V. Interventions for Grieving Children

A. Caregiver Communication

Initial eforts at intervention should focus on communication techniques that are age-appropriate. Children should be encouraged to express themselves in play, artwork, music, dance or drama. Verbal communication through which children explain their activities should also be sought.

Attention should be paid to helping children develop a narrative or a story of the traumatic death. Key components of such a story include placing the death in the context of time, space, understanding clearly what they observed and clarifying any particular misperceptions, and assisting children as they seek to find a meaning or purpose in what happened.

Caregivers should remember that children need to take the lead in defining the parameters of discussion or expression. A childs questions should be answered factually and simply when possible. Caregivers should listen carefully to questions so that they dont make assumptions about what the child knows or what he wants to know. Often caregivers fall into the trap of providing too much information in response to a question.

Behaviors should be non-judgmental with regard to the traumatic event, the traumatic grief reaction, and the childs age-related behaviors.

B. Goals of Assistance

1. Establish Safety and Security

a. Respond to and provide opportunities for children to receive positive human physical contact to reaffirm needs for sensory comfort and care.

b. Help children get enough sleep. This may involve responding to a childs concern about the safety of his bedroom or home, ensuring that someone is readily available to provide assurance after nightmares or sleep disturbances, or providing a soothing and calming environment before bedtime.

c. Help children develop protective plans of action if another traumatic event were to occur. This may include educating them on what they might do if something happened again and providing them opportunities to practice their trauma response.

d. Provide them with physical symbols of nurturing, love or remembrance. Teddy bears or stuffed animals are often a source of great comfort to children of all ages. Reestablishing routines and habitual activities gives children reassurance that life has returned to a kind of order. Rituals such as prayers, a regular "memory time", or special ceremonies may also be a source of security.

2. Allow Children to Tell What Happened and to

Talk About Death

a. Encourage them to tell or develop stories that help them explore intense reactions such as anger or fea.

b. Ensure that children understand differences between life and death.

c. Reassure them that sadness and grief are a necessary part of surviving the death of someone they loved. Help them to describe and understand reactions to trauma and reactions to the death.

d. Talk with them about what they observed in the reactions of parents, peers, or other significant adults.

3. Predict What Will Happen and Prepare

Children for the Future

a. Encourage the reestablishment of comforting routines.

b. Educate children about trauma, death, and loss.

c. Help them develop reasons for living.

d. Help them take time to think about their future.

e. Support adult caregivers in their efforts to react appropriately.

f. Work to help children solve problems they face because of the trauma.

Address what can and cant be done.

Help mitigate other changes in their lives.

Address estrangement from peers.

Help children frame their loss in the context of all of their relationships

and their life as a whole.

Help children focus on the future.

g. Give concrete aid and factual information.

C. Methods of Intervention

Much of what caregivers do when intervening is to try to help children tell the story of what happened and how they feel about it. The following methods can help children feel comfortable telling about their thoughts, emotions and concerns.

1. Oral Storytelling

Caregivers encourage children to tell a short story about the traumatic death, the person who died or about themselves. Careivers can suggest the following types of introductory sentences or phrases:

"Once upon a time there was a little girl named Mary who was very,

very sad because...";

"A few days ago I woke up and it was bright and sunny and I was

very happy, but then...";

"Id like to tell you a story about my mother who was killed in an

automobile crash."

With younger children, caregivers may need to model telling a short story. It may be useful for caregivers to consider telling a story about their own life when someone they loved died. While this technique is not usually suggested for use with adults, children are often exceedingly curious about adults who have suffered traumas similar to their own.

2. Guided Free Play

Traumatized children will often automatically use toys to reenact their trauma and their concerns. If caregivers have a range of toys available in a special box, shelf, or a bag, children can pick and choose their favorite mode of expression. Young children will run to the toys or immediately ask what is in the bag so they can start to play as soon as possible. Caregivers can observe children begin to play without prompting while doing preparatory things such as putting out refreshments, or hanging up coats. They can join the children with neutral questions such as, "That looks interesting. What are you playing?" Toys that are often helpful story tellers are: building blocks, cars, trucks, airplanes, human figures, dolls, stuffed animals, simple puzzles of people or peoples faces.

3. Stimulating Discussion

For children who are articulate and verbal, discussions can have a healing effect similar to that experienced by many adults who "talk out" their concerns and reactions. Caregivers can help children begin to discuss the traumatic death by showing photographs of the deceased, showing a video story about death and trauma, reading a short story, poem or parable relating to death and trauma, or presenting a news story or media article about the event for critique.

The videotape that accompanies this guidebook is designed to stimulate discussion about childrens reactions, but other videos could be used as well.

4. Creative Writing

School age children and adolescents often find it helpful to write about what concerns them. Outlets for creative writing include journals, letters to loved ones, prose, poetry, articles, or memory books. Caregivers can help suggest titles for pages in memory books that may help children express potent feelings. Some ideas are:

"Marys Name" [the child spells Mary vertically down the page and attaches

a word to each letter that reflects what Mary meant to the child].

"The thing I loved most about Mary is..."

"My saddest memory of Mary is..."

"My happiest memory of Mary is..."

"My funniest memory of Mary is..."

"Marys favorite hobby, color, bird, music, food, sport was..."

"If you had been able to say good bye to Mary, what would you have said?"

5. Creative Art

Children love to draw, paint, play with clay, and do crafts. Al can serve as useful media for expressing the message of grief and trauma. Finger painting and working with clay are both messy arts but can be particularly helpful because they seem to offer children a more interactive, visceral sense of expression. Clay is often soothing to the touch although some children like to pound or stab it in anger. One imaginative caregiver offered children the opportunity to finger paint shower stalls in the school locker rooms. They had plenty of room and the finished product could be washed away easily. The negative side of using impermanent art is that some children want to keep their creations because the expression of their feelings is so meaningful to them. When working with groups, caregivers might suggest that the group create a community mural.

6. Dramatic Enactments

Most children like to play-act, particularly if props, costume or makeup are available to enable them to become totally involved in being another person. Puppets can also be used. Young children may simply use the opportunity to reenact funerals or portions of the trauma stories. Older children and adolescents may want to create their own "mini" plays. Adolescents may also find playing parts or reading scripts from classic and modern tragedies helpful in expressing their concerns over death.

7. Music

Listening to, playing or singing music can be a wonderful release for children. It provides a reconnection to the sense of rhythm as well as the fact that certain musical instruments may echo sounds of grief reactions: anger might be expressed through the sound of drums or a blaring trumpet; reed and string instruments might remind children of weeping or feelings of loneliness; drum rolls and cymbals may reflect tensions, anxieties and fears; harps, flutes, and piccolos often sound like spirits talking, and so forth. Death-related lyrics are found in music as diverse as country-western, rap, opera, or hymns.

8. Prayer, Repetitive Meditations, and Chants

The power of prayers for many children rests in the affirmation of spiritual beliefs, but also in associated relaxation responses triggered by the repetition of familiar and comforting words. They add an air of solemnity and gravity to rituals and memorial activities.

D. Sample Questions, Exercises and Activities Useful

in Working With Children

The following questions, exercises and activities have been used with individual children and with groups of children who are grieving after violent death. They draw upon the methods of intervention described above and illustrate how these interventions can be used to address common concerns children may have. To the extent possible, children should be allowed to choose exercises and activities they want to do or to suggest alternatives. It is useful for caregivers who work with grieving children to keep toys, art supplies and light refreshments readily available. If caregivers are responding immediately after a violent death, they should take paper and colored markers or crayons with them to use in talking to surviving children. Most children talk more readily when their hands are busy. When watching a videotape or listening to a story, many children also want to have something to do with their hands. While caregivers want to listen to childrens stories and assist them to understand that someone they loved died in the immediate aftermath of violent death, most questions and activities will be addressed or used in he days or weeks following violent death.

1. Finding Out the Childs Version of What Happened

Underlying Questions: How did [person(s) name(s)] die? What happened when s/he died?

Activities that Help Address the Questions:

Drawing or painting images of what happened.

Hint: If children are reluctant to begin drawing or painting, caregivers may begin to draw and encourage the children to add to their drawings. Useful starting points include drawing a face or a person, a house, or the weather for the day.

Hint: Children should be encouraged to describe their drawings as they tell what happened. Often, children will add written words to their drawings that help them to articulate their fears.

Guided free play: in working with grieving children who have survived or witnessed violent death, toys that give them an opportunity to play or act out the event may be helpful.

