WHEN A STUDENT LOSES A SIBLING: A Toolkit for Schools

WHEN A STUDENT LOSES A SIBLING: A Toolkit for Schools

SUDC Foundation 549 Pompton Avenue, Suite 197 Cedar Grove, New Jersey 07009 www.sudc.org 800.620.UDC | 973.239.4849 | Fax: 973.559.6191 [email protected]

Rev. 3/2017

TABLE OF CONTENTS Introduction and Acknowledgements.................................................................................................................................. 3 What Is SUDC? ................................................................................................................................................................................. 4

About the SUDC Foundation ..................................................................................................................................................... 4

Statistics.............................................................................................................................................................................................. 5 Feedback from Families .............................................................................................................................................................. 6

The New School Year .................................................................................................................................................................... 7

A Note About Assignments ........................................................................................................................................................ 7 Developmental Ages/Stages of Children and Grief........................................................................................................ 8 When to Be Concerned and What You Can Do…………………….……………………………………………………….12

Trauma and Loss ......................................................................................................................................................................... 13

Identifying Traumatic Grief in Students .......................................................................................................................... 14

Additional Resources for Students ..................................................................................................................................... 17

Books on Death for Children and Teens........................................................................................................................... 19 Appendix

Coalition for Grieving Students Modules 1A – 6D

Coalition for Grieving Students Power Point Presentations 1 – 3

Coping with the Death of a Student or Staff Member, US Dept. of Education

National Center for School Crisis and Bereavement, Guidelines for Responding to the Death of a Student or School Staff

SUDC Foundation

Sibling Toolkit for Schools

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INTRODUCTION AND ACKNOWLEDGEMENTS Every family that has come to the Sudden Unexplained Death in Children (SUDC) Foundation has said the same thing: “I didn’t know SUDC existed until now” or “I thought my child was safe once they turned one.” What many families soon learn is that there are hundreds of families affected by SUDC around the world.

The lack of SUDC awareness extends beyond parents and families. In fact, many professionals, including those in medicine and education, have little knowledge of SUDC. This, coupled with the difficulties that many families face in the aftermath of their traumatic loss, particularly concerning siblings, is why the SUDC Foundation developed this toolkit for schools. Due to their age and developmental stage, surviving siblings (as well as any future children in the family) will have less of an ability to process this loss. Parents and other influential adults, including their teachers, must be empowered to appropriately assist a child in dealing with the aftermath. It is important to keep in mind that this is a traumatic event. Children need the right support, understanding, and interventions when necessary. Fortunately, educators are in a unique position to help. The toolkit is divided into two main sections: (1) specific information on SUDC and the impact on surviving siblings and (2) general grief information for coping with any loss a student may experience.

We hope the information pertaining to SUDC will help further develop your knowledge and understanding of this traumatic loss. The section by the “Coalition to Support Grieving Students,” which developed a series of free modules included within, also has videos on their website (grievingstudents.org) to assist schools on this issue. We thank them for developing such an excellent resource, and feel privileged to be able to include this in our toolkit. Along with this toolkit, the staff at the SUDC Foundation is available as an additional resource for you. Please do not hesitate to reach out to us with any questions or for more information. We hope that you find this toolkit to be a valuable addition to your school!

Best regards, SUDC Foundation

SUDC Foundation


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WHAT IS SUDC? Sudden unexplained death in childhood (SUDC) occurs in children at or beyond the age of twelve months. The cause of death remains unexplained after a thorough case investigation, which includes an examination of the death scene, autopsy, and careful review of the child’s and family’s medical history. SUDC is a category of death, not a diagnosis. It is used when other causes of death are not identified.

SUDC leaves families with many unanswered questions about their child’s death. There are parents who witnessed their child’s death, and others who found their children after putting them down for a nap or to bed the night before. Some parents received the news via a phone call from a daycare or other relative. Regardless of the circumstances, each scenario is traumatic, which further compounds the bereavement process of each family. Research on SUDC is currently underway. The SUDC Foundation is spearheading these efforts to find any potential cause(s), and, ultimately, to find a way to prevent SUDC.

ABOUT THE SUDC FOUNDATION Our Mission Is... The SUDC Foundation (formerly The SUDC Program) is a centralized resource for information, support, and advocacy. It serves families and professionals affected by SUDC, and promotes awareness of SUDC in communities.

Our History… In 1999, a small group of parents affected by unexplained toddler death attended a presentation at the SIDS Alliance national convention in Atlanta, GA. The presentation by Dr. Henry Krous was entitled "Post-Infancy SIDS: Is it on the Rise?" At the request of the families, Dr. Krous agreed to review their children’s records.

Over the following two years, more families who had experienced an unexplained childhood death were discovered and the beginning of the San Diego SUDC Research Project began.

Laura Crandall, a neurologic physical therapist and SUDC parent, and Chelsea Hilbert, an emergency room social worker, brainstormed together to create the mission of The Sudden Unexplained Death in Childhood Program. A proposal was submitted to the CJ Foundation for SIDS, a national nonprofit, to support this new program, which was granted in the fall of 2001. In 2014, Laura, along with another SUDC parent, Lorri Caffrey, decided to form the SUDC Foundation, a non-profit solely dedicated to SUDC and the needs of those affected. Services of the SUDC Foundation: • Advocacy, including systems advocacy • Awareness and events • Research • DNA Banking and genetic testing • Education/information, including webinars

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• o o o o o o o

Support Services, including: Peer Support Volunteers Monthly Skype based chat groups NJ/NY/CT area support group Online support community for families Individual support calls Referrals to local services Ongoing grief resources


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STATISTICS In 2015, the CDC (Centers for Disease Control) estimated nearly 400 children (aged 1 to 19) died without a clear explanation for their death.

Each year, we know SUDC: • Is receiving increasing recognition • Has more relevant papers appearing in literature • Has a parent movement that parallels SIDS • SIDS research has revealed a great deal of information, and we expect the same from the study of SUDC

SUID and SUDC United States Crude Death Rates/100,000**, 2011-15 Year 

Under 1 yr

Age 1-4 yrs

2011 2012 2013 2014 2015

69.7 69.6 66.4 66.8 69.6

1.5  1.4 1.4 1.3 1.4

Age 5-9 yrs Age 10-14 yrs Age 15-19 yrs .1 .2 .1 .1 .2

.1  .1 .1 .1 .2

.4 .6 .5 .4 .5

SUDC Statistics above are based on ICD-10 Codes R95 - R99 from CDC Wonder Database **Death rates for infants less than one year of age are calculated per 100,000 live births; death rates for children over the age of one are age adjusted.

Based on the above statistics, those affected by sudden unexplained death in 2015 occurred in: • 216 children ages of 1-4 years, • 38 children ages of 5-9 years, • 35 children ages of 10-14 years, • and 104 teens ages of 15-19 years. The SUDC Foundation has identified hundreds of families around the world who have been impacted. We average approximately 60 new families each year who accesses our services. However, we may never know the true incidence of SUDC, and assume there are more families that have not been identified.

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FEEDBACK FROM FAMILIES Parents have communicated a variety of experiences related to the siblings of the child who died, as well as subsequent children (also known as “rainbow babies”). Most commonly, parents experience anxiety or general concern upon the start of a new school year and/or when their child returns to school after the loss. Below is a list of some of the feedback we have received from parents that are particular to schools.

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“Every year for a few years, the first back to school project was to draw a family tree. My daughter always included her sister, who passed away, which made me very happy. Each year I tell her teachers about her sister. We wanted our daughter to be open to talking about her sister, and we wanted her teachers to be able to do the same. They were always very supportive of that.” “The school counselors were great. They kept in touch with my child’s therapist, and used the interventions discussed so that he was getting consistent care and responses from everyone involved.” “The school had identified other kids in the school who had also experienced a loss. They held a little peer group at school around the holidays, which really helped him feel not so alone.” “The teachers were very compassionate.” “The school counselor suggested my child bring in an item belonging to his late brother, so that when he got sad while in school, he could pull out the item and use it to self-soothe.” “All of the teachers were very encouraging, and were open to talking about his brother. They were patient, and allowed him to see the school counselor whenever he needed.” “Many of the teachers and staff at the school didn’t know how to react to the news.”

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“Every year, I talk with my child’s teachers before school starts to fill them in on what’s happened, and what’s helped at school in the past. This has helped them be open, but also not push too much when he doesn’t want to talk.” “The teachers were amazing. They got together and bought us a gift and a card and expressed their sympathy and support.” “Every month, my girls would be pulled out of class to do an activity with the school counselor, who was available whenever they needed her.” “As soon as the principal heard, he called us immediately and met with us a few days later.” “The teachers always kept me in the loop to let me know how my son was doing. Because of this and how supportive they were, my son did really well in school.” “My son’s school was amazing. They brought in a grief counselor to work with the students. The class was very supportive.” “The teachers allowed my daughter extra time to complete assignments. We were very grateful for that.” “Our principal was useless. We had moved and our son was attending a new school. I called the principal multiple times to discuss my son and she never returned my calls or emails.”

Regardless of what age the siblings are, parents commonly report that the support, understanding, and flexibility of the school’s administrators and teachers made a significant difference to both the parent(s) and child(ren). Don’t hesitate to reach out to the parent(s) to discuss their needs and concerns, and that of their child(ren), to help ensure a successful school year.

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THE NEW SCHOOL YEAR

A NOTE ABOUT ASSIGNMENTS

Most families experience a mixture of excitement and anxiety when the new school year starts. It can be overwhelming for both parents and kids. When a family has experienced the sudden and unexplained loss of their child, the experience is peppered with dread, sadness, and anger, amongst other emotions.

We never quite know what will trigger someone who has experienced a trauma and/or loss. By learning as much as you can about the child who died, the family, the surviving siblings, and any subsequent children will help empower you as a school administrator, teacher, or counselor.

For parents and caregivers, this can make the new school year even more challenging. Since many of our families experience the loss of a young child, some siblings may be entering school for the first time. Registering their child, bringing them the first day, parent-teacher conferences, and Backto-School nights can bring up feelings of sadness and anger. If the school is the same, entering the building may in and of itself be a challenge. Grandparents are sometimes very involved with the care and supervision of their grandchildren. Grandparents also experience many of the same thoughts and feelings as parents do. When they had a close relationship with the child, or when either or both grandparents bring them to school, pick them up afterwards, drive them to activities, babysit, etc., the grandparents experience triggers of their own. Often, grandparents find themselves experiencing a “double grief”: grief over the loss of their grandchild, as well as the pain of feeling powerless to help their adult child through their own pain and mourning.

Regardless of which family members are involved with the child and his or her education, a strong partnership among school administrators, teachers, school counselors, outside service providers, and the family is a necessity in ensuring a successful school year for the bereaved child.

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Additionally, it is important to not only think about how to support the child and family upon their return to the classroom, but to also be mindful about the dynamics within the classroom, especially when it comes to assignments. As mentioned in the Feedback from Families section of this toolkit, many young children return to school and are asked to draw a picture of their family or family tree. Any assignments that rely on the child to talk about, draw, or write about their family may result in discomfort or other reactions. Consider the potential impact on the child and be prepared to handle the questions and reactions of the other students.

In the modules developed by the Coalition to Support Grieving Students (additional videos are also available on their website at grievingstudents.org), you will review strategies and recommendations on how to handle the classroom and any discussion around the child’s loss. As a teacher or administrator, you have the benefit of the parents, school counselors, outside support persons/providers, knowledge about SUDC, trauma, and loss to help respond to the child’s needs as well as the other students.


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DEVELOPMENTAL AGES/STAGES OF CHILDREN AND GRIEF When faced with death, many families struggle with how to tell their other children and what to expect from them throughout their grief. Telling other children, such as their friends and other family members can also be a challenge. In general, understanding the age and developmental stage of a child can help you, as the adult, help them navigate their grief in a healthy way.

Most importantly, if a child says that he or she wants to hurt/injure themselves, or take their own life, immediately take the child to your local emergency room where a professional can assess their mental health. If you have a school counselor that is available to do the initial evaluation prior to this, please rely on their recommendation and follow-up plan. If you are unable to do either scenario, call 911 or your local police department immediately for assistance. The following sections will also provide additional information on how to help.

Ages and Developmental Stages: Ages 2 to 4 Developmental Stage/Task - Egocentric. Believe world centers around them. Narcissistic. Lack cognitive understanding of death and related concepts. Limited language skills. Concept of Death - Death seen as reversible, as abandonment, not permanent. Common statements: “Did you know my sister died? When will she be home?”

Grief Response - Intensive response but brief. Very present oriented. Most aware of changes in patterns of care. Asking questions repeatedly. Signs of Distress – Regression, changes in eating and sleeping patterns, bed wetting, general irritability, and confusion. Traumatic Grief Reactions - May repetitively engage in play about the death or the person who died. May have problems getting back on schedule or meeting developmental milestones. May have difficulty being comforted.

Possible Interventions - Short, honest answers, frequent repetition, lots of reassurance and nurturing. Consistent routine. Play is their outlet for grief.

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Ages and Developmental Stages: Ages 4 to 7 Developmental Stage/Task - Gaining a sense of autonomy. Exploring the world outside of self. Gaining language. Fantasy wishing and thinking. Initiative phase seeing self as the initiator. Concerns of guilt.

Concept of Death - Death still seen as reversible. Personification of death. Feeling of responsibility because of wishes and thoughts. Common statements: “It’s my fault. I was mad and wished she’d die.” Grief Response - More verbalization. Great concern with process. How? Why? Repetitive questioning. May act as though nothing has happened. General distress and confusion.

Signs of Distress – Nightmares, sleeping and eating disturbed. Possible violent play. Attempts to take on role of person who died.

Traumatic Grief Reactions - May repeatedly exhibit play or talk about the death. May have nightmares about the death. May become withdrawn, hide feelings (especially guilt), avoid talking about the person, or about places and/or things related to the death. May avoid reminders of the person (for example, avoid watching TV news or refuse to attend the funeral or visit the cemetery). May become jumpy, extra-alert, or nervous. May have difficulty concentrating on homework or class work, or may suffer a decline in grades. May worry excessively about their health, their parents’ health, or the health and safety of other people. May act out and become the “class clown” or “bully.” Possible Interventions - Symbolic play using drawings and stories. Allow and encourage expression of energy and feelings through physical outlets. Talk about it.

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Ages and Developmental Stages: Ages 7 to 11 Developmental Stage/Task - Concrete thinking. Self-confidence develops. Beginning of socialization. Development of cognitive ability. Beginning of logical thinking.

Concept of Death - Death seen as punishment. Fear of bodily harm and mutilation. This is a difficult transition period, still wanting to see death as reversible but beginning to see it as final.

Grief Response - Specific questions. Desire for complete detail. Concerned with how others are responding. What is the right way to respond? Starting to have ability to mourn and understand grief.

Signs of Distress - School problems, withdrawal from friends, acting out, sleeping and eating disturbed. Overwhelming concern with body. Death thoughts (desire to join one who died). Role confusion.

Traumatic Grief Reactions - May repeatedly exhibit play or talk about the death. May have nightmares about the death. May become withdrawn, hide feelings (especially guilt), avoid talking about the person, or about places and/or things related to the death. May avoid reminders of the person (for example, avoid watching TV news or refuse to attend the funeral or visit the cemetery). May become jumpy, extra alert, or nervous. May have difficulty concentrating on homework or class work, or may suffer a decline in grades. May worry excessively about their health, their parents’ health, or the health and safety of other people. May act out and become the “class clown” or “bully.” Possible Interventions - Answer questions. Encourage expression of range of feelings. Explain options and allow for choices. Be available but allow alone time. Symbolic plays. Allow for physical outlets. Listen and allow for talk about the death.

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Ages and Developmental Stages: Ages 11 to 18 Developmental Stage/Task - Formal operational problem solving. Abstract thinking. Integration of one’s own personality. Concept of Death - A more “adult” approach. Ability to be abstract. Beginning to conceptualize death. Work at making sense of teachings.

Grief Response - Extreme sadness. Denial. Regression. More often willing to talk to people outside of family and peer support. Risk taking. Traditional mourning. Signs of Distress - Depression. Anger often towards parents. Suicidal thoughts. Noncompliance. Rejection of former teaching. Role confusion. Acting out.

Traumatic Grief Reactions - May have similar traumatic grief reactions to those of schoolage children when at home, with friends, and at school. May avoid interpersonal and social situations such as dating. May use drugs or alcohol to deal with negative feelings related to the death. May talk of wanting to harm themselves and express thoughts of revenge or worries about the future. May have low self-esteem because they feel that their family is now “different” or because they feel different from their peers. Possible Interventions- Encourage verbalization. Allow for choices. Encourage selfmotivation. Listen. Be available. Do not attempt to take grief away.

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WHEN TO BE CONCERNED, AND WHAT YOU CAN DO In the prior section outlining the various stages of development, we have highlighted in red the “Signs of Distress” and “Traumatic Grief Reactions.” We encourage you to review the “Possible Interventions” in each stage of development and implement either in the classroom or one-on-one, if possible. Here are some helpful tips if you see any of these behaviors in the classroom: •

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Acknowledge the loss the child has experienced. Let them know that you are sorry for the loss of their brother or sister, and that you are available for them. Consider attending the viewing and/or funeral services if you are able. Show your concern, and express your support in an ageappropriate manner. It’s okay to let them know that you are here for them, or are concerned about them given their loss. Provide the safe space for expression of thoughts and/or feelings. By creating that space, a child is better able to allow themselves to show you how they are grieving, or let you in to their innermost thoughts and feelings. Let them know the limits and boundaries. Provide accurate and clear instructions, and let them know about any deadlines or assignments. Reinforce interpersonal boundaries when playing with other children, and pull them aside to check in if you see any behaviors that are concerning. Be flexible. While it’s important to reinforce boundaries, it’s also important to know when to give your student extra time or space. Let your student know that they can talk to you. Boundaries are still very important, so inform your student of what you’d have to talk to their parents and/or a counselor about before they open up to you. Communicate openly with the student’s primary caregiver. Be sure to let them know when you see any concerning behaviors, and what you have tried to do to help. If the student is in counseling, suggest to the parent(s) or legal guardian that it may be helpful to mention this feedback to the counselor. Ask the caregiver if the counselor has any suggestions for you, and offer the ability to speak with the counselor directly. Refer the student to the school counselor. Suggest to the student that it may be helpful to talk to someone who is in a counselor role and why you think it may help. This can be done whether the student has their own outside therapist or not.

Being a safe, stable, caring, and nurturing adult in this student’s life helps build resiliency and strength.

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TRAUMA AND LOSS Sometimes, the loss that a family has experienced is traumatic. If you consider the definition of trauma from the Diagnostic and Statistical Manual of Mental Disorders (5th edition), a trauma can occur if a person directly witnessed the event, or heard about it from someone else. A child lost to SUDC is often traumatic for whoever found the child, or at the point at which they learned about the death from another source.

Some SUDC families have expressed symptoms consistent with post-traumatic stress disorder (PTSD), and therefore seek treatment with a trauma specialist. Not everyone who experiences a trauma develops symptoms of PTSD, but it is helpful to learn about the symptoms in order to recognize these in the other surviving siblings. The National Child Traumatic Stress Network (NCTSN) confirms that a child may have a traumatic reaction after a sudden, unexpected death of someone close to them.

Further, the NCTSN reports that if the child’s responses are severe or prolonged and interfere with the child’s functioning, the child may have a condition called childhood traumatic grief (CTG). Thinking about the person who died—even happy thoughts—can lead to frightening images or memories of the way that person died. The symptoms of CTG include the following: • • • •

Repeated or intrusive images about the person’s death (such as in nightmares). Avoidance of thinking or talking about the person who died, the cause of death, or avoidance of places, or activities associated with the person, or what happened. Negative beliefs or negative mood occurring since the death. Other changes in behavior, such as trouble sleeping, poor concentration, or being jumpy.

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IDENTIFYING TRAUMATIC GRIEF IN STUDENTS Children at different developmental levels, such as preschool, school age, and adolescence, may react differently to a loved one’s death that has been traumatic for them. However, there are some common signs and symptoms of traumatic grief that children may show at school. These may include the following.

Being overly preoccupied with how the loved one died. This preoccupation may involve repeated descriptions of the death to teachers and peers or repetitive drawings illustrating the death. For example, following the stabbing death of a loved one, a child might draw pictures of a bloody knife over and over again. The child may also repeatedly ask the same questions about aspects of the way the loved one died: “What does it feel like to get stabbed?” The student may also speak excessively about death and dying in general without specifically focusing on the death of his or her loved one. These symptoms suggest that the child has not come to terms with how the person died. This can interfere with the resolution of the child’s grief. A preoccupation with or distressing thoughts and feelings about how a loved one died can interfere with the grief processes. For example, traumatically bereaved youths may avoid mourning rituals such as funerals or memorial services. They may shun conversations about the deceased that help survivors remember, reminisce, and learn more about the person that died. They may avoid making life changes that reflect an acceptance of the permanence of the death, such as redecorating a bedroom that is no longer shared with a sibling who died.

Reliving or re-enacting the traumatic death through play and/or artwork. Following a gun-related homicide, a child might repeatedly run around with a stick while “shooting” other students. The child whose father died in a car accident may use toy cars to re-create the details of the accident. This child may also incorporate themes of the event (violence, murder, fear, and so forth) into his or her play. Child’s play incorporating themes of traumatic death tends to be repetitious, to culminate in the same tragic and unacceptable ending, and to generate feelings of irritability, frustration, or tiredness instead of enjoyment. The child may also report nightmares or upsetting memories of the death that interfere with daily activities. Showing signs of emotional and/or behavioral distress when reminded of the loss. Children may experience distress when cues in their environment remind them of the loss. These reminders may be difficult to predict and can range from seemingly insignificant events to more traumatic reminders. For example, a student whose brother died of leukemia begins to cry and complains of his heart pounding during a science-class lecture on cancer. This stress reaction may be caused by physical reminders. For example, following the death of her father in a car accident, a child becomes withdrawn and tearful when classmates playing with toy cars crash them together. It may also be triggered by SUDC Foundation


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thoughts like after hearing another child talk about his mother, a child begins to think about his recently deceased mother’s death and angrily throws his books off his desk.

Children may also become intolerant of these reminders. For example, a student who lost his father in a car accident begins to persecute the only boy in his classroom whose father drops him off at school. Children may also show signs of increased aggression for various psychological reasons, such as contending with perceptions of danger and increased vulnerability or acting out on revenge fantasies.

Because teachers and other observers may not always see or connect the cues that remind the child of the traumatic death, it may appear that such outbursts are coming out of nowhere. This is especially true if the distressing cues are internal or otherwise subtle, such as thoughts or dreams about the lost loved one or the arrival of the anniversary of a loved one’s death. Unfortunately, traumatically bereaved children may be disciplined at school, and their inappropriate behavior may be confused with acting out rather than recognized as a sign of unresolved grief.

Attempting to avoid physical reminders of the traumatic death, such as activities, places, or people related to the death. Students may avoid situations they fear will provoke painful or uncomfortable thoughts or feelings about the death. A student whose best friend died in a fire, for example, may refuse to walk by his friend’s former locker at school. Children may try to avoid conversations and/or thoughts about the loss, as well. For example, a child might throw a tantrum when another student asks him about his grandmother’s death.

