Bereavement and Loss Training for Mental Health and

Bereavement and Loss Training for Mental Health and Pastoral Leads 2020

Delivered by: Anna Robinson BEP Mental and Emotional Health Lead Anna Bateman: BEP Strategic Lead Mandy Mc. Crohon: BEP Strategic Lead With thanks to: DSL reference group Jenny Graham: Beyond the Horizon Lisa Sabotig: Illuminate Psychology

Introduction • The information here offers some guidance and considerations for your school community • You do not have to do it all but we know schools have found the guided thinking space helpful – this is an annual training that we offer and our preference is face to face. We understand the need at this time. • Remember that looking after yourself is important. This is an emotive subject for us all (sometimes when we are not expecting it to be) • Know that the sources of support are as much for us as the leaders as they are for those whom we lead AR

Housekeeping • We will ‘mute all’ • Feel free to turn your camera off too • Questions – due to our numbers today we will not take question as we go through. You can write them in the chat and we will answer those if we can, time permitting, at the end. • Resources will be circulated • Acceptance of difference AR

What we will cover? • What we will cover: • What is bereavement and loss? • How do we process loss? üIndividual loss üSocial loss üCultural expectations • Guidance for schools including a preparedness check, helpful/unhelpful things to say for staff and staff wellbeing check in AR

We navigate change and loss more than we may realise • Moving - house and friends • Starting school, college, work • Examinations: job hopes, promotion • Serious illness or disability • Relationship breakdowns • Redundancy • Bereavement

We know that these are unprecedented times but let’s take a moment to remind ourselves about the scale of bereavement outside the here and now: • Every 22 minutes a parent of dependent children dies in the UK • Up to 70% of schools have a bereaved pupil on their roll at any given time – about 1 in 25 children have experienced the loss of a parent/sibling • 92% of young people will experience a significant bereavement before the age of 16 years Source: (Child Bereavement UK 2018) AR

What they will need is people who care and the understanding of familiar and trusted adults Schools are well placed to provide such support – just by carrying on with day-to-day activities, schools can do a huge amount to support a grieving child, family or colleague. With the right help and support, most children and young people will not require professional help or a ‘bereavement expert’. All staff having an understanding of child development is important – regression is common. Think about the student’s developmental level in your interventions rather than chronological age. AR

What is grief? • Grief is the acute pain that accompanies loss. It is deep, because it is a reflection of what we love, and it can feel all-encompassing. • It is not limited to the loss of people; it can follow the loss of a treasured animal companion, the loss of a job or other important role in life, or the loss of a home or of other possessions of significant emotional investment. • Grief is complex; it obeys no formula and has no set expiration date. • Some believe grief follows stages, others that grief is a highly individual emotion and not everyone will grieve the same way. AR

Bereavement and loss theory • Stage theories: Bowlby, Kubler. Ross • Freud – Mourning and melancholia • Process theories: Worden, Silverman and Klass, Stroebe and Schutt • And more… AR

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Stroebe M, Schutt H (1999) Theory of bereavement and loss AR

Children grieve differently • Most children do not experience the sustained intense emotions experienced by adults • Sadness may show only occasionally and briefly • Children may complain of physical discomfort – tummy ache, headache instead • Grief comes and goes and may be experienced in new ways as they grow older • Developmental milestones and events may be triggering AR

How would you recognise a grieving child? Mood Swings Sleeping pattern disturbed Difficulties with friends/peers Quiet and withdrawn Difficulty concentrating Significant behaviour change Breaking rules Increase in minor illnesses Loss of or increased appetite Regressed behaviour AR

• For very young children under 5 (although not exclusively), the concept of death as being permanent, final and forever is a difficult idea to relate to – death seems reversible however is also curious. • ‘Magical thinking’ or omnipotence – some how I caused this, naturally egocentric • Children of all ages need to be reminded that nothing that they did or did not do caused someone to die - it was not their fault. They need reassurance they are not that powerful and sometimes things happen for reasons that cannot be explained. • Abstract explanations or euphemisms difficult to understand e. g. someone being buried but also going to heaven, death being described as going on a long journey or as a long sleep. This may create worries about going to bed or about people going on journeys and not coming back. • Normality and routine are important Children’s understanding of death less than 5 years old AR