Hint: Toys might include child and adult figures, policemen, firemen, doctors, ambulances, fire trucks, cars, buildings, pets.

Hint: Caregivers should ask the children how they might play with them. Often children have caregivers play the "bad guy" or someone with whom they are upset so they can express their distress at a real person.

Hint: Children often have an acute memory of the traumatic event and can replay vividly the most frightening part of that event. It may involve loud sounds, angry responses, or sporadic activity. Caregivers should be prepared to cope with such reactions and provide immediate nurturing to children to help them feel safe again.

Dramatic reenactments: older children may want to develop a play to describe what happened, particularly in the weeks or months following the death.

Hint: With older children, caregivers should be prepared to clarify any misconceptions the children may have about what happened when the violent death was a suicide, homicide or an accident.

Hint: Dramatic reenactments may be traumatic events for children and caregivers should be prepared to provide crisis assistance if the drama is overwhelming.

2. Exploring the Difference Between Life and Death

Underlying Question: How do you know that someone or something is dead?

Activities that Help Address the Question:

Touching a dead person or animal may help children compare body warmth and identify a difference in the feel of the skin of someone living.

Listening for the heartbeat of a dead person or animal may help children to compare the heartbeat of someone living.

Hint: Looking at what happens when eyeglasses or a mirror are placed close to the mouth of a dead person or animal and compare the results to what happens when the same things are placed close to someone living. Breath contains moisture that will cause a fog when it comes into contact with a cool pane of glass.

Hint: Some children never have the opportunity to see the dead body of a loved one or acquaintance because they are not permitted to attend the wake or go to the funeral home or funeral service. However, it is not uncommon for children to see a dead animal, either a pet or an animal who has died outside (baby birds that have fallen out of trees, for example).

Hint: It may be extremely difficult for the parent or other caregiver to assist a child to explore the meaning of death by viewing the body of a dead loved one. It might be easier for someone who works in the funeral home to help the child see and touch the body.

Use an illustrative analogy through a glove exercise.

Hint: Have the children put on a glove and then move their hand -- pick up an object, shake hands with another person, or play with a toy. The glove moves with the hand because the hand is the life force within the glove. Have the children take off the glove and lay it on the table. Explain that when the life force is removed, the glove is similar to a dead body which has no life in it. It can no longer move, feel, touch, or play.

Some children may want to see the body of the loved one who died.

Hint: If the death was violent, this may not be possible due to law enforcement policy or parental objection. A viewing of the body is useful, if children are properly prepared for what they will see. If they cannot see the body, it may be important to let parents know that it may take some time for children to absorb the concept that the person is dead and will not return.

3. Exploring What Happens to a Person After He Dies

Underlying Question: What happens to a person after he dies?

Activities that Help Address the Question:

Read a poem or story, or show a videotape about someone or something dying. Ask the children to comment on the ending. What are their beliefs or thoughts about what happened?

Hint: Examples of short stories include: Arvy Aardvark finds Hope, a book by Donna O Toole. More excellent stories will be in the local library.

Hint: Check the local library or video stores for videos that address death that would be appropriate for children of varying ages.

Hint: If children are school-age or above, thecaregiver may ask them to help read the story.

Hint: Caregivers should encourage children to write their own stories about what happened to the body of their loved one and what they believe happens to the spirit of their loved one.

Drawing or painting images of what happens. Common picture themes include:

-- Depiction of burial or funeral proceedings.

-- Spiritual concepts such as a person going to heaven or being in heaven,

ghosts, good or evil spirits.

-- Thoughts on where the person is or what he looks like after death.

Hint: Caregivers should be alert to frightening images, self-depictions of the child where the child might be shown in hiding or without important body parts, depictions of the deceased that are distorted or partially drawn, etc.

Hint: Caregivers should encourage children to describe the pictures and ask questions about any imagery that is disturbing.

4. Exploring Why a Sudden Death has Occurred

Underlying Question: Why do you think [person(s) name(s)] died?

Activities that Help Address the Question:

Life Cycles Discussion

Take children on a field trip to observe life and death in the natural world. In a park, children might be able to look at a living tree, a dying tree, and a tree killed by a storm or fire. Insects may be observed living and dead -- some suddenly because a child stepped on them. A young animal may be viewed and contrasted with a very old animal.

Hint: This discussion is most helpful as an educational tool in preparation for death; however, it can be used in the aftermath of sudden death to try to place all death in perspective.

Hint: Caregivers should be prepared for questions about the differences between various kinds of life, how it is decided when life should end, why does someone I love die, etc.

"Finding Answers" Game With Discussion

Instructions: Provide a large sheet of construction paper that is divided into a matrix of three large squares by six large squares. Children are asked to write or draw six reasos they believe helped to cause the death of the person they loved in the first set of vertical squares. Caregivers then verify or correct each of those reasons in the second set of vertical squares. In the third set of vertical squares, caregivers and children together agree on the assessment that it was not the childs fault.

Hint: This exercise explores magical thinking and the possibility that children blame themselves for things they do, think or feel prior to the death of a loved one. Caregivers can reassure children that their job in life is to be a child and that life and death decisions are not under their control.

Hint: This exercise also helps children to learn about the facts that surround the death of a loved one and to clarify misconceptions and rumors.

"If I Could Say Good-bye" Exercise With Discussion

Instructions: Ask children to write or to depict what they think their loved one would want them to know if that person would have had an opportunity to tell them they were going to die suddenly. After children express this idea, they are then asked to write or depict what they would have wanted their loved one to know.

Hint: This exercise helps children explore issues of abandonment, anger or grief over the sudden loss of a loved one. It also helps children to express their confusion over why death happens.

Hint: The second part of the exercise helps children think through how they might resolve these issues and go on living.

5. Identifying Trauma or Grief Reactions

Underlying Question: What do you remember feeling after you knew or found out that [person(s) name(s)] was dead?

Activities that Help Address the Question:

"Color Me Blue" Exercise and Discussion

Instructions: Distribute paper and colored markers and ask children to make a series of self-portraits identifying how they feel when they are angry, afraid, confused, ashamed, guilty, lonely, sad, excited, happy, feeling loved. These can be done on one page or a series of separate pages -- one for each type of feeling. Ask children to use a special color for each feeling. After they have drawn those pictures, children are asked to identify which feeling they remember having first after learning of their loved ones death. Then they are asked to identify other pictures that illustrate additional feelings.

Hint: In the initial stages of this exercise, caregivers should use simple, nonthreatening illustrations with younger children of what the various emotions might mean. For example, guilt might be described as "drawing how you might look if you felt bad because you did something wrong but didnt want to tell anyone."

Hint: Caregivers and children may want to keep these illustrations to use as they continue to meet and talk about traumatic grief. They can become a useful reference point. However, caregivers should note that children may want to change the color of different emotions as their feelings change.

Hint: Older children may not want to take the time to draw pictures; however, many may be able to think in terms of colors that correspond to their reactions more easily than naming their reactions. They might be asked if they can think f a color that fits how they felt. Sometimes a video projection of the color wheel might assist them in identifying the nuances of their feelings.

Roadmap of Trauma Exercise and Discussion

Instructions: Ask children to draw a line from the time that their loved one died until the present. Have them mark important events that have happened during that time on the line and indicate whether they were things that felt sad, bad, mad, or glad.

Hint: Events may include the first time they returned to school, the funeral, an interview by the police, a life change such as a divorce of parents or the birth of a new sibling, and so forth.

Hint: Most events will relate directly to the traumatic death or be interpreted in light of that trauma.

Hint: Caregivers should be prepared to talk about the ongoing impact of the trauma, clarify any misconceptions, and help with childrens understanding of ordinary life changes that take place and those that might have been precipitated by the impact of the trauma.

Hint: Many things in a childs life will change as a result of traumatic death. The caregiver may seek to find positive resolutions in those changes, but some negative changes may take place. Caregivers should be prepared to help children cope with consequent and succeeding traumas.

6. Coping With Trauma or Grief Reactions

Underlying Question: How can you live with your feelings?

Activities that Help Address the Question:

Clay-throwing -- to Address Anger

Anger and rage are the most volatile and potentially violent emotional reactions to trauma and grief. Older children may be able to express anger in writing, verbally or through constructive social action. Younger children may find it more difficult to find ways to adequately alleviate their fury. Clay-throwing has been used by some caregivers to assist them. A large plastic sheet or garbage bag is placed on the ground or floor. Unmolded soft clay is given to children. They may shape it or simply rol it in a ball. They are then allowed to throw the clay on the sheet as hard as they can. Each time they throw it down, they are encouraged to express what they are throwing it for.