Withdrawing from important aspects of their environment. Children may lose interest or stop participating in activities they previously enjoyed. For example, following the death of his father, a child who was a very gifted baseball player might quit the team. Or they may show less willingness to interact with other people, including family, important adults (such as teachers), friends, and classmates. This withdrawal may be at least partly due to a sense of distrust in others, to avoid reminders of the traumatic death or of the loss in general, or to guilt. For example, youths who suffered the traumatic death of a friend may avoid other friends of the deceased or may avoid activities in which the deceased formerly participated. They may also withdraw in an attempt to avoid intrusive questions by peers about the traumatic loss. These behaviors may create additional adversities in the form of loneliness, peer rejection, and the loss of developmental opportunities.

Showing signs of emotional constriction. Children may seem unable to experience either negative or positive emotions. This can result in the child appearing “numb” or “flat.” For example, a student that used to laugh and smile frequently at recess now has a blank expression. This seeming lack of emotion can be seen as a form of avoidance that the child uses to protect him- or herself from feelings that seem overwhelming. SUDC Foundation


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Being excessively “jumpy” or being easily startled. A child whose father died in a hunting accident might jump up and scream when a student behind him drops a book. He or she may also be constantly on the alert or on edge. This exaggerated startle response may unfortunately lead to additional social adversities for the child in the form of teasing by insensitive or uninformed peers. For example, fellow students who find amusement by clapping their hands behind his head and watching him jump. These children may show other signs of being over-aroused, including increased activity levels, inability to settle down, and difficulty sleeping.

Showing signs of a loss of a sense of purpose and meaning to one’s life. A traumatized child may show disinterest in previously valued goals or activities, or may engage in increased risk-taking (for example, not wearing seatbelts or helmets, or engaging in drug abuse or sexually precocious behavior) because “it doesn’t matter anymore,” “I deserve it,” or for other reasons that may or may not be related to the death. For more information on this subject, visit the National Child Traumatic Stress Network at www.nctsn.org. To view the aforementioned publication in its entirety, please visit http://www.nctsn.org/sites/default/files/assets/pdfs/schools_package.pdf. We also included the possible “Traumatic Grief Reactions” within the Ages and Developmental Stages section of this toolkit so that you can identify these, and how they differ from normal grief. (Source: National Child Traumatic Stress Network’s “Childhood Traumatic Grief Educational Materials,” 2004.)

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ADDITIONAL RESOURCES FOR STUDENTS Dougy Center: The National Center for Grieving Children & Families The National Center for Grieving Children & Families has provided support and training locally, nationally, and internationally to individuals and organizations seeking to assist children in grief. The website offers resources for adults and kids, including workbooks and pamphlets on grief. Several resources are available in Spanish. www.dougy.org (866.775.5683 or [email protected]) Fred Rogers Center This center helps children deal with the death of a loved one. http://www.fci.org/newsite/par-death.html Fernside: A Center for Grieving Children Fernside provides support and advocacy for grieving children and their parents and families. www.fernside.org

New York Life Foundation: A Child in Grief | Parents and Family Members This foundation has resources for children who have experienced the loss of a loved one. http://www.newyorklife.com/nyl/v/index.jsp?contentId=143541&vgnextoid=9b20f5959 4442310VgnVCM100000ac841cacRCRD Solace House Their belief is that “no child should grieve alone.” Their site is a resource for other grief support services. www.solacehouse.org

The Sibling Connection This site is a resource for anyone who have lost a brother or sister. www.counselingstlouis.net

The Compassionate Friends: Sibling Resources The Compassionate Friends is a national nonprofit, self-help organization that offers friendship, understanding, and hope to bereaved parents, grandparents, and siblings. www.compassionatefriends.org

KidsAid This website gives kids their own place to deal with their feelings with other children who have suffered major losses. www.kidsaid.com Comfort Zone Camps Bereaved children given the opportunity to remember their loved ones in a safe and healing camp environment. http://www.comfortzonecamp.org

Seasons Centre for Grieving Children This organization believes "every child deserves an opportunity to grieve in a supportive and understanding environment." http://www.grievingchildren.com SUDC Foundation


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Coalition for Grieving Students A collaboration between multiple partners, this website assists school systems in responding to and addressing grief and loss in students. www.grievingstudents.org

Rainbows for All Children Dedicated to being the premier source of support for all youth as they navigate grief and heal from any kind of loss. Trained facilitators, supported with a repository of resources, are available to help youth through their grieving process. www.rainbows.org For additional resources, please visit our website at www.sudc.org.

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BOOKS ON DEATH FOR CHILDREN AND TEENS Isabelle’s Dream: A Story and Activity Book for a Child’s Grief Journey by Betsy Bottino Arenella. This coloring and activity book was written by a good friend and neighbor of a family who lost their two-year-old child, Sophia, suddenly and to unexplained causes. The book has 24 pages of narrative and illustrations which tell the story of Sophia who returns to her sister in a dream, reminding her that her spirit will always remain through the beauties of nature. The proceeds are being donated to the SUDC Foundation. http://www.isabellesdream.org What Do They Do All Day in Heaven? By Staci Thomas Parents and children can discuss death of a sibling and heaven.

When My Brother/Sister Died by Dorothy Gehres Fraembs Stories told from the children’s perspective about feelings of loss resulting from the death of a sibling.

Where’s Jess? by Joy & Marv Johnson (Ages 3 to 8) Story about how a brother and his family grieve after their baby, Jess, dies.

The Fall of Freddy the Leaf by Leo Buscaglia (Ages 4 to 8) This is a warm, wonderfully wise, and strikingly simple story of how Freddy and his companion leaves change with the seasons, finally falling to the ground with the winter’s snow. This is a classic and wonderful for explaining death to a child.

Sad Isn’t Bad- A Good Grief Guidebook for Kids Dealing with Loss by Michaelene Mandy and RW Alley (Ages 4 to 8) This book is loaded with positive, life affirming advice for coping with loss as a child. This guide tells kids what they need to know: the world is still safe, life is good, and hurting hearts do mend.

The Badger’s Parting Gifts by Susan Varley (Ages 4 to 8) All the animals loved badger and when he dies they are overwhelmed by their loss. They begin to remember and through their memories the animals find strength to face the future with hope. This Book is for All Kids but Especially My Sister Libby. Libby Died. By Jack and Annette Simon (Ages 4 to 8) Children ask many questions about death and this book explores some of the common ones. It will bring a tear to your eye. The illustrations are colorful and wonderful.

Help Me Say Goodbye: Activities For Helping Kids Cope When a Special Person Dies by Janis Silverman (Ages 5 and up) An art therapy and activity book for children coping with the death of someone they love. Sensitive exercises address all the questions that children may have during this emotional and troubling crisis. Children are encouraged to express in pictures what they are often incapable of expressing in words.

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When Someone VERY Special Dies: Children Can Learn to Cope with Grief by Marge Heegaard (Ages 6 to 12) This book was designed to teach children death education, to recognize and express feelings of grief, encourage open communication, and help adults discover unhealthy misconceptions the child may have. Losing Someone You Love by Elizabeth Richter (Ages 7 and up) Fifteen young people tell about the death of their brother or sister. They tell about their feelings, sorrows, fear, loneliness, and anger, as well as, their difficulties both at home and at school.

Children Facing Grief by Jan Rodmond (Ages 8 to 16) A collection of letters written by children ages 6 to 15 who tell about their feelings and experiences after the death of a brother or sister. They tell what hurt and what helped very openly and honestly.

Children Are Not Paper Dolls by Erin Linn (Ages 9 to 15) Six bereaved siblings ages 10 to 13 write and draw pictures about funerals, family, friends, school, feelings, holidays, etc. They tell it like it is. I Wish I Could Hold Your Hand by Pat Palmer and Dianne O’Quinne Burke (Ages 9 to 12) This warm and comforting book gently helps grieving children identify their feelings and learn to accept and deal with them. It has wonderful heartwarming illustrations. Simple direct writing helps children discover that it is normal and natural to feel the pain of loss. To Healing Your Grieving Heart: 100 Practical Ideas for Kids by Alan Wolfet (Ages 9 to 12) A clear concise book with sensitivity and insight that offers suggestions for healing activities. It acknowledges that death is a painful part of life. It offers ideas and activities aimed at reducing confusion, anxiety, and the huge personal void so that the living can begin their lives again. Today My Sister Died by Ronee Christy Domske (Ages 10 and up) A book written from the point of view of a fifth grader, discussing death and a family’s reaction to it.

My Brother Joey Died Today by McLendon & Messner (Ages 10 to 14) The young girl in this story feels anger and guilt after her brother dies suddenly. She feels better after talking with other kids in a support group.

Healing Grieving Hearts for Teens by Alan Wolfet (Young Adult) A book written in clear, user-friendly prose. Each page presents a different idea designed to help teens recognize mourning as a natural process connected with loss, reassuring them that they should not be afraid of deep sometimes uncontrollable emotions and showing them how to release grief in healthy, positive ways. Fire in My Heart, Ice in My Veins—A Journal for Teenagers Experiencing a Loss by Enid Samuel Traisman (Young Adult) The journal encourages teens to work through grief in creative and healthy ways. It allows them to keep permanent memories of the person who died.

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Dancing on the Moon by Janice Roper and Lauren Grimm (Infant to Pre-school) This book is designed to help families coping with a SIDS loss. Written by a parent whose three-month-old son died of SIDS.

The Tenth Best Thing About Barney y Judith Viorst and Erik Blegvard (Ages 4 to 8) In simple phrases narrated by a child whose cat, Barney, has died. The author honestly and simply handles the emotions of losing a beloved pet and the questions about the finality of death. I’ll Always Love You by Hans Wilhelm (Ages 4 to 8) This story is about Elfie, a dachshund, and her special boy who go through life together. One day Elfie doesn’t wake up. The family grieves and buries her. Very sweet and tender. What's Heaven by Maria Shriver Religious connotation around a grandparent who died and a good explanation of the concept of heaven.

I Miss You: A First Look at Death by Pat Thomas Explains to children the concept of death. Includes diverse characters and provides some insight into the various ways people express their grief, including culturally.

What on Earth to Do When Someone Dies by Trevor Romain (Ages 9 to 12) This simple, insightful, straight-from-the-heart, book is for any child who has lost a loved one. The author talks directly to kids about what death means and how to cope. Answers kids questions including why, how, what next, is it my fault, what’s a funeral, etc., in basic straightforward terms.

All God's Creatures Go to Heaven by Amy Nolfo-Wheeler. (All ages) The angel paintings of artist, Nancy Nolfo, beautifully portray the story of Jacob, a child angel on a journey of discovery. It is an inspiring message of joy and hope. This is a story about baby angels who are in heaven and they take care of God's animals. A new little boy goes to heaven and receives a pet to love and care for.

Someone Came Before You by Pat Schwiebert (Pre-school) This paperback picture book is for very young children through preschool age who were born after their parents lost a child born earlier. It describes the parents’ grief and sadness and how they eventually decide they wanted to bring another child into their lives. The book offers ideas for keeping the deceased child’s memory alive. Grieving for the Sibling You Lost by Erica Goldblatt Hyatt (Teens) This book provides practical tips, tools, and coping strategies on how to find hope and meaning after sibling loss.

For an up-to-date listing of books for children, please visit our website at www.sudc.org > Family Services > Grief Resources > For SUDC Siblings > SUDC’s book list recommendations. SUDC Foundation


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APPENDIX

MODULE SUMMARY

Talking With Children Take-Home Message

What Children Are Often Thinking

Making contact and talking with grieving students helps them cope with their loss. But some teachers aren’t sure what to say. They’re afraid they’ll cause the child more pain. It’s important to remember that a student’s grief and pain are caused by the death or loss, not by talking about it.

Children learn from an early age that conversations about death make people uncomfortable. If they ask questions, people may look away or not continue the conversation. If they speak to grieving family members after a death, adults may cry or show distress. Children sometimes conclude they have done something wrong and avoid raising the subject again. They may hold in their feelings as a way to support their family. They may try to look fine and reassure family they are okay when they really need support.

This handout provides practical suggestions to school professionals on how to initiate a conversation with a student who has recently experienced the death of a close family member or friend.

Why It’s Vital to Speak Up School personnel are often concerned about the possibility that they will upset children by raising the topic of death. They may worry that they will make matters worse. They may choose to say nothing. Saying nothing actually communicates a great deal to children. It tells them that you may be: • Insensitive. You don’t realize they are confused and struggling. • Uncaring. You don’t care about this important event in their lives. • Incapable. You don’t believe you are capable of providing the support they need. • Unconfident. You feel the child is unable to adjust and cope even with your assistance. • Unapproving. You believe it is wrong to talk about death. No one wants to communicate these messages to grieving children. Speaking up lets grieving children know you recognize their situation and want to be supportive.

School professionals can play a powerful role in reaching out to students, acknowledging their loss, and offering to speak with them and answer their questions. Staff who already have a trusting and genuine relationship with the grieving student are in the best position to offer this support.

Initiating the Conversation These steps can help get the conversation started. 1. E xpress concern. Let students know you’ve heard about their loss and are available to listen and offer support. 2. Be genuine. Children can tell when adults are authentic in their communications. For example, don’t tell a child you will miss her uncle if you did not know the man. Do tell the child you are sad she has experienced this loss. 3. Invite the conversation. Use simple, direct, open-ended questions. For example, ask, “How are you and your family doing?” 4. L isten and observe. Listen more and talk less. Share observations about students’ behavior or responses in a nonjudgmental manner. 5. L imit personal sharing. You can draw on personal experiences to help you better understand students, but do not need to share this with them. Keep the focus on the student. 6. O ffer practical advice. For example, discuss ways to respond to questions from peers or adults about the death. 7. O ffer reassurance. Without minimizing their concerns, let students know that over time they will be better able to cope with their distress, and that you will be there to help them. 8. M aintain contact. At first, children may not accept your invitation to talk or offers of support. Their questions will evolve over time. Remain accessible, concerned, and connected. (Continued)

Talking With Children What to Expect You may experience feelings of your own when you talk with students about the death of a loved one. Students usually appreciate concerned adults showing they are touched by the event and/or how the student is feeling, such as by the adult appearing sad or becoming tearful for a moment. Students can learn more about coping strategies when they see competent adults showing some distress and modeling effective coping.

Offer a private setting in the school for the conversation. Remain available and present over time. Offer other outlets within the school for support (another teacher, a school counselor, school psychologist, school social worker, or a school nurse). Help them think of other options in their family and community as well.

Even when teachers follow all of these guidelines, some students may still be reluctant to talk about the death. They may not fully understand it. They may feel overwhelmed by the experience and their strong feelings. They may worry that they will lose control, or feel ashamed of these deep emotions. They may have complicated feelings, such as guilt or shame.

For more information on supporting grieving students, refer to The Grieving Student: A Teacher’s Guide by David Schonfeld and Marcia Quackenbush.

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FOUNDING MEMBERS

MODULE SUMMARY

What Not to Say Take-Home Message Many school professionals worry they may say the wrong thing to grieving students and make matters worse. Understanding what not to say will help you be more confident and effective when you reach out to students. The suggestions can help you support grieving children.

How to Act Here are some behaviors that will increase children’s comfort, sense of safety, and ability to express themselves. • Be present and authentic. Keep the focus on the student. Offer supportive statements that honestly reflect both your relationship with the deceased and your sense of the student’s response. • L isten more, talk less. Keep your own comments brief. Ask open-ended questions to help students discuss their experiences, thoughts, and feelings. • Avoid trying to “cheer up” students or their families. Grief is painful. Attempts to cheer people up or bring focus to the good things in their lives are likely to communicate that you don’t want to hear students or their families talk about their pain. • Accept expressions of emotion. Expressions of sadness, anger, selfishness, or confusion are common in grieving children. These are an important part of the process. When children hear they should “toughen up” or “be strong for their families” they are less likely to fully express their feelings of grief. • Show empathy. Reflect back what you hear students say and the actions you observe. Use compassion. Avoid judgment. • Step in to stop harmful actions when safety is a concern.

It’s important to let children express their feelings of grief. Sometimes these can be quite dramatic—shouting, crying, kicking the floor. It’s also appropriate to stop behaviors that may be harmful to the children, to others or to property.

What Not to Say Many common and well-intentioned statements are not helpful to grieving children and their families. Here are some comments to avoid, and suggestions for what to say instead. Don’t worry if you’ve used these statements in the past. Children are very forgiving as long as they feel valued and supported. They hear our concern more than our exact words.

Don’t Say This

Say This Instead

“I know just what you’re going through.” You cannot know this. Everyone’s experience of grief is unique.

“Can you tell me more about what this has been like for you?”

“You must be incredibly angry.” It is not helpful to tell people how they are feeling or ought to feel. It is better to ask. People in grief often feel many different things at different times.

“Most people have strong feelings when something like this happens to them. What has this been like for you?”

“This is hard. But it’s important to remember the good things in life, too.” This kind of statement is likely to quiet down true expressions of grief. When people are grieving, it’s important they be allowed to experience and express whatever feelings, memories, or wishes they’re having.

“What kinds of memories do you have about the person who died?”

“At least he’s no longer in pain.” Efforts to “focus on the good things” are more likely to minimize the student or family’s experience (see above). Any statement that begins with the words “at least” should probably be reconsidered.

“What sorts of things have you been thinking about since your loved one died?”

(Continued)

What Not to Say “I lost both my parents when I was your age.” Avoid comparing your losses with those of students or their families. These types of statements may leave children feeling that their loss is not as profound or important.

“Tell me more about what this has been like for you.”

“You’ll need to be strong now for your family. It’s important to get a grip on your feelings.” Grieving children are often told they shouldn’t express their feelings. This holds children back from expressing their grief and learning to cope with these difficult feelings.

“How is your family doing? What kinds of concerns do you have about them?”

“My dog died last week. I know how you must be feeling.” It is not useful to compare losses. Keep the focus on grieving children and their families.

“I know how I’ve felt when someone I loved died, but I don’t really know how you’re feeling. Can you tell me something about what this has been like for you?”

Expect a Range of Responses The most important thing you can do is simply be with students while they are grieving. Witness their distress. Listen to what they have to say. Tolerate silence when they’re not ready to speak. Suspend judgment about how students “should” cope with their situations and stay open to the wide range of responses children may have. Let them experience their grief in their own way. Let them know you will be there with them. While it’s important to intervene when you think children may hurt themselves or others, most of the time children are able to express intense feelings without danger.



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MODULE SUMMARY

Providing Support Over Time Take-Home Message

Goals of Support

School professionals play a unique role in supporting grieving students both in the immediate aftermath of a loss and over time. Children do not adjust to a major loss in a matter of months or a year, but over a lifetime. The second year after a death is often more difficult than the first. Teachers can play a vital role by offering students ongoing understanding and support that can help them make sense of their experiences and stay productive and positive in their lives.

The primary goal is to offer support in the areas most likely to present challenges to students after the death of a family member or friend. Teachers can take steps to:

School Professionals: A Unique Role When a death occurs in a family, the entire family is grieving. A parent may be preoccupied and less able to manage the details and demands of the family. Children sometimes feel it is better not to burden their parent with additional concerns. A child may feel guilt or shame about the death and find the idea of talking with family overwhelming. Peers often have limited experience supporting someone who is grieving. Their attempts at support may be awkward. They may pull back because of their own discomfort. School professionals who are not personally affected by the death in a deep way are often ideal sources of support. They are concerned, accessible, and competent. Students may see them as safer to approach. Often, school professionals are better able to attend to a child’s emotional needs. School personnel are not expected to provide bereavement counseling to children, but rather to provide bereavement support. They can do this best when they work as a team to meet students’ needs.

1. D ecrease the sense of isolation. When teachers talk about death in the classroom, both as part of regular coursework and in response to a recent event, all students learn more about how to give and receive support. 2. Increase academic function. It’s common for grieving children to have difficulty concentrating and have a drop in academic performance. Teachers who talk with children and make appropriate adjustments to their class work can help them stay on course academically. 3. Increase the likelihood children will talk with their families. When children experience support and understanding from teachers, they may find it easier to turn to other adults, including their family members, for support. 4. I ncrease the likelihood children will talk with and receive support from their peers. Through classroom discussions and one-on-one conversations, teachers can model understanding and give all students better opportunities to listen, understand, and express feelings among their peers. 5. I dentify problems in the family. During talks with teachers, students may reveal family issues, such as a parent struggling with depression. Teachers can help arrange appropriate referrals for the family. 6. C onnect with students on something of immense importance. These are the kinds of lessons and conversations that can genuinely transform children’s lives.

Grief Over Time Here are three key features to remember about grief over time for children. 1. G rief proceeds on its own terms. There is no set time frame. There are no firm stages. Children don’t get over grief in a fixed amount of time. The second year after a death can seem even more challenging than the first. However, this is a point where the support and concern available immediately after a death has diminished greatly—sometimes it has virtually disappeared.

(Continued)

Providing Support Over Time In many ways, children never get over a significant loss. The death of a close family member or friend is a lifechanging experience. 2. As children grow and develop, even normative transitions and changes in their lives will remind them of the loss. A boy whose father died while he was in elementary school may miss him acutely when he enters puberty or transitions to college, at college graduation, when he is married, and when he has children or grandchildren. 3. As children develop, they become more capable of understanding and adjusting to their loss. The work of grieving becomes less difficult and requires less energy. It begins as a full-time job, but becomes more of a part-time effort that allows other meaningful work and experiences to occur. Grieving lasts a lifetime, but does not need to consume a life.

Special Events Children experience grief differently over time, and often revisit deep feelings at special events and times of transition. It can be helpful when teachers make a special effort to contact students at such moments. These may include: • Holidays • Birthdays • Moves to a new grade or school • Celebrations • Awards, graduations, recognition • Rites of passage (first bicycle, first job, first date) LEAD FOUNDING MEMBERS

FOUNDING MEMBERS


MODULE SUMMARY

Peer Support Take-Home Message Children who are uninformed or unprepared may unintentionally isolate or tease a classmate after a death. This can worsen the isolation grieving students already feel. But children naturally want to help their friends. Teachers can equip their students with the skills to support a peer. This can make a profound difference for a grieving student. There is probably no more important lesson or life skill for an educator to teach.

Grieving Students’ Relationships With Peers After the death of a close friend or family member, children are likely to experience a range of confusing and strong feelings, including guilt and shame. They may worry that something is wrong with them, or be embarrassed about being associated with a death. They may worry about their appearance, or expressing too much emotion. They may not know what to say or how to act, even with their friends. They may withdraw from peers.

When a Peer Experiences a Death Like adults, children often have limited experience supporting a friend who is grieving. They may be afraid to say or do the wrong thing. The death may create uncertainty in their own lives—“Could my father also die?”

But what they may say instead is, “Your daddy died. You can’t make a Father’s Day card!”

Equip Students With Skills When teachers take the following steps, students are more likely to provide effective support to a grieving peer. 1. P rovide information. Help students understand, at a very basic level, what has happened. They will be less likely to burden a grieving peer in the immediate aftermath of a death with repetitive questions. 2. Give students an opportunity to ask questions. Students are likely to have questions about what death is and the effect it has on children and their families. They will want to know how to be helpful to someone who is grieving. Teachers can often discuss this information with a class before the grieving student returns to school. This helps everyone feel more prepared. 3. Provide a safe environment for students to share thoughts and feelings. Invite students to talk about their own losses or the fears they may have about someone in their own life dying. 4. O ffer concrete advice and practical suggestions. For example, talk about ways to start a conversation with someone who is grieving. Discuss helpful things to say, and what not to say. Most of the advice in Talking With Children and What Not to Say will also be helpful to students.

