Grief and bereavement

When someone dies—whether it’s a parent, sibling, friend or other loved one, or even a beloved pet—it’s perfectly normal to experience a period of profound sadness, loss and mourning. This is known as grief and bereavement.

Everyone, including very young children, goes through grief after a loss. Though the feelings associated with bereavement are painful, the process is a natural part of human life and emotional development. It is only when grief seriously interferes with day-to-day activities, routines and outlook on life that it can become a problem. 

Here are a few things to keep in mind about grief:

• Grief does not “end” at any given time. People can go through the stages of grief—denial, anger, bargaining, sadness and acceptance—in any order, and waves of strong grief can re-emerge years (even decades) after a loss.
   
• Children who are grieving can experience misdirected anger (for example, lashing out at a surviving parent or sibling), as well as feelings of guilt and self-blame. These feelings, if not properly addressed and managed, can be very detrimental to the child and to the entire family.
   
• Support groups are one of the best avenues of treatment for children and families who are dealing with a loss. These groups allow for the sharing of feelings, concerns and worries with others who are in a similar situation and can relate.
   
• In some cases, grief can lead to dysthymia (mild to moderate depression) or to major depression. Depression always calls for professional mental health treatment.
   
• Sometimes, a child or teen is so severely affected by their grief that they may have suicidal thoughts. Threats or other warning signs of suicidal thinking should always be taken very seriously, and parents should seek immediate help.

Here at Children’s Hospital Boston, our expert team of family-centered, child-focused clinicians is here to help you, your child and your family work through your bereavement and to support you as you come to terms with your loss.

How Boston Children's Hospital approaches grief and bereavement

Children’s Department of Psychiatry team members are leaders in researching, diagnosing and treating issues like severe grief and bereavement and the depression it can cause, as well as:

• anxiety disorders
• bipolar disorder
• eating disorders
• post-traumatic stress disorder (PTSD) 

Children’s approach to mental health care is evidence-based—which means that our treatments have been tested and proven effective through scientific studies, both here at our hospital and by other institutions. Our psychiatrists, psychologists, social workers and other mental health professionals have extensive experience helping kids and families who have suffered a loss. We are here to help your family manage the mental, emotional and behavioral aftermath of a loved one’s death.

Our team is always aware that your child is, first and foremost, a child—and not merely a recipient of care. We will work with your family to determine the right therapeutic approach for your child’s grief. Treatment options can include:

• psychotherapy, or “talk therapy” for the child
• talk therapy for the family
• support groups
• if necessary, antidepressant medication in conjunction with therapy

You and your family are essential members of the treatment team, and our compassionate mental health professionals will include you in the therapeutic process at every step of the way. 

Grief and bereavement: Reviewed by David R. DeMaso, MD
© Children’s Hospital Boston; posted in 2011