Hint: If done in groups, this activity needs to be closely monitored so that children do not throw the clay at each other.

Hint: A modification of this exercise involves using different colors of clay and having children identify different feelings with each color and throwing the colors as they express different feelings.

Hint: Ventilation of anger is a useful exercise so long as it is followed by relaxation and defusing exercises so that the anger does not escalate in emotional intensity.

Preparing Safety Plans -- to Address Fear

Children who have been traumatized by violent death need to have ideas about how they can protect themselves in the future. Practical safety plans may not be foolproof but they can provide children with a measure of reassurance. Caregivers should talk to children about their fears and try to provide them with skills to address basic problems. For instance, a child may have heard that they should call the police in an emergency, but they do not know what the number is or how to dial it. That is a simple lesson. The disaster education provided to children in earthquake and hurricane zones are examples of education programs that help children feel more competent when threatened with those disasters. Crime prevention and education programs can help children feel more competent when threatened with violence. Caregivers should also work with significant adults to ensure that children know what will happen to them if another traumatic death occurs in their lives. Where will they go? Who will they live with? How might they continue to be in contact with their friends if they must move to another neighborhood?

Hint: Children should be allowed to practice safety skills over and over again until they respond automatically to perceptions of threats.

-- Continued --

Hint: Children should be allowed to develop their own safety techniques and try them out to see if they work. If their suggestions or attempts reflect good thinking but need refinement, caregivers

should reinforce their efforts. If their suggestions are dangerous or would be futile, they should be encouraged to consider alternatives.

Hint: Safety plans should have realistic chances of success. Carrying a good luck charm may provide reassurance, but will not provide a child with safety.

Journal-writing -- to Address Confusion

Keeping a regular journal is something that all school age children can do. For young children this may involve keeping a scrapbook of things with a few printed words that describe feelings and thoughts. Older children can expand their ideas and reactions. The value of journal-writing is that it gives children a chance to narrate their story over and over again as well as to express their reactions. Each narration may help them sort through facts and emotions that confuse them.

Hint: Caregivers should assure children that their journals can be kept private but encourage them to share them voluntarily.

Hint: Children may find it easier to share the contents of their journals if they think that their experiences will help others who face similar trauma or grief.

Im OK Affirmations -- to Address Shame

Caregivers can talk to children who feel ashamed of what they did during a traumatic event, having survived a trauma, or how their loved one died to think about the good things they do and the good things their loved ones have done. Children may be asked to list the things that they are proudest of -- in themselves or their loved ones -- and to keep a chart of each time they do something or remembr something that reaffirms that quality or attribute. Children may also feel ashamed of things that happen to them after a trauma. Sometimes children who have been perceived by adults to have been "heroes" during a trauma feel particularly ashamed because they "know" inside that they were scared and felt helpless. Caregivers can talk to children and develop plans for how to respond to embarrassing questions, comments or situations. Writing out "cue cards" that children can carry with them to remind them of how they plan to respond can provide extra security.

Worry Beads -- to Address Guilt and Anxiety

Worry beads are common objects used in prayer and meditation in many parts of the world. In an adaptation of this use, caregivers may ask children to make a set of beads out of papier-mache, old jewelry, glue and paper or other materials. Each bead can be used to symbolize specific worries, guilt feelings or anxieties a child may have. They string and keep them to touch and feel whenever they are thinking anxious thoughts. They symbolize that these thoughts are within their control and can be soothed and calmed by their fingers.

-- Continued --

Ritual: The Burden Basket

This ritual, drawn from Native American Tribes, where burden baskets were constructed out of cedar to absorb anger and tears to carry everyday burdens, involves creating a basket out of the childs choice of material. The child then writes or depicts feelings that are overwhelming and deposits

them in the basket. The basket then is burned and the ashes scattered to help defuse the intensity of the immediate feelings.

Hint: Children should be supervised closely if the basket is burned.

Hint: Sometimes children want to dispose of the basket in a different way -- such as throwing it in a body of water.

Hint: Sometimes children might want to keep the basket and its contents and pick a specific time each day or week to look at their burdens and reexamine the issues in a new context.

Ritual: The Healing Circle

The shamani (natural medicine) tradition throughout the world suggests that a healing circle can help us connect with spirit and affirm our place in the universe. The Healing Circle uses each of the four directions in nature -- South, West, North and East to identify specific tasks and processes of development for individuals and communities to attend to in their lives. Children may participate in a ritual adapted from the shamani tradition that uses these directions to address their needs. Music and rhythm can be used to accompany this ritual.

A circle is drawn on the ground and the child stands facing South. This is the direction of the healer. The child asks the winds of the South to help him deal with his trauma and grief. The child tells the south winds of his sorrow and loss as well as any sense of abandonment by the one he loved. A rhythmic drumbeat accompanies the story.

The child then faces West. It is in this direction that the child is asked to talk about his fears and his loneliness. This is the direction of courage. He calls upon the spirits of the West to help him face those fears. A time of silence is used to help the child gather his courage.

The child then faces North to ask for the bility to cope with his anger, fear, and sadness. He asks the spirits of the North to help him reconnect with family and community -- to breach the gap the trauma has caused. A dance of remembrance and outreach to others is used to begin this process.

The child finally faces East to find a vision to guide him in the future. The task of deciding how to go on involves freeing oneself from the past so that one can be fully committed to the present and the future vision. Songs of hope accompany the child as he faces this direction.

Hint: This ritual should be planned in advance and involve participation and assistance of caregivers. It may be most appropriate for older children because of the complexity of the symbolism. Adolescents may want to create their own rhythm and musical accompaniment.

Hint: This ritual may be used in four different discussion sessions with the children involved.

7. Memorials and Remembrance

Underlying Question: How can you remember the one you loved and express your loss?

Activities that Help Address the Question:

Funerals and Formal Memorial Services

Consistent with the spiritual beliefs of the family, caregivers should encourage parents to include children in funerals and memorial services so they can express their own grief, say good-bye to their loved one and be more connected with the grief of their peers and significant adults. Children may want to bring "gifts" to such services or deposit letters or mementos in the coffin or at the burial site. Often traditional spiritual and mourning rituals help to accomplish the acknowledgment of death and the reaffirmation of life.

Child-centered Memorial Services

Many times children need to have their own memorial services in addition to the ones planned by and for adult grievers. Such plans should be encouraged and supported.

Culturally-sanctioned Ritual: All Saints Day

In Mexico, All Saints Day is a time to honor the dead. It centers around feasting and offering food to the dead as well as gift exchanges and family reunions. Caregivers could suggest that children and their families adopt a similar ritual -- perhaps on the birthday of the deceased loved one or on a day with special meaning for the family.

Culturally-sanctioned Ritual: Buddhist and Shinto Traditions

Many homes have an altar honoring deceased ancestors. Pictures might be placed there and even an urn containing cremation ashes. Family members may make offerings to their loved ones, ask advice, or state opinions. The connection with the past lives in the present. Children may want to choose a special place in their own home where they feel especially close to a deceased family member and make a habit of communicating their ideas and feelings to that person.

Because children tend to grieve and mourn sporadically ovr long periods of time, individualized memorial activities should also be supported.

-- Continued --

Treasure Map

Caregivers can supply children with a large stack of old magazines, scissors, glue and a large piece of construction paper. Instruct children to go through the magazines quickly and find pictures, words, or captions that remind them of their loved one. Ask them to cut out those that catch their eyes. After they have assembled a pile of cutouts, tell them to write the name or draw a picture of their loved one in the middle of the construction paper and then glue the other items around in whatever order they want. They may want to draw lines from each item to the picture or name in the center. Or they

may want to draw lines that connect all the items to each other and then end in the center. Whatever the order, the children have created a treasure map of their thoughts and feelings of the loved one.

Hint: A variation of this exercise for older children is to take a piece of paper, and in the middle of the paper put the name of the person. Then, they should be instructed to write words around that persons name that they associate with them.

Hint: Children may use this as a way to memorialize a loved one. It may also be used to explore unresolved feelings of the child about the deceased.

A Memory Box

Children may want to save items that remind them of their loved one in a special box that can be looked at when they feel sad or when they want to feel the presence of their loved one. Constructing and decorating an old cigar box or shoe box for this purpose can be creative and comforting work.

Visits to Cemetery

Caregivers might suggest regular monthly visits to the cemetery where the loved ones of children are. Children can write letters about their current activities in life, poems of remembrance, or choose songs to sing. This activity helps children keep a sense of communion and connection with the spirit of the loved one.