They may make insensitive comments, ask repetitive or detailed questions about the death, or even tease the grieving student. They may distance themselves from the grieving student to cope with their own anxieties. They may want to say, “I worry my father might also die someday. Can you let me know what the experience is like and help me understand it better so I can prepare myself?”


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MODULE SUMMARY

Concepts of Death Take-Home Message The death of someone close can be overwhelming for children. There are four concepts about death that are important for children to understand. Children who understand these concepts will be better prepared to cope with a loss.

Four Concepts About Death 1. Death is irreversible. 2. A ll life functions end completely at the time of death. 3. Everything that is alive eventually dies. 4. T here are physical reasons someone dies.

The Four Concepts and Why They’re Important 1. Death is irreversible. Children often see cartoon and TV characters who “die” and come back to life. Adults may describe death as “going on a long journey.” Children may view death as a temporary separation. They have no reason to begin the mourning process. They may even be angry at the person for not contacting them or returning for important occasions. An essential first step in the mourning process is understanding and accepting that the loss is permanent. Understanding this concept allows children to begin to mourn.

2. A ll life functions end completely at the time of death. Very young children initially view all things as alive—toys, rocks, cars. Adults may add to this confusion when they use phrases such as, “The car died.” As they grow older, children will understand that inanimate objects are not alive, but they may still be confused at times. A robot may seem alive, a tree may not. Children may assume a person who has died doesn’t move because there is no room in the coffin. If children are asked to draw a picture or write a note to put in the coffin, they may assume the person who died will see their work. They may believe the deceased will see how dark it is in the coffin, or hear the sound of dirt falling on the casket. Children may worry that the deceased is suffering—afraid, cold, hungry, in pain, or lonely. Understanding this concept helps children realize the person who died is not suffering.

3. Everything that is alive eventually dies. hildren may assume they and their loved ones will never C die. Some parents reassure their children that they will always be available to take care of them. They may tell their children they don’t need to worry about dying. It is understandable that parents want to shield their children from death, but once a death occurs in a child’s life, these messages can be troubling and confusing. It is difficult for children to learn this concept the first time a death occurs. If they do, children may worry that all the people they care about will die and they will be left alone. If children don’t see death as inevitable, they may wonder why a particular death occurred. Often they conclude it is because of something bad they did, or something they failed to do. This can lead to guilt. They may also believe it is because of something the deceased did or didn’t do. This can lead to shame. Understanding this concept makes it less likely that children will associate death with guilt and shame.

4. There are physical reasons someone dies. When children don’t understand the true reason a person died, they are more likely to create explanations that create confusion and add to guilt or shame. Adults can help children understand the physical cause of a death by being brief and using simple language at a developmentally appropriate level.

(Continued)

Concepts of Death Understanding this concept helps minimize possible confusion and feelings of guilt and shame children may feel when a loved one dies.

What Children Can Understand Most children understand these concepts between ages 5 and 7. Younger children can be helped to understand these concepts, especially once they have experienced a close personal loss. While older children and adolescents usually understand the four concepts more fully than younger children, they are also likely to have questions related to these concepts when a death touches them in some way. They may wonder if they were responsible in some way or worry that others they care about will die soon. If they have not previously experienced a death, accepting the true inevitability of death can be painful and confusing.

Children Want to Engage in This Dialogue

dialogue about loss and death children seek with adults. The translation of peekaboo from Old English is “alive or dead.” Adults may discuss death with children as they grow older, but often choose words they feel are gentler. However, less direct terms may be confusing. For example, if children hear someone who died is in a state of eternal sleep, they may be afraid to go to sleep. Especially with younger children, it’s important to use the terms dead and died.

Faith-based Beliefs Children of any age may find comfort in a family’s faithbased beliefs. However, some religious concepts may be too abstract for young children. In addition to a family’s faithbased beliefs—what happens to a person’s spirit after death, for example—it is important for children to understand the physical realities about what happens to the body. This includes the Four Concepts About Death. Teachers can encourage children who ask faith-based questions about death to discuss their questions with family members.

Adults don’t usually realize that from very early on in life, children develop an awareness of loss and seek to engage adults in a dialogue about this. Between six and twelve months of age, for example, infants begin to develop “object permanence”—the recognition that even when a person is not in their immediate view, the person exists elsewhere. They may become distressed at the absence of an important person.

Check Children’s Understanding

1. S tart by asking children what they understand about death.

Infants this age all over the world begin to play the game we call peekaboo in the United States. They fix their attention on someone, then experience a brief separation. This is followed by heightened awareness and concern, then relief and joy at the reunion. This may be the first

2. Give them simple and developmentally appropriate explanations.

3. Ask them to explain back to you what they understand.

4. Correct any misunderstandings or misconceptions.

When discussing a death, it’s useful to check children’s understanding of the Four Concepts About Death. These steps will be helpful:

These steps will help make any misunderstandings clear. For example, when children are told that the body may be placed in a casket, they may decline to attend the funeral. They may assume the head will be placed somewhere else and may not want to see a loved one decapitated.

Children With Intellectual or Other Disabilities The Four Concepts About Death, and the four steps listed above to check children’s understanding, will also be useful for children with intellectual disabilities. Their understanding of the concepts will usually be on a level commensurate with their level of general cognitive functioning. Even if (Continued)

Concepts of Death they cannot fully comprehend the concepts or communicate their understanding, they are likely to be deeply affected by a close personal loss and benefit from efforts to help them better understand.

Supporting Adolescents Society often perceives that the impact of death on adolescents is less taxing than for young children. Adolescents are expected to be more mature and better able to handle the concepts and consequences of a death. They can think more rationally and abstractly than younger children. They are capable of independent thought and action. They may be less open to offers of assistance and guidance.

facing a loss, they will question each of the Four Concepts About Death. Did they see their loved one in a crowd? Hear the person’s voice? Do they feel the person is still present in some way? They may ask themselves how this event happened, and wonder if they might have done something to prevent it. The Four Concepts About Death can offer a useful framework for discussions with adolescents. Even when they clearly understand death, they are likely to need to discuss the same issues as young children.

Adults may believe that adolescents don’t need the kind of support and outreach that younger children do at the time of a death. Adolescents may receive fewer services than parents and younger children. They may be expected to provide comfort to both parents and younger siblings, and required to take on more adult responsibilities in the family. While adolescents may understand death better than young children, they will still have questions. Like adults



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MODULE SUMMARY

Connecting with Families Take-Home Message Teachers and schools play a vital role when they reach out proactively to make contact with students’ families after a death. They can provide information, find out how students are doing, offer advice and assistance, and partner with families to provide support over time. Note: In this handout, “parents” refers to those functioning as students’ primary caregivers. This might include grandparents, other family members, or guardians.

Make Contact Schools communicate regularly with families in a variety of ways and for many reasons. It is appropriate for schools to initiate contact with students’ families after a death occurs. Parents may be overwhelmed by events and may not think of their children’s school as a resource for information, guidance, and support. Proactive outreach can also help set the stage for planning and providing support for students when they return to school. Initially, it’s best to meet with families in person if possible. If not, phone contact may be a good start. For first contact, email and text messaging may be seen as impersonal and may not be able to fully convey the nuances of the school’s intentions. Later, these may be practical ways to make contact with busy and overwhelmed parents. Normalize your outreach—let students and families know these communications and offers of support are provided to all families after students experience a significant loss.

Goals for Communication With Families 1. Express condolences on behalf of the school community. Let the family know the professional resources of the school are available. 2. Offer advice on how to support grieving children. Parents may appreciate guidance on what to say to their children about the death. School personnel are often involved early enough to provide advice on funeral attendance (see Funeral Attendance). 3. R emind parents of their critical role in supporting children at this time. LEAD FOUNDING MEMBERS

Let parents know their children may be worried about them, and are looking to them for guidance on how to cope. You may be able to equip the family with needed information and advice that allows them to better fulfill this role. 4. A ssist with transition of the student back to school. Most children are likely to experience at least some temporary learning challenges after the death of a close family member or friend. Help the family plan a timely return to school. Help prepare the student, their classmates (as appropriate), and school personnel for the student’s return. 5. Seek feedback from parents about their children. How are the children coping? What strategies do parents think will be helpful for school personnel in providing support over time? Parents can provide useful insights about what is, and is not, likely to work. 6. O ffer supportive resources in the school and information about community resources that may be of help to everyone in the family (mental health professionals, bereavement support groups). Suggest the family check with their pediatrician or other health-care provider for guidance and referrals. Help them think through other supports in their extended families and communities. 7. Identify and anticipate potential challenges. Families may need practical support (transportation, childcare). Schools can sometimes identify resources to address practical needs. Parents can often identify potential trigger situations for their children (significant dates, upcoming transitions). 8. P artner with families to support children over time. Let parents know they are helping the teacher and school better support their children—academically and emotionally—by providing useful information and valuable insight. 9. Provide appropriate reassurance and positive feedback. Identify ways students and families are already coping effectively. Families may feel both overwhelmed and unfamiliar with grief. They may not recognize the ways they are coping well because the children are still upset.

Some Families Decline Assistance

Recognize that some families will decline offers to meet, speak, or receive assistance—especially at first. Re-extend the invitation occasionally and keep the door open, should the family become ready at a later time. For more information on supporting grieving students, refer to

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The Grieving Student: A Teacher’s Guide by David Schonfeld and Marcia Quackenbush.

MODULE SUMMARY

Cultural Sensitivity Take-Home Message

Be Observant

Families from different cultures may follow specific traditions, rituals, and practices after a death. Although there are real differences between cultures, the fundamental experience of grief is universal. Rather than attempting to gain knowledge about every culture, teachers can aspire to achieve a general sensitivity to the unique needs of children and families coping with loss.

We are all enriched when we learn about different cultural beliefs, expectations, and traditions. When we recognize that there is a range of acceptable ways to experience and express grief, we can watch for approaches that may vary from our own and explore ways to bridge cultural differences in order to truly help our students and their families.

Different Cultures Express Grief in Different Ways

Individuals from different cultures may follow specific traditions and practices after the death of a loved one. These practices are informed by the different cultural beliefs, norms, and expectations that guide the bereaved person’s behaviors. One culture may expect its members not to speak the name of the person who died. Another may encourage families to name the next child born after the deceased. People of one culture may believe that each tear shed creates another hardship for the deceased, so remain quiet and reserved at funerals. Those of another may believe the extent of love for the person who died is demonstrated by the degree of emotions expressed at the funeral. It is understandable that school personnel may not be familiar with the rituals and expectations of every culture represented among their students. Sometimes, rather than reaching out to a family after the death of a loved one, school staff will minimize their interactions with the family to avoid doing something inappropriate or offending the family somehow. Although these are real differences, the fundamental experience of grief is universal. If someone is able to be empathetic, thoughtful, sensitive, and supportive to grieving children of one culture, chances are quite good that this person will be able to help children of another culture as well. Being observant, genuinely curious, respectful, and responsive to your students will enable you to learn about their families and cultures and be guided by their responses. Often what works best is to simply be present, express your concern, and remain available to provide helpful assistance.

1. Ask questions. Ask openly when you are unsure what would be most helpful for a family or individual. For example: • “Can you tell me how your family and your culture recognize and cope with the death of a family member? How does this fit with your own preferences at this time?” • “Can you help me understand how I can best be of help to you and your family?” 2. Watch out for assumptions. Even if you know about the common practices of a culture, this may not accurately predict how a family or individual from that culture will behave. Many people have been exposed to multiple cultures. Parents sometimes have different beliefs or practices from their children. Some families or individuals choose to follow practices of a different culture when these align better with their current beliefs or preferences. Assumptions may result in stereotypes that cloud our perceptions and make us miss opportunities to be helpful. 3. Be present and authentic. Even if you don’t know about a particular culture’s practices concerning death and grief, you can approach the family with an open mind and heart. Be guided by their responses. This works well across many different cultures.


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MODULE SUMMARY

Advice on Funeral Attendance Take-Home Message

Benefits for Children

It’s important to offer children a chance to attend funeral or memorial services after the death of a family member or a loved one. Most of the time, it’s better for children if they do attend. School personnel often have a chance to play a vital role in helping families make good choices about children’s participation in services.

There are a number of benefits for children who attend funeral or memorial services.

Families may ask the school for advice on this matter. Often, school personnel are the only professionals who interact with families before the funeral.

Why School Personnel? Parents often notify schools immediately after the death of a family member and before the funeral occurs. School personnel may be the only professionals who have the opportunity to provide advice to parents about the benefits of allowing children to participate in the funeral. They can help families understand how to best prepare and support children through the experience.

Parents’ Wishes Some parents are clear that they want to include their children in the funeral or memorial service of a family member, or support their children in attending the funeral of a friend. Other parents hesitate. They may wish to protect their children from the distress of seeing others expressing grief. They may feel their children are too young to understand or benefit from going to the funeral. Ideally, children will make their own decisions about funeral attendance. Most of the time, it will be better if they do attend.

• They feel included and affirmed. • T hey are comforted by the support of friends and family. They may also gain support from the family’s spiritual community. • T hey learn more about their own grief when they see the different ways people grieve and give and seek support. • T hey appreciate participating in an important event or ritual. Problems may develop when children are not included. • T hey may feel hurt, discounted, excluded, or unimportant. • T hey often create fantasies that are far more frightening than what actually occurs. They may wonder what could possibly be so awful about the services or what is done to the body of their family member or friend when they are not allowed to be there.

Guidelines for Families It is important for children to understand beforehand what is likely to occur at the funeral. Teachers can share the following guidelines with families to help them prepare and support children attending services. • Explain what will happen. In simple terms, describe what the service will be like. For example, talk about where it will be held, who will be there, the sequence of events, and what people might say or do. Will there be laughter? Tears? Stories? Music and singing? Will the casket be present? Will it be an open casket? Will there be a funeral procession or a graveside service? • A nswer questions. Invite children to ask questions at any point over the days leading up to, as well as during and after the service. Check in with children several times over this period. • Let children decide. Give children choices—to attend the services or not, to participate actively or sit quietly, or to stay for the entire service or part of it. It’s helpful to tell children they can leave the service at any point, or take a break for a short time if they wish. • P air an adult with each child. Especially for young children and preteens, find an adult who can stay with the child throughout the service. This adult can answer questions, provide support and comfort, and accompany the child if he or she wishes to leave for a period of time. Ideally, this will be someone known to the child, but not deeply affected by the death. (Continued)

Advice on Funeral Attendance A babysitter or neighbor often works well. Teachers can also offer to fulfill this role. • A llow options. Help children find ways to be present at the service that feel safe and meaningful. Young children might want to play quietly on one side of the room. Teens might want to invite a close friend to sit with them in the family section. • O ffer a role. When the service is for a family member, offer the child an opportunity to play a role in the service. Choose simple options that are a good match for the child’s age and personality. It might be helpful to select music, read a poem, pass out memorial cards, light candles, or perform some other activity. It’s also fine if the child prefers not to participate actively in the service. • C heck in afterward. Ask children what they thought of the service and how they are feeling about it. Find out if they have any questions. Check in periodically over several days. Teachers can also check in with students after they have attended a service.

Attendance of School Personnel Most families are open to, and appreciative of, members of the school community attending their family member’s funeral. Others may prefer smaller, more private funerals with only family members attending. The first step is to consult with the family about school personnel (and others) attending the funeral and to follow the family’s wishes. When school personnel attend funerals, they demonstrate to grieving students and their families that the school is caring and concerned. It helps establish school personnel as safe people for students to talk with about thoughts, feelings, and questions as their grief progresses. Some school personnel worry they will not be “strong,” and will show too much emotion at the funeral. Genuine displays of emotions, such as becoming tearful or displaying sadness, show children that it is okay to express emotions. This models for children that people can experience grief and still cope with these strong feelings.


Just being present communicates a great deal to students. They may be more likely to reach out to these staff members at a future time.

Attendance of Peers School policies should be developed that facilitate the attendance of interested students and staff at the funeral of someone close to them. If the funeral takes place during school hours, parental permission to attend will be necessary. For young children, it may be most appropriate to ask parents to personally accompany their children to the services. When the death involves a member of the school community, such as a student or staff member, consideration should be given to hiring substitute teachers and making arrangements for coverage of other personnel. It may be helpful to modify the school schedule so that attendance does not create an academic burden on students. However, students and staff should not feel any obligation to attend the funeral. Acceptable alternative activities can be provided for those who prefer to stay at school. If many students and staff are likely to attend, it will be important to talk with the family so they can be prepared. Explore the possibilities that will best serve both the grieving family and the school community. The family may be able to arrange visitation hours outside of school time, for example. They may choose to move the services to a larger location. In some cases, there may not be enough room at the funeral location for all who wish to attend. Schools can plan alternative gestures for interested students and staff. They might gather outside the facility before the service to show their caring and remembrance to the family, or do activities in small groups at the school that allow them to share their thoughts with each other and possibly with the family of the deceased. We discourage the use of school buildings for funeral services, especially if the body of the deceased will be present. This may establish difficult associations with that space for students and staff in the future. The exception would be schools with religious affiliations that have an onsite place for worship, such as a chapel or temple.

For more information on supporting grieving students, refer to

FOUNDING MEMBERS


MODULE SUMMARY

Secondary and Cumulative Losses Take-Home Message Primary loss: the death of an immediate family member, close friend or loved one. Secondary loss: Children experience secondary losses as the result of a primary loss such as the death of a loved one—such things as changes in relationships, schools, family finances, and lifestyle. Grieving children mourn not only the loss of the person who died, but these associated losses. Cumulative loss: In communities with high rates of violence, studentsmayhaveexperiencedthedeathofmultiplepeersand family members. They do not become accustomed to such losses. Rather, they become more sensitized to loss and death.

• Changes in school. Sometimes a family must move after a death. Moving to a new school disrupts friendship networks andreducesthesupportstudentsmayhavebeenreceivingat their old school. • Financial challenges. When a family provider dies, there may be new and sudden financial difficulties. • Changes in lifestyle. If there are financial challenges, the family may have to move to a smaller apartment, a less expensive neighborhood, or the home of extended family members. There may be less privacy and comfort. The child may not be able to participate in extracurricular or afterschool programs that cost money.

When school personnel are aware of these types of loss, they are better able to provide helpful support to students.

• Changes in peer group or status. Moving, a new school, or diminished resources can change children’s friendship networks or their status among their peers.

Secondary Loss

• A parent who is less available. A surviving parent may have to work more and have less time to spend with children. A parent who is struggling with depression or complicated grief may not be emotionally available.

The death of a family member or friend is considered a primary loss. When a close family member dies, children may also experience a range of secondary losses that are the result of a primary loss and contribute to the difficulty of adjusting to the death. Common secondary losses include: • Changedrelationships.Friendsandassociatesofthedeceased may no longer be a regular part of children’s lives. For example, after the death of an older sister, a student might no longer see the sister’s boyfriend, who may have served as an important role model, confidant, or source of support. Relationships that seem incidental to adults, or even to the children themselves, may be quite significant. This is especially true for children who have limited support or are experiencing family or personal challenges.

• Loss of shared memories. Children feel connected to family and loved ones through shared memories about their times together. This might include private jokes, stories about the child’s early years, or shared experiences. No one else knows them in quite this way, and no one else will ever know them in this way again. Children may also lose the opportunity to learn more about their own and their family’s history. • Change in future plans. After the death of a parent or provider, teens may not be able to follow through on plans for college or developing a career. They may not be able to afford the college or trade school they had chosen. They may not have the help they had expected with the application process or choosing a school. They may not want to go to a school that reminds them of their loved one (e.g., their father’s alma mater), or they may feel obligated to go to that school. They may feel a need to get into the job market immediately to help the family financially and give up other plans. • Lossofspecialrecognitionandsupport.Childrenlooktoloved ones for support at challenging times and recognition at times of success and achievement. Without the support of the deceased, they may find achievements less rewarding and feel less motivated to pursue their interests and goals. • Decreased sense of security and safety. After the death of a loved one, children lose the ability to count on their worlds being safe in the same way. If this person could die, others they love could also die.

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Secondary and Cumulative Losses Secondary Loss: What School Personnel Can Do Each student’s experience of secondary loss will be different, depending on the situation. School personnel can help greatly by appreciating and recognizing the range of possible losses. They can ask specifically about these issues, or use their knowledge about a student to offer support. For example, if a teacher realizes that a student looked forward to the school science fair because of the pride he received from his mother coming to the event, the teacher could offer assistance and encouragement for the project. The teacher could speak to the surviving parent to see if another family member could attend. The teacher could also stop by the science fair and offer attention and praise to the student.

Cumulative Loss Communities that face high rates of violence may have many students who have experienced the death of multiple peers and family members. Adults too often assume these children have somehow become accustomed to these losses. They fail to recognize students’ many acute expressions of grief. In communities without this background of violence, children who experience a death and have both personal resiliency and external support from caring adults are likely to cope well with the loss. They will eventually establish a renewed sense of personal safety and security. They may emerge with new coping skills that prepare them for future adversity. In neighborhoods characterized by community violence, poverty and neighborhood disorganization may complicate the setting further. Children here may have personal resiliency, but often lack sufficient external support to cope effectively with death. With each subsequent death, they emerge more vulnerable to the impact of future loss.


Traumatic experiences accentuate the feelings of sadness, anxiety, and stress that they naturally feel. These cumulative losses are neither protective nor desensitizing. Children do not get used to the death of their peers or family members. Students in these communities may come to believe that adults are unable to provide support after a death has occurred. They may view adults in their lives as also unable to establish a safe environment. They may appear to dismiss concerns after a death or show no reaction. Their failure to ask for support is often not because they don’t need it, but because they believe it is futile to ask. Children may turn to peers for support. They might engage in a range of risky behaviors to challenge their fears about their own mortality. Children afraid of dying from community violence may join gangs if they believe that is their sole option for finding protection.

Cumulative Loss: What School Personnel Can Do Children generally want and need to talk about important and meaningful experiences in their lives. It’s hard to imagine anything that fits this description more than the frequent violent deaths of family members, friends, and peers. Children will benefit from adult guidance about how to express their thoughts and feelings, and how to cope best under these frightening circumstances. They will also benefit from being reminded of their personal resiliency and the support system they still have. School personnel can achieve a great deal by providing opportunities for grieving students to express themselves and be heard by concerned, caring, and competent adults. While this is true in all settings, it is perhaps even more critical in the setting of cumulative loss.


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MODULE SUMMARY

Coordinating Services and Supporting Transitions Take-Home Message

Choosing a Primary Contact

Grieving students interact with a large number of school personnel. Ideally, all of these professionals will function as a team that coordinates services. It is critical that representatives from this group maintain effective communication with the student and the family. The team can offer information and status updates, answer questions, provide referrals, and support grieving students over time and during periods of transition.

