When did you start the bereavement groups for children?
We started in 2005.
And why did you feel that you needed to start this service?
We had worked with adults before, doing bereavement work with adult family members of palliative care patients. We had worked in the palliative care ward and in the ambulant setting. We saw that there wasn’t anything set up for children to help them in their grief when parents or siblings died.
In our work with adults, we noticed that a lot of the somatisation, the bodily symptoms, were a result of bereavement in childhood that had not been dealt with, and not the current lived grief. We thought that if we can prevent that from happening with these children, we can prevent them from having these symptoms in later life.
We had started bereavement groups for the spouses of patients of the Malteser service who had died. At first we had older spouses and younger spouses in the same group, but it soon became clear that the difficulties faced when losing a spouse at a young age were very different to the difficulties faced by people who had lost their partners later in life.
They younger widows did not have the same feelings about the death, and also as they were often left to care for young children, they had no time to care for themselves. So we started offering two groups for the younger widows, one for bereaved spouses, and one for their children.
We wanted to do a bridging between the understanding of the adults and their children, and the other way around. There was a need to help the children to understand why their parents were not acting as they had acted before, why they perhaps were not caring as they had cared before, not being as tender as they were before.
We have the children and their parents in separate groups because when they are together, the children are reluctant to show that they or sad or that they are angry, in case their parent becomes upset. They will try to protect their parents.
Of course they way in which children understand the death depends on what stage of development the child is in when their loved one dies. For example, when children are very young, they don’t understand that ‘dead’ is not just sleeping. Until the child is around six years old, they don’t realise that endless is endless. They will keep asking when their loved one will come back, saying for instance: “Yes I know he’s dead, but when is he coming back.”
Children can’t understand saying of final goodbyes. They understand it emotionally, from the stomach, but not intellectually. They feel abandoned by the parent who has died, when they do not come back.
Children also feel a lot of guilt when the parent doesn’t come back. They often feel that it is because they were naughty that their parent has left them.
Can you tell me a bit about how the service works in practice?
It has a focus on creativity. You can’t only speak with children. You have to use creative methods.
We have three courses per year, with between eight and 12 families in each course. Each season (Spring, Summer, Autumn, Winter) we have a family day when all the families that have been part of the service in the past can come together. We have families that come back even after many years.
We have seven dates per course, one afternoon a week for seven weeks. Each session we have a different topic or theme that we will talk about. In the first session, we will take some time to get to know each other, the children will tell their stories, what happened to their parent or sibling, what they felt like when that happened.
During each session, we will talk for an hour with the children, then we will have a break during which time the children will talk freely among themselves on any topic. Then in the second hour, we will come together again for a creative activity.
One example of these activities is that the children will pour coloured salt into jam jars. They make each colour represent a different feeling that they have or a memory about their loved one who has died. They put their feelings into this salt and create a beautiful design in the jar, which they can keep to remind them of their loved one.
Session topics might include: The children’s feelings about the person who has died, things they might want to tell them, their feelings about the illness, whether they could see the parent or sibling after they had died, whether they were able to visit them in hospital.
The children look at what they have lost, but we also look towards the future. One of the days is about what the children want to do in the future, or what they think their parents would have wanted for them.
Sometimes the people in the child’s life will try to move on from the death that has happened, but we try to let the children know that: “It’s alright if you love him, even if other people are trying to forget him.” We try to show the children that there is a bond that remains after death.
How many staff are you who work in the service?
We have two staff members, Ursula works with the parents, and Mariette works with the children. We have volunteers that help us, particularly with the children’s groups. Sometimes children who are too young and can’t read and write will need more one-to-one support to take part in the group activities.
Are seven sessions enough to help deal with bereavement?
We find that it helps. If we see that people need additional support, we help them to organize psychotherapy.
And how do you take care of yourselves?
I draw a lot of support from my family. This was not always the case, when I started working in bereavement counselling, I needed to split my energy between my duties as a mother and my responsibility to the people I was helping. Now my children are adults and they are a great source of strength for me.
Is there anything else that you would like to add?
Yes, I would like it if sometime there was more money for this work, that we could grow a bit more and that we could help more people.
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