It is not unusual for us to see children in clinic with non-specific ailments who have been bereaved and are still trying to come to terms with their loss, sometimes years later. I am sure it is not uncommon in General Practice either. Whenever a child dies at my hospital I worry about how the siblings are going to feel. Children experience death differently according to their age and stage. There is some good advice on “Explaining death to children” and some other useful links at www.bbc.co.uk/health/emotional_health/bereavement/bereavement_childtalk.shtml. www.childbereavement.org.uk/For/ForBereavedFamilies/SuggestedReadingandResources lists some very helpful reading material for all ages of bereaved people.
This month I have been across to the Margaret Centre at Whipps where our Psychological Support Service (PSS) is, to try and get a clearer idea of what sort of support there is in Waltham Forest for bereaved children and their families.
The Zig Zag Children’s Service accepts referrals from health professionals of children aged 3-11 in Waltham Forest with pre- and post-bereavement difficulties. This would include children with a life-limiting illness themselves or those with a family member with a life-limiting illness as well as those who have been bereaved. There is also a service for bereaved young people (11-17yr olds) and adults. Contact the PSS on 0208 539 5592 or by post at The Margaret Centre, Whipps Cross Hospital, Whipps Cross Road, E11 1NR for further information.
They do not offer crisis counselling but there is no stipulated amount of time a family or individual has to wait before being offered an appointment. In the ED we refer the family of a child who has died under our care to this service straight away, a letter is then sent to them suggesting that they ask their GP for a referral if they wish to make use of the child bereavement service. You can download their referral forms here:
Referral form for adults and children
Extra, additional referral form for a child (3-11yrs)
Additional referral form for young person aged 12-17 years
You may be reading this from outside our region. Nationally I can recommend the Child Bereavement Trust which is a UK charity supporting families when a child dies or is bereaved. It also trains health professionals to deal with the effect that a bereavement has on a family and indeed on us, the health professionals. http://www.bereavement.org.uk/home/html_index.asp?p=222 seems to have information on other bereavement services in London. Do leave a comment below if you want to recommend any other services you are aware of.
Some of the Zig Zag staff have added comments below which I think all of us who come across bereaved families will find helpful.
At The Margaret Centre we are re-establishing a counselling service for 12-17 year olds who have been bereaved or who are affected by life-limiting illness (themselves or of someone close to them). The Young People’s Service complements the existing Psychological Support Service provision for children and adults by offering specialist therapeutic support for teenagers, whose grieving process is inevitably affected by the physical, emotional and developmental changes of adolescence. Young People will experience and express their feelings about a bereavement in different ways, but all will experience a range of emotions when they are coping with the death of someone close and these can feel overwhelming and confusing, particularly if they find that they are not reacting in ways that are expected of them by others or if they feel the need to appear to be coping well when in fact they have a great deal of unexpressed emotion that it is hard to show or articulate. Therapeutic approaches that enable teenagers to express, explore and understand themselves and their situation in a confidential setting can be invaluable in helping them to cope with a bereavement and to acknowledge the death and what it means for them. Adolescents are always helped, moreover, by safe and honest relationships in which they are listened to without judgement, in which their feelings are honoured and in which their strengths and coping skills are affirmed. They also need time, as grieving is not a process that can be rushed and young people, like adults, need to progress at their own pace.
Kathryn Kashif, Lead Counsellor Young People, Psychological Support Services, The Margaret Centre.
For inquiries about the Young People’s Service, I can be contacted by email on kathryn.kashif@whippsx.nhs.uk or through the Psychological Support Service office.
Even in the adult service we see people who are still profoundly affected by a death which occurred in childhood – it may have been the death of a parent, grandparent, sibling or friend. Children take in information very differently to adults. It is not unusual for adults to say that the children don’t know what’s going on but they forget that a child has the ability not just to hear but also to pick up on atmospheres. They will ‘know’ if there is tension, conflict or distress in the adults around them and when no-one tells them what is going on they make up their own explanation based on their own language, age, experience and ability – so it may be a story about monsters and scary things, nightmares and fears. This can lead to them taking responsibility for an event, thinking that it is about them being ‘bad’ or ‘naughty’. Although it isn’t easy for the adults around them and the illness or bereavement may be difficult or painful to talk about, it is better to find a way to tell them the truth in a way that is appropriate to their age and level of understanding.
Our service offers parents and carers support and advice meetings. These aim to provide an opportunity for individuals to ask questions and/or discuss any concerns they may have regarding their children’s emotional well-being – following bereavement. Within this safe space, parents and carers are also helped to consider the impact the circumstances may have on the youngsters concerned. Advice is also offered and the information gained, during the meeting, enables us to plan the best way forward in terms of how our service might best support the family moving forward. This may include, for example, where appropriate, referring the family to other services.
Referrals usually come via G.P.’s. However, any professional working with the family can refer them to our service. Please contact us on 020 8539 5592 for more information or feel free to visit our offices by prior arrangement. We are more than happy to answer your questions but also welcome the opportunity to offer you support or advice, concerning bereavement, and guidance on ways in which you might support a family – if you feel this would be helpful.
Other useful bereavement organisations include: Winston’s Wish (http://www.winstonswish.org.uk/?gclid=CP6I-PPBp6wCFSIhtAodWHKQ1w) and The Childhood Bereavement Network (http://www.childhoodbereavementnetwork.org.uk/aboutUs.htm). Links to these and other related support networks and useful information can also be found via: http://www.bbc.co.uk/health/emotional_health/bereavement/bereavement_helpchildren.shtml
Jenni Whitley, Play Therapist, Psychological Support Services, The Margaret Centre. Email: jennifer.whitley@whippsx.nhs.uk
The Child Bereavement Charity is the UK’s leading charity that provides specialist support, information and training to all those affected when a baby, child or young person dies, or is bereaved. By learning continuously from families, we lead the way in improving the quality of care offered by professionals. We provide a range of training courses and award-winning resources for professionals from the NHS, emergency services, schools, social care and the voluntary sector, each year training around 5,000 professionals.
These courses include workshops specifically for Paediatric trainees: ‘Bereavement Training for Paediatric Trainees’ – Supporting Parents and children in end of life care and following bereavement.
If you would like any more information please contact training@childbereavement.org.uk, ring 01494 568 900 or browse our website http://www.childbereavement.org.uk