It is often helpful to establish one (or a few) primary points of contact for student and family. Families may feel overwhelmed if they are being regularly updated by many school staff members, especially if they have more than one child in the school system. Students may find many update meetings burdensome. They may not wish to discuss the impact of their loss with multiple adults at the school on a regular basis.

Functioning as a Team Grieving students are likely to interact with many different school professionals every day. These include educators, administrators, and support staff. Each has the potential to offer valuable assistance to students. Other school personnel may also be available, such as school counselors, school nurses, school psychologists, and school social workers. Each provider brings different perspectives and unique insights about the student’s experience. Working together, they can identify strategies most likely to be helpful for students. It is important the group function as a team, communicating together often and coordinating services. It is critical that they maintain frequent, effective contact with the student and the family. The team can offer the family information, status updates, answers to questions, and responses to concerns. They can provide referrals where appropriate and partner with the family to coordinate support strategies between school and home.

Ideal primary contacts might be a team member who already has a special relationship with the student or one who has a greater level of comfort or experience supporting grieving students and families. The main contact for the parent or caregiver may be the same individual, or someone different. It is important to ensure that there is at least one point of contact for every student who has experienced a significant loss. This contact should be clearly and expressly identified by the team so there isn’t a mistaken assumption that “someone else is taking care of this.”

Each Member’s Unique Role While one person may take on the role of primary contact with the student and family, this doesn’t mean that all responsibility for support is delegated to that person. Each member of the team can take on a unique role, depending on the student’s and family’s needs. For example, the English teacher might support the student with organizational skills and planning for the transition back to school. The math teacher might monitor and help balance the student’s cumulative workload across various subjects. The school counselor might meet with the family to discuss how the student and family are coping. An administrator may check school records and databases to be sure future letters or report cards are not addressed to a parent who died.

Support During Transitions Transitions between schools—and even between grades— can be both exciting and stressful for all students. There may be a change in teachers, routines, rules, schedules, and peer groups. The academic curriculum may be more demanding. For grieving students, these stressors can be more severe. They are particularly vulnerable at times of transition. The person who died may have been someone who provided valuable guidance or support at such times—a sister who offered advice on navigating a new social network, a dad who was there to listen with compassion when changes felt overwhelming. Feelings of grief and loss may be accentuated. (Continued)

Coordinating Services and Supporting Transitions Older Students: Special Concerns for High School Juniors and Seniors High school juniors and seniors may be especially challenged by the death of a family member or close friend. They are coping with heightened academic demands and scrutiny. Difficulties concentrating and learning that are common in bereavement may seem to carry major implications for their future success. Students who are considering upcoming independence from their families—by going to college, embarking on a career, or leaving the family home—are typically ambivalent to some degree. They want separation from their parents, but also worry about how well they can live without their family’s support and comfort. The school team can help grieving students during transitions between grades in the same school, or during promotions to other schools. With the student’s knowledge and the family’s permission, school professionals can communicate the student’s needs and describe strategies that have been effective in providing support. When a student is changing grades or classrooms in the same school, the information can be shared with the new teachers. The team can explore ways to provide some constancy in the support the student receives. Perhaps the student will continue to meet regularly with a school counselor, be invited to check in with a favorite teacher, or continue to receive additional support from the coach. For transition to a new school, it will be helpful for the team to share information with teachers, administrators, counseling staff, and school health personnel. Parents may not realize that this information is not automatically shared with a new school. The school team can also help the family identify ways to prepare the new school to best support their child. In some cases, students may benefit from meeting with the new team before the start of the new year to discuss options for ongoing support.

After a death, students may become more anxious about leaving friends and family behind. They may worry that something will happen to their loved ones, or to themselves, if they don’t remain together. They may feel new obligations about assisting a surviving parent with chores, providing emotional support, or getting a job to help the family financially. A plan to pursue personal goals may feel like a selfish act, or even abandonment. Delaying independence from the family immediately after a significant death may be the best choice for the student and family in some situations. However, it is important to explore carefully whether this is truly in the best interests of the student and aligns with the student’s personal choice. Involvement of the school counselor or other student support professional may help the family and student explore these options in a careful, balanced way.


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For more information on supporting grieving students, refer to The Grieving

Student: A Teacher’s Guide by David Schonfeld and Marcia Quackenbush.

MODULE SUMMARY

Social Media Take-Home Message Social media is a powerful influence in young people’s lives. When a death occurs in the school community, information can be passed quickly among students—sometimes accurate, sometimes not. Grieving students can obtain considerable support from peers and school through social media. It is important for school professionals to consider how to best adapt the use of social media when a death has occurred, and understand how to use it optimally.

Defining Social Media In this handout, we define social media broadly, to include technology such as texting, instant messaging, emails, online gaming, meet-ups, Skype, and similar services.

Opportunities and Benefits Adults sometimes feel uncomfortable with the use of social media, especially when dealing with sensitive topics such as bereavement. For most children and adolescents, however, social media is a familiar and comfortable way to communicate. For grieving children, social media offers unique and powerful ways to gain support and check in with peers. In fact, children often choose social media and technology as preferred methods of communication. Not only is it easier to text a friend, in many cases it is socially more appropriate. A text is delivered immediately, but recipients can consider the message privately. They can choose when and where to read it, then take time to consider a response. They do not need to worry about facial expressions or body language sending unintended messages. For example, condolences or questions posed in person or by phone place immediate expectations on the recipient.

By contrast, a grieving child might read a message, cry privately, then send a reply when feeling more composed. A child who has lost a parent after a lengthy illness might post a notice on a social media site at the time of death and quickly receive expressions of condolence. The child can communicate what has happened without having to contact every friend individually and repeat a difficult story. These communications can help alleviate feelings of awkwardness when the child returns to school. The sense of anonymity and privacy users may feel with social media can facilitate the sharing of personal and sensitive information. Children may discuss feelings, wishes, and thoughts that are difficult to communicate face-to-face, but are important to express while grieving.

Challenges and Cautions As much as social media can provide powerful and positive support to a grieving child, this form of social interaction is not the same as having a heartfelt conversation with a friend. It does not offer the same kind of support as someone who sits with you while you are crying or gives you a hug. Without some balance of personal interactions and real-world contacts, reliance on social media risks increasing the sense of social isolation often felt by grieving children. Additionally, when people meet face-to-face, there is a social consciousness present. They are less likely to say things that are hurtful, insensitive, or inappropriate. In the absence of these social filters, harmful statements and conversations sometimes occur.

School Notifications Social media and text messages are delivered at all times of the day, anywhere there is a signal. Messages about the death of a student during school hours are often received first by students via their phones. Teachers may not have advance preparation. They may find themselves responding to student reactions without having a chance to confirm the accuracy of the information or receiving guidance about what to say. The school’s mental health staff may not be immediately available to provide support. Similarly, if the death of someone in the school community occurs over the weekend or during a holiday, students often learn of the event quickly through social media. They may return to school with questions, fears, grief, or confusion. Rumors or inappropriate information may exacerbate their reactions.

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Social Media While this immediacy of information sharing can seem intrusive, it is a simple reality of today’s world. Adults have little meaningful control over communication among children, even in the absence of social media.

information expressed through social media to be acted on if necessary to preserve safety—for example, if an individual is expressing suicidal intentions.

This is an excellent reason for teachers to prepare proactively to deal with a death in the school community.

Suitable for Public Distribution

Friends and “Friends” Social media connects children with a wider social network. It can simulate being personally present as an event occurs in real time, even if it is at a distant location. This can be exciting, but when a death or tragedy is involved, the sense of personal involvement can be upsetting and unsettling. Adults in children’s lives may not even know of these indirect but often powerful experiences. They may not understand the impact they have on children. The death of a “friend” known to the child only through online gaming or social media may still represent a significant loss.

The Broader School Community Social media can be a highly effective means to rapidly disseminate information to the school community as a whole. When appropriate, this outreach can include recent graduates who may have known the person who died, but are now living in other locations for work or college. Young people in new social situations may lack the sense of shared experience and support they would have previously obtained from peers and family. Social media may also offer a way to reach out to grieving families or students in the initial period after a death, if the family is not yet ready to accept calls or visitors. Information being shared among students and staff through social media can offer insight into how people are responding to a death. This can help inform plans to provide support to the community. Schools need to develop policies concerning the monitoring of social media. It is important to find a balance that precludes infringing on privacy but allows LEAD FOUNDING MEMBERS

Any information posted through social media can easily be forwarded and re-posted repeatedly. It is essential that all content be suitable for public distribution. This may encompass individuals and groups well beyond the school community, including the media. Potentially sensitive messages should be reviewed, not only by an administrator and/or someone overseeing public relations, but also by a mental health professional in the school who may be attuned to the sensitivities of those who are grieving.

Commemoration and Memorialization Increasingly, social media is being used to facilitate commemoration and memorialization efforts. This can be especially useful when children travel and create social networks that they maintain through social media and online communication. For example, after the death of a student who had recently participated in an international exchange program, an online memorial service allowed children from both countries to share memories and stories.

Perform a Social Media Policy Audit Social media is a powerful tool to share accurate and timely information as well as socially appropriate messages after a death has occurred. Schools should review policies related to the use of social media with an eye to how these might best support grieving students and the broader school community. Maintaining a strong social media presence helps schools stay prepared to support students, staff, and families. For more information on supporting grieving students, refer to

FOUNDING MEMBERS


MODULE SUMMARY

Impact on Learning Take-Home Message Temporary academic challenges are common among grieving students and should be anticipated. Teachers and other school staff can provide proactive support and modifications in academic expectations, homework assignments, and testing. This can provide tremendous help to grieving students at a time when they are struggling to understand and cope with a death.

Expect Temporary Challenges It is common for children to experience academic challenges after the death of a family member or close friend. These may occur immediately after the death. They might also first appear weeks or even months later. Preexisting learning challenges often become worse in the aftermath of a loss. Typical experiences for grieving students include: • Difficulty concentrating and distractibility • Limitations in learning and/or remembering new facts or concepts • Anxiety, sadness, and sleeping difficulties—all of which contribute to difficulty learning

Offer Support Proactively It’s important for school professionals to offer academic support proactively. Don’t wait for students to begin demonstrating academic challenges, or for academic challenges to become academic failure. Schools can be a source of valuable support to grieving students. However, if academic expectations temporarily

exceed students’ capacity to learn, schools are more likely to become an additional source of distress.

Helpful Modifications Assist grieving students in identifying the level of academic work that feels appropriate and achievable. Some helpful modifications include: • Change an assignment. There are many ways to adapt assignments to better match grieving students’ current ability to focus. For example, allow a student to work on a project with a partner rather than solo. Suggest a student adapt a formal research paper into a more engaging assignment, such as an oral history project or a video. Offer a student the chance to defer an oral presentation and submit a written assignment instead. • Change the focus or timing of a lesson. A literature class might choose a different book to discuss if the one originally scheduled describes a death similar to the one a student is currently grieving. A health class on the dangers of substance abuse might be postponed, or the grieving student excused, if he has just lost a sibling to a drug overdose. • Reschedule or adapt tests. Immediately after a death, students might be exempted from some testing, or given modifications such as testing alone in a quiet location with extra time. Scores might be omitted or weighted less in determining final grades. It’s important for teachers to find a balance between maintaining reasonable expectations and being ready to provide additional support and accommodation for grieving students. Students need to be appropriately prepared to move ahead to their next grade. If they are promoted without learning the essential facts and concepts of their grade, they will be at a disadvantage the following year, when new teachers may be unaware of their losses.

Students Who Cope Exceptionally Well Some grieving students actually engage more actively in their schoolwork after a death. They may do so to distract themselves from uncomfortable thoughts and feelings related to the death, to compensate for some imagined fault, or to reassure adults—and themselves—that they are doing well at a time when others worry that they will become overwhelmed. Adults may view this as resilience, but the appearance of

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Impact on Learning coping is often maintained at a great personal price to the student. Ultimately, this level of work may be difficult to sustain. It may mask underlying distress that would benefit from assistance. It is important to explore any significant change in academic function.

Coordinating Services and Supporting Transitions offers advice on how school professionals working with a grieving student can work together as a supportive team. The team can assess the student’s cumulative workload, identify ways to balance academic demands with extracurricular activities, and share ideas among teachers and the family on how to best support the student.

Use Guidance From Other Modules Other modules in this course provide guidance that will be helpful when planning modifications for students’ academic work. Connecting With Families underscores the importance of collaborating with families to support students’ adjustment both at school and at home. Understanding how the family is coping can provide useful insights on how to modify homework or test preparation.



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MODULE SUMMARY

Guilt and Shame Take-Home Message Shame and guilt are common reactions among grieving children—and grieving adults as well. School professionals who understand why these reactions occur can take steps to create a safe environment for children that encourages them to express their thoughts and feelings. Speaking directly to children and normalizing these reactions are important first steps in helping children adjust to a loss.

Magical Thinking Young children see themselves as the center of their universe. In their view, things happen because of them. They often assume their thoughts, feelings, and actions can influence unrelated events. This is called magical thinking.

failed to take before. For example, someone might think, “If I call home several times a day to check on my mom to be sure she is okay, she won’t die like my dad did when I forgot to check on him.” The alternative to this kind of thinking is accepting that we have limited influence over these events. This can leave us feeling helpless. It is frightening to realize someone we care about could die at any time, no matter what we do. However, guilt about a death makes it difficult to cope with the loss. The solutions that come from guilt (such as calling a parent every hour) generally do not solve problems. Rather, they create more difficulties.

Children, Guilt, and Death

Adults sometimes encourage magical thinking in children. They may suggest children wish for something good to happen in the world, or urge them to behave well so something good follows.

When something bad happens in children’s worlds, they often assume they have caused the problem by acting badly. They may worry about the possibility that they will repeat their bad behavior and cause the death of someone else close.

Magical thinking is helpful at times. It allows children to feel less vulnerable in a world they do not actually control. But when tragedy occurs, this same type of thinking can cause children to feel profoundly responsible for something over which they had no influence. If they wish for a war to end and the war continues, is that their fault? If being good resulted in presents for Christmas, did their unkind thought lead to a neighbor’s death?

Guilt is more likely when the preexisting relationship with the person who died was ambivalent or conflicted. This would include when a parent was abusive, absent, mentally ill, drug involved, or incarcerated. It might also stem from developmentally common situations—for example, an adolescent who clashed with her father’s attempts to limit her independence.

Adolescents and adults engage in their own forms of magical thinking about death. People sometimes take some responsibility for a death because it helps them believe they can prevent other deaths. They only need to take a step they

When a death is preceded by a lengthy illness, children (and adults) may have had moments when they wondered whether it might not be best for the person to die and be relieved of the physical suffering. This would also end some of their own emotional suffering as they anticipate the death and adjust to the needs of the sick person. These children may feel guilty for wishing for the death of someone they loved. Sometimes, children may express persistent guilt. In some instances, there may be some logical reason to experience guilt feelings—for example, if a child accidentally discharged a firearm, killing a sibling. It is important to involve mental health providers, either from the school or the community, to help such children address their feelings. Through counseling they may come to appreciate that their guilt is unwarranted, or be helped to forgive themselves if they contributed to an action that resulted in a death.

Children, Shame, and Death Another common reaction children have to a death is shame. They understand from an early age that questions about death (Continued)

Guilt and Shame make adults uncomfortable. They may see that their questions or comments about the deceased make a family member cry. Children may conclude that they have done something naughty in broaching the subject. They are likely to feel guilty or ashamed about their behavior, and then keep their questions and feelings to themselves. This may provide reassurance to the adults in their lives that they are fine even though they continue to have questions and feelings about the death. Children may also conclude that the person who died did something wrong that resulted in his or her death. They may then feel ashamed of their relationship with the deceased. Deaths that carry an additional stigma, such as deaths involving suicide, drug overdose, or criminal activity, are therefore even more difficult to discuss. Children and adults may choose not to even inform the school that a significant death has occurred, in part related to feelings of shame or embarrassment. When children withhold information about a loss or expressions of grief out of shame, they will be even more isolated in their grief.

Bring It Up Explicitly It’s helpful to discuss guilt and shame explicitly with grieving children. Ask about the kinds of thoughts, questions, or feelings they have been having. Describe the kinds of reactions related to guilt and shame that people often have.

Normalize the experience of guilt and shame while creating a safe environment where children can speak honestly about their experiences.

Use Guidance From Other Modules Concepts of Death addresses children’s understanding of death in more detail.



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MODULE SUMMARY

Other Reactions Take-Home Message

Nonverbal Reactions

Reactions to death vary greatly in children. Learning how children understand and feel about a loss is a useful way to determine how to best help them cope. Children’s thoughts and feelings can help explain their behaviors both immediately after a death and after some time has passed. School professionals are able to intervene in more appropriate ways when actions that might be perceived as misbehaviors are understood in the context of a student’s reaction to a death.

Many children express their feelings in ways other than talking. Very young children often work through their feelings during play. Older children may use creative activities such as writing, role-playing, or art to express their thoughts and feelings.

A Range of Reactions Other modules in this section address the learning challenges children often experience after a death, as well as the guilt and shame commonly seen in grieving students. (See Impact on Learning and Guilt and Shame.) After a death, students may express a range of other reactions as well, including the following.

Little or No Reaction Some students appear to have little or no reaction at all after the death of someone important in their lives. They may actually be making an extraordinary effort to keep their emotions hidden from others. Often, they do a very convincing job. Adults in their lives may be unaware of their distress. This does not mean they are not greatly affected by the death. It is important not to rely solely on children’s behaviors to assess how they are doing. Conversations, check-ins, and invitations to ask questions or discuss feelings can be useful for all students.

While play and creative activities can provide important clues to children’s thoughts and feelings, adults should be careful not to jump to conclusions. For example, children who draw only happy scenes after a traumatic loss might give the impression they are not affected by the events. In actuality, they may instead be giving a sign that they are not yet ready to process or express their grief. Rather than interpreting children’s play or creative work, consider asking them to describe what their work is about or what story they are telling.

Anger Children may express anger after a death and look to assign blame to others. These reactions may be an attempt to establish control in response to an overwhelming experience. Parents and other family members are often the targets of such anger. They are close by. They are also relatively safe because they are likely to be more tolerant of emotional outbursts. Children may feel anger at their parents for not protecting them from personal tragedy. Children may also direct anger toward the person who died. They may feel abandoned, or be angry about negative consequences and secondary losses that resulted from the death. The death of a loved one can also result in anger at God. Children may question even strongly held spiritual beliefs. It is important to normalize feelings of anger and encourage grieving children to express their feelings in nonharmful ways. When children understand that people often feel angry after a death, they are less likely to feel guilty or ashamed of their feelings.

Preexisting Challenges Preexisting learning, emotional, or behavioral challenges may resurface or worsen after a death. Normalize such setbacks for grieving children—they are common. Help plan extra supports from professionals with the school and community as students learn to cope with their loss. (Continued)

Other Reactions Risky Behaviors Older children and teens may engage in risky behaviors such as drinking alcohol or using other substances, engaging in risky sexual activity, or participating in violent or delinquent behavior. This often reflects their struggle to master an increase in feelings of personal vulnerability after the death of someone close to them. Invite these students to think about possible links between the risks they are taking and their feelings about their loss. When the risky behaviors persist, or when they are serious, refer students to appropriate mental health professionals.

reality, however, when under significant stress, children often focus more on their personal needs, at least at first. They may act more immature, self-centered or demanding, and be less tolerant of change. Once children’s needs are met and they are feeling more secure, they are likely to feel more capable and able to attend to the needs of others. Over time, they will return to developmentally appropriate behavior, including an interest in seeking increased personal independence.

Acting Younger In the aftermath of a death, children may begin to act more like they did at an earlier age. Children who were comfortable with independence may become sensitive to separation from surviving family members. For example, a kindergarten student who tolerated being left at school may become clingy after a death. Adults often expect children to become more generous and considerate of the needs of others at times of crisis. In



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MODULE SUMMARY

Grief Triggers Take-Home Message Grief triggers are sudden reminders of the person who died that cause powerful emotional responses in grieving children. They are most common in the first few months after the death, but may happen at any time. School professionals can prepare students with information about grief triggers, proactively establish a safety plan with grieving students, and approach potentially difficult classroom lessons or activities with increased awareness. This creates a more supportive classroom environment that is appreciated by all students.

How Children Feel and Respond Children experiencing a grief trigger may respond many ways, including one or more of the following: • Outbursts of anger or sadness • Uncontrollable crying • Feelings of emptiness • Feeling out of control or frightened • Embarrassment

What Grief Triggers Are Like

• Inability to concentrate

After a significant loss, students may unexpectedly encounter situations or comments that remind them of the person who has died. This can cause sudden and intense feelings of distress and other strong emotions.

•F rustration or disappointment (“I thought I was getting better, and now I’m out of control again”)

This can be unsettling at any time, but especially so when it occurs in a school setting. Students are caught off guard. They may feel a loss of control. This can be especially disheartening after they seemed to be gaining some relief from the strong feelings that occurred immediately after the death. Students may worry that they’ll start crying in front of classmates or otherwise embarrass themselves. They may feel overwhelmed and unable to ask for support.

• Wishing to escape the situation, to “get out of the room”

Common Grief Triggers Events such as the following may act as grief triggers for children if they are associated with the person who died: • Hearing a song or seeing a TV show • Going to or seeing a photo of a place • Smells or sounds • Hearing a news report (of someone who died in a similar way, for example) • Special occasions (holidays, birthdays, Mother’s Day or Father’s Day) • Transitions (graduation, starting at a new school, moving) • Lost opportunities (vacations, performances, sports events, father-daughter dances) In a school setting, the class may be talking about a city in social studies that reminds the student of a prior family vacation and special time spent with the deceased. A peer may comment over lunch about a television show the student had always watched with a sibling who died. The class may be asked to discuss an assignment with their mother or father, and the student is reminded that she no longer has two parents. Almost anything can serve as a grief trigger. (Continued)

Grief Triggers Supporting a Child Experiencing a Grief Trigger Support from teachers and schools can help students move through these experiences in a positive and productive way. Ideally, there will be a chance to explain proactively to grieving children that it is fairly common for such triggers to occur. Reassure them that, while intense, the immediate experience will pass. School professionals can work with a child to develop a plan for grief triggers. Options include: • Identify a safe space or location where the student can go. This might be the library, a study hall, a nearby classroom, or the office of the school counselor, school nurse, school psychologist, or school social worker. • Provide the child with the name of an adult he or she can see when feeling upset or wishing to talk. • Set up procedures that allow the student to obtain support, such as a signal or statement that doesn’t draw attention but does allow the student to leave the classroom. It’s difficult for children to ask for help and expose their vulnerabilities in front of peers when they are already feeling overwhelmed. • Allow the child to call a parent or family member if he or she feels it would help. • Give permission and encouragement for the child to speak with a school counselor, school nurse, school psychologist, or school social worker.