E. Support Group Activities

The following pages contain sample support group session topics that can be used with grieving children, broken down into age groups by developmental levels. While some caregivers may feel more comfortable if groups are limited to children of similar developmental levels, other caregivers have found mixed ages manageable in one group. Groups should be limited to no more than 20 children to facilitate communication. It is best to have at least two trained caregivers in attendance. Support groups with older children can be facilitated by peers or group members but should have adults available for resource and counsel. Younger groups may be facilitated by adolescents in partnership with adults.

Group sessions should usually last no longer than 1/2 to 1 hour with groups ages 2-6; 1 hour for groups ages 7-11; and 1 1/2 hours to 2 hours for groups over the age of 12. Refreshments should be provided, if possible. It is preferable if groups meet weekly for 6 weeks and then take a break before starting again, if needed. This allows time for the group members to get to know and trust each other, but also allows group members an opportunity to drop out after the first cycle, if the sessions are no longer needed or do not fit into their schedule.

Support groups may center around one particular traumatic event that affected a significant population of children such as a sudden death in a school setting or on the grief of children who have survived the death of a loved one in a variety of traumatic events.

The purpose ofthe group is:

To help the children process the traumatic experience, its aftermath and their reactions.

To identify troubling thoughts or emotions surrounding the experience and the death.

To provide education for children on trauma, grief, and healthy coping strategies.

To provide tools and skills for children to use in everyday life as they cope with traumatic grief.

1. Ages 2-6

Setting: When young children meet in a group it is best if the facilitators arrange for a comfortable environment where they can sit on the floor in a circle. Children may be encouraged to bring a favorite stuffed animal to the group. Alternatively, facilitators might provide the children with such a stuffed toy to hold on to while they participate in the group. Parents may be present but should not participate in the sessions. Parents should be kept informed of the subject matter of each group and any requests for children to do activities at home or bring things from home. Refreshments such as cookies and juice should be provided at the end of the session.

Tools: Paper, crayons, glue sticks, pictures cut from magazines, houseplants or flowers, a pitcher and paper cups, ribbon, and a ball.

Session One (2-6): Introduction; Discussion of Violent Death

A. Facilitators Introduce Themselves and Explain the Purpose of the Group sessions.

"Good afternoon. I am Suzie Wilson and this is Judy Martin. We are looking forward to talking and playing with you today. Did everyone bring a toy with them? [Alternative: Did everyone get a toy as they arrived?] Can you all hold your toy up for us to see? Thank you. Judy and I are going to play with you every week until Thanksgiving. [Facilitators should identify a holiday or season that corresponds to when the six weeks will end.] Everyone here has known someone they loved who died recently. That is what we want to talk about -- what you think about that and how you feel. We also want to get to know you all a little better. So we want you to tell us your name and a little bit about the person you know who died. To help us do that, we are going to play a ball game.

B. List Basic Rules; Tape Them to the Wall to Refer to Throughout the Session.

Rules for Group Participation

Only one person talks at a time.

Everyone has a chance to talk but no one has to.

No one should make fun of anyone else in the group.

Its okay to be upset and feel feelings.

Its not okay to hit or shove someone else.

Any question can be asked, not all qustions can be answered.

C. Ball Game

Facilitators hold a ball in their hands and give the following instructions.

"We are going to roll this ball to one of you. You will catch it. When you catch it, we want you to tell everybody your name, the name of your stuffed animal, and the name of the person who died. Then, we want you to tell us when the person died and how she or he died. When you are finished talking, you get to roll the ball back to us and we will roll it to someone else. When you have the ball, you get to talk; when someone else has the ball, you get to listen."

Model this activity by rolling the ball to another facilitator and telling your name, the name of your stuffed animal, and the names of persons whom you have known who have died. When the ball is rolled to the children, facilitators should be prepared to help the children remember the questions by asking again, "Whats your name? Who is your friend [indicate the stuffed animal]? Who did you know who died? Can you tell me when or how it happened?" Facilitators should respond by saying they are sorry the person died and reassure children that being sad is okay.

D. Thinking About Life and Death

Begin this exercise by saying,

-- Continued --

"When someone dies, they are dead. They dont move, eat, sleep, or

breathe. Their heart doesnt beat. When they die, they cant come

back to life. What do you think being dead means?"

Ask the children to choose a piece of paper and some crayons.

Ask the children to draw a picture of death on one side of the paper.

Ask them to draw a picture of life on the other side.

Ask each of the children to explain their pictures.

Clarify misconceptions and be prepared to answer questions.

E. Conclusion

Thank them for being a part of the group and for playing together.

Serve refreshments.

Encourage the children to take their pictures home.

Remind them that they might think about death or the person they loved during the next week and if they want to draw more pictures about what they think or feel, the facilitators would like to see those pictures at the next group session.

Session Two (2-6): Feelings

A. Introductions and Purpose of Group Session

Facilitators should begin by reviewing thoughts the children might have had during the week.

"Hi. Its great to see you all again. I hope you all brought your friends (the stuffed animals). Did anyone draw any pictures ast week that you would like to share? Does anyone have a story of something that happened during the week that you would like to tell?" [If the children answer yes, facilitators should ask each one who wants to show something or tell something to do so.]

"This week, we want to learn more about the people you know who died -- what they were like and how you feel now that they are gone."

B. Memory Pictures

Ask the children to draw pictures of things their loved one liked or that remind them of their loved one.

Suggest that the children select some pictures from magazines or other publications of common items such as candy, flowers, household appliances, cars, animals or furniture that remind them of their loved one and glue them on the picture paper. [Pre-cut pictures can save time.]

Ask each child to talk a little bit about the memory picture.

C. Feeling Picturebook

Ask the children to draw one picture each of how they look when they experience the following feelings.

"How do you look when you feel happy?"

"How do you look when you feel mad?"

"How do you look when you feel afraid?"

"How do you look when you feel like you did something wrong?"

"How do you look when you feel sad?"

Help the children staple or tape them together in a book with a cover on it that says " [Childs Name]s Feelings Book".

Explain that:

"Feelings arent wrong or right but they can make us feel good or bad."

"Everyone has different feelings at different times but most of us have similar feelings to each other at some time."

-- Continued --

"Sometimes it is hard to talk about what we are feeling because we dont think other people can understand, but it often helps to talk about what we are feeling because it makes us feel less lonely."

Explain that these books can be used every time the group meets to show each other how each child feels that day.

Ask each child which feeling they have right now when they think about their loved one.

Use the ball game to help children take turns talking and listening.

D. Conclusion

Thank the children for coming to the session.

Serve refreshments.

Ask the children to remember todraw pictures of what they might feel during the week so that they can bring them to the next session.

Session Three (2-6): Fear

A. Introductions and Purpose of Group Session

Facilitators should begin by reviewing thoughts the children might have had during the week.

"Hi. Its great to see you all again. I hope you all brought your friends (the stuffed animals). Did anyone draw any pictures last week that you would like to share? Does anyone have a story of something that happened during the week that you would like to tell?" [If the children answer yes, facilitators should ask each one who wants to show something or tell something to do so.] Remember our feeling books that you made last week [distribute the feeling books]? Can each of you pick out the picture that shows how you are feeling right now? [As the children pick out their pictures, ask them to tell why they are feeling that way.]

"This week, we want to talk about things that we are afraid of. Lots of times when someone we love dies, we get scared about the way they died, how other people treat us, or maybe whether were going to die soon, too. Everyone is safe here right now, but I know when I get scared of something sometimes I want to curl up into a little teeny ball and hide."

B. Scary Pictures

Ask the children to draw a picture of a scary thing.

Ask each child to explain what it is that is scary in the picture.

Ask the children to try to change the picture to make it less scary. This activity allows children to realize that they have some power over scary things.

C. Stuffed Animal Play

Ask the children to pretend that their stuffed animals are very frightened of something.

Allow each child to describe what their animal is afraid of.

Ask each child to show the group what their animal might do if it were afraid or how they might make the animal feel safe again.

D. Houseplant Activity

Fill a large pitcher with water and label the pitcher with a marker as "Fears".

Give each child a paper cup.

Ask each child to name something they are afraid of. While the child is talking about it, the facilitators should:

Pour their "fears" from the pitcher into their paper cups. When each child has a cup full of fears:

-- Continued --

Ask the children to pour their fears into a houseplant.

Explain that when we keep our fears to ourselves, they often make us more afraid. When we are able to pour them out, we can feel stronger and they can help us grow -- just like the water will help the plant to grow.

