overview grief & loss what grief looks like what is normal dos and don'ts activities ○...

30
Overview Grief & Loss What grief looks like What is normal Dos and Don'ts Activities In class demo

Upload: brandon-horton

Post on 24-Dec-2015

220 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

Overview

Grief & LossWhat grief looks likeWhat is normalDos and Don'ts Activities

○ In class demo

Page 2: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

Overview

SuicideRates & patternsProtective & risk factorsWorking with suicidal studentsRisk AssessmentCrisis managementPrevention

Resources

Page 3: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

GRIEF AND LOSS

Page 4: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

What grief looks like

Varies from child to child and across dev stages

PreschoolTend to see death as temporary and

reversibleCartoons portrayal of death

Primary/intermediate agedMore advanced view of death, though still

do not think it could happen to them or anyone they know

Page 5: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

Normal Responses Sadness immediately following death, as well as on

and off over long period of timeUnexpected moments of sadness are typical

Anger In the form of boisterous play, nightmares, irritability Often directed towards surviving family members

RegressingTypical with death of a parent Infantile behavior, demand food, attention and cuddling, baby

talk Guilt

Younger children especially feel like they were the cause of death, due to their egocentric world view

Page 6: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

DOs and DON’Ts with Grieving Students

DO listen. DO follow routines.

Routines provide a sense of safety which is very comforting to the grieving student.

DO set limits. Just because students are grieving, doesn’t

mean that the rules do not apply. DO NOT suggest that the student has grieved long enough.

Page 7: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

Dos and Don’ts DO NOT indicate that the student should

get over it and move on. DO NOT act as if nothing has happened. DO NOT say things like:

  - “It could be worse. You still have one brother.”  - “I know how you feel.”  - “You’ll be stronger because of this.”

DO NOT expect the student to complete all assignments on a timely basis.

Page 8: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

Activities for children Drawing

Family before/after loss Small groups Letter writing Puppet shows Balloon activity

All ages TR Grief DVD

http://trevorromain.com/products-page/dvd/death-dvd/

Page 9: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

Activities for adolescents Journaling/letter writing

Prompts: ○ The thing that makes me feel the saddest is .....○ If I could talk to the person who died I would ask….○ Since the death my family doesn’t….

Coping/relaxation techniquesSailboat breathing

Role plays Small groups Drawing/memory books TR DVD

Page 10: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

Activities for teens

Journaling Letter writing Reading Memory book/collage Teaching relaxation/coping strategies Small groups

Page 11: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

Discussion

For what populations to do foresee traditional responses to grief being inappropriate or ineffective?What would you do instead?

Page 12: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

Balloon Activity

Think of a significant person in your life that has passed away

If you could send them a message today, what would it say?

Page 13: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

Youth Suicide

Page 14: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

Rates & Patterns

Many youth suicides occur between ages 12-14

Incidence increases again in late teens Girls are more likely to have suicidal

ideation Boys ideation more often results in

completed suicide Highest rates among Native American

youth

Page 15: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

Risk Factors Personal characteristics

Psychopathology, namely depression○ 90% of youth suicide victims have at least one

major psychiatric disorder

Prior attempts○ Strong predictor of completed suicide

LGBTQ Personality factors

○ Poor interpersonal problem solving linked with risk of suicidal behavior

Page 16: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

Risk Factors cont.

Family characteristicsHistory of suicidal behaviorParental psychopathology

Adverse life circumstancesStressful life eventsPhysical abuse

Socioenvirnomental FactorsSchool and work problemsAccess to firearmsSuicide contagion

Page 17: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

Protective Factors

Family cohesion Religiosity Restricting access to means Peer support Pets Sound emotional regulation

Page 18: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

What to do when faced with a suicidal student.. Try to stay calm and be supportive

Student is feeling hopeless and stressed, your reaction is pivotal

Take a nonjudgmental stanceMoral reasoning is not appropriate

Encouraging self-disclosurePainful for student to share Helps with lethality assessment Empowering students, emphasizing their worth, and

making them feeling heard and respected are key elements Share with the student your responsibility to keep

them safe and your next steps to do so

Page 19: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

Things to consider when assessing risk Has the student imagined the reaction of

others to his/her death? Has the student made any final

arrangements? What is the method of planned use?

Does he/she have access to the means? Support system? Any reasons inhibiting suicide?

Page 20: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

Risk Assessment

Be direct and unambiguous in asking questions i.e. Are you considering harming yourself? If

so, how? Assess lethality of method and identify a

course of action Determine if student has a thorough

understanding of the finality of death

Page 21: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

Risk Assessment cont. Outline the steps that will be taken to help

the student Keep detailed notes Gather information from parents and

teachers Take necessary action

Call parentsLaw enforcementSocial workerNo Harm contract

Page 22: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

No harm/safety contracts Some debate regarding their use

Counselors choice to implementTend to emphasize what students won’t do,

rather than what they will doFalse sense of security

Alternatives might look like encouraging student to agree to meet weekly with you from now on

Page 23: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

Discussion

Thoughts on no harm contracts?Given that they are neither contractual nor

ensure student safety

Page 24: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

What to NOT do… Do not attempt to provide in-depth

counseling regarding their issuesThis cannot take place during height of suicidal

crisis Do not normalize suicide

It is one option, but there are stressing that others exist as well

Do not do the assessment aloneObservations made by multiple professionals are

more comprehensiveConsultation is key!

Page 25: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

Discussion

How will consultation look differently at each our your internship sites?

What barriers exist at these levels?

Page 26: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

Crisis Management/Postvention

Telephone network should be in place to notify staff and arrange staff meeting prior to following school day

Statement given to staff Esp important for contact with media

Upset students have a place to go outside of class MH resources/referrals in place for students and

families Memorial service held off school grounds

Suggested for deaths of any kind Contacting family and offer support

Page 27: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

Prevention

Coping and Support Training (CAST)Empirically supported 12 session peer group

intervention for HS students Effective with students at-risk for drop

out and screened as suicide vulnerableOver $400 for curriculum package

Communication with adminIdeally, district wide procedures

Participation in crisis teams

Page 28: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

Prevention cont.

Faculty trainingTeachers are often the first to know/suspect

Parent educationProtective factorsWarning signs

Classroom presentations re: your role as school counselor

Page 29: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

Resources

For information/resources on grief & loss: Dougy Center

http://www.dougy.org/ Hospice of the Valley

http://www.hov.org/teen_grief_program.aspx American Hospice

http://www.americanhospice.org/articles-mainmenu-8/grieving-children-

mainmenu-12

American Academy of Child and Adolescent Psychiatry http://www.aacap.org/cs/root/facts_for_families/children_and_grief

Camp Willie http://www.campfireusasnohomish.org/campwillie.htm

Trevor Romain DVD – Grades 2-8 http://trevorromain.com/products-page/dvd/death-dvd/

Page 30: Overview  Grief & Loss What grief looks like What is normal Dos and Don'ts Activities ○ In class demo

Resources cont.

Suicide Prevention Efforts Youth Suicide Prevention Program

http://www.yspp.org/ High school based prevention: CAST

http://www.reconnectingyouth.com/cast/

Responding to school crisis National Child Traumatic Stress Network

http://www.nctsn.org/resources/audiences/school-personnel/crisis-situation

UCLA Center for Mental Health in Schools http://smhp.psych.ucla.edu/

National Institute for Trauma and Loss in Children http://www.tlcinstitute.org/crisisint.html