well and stated that the play therapy they engaged in during their time of loss helped them and made a big difference in their lives.

The only topic that was not covered was the adoptee and grief. There are several other books that I have read about adoption that cover that particular issue. I also would have preferred a book by a Christian author and written from that perspective. My original choice met that criteria but was too short and did not encompass terrorism.

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