E. Conclusion

Thank the children for coming to the session.

Serve refreshments.

Ask the children to remember to draw pictures of what they might feel during the week so that they can bring them to the next session.

Session Four (2-6): Anger

A. Introductions and Purpose of Group Session

Facilitators should begin by reviewing thoughts the children might have had during the week.

"Hi. Its great to see you all again. I hope you all brought your friends (the stuffed animals). Did anyone draw any pictures last week that you would like to share? Does anyone have a story of something that happened during the week that you would like to tell?" [If the children answer yes, facilitators should ask each one who wants to show something or tell something to do so.] Remember our feeling books [distribute the feeling books]? Can each of you pick out the picture that shows how you are feeling right now? [As the children pick out their pictures, ask them to tell why they are feeling that way.]

"This week, we want to talk about times when we are angry. Lots of times when someone we love is killed, we get mad at the person who killed them, at people who should have helped them, at other people who dont understand. Sometimes people tell us we shouldnt be angry, but no one can help it if they feel angry sometimes when someone dies suddenly."

B. Working With Clay

Place plastic garbage bags in front of each child and give the children balls of clay.

Ask them to make something that makes them angry.

Make something that angers you as well. It helps small children to see facilitators do the same things that they do.

Ask each child to describe what they have made and why.

Ask them what they would like to do with their clay -- some may smash it, others may throw it on the plastic as hard as they can, or others may just roll it up.

C. Physical ctivity

Guide angry activity and teach children to connect their feelings with safe physical expression.

Adapt the childrens song, "If Youre Happy and You Know It Clap Your Hands" to provide a safe outlet for anger. Teach the children the song using "If Youre Angry and You Know It" as a substitute for "Happy". Encourage children to clap their hands, stomp their feet, and sing loudly in anger.

D. Stuffed Animal Play

Explain to children that it is okay to be angry at someone, but it is not okay to hurt or hit someone with whom we are angry.

-- Continued --

Ask the children to pretend they are very angry at their stuffed animal and then to demonstrate what they might do to show their pet they are angry.

Explain that hitting or throwing is not a good way to be angry.

Encourage them to alternatively deal with anger by not playing with the animal, drawing a picture of their anger and showing it to the animal, or by picking up their clay, making an animal likeness and smashing it.

E. Conclusion

Thank the children for coming to the session.

Serve refreshments.

Ask the children to remember to draw pictures of what they might feel during the week so that they can bring them to the next session.

Session Five (2-6): Grief and Mourning

A. Introductions and Purpose of Group Session

Facilitators should begin by reviewing thoughts the children might have had during the week.

"Hi. Its great to see you all again. I hope you all brought your friends (the stuffed animals). Did anyone draw any pictures last week that you would like to share? Does anyone have a story of something that happened during the week that you would like to tell?" [If the children answer yes, facilitators should ask each one who wants to show something or tell something to do so.] Remember our feeling books [distribute the feeling books]? Can each of you pick out the picture that shows how you are feeling right now? [As the children pick out their pictures, ask them to tell why they are feeling that way.]

"Weve talked a lot about the way we feel afer someone we love is killed, but often the main thing we feel is sadness. There are a lot of reasons to be sad and most of them have to do with missing the person who is gone. Today we are going to talk about how we can remember the person we love so that their memory can be with us always."

B. Funeral Activity

Explain to children that many adults participate in memorial services and funerals to remember the person who died.

Find out from the children if they attended such a service or funeral for their loved one.

Ask them if they have any questions about the funeral and try to clarify any misconceptions or concerns.

Ask them to draw a picture of things they remember at the funeral or memorial.

Ask them to tell the story of the picture.

C. Memory Stories

Explain to the children that one way of remembering someone they love is to tell stories about them to people they meet.

Encourage them to practice telling stories about the person they love by telling a story to their stuffed animal for the group.

D. Color Memories

Explain to the children that often certain colors remind us of other people. Sometimes the color was the favorite color of the person who died. Sometimes the color is a color that you saw on the day of the funeral.

Show the children a color chart or box of colored markers and ask them to pick the color that reminds them of the person who has died.

-- Continued --

Ask the children to explain why the color reminds them of the deceased. If the color is associated with good memories, the child should be encouraged to do an entire picture in memory of the loved one in that color. If the color is associated with bad memories, the facilitator should talk to the child about how the color might be changed and the memory might be shaded in favor of a good memory. Example: A child may pick a red marker because he saw his mother killed and remembers the blood. The facilitator may be able to encourage the child to think about a good memory of his mother such as when they played in the sun. The facilitator can then take a yellow marker and show the child how to change red to orange to represent the sun rather than the blood.

E. Conclusion

Thank the children for coming to the session.

Serve refreshments.

Ask the children to remember to draw pictures of what they might feel during the week so that they can bring them to the next session. Since the next session will be the last session, ask the children to look around during the week for something -- a memory object -- that they can bring to the group that reminds them of their loved one.

Session Six (2-6): Going on With Life

A. Introductions and Purpose of Group Session

Facilitators should begin by reviewing thoughts the children might have had during the week.

"Hi. Its great to see you all again. I hope you all brought your friends (the stuffed animals). Did anyone draw any pictures last week that you would like to share? Does anyone have a story of something that happened during the week that you would like to tell?" [If the children answer yes, facilitators should ask each one who wants to show something or tell something to do so.] Remember our feeling books [distribute the feeling books]? Can each of you pick out the picture that shows how you are feeling right now? [As the children pick out their pictures, ask them to tell why they are feeling that way.]

"Today is the last time that we will meet before Thanksgiving. Its been very special getting to know each of you. But its time to say good-bye for a while. So today we want to talk about what each of us is going to do as you continue to grow up and get older. First, I want to see what memory object you brought to show us."

B. Memory Objects

Bring to the group a roll of ribbon and pre-cut hearts at least two inches in size. (Heart doilies can also be used.)

Allow each child to show the memory object, describe it and tell why it is important.

Cut a piece of ribbon and attach it to a heart. As the child says the name of the person who died:

Write the name in block letters on the heart. (Allow the child to do this if he or she knows how to print.)

Attach the heart to the memory object.

Tell the children that in many cultures, people keep memory objects in their home or carry them with them to continue to feel that they can talk to their loved ones.

C. Looking Into the Future

Ask the children to draw a picture of what they want to be when they grow up.

Ask them to tell the story of the picture.

Provide them with encouragement and validation of positive personality attributes that are reflected in their dream.

-- Continued --

D. Conclusion

Thank the children for coming to the sessions.

Give each child a special memento to take home from the group (Examples: a large gold star with the groups name and the childs name, a certificate, a set of color crayons and paper, a small toy, and so forth).

Serve refreshments.

2. Ages 7-11

Setting Children should be seated in chairs around a table in a comfortable environment with the facilitators. Paper, crayons, and markers should be available on the table. Refreshments such as chips, cookies, fruit and juice or soda should be provided at the end of the session.

Tools: Paper, crayons, markers, name badge maker with colored paper, and assembly materials (alternatively: name tags with plastic holders), stickers, old magazines, paper bags, glue sticks, flip chart.

Session One (7-11): Introduction;

Discussion of Violent Death

A. Introduce Yourselves to the Children and Explain Purpose of the Group Sessions.

"Good afternoon. I am Suzie Wilson and this is Judy Martin. We are looking forward to talking with you today. Judy and I are going to be here on Thursday afternoon every week for the next six weeks. Everyone here has known someone they loved who was killed recently. Violent death is a terrible thing and were sorry that it has happened in your lives. That is what we want to talk about -- what you think about homicide and murder and how youve been feeling. During these sessions there are some basic rules to follow so that everyone feels comfortable and has an opportunity to talk if they wish."

B. List Basic Rules; Tape Them to the Wall to Refer to Throughout the Session.

Rules for Group Participation

Only one person talks at a time.

Everyone has a chance to talk but no one has to.

No one should make fun of anyone else in the group.

Its okay to be upset and feel feelings.

Its not okay to hit or shove someone else.

Any question can be asked, not all questions can be answered.

C. Name Game

"We also want to get to know you all a little better. So we want you to tell us your name, something about the people who died and how they died. To help us get acquainted, we have handed out two name signs -- one is a badge for you to wear and the other is a sign to place in front of you at the table. We want you to write your name on each, but we also want you to think about a picture or symbol that you think describes you or your loved one and to draw it or choose a sticker or cut out a picture that represents it and put that on the badge and sign as well."

After the children do this, go around the circle and ask each child to say their name, and describe the symbol or picture.