• Children are beginning to develop an understanding of death as permanent, irreversible and that life functions end when you die. • Children are starting to understand that death is universal and that includes them and those they care about • Curiosity about death may lead to lots of questions, as well as some “inappropriate” behaviour during rituals (morbid curiosity) • Children may use play to make sense of what has happened. Children’s understanding of death 6 -12 years old • Children are more aware of how others might be feeling and this may make them more empathic to others but may also make them hide their reaction for fear of upsetting others • Encourage children to express feelings and understand that they are normal AR

Adolescents and teenagers • Young people are developing their own ideas about who they are, what’s important in their lives. • Death may cause them to reflect on the meaning and purpose of life…. or not and may want to hide feelings. • Our job is letting them know we’re here to talk, or that we can help them find someone else • Death of someone important, may make them feel different at the time when, developmentally, they want to be the same as everyone else • Relationships with others are increasingly important, any loss can lead to feelings of anger/severe distress AR

Adolescents and teenagers • Have an adult understanding but not the experiences, coping skills or behaviour of an adult • May ‘act out’, show impulsive/reckless behaviour e. g. fighting/substance misuse • Wide range of emotions but may not know how to handle them/feel comfortable expressing them • Reality of death conflicts with teenage ‘task’ of being invincible • Developmental issues of independence and separation from parents can interfere with ability to receive support from adult family members • Coping strategies may cause tension with family members – adolescents may cope by spending more time with friend or withdrawing from family AR

Adults • Low motivation • Difficulty problem solving • Fear of being alone • Use of substances to medicate • Vulnerable immune system • Denial • Difficulty finding consolation • Irritability and mood swings • Sleep difficulties • Change in eating habits AR

Individual and Social Loss AR

• Anger at Higher Power • Questions of “Why me? ” and “Why now? ” Faith, Bereavement & Children • Questions about meaning of life • Feelings of being alone in the universe • Doubting or questioning current beliefs • Sense of meaninglessness about the future • Changes in values, questioning what is important AR

• You may not know or fully understand values and customs of other faiths or non-faith • Acknowledge and ask for help to understand Faith, Bereavement & Children • Find out the rituals and customs following death for that family • Distress and upset is displayed in many different ways, not always visible • Respect a child’s beliefs whatever they are – imposing your own beliefs adds to confusion • Seek help and advice from appropriate faith leaders • Involve an interpreter to help you understand the family needs AR

Endings and transitions • Remember that loss is not just about death • We experience loss in all different parts of our lives: • • • Relationship breakdowns Prolonged absence Loss of home Loss of teacher Disenfranchised grief Not being able to say goodbye (COVID 19) AB

3 ½ minute video clip Dr Susan Delaney on grieving • https: //youtu. be/F_HVe. L 99 e. K 4 AB

Things that may be helpful to say • Listen and validate • Acknowledge their fears • Reassure, but only as much as you can do so honestly • Check their understanding • Share your own feelings AB

Things that may be unhelpful to say • Avoid using euphemisms • I know how you feel” • “He/she is in a better place now” • “At least she/he lived a long life” • Everything happens for a reason” • Don’t cry” or “You need to be strong now • It could be worse. I know this person who. . . ” AB

School helps by… Normality – everything else may have fallen apart, routine offers security and continuity. Schools are excellent for this Opportunity to be a child – School gives chance for play, laughing, singing, being a child without feeling guilt Relief from grief – school can be a relief from what is going on at home General Support – systems in place to have contact with home to talk about concerns and success, helps give a realistic picture of how a child is coping An outlet for grief – sometimes children can try to sparents etc by hiding grief, school provides an outlet Resources – stories, novels, poems, giving young people a chance to talk through Listening ear – never underestimate the power of Taking care of yourself – do what you can to support listening a child or colleague without expecting too much from yourself AB

Thinking about a process MM • Be prepared- Having a policy will greatly help • Identify key people in your organisation • Decide who will take overall charge and delegate substitutes should they be absent • Decide who will be responsible for communicating directly with the families involved • Decide who will give the news to the rest of the school community

