A week ago I sat in a room with 30 professionals in a class designed to help us assist children in the grief process.  Half of the participations were Hospice workers, tasked with the daunting job of helping a child grieve through the loss of a parent, grandparent, or sibling through death.  The other half of the class were adoption/foster care social workers, tasked with the daunting job of helping children deal with the trauma of abuse and neglect that ultimately resulted in a figurative death of the relationship between parent and child.  It was not long into the class when questions and differences emerged between the two groups of professionals — the main difference centered on the ability to define the loss through death as a permanent loss, where the loss felt in foster care and adoption was often an on-going and recurring loss as the child moved through the system and even after an adoptive placement.  As one caseworker aptly stated, “the grief associated with recurring rejection may be harder that the loss of a loved one through death.” With that being said how do we help children traverse the gantlet of grief?

     The first step is to recognize the signs of grief in a child.  The normal response to grief can be found in physical, emotional, behavioral and cognitive responses.  Physical responses can include, dry mouth, lack of energy, muscle weakness, shortness of breath, tightness in the throat and chest and over sensitivity to noise. Emotional responses, which may be recognized more easily, include sadness, anger, loneliness, guilt, self-reproach, fatigue and helplessness.  These emotional responses may be manifested in behaviors such as changes in sleep and eating patterns, nightmares, recurring dreams of death, crying, and social withdrawal. Changes in the ways that a child may think during grief can be seen in disbelief, confusion, and preoccupation. Magical thinking may be prevalent in a younger child during grief.  The child may seek to blame anyone BUT their offending parent for the removal from their home and the termination of rights (TPR). The blame can be focused on a sibling, the foster parent, the social worker or even the judge. The younger child may also refuse to accept and understand the finality of the court decision to place a child in foster care and to TPR the birth parent’s rights, thus creating a death in the relationship. It is also important for foster parents to be aware that the child may also experience grief that is not associated with the TRP of their parents, but with the inherit changes in the daily life of a foster child. When an older child is moved away from their current setting to their new home, the child experiences the loss of former caregivers and friends, the loss of familiar objects, and the loss of familiar routines and habits, thus causing some of the same responses of grief. The adoptive or foster parent needs to acknowledge how these often times abrupt changes can trigger grief.

      Another important key in recognizing grief is to look for visual ques over verbal cues.  Children are not always able to talk about their feelings, thus using their actions to speak louder than their words.  Younger children may exhibit physical symptoms and/or regression which are also a common reaction to loss and grief. Children may revert to thumb sucking, rocking, tantruming, or enuresis.  A loss of concentration and mood swings may also occur in older children. In addition, some children fluctuate between withdrawal and aggression. Others may exhibit guilt about getting a new family, resembling survivor guilt.  This is most common when a sibling group is separated and some of the children are not adopted.

     It is also important to note that as children go through certain developmental stages, the feelings of loss and grief may be more prevalent. The children’s level of thinking and reasoning go through progressive stages, culminating in the ability to process complex material.  As a child’s ability to reason progresses, higher order questions evolve about the reasons behind their placement and their birth family.  This may cause the child to “circle back” to some previous issues of loss and grief that the foster/adoptive parents thought had been resolved years earlier. Consequently, the issues of loss and grief can be linear, curricular and developmental. REMEMBER— there is not a statute of limitation on grief.

     Is there any one underlying premise when working and living with a child that is suffering loss and grief?  The MOST important thing that we can do for a child is to be honest and answer their questions when they are asked.  Children learn by asking questions.  We must be sensitive to the child’s need to understand what has happed that has changed their family dynamics. For example, why am I not with my parents?  If termination is not completed by the court, the foster parent may say, “It is the court’s job to make sure that you are safe and you were not in a safe place and had to be moved to a safe place to live.”  If termination has been accomplished, the child needs to understand that being reunited with their parent is not a possibility.  This is a critical step in being able to grieve and to get through the loss. An initial part of adoption preparation must focus on the finality  of the termination of parental rights. This needs to be reinforced by the foster family and social worker. This will have to be done knowing the level of the child’s comprehension and the circumstances surrounding the adoption plan.  It is also important to help the child understand that the adoption plan was not the result of any fault or issue that the child had.  This is very important when the adoption plan was made due to abuse of the child.  Without a firm understanding about the finality of the TPR, children can emerge into the world of magical thinking, which can include the ability to go back to their family of origin  —- or the blaming of siblings or someone else for their removal, rather than understanding the loss and the right to move forward with another family.

      As parents, social workers, and caregivers, what are other ways that we can help children resolve their feelings of loss and grief regarding adoption?

Acknowledge times that you have felt loss and grief and how you dealt with it.

Suggest for older children to keep a journal to write about their feelings that they may not want to share with anyone else.

Keep open ended art supplies for the younger child to express their feelings.  Use open ended color books that can promote the expression of feelings through art.

Read books to your child about others who have experienced loss and grief and have lived through their losses. Use gentle questioning about how their situations may be alike or different.  Some suggestions include:   A Taste of Blackberries, Badger’s Parting Gifts, Bridge to Terabithia, First Snow, Missing May, Annie and the Old One, Ten Good Things About Barney, Nadia, the Willful, and Tiger Eyes.

Be prepared to discuss some issues about the placement plan over and over again as the child matures and has a deeper level of comprehension of the initial facts. Remember that loss and grief issues can be circular as the child’s development progresses.

Seek out other resources such as an adoption support group for adoptees and counseling for the adoptee and for the entire family unit. Be aware of how the child’s loss and grief issues may be affecting the bonding between you and your child.

      Loss and grief is a normal part of all life.  Each of us will suffer loss and grief at some time in our life. The ability to deal with the loss and grief with a supportive caring family can help a child move forward to know that his losses and grief can be replaced with a loving forever family on whom he can depend!  Remember that positive grief leads to healthy relationships and moving beyond the past hurts.

By June Bond