Kimberly Keith, MEd, LPC Academic Partnerships for Public Child Welfare Department of Behavioral & Social Sciences Southern Arkansas University Magnolia, Arkansas

1. Grief and Loss of Children in Foster Care Every child removed from home grieves that loss, no matter how superior the foster care placement may be. (Wallace, 2003)

2. Individual Exercise Handout Before we start… As we go through the developmental stages, think of a child you know in each age range who is showing these or other expressions of grief. On the Individual Exercise Handout, list the behaviors the child is showing. (Don’t put the children’s names; just keep them in mind.) As we go through the lesson on helping the grieving child in foster care, think of what might be done to support and encourage the child during separation, grief, and loss? List on the Individual Exercise Handout.

3. What We Know about the Grief of Children in Foster Care The grief of children in foster care is different from a child who loses a parent to death. The level and type of grieving in foster children depends on many factors. Grief in foster children is complicated and proceeds in both linear and circular patterns. The way grief is expressed and coped with depends on the child’s developmental level.

4. How to Help the Grieving Child in Foster Care The salvation for foster children is in learning to take the energy from their grief and trauma and focus it on something positive, like school, positive play, and relationships with friends – anything that is positive for that child. (Anderson, 2000 in Wallace, 2003)

5. Infants and Toddlers How Infants & Toddlers May Express Grief Crying loudly, mournful crying, Withdrawal, apathy Sleeping and eating problems (too much, too little) Needing to be held Separation anxiety Regression Irritability and temper tantrums Rocking back and forth Head banging

6. Infants and Toddlers How to Help the Grieving Infant or Toddler Provide lots of physical contact and nurturing Provide a consistent routine Provide concrete rules and limits Explain what has happened in very simple terms Make time for play Let the child have things from home (blanket, stuffed toy) to provide a sense of security

7. Preschoolers How Preschoolers May Express Grief Bedwetting Thumb sucking Clinging to foster parents Exaggerated fears Excessive crying Temper tantrums Regression Stubbornness

8. Preschoolers How to Help the Grieving Preschooler Answer the child’s question honestly; allow them to talk about the parent and how things were at home; help them share their fears and worries. Provide simple routines Give the child affection and nurturing; attempt to connect with them Provide opportunities for play Be patient with regressive behaviors such as thumb sucking Keep them focused on their immediate environment and activities. Let them know where you are going and when you will be back.

9. Elementary-School Age How Elementary-Age Children May Express Grief School and learning problems Preoccupation with the loss of parents and related worries; trouble paying attention Bedwetting Eating and sleeping problems (overeating, refusing to eat, nightmares, sleepiness) Daydreaming Fighting, anger

10. Elementary-School Age How to Help the Grieving Elementary-Age Child Keep tasks simple. Explain things before they experience them – court, new school or church, foster family outings and traditions. Provide a structured environment that is predictable and consistent. Limit choices. Introduce small, manageable choices over time. Contain acting out behavior. Push them to express their wants, needs, and feelings with words, not by acting out. Encourage them to let you know when they are worried or having a difficult time.

11. Pre-Teens and Teens How Pre-Teens and Teens May Express Grief Physical symptoms (headaches, stomachaches, sleeping and eating disorders, hypochondria) Wide mood swings Verbally expresses emotions but also needs physical outlets Feelings of helplessness and hopelessness Increase in risk-taking and self-destructive behaviors Anger, aggression, fighting, resistance, oppositional behavior Withdrawal from adults, increased time with friends Depression, sadness Lack of concentration and attention Identity confusion; testing limits

12. Pre-Teens and Teens How to Help Grieving Pre-Teens and Teens Accept that they will experience mood swings and physical symptoms. Encourage them to honestly recognize their painful feelings and find positive outlets in physical and creative activities. Listen for the feelings behind their words and actions and respond with empathy. Be truthful and factual in explaining their circumstances. Help them develop and maintain their sense of identity. Allow teens to make choices that are not harmful. Encourage safe expressions and experiences of freedom and independence.

13. Ways to Support and Encourage a Grieving Child Give children affection and nurturing. Infants through preschoolers need physical contact for a sense of security. Affection and attachment with older children takes time, but is still just as important. Be empathetic to the emotions that children express directly and indirectly through acting out or withdrawal. Learn to recognize the emotion behind the words or actions and acknowledge it. Maintain an atmosphere of openness to verbal expression of feelings, but not allowing bad or harmful behavior to self or others in the expression of those feelings. Be alert to expressions of grief and use listening skills to help children talk about what is on their mind. It doesn’t hurt to ask children questions about how they did things at their house or about memories of family events, both good and bad. Encourage them to let you know when they are having a hard time.

14. Ways to Support and Encourage a Grieving Child Be truthful and factual in explaining the situation. This helps a child feel more in control. Crying really does help. Children need a safe place to talk about their losses and grief. All children who are removed from a parent should receive therapeutic counseling services as often as possible. Use planning, structure, and clear limits to help children who have been traumatized to stay in control. This will also help to contain acting-out behaviors associated with the avoidance of painful emotions in grieving. Keep the child’s tasks simple. Don’t offer too many choices. Explain things before they experience them – court, new school or church, foster family outings and traditions. Encourage children to find positive outlets for the emotional energy that accompanies grief through playtime, physical activities, and creative activities.

15. Ways to Support and Encourage a Grieving Child Address the physical and medical needs of the child and encourage healthy habits of proper rest, nutrition, and grooming. Seek extra help for the child in their schoolwork, such as after-school tutoring, to help remediate academic delays that are common in grieving and traumatized children. Help children develop a “survivor” identity rather than “victim”. Help them recognize their strengths and call attention to the positive steps they take in coping with their losses.

16. Sources Developmental Issues of Grieving Children and How to Help by Dr. Sheri Siegel The Grieving Child in Care Factsheet by Sheri Wallace Children: Grief and Loss in Foster Care by Holly Martinac A Child’s Journey through Placement by Dr. Vera Fahlberg Helping the Grieving Student: A Guide for Teachers from the Doughy Center Helping Children Cope with Death from the Doughy Center How Do We Tell the Children? by Dan Schaeffer and Christine Lyons The Grieving Child by Helen Fitzgerald