D. Videotape

Tell the children:

"Many children have had parents, siblings or friends who were killed. These facts dont make it any easier to live with a personal loss but it may help to hear how other children have thought about violent death. The videotape was prepared o help children tell other children what they have felt after someone they loved had been killed."

-- Continued --

Show the videotape.

"You have seen some of the reactions of kids who have suffered a violent death among their families or friends. Everybody reacts differently. Each of you have your own stories. We want to hear those stories to learn more about how we are different and how much we are the same."

E. Telling the Story of Violent Death

Ask the children to take a piece of paper and some colored markers. Ask them to think about the day their loved one was killed, and what they remember. Facilitators can prompt their thinking by asking some of the following questions depending upon the event(s) group members have experienced.

-- Where were you when it happened?

-- How did you find out what happened?

-- What do you remember seeing?

-- What do you remember hearing?

-- What do you remember smelling?

-- What did you do?

As they are thinking about the day, ask them to draw a picture of the worst memory they have about that day. After they have completed their drawings, ask for volunteers to show their pictures or to tell the story of those bad memories.

Ask the group try to remember if there was any good part of the day.

Ask them to draw a picture of the best memory they have about the day.

Ask for volunteers to show or tell those stories.

F. Thinking About Life and Death

Facilitator should begin this exercise by saying, "What does it mean to be dead?" Then ask the children to choose a piece of paper and some crayons. Ask them to draw a picture of death on one side of the paper. After they are finished, ask them to draw a picture of life on the other side. When they are through drawing, ask each of the children to explain their pictures. Facilitators should help to clarify misconceptions and be prepared to answer questions.

G. Conclusion

Thank them for being a part of the group.

Serve refreshments.

Encourage children to take their pictures home.

Remind them that they might think about death or the person they loved during the next week and if they want to draw more pictures about what they think or feel, the facilitators would like to see those pictures at the next group session.

Session Two (7-11): Feelings

A. Introductions and Purpose of Group Session

Review thoughts the children might have had during the week.

"Hi. Its great to see you all again. Did anyone draw any pictures last week that you would like to share? Does anyone have a story of something that happened during the week that you would like to tell?" [If the children answer yes, facilitators should ask each one who wants to show something or tell something to do so.]

"This week, we want to learn more about the people you know who died -- what they were like and how you feel now that they are gone."

B. Memory Pictures

Ask the children to create pictures of things their loved one liked or that remind them of their loved one.

Suggest that children look through the magazines and cut out pictures of things that remind them of their loved one and glue them on the picture paper.

Ask each child to talk about the memory picture.

C. Feeling Picture Book

Ask the children to draw one picture each of how they look when they experience the following feelings.

"How do you look when you feel happy?"

"How do you look when you feel mad?"

"How do you look when you feel afraid?"

"How do you look when you feel like you did something wrong?"

"How do you look when you feel sad?"

Help the children staple or tape the feeling pictures together in a book with a cover on it that says "[Childs Name]s Feelings Book".

Explain that:

-- Feelings arent wrong or right but they can make us feel good or bad.

-- Everyone has different feelings at different times but most of us have similar feelings to each other at some time.

-- Sometimes it is hard to talk about what we are feeling because we dont think other people can understand, but it often helps to talk about what we are feeling because it makes us feel less lonely.

-- Continued --

Explain that these books can be used every time the group meets to show each other how each child feels that day.

Ask each child to demonstrate a feeling that they have now when they think about their loved one.

D. Conclusion

Thank the children for coming to the session.

Suggest that they take their memory pictures home.

Keep the "Feeling Books" until the next session.

Serve refreshments.

Ask the children to remember to draw pictures of what they might feel during the week so that they can bring them to the next session.

Session Three (7-11): Fear

A. Introductions and Purpose of Group Session

Review thoughts the children might have had during the week.

"Hi. Its great to see you all again. Did anyone draw any pictures last week that you would like to share? Does anyone have a story of something that happened during the week that you would like to tell?"

Ask for volunteers who want to show or tell something.

Distribute the Feeling Books.

Ask children to pick out a picture that shows how they feel right now.

Ask for volunteers to tell about the picture they chose.

Introduce the topic for the day.

"This week, we want to talk about things that we are afraid of. Lots of times when someone we love dies, we get scared about the way they died, how other people treat us, or maybe whether were going to die soon, too. Everyone is safe here right now, but I know when I get scared of something sometimes I want to curl up into a little teeny ball and hide."

B. What Makes You Scared?

Ask each child to name something that scares them and to tell why it scares them.

C. Letter Writing

Ask the children to write a letter to someone whom they think is very important or powerful and tell them in the letter what they should do about the scary thing. (Examples of people to write to include: The President, God, a policeman, a teacher, their parents.)

D. Action Planning

Divide the children into small groups of 3-5.

Tell them to talk and think about three things they want to know how to do that would make them feel safer.

Ask each group to list those three things on a piece of paper.

Ask each group to report their list to the full group.

-- Continued --

Identify things that children can learn in order to feel safer.

Demonstrate how to do simple things. Examples include:

-- How to use a fire extinguisher.

-- How to call the police or emergency services.

-- What to do if there is an earthquake (or tornado or hurricane or flood, etc.).

E. Conclusion

Thank the children for coming to the session.

Serve refreshments.

Ask the children to remember to draw pictures of what they might feel during the week so that they can bring them to the next session.

Session Four (7-11): Anger

A. Introductions and Purpose of Group Session

Review thoughts children might have had during the week.

"Hi. Its great to see you all again. Did anyone draw any pictures last week that you would like to share? Does anyone have a story of something that happened during the week that you would like to tell?"

Ask for volunteers to show or tell something.

Distribute the Feeling Books.

Ask for volunteers to choose a picture to show how they feel right now.

Introduce the topic for the day.

"This week, we want to talk abut times when we are angry. Lots of times when someone we love is killed, we get mad at the person who killed them, at people who should have helped them, at other people who dont understand. Sometimes people tell us we shouldnt be angry, but no one can help it if they feel angry sometimes when someone dies suddenly."

B. Puppet Play

Distribute paper bags, markers, colored paper, scissors and glue to the children.

Ask them to make a paper bag puppet of their favorite animal.

Ask the children to name the puppet.

Make a paper bag puppet of yourself or an animal.

Use your paper bag puppet to ask the question of each childs puppet --

"What makes you really, really mad?!"

Ask the puppets: "What do you do when you get mad?"

List all the ways that the puppets respond on the flip chart.

Distribute handout on good ways to be mad and bad ways to be mad.

Talk to the children about good ways to be mad and bad ways to be mad.

-- Continued --

C. Physical Activity

Anger creates energy that needs to be released. Facilitators can guide that activity and teach children to connect their feelings with safe physical expression.

Give the children a piece of paper and a pencil or marker.

Ask the children to write or draw about the thing that makes them angry.

Tape a large piece of paper with a big red circle on the wall.

Ask the children to wad their anger [paper] into a ball.

Ask the children to throw their anger at the circle on the wall.

Allow them to pick up the paper balls and throw them again and again.

D. Conclusion

Thank the children for coming to the session.

Serve refreshments.

Ask the children to remember to draw pictures of what they might feel during the week so that they can bring them to the next session.

Session Five (7-11): Grief and Mourning

A. Introductions and Purpose of Group Session

Review thoughts the children might have had during the week.

"Hi. Its great to see you all again. Did anyone draw any pictures last week that you would like to share? Does anyone have a story of something that happened during the week that you would like to tell?"

Ask for volunteers to show or tell something.

Distribute Feeling Books.

Ask for volunteers to choose a picture to show how they are feeling right now.

Introduce topic for the day.

"Weve talked a lot about the way we feel after someone we love is killed, but often the main thing we feel is sadness. There are a lot of reasons to be sad and most of them have to do with missing the person who is gone. Today we are going to talk about how we can remember the person we love so that their memory can be with us always."

B. Funeral Activity

Explain to children that many adults participate in memorial services and funerals to remember the person who died.

Ask the children if they attended such a service or funeral for their loved one.

Ask them if they have any questions about funerals.

Clarify any misconceptions or concerns.

Divide the children into small groups.

Ask each group to plan a funeral or memorial.

Reconvene the children as a large group and ask each group to tell or demonstrate the funeral or memorial they planned.

C. Memory Stories

Explain to the children that one way to remember someone they love is to tell stories about them to people they meet.

-- Continued --

Read a short story about someone who has died.

Ask the children to write a short story about the person they loved.

