A few weeks ago I happened to catch Episode 557 (Birds & Bees) of This American Life. The show focused on having difficult conversations with kids. It covered topics such as race, sex and death. The last segment was particularly interesting to me because it provided a unique perspective on helping children manage grief. They featured the Sharing Place, a grief support center for families in Salt Lake City, Utah. I contacted the center to see if they would be willing to continue the conversation with me. Jill Macfarlane, their Development Director and Family Placement Coordinator, was kind enough to share some of her time with me and answered a few of my questions that came from listening to the piece.
I was really impressed by how direct some of your conversations with kids about death and grief are. Can you speak a little bit about your approach to talking to children?
I want to preface the answer by saying that here at the Sharing Place, despite what the piece portrayed, we don’t focus just on “how the person died” but rather, on the person and the memory of that person. We say over and over again that it does not matter how someone died but just that we loved them.
We do talk about the ways in which people die when kids have questions so that that they can process it in the correct way. Developmentally, kids, especially for the younger ones, tend to have imaginative thinking such that they feel they caused the death of a parent or that they are going to catch their little brother’s cancer.
We advise parents that if the child is not asking the questions, don’t give them information that they may not be ready to hear. They will ask you the questions when they are ready. We just have to be there to answer them when they are, not when we are ready to “tell them” but when they are ready to listen.
I can imagine that when a parent or another adult is dealing with their own grief that there can be a tendency to sometimes over-share.
So often, the questions will come in stages. The child may ask “how did dad die”. The parent might say, “he died from suicide”. Then the child may ask “what does suicide mean?”. And the parent can offer that suicide means that he chose to make his own body stop working because he had a sickness called depression. Then maybe six months to a year later the child may ask, “well how did he make his body stop working?”. And that may lead to more questions. As the child is ready to learn more, they will ask more questions. You don’t need to sit a four-year-old down and talk about suicide but if the child asks the question, you should definitely answer it truthfully.
What’s the best advice you can give for someone that may be more peripherally involved in a child’s life, such as a teacher, friend or even a pediatrician, to express their concern in way that is helpful for the child?
I would say don’t ask questions. Just be validating and supportive vs. peppering them with questions. Using reflective listening is really important so that the child feels heard. Instead of asking questions, we just listen and validate so they feel heard. Sometimes it’s scary for adults to hear children use big words like suicide so they just ignore it and change the subject (maybe to protect other children in the room). So the kids don’t feel heard, and in fact, they feel like their feelings don’t matter.
Another thing I’ve heard from families over and over again is how much they appreciate when you bring their person up and use their name. It can be scary because you don’t want to upset someone or open up a wound. Often times people just won’t mention their person. But really it can be so meaningful to families. So instead of saying “how was it for you on Johnny’s birthday, was it hard for you?” offering “ hey, I just remembered that it was Johnny’s birthday last week and I wanted you to know I was thinking about him”. Again, it’s the questions. People don’t want questions; they just want to know that their person is remembered and that they are loved.
I’ve often seen situations where parents will feel they need to keep their emotions in check in front of their children. What’s the best way for parents to support their children when they are dealing with their own feelings of grief and loss?
I think it’s important for parents to normalize emotions in front of kids – “mom’s sad and it’s ok for mom to be sad because mom loved dad very much”. We talk a lot about all of your feelings are ok. The behaviors that may come along with the feelings may not always be ok, but every feeling you have is ok.
We’ve often heard kids say mom didn’t’ care about dad because she never cried, and then, the kids don’t cry. There is a huge disconnect because everyone’s hiding their feelings from one another. Now if the parent isn’t getting out bed in the mornings, that may not be okay, but it’s ok for them to know you’re sad.
What’s the typical way in which you work with families in terms of time frame?