Anticipate and Minimize Triggers When possible, it’s helpful to anticipate and minimize grief triggers. Here are some steps that will help. • Expect that triggers may occur around holidays, Mother’s Day and Father’s Day, the child’s birthday, the birthday of the deceased, or the anniversary of the person’s death. Children and their families may be able to suggest dates that may be difficult. Note: Children who have a parent deployed in the military, living in another city or state, in prison, or otherwise absent from their daily life may also experience sadness or distress at similar times. • Introduce class activities in a way that acknowledges absences and offers alternatives. Example: “For this Father’s Day activity, I’d like you to focus on your father or another important male adult in your life— someone who cares for you and has provided support. If your father is not living, or he does not live with you, you can still complete this activity with him in mind if you wish.” • Make an effort to reach out to grieving students at school events where the absence of a loved one may be especially noticeable (performances, sporting events, science fairs). • Introduce subjects such as serious illness, accidental death, war, or violence with sensitivity. Recognize that students in your class may have lost a family member or close friend in one of these ways.

• Offer private time with a teacher to talk over feelings, questions, or other concerns. When children know there is a plan in place to deal with grief triggers, they feel less trapped when they occur. If children know they can leave without drawing attention to themselves, they become less anxious. Their distress passes more quickly, and they actually rarely need to leave the classroom. They are more likely to remain in class and be available for learning. LEAD FOUNDING MEMBERS

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MODULE SUMMARY

Professional Preparation Take-Home Message Professional development addressing support for grieving students is an essential component of training for teachers and other school staff. Unfortunately, it is offered far less often than needed. Most school professionals want to receive such training. There are resources to help make effective professional development possible.

Bereavement Will Affect Most Students Approximately 5% of children nationwide will experience the death of a parent by the time they reach age 16. About 90% of all students will experience the death of someone close to them by the time they complete high school. It is likely there is at least one grieving student in every classroom, in every school, every day. Bereavement has a profound impact on learning, development, and the emotional adjustment of children. The unique role schools can play in supporting grieving students is powerful. It is important to provide training in this area for school professionals. Ideally, introductory training would be provided at the preservice level, and continuing opportunities for learning would be offered for experienced teachers and school staff.

School Professionals Want Training Many teachers and other school professionals feel unprepared and apprehensive about reaching out to provide support to grieving students. They worry that they will say or do something clumsy or wrong, make matters worse, or start a conversation they don’t know how to finish. A survey examining this issue was conducted in October 2012 by the American Federation of Teachers, the New York Life Foundation, Tiller Inc., and Hart Research Associates. It involved more than 1,200 members of the American Federation of Teachers. Respondents recognized that bereavement is common in the lives of children and that students have a wide range of problems and challenges after experiencing a significant loss. Teachers reported that they wanted to provide support and assistance to their students when they were affected by a death. They recognized the unique role they can play in these situations.

But the single most important barrier preventing them from providing this support was insufficient training and/ or professional development. An overwhelming majority of teachers— 93%—reported they had never received any training about supporting grieving students. Only 3% of schools or districts reported offering such training.

Schools Can Meet the Challenge Schools can help meet this gap by ensuring that in-service training addresses the topic of children and grief. This should be offered as a component of ongoing professional development in relevant school professions. The benefits of such training are considerable. This training can: • Provide school personnel with the information and skills necessary to support grieving children and their families. • Establish norms about what school professionals can and should do to support grieving students. • Deliver a clear message that supporting grieving students is important. • Emphasize the importance of school professionals in providing this support, and establish that these are valued skills for them to acquire. • Demonstrate that the school administration is sensitive to teachers’ needs in this area and committed to providing support to assist them in their efforts. It is best to plan and offer training prior to a school incident or crisis so that school staff will be better able to respond.

(Continued)

Professional Preparation There Are Resources to Help Schools can collaborate with professionals, agencies, and organizations in the community that provide bereavement support. This might include agencies such as a children’s bereavement center, a hospice program, or a mental health agency. These groups can serve as referral resources and may also be able to offer direct services at the school—perhaps bereavement peer support groups or individual counseling with students.

Look to the Coalition to Support Grieving Students The Coalition to Support Grieving Students can provide the spark for targeted discussions among school staff. There are abundant resources available to form a foundation for more structured presentations. There are materials that can facilitate self-directed or small-group professional development. The website houses other resources that can be useful in training or personal education.

They may also be able to assist with ongoing consultation and training. School-based health, mental health, and counseling staff can also be asked to provide training to educators in their own school or district. Often these trainings are planned and provided in the aftermath of a school crisis or school-wide bereavement. While this is generally better than offering no training at all, “just in time” trainings usually are not actually in time. When school staff is personally affected by a situation—they knew the individual who died, they are close to bereaved students— it is more difficult to consider the topic, incorporate the information, and learn the relevant skills.



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MODULE SUMMARY

Professional Self-Care Take-Home Message Most school professionals choose their profession because they want to help children learn and develop. Precisely because they care so deeply about students, offering support to grieving children can be both deeply gratifying and demanding. Providing support means bearing witness to students’ pain. It is critical that school professionals take care of themselves and their colleagues in ways that recognize the challenges of this work.

Lasting Impact There are few ways to have a more meaningful and lasting impact on children than providing support as they cope with one of life’s most difficult challenges. In supporting grieving children, teachers connect with students in a powerful and qualitatively different way. It can be gratifying to see that relatively modest efforts to offer compassion and support have a dramatic effect on children. This support can help reduce the amount of time grieving children feel isolated, confused, or distressed.

Grief Is Difficult to Witness Being with children who are in distress can be unsettling for adults. We sense a vulnerability in children and naturally want to shield them from painful experiences. Children’s questions as they try to make sense of a death can be poignant and moving. It can be difficult to bear witness as children struggle to cope with a death, and in so doing, lose some of their innocence about the world. Sometimes it is difficult to recognize that the assistance we provide is important. We reach out to help others in the hopes they will feel “better.” But students who are actively grieving can be very upset. We may question how helpful we’re being if the person we’re helping is sobbing in despair.

When school personnel talk with grieving students only in the immediate aftermath of a death, they see children when they are feeling most overwhelmed. It may be difficult to remember that students cope differently with these feelings over time, and they do not always feel their despair so deeply. Checking in with students at a later point—even a year or two later—will reveal the growth and acceptance that typically come as time passes. This can help affirm that the assistance provided was meaningful. Students generally appreciate these expressions of concern. If you have questions about how best to support grieving students, don’t hesitate to seek consultation. Look to the school counselor, school nurse, school psychologist, school social worker, or other members of the school staff who have skills or experience in this area. Reassurance that you are doing what is needed can be very helpful.

Triggers for Adults Supporting grieving children can trigger a range of reactions in adults. This is especially true if a child’s loss is somehow similar to an adult’s personal experience. But even when the circumstances are quite different, the simple, powerful reality of a grieving child can raise thoughts, feelings, and memories concerning the adult’s own family and friends. Examples of situations where adults may experience triggers include: • A past personal experience with grief. School professionals who experienced the death of a parent during childhood may bring greater empathy and insight to their interactions with grieving students. They will also be more likely to experience a rekindling of their own memories. • Coping with serious illness. An adult facing a life-changing or life-threatening illness may become more anxious about personal health and outcomes while comforting a student whose parent or sibling died of a serious illness such as cancer. • Having a friend or family member who is ill. When someone close to a school professional is facing possible disability or death, a student’s grief may heighten worries or anticipatory grief reactions. • New concerns about loved ones. Even when adults are not dealing with past deaths or current illnesses in their lives, the process of watching a child struggle to cope may heighten their own concerns about family and loved ones. A child’s grief can be a stark reminder that all life is fragile and uncertain.

(Continued)

Professional Self-Care Discomfort With the Role School professionals may feel uncomfortable with the role of providing support for grieving children. It may feel like an additional expectation that is outside the realm of teaching academic subjects. They may feel untrained and unprepared to offer such support. Sometimes teachers who feel resentful or unprepared in this way also feel guilty. They realize how important support can be to grieving students. They may feel that they aren’t putting in the appropriate amount of effort or that they are lacking some essential skill for effective teaching. These are fairly common feelings. It is important for all school professionals to assess honestly and fairly what they feel able to do. Each individual is a member of a broader team that is available to support grieving students. While it is important that critical services be provided to students in need, it isn’t necessary for the bulk of those services to be provided by any one member of the team. Teachers and other staff should monitor their personal reactions and offer what they are able to at a given point in time. It is acceptable and appropriate to seek assistance from others to ensure that necessary support is provided to grieving students. There will be times when it may be best to call on a colleague to take the lead in supporting a student.

There will be opportunities to pay back such favors, either by taking the lead in supporting a student at another time or by assisting a colleague in some other way. Keep in mind that allowing others to assist you when a student needs support is an excellent way to model attention to self-care and give others a chance to contribute something of value to the effort.

Getting Support School personnel should identify friends, family, and colleagues to talk with about the experience of supporting a grieving student. There may be times, however, when the support of family, friends, and colleagues is not the right match for the concerns at hand, or not sufficient on its own. Consider seeking additional support when guilt, resentment, or personal grief is particularly strong or persistent, or when these or other feelings begin to interfere with personal or work life. In such situations, it may be best to seek the guidance of a bereavement specialist or mental health provider. This might be a consultant to the school or district, a mental health provider in the community, or an employee assistance program offered through work.



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MODULE SUMMARY

Death and School Crisis Take-Home Message When the death of a student, teacher, or other school staff member occurs, the loss can have a profound effect on the entire school community. It is vital that schools plan ahead to cope with crisis events, including creating appropriate plans and policies and establishing partnerships with community professionals who can help address the needs of students and staff.

Grief Is Different for Each Person At some level, individuals who are grieving have similar types of needs—such as for acknowledgment, understanding, and support. At another level, however, grief is quite personal. Variables that can determine the responses of individual students include:

one person crying, for example, may trigger crying in others. Similarly, however, one student’s resiliency or act of compassion often serves as a positive role model for others.

Supportive Services When a death directly affects many people in a school community, a large number of students and staff may benefit from supportive services. Current staff may find it difficult to meet all of these needs, especially if they, too, are grieving. It is therefore critical to have plans in place prior to a school crisis event. These plans need to outline the steps for staff and students to take in response to the event and to have relevant policies in place. Plans should take into consideration such matters as:

• personal relationship or perceived connection with the deceased

• How will the information be shared with staff, students, and families, as well as the larger community? Draft communications for families should be developed, as well as model press releases.

• prior experience with loss

• Who will provide support to students? To staff?

• age and level of understanding about death

• If outside consultants or community partners will be used, what agreements are in place about their services? How will they be engaged in providing support?

• preexisting coping mechanisms • method of expressing strong emotions • available support systems • level of empathy for the needs of others Each student’s personal reactions are likely to be quite varied. Helping students and staff accept the range and diversity of reactions is an important lesson in tolerance that will serve them well in the future. In the school setting, reactions may also be intensified—

• What are the school’s policies concerning funeral attendance, commemoration, and memorialization? It is difficult to identify trusted professional partners in the immediate aftermath of a crisis. It is vital that schools establish preexisting relationships with organizations and professionals outside the school who can be called upon with short notice to provide needed support. In some cases, it may also be helpful to seek the consultation and technical assistance of experienced professionals outside the community. The National Center for School Crisis and Bereavement (www.schoolcrisiscenter.org) provides such consultation and technical assistance. They can be reached at [email protected] or at the phone number listed on the Coalition’s website (www.grievingstudents.org).

Informing Staff and Students About a Death Information about the death of a member of the school community is likely to spread quickly among students and staff. This increases the likelihood of rumors, misinformation, and gossip. This is one reason it is important to notify the entire school community, at the same time, as soon as possible after information is known about a death. (Continued)

MODULE SUMMARY

Death and School Crisis If a death occurs outside of school hours, it is helpful to hold a meeting of school staff before the start of the next school day. Staff should be informed about what is known and be briefed on how to discuss the event with students. They need to know what supportive services will be available for students and staff, and be informed about any changes in the school’s schedule for the day. Guidelines for making the announcement to students can be distributed. Copies of communications that will be sent to parents and guardians can also be shared at this time. (Sample notification letters and announcements that can be downloaded and adapted by schools are available at www.schoolcrisiscenter.org or by following links within the Guidelines for Responding to the Death of a Student or Staff, or Guidelines for Schools Responding to a Death by Suicide, located in the Additional Resources section of www.grievingstudents.org.) Students should all be informed at the same time, as soon as possible after the start of the school day. It is best that someone familiar to students provide the notification, in person, in small, naturally occurring groups such as homerooms or classrooms. Announcements in large assemblies or over public address systems are not recommended. The person giving the notification can observe students’ reactions and answer questions as they arise. Students should be informed in a setting and at a time where immediate support is available to them; schools should avoid notification at dismissal. Even if staff members are available to students after dismissal, not all students are able to stay after school hours to access those supports. It is important to make sure that students and staff who are off-site for the day—on field trips or home sick, for example—are also notified as soon as possible. If a class is on a field trip, an administrator can call the cell phone of a teacher or chaperone on the trip. Ideally, someone from the school will be available to meet with students when they return from the trip.

phone calls, or postings on social media. Students may know of a death before an organized communication with staff can be arranged. Teachers may first become aware of a death through comments from students and need to respond supportively without prior preparation.

What Information Is Shared Information about a death should be verified by a reputable source. This includes direct communication with family members, police, or other local authorities. When talking with family members of the deceased, determine what information they wish shared with students and staff. Grieving families may need guidance about how important it is to share information about a death. Clear information can help prevent the spread of rumors and misinformation. Sometimes, parents prefer to withhold some information, especially if the death is felt to be related to suicide, substance abuse, or some other stigmatized circumstance. Keep in mind that any communication sent home to families or posted on the school’s website should be considered as available to the general public or media. Content should be written accordingly. Confidential or sensitive material should not be included. Schools attended by siblings or other relatives of the deceased, or feeder schools the deceased attended in the past, should also be contacted. It may be appropriate to notify all schools in the district, especially after a significant crisis event or in a small community.

Media

Media such as newspapers, radio, and television

Schools might also call or send emails to parents and guardians of absent students, along with information and suggestions about how to talk with their children. (A PDF parent guide on how to support grieving children can be found in the Additional Resources section.) Schools should also plan a process for notification should a death occur during a weekend, holiday, or vacation period. Over a longer vacation period, the school may decide to open for specific periods of time to offer a supervised location where students can come together and get support. When a death occurs during school hours, students will often become aware of the event through text messages, cell (Continued)

Death and School Crisis can be a useful way to share relevant information broadly in the community. A district media coordinator or school administrator should be designated as the media contact. Students should be advised to avoid speaking directly with media when they are acutely grieving. In the aftermath of a crisis, it is not generally helpful for students to speak with the media. Such contact should occur only with the permission of a parent or guardian, after careful consideration of whether sharing students’ comments or image is in their best interests.

Where Impact Is Deepest After a death in the school community, it is helpful to identify students who may be at higher risk of emotional distress. This might include students who: • are friends of the deceased • had a complicated or difficult relationship with the deceased (for example, someone who recently ended a romantic relationship with the deceased) • believe they are somehow responsible or contributed in some way, even indirectly, to the death • may share a relevant affiliation (for example, a situation where a student died of cancer and another student has a family member with cancer) • are friends of a sibling of the student who died • have experienced prior losses or emotional difficulties A school mental health professional might follow the schedule of the student who died and offer additional support to classmates or students who shared extracurricular activities with the deceased. Peers often know which students are most deeply affected by a death. They might have personal knowledge of the issues or see content posted on social media.


It’s also important to identify teachers and other staff who had a closer relationship with the deceased. This might include a current or past teacher. For example, if a fifthgrade student dies, the second graders may have little if any personal relationship with the child, but the second-grade teacher who once taught that student may be deeply affected. School staff should always speak sensitively about the death, recognizing that in any gathering within the school community there may be students or staff who are deeply affected, even if they do not show signs of distress. While it is helpful to shift the focus from the crisis event and return to a regular school schedule as soon as is practical, it is also important not to withdraw bereavement support prematurely. Some students who need significant support may be best served through referral to community-based services, but most will have their needs met through general supportive services and school-based bereavement support.

If a Teacher or Staff Member Dies If a teacher or staff member dies, it is helpful initially to assign a well-known member of the school community to cover that person’s classes and activities, rather than bringing in a stranger. This might be another teacher from the same grade level, a teacher from the prior grade, or a well-liked administrator or assistant. When a colleague dies, teachers and other staff often feel not only grief, but an increased sense of vulnerability in their own lives.

Use Guidance From Other Modules The module Suicide addresses the unique challenges of suicide and stigmatized deaths in more detail. Professional Self-Care addresses the importance of selfcare and suggests strategies for getting support.


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MODULE SUMMARY

Suicide Take-Home Message School staff face unique challenges when supporting students who are grieving a death by suicide. Effective and appropriate communication about a death by suicide is important in order to reduce the risk of other students or members of the community engaging in self-harm or attempting suicide. Many people believe that talking about suicide will prompt individuals who wouldn’t have otherwise thought of suicide to consider harming themselves. This is not correct—clear, open, appropriate discussions are essential. Schools will want to take steps to address the strong feelings of survivors and decrease the risk of another suicide in the school community.

not cause students who otherwise wouldn’t have to consider self-harm. People need clear, open, appropriate information and a chance to discuss their own reactions when a suicide occurs. However, sensationalized media coverage that brings notoriety to someone who died by suicide may increase the likelihood of a student who is already vulnerable to attempt suicide. This is why it is especially important to understand how to frame these discussions constructively and provide assistance to school staff as they approach this difficult topic with their students.

Resources for Support

Background on Suicide

Mental health and counseling staff of the school, as well as community-based partners, can serve as excellent resources to support classroom interventions.

Death by suicide is the third leading cause of death in children ages 10–14 and the second leading cause of death in children ages 15–19. Almost one in five high school students has considered suicide, and 2% to 6% of children attempt suicide.

It is important to offer support resources for school staff as well. Some individuals will have had personal experiences with depression. Some have probably also experienced suicidal intentions themselves. It is quite likely some have also lost family members or friends through suicide.

It is highly likely that many members of the school community, students as well as staff, have personal experiences with suicide among family or friends. Also, anyone might have considered or attempted suicide in the past—you cannot tell by looking at or talking with someone.

Remind staff of supportive services available to them personally, such as the employee assistance program. Provide information about suicide hotlines and related resources within the school and community.

Why It’s Hard to Discuss Suicide carries a great deal of stigma. People often do not wish to discuss personal experiences related to suicide. School staff and parents are also concerned that discussion of suicide with students may prompt others to consider harming themselves. It is important to recognize that talking about suicide will

Respecting the Wishes of the Family Because of the stigma and pain of suicide, survivors often experience strong feelings of guilt, shame, regret, and anger. Families may not wish suicide mentioned as a possible or likely cause of their child’s death, even when circumstances suggest otherwise. When possible, explain to the family that an honest, sensitive discussion about the cause of death with students may decrease the risk that others will die by suicide.

Clear Communication With Students If the family is unwilling for these open discussions to take place, school staff can still speak with students in a clear and appropriate way about the death while respecting the family’s wishes. For example, teachers can state that the cause of death was hanging, but the family is unsure whether or not it was accidental. When students raise concerns about suicide, they can be told: “The family is unsure of the reason for John’s (Continued)

MODULE SUMMARY

Suicide death and believe it to be accidental. However, many of you (or the media) have suggested that suicide may have been the cause. While we don’t yet know the cause of John’s death, suicide is a cause of death for a number of children and adults. I think it’s important that we talk about suicide in general.” When talking with students, be sure to use the phrase “death by suicide.” This demonstrates that you are prepared to discuss this sensitive topic. Some people avoid using the term “committed suicide” because it may be viewed as implying a criminal act.

Sample Scripts The National Center for School Crisis and Bereavement (NCSCB) offers sample language for discussing suicide with children of different developmental levels within the document: “Guidelines for Schools Responding to a Death by Suicide.” This guidance document can be found at the website of the NCSCB at www.schoolcrisiscenter.org or at www.grievingstudents.org in the Additional Resources section.

Help Students Navigate the Process Death by suicide should not be sensationalized or glamorized. Media coverage should be minimized—for example, avoiding front-page coverage or details about the means of suicide. At-risk individuals experiencing depression or feeling disenfranchised may find this type of attention appealing and experience more powerful thoughts or impulses about suicide themselves. On the other hand, it is important to acknowledge the grief of survivors who lost a friend and classmate and to guide students toward resources for support. Discussions with students should be geared toward remembering what made the student special,

and not emphasize the way the student died. In addressing the topic of suicide at this time, the focus should be on the importance of students talking with a trusted adult if they are considering harming themselves or suspect that someone they know is potentially suicidal. Information about suicide hotlines and other school and community programs for suicide prevention should be prominent in school materials and media coverage.

Causes and Risks Suicide is usually the result of underlying depression or other mental health problems. It may also be related to alcohol or other substance abuse. In general, this is not a logical “choice” made by someone who is thinking clearly and able to consider a range of solutions to problems. The ready access to lethal means of self-harm, especially firearms, is a major risk factor. In presentations to students, it’s important to destigmatize seeking help for depression, other mental health problems, and substance abuse. Emphasize that while thoughts of escape through suicide may be fairly common—many people have such thoughts at some point in their lives—these thoughts are normally set aside by clear thinking. Self-destructive behaviors occur when a person is not able to think clearly. They are often the result of impaired problem-solving abilities.

The Danger of Keeping Secrets Peers often know when a friend is thinking of self-harm. They are often asked to keep this information confidential. Explain that just as true friends don’t allow their friends to drink and drive, they should never agree to keep suicidal intentions secret. Emphasize that this advice is intended to help prevent future deaths by suicide, not to make people feel guilty if they had concerns or information about someone who completed a suicide and chose not to bring that to an adult’s attention.

Commemorating the Death Avoid formal acts that recognize and memorialize someone in the school community who has died by suicide. This would include actions such as a yearbook dedication or planting a tree or placing a plaque in the person’s honor. We generally recommend that for all deaths, no matter the (Continued)

Suicide cause, informal, individualized responses that are meaningful to students be chosen instead. In the case of someone who has died by suicide, for example, students may wish to implement a yearly speaker series addressing topics related to the mental health of students. They might want to arrange a community service initiative that isn’t directly related to suicide. They might choose personal gestures rather than organize a broader, school-wide activity. After a student dies by suicide, it is particularly important not to invite anonymous comments from students. Some schools have posted a large piece of paper in an unattended area and invited students to write comments. Negative comments about the deceased or the means of death may be written in these situations. Other students who are considering suicide themselves may disclose this, and there is no way to follow up or provide assistance.

and school social workers can help teachers and other school staff identify risk factors and signs of distress among individual students that may indicate the need for mental health services beyond what is offered in the school. Schools should communicate with other schools and community mental health agencies to monitor whether there is an increase in suicide attempts, or any pattern that would suggest a possible suicide pact or cluster. If this is a possibility, we strongly recommend involving experts who have experience dealing with suicide clusters in order to minimize the chance of secondary cases.

Use Guidance From Other Modules Commemoration and Memorialization provides guidelines for memorializing a member of the school community who has died.

Preventing Another Suicide A major goal of suicide postvention activities (those that occur after a death by suicide) is to decrease the risk of another suicide. Those closest to the deceased should be given additional support at this time. So should individuals who believe they may have neglected or mistreated the person who died. They may feel guilt themselves or be targeted and blamed by peers—for example, an ex-girlfriend who just ended a relationship with the deceased. Individuals experiencing depression, those who have contemplated or attempted suicide in the past, or those with family members who died by or are at risk for suicide may also have more difficulties and warrant additional support. School counselors, school nurses, school psychologists,


FOUNDING MEMBERS


MODULE SUMMARY

Commemoration and Memorialization Take-Home Message Memorial and commemorative activities can be helpful to students and staff. However, it is essential that schools give careful consideration to policies and practices to ensure that activities are appropriate and address the needs of the school community. It’s also important to engage students in planning memorial activities. This helps ensure the activities are appropriate to the interests of the students and responsive to their needs.

