Matthew, a precocious and sensitive child, was fortunate in at least one important respect during his mother’s struggle with cancer: As her illness entered an aggressive stage, she linked the family to community agency-based and private practice social workers.

When Matthew was 6, clinical work started with a non-profit organization that provides services at no cost to children and families affected by cancer. The boy and his family developed a long-term therapeutic relationship with a private practice social worker whom they saw on and off until his early twenties.

Matthew’s story over this 14-year span is detailed in a case study authored by assistant professor Allison Werner-Lin of the Silver School of Social Work and Illinois private practice social worker Nancee M. Biank, “Growing Up With Grief: Revisiting the Death of a Parent Over the Life Course,” published in the October 2011 edition of Omega. Matthew’s case suggests the need for coordinated care for children who are moving beyond the initial trauma of a parent’s death into various stages of grieving, reliving the loss, and, finally, acceptance.

Younger children are likely to experience guilt-laden “magical thinking”—dreams and fantasies of reunion, coupled with continued devastation and regret about the life that could have been had the parent lived. Over time, as the child’s cognitive, moral, and emotional skills develop, he or she reinterprets a lost parent’s life. “We suggest here,” the authors write, “that this reworking is a lifelong process.” The complex and dynamic child-parent relationship continues, emotionally and psychologically, as does the processing of the parent’s death.

“Further, we suggest that as children interpret the death of their parent, they must also address their own earlier understandings of their parent’s life and death, and they must grieve the life they lost when their parent died,” they write.

Matthew’s grief was sometimes acute, at other times dormant, and at one point—when he was 11—a school assignment to write an autobiography reignited it. He could not complete the project and failed English.

He reconnected with therapy throughout his growth into adulthood. The clinicians, who had known his mother, were able to help him clear up misconceptions about the circumstances surrounding her death, helped him interpret his most deeply resonant dreams, and provided parent-like approval at key junctures as he began making accomplishments of his own (social workers refer to this as a critical transference experience). They worked with his father, who at times was impatient with Matthew’s lingering grief, questions, and self-doubt.

The authors note that community agencies and clinicians in private practice would do well to seek out opportunities to collaboratively establish support systems to help children when, inevitably, grief resurfaces in adulthood. Such partnerships, they write, would provide rich opportunities for true longitudinal research, helping to “normalize the ongoing nature of childhood grief to showcase the creative ways children mourn and adapt.”

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