Teen years are already tumultuous, and the bereaved teen needs special attention. Under ordinary circumstances, teenagers undergo many changes in their body image, behavior, attachments and feelings. Conflicts often arise within the family system as they break away from their parents to develop their own identities. Life becomes even more complex when a father, mother or other significant person dies – a shattering experience faced by one child in every 10 before age 18. While people in all age groups struggle with such losses, teenagers face particularly painful adjustments following the death of a loved one.
Do teens grieve like adults?
Teens grieve deeply but often work very hard to hide their feelings. Fearing the vulnerability of expression, they look for distractions rather than stay with the grief process long enough to find relief. Emotions can be turned off quickly, much like flipping a light switch. Teens can act like nothing has happened while they are breaking up inside. You may observe teens who take on the role of caregiver to family members or friends, denying their grief.
Gender makes no distinctions when it comes to experiencing grief, but the outward signs may be different. Young men of this age may have a difficult time when they have been taught that showing emotion is something that girls do – but guys don’t.
Who do teens trust and talk to?
Teens often trust only their peers, believing no one else can understand their feelings and react to life’s problems. Relationships with friends can be deep and meaningful, sharing conflicts at home and details of their love lives.
To gain the trust of teens, adults must become good, nonjudgmental listeners. Tell teenagers you are interested in their views, ideas and thoughts. Let them know that you like and care for them. Support their ideas or gently introduce new ways to approach their ideas. Acknowledge their grief and offer your thoughts on how to ease their pain.
Does peer counseling work?
Because teens are most open to fellow teens, one approach to providing help is through peers. And it works. Peer counseling is now an elective course for teens in many schools. Peer counselors are trained to look at life problems personally and then at ways to help their peers. They are introduced to different situations that may occur, and speakers are brought in to teach them about specific topics.
Because teens are willing to listen to other teens, peer counseling can be essential in establishing communication with distressed classmates and friends and steering them to professional help if needed. Peer counselors learn about depression, grief, communicating with parents and other adults, suicidal ideation, etc. At the same time, they discover their limitations and are assured of the support and expertise of their peer counseling teachers for consultation.
Selecting the right teacher for this is, of course, critical since they must gain the trust and respect of the students – just as students will seek the trust and respect of the peers they may be called upon to counsel.
Do grief support groups work?
Grief support groups are effective for sharing feelings. Teens discover they are not alone and that others are also struggling to rebuild shattered lives. Grief groups help teens feel understood, accepted and supported.
How do you start a group?
Decide on the format that will work best, including these possibilities:
Opened-ended. This format allows new kids to arrive at any time, and group introductions must be made often. The advantage is that teens have more time to work on grief, especially after sudden, violent or traumatic deaths.
Time-limited. These groups work best in the school setting. School schedules often do not allow flexibility for an ongoing group. Teens may also be more comfortable knowing there is a beginning and an end to the group. The number of sessions is usually 8-12, but shorter groups could be offered along with the opportunity for teens to request additional sessions.
Walk-in. This format frees the teen from any commitment and fits into the busy routine of school life. The difficulty is not knowing who or how many kids will attend.
How do you select the group members?
Group leaders have to decide on the parameters of the group. Will this be limited to teens who have had a parent die, or will it be more general? If there are enough teens to do a group focusing on parent loss, this type of focused group may work best. Grief groups that are broader in nature work well, too.
Other referral sources will come from teachers, coaches, counselors and parents. The PTA newsletter or the school website can be an excellent place to advertise the group.
What activities work with teens?
Teens will tell you they just want to talk and not have any activities. This is true for some grief groups, but you need some ideas to fall back on if a group needs to be more active and responsive. The following activity makes group members comfortable with each other because it immediately addresses why they are there.
Other ideas for activities
Writing or drawing spontaneously on mural paper taped to the wall
Creating a collage using pictures and words cut from old magazines
Constructing a book that can be used as a journal or a memory book
Writing a poem, eulogy or song
Going on a field trip to a funeral home, cemetery, etc.