Memorials and Commemorative Activities as a School Community Response The wish to develop memorials and commemorative activities is common following deaths that touch many members of a community. When a death occurs in the school community, these activities help students to: • communicate at a public level their connection and attachment to the person who died • express and cope with difficult feelings that may otherwise seem overwhelming and difficult to deal with on their own • realize that they are not alone in having strong feelings • draw on the support of peers and adults in the school community • begin to find some meaning in the loss • feel reconnected to beliefs that may have been shaken by the experience

• be capable of being readily applied fairly and consistently across a wide range of contexts involving the death of a member of the school community (see “Set Appropriate Precedents,” on the next page) Schools should also consider how to coordinate their activities with plans for commemorative or memorial activities in the larger community. It may be helpful to invite religious, cultural, civic, or other community leaders to assist in this process.

How Is More Important Than What What is planned for a memorial or commemorative activity is far less critical than how the school goes about the planning process. For these activities to be helpful, it is critical that students play a central role in planning events. This ensures that the activities are relevant to students’ interests and responsive to their needs. Simply stated, a commemorative or memorial event planned by adults for children is likely to be helpful to the adults rather than the children. When children plan and take part in these activities, they can exercise some control over how they choose to remember and honor the person who died. They have a say in the ways they recognize what was lost or permanently altered by the death. They can take action that helps them determine how they wish to acknowledge any associated crisis event— a violent incident, a tragic accident, or a formidable natural disaster, for example. When someone close to us dies, we feel powerless and vulnerable. Helping children feel some sense of control over the response to the death lessens these feelings.

• learn coping strategies that have worked for others, and share their own coping approaches with peers

Schools Should Set Appropriate Guidelines Schools should give careful consideration to ensure that any policies and procedures followed to commemorate a death support the needs of the students who are grieving as well as heed safety concerns. Any activities should: • be thoughtful • be respectful of the diversity of views and needs of students and staff • include students in some part of the planning or development process (Continued)

MODULE SUMMARY

Commemoration and Memorialization Listen to Students It is sometimes tempting for school staff to tell students what they are probably feeling at the moment, or suggest the best ways to express their feelings and remember the deceased. However, this is not helpful. Instead, allow students to discuss in small groups their thoughts and feelings. Encourage them to identify collectively a helpful and meaningful way to commemorate the life of the person. Even young students are capable of having these conversations and coming up with appropriate ideas. Often, what students choose will rely on thoughtful and symbolic activities that are more meaningful and expressive than the suggestions of staff. This is more therapeutic for them as survivors.

Set Appropriate Precedents Death in a school community can occur in a number of different ways. It is important for schools to choose policies and guidelines that can be applied appropriately under any circumstances. In general, it is best to avoid legacy memorials, such as placing a plaque in the hallway or planting a tree, or choosing a memorial effort that requires raising substantial funds. These are precedents that the school won’t wish to apply consistently to all possible future deaths. For example, the friend of a child who dies of cancer may question why more attention was given to a star athlete who died from an injury during a football game. Classmates of a student who dies by suicide or a drug overdose may resent that this death is not acknowledged with a plaque. Formal permanent markers may also be vandalized, damaged, or fall into disrepair. Years later, few students or even staff may have any personal connection to or memory of the person who died.

Trees and other living memorials may die or fail to thrive. This can be distressing to family members and friends of the deceased. In addition, these types of physical reminders can sometimes have unintended negative connotations for students. For example, if a school within a community with a high rate of violence decides to memorialize by planting a tree within a “peace garden” for each student who dies, surviving students may come to see the growing number of trees as more of a body count than a memorial. The garden becomes a constant reminder that they live in a violent neighborhood. They may wonder when their own tree will be planted.

Give It Time It is important to allow sufficient time and space in which members of the school community can identify and understand their thoughts and emotions about a death. Often, students and staff rush to plan commemorative and memorial activities, sometimes beginning such discussions hours, or even minutes, after hearing the news of the death. These individuals are struggling to cope with the absence of the person who died. However, this rush to commemoration may divert attention from addressing the acute emotional needs of the broader school community. It can give the false appearance that the school is attempting to reach closure prematurely. This is likely to discourage students from continuing to share their feelings and receive the support necessary to adjust to and cope with the loss.

Be Aware of Social Media Students increasingly utilize social media as a means to commemorate and memorialize those who have died. They might continue to post messages to a deceased student’s personal site, or create a new site for this purpose. It is important that schools be aware of any such sites used or visited by students for this purpose. Speak with students to gain information about what is being communicated. The goal is not to police the site, but rather to maintain a level of general awareness. Ask students to bring any comments that are worrisome, destructive, or troubling to the attention of an adult—for example, suicidal or homicidal intentions, or comments about the deceased that are highly critical. The module on Social Media provides more information on this topic.

(Continued)

Commemoration and Memorialization Manage Spontaneous Memorials When schools do not engage students in the process of planning for commemorative and memorial activities, there is a greater risk that spontaneous, informal memorials will appear in the school or community. These might include collections of notes, flowers, photos, stuffed animals, or something associated with the interests of the person who died. It may also involve the writing of messages and notes directly on the student’s locker or desk, or at the site of death. Often, these spontaneous memorials appear almost immediately after notification occurs. When this happens, it is important to communicate appropriate limits. For example, no permanent writing on property may be permitted. Objects left at the memorial cannot be perishable or pose a risk to safety (e.g., lit candles, alcoholic beverages). If on school grounds, the memorial may not block exits, hallways, or access to student lockers. Temporary memorials should generally not be in locations where all students pass regularly, such as cafeterias or main hallways. If necessary, work with students to relocate a temporary memorial to another site. Monitor the site regularly. Inappropriate material, whether written comments or objects, should be removed promptly. Discuss with students how long such a memorial will be left in place (generally, a few days to a week). Let them know when they may have access to the memorial and what will happen with the items left at the site. For example, the family of the deceased student might be offered a special scrapbook created using photos taken of the memorial. It is useful to involve students in these plans as much as possible. This helps students feel that decisions made are respectful of their wishes.

activities, and discussions about planning such activities, will be upsetting to students and staff. Remember, it is the death itself that is upsetting, not discussions about the death. Nevertheless, these conversations may sometimes expose underlying distress in some students. Sometimes, discussions about a crisis lead people to reflect on other troubling experiences in their lives. These won’t necessarily be related to the current event. Schools should therefore notify families of students in the class or school prior to memorial events or planning efforts. This allows parents the chance to bring relevant family experiences to the school’s attention. For example, they may have a young child who recently experienced the death of a relative, a teen who is struggling with depression and suicidal feelings, or a frightening immigration experience where the entire family escaped serious violence in their home country. Parents can also have discussions at home with their children about the ways the school will memorialize the life of the deceased. Further information on how to anticipate and address situations that may inadvertently remind students of prior loss and trauma can be found in the module on Grief Triggers.

Respect Different Needs and Interests Individuals often have very different needs and interests concerning commemoration. A child whose brother died in a fire may be confused that more focus seems to be given to the heroic efforts of rescue workers. Children who have lost friends or family previously may resent what they perceive as much greater attention given

Spontaneous memorials constructed in the community can be problematic, especially if they are placed in dangerous locations, such as busy intersections or railroad tracks where the student died. These also may become sites for future risktaking behaviors, including substance abuse.

Discuss Memorial Plans With Students School staff may want to arrange thoughtful discussions with students about appropriate means of commemoration. This can help shift students’ focus to memorials that are appropriate in the school setting and more easily supervised by school staff. Staff sometimes worry that memorial and commemorative (Continued)

Commemoration and Memorialization to this current death. Family members and close friends of the deceased may advocate for more extensive, formal, or permanent efforts than the school has planned. Some children who have not been deeply affected by the death may simply be uninterested in giving this particular incident a great deal of attention. They might resent having their school experience defined by an event that did not actually touch them in a meaningful way. Those who have different needs deserve to have their views respected. Sometimes students feel they are being coerced to participate in memorial activities that do not reflect their interests or needs. Children who are uncomfortable about attending a memorial, or prefer not to participate, should feel free to choose not to go. Well-planned commemorative and memorial activities, appropriately managed and monitored, can be very helpful

to students and staff as they grieve the death of a member of the school community. Because there may be many different preferences about how to best commemorate an individual, establishing a tolerance for a wide diversity of needs is important. This demonstrates to students and staff how to compromise and respect differences—an important life lesson for all to learn.

Use Guidance From Other Modules The module on Social Media provides further background on the use of social media for commemoration and memorialization. Grief Triggers describes grief triggers and outlines effective ways to plan for these reactions and give students appropriate support.



FOUNDING MEMBERS

MODULE SUMMARY

Potentially Life-Limiting Conditions Take-Home Message It is increasingly common for children with serious and potentially life-limiting medical conditions to attend school in regular classes. School staff can take important steps that provide support to both the ill student and to classmates who are likely to have questions and concerns.

Children With Life-Limiting Conditions in the Classroom Children with serious and potentially life-limiting conditions are frequently enrolled and active in regular educational settings. This is the result of: • advances in medical treatments and assistive technologies • a trend toward brief hospitalizations • policies that aim to maintain children with disabilities in regular education settings whenever possible Such children may continue in school until very close to the time of their death. Some children also take advantage of technologies that allow them to participate remotely in classroom activities. They can stay in touch with teachers and classmates even while they are in the hospital undergoing treatment, or very ill at home. Teachers are often in a situation where they need to consider how to both support a seriously ill student and help classmates understand and cope with the illness of a peer.

Help Students Understand Help students understand what is happening with their ill classmate. The focus should be on providing relevant information about the illness. Ideally, this will cover information about the underlying condition and its treatment. Emphasize that the condition is not contagious; otherwise the student would not be permitted to return to class.

class. Some prefer to have the classroom teacher speak to the students after being briefed by a professional. Some students elect to speak on their own behalf. They may wish to be present to answer questions after someone else has presented background information.

Classmates’ Reactions Children who witness the physical deterioration of a peer or are aware of the seriousness of the condition may become worried about their own health. Sometimes they become overly concerned about common illnesses such as when they, their family, or friends get sick with a cold or the flu. This underscores the need for students to understand the cause of their peer’s illness. With appropriate understanding, they will be able to differentiate mild illness from more serious conditions. These discussions can also help create an atmosphere where students can express their concerns openly and receive appropriate information and reassurance.

Keep Parents Informed It’s important to inform parents about what their children are learning in class. Provide additional information that will prepare them to answer their children’s questions and respond to their concerns. Most parents appreciate this guidance. They will respect the ill student’s desire to remain in school. They will see this as an opportunity for their own children to learn tolerance for differences and empathy for others. Some parents, however, may feel protective of their children. They may advocate for the ill child to be educated

Include discussions of side effects—both those that are visible, such as weight gain or acne caused by steroid use, and those that are less apparent. These might involve such things as learning difficulties, pain, or fatigue. Obtain permission from the ill student’s parents or guardians about what information may be shared with the class. The student should also be asked what information is to be shared and how he or she would like this done. For example, ask if the student would like to be present for this discussion. Students sometimes ask that a parent, a member of the medical team, or the school nurse speak to the (Continued)

MODULE SUMMARY

Potentially Life-Limiting Conditions outside the regular classroom. In these instances, it will be useful to arrange a parent meeting involving medical professionals such as the school nurse, along with the school mental health and support personnel. This discussion can address the parents’ concerns and questions while clarifying that the child who is ill has a right to attend the school.

Other Seriously Ill Students There may be other seriously ill students in the classroom, or students who have a seriously ill family member. These children may be more sensitive to their classmate’s condition and the progression of his or her illness. Often, teachers are not aware of these concerns or experiences. It is helpful to conduct all discussions of the ill child’s circumstances with the presumption that other students in the class may also have these vulnerabilities.

Help Peers Be Helpful If students are unable to understand what is happening to a seriously ill peer, or why their classmate looks or acts different, they are more likely to isolate or even tease the child. Part of the ongoing discussion about the child’s condition can include suggestions about what peers might do to be helpful to the ill student. These are steps that will be different for every ill student, and that are likely to change over time as the condition progresses. They might include such things as inviting the student to join them at lunchtime, coming up with a sit-down activity they can share at recess, or offering to carry books when walking between classes. Classmates might share notes for lessons missed or offer peer tutoring for concepts the ill child has difficulty understanding (perhaps because of side effects from treatment).

near-term changes, such as fatigue or the need for extra infection-control measures due to a weakened immune system. This might be appropriate, for example, in the week following a course of chemotherapy. In situations where a student is known to be critically ill and likely to die soon—for example, the student is in a coma and expected to die in the coming week—classmates can be told that the student is seriously ill and the family is concerned that the child may not recover.

Support the Ill Student Ultimately, the goal is to maximize the ill student’s current quality of life. Sometimes the greatest gift teachers can provide such students is the opportunity to feel normal. School and learning are the primary work in children’s lives. Students’ ability to attend school, actively learn, and contribute in class allows them to feel a continued purpose in life. Children who are seriously ill with a potentially life-limiting condition tend to have a precocious understanding of the concepts of death—even young children. They are usually aware of the seriousness of their condition even if they haven’t been explicitly told. Parents often prefer to think their children are unaware. Children tend to comply by entering into a mutual pretense where they don’t share their awareness with family members. Unfortunately, this leaves children emotionally isolated. They are unable to seek information or reassurance about concerns they may have from their own family and may turn to their teacher, or other adult in the school such as the school nurse, for advice. Staff should seek advice from a school mental health or support professional about how to help a student in this situation.

Students might come up with ideas for group projects where the group collaborates to complete a project or assignment, thereby engaging the ill student in a more dynamic and active way.

Focus on the Present and NearTerm The aim of these interventions is not to anticipate or prepare the class for the student’s death. Rather, it is to help everyone understand the student’s current condition and level of functioning. It is sometimes helpful to prepare students for likely (Continued)

Potentially Life-Limiting Conditions When a Teacher or Other Staff Member is Ill

accommodate the additional needs of a seriously ill student, while also considering how to support other students, is likely to be difficult for any teacher.

When the person with the serious illness is a teacher or other school staff member, similar steps can be taken to support and prepare students. For example, while respecting the individual’s privacy, explain to students why the person will not be in school for a prolonged period of time. Describe the nature of the illness and explain any major changes in appearance that are likely.

Teachers care about their students. Watching a student deteriorate physically and eventually die can be particularly difficult.

Work with students to identify ways to offer support and assistance. They might want to make cards, draw pictures, create a video, or record messages to send. These activities will help students feel less anxious about the situation or what to expect upon the staff member’s return.

Seek Support Yourself It is challenging to meet the diverse needs of a large group of students, even when they are all healthy. Trying to

Seek assistance from support staff at school. It is helpful to have colleagues and friends to talk to. It may be useful to engage in specific activities for stress management or seek out an employee assistance program. The advice in the module on Professional Self-Care is particularly relevant in this context.

Use Guidance From Other Modules Professional Self-Care offers suggestions for recognizing the challenges of this work and obtaining appropriate and helpful support.



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Supporting Grieving Students in Schools: Training Module - 1

Understanding the Grieving Student This module will help school staff be better prepared to support grieving students through presentations about

1. Children’s understanding of death 2. How grief is experienced in children and adolescents 3. How children show their grief 4. Reactions of children to loss 5. Shame and guilt following a death 6. Impact of grief on learning 7. Types of losses 8. Grief triggers 9. How grief will occur over time

Loss is common in the lives of children • Loss is common in the lives of both younger children and adolescents • About 5% will face the death of a parent by age 16 • Almost all children experience the death of an important person in their lives • It’s likely you work with grieving children every day, even if you don’t see any children who appear to be grieving

Between Six and Twelve Months of Age Children Begin to Understand Separation & Loss • recognize that even when a person is not in their immediate view, the person exists elsewhere •

may become distressed at the absence of an important person

• Play “peekaboo” wherein they fix their attention on someone, then experience a brief separation

“Peekaboo”

• This is followed by heightened awareness and concern, then relief and joy at the reunion

Four concepts about death 1.

Death is irreversible

2.

All life functions end completely at the time of death

3.

Everything that is alive eventually dies

4.

There are physical reasons someone dies

Death is irreversible • Children may view death as temporary separation • Adults may reinforce this belief Understanding this concept allows children to begin to mourn

All life functions end completely at the time of death Children may worry that the person who died is • Cold

•

In pain

• Afraid

•

Lonely

• Hungry Understanding this concept helps children understand that the person who died is not suffering

Everything that is alive eventually dies • Children may believe they and their loved ones will never die • If children don’t see death as inevitable, they may wonder why a particular death occurred • Misunderstanding can lead to guilt or shame Understanding this concept makes it less likely that children will associate death with guilt and shame

There are physical reasons someone dies • If children don’t understand the real reason a person died, they are more likely to create explanations that add to guilt or shame • Adults can help children understand the physical cause of death: ~ Use brief, simple language ~ Avoid graphic details Understanding this concept helps minimize possible confusion and feelings of guilt and shame

Grief Is Different for Each Child Based on… • Personal relationship or perceived connection with the deceased • Prior experience with loss • Age and level of understanding about death • Preexisting coping mechanisms • Method of expressing strong emotions • Available support systems • Level of empathy for the needs of others

Deepest Impact of Grief Experienced by Students Who: • Were family members or relatives of the deceased • Were friends of the deceased or friends of a family member of the person who died • Had a complicated or difficult relationship with the deceased • Believed they were somehow responsible or contributed in some way, even indirectly, to the death • Shared a relevant affiliation • Experienced prior losses or emotional difficulties

How do children experience or show their grief? • Sometimes grief is showed or observed on the outside through behaviors and what children say. • Often grief is experienced on the inside and only discovered if the child is asked.

Reactions of Children to Loss Little or No Reaction

 Preexisting learning, emotional, or behavioral  Nonverbal Communication challenges may resurface or worsen  Anger  Acting Younger  Risky Behaviors 

How children understand death

Guilt is Very Common After a Death… • When something bad happens, children often assume they have caused the problem by acting badly • Children may worry about the possibility that they will repeat their bad behavior & cause the death of someone else

Guilt is More Likely When… • The preexisting relationship with the person who died was ambivalent or conflicted • A death is preceded by a lengthy illness • There may be some logical reason to experience guilt feelings

Shame Can Be Experienced when Children & Adolescents Believe • Their questions or comments about the deceased make a family member or adult upset. • The person who died did something wrong that resulted in his or her death

Impact on Learning • Difficulty concentrating and distractibility • Limitations in learning and/or remembering new facts or concepts • Failing to hand in assignments or study for exams because of reduced family supervision • Preexisting learning challenges become worse

Types of Losses Primary Loss: the death of a family member, close friend or loved one Secondary Loss: Such things as changes in relationships, schools, family finances, and lifestyle Cumulative Loss: Results following a number of successive losses experienced by a child over time

Common Secondary Losses • Changed relationships

• A parent who is less available

• Changes in school

• Loss of shared memories

• Financial challenges

• Change in future plans

• Changes in lifestyle

• Loss of special recognition &

• Changes in peer group or status

support • Decreased sense of security & safety

Communities with Cumulative Loss • Students may have experienced the death of multiple peers and family members but do not become accustomed to such losses • Poverty and neighborhood disorganization may complicate the child’s adjustment • Children will benefit from adult guidance about how to express their thoughts and feelings, and how to cope best under these frightening circumstances • Children may turn to peers for support and engage in a range of risky behaviors to challenge their fears about their own mortality • Children benefit from being reminded of their personal resiliency and the support system they still have • School personnel can achieve a great deal by providing opportunities for grieving students to express themselves and be heard by concerned, caring, and competent adults

Common Grief Triggers • Hearing a song or seeing a TV show • Special occasions • Transitions • Lost opportunities

Grief Over Time • Grief proceeds on its own terms •

As children grow and develop, even normative transitions and changes in their lives will remind them of the loss

•

As children develop, they become more capable of understanding and adjusting to their loss

• Children experience grief differently over time, and often revisit deep feelings at special events and times of transition

Grief in High School Juniors & Seniors • Expected to be more mature and better able to handle the concepts and consequences of a death • Difficulties concentrating may impact on their future • Ambivalence about independence & worry about need for support • Anxious about leaving family & friends behind • Feel obligated to surviving family members • Feel selfish about pursuing personal goals

This presentation was developed by… David Schonfeld, M.D., University of Southern California Thomas Demaria, Ph.D., Long Island University – C.W. Post Campus Marcia Quackenbush, M.S., M.F.T., M.C.H.E.S.

With the support of members of the… National Center for School Crisis & Bereavement Coalition to Support Grieving Students

For further information

Toll Free: 877-53-NCSCB (877-536-2722) www.schoolcrisiscenter.org

www.grievingstudents.org * Six topic sections contain 2 - 4 video modules with each video accompanied by downloadable handouts that summarize the major points covered.

* Links to additional resources for schools and families

www.achildingrief.com

Schonfeld, D., and M. Quackenbush. After a Loved One Dies—How Children Grieve and How Parents and Other Adults Can Support Them. New York, NY: New York Life Foundation, 2009.

Art Credits William T. Demaria [email protected] Module 1 - slides 3 ,11, 29 Daniel Pollera www.danielpollera.com Module 1 slides – 5, 6, 7, 8, 9, 13, 24


Supporting the Grieving Student This module will help school staff understand how to support the grieving student through presentations about 1. Barriers children and school staff face 2. How to initiate a conversation and what to say 3. How to act with a grieving child 4. Goals of support with a grieving child 5. Checking a child’s understanding of death 6. Cultural sensitivity 7. Supporting children with guilt and shame 8. Offering academic support proactively 9. Preparing students to manage grief triggers 10. Providing support over time 11. Supporting transition between grades and schools

Barriers for Children in Talking About Loss Children may… •

Conclude they have done something wrong by talking about death and avoid raising the subject again

•

Hold in their feelings as a way to support their family

•

Try to look fine and reassure family they are okay when they really need support

•

Not fully understand death and loss

•

Have problems expressing their complicated feelings

•

Feel overwhelmed by the experience and their strong feelings

Initiating the Conversation • Express concern

• Limit personal sharing

• Be genuine

• Offer practical advice

• Invite the conversation

• Offer reassurance

• Listen and observe

• Maintain contact

What not to say… Don’t Say This “I know just what you’re going through.” “You must be incredibly angry.”

Say this instead “Can you tell me more about what this has been like for you?” “Most people have strong feelings when something like this happens to them. What has this been like for you?”

“This is hard. But it’s important to remember the good things in life, too.”

“What kinds of memories do you have about the person who died?”

“At least he’s no longer in pain.”

“What sorts of things have you been thinking about since your loved one died?”

Don’t Say this

Say this instead

“I lost both my parents when I was your age.”

“Tell me more about what this has been like for you.”

“You’ll need to be strong now for your family. It’s important to get a grip on your feelings.”

“How is your family doing? What kinds of concerns do you have about them?”