Ask for volunteers to read their stories when they are finished.

E. Conclusion

Thank the children for coming to the session.

Serve refreshments.

Ask the children to remember to draw pictures of what they might feel during the week so that they can bring them to the next session. Since the next session will be the last session, ask the children to look around during the week for something -- a memory object -- that they can bring to the group that reminds them of their loved one.

Session Six (7-11): Going on With Life

A. Introductions and Purpose of Group Session

Review thoughts the children might have had during the week.

"Hi. Its great to see you all again. Did anyone draw any pictures last week that you would like to share? Does anyone have a story of something that happened during the week that you would like to tell?"

Ask for volunteers to show or tell something that happened.

Distribute the Feeling Books.

Ask for volunteers to choose a picture and describe their feelings right now.

Introduce topic for the day.

"Today is the last time that we will meet before Thanksgiving. Its been very special getting to know each of you. But its time to say good-bye for a while. So today we want to talk about what each of us is going to do as you continue to grow up and get older. First, I want to see what memory object you brought to show us."

B. Memory Objects

Have a roll of ribbon and pre-cut hearts at least two inches in size. (Heart doilies can also be used.)

Allow each child to show the memory object, describe it and tell why it is important.

After each child tells about the memory object, the facilitators should cut a piece of ribbon and attach it to a heart.

Allow each child to write the nameof the loved one on the heart.

Tie or glue the ribbon and heart to the memory object.

Explain that in many cultures, people keep memory objects in their home or carry them with them to continue to feel that they can talk to their loved ones.

C. Looking Into the Future

Ask the children to think about what they want to be when they grow up.

-- Continued --

Divide the children into small groups and ask them to talk with each other about what they want to be and plan how to "act out" their future for the whole group.

Reconvene the children as a large group. Ask each small group to "act out the dreams" of each group member.

D. Conclusion

Thank the children for coming to the sessions.

Give each child a special memento to take home from the group (examples: a photograph of the group together, a card with autographs from each group member, a poem or quotation.)

Serve refreshments.

3. Ages 12-18

Setting: Youth should be seated in chairs around a table in a comfortable environment with the facilitators. Paper and pencils should be available on the table. Refreshments such as chips, cookies, fruit and juice or soda should be provided at the end of the session.

Tools: Paper, crayons, markers, name badge maker with colored paper, and assembly materials (alternatively: name tags with plastic holders), stickers, old magazines, small notebooks, glue sticks, flip chart.

Session One (12-18): Introduction;

Discussion of Violent Death

A. Introduce Yourselves and Explain Purpose of the Group Sessions.

"Good afternoon. I am Suzie Wilson and this is Judy Martin. We are looking forward to talking with you today. Judy and I are going to be here on Thursday afternoon every week for the next six weeks. Everyone here has known someone they loved who was killed recently. Violent death is a terrible thing and were sorry that it has happened in your lives. That is what we want to talk about -- what you think about homicide and murder and how youve been feeling. During these sessions there are some basic rules to follow so that everyone feels comfortable and has an opportunity to talk if they wish."

B. List Basic Rules; Tape to the Wall to Refer to Throughout the Session.

Rules for Group Participation

Only one person talks at a time.

Everyone has a chance to talk but no one has to.

No one should make fun of anyone else in the group.

Its okay to be upset.

Its not okay to hurt someone else.

Any question can be asked, not all questions can be answered.

Nothing said in the group should be repeated to others except for general ideas.

C. Name Game

"We also want to get to know you all a little better. So we want you to tell us your name, something about the people who died and how they died. To help us get acquainted, we have handed out two name signs -- one is a badge for you to wear and the other is a sign to place in front of you at the table. We want you to write your name on each, but we also want you to think about a picture or symbol that you think describes you or your loved one and to draw it or choose a sticker or cut out a picture that represents it and put that on the badge and sign as well."

After the youth do this, go around the circle and ask each person to say their name, describe the symbol or picture.

D. Videotape

Tell the youth:

"Many kids have had parents, siblings or friends who were killed. These facts dont make it any easier to live with a personal loss but it may help to hear how others have thought about violent death. The videotape was prepare to help kids tell other kids what they have felt after someone they loved had been killed."

-- Continued --

Show the videotape.

"You have seen some of the reactions of people who have suffered a violent death among their families or friends. Everybody reacts differently. Each of you have your own stories. We want to hear those stories to learn more about how we are different and how much we are the same."

E. Telling the Story of Violent Death

Ask the youth to close their eyes and think about the person who has died and when they first learned about the death.

Ask them to think about the following questions:

-- Where were you when it happened?

-- How did you find out what happened?

-- What do you remember seeing?

-- What do you remember hearing?

-- What do you remember smelling?

-- What did you do?

Ask them to open their eyes and ask for volunteers to tell what they thought about.

Record common crisis reactions on the flip chart.

Explain the pattern of trauma and grief reaction.

Distribute handouts on trauma and grief reactions (see Appendix I).

Ask the youth to take a piece of paper and draw a straight horizontal line across it. Tell them to mark the start of the line and indicate that the start of the line will symbolize when the death happened. The end of the line will symbolize today. Now ask them to mark on the line any significant events that have taken place since the death -- indicate those things that were unhappy events or sad times underneath the line and those that were positive or good events above the line.

Show the youth an example of such a line on the flip chart.

Ask for volunteers to describe what they have drawn on their paper.

F. Thinking About Life and Death

Begin this exercise by asking --

"What does it mean to be dead?"

"What happens when you die?"

-- Continued --

Distribute poem, "Dirge without Music" by Edna St. Vincent Millay (see Appendix II).

Read the poem and ask the group for comments and thoughts on their own perspectives of death.

Ask the group to help you list the most common conceptions of death. Include:

-- Death as an ultimate finality -- with no afterlife.

-- Biological decay of the body.

-- Death as a release of the spirit.

-- Death with an afterlife in which there is a heaven, purgatory and hell.

-- Death with an afterlife through reincarnation.

-- Death with an afterlife in heaven.

G. Recording Your Thoughts and Reactions

Distribute small notebooks to each person.

Ask them to write or draw about thoughts or reactions they have about the person who was killed during the next week. Tell them that the notebooks are to be confidential but everyone will be given an opportunity to read or show what they have recorded if they choose to do so.

F. Conclusion

Ask the group to each bring a photograph or picture of the person who was killed to the next group session.

Thank them for being a part of the group.

Serve refreshments.

Session Two (12-18): Trauma and Grief Reactions

A. Introductions and Purpose of Group Session

Review thoughts the youth might have had during the week.

"Hi. Its great to see you all again. Did anyone make any journal entries last week that you would like to share?"

Introduce topic for the week.

"This week, we want to learn more about the people you know who were killed -- what they were like and how you have been reacting since their death."

B. Picture Collage

Ask the youth to create a collage of things their loved one liked or that remind them of their loved one.

Have group members select a piece of colored construction paper.

Glue the photograph or picture of the loved one on the paper.

Suggest that group members look through the magazines and cut out pictures of things that remind them of their loved one and glue them around the picture.

Ask each young person to talk about the picture collage and describe their loved one.

C. Reaction Exercise

Tape six sheets of colored construction paper with different reactions written on them in different locations around the room. The six reactions should be:

Red - Anger

Yellow - Fear

Green - Guilt

Orange - Shame

Blue - Sadness

Pink - Happy

Explain that:

-- None of these reactions are wrong or right but different reactions can make us feel good or bad.

-- Continued --

-- Everyone has different reactions at different times to different things but most of us have similar reactions to others at some time.

-- Sometimes it is hard to talk about how we react or what we are thinking because we dont think other people can understand, but it often helps to talk about our reactions because it makes us feel less lonely.

Ask the group to choose one of these reactions to think about and then to go to the location marked by the appropriate paper.

Ask group members to tell the rest of the group:

-- what they thought about when they picked the particular reaction.

-- how they react when they feel angry, fearful, guilty, ashamed, sad, or happy.

-- what they usually do or what they would like to do when they feel angry, fearful, guilty, ashamed, sad or happy.

After each person has responded, ask the group members to select another color and reaction and move to it.

Repeat the exercise until each group member has commented on each reaction.

Ask the group to sit down.

D. Coping With Reactions

Explain that reactions can be expressed in positive or negative ways.

Ask the group to help you create a list of positive and negative ways of dealing with anger, fear, guilt, shame, sadness and happiness.

List their responses on the flip chart.

E. Conclusion

Thank the group members for coming to the session.

Suggest that they take their picture collage home.

