What can help

The broad framework that allows children to grieve and grow through their grief has to be provided by the adults who have responsibility for their care. This includes the wider family, their teachers, youth group leaders, religious ministers and employers.

Diane Briggs runs a bereavement support group for children. "Sometimes children don't get to say goodbye or don't get to say the things they feel sorry or guilty about. So we like to give them that opportunity to say I still love you or I'm sorry and I miss you." (from the DVD Someone Died - "It happened to me" ).

Numerous studies have indicated that following the death of a parent or the departure of a parent from the family home, children tend to suffer from a loss of self esteem. In fact this often also occurs in bereaved adults who have lost a spouse. The children's sense of personal worth may be damaged and this needs to be balanced by the remaining parent and other significant adults. When a child dies in the family, the remaining brothers and sisters may feel neglected as so many emotions are centred on the dead child. In either event, it is too much to expect a grieving parent to meet all their child's needs. They will need support for themselves to better enable them to do so.

When we listen to bereaved children and teenagers, they tell us what their needs are:

• for there to be adults around them who they can turn to and trust

 • for them to have their feelings received without judgement or criticism (they will already feel vulnerable and helpless and this will be compounded by indifference or disapproval)

• for tears to be allowed to flow (it is not helpful for them to be encouraged to be brave or to become 'the man or lady of the house')

• for acceptance, when tears don't flow easily

• for a secure setting and acceptable safe ways in which anger and other feelings can be expressed

Some practical ideas for providing these safe ways are - allowing lots of physical exercise or shouting and noisy play, steering them towards cushions or a punch bag (if you have one!), acknowledging that fighting has to be kept safe but is a good way of letting out aggression, going for walks, playing sport or allowing a very messy painting session!

In the CBC children's DVD, Someone Died - "It happened to me", most of the children say that it helped to have someone to talk to. Talking within the family is essential, but intense and difficult feelings may arise at the most unexpected times and it is helpful to have someone outside of the family to talk to as well.

Practical things that may help

It can help to take time before changing things that are familiar and to include everyone in the family in making these decisions. Children and adults need time with things that belonged to the dead person. It is helpful for children to choose belongings which they can treasure. These memories are what help us get in touch with our feelings - for instance, it may be more helpful to hug each other whilst listening to a particularly emotive piece of music rather than to always avoid hearing it.

Pets can be important in children's lives when they are grieving, an animal to love or cuddle or take on walks. Equally a favourite soft toy can be very comforting and this is also true for very sick children. Touch is important. Many children like to be stroked or be given a gentle massage and a cuddle. Listening together to relaxing music, a story tape or a relaxation tape can sometimes be very helpful, especially if getting to sleep is difficult. It may help children to meet other children who have been bereaved, even watching the video "Someone died - It happened to me" elicited the response from Laura aged 10, "It’s nice to know that I'm not the only one."

In some areas there are children's bereavement services. The website of the Childhood Bereavement Network (http://www.childhoodbereavementnetwork.org.uk/ ) has a directory of children's bereavement services in the UK and our website includes a database which will give you details of support organisations in your area. It's also worth approaching your G.P. to find out what's available locally or the local branch of Cruse (an organisation supporting the bereaved) to ask if they have someone trained in supporting children, or a local children's hospice who might have someone in their team who offers additional support. Anthony says "Counsellors are helpful I feel because they won't necessarily ask you questions - they'll just say 'Well tell me about how you're feeling.' You make up your own mind. You work out for yourself how you're feeling."

Diane Briggs' group at the Marie Curie Centre in Penarth encouraged children to write about and draw their thoughts and feelings about the death and their memories. The children were given an opportunity to write down what they would have liked to say to the person who had died, tie their message to a balloon and say goodbye; a simple ceremony to help share some of the hurt and pain and begin to let it go. They lit candles to symbolise the passing on of the strengths and qualities of the dead parent, brother or sister, and planted trees in their memory.

All of these small rituals can be transposed into families, schools or youth groups if one of their members dies. Their importance lies in giving weight to the feelings the children already experience, feelings that are sometimes ignored or are beyond words.

Other ways of remembering are creating scrapbooks of times spent together or filling a 'memory box' with special things associated with the person who has died (sometimes possessions that smell of the person may be very precious). There are also special workbooks available in the CBC shop.

It can be helpful to make time for 'special days' like anniversaries, birthdays, or Mother's and Father's Days, perhaps plan to do something in memory of the person who has died. One family takes the day off work and school and buys something together for the house, others go on a special outing or visit a grave or memorial, at Christmas one family makes something for the tree, another family lights a candle to burn throughout the day.

Children and teenagers may need to look again at the details surrounding the death of the important person in their lives as they grow older. Feelings they had when they were eight will be very different several years on. This is not unresolved grief but the experience of different feelings at a later stage in life.

For those who have been bereaved a long time ago, it can still be helpful finding out details surrounding the death years later. Although this can be painful, it can also be a healing and comforting thing to do.

So - for children, what helps is:

• to be told as simply and honestly as possible what has happened

• to be reassured that they will still be loved and cared for

• to be allowed to say goodbye

• to be encouraged to participate in simple rituals

• to know that whatever they feel is alright

• to be helped to feel and express emotions

• to be told it's alright to enjoy themselves

• to be encouraged to look forward to a time when they won't forget the person who's died, but will remember without such hurt

If we listen to children, they will tell us what they need. There is clear evidence that children can survive the pain of loss providing they are loved and cared for.

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