“My dog died last week. I know how you must be feeling.”

“I know how I’ve felt when someone I loved died, but I don’t really know how you’re feeling. Can you tell me something about what this has been like for you?”

How to Act

• Be present and authentic • Listen more, talk less • Avoid trying to “cheer up” students or their families • Accept expressions of emotion • Show empathy • Don’t be afraid to show emotions • Step in to stop harmful behaviors when safety is a concern

Goals of Support •

Decrease the sense of isolation

•

Increase academic function

•

Increase the likelihood children will talk with their families

•

Increase the likelihood children will talk with and receive support from their peers

•

Identify problems in the family

•

Connect with students on something of immense importance

Checking a Child’s Understanding of Death • Start by asking children what they understand about death • Give them simple, direct and developmentally-appropriate explanations • Ask them to explain back to you what they understand • Correct any misunderstandings or misconceptions.

Cultural Sensitivity • Remember that the fundamental experience of grief is universal • Ask questions • Ask openly when you are unsure what would be most helpful for a family or individual • Watch out for assumptions • Be empathetic, thoughtful and sensitive

Supporting Children with Guilt and Shame • Discuss guilt and shame explicitly with grieving children • Ask about the kinds of thoughts, questions, or feelings they have been having • Describe the kinds of reactions related to guilt and shame that people often have • Normalize the experience of guilt and shame while creating a safe environment • Talk to a school mental health professional if these emotions are persistent or causing marked distress

Offer Academic Support Proactively • Change an assignment • Change the focus or timing of a lesson • Reschedule or adapt tests

Preparing Students to Manage Grief Triggers • Identify a safe space or location where the student can go • Provide the child with the name of an adult he or she can see when feeling upset or wishing to talk • Set up procedures that allow the student to obtain support • Allow the child to call a parent or family member • Give permission and encouragement for the child to speak with other school staff • Offer private time to talk over feelings, questions, or other concerns

Anticipate & Minimize Triggers • Expect that triggers may occur around holidays, Mother’s Day and Father’s Day, the child’s birthday, the birthday of the deceased, or the anniversary of the person’s death • Introduce class activities in a way that acknowledges absences and offers alternatives • Make an effort to reach out to grieving students at school events where the absence of a loved one may be especially noticeable • Introduce subjects such as serious illness, accidental death, war, or violence with sensitivity

Providing Support Over Time

One week? One day?

One month?

One year?

Lifetime?

Supporting Transitions • With the student’s knowledge and the family’s permission, school professionals can communicate the student’s needs and describe strategies that have been effective in providing support • The team can explore ways to provide some constancy in the support the student receives • The school team can also help the family identify ways to prepare the new school to best support their child

High School Team Middle School









Art Credits William T. Demaria [email protected] Module 2 slide – 8, 22 Daniel Pollera www.danielpollera.com Module 2 slides – 9, 17


Practical Considerations This module will provide information about how school staff can 1. Provide advice on Funeral Attendance for Families

7. Use Social Media Following a Death

2. Connect With Grieving Families

8. Set Goals for School Staff following a Suicide

3. Coordinate School Team Services

9. Respond When a Teacher or Other Staff Dies

4. Foster Peer Support

10. Provide Support through Memorials & Commemorative Activities

5. Inform Staff and Students About a Death 6. Prepare for a Crisis

11. Focus on Professional Self-Care

Providing Advice on Funeral Attendance for Families • Explain what will happen • Answer questions • Let children decide • Pair an adult with each child • Allow options • Offer a role • Check in afterward

Connecting With Grieving Families • Express condolences on behalf of the school community • Determine what information they wish shared with students and staff • Check-in with the family about your efforts to support the child and ask for assistance in identifying what the child knows or does not know about the death • Let the family know the professional resources of the school are available • Offer advice on how to support grieving children • Remind parents of their critical role in supporting their children at this time

• Assist with transition of the student back to school • Seek feedback from parents about their children • Offer information about community resources that may be of help to everyone in the family • Identify and anticipate potential challenges • Partner with families to support children over time • Provide appropriate reassurance and positive feedback

Coordinate School Team Services for the Grieving Child • Maintain effective communication with the student and the family

Nurse

Counselor

Teacher

Grieving Child Psychologist

• Maintain frequent, effective contact with the student and the family Social Worker

Administrator

• Offer information and status updates, answer questions, provide referrals, and support grieving students over time and during periods of transition

• Establish one (or a few) primary points of contact for student and family • Ensure that there is at least one point of contact for every student who has experienced a significant loss

Fostering Peer Support Equip Students With Skills • Provide information • Give students an opportunity to ask questions • Provide a safe environment for students to share thoughts and feelings • Offer concrete advice and practical suggestions

Informing Staff About a Death • What is known about the death

• How to discuss the event with students • What supportive services will be available for students and staff • Any changes in the school’s schedule for the day • Copies of communications that will be sent to parents and guardians

Informing Students About a Death • At the same time, as soon as possible after the start of the school day • By someone familiar to the students • In person, in small, naturally occurring groups such as homerooms or classrooms • In a setting and at a time where immediate support is available

Prepare for a Crisis • Critical to have plans in place prior to a school crisis event which outline the steps for staff and students to take in response to the event and to have relevant policies in place • Establish pre-existing relationships with organizations and professionals outside the school who can be called upon with short notice to provide needed support

Before

Crisis

After

Use of Social Media by Schools Following a Death • A highly effective means to rapidly disseminate information to the school community as a whole • Offers a way to reach out to grieving families or students in the initial period after a death, if the family is not yet ready to accept calls or visitors • Offers insight into how people are responding to a death • Used to facilitate commemoration and memorialization efforts

Suicide • Death by suicide is the third leading cause of death in children ages 10–14 & the second leading cause of death in children ages 15–19 • Almost one in five high school students has considered suicide, and 2% to 6% of children attempt suicide • Suicide is usually the result of underlying depression or other mental health problems and often is related to alcohol or other substance abuse

Setting Goals for School Staff following a Suicide •

Talk with the surviving family about sharing the cause of death

•

Have clear communication with students

•

Help students & staff navigate the process

•

Explain to students about the danger of keeping secrets

•

Use sensitivity when deciding how to commemorate the death

•

Take steps to prevent another suicide

Responding When a Teacher or Other Staff Member Dies • Assign a well-known member of the school community to cover that person’s classes and activities • When a colleague dies, teachers and other staff often feel an increased sense of vulnerability • Support staff who want to attend the funeral • Students and staff should not feel any obligation to attend the funeral • Explore the possibilities for visitation hours that will best serve both the grieving family and the school community

Providing Support through Memorials & Commemorative Activities

• Communicate at a public level their connection and attachment • Express and cope with difficult feelings • Realize that they are not alone in having strong feelings • Draw on the support of peers and adults in the school community • Begin to find some meaning in the loss • Feel reconnected to beliefs that may have been shaken by the experience • Learn coping strategies that have worked for others and share their own

School-Sponsored Memorial & Commemorative Activities • Allow students to play a central role in the planning and development process • Be respectful of the diversity of views & needs of students and staff • Ensure policies are capable of being readily applied fairly and consistently across a wide range of contexts • Coordinate with plans for commemorative or memorial activities in the larger community

• Set appropriate precedents • Allow time to pass before decisions are made • Make use of social media • Manage spontaneous memorials • Schools should notify families of students in the class or school prior to memorial events or planning efforts • Children who are uncomfortable about attending a memorial, or prefer not to participate, should feel free to choose not to go

Professional Self-Care Focus

Possible Grief Triggers for School Staff •Past personal experience with grief •Coping with serious illness •Having a friend or family member who is ill •New concerns about loved ones

Professional Self-Care in Schools • Identify friends, family, and colleagues to talk with • Seek additional support when guilt, resentment, or personal grief is strong or persistent • Consult with a school counselor, school nurse, school psychologist, school social worker, or other members of the school staff

Creative

Spiritual

Physical

Emotional

Social

Occupational Intellectual









Art Credits William T. Demaria [email protected] Module 3 – slide 12, 26 Daniel Pollera www.danielpollera.com Module 3 slides – 8, 9 , 13, 14, 16, 21

U.S. Department of Education Emergency Response and Crisis Management (ERCM) Technical Assistance Center

Emergency Response and Crisis Management TA Center

ERCMExpress Volume 3, Issue 2, 2007

Coping with the Death of a Student or Staff Member Most children experience the death of a family member or friend by the time they complete high school; and one in 20 children face the death of a parent by age 16.1 The sadness and sense of loss that results from the death of someone close can impact significantly a student’s social and emotional health as well as his or her ability to learn at school. As such, bereavement is a very common experience among school-age children that holds important educational significance. Unfortunately, school staff, including school guidance counselors and other mental health professionals, often receive little training in this area. School personnel who feel unprepared or uncomfortable to help students cope with death may miss a critical opportunity to provide needed support or misinterpret learning or behavioral difficulties. This issue of ERCMExpress highlights the range of impact death can have on a school community; addresses the importance of emergency management planning; offers suggestions for responding to a loss; discusses strategies for recovery; and suggests resources for further information. Range of Impact Death can have a significant impact on the abilities and behaviors of members of a school community. The degree of impact differs depending on whether the death is that of a staff member or student, the age of the student who passed away, the nature of the death, the time of year the person passed away (i.e. during summer break, at the end of the school year, during first semester), the location of the death (e.g., 1 Mahon M: Children’s Concept of Death and Sibling Death from Trauma. Journal of Pediatric Nursing, 1993: 8(5): 335-344.

on-campus or off-campus), and the number of family members, such as siblings, cousins, or children, who attend the school of the deceased. Regardless of the circumstances surrounding the death of a school-based individual, students, teachers, and staff may be impacted in a variety of ways. Academic performance may decline if a student has difficulty concentrating to learn new material. Social and emotional challenges for students or adults may result from feelings of sadness, depression, or anxiety or from withdrawing from fellow classmates, students, teachers, or staff. Young students in particular may be fearful to leave family members, resulting in school avoidance and increased absenteeism. Students may find it difficult to learn or teachers may struggle in the classroom if they experience physical symptoms, such as headaches, stomachaches, or exhaustion as a result of restless sleep. Behavioral changes such as irritability, acting out, or increased risk-taking may ensue. For younger students this could be manifested in class outbursts or bullying while substance abuse could be an issue for some older students.

community partners, including mental health professionals. Developing a Memorandum of Understanding (MOU) with area mental health organizations that includes activities such as providing ongoing training of school personnel in bereavement and crisis response, supplying professional counseling services, when necessary and appropriate, to students or staff in need of assistance, and offering relief to schoolbased guidance counselors, social workers, and psychologists when needed could all minimize some potential barriers to recovery. Training for teachers and staff might include: an appreciation of the impact bereavement can have on learning, behavior, and development; developmental understanding of death; and age appropriate responses to support grieving students.

Providing both immediate and long-term support to grieving students, faculty, and staff as early as possible can support academic progress and the social, behavioral, emotional, and mental health of all members of the school community. Barriers to Effective Bereavement Support Within Schools Schools could be a logical and effective site for the delivery of supportive services such as additional tutoring as needed, individual counseling, or bereavement support groups. Schools have ready access to a sector of the impacted community and long-term ongoing relationships with staff, students, and families, but, despite this, there are still some barriers to providing effective bereavement support within school settings, including: limited staff expertise and training; funding constraints for mental health personnel; concerns about family privacy; and the persistent stigma associated with mental illness, which may contribute to students’ reluctance to disclose their reactions or seek services.

Elements Related to Bereavement to Include in Emergency Management Plans Schools should develop emergency management plans that foster an open and supportive school climate and active parent involvement, and demonstrate a strategy, including clear staff roles and responsibilities, for responding proactively to losses that impact students and staff. Losses range from the death of a preschool classroom pet to a high school student suicide to a weather-related disaster that takes the lives of several school members. Plans should include policies for managing and screening community volunteers who may show up at school to lend support. Protocol for memorials should be defined in a school’s emergency management plan.

Emergency Management Planning Partnering With Community Mental Health Providers Schools can prepare for responding to and recovering from the death of a student, staff, or faculty member by actively partnering with their community mental health providers prior to an incident and establishing a crisis response team that includes school social workers, psychologists, and guidance counselors. All districts and schools should create an emergency management plan in collaboration with

School plans should also include policies and protocols for handling the media. If the death is likely to result in attention from the media such

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media attention while facilitating accurate and appropriate information regarding the incident.

as might be expected in a murder, suicide, or other sudden and dramatic loss, school policies and procedures should limit direct access of the media to solely the media spokesperson for the district and the school. Students should be advised to speak with school staff and their parents or guardians if they receive inquiries from the media such as phone calls, e-mails, contacts through their personal Web pages, or in person, while staff and parents should direct all media to the spokesperson. The goal is to protect the students and the school from any unwanted

Responding to the Death of a Student or Staff Member The type of information schools should or should not share or can or cannot provide in the case of death varies based on the specific incident. Exhibit 1, Illustrative Examples of Sharing Information for Specific Incidents, offers a few examples for schools to consider regarding information sharing.

Exhibit 1: Illustrative Examples of Sharing Information for Specific Incidents Circumstance

Suicide

Can Share

Should Share

Directory information*

Cannot Share

Should Not Share

Circumstances of death

Anything about the student

Information about grades, friends, coursework

Funeral arrangements

Death by Accident (if no violation of the law)

Directory information Funeral arrangements*

Information about grades, friends, coursework

Perpetrator in a Crime


Details of crime, any subsequent criminal or legal action (refer to law enforcement)


Cause of accident (refer to law enforcement)

Anything about the student Funeral arrangements

Information about grades, friends, coursework Death by illness or disease

Directory information

Directory information *

Funeral arrangements * * Only after consultation with the family

3

Circumstances of death Information about grades, friends, coursework

Verification of Information

death and the appropriate details surrounding the incident have been verified, activation of the school crisis team, initiation of the emergency management plan, and notification of the school community can occur.

When a student or staff member passes away, school personnel may want to share the news of the loss with the school community. Verification of information is one of the initial steps in this process. Potential sources of accurate information include family members, local police in certain circumstances, or disaster relief agencies in the event of a natural disaster. In the death of a student or staff member, school personnel should contact family members to determine what they would like to have disclosed to the school community. Once the

Sharing the News With Crisis Team Members and Other Faculty and Staff The degree of information shared and the audience it is shared with will vary depending on the type of death. For example, the school will likely respond differently to a student who lost a parent than it would to a class of students who

Special Considerations for Sensitive Deaths Provide education to students, parents, and staff about the warning signs and symptoms of suicide or risky behaviors and how to access school and community support services;

When the cause of death is particularly sensitive, such as suicide or drugs or alcohol, it is important to contact the family to identify what information they wish shared with the school community and to help them understand the benefit of open discussion with students in order to help identify other students who may be at risk of, or already considering, engaging in these life-threatening behaviors. It is not necessary to obtain parent permission to share information that is widely available publicly, for example, if suicide as the cause of death has been announced in public media. Special effort is needed to:

Encourage students to seek help and reduce the stigma associated with seeking and accepting mental health services; Avoid romanticizing the cause of death while at the same time acknowledging the individual who died; Minimize media coverage; and Communicate with community mental health providers and agencies and the police to monitor possible additional deaths from high-risk behaviors that could occur within the community.

Identify students at increased risk of adjustment problems, especially students who may have been aware of the suicide plan or who may become scapegoats, such as the former boy or girlfriend if the suicide occurred after a couple broke up;

4

Talking With Students About the Loss Strategies for talking with children and young adults about the death of a fellow student, staff member, teacher, family member, or friend will vary greatly depending on the age and maturity level of the audience. Tasking classroom teachers with sharing the news and facilitating discussion may be appropriate for younger children; however, older students may be more likely to already have information about the event so may be more interested in information about what happens next, such as memorials, opportunities for grieving, etc.

lost a teacher or a school that experienced death as the result of a school shooting. School officials and crisis team members must adapt their approach to match the particular circumstance.

Reading a brief statement to students, within small, naturally occurring groups such as homeroom or first-period class, can be used for initial notification and to outline support services that will be provided. It is important that schools plan for notifying students who are not on campus at the time (e.g., those who are

Schools should have procedures in place for notifying crisis team members and other school faculty and staff. If the death occurs during the school day, administrators may call an emergency staff meeting and use this time to share the news, confirm a plan of action, reiterate roles and responsibilities as laid out in the emergency management plan, identify and dispel rumors, allow for questions and discussions, and—especially for teachers of younger children—provide advice on how to inform students. If the event takes place outside of school hours, including during vacations or summer recess, schools could activate phone trees, e-mail or text messaging chains, or an automated messaging system to invite staff to a meeting to brief them on the loss and confirm a plan of action, if deemed necessary, based on the emergency management plan.

5

What to Say: Appropriate Statements and Potentially Unhelpful Approaches When considering what to say, the goal of the communication should be kept in focus: to assist those who are grieving in expressing their feelings and reactions in a safe and supportive environment without trying to alter those feelings.

Potentially Unhelpful Approaches and Corresponding Statements:

Appropriate Statements:

“I’m sure you will feel better soon.”

“I’m so sorry to hear about your brother’s death. Is there something that I can do that will be helpful?”

Encouraging them to be strong or hide their feelings

Emphasizing a positive perspective or trying to cheer people up “At least he had a good life before he died.”

“You don’t want to upset the other students or have them see you cry.”

“I am so sad to hear about your friend’s death; I can only imagine what you may be going through.”

Telling them you know how they are feeling or ought to be feeling

“I heard that your cousin died last week. I understand that it may be difficult to concentrate or learn as well when you are grieving; I would like you to let me know if you find yourself having any difficulty with your school work so that we can figure out together how to make it easier for you during this difficult time.”

“I know exactly what you are going through.” “You must be angry.” Instead, demonstrate your own feelings and express sympathy. Competing for sympathy

“I’m so sorry that your teacher died. Please know that I am here whenever you want to talk or just wish to be with someone.”

“Both of my parents died when I was your age.”

on the school’s Web site.2 For major events, automated messaging systems or e-mail listservs can be utilized to share information.

on field trips or absent). Notifying students via large assemblies and public address systems should be avoided as they tend to be impersonal and do not allow the speaker to be responsive to student reactions. Letters can be sent home with students for parent notification and-or posted

2 Sample templates for letters of notification of parents, students, and staff can be downloaded from www. cincinnatichildrens.org/svc/alpha/s/school-crisis/letterstemplate.htm.

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Providing Classroom Assistance

of a teacher, it is often quite helpful to arrange for a few substitute teachers, if only to provide rotating coverage for the teaching staff so that they can access their own support services during the school day.

The crisis team should have a plan in place to assist in message delivery to classrooms in which a teacher does not feel able to notify or comfortable notifying the class or facilitating a brief discussion. For K–8 classrooms of a student who passed away it may be helpful to assign a mental health personnel to that class. Extra support may also be needed in classrooms of siblings, cousins, or close friends of the student who passed. Older students who are not assigned to a stationary classroom may benefit from having support staff and mental health personnel available in a designated room on campus.

Legislative Authorities for Releasing Student Information There are two legislative authorities for releasing student information: Family Education Rights and Privacy Act (FERPA) and Health Insurance Portability and Accountability Act (HIPAA). FERPA requires that local education agencies provide parents notification annually about the release of allowable information via a notice in a registration package, a notice in a local paper, a notice in the student handbook distributed each year, or a posting on the school’s Web site. HIPAA ensures continued health insurance coverage to individuals who change jobs and establishes standards regarding the electronic sharing of health information. For purposes of HIPAA, “covered entities” include health plans, health care clearinghouses, and health care providers that transmit health information in electronic form in connection with covered transactions. Exhibit 2, Legislative Authorities for Releasing Student Information, outlines who is protected, what information is protected, what information can be released, and illustrative circumstances when information can be released without permission under each law.

If the crisis involves the death of a teacher, the school may consider assigning, at least for a couple of days, a teacher from the same or lower grade to the deceased teacher’s class who is familiar with the students, or a staff member from the school crisis response team. Even if the crisis does not involve the death

7

Exhibit 2: Legislative Authorities for Releasing Student Information Who Is Protected

FERPA Privacy interests of students, of any age, enrolled in a public (and some private) elementary, secondary, or postsecondary institution

What Information Is Protected

What Information Can Be Released

Illustrative Circumstances When Information Can Be Released Without Permission

Education records that contain:

Personal notes made by teachers or staff if:

Grades

Kept in sole possession of the maker Schools must make a reasonable effort to Not accessible to any notify the parent or other person, except student in advance. a substitute

Classes Class schedules Teachers

Parents* have:

Judicial orders or lawfully issued subpoenas:

Used as a memory aide Health and safety emergencies: Directory information: Can be released to Student’s name appropriate officials Student’s address if information contained in the Telephone number record is needed to Date and place of birth protect the health or Honors and awards safety of the student or other individuals. Dates of attendance

1. Right to access and amend children’s education records; and 2. Some control over the disclosure of these records. Education agencies and institutions cannot share without the parents’ consent:

Family members’ names State and local authorities within School activities a juvenile justice Height and weight system, pursuant to a of athletes specific state law: Records created and Can be released maintained by a law to state and local enforcement unit for law juvenile justice enforcement purposes authorities after the school receives written certification that information will not be disclosed to any other agency, organization, or third party without the parent’s permission, except as allowed in state law.

1. Student records; and 2. Personally identifiable information in the record.

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Exhibit 2 (Con’t.): Legislative Authorities for Releasing Student Information Who Is Protected

HIPAA Covered entities, such as health care workers, which include school nurses, only if they transmit health information electronically in connection with a HIPAA transaction.

What Information Is Protected

What Information Can Be Released

Protected information is any information held by the school nurse or school that:

Illustrative Circumstances When Information Can Be Released Without Permission

Information considered Information “education records” considered under FERPA is “education records” exempt from HIPAA under FERPA as long requirements as long as the information as the information is in the aggregate is in the aggregate and does not and does not include include personally personally identifiable identifiable information such as the information. ‘directory’ information stated above, or any information that could easily be traced to a student’s identity.

Identifies an individual. Relates to: Past, present, or future physical or mental health or condition; or Past, present, or future payment for the provision of health care to the individual.

Source: National Forum on Education Statistics. (2006). Forum Guide to the Privacy of Student Information: A Resource for Schools (NFES 2006–805). U.S. Department of Education. Washington, DC: National Center for Education Statistics. * Parent is defined as: natural or adoptive parent, a legal guardian, or an individual acting as a parent in absence of a parent of guardian

inaccurate conclusions based on misinterpretations or misconceptions, for example, concerns that the teacher died of a heart attack because of the student’s misbehavior or worries about dying from a non-contagious condition.3

Strategies for Recovery Opportunities for small group or individual discussions Students often benefit from the opportunity to talk in small groups with their peers and teachers, or individually, about a death and their own associated reactions and feelings. Students may express many different reactions and emotions, including guilt, even if there is no rational reason why they may feel responsible, and regret, especially if they had mistreated the deceased in the past or simply had not offered their friendship or support. Adolescents, especially when a death is a suicide, are particularly likely to experience these feelings, resulting in self-blame. Younger students are more likely to be confused about what has occurred or to reach

Writing Letters or Drawing Pictures for the Family of the Deceased To minimize feelings of guilt and to help process loss, teachers may provide opportunities in the classroom setting for students to write about or otherwise express their feelings about their loss. Adolescents may want opportunities to journal 3 For further information on young children’s understanding of death and how to structure explanations, see Schonfeld D: Talking with children about death. Journal of Pediatric Health Care 1993; 7: 269-274.