When should a referral to professionals be made?
It can be challenging to separate typical teen behavior from that of a grieving teen in trouble. Some of the indicators that let you know when a teen needs more than the help group or peer counselors offer are:
Dramatic behavior changes. A teen’s home, school and social life are the arenas for observing behavior changes. Listen and take notes if comments and concerns are being expressed.
Extraordinary pressure. Get to know the teen and invite discussion about their home or school activities. Find out if keeping up with work is a problem or if the teen feels anxious about what needs to be done. Ask if there is some time to spend alone or with friends.
Isolation. Is the teen spending too much time alone, canceling on dates and parties, or dropping out of after-school activities?
Depression. Discuss the differences between bereavement depression and clinical depression. Encourage the teen to consider further help if indicated. Supply information about where to go to get counseling.
Death wish. Always take any talk of death seriously and explore the teen’s thoughts and feelings. Listen carefully to messages from the teen indicating there is a death wish. When a loved one has died, it isn’t uncommon to make statements such as, “I just wish I could go to sleep and not wake up in the morning,” or “I don’t care if I get in a car wreck.” These are passive death wishes – something or someone causing a death. On the other hand, if a teen starts talking about when, where and how to do it or if there is a history of depression or suicidal behavior, this is a much more serious matter and needs immediate attention. Get prompt, professional help and call The National Suicide Prevention Hotline at 988 or (1-800-273-8255) if the situation is urgent.
Anger. Anger can often create problems at home, school or with friendships; it must be expressed appropriately. Unspoken anger can become depression. If the angry teen is creating problems and common forms of expression are not helping, this teen may need further counseling for anger management.
Guilt. Feelings of guilt often leave the teen isolated and alone, with an absence of self-esteem. The shame accompanying guilt takes the form of deep, dark secrets — a very heavy weight to carry around. You can help the teen find some relief from these feelings by being a good listener and not trying to talk them out of it. Suggest writing a letter to the person who died asking for forgiveness, perhaps even taking that letter to the grave and reading it out loud. Or list the things that are most guilt-inducing on a biodegradable helium balloon and let it go. If measures like this don’t help, don’t hesitate to refer the teen for further therapy.
Substance use. Have information about the perils of substance use available. There are times when teens use drugs or alcohol to try to take away the pain. Look for denial, anger and guilt in teens you suspect are using drugs or alcohol. When referring such a teen for additional help, find a therapist specializing in grief and substance use.
Skipping school or dropping grades. A common symptom of grief is not caring about anything and a lack of motivation or interest. Help the teen understand that these intense feelings of grief are temporary and that the more they skip school or don’t do their homework, the harder it will be to catch up. Teens staying away from school may not know that, if this continues, they could be brought before a judge and sent to a probation home or juvenile detention center.
Acting out sexually. The pain of grief is so great and the emptiness so profound it is not uncommon to look for a warm body to fill the void. This closeness is usually only a temporary fix that may lead to regret, shame, and fear of disease and pregnancy. If a girl thinks that sex will make her feel better, help her understand her displaced needs and what she may get herself into. If a boy is showing the same tendency, help him understand that the issue goes beyond contraception; what is involved is his own need to address his grief in a way that will bring him real relief.
Making referrals and offering resources
Develop a list of mental health centers and know what services they offer. Put together a list of private therapists specializing in adolescents, grief, substance use and depression. Update this list yearly. If you need assistance, reach out to a [PBN] Care Advocate by calling [GPN]. Assistance is available 24/7/365.
Working with teens is both challenging and rewarding – challenging because you need to break into their world and develop a trusting relationship, rewarding because of the pleasure you will have in being a confidante to their secrets and concerns, seeing smiles and cheery greetings gradually replace those frowns and stares. Becoming a part of a teen’s life as they struggle with life-shattering grief is a privilege to be exercised with care, but a privilege all the same.
Source: American Hospice Foundation