Remind them to continue to write or draw in their journals over the next week.

Serve refreshments.

Session Three (12-18): Fear

A Introductions and Purpose of Group Session

Review thoughts the youth might have had during the week.

"Hi. Its great to see you all again. Did anyone record something in your journals that you would like to share?"

Ask for volunteers to respond.

Introduce the topic for the day.

"This week, we want to talk about things that we are afraid of. Lots of times when someone is killed, people become scared about the way they died, how other people react, what is expected of us, or maybe whether we will be killed or die soon, too. Many people are afraid of lots of things about death."

B. Fears About Death

Distribute worksheets on fears about death (see Appendix III).

Ask each group member to spend ten minutes thinking about various fears and complete the worksheets.

Instruct them not to put their names on the worksheet.

Collect the worksheets, mix them up, and distribute them back to the group making sure that no one gets their own worksheet back.

Taking each fear, one at a time, ask each group member to read what is written on the worksheet he or she now has.

Discuss the difference between practical, realistic fears and improbable fears.

C. Action Planning

Divide the youth into small groups of 3-5.

Distribute fear action planning worksheets (see Appendix IV).

Tell them to identify three practical things that they worry about or are afraid of in their everyday life.

-- Continued --

Ask them to work together to develop a plan for what they can do to make themselves feel safer.

Emphasize that the plan should include practical action steps that they can implement by themselves or with the help of other members in the community.

Ask them to identify what action that they will take during the next week to begin to implement their plan.

Ask each group to report their group plan to the full group.

D. Conclusion

Thank the group members for coming to the session.

Serve refreshments.

Remind the group to continue to record thoughts and reactions in their journals.

Session Four (12-18): Anger

A. Introductions and Purpose of Group Session

Review thoughts that group members might have had during the week.

"Hi. Its great to see you all again. Did anyone record anything in your journal during the last week?"

Ask for volunteers to show or tell something.

Ask for small group reports on what they accomplished on their action plans developed last week.

Introduce the topic for the day.

"This week, we want to talk about times when we are angry. Lots of times when someone we love is killed, we get mad at the person who killed them, at people who should have helped them, at other people who dont understand. Sometimes people tell us we shouldnt be angry, but no one can help it if they feel angry sometimes when someone dies suddenly."

B. Discussion of the Physiology of Anger

Read and distribute excerpt from Anger: The Misunderstood Emotion, by Carol Tavris (see Appendix V).

Distribute anger worksheets (see Appendix VI).

Ask the group members to fill out the worksheets.

Ask for volunteers to read the comments they made on the worksheets to the group.

C. Burning up Your Anger

Give the group members a piece of paper and a pencil or marker.

Ask the group to list the things that make them most angry about the death of their loved one.

Instruct them to check off things that they can do something about.

Divide the group into small groups of 3-5.

Distribute anger action planning worksheets (see Appendix VII).

-- Continued --

Tell them to work together to create a personal action plan for eachmember to address the issues over which they have some control.

Emphasize that the plan should include practical action steps that they can implement by themselves or with the help of other members in the community.

Ask them to identify what action that they will take during the next week to begin to implement their plan.

Pass a metal waste can or bucket around the room and ask the group members to throw the remaining list of angry things that they cant control into the can or bucket.

Set fire to the paper to symbolically burn away the anger.

D. Physical Activity

Anger can also be "burned up" or defused through physical activity.

Ask each member of the group to think of a specific type of physical activity which they enjoy that they can use to burn up anger when they become upset. Some examples might be:

-- running or jogging

-- playing football

-- playing a musical instrument

-- dancing

-- rowing a boat

E. Conclusion

Give the group the reading assignment of "Funeral and Mourning Customs", from Giving Sorrow Words by Candy Lightner and Nancy Hathaway, and distribute copies of the chapter (see Appendix VIII).

Thank the group for coming to the session.

Serve refreshments.

Remind the group to continue to record entries in their journals and to implement their fear and anger action plans.

Session Five (12-18): Grief and Mourning

A. Introductions and Purpose of Group Session

Review thoughts the youth might have had during the week.

"Hi. Its great to see you all again. Did anyone draw any pictures last week that you would like to share?"

Ask for volunteers to show or tell something.

Ask for group reports on what people have done to implement their fear or anger action plans.

Introduce topic for the day.

"Weve talked a lot about the way we feel after someone we love is killed, but often the main thing we feel is sadness. There are a lot of reasons to be sad and most of them have to do with missing the person who is gone. Today we are going to talk about how we can remember the person we love so that their memory can be with us always."

B. Funerals and Memorials Activity

Explain to the group that funerals and memorials are a way of saying good-bye to people who have died and often help people to grieve their loss. Funerals and memorials can be painful and grim for some survivors.

Ask the group how many attended such a service or funeral for their loved one.

Ask them if they have any questions about what they saw or heard.

Clarify any misconceptions or concerns.

Ask them to help you list examples of funeral or memorial customs that are used in different cultural groups or different parts of the country.

Divide the youth into small groups.

Ask each group to plan a funeral or memorial the way they would like to see one held.

Reconvene the youth as a large group and ask each group to report on the funeral or memorial they planned.

-- Continued --

C. Video and Memory Stories

Explain to the group that one way to remember someone they love is to tell stories about them to people they meet.

Show the video, "Shadow of the Dream". (Contact NOVA for information on how to obtain a copy of this video.)

Explain that Betty Jane Spencer agreed to do the video as a memorial to her boys.

Ask the group members to write a short story about the person they loved.

Ask for volunteers to read their stories when they are finished.

D. Conclusion

Assign the group members to bring a memory object to the next and last session.

Assign the group members to write a letter to the person who was killed telling them anything they would especially like them to know.

Thank the group for coming to the session.

Serve refreshments.

Remind the group to continue to record entries in their journals.

Session Six (12-18): Going on With Life

A. Introductions and Purpose of Group Session A. Introductions and Purpose of Group Session

Review thoughts the group might have had during the week.

"Hi. Its great to see you all again. Did anyone draw any pictures last week that you would like to share?"

Ask for volunteers to show or tell something from their journals.

Ask for group reports on the progress of their fear or anger action plans.

Introduce topic for the day.

"Today is the last time that we will meet before Thanksgiving. Its been very special getting to know each of you. But its time to say good-bye for a while. So today we want to talk about what each of us is going to do as you continue to grow up and get older. First, I want to see what memory object you brought to show us."

B. Memory Objects

Have a roll of ribbon and pre-cut hearts at least two inches in size. (Heart doilies can also be used.)

Allow each group member to show the memory object, describe it and tell why it is important.

After each young person tells about the memory object, cut a piece of ribbon and attach it to a heart.

Allow each person to write the name of the loved one on the heart.

Tie or glue the ribbon and heart to the memory object.

Explain that in many cultures, people keep memory objects in their home or carry them with them to continue to feel that they can talkto their loved ones.

C. Letters to Loved Ones

Ask for volunteers to read the letters they wrote to the person who was killed.

Offer to collect the letters from the group and make a book of all the letters to be distributed to all the group members.

-- Continued --

Ask if there is anything else they would like to do with the letters.

D. Thinking About the Future

Break the group into pairs of young people.

Ask each pair to take turns interviewing each other about what they want to do when they grow up and how they plan to accomplish their goals.

Tell them to be specific because after they have talked for fifteen or twenty minutes, each person will be asked to "introduce" their partner to the group as if they were now thirty-five years old.

Have the group members make their presentation.

E. Conclusion

Thank the group members for coming to the sessions.

Give each young person a certificate of completion of the group process.

Take a picture of the group together as a "graduation" picture.

F. The Need for Professional Help with

Grieving Children

While this guidebook can be used by victim assistance professionals and other caregivers to help grieving children, many children who survive the traumatic, violent death of someone whom they love may need professional mental health help.

The following may be symptoms of the need for additional help:

1. When children dont talk about the deceased, dont mention his or her name, and avoid hearing any conversations about the deceased.

2. When children becomedestructive to property, other people, pets or themselves.

3. When school performance goes down and remains low.

4. When children become overly concerned with doing anything wrong.

5. When children show a preoccupation with death.

6. When children reenact the death experience over and over. (Some reenactment is a part of ventilation, but obsessive reenactment over time may indicate extraordinary distress.)

7. When children use the death experience as an excuse for undesirable behavior.

8. When children overidentify with the deceased and begin to take on a similar personality.

9. When children show signs of having trouble eating or sleeping.

10. When children complain of not feeling good without any evident physical symptoms for a long period of time.

Back to Table of Contents