9

while younger students may wish to write letters or draw pictures to send to the family of the deceased. Student letters, notes, or artwork for families should be reviewed before they are shared to ensure that well-intentioned but potentially non-supportive statements, comments, or pictures are not shared with grieving family members. When creative writing or artwork is used, teachers should seek adequate input from mental health professionals to avoid over-interpretation and to obtain advice on how to ensure that students receive appropriate services if they are demonstrating distress from the recent death or experiencing problems from unrelated events that have surfaced in the aftermath of the crisis. Activities that solicit anonymous statements, such as inviting students to write messages on a poster that is placed in an unmonitored location, should be avoided, especially in the setting of very traumatic losses, such as suicide or homicide, as school staff may not be able to respond appropriately to worrisome statements about suicide or threats for example.

be monitored? Furthermore, in some situations schools may consider limiting off-grounds privileges in the immediate aftermath of a crisis and establish policies that require students to be cleared before leaving school during the day and dismissed early only to the legal guardian or designee. After a major event, support services may be offered to students and staff before, during, and after the regular school day, and may also include services for interested family members. These services could occur on campus for a brief time after the incident, and after a few days the school may want to outsource the services by referring persons to pre-designated community mental health professionals.

Designate Areas for Further Support

Students, current or past teachers, coaches, and staff who shared a class or group activity with the deceased (for example, schools could have a member of the crisis response team follow the student’s schedule to identify classes, individuals, or groups that may benefit from extra attention);

Monitoring and Referring Persons Needing Additional Support The crisis response team should consider providing outreach to individuals who may be more likely to need and benefit from additional support. This might include, but is not limited to: Close friends of the deceased;

Support rooms for students and for school personnel can be staffed by mental health professionals from the school system or the community. Prior to any event, schools should establish policies for how students will access these support services. In establishing these policies, the following questions should be considered: Is parent or guardian notification or permission required? Are children self-referred or do they require referral by a school staff member? Do they require a pass? Who will escort students who are very distressed? Do they need to report back to class before the end of a class period so that their whereabouts can

Students and staff who shared a similar characteristic with the deceased (for example, if the death was from a motor vehicle accident, then student drivers may be impacted more; if the death was from a chronic illness, students or staff with the same or other chronic illness may benefit from more assistance);

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Attending Funerals and Memorial Services

Students or adults who had a difficult relationship with the deceased;

Students may wish to participate in funeral and memorial activities and benefit from doing so. Schools could communicate with the family to find out the time and location of services and their wishes about attendance of students and staff. If the funeral is going to be held during school hours and it is likely that many students or staff will wish to attend, schools could explore with the family the option of offering visitation hours or a memorial service as an alternative outside of school hours. Emergency management plans should include policies for attending funerals and memorial services that address such issues as attendance during school hours, requirements for permission slips and parent chaperons, and the like.

Students with pre-existing mental health problems; Staff or students whose family member recently died from an unrelated cause; and Students who attend other schools, particularly if the deceased transferred or has siblings or relatives who attend another school (a districtwide database can assist in identifying schools to contact in these cases). Schools, in conjunction with their mental health community partners, should work to establish an environment that is supportive of seeking and accepting assistance and encourage staff and students to refer individuals who express distress. These partners should emphasize to students that it is not safe to hold in confidence remarks by other students who are harboring suicidal thoughts or making threatening statements.

Removing Personal Effects in a Timely Fashion The desk or personal effects of the deceased may serve as painful reminders to survivors. School emergency management teams should draw on the input of classmates and staff about how to deal with such permanent reminders in a manner that is respectful and meaningful to the school community. Schools should arrange a location such as the administrator’s office, and a time, possibly outside school hours, with parents and family members, for the return of personal belongings from lockers, classrooms, display cases, etc. Schools may want to consider inviting a member of the crisis response team to be present.

Commemorations and Memorials If many in the school were impacted by the death, consideration should be given to issues of commemoration and memorialization of the deceased. These activities should not be an early focus of the response because that could signal to the school community that its members are expected to “move past” their initial reactions. The goal is to remember the individual who died rather than glamorize the means of death, and the school should strive for less formal but thoughtful responses guided by active student input. Policies should be developed for minimizing spontaneous memorials and addressing them when they are created. An ERCMExpress newsletter specifically devoted to memorials can be found at www.ercm.org.

Ongoing Support Maintaining communication among school staff and parents when appropriate can facilitate ongoing monitoring of students’ academic progress, social interactions, and 11

Resources National Center for School Crisis and Bereavement

The Dougy Center for Grieving Children and Families

The NCSCB provides free consultation and technical assistance to schools related to bereavement and school crisis events. The NCSCB aims to serve as a resource for information, training materials, consultation, and technical assistance for school systems, professional training programs, professional organizations, and agencies in order to further the role schools can take in supporting students, staff, and families at times of crisis and loss.

The Dougy Center provides peer support groups for grieving children in Portland, Oregon, and provides training and technical assistance to establish peer support groups throughout the country. The center’s Web site includes a directory of programs across the country and internationally that serve grieving children, teens, and their families. www.dougy.org

www.cincinnatichildrens.org/school-crisis that nonetheless can have a significant impact on one’s social, emotional, and academic functioning. Schools may be in a position to support those grieving and, with the assistance of the mental health community, help them learn how to cope with loss. As with other crisis events, preparation, training, a comprehensive emergency management plan, and a wellfunctioning crisis response team go a long way toward minimizing the negative impact of loss and promoting adjustment and coping of students and staff.

peer relationships; identification of students or staff likely to benefit from additional schoolor community-based services; and needs assessment. Schools should plan for additional services at times that may trigger grief reactions, such as the anniversary of the death, graduation, the prom, athletic events, after the death of another member of the school community. Conclusion The death of a family member, friend, teacher, or colleague is a common experience for many

The ERCM TA Center would like to thank David J. Schonfeld, M.D., director of the National Center for School Crisis and Bereavement, Cincinnati Children’s Hospital Medical Center, for his role as lead author of this newsletter. Additional members of the National Center for School Crisis and Bereavement—Barbara W. Boat, Richard C. Gilman, Vincent B. Giordano, Trena Goodwin, Robin H. Gurwitch, Daniel Nelson, Scott Newgass, Dominick Nigro, Frank W. Putnam, MaryEllen Salamone, Sara Strizzi, Gregory A. Thomas, and Marleen Wong—also assisted in the production of this newsletter. Special thanks to Christine Mecke, director of Pupil Personnel Services in Elmira City School District (N.Y.); and Jeffrey Bristow, executive director of Compliance and Risk Management in Capistrano Unified School District, South Orange County, Calif., for the insights they provided in their interviews regarding the subject matter of this newsletter. For information about the Readiness and Emergency Management for Schools grant (formerly the Emergency Response and Crisis Management grant) program, contact Tara Hill ([email protected]), Michelle Sinkgraven ([email protected]), or Sara Strizzi (sara.strizzi@ ed.gov). Suggestions for newsletter topics should be sent to the ERCM TA Center Suggestion Box at http://ercm.ed.gov/ This publication was funded by the Office of Safe and Drug-Free Schools at the U.S. Department of Education under contract number GS23F8062H with Caliber Associates, Inc. The contracting officer’s representative was Tara Hill. The content of this publication does not necessarily reflect the views or policies of the U.S. Department of Education, nor does the mention of trade names, commercial products, or organizations imply endorsement by the U.S. government. This publication also contains hyperlinks and URLs for information created and maintained by private organizations. This information is provided for the reader’s convenience. The U.S. Department of Education is not responsible for controlling or guaranteeing the accuracy, relevance, timeliness, or completeness of this outside information. Further, the inclusion of information or a hyperlink or URL does not reflect the importance of the organization, nor is it intended to endorse any views expressed, or products or services offered. All hyperlinks and URLs were accessed on July 2, 2007.

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Guidelines for Responding to the Death of a Student or School Staff

These guidelines are designed to help school administrators, teachers, and crisis team members respond to the needs of students and staff after a loss has impacted the school environment, such as after the death of a student or staff member or when deaths occur that affect many people in the community. These guidelines are not intended to provide guidance on clinical care or bereavement counseling and are not intended to address personal losses that impact only one or a few members of the school community. BEREAVEMENT IS COMMON AMONG SCHOOL CHILDREN For school personnel, this means that it is highly likely you will encounter a grieving student almost every day, even if you do not see any outward or visible signs of grief. In some communities, violent deaths may be sadly common – although students in these high-risk communities may appear to be “used to loss,” they are likely to have more difficulty adjusting to multiple losses. Well informed teachers and school personnel can be a source of support for students, but unintentionally they may, if not well informed, be a source of stress. For example, not understanding reactions may lead to misinterpretation of behavioral reactions to loss as misbehavior and disrespect for others. How long it may take for students to adjust to the loss will vary, but most children are not “over a loss” in six months or a year. As such, appropriate services should be planned for the immediate aftermath, the months following the loss, and for the long-term. SCHOOL CRISIS TEAM INTERVENTIONS: Responding to a Student or Staff Death in a School Setting

By the time children complete high school, most will experience the death of a family member or friend, with 5% of children experiencing the death of a parent by 16 years of age. Nearly 40% will experience a death of a peer 20% will have witnessed a death Schools can be the best setting to provide services to students (and staff) after a loss that affects the school community: 1. 2. 3. 4. 5.

Schools provide a familiar environment Large numbers of students can be served Many children will benefit from supportive services that can be readily provided in a school setting Students coping after the loss can be monitored over time and referrals for clinical services can be facilitated as needed Parents may be more willing to accept services provided in school settings, where the stigma associated with mental health services may be decreased

When a death occurs, activate the school’s crisis team and plan to address the loss. Coordinate efforts with other schools that may also be impacted. 1. 2. 3.

First, it is extremely important to verify the information (e.g., from family members or local authorities). Next, determine what information the family would like to have disclosed (or what information has already been released publicly from a reliable source). Once the death has been verified, notify the school staff and students.

www.schoolcrisiscenter.org (877) 53-NCSCB (877-536-2722)

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CRISIS AND GRIEF COUNSELING AND OTHER SUPPORT SERVICES AT SCHOOL NOTIFICATION 1.

Help Students with Coping Behaviors to Support and Maintain their Attendance and Classroom Learning: Following a loss, addressing the event with students directly may decrease the negative impact on school attendance and learning. This can be done individually and in group settings. Students may express many different emotions and feelings. The goal is to allow this expression in a safe and nonjudgmental environment.

Notify Teachers and Staff First: Meet before school with school teachers and staff to discuss what is known about the death. This gives teachers an opportunity to ask any questions they wish and to prepare themselves before they see their students in class. If a teacher does not feel able to talk to his/her students about the death, a member of the crisis team should be available to step in or assist with the notification.

2.

Help Students Deal with Difficult Feelings: Students may also have feelings of regret, particularly if they believe they had mistreated the individual in the past. Adolescents may be particularly vulnerable as a group with an increased risk of feeling depressed or anxious and engaging in self-blame or guilt related to the loss. If the death was a suicide (see Special Circumstances below), these feelings may be heightened.

3.

Notify Students Face-to-Face with Familiar Staff: If a teacher has died, consider having a teacher from the same or a lower grade who is familiar with the deceased teacher’s students, or a teacher from the school crisis team who is more comfortable, notify that class. Consider having this teacher remain with the class over the next couple days and have a substitute cover for the less directly impacted class.

3.

Help Younger Students: Younger students may have more difficulty understanding death and are more likely to have literal misinterpretations in response to explanations (e.g., if told the deceased is in everlasting sleep, they may become fearful at bedtime). All students (and staff) are likely to experience some guilt feelings after a death, even if there is no logical reason.

4.

Prepare a Statement for Students: Adults often struggle with what to say. With a prepared statement, teachers can give the same information to all students simultaneously. This should be done in small, naturally occurring groups such as homeroom or first period classes; every effort should be made to ensure that all students are present at the time this information is shared. Include information about the availability of mental health and support services and how students may access those services. Avoid use of public address systems or large assemblies to make such announcements.

5.

Prepare a Statement for Parents: Draft a letter to be sent home with students for parents to notify them about the death and what services are being offered to students and families. Assure parents that crisis teams have been mobilized and support services are available. (Template letters, that schools can have in advance of a crisis so that notification statements can be quickly and easily prepared, are available at the National Center for School Crisis and Bereavement.)

1.

Notify the School Crisis Team and Develop a Plan: Consider activating the school crisis team. If initial notification occurs outside of school hours, this may require initiating the phone tree to notify the school staff and to invite them to meet before school to organize a unified plan and to brief school staff. If notification occurs during school hours, this may require the distribution of a written statement or a staff meeting.

2.


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CRISIS AND GRIEF COUNSELING AND OTHER SUPPORT SERVICES AT SCHOOL (Cont’d) 4.

Establish Crisis Counseling or Grief Counseling Support Rooms and Protocols:

1.

2.

3.

4.

5.

6.

7.

Establish procedures for leaving class (e.g., Will a pass be required? Should a student who is very distressed be escorted to the support room?) and for returning to class before the end of the period. If a student remains in the support room at the end of the period, be sure notice is provided to the classroom teacher for that period as well as the next one. Such actions ensure that the school has accurate knowledge about student whereabouts. In the immediate aftermath of a death, limit off-grounds privileges if indicated and establish procedures to clear students prior to leaving school grounds during the school day. More extensive services will be needed in the immediate aftermath of a schoolwide crisis. Consider having support and counseling services available to students and school personnel before, during and after school hours in the immediate aftermath. Plan for ongoing and long-term services to be available to students. If the death was due to a school crisis, plans should be made for commemoration and memorialization, especially at the time of the anniversary of the death(s) (Further guidelines on memorialization and commemoration). Additional services should also be planned for dates and events may serve as triggers for grief of students or staff, such as graduation, the prom, athletic events (if the deceased was an athlete) etc. Have substitute teachers available that can rotate among classes to allow teachers to seek supportive services in teacher/staff support rooms during school hours. If the death(s) are associated with a crisis that has impacted the community, consider some support services for parents at school in the immediate aftermath. School counselors, school nurses, school psychologists and school social workers can help teachers identify risk factors and signs of distress that may indicate the need for mental health services above what is offered at school. As with any counseling services, parents should be notified if additional services are recommended. Especially after traumatic losses (e.g., suicide or homicide), be proactive and set the tone for students to seek out counselors if they have troubling thoughts. Encourage students to identify friends they may be concerned about. These include students who have suicidal thoughts or have made threatening statements.


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Guidelines for Identifying Students Who May be at Higher Risk for Emotional Distress: 1. 2.

3. 4.

5. 6. 7.

6.

Students who were close friends of the deceased Students who shared a class with the deceased. Have a member of the crisis team follow the student’s schedule to help determine classmates that may benefit from extra attention. Students who shared extracurricular activities with the deceased Students who shared a similar characteristic with the deceased. This will depend on the circumstances of the death (e.g., chronic illness – other students with chronic illness; suicide after bullying – students who may be bullied or who had pre-existing depression; car accident – students that have recently received their driving licenses; or pedestrian accident – students who walk to school). Students with a troubled or strained relationship with the deceased Students from other schools if the deceased recently transferred or has siblings at another school Students with a history of prior or concurrent losses and/or emotional difficulties.

Funerals, Memorial Services and Spontaneous Memorials 1.

Participation of Students: Students may wish to attend the memorial services and/or funeral of the deceased student or teacher. Talk to the family of the deceased and determine their wishes. If many students or staff are likely to attend, inquire if there may be visitation hours/memorial service outside of school hours. If the services are during school hours, establish a policy for student absence that allows students who have a close relationship to the deceased to attend. Have substitute teachers available for teachers who wish to attend the services. Consider arranging for crisis counseling staff to attend after-hours services that are likely to be attended by large numbers of students.

2.

Spontaneous Memorials: Informal memorials are likely to “spring up” after the death of a student or teacher. Plans to handle the flowers, cards, etc. should be made in advance. Determine the time period that the memorial will remain (one week, two weeks, a month?), and communicate to students that the memorial will be removed after that time and indicate what will be done with the non-perishable items (e.g., stuffed animals will be sent to the children’s ward of local hospitals, etc.). Providing alternate commemorative opportunities for the students and engaging students early on in the response efforts or an announcement about the family’s wishes may help to minimize these spontaneous memorials.


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Funerals, Memorial Services and Spontaneous Memorials (Cont’d) 3. Timing of Memorial Activities at School: Commemorative activities and memorialization efforts should not be a focus of the crisis response in the immediate aftermath of a death. If done too soon, there may be a perception that the school is trying to “close the chapter” on grieving. 4. Equitable Policies: In general, schools should avoid formal commemorative or memorialization activities or acts (e.g., naming a building or hanging a plaque) to mark the death of a popular student or staff member since failure to respond in the future in a similar manner to the death of a less popular student/staff may raise equity concerns; schools may be reluctant to provide similar responses after certain deaths (e.g., suicide, drug overdose) in order to minimize glamorization of the cause of death (see Special Circumstances below). Instead, less formal but thoughtful commemorative activities developed over time with active student involvement is often much more meaningful (and therapeutic) to students and staff. Such commemoration is more likely to recognize and preserve essential memories of the deceased than are more routine and reactive efforts instituted shortly after notification. (Further information about developing appropriate commemorative and memorialization activities in schools) 5. Constructive Expression of Grief: Students may wish to write letters/draw pictures to send to the deceased student’s or staff member’s family. Be sure these are reviewed before sending them out. Also, be careful not to interpret the drawings and writings without adequate input from mental health professionals. Avoid activities that solicit public anonymous statements, such as posting places for students to express their thoughts anonymously about the deceased, as school teachers and staff will not be able to identify students who may express worrisome thoughts (e.g., suicidal ideation or threatening statements). 6. Handling Traumatic Reminders for Students: School desks and lockers may serve as unwelcome reminders of the deceased student(s). Consider procedures for handling these, drawing on the input of the classmates. 7. Personal Effects of the Deceased: Arrange with parents/family members for the return of belongings that is at a time convenient for them, preferably after school hours. Have the personal effects available at the office so that parents/families are not presented with the emotional challenge of having to clean out a locker or desk. Have a member of the crisis team or a school counselor present when parents come to retrieve a child’s belongs. 8. Take the family’s address off the school mailing list to ensure that further routine mailings are not inadvertently sent to the victim’s family.


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IMPACT ON LEARNING Reactions after a loss can have a significant impact on learning. Students may 1. 2. 3. 4. 5. 6. 7.

Show a decline in school performance Have difficulty mastering new material Become more irritable Become more withdrawn Become more anxious or depressed Become more likely to engage in risk-taking behaviors such as substance abuse, promiscuity, reckless driving, and suicide attempts in adolescents Become focused on the loss

Students should be offered additional supports, such as tutoring or participation in mentoring programs to assist them in maintaining their academic progress before academic failure occurs, which would represent an additional stressor.

What Teachers Can Do: 1. 2. 3.

4.

5.

Listen – to what students want to share with you. It may be difficult but just listening can be a powerful healing force. Protect – students from becoming re-traumatized. Sometimes other students may ridicule or bully students who are highly emotional or cry. Connect – with students who have suffered a loss by asking how they are doing; checking in with them on a regular basis; letting them know that you are available to listen; or giving them positive feedback about their attendance or classroom work. Model – adult behavior that shows them how responsible adults react to loss and respond to a crisis. Adults may grieve, but they continue to act with consideration and maintain calm routines at school. Teach – Crisis counselors can teach students about the normal signs and symptoms of grief and/or trauma so that students can assess and understand their own behavior and learn new ways of coping.


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SPECIAL CIRCUMSTANCES 1.

Suicide of a Student: The suicide of a student creates unique issues for school personnel. 1. Clarify with family about information they wish to disclose about the cause of death, but be aware if information has already been shared publicly by a reliable source. 2. Identify students considered at greatest risk for mental health distress. (Use the same ideas as listed above, especially any students who may have known of the plan or students who may become “scapegoats” after the death.) 3. Educate students, staff, and parents about warning signs and symptoms of suicide and distribute broadly information about hotlines and support services. 4. Encourage students to seek help; de-stigmatize and legitimize the importance of mental health services and communication with others who can help. 5. While being sure to acknowledge the individual who died, avoid romanticizing or glamorizing suicide. 6. Minimize media coverage of the suicide. 7. Be aware of any suicides in the larger community by maintaining good communication with other area schools, community mental health providers/agencies, and the police.

2.

Other Situations When the Family May Not Wish to Disclose the Cause of Death (e.g., drunk driving or other alcohol-related death, overdose, related to self-inflicted or intentional asphyxiation): As with any death of a student, initiate the school crisis plan and support services. Like suicide, the death may present a “window of opportunity” to educate students, staff, and parents about li8fe-threatening behaviors and their consequences. Many of the issues to consider with suicide with also apply to these circumstances.

3.

Circumstances in Which School Liability May be at Issue: Although the circumstances of the death do not have to be discussed, the death itself will need to be addressed and support services provided to staff and students. Sending letters to parents alerting them of the death as well as available services remains important.

4.

Death of Student or School Personnel When School is Not in Session: If a death occurs that is likely to impact broadly the school community when school is not in session, such as over the summer or other vacation, involve the school crisis team in developing a plan including how to contact students and staff such as via telephone trees and mailings. School administrators may wish to offer the school building as a place for support services to be offered in the immediate aftermath of the event and may choose to communicate this through public media. When school resumes after the holiday or vacation, additional plans should be in place for notification of those students and staff not previously contacted. Have crisis team members and supportive services available once this information is shared with students and staff.

COMMUNICATION AND OUTREACH 1.

The Role of the PIO: Media attention is likely after a death of a student or school staff. This is best handled by the Public Information Officer (PIO) of the district or the principal at the school site. Teachers, staff, and parents should be made aware that all media requests should be referred to this individual.

2.

Protect Students from Being Re-Traumatized: The focus of all communications, including media coverage, should be on the protection of students and the school environment from unwanted intrusive attention. Television coverage of the event should not be watched in the classroom during school hours. Information about how to handle media requests can be distributed to parents.

3.

4.

Ongoing communication between parents and school teachers and staff about how students are doing will be more important to ensure appropriate support and intervention services in the immediate aftermath of a death and in the long-term. Parents of children identified as at-risk for mental health difficulties should be given information about whom to contact with concerns and about positive progress. School personnel should also keep parents informed about their children’s functioning at school (e.g., school work, peer relationships, and behaviors). Again, parents should be provided with information related to common reactions after a death as well as behaviors that may signal the need for more intensive mental health services. The formal establishment of communications and liaison with community resources is an important relationship to develop prior to any type of crisis. Developing a relationship and crisis plan role with community-based mental health professionals in advance of the need will allow the school to quickly and effectively activate these resources in times of need. They can provide mental health services at the school as well as be available for students and staff who may need more intensive services. Furthermore, mental health experts can assist schools in: 1. Crisis team development 2. Crisis preparedness planning and exercises 3. In-service trainings around school crisis and bereavement 4. Consultation on issues of child development, crisis and bereavement


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