It really does vary from family to family. Some families call us two hours after the death, others may call after the funeral, and some families may not reach out to us for a year after the death. I would say after the first 6 months is when we usually see families. There are exceptions but we do have a waiting list for services so that’s when we typically start to see families. The average family stays in our program for about two years, and we’ve really found that kids do their best grief work about a year after the death. That’s when life is beginning to come back to a routine, and that’s when it really hits kids that they are not coming back.
Do you manage crisis type situations and what do you do when a family’s needs are outside of the “normal” grief process?
We do not provide therapy. We are a support group, which is completely different from therapy. Therapy and support groups work well together. We have an incredible list of therapists and resources in the Salt Lake area and we refer out for that acute, crisis management. The Sharing Place is here for long-term grief support and not necessarily the acute management. We do also have lots of community resources such as local food banks and mental health specialists.
It’s wonderful how you are able to facilitate some of these really difficult conversations with families and be such a resource and support for them during a challenging time.
This American Life did a great job on the piece but in terms of the editing I just wanted to say that with regards to the “way people die”, we don’t speak to every family about how someone died. Many, many families have already done a wonderful job talking to their kids. There are some situations, though, where families have a hard time, and they just can’t find the words. That’s when we are able to help them with the conversation.
Are the conversations usually pretty heavy or are you able to bring any joy or laughter into the groups?
That’s the beauty of the group sessions. You have these families that are new and so raw, and then you have these families who are 2 or 3 years out and at point where they can smile and laugh. It’s such a great mentoring system, that these families on this end say “wow, I can get there” and the families on the other end are saying “look how far I’ve come”.
I tell kids all the time, especially the teens, that we have fun here. Our teens tend to stay the longest. They are the hardest to get here but they stay the longest. Our groups always focus on the memories of the people. Sometimes we cry but most of the time we share, we laugh and really get to know one another.
Is it hard to say good-bye to the families once they’ve completed the program?
Yes, it is hard. We have a process called a closing. The families have to tell us three times that they are leaving before they leave group. We have a really wonderful ritual where we say good-bye. It’s sad to see them leave but at the same time, we are happy to see them move on without us.
Who decides when it’s time to leave group? Once they leave, do they come back?
They decide. There’s no time frame on our end. Once they leave, they’re done. Leaving is about a 6-week process and we are very thoughtful about it. If a new loss occurs, they can get back on the waiting list but that is very rare.
What do you think is the biggest misconception surrounding grief, and what do you think kids would want us to know?
I think they would want you to know that they want to talk about it. That they want you to remember their person and acknowledge them. They don’t want their person to be forgotten and they don’t wanted to be treated any differently. Especially for teenagers, they feel like they’ve become “that person whose brother died” and they don’t want to be treated any differently but they still want their person to be remembered.
Do you have any suggestions on helping children with loss, perhaps not at a personal level but a more global level like a death in the community or for instance the earthquakes in Nepal?
I would say it’s the same basic message – be honest in a developmentally appropriate way. Little kids may not understand earthquakes and school shootings. When they ask questions be prepared to answer them. If they aren’t asking the questions you don’t necessarily have to sit them down to talk about it. If they do ask, it’s important that the questions are answered truthfully and in language that they can understand.
At what age do those sorts of question tend to come up?
Usually 5th and 6th grade — the pre-teens are the ones that ask those sorts of questions. The younger kids are usually focused on their four walls. The pre-teens are beginning to see that there’s this whole world around them.
Do you have any resources for parents that may not be in the Salt Lake City Area?
The first group support center for children was The Dougy Center located in Portland, Oregon. We are a Dougy Center model. They have training centers all over the country. They have a tremendous amount of resources on their site – tip sheets, how to talk to kids, a teen section, etc. There’s also the National Alliance for Grieving Children and they have a resource at childrengrieve.org that helps families find local support groups.
I hope that this piece brings some insight into the ways in which we can help children manage grief and to encourage families to seek out community resources. I thank Jill Macfarlane for taking the time to speak with me and for the wonderful work that centers like hers do every day. I’m sharing some of the links that Jill provided below, and of course, I encourage you to listen to the original piece from This American Life.