Thinking about a process • If the Press are involved, decide who will liaise with journalists • Organise training for all involved • Exemplar policies : Primary School p 69, Secondary School p 78 MM

Managing (Social) Media MM • Permission from family is crucial in any communication or social media • School cannot however ‘contain’ information that is shared within the community, it will inevitably leak out. • Communication with the whole school community with as much information (see point 1) and language appropriate for the audience, reduce anxiety and spread of rumours • High profile situations, LA can offer help and guidance on process and protocol • YP’s perspective

MM Supporting a bereaved child • Think about telling close friends away from a large assembly • Try not to judge • Check out the facts - young people need honesty. Answer awkward questions truthfully • Acknowledge what has happened – don’t be afraid to use the words dead or death “I was very sorry to hear about the death of your…” • Be prepared to listen – recognise the full tragedy, avoid comments such as “at least it’s not as bad as…. ”. You might think it’s helpful, it’s not! • Give bereaved pupils time “I’m here and am around if you want to just be. ”

MM Supporting a bereaved child • Grief is very personal – everyone deals with it differently • Whether a pupil is returning to school quickly or after a period of absence, ensure there are systems in place such as: • Time out cards – young people often feel embarrassed about showing their emotions, so this gives a way for a young person to express their grief more privately • Access to a quiet space if needed • More intensive support from identified staff • Access to any specialist support in school if wanted or other local services

Supporting grief remotely • Stay in regular contact with the bereaved child • Appoint 1 or 2 people to liaise with the child. These could be members of the bereavement team or teachers that are close to the pupil. • Schedule regular points of contact during the week using whatever mode of communication is approved by your school. • Provide a space for other children to share their grief and condolences • Let pupils know how they can come to you for support AB

As time passes… • Grief pops up…normally at the most inconvenient times! • Be prepared to listen, again and again • Give time – it may be a good while before they can fully cope with pressures of school work • Be aware of important dates, often the day itself can pass quite easily but the days after can be hard • Know that there will be things that need to happen in school that will stir up feelings e. g. an empty desk AB

When to contact a specialist • The child or young person should get specialist help if they are experiencing any of the following: • Extended period of disrupted relationships with family and friends. • Inability of parent to meet child's needs (due to parental grief). • Prolonged lack of interest in activities they used to be involved in. AB

When to contact a specialist • Prolonged refusal to attend school or poor academic performance. • Continuing problems with sleeping. • Persistent low confidence, shame or guilt. • Prolonged fear of being alone. • Signs of chronic depression. • Risk-taking behaviour, for example, drug or alcohol abuse, sexual experimentation, fighting, reckless driving. AB

When to contact a specialist • Repeated desires to join the dead person, copying symptoms/behaviour of the deceased or repeatedly dreaming of their own death. • They are convinced they have caused harm/death. • The death of their parent or sibling was by suicide. • They were directly/indirectly responsible for the death.

Links to PSHE – Primary and Secondary How to talk about their emotions accurately and sensitively, using appropriate vocabulary. How to recognise the early signs of mental well-being concerns Common types of mental ill health e. g. anxiety and depression (Secondary) AB

Looking after yourself ( Staff) • Know that you don’t have to be an expert to offer effective help • Share feelings • Anticipate that you may experience an emotional reaction – do what you can to help without expecting too much from yourself • Have information on resources staff can use or organisations they can contact MM

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Bereavement UK Birmingham Education Psychology Service Information also available via Education Psychology service based on responding to critical incidents – Birmingham EPS are offering some support time to schools via Heads MM

Kooth is a safe, confidential and anonymous way for you to access emotional wellbeing and mental health support. It is widely used across the country and is well rated by other young people. It is free for you to use. Check it out here: http: //www. kooth. com/ MM

Organisations who offer support https: //edwardstrust. org. uk/ http: //www. beyondthehorizon. org. uk/ https: //www. cruse. org. uk/children/how-tohelp https: //youngminds. org. uk/find-help/feelings -and-symptoms/death-and-loss/ https: //childbereavementuk. org/places/unit edkingdom/london/other/youngmind s-parents-helpline/ https: //www. winstonswish. org/ MM

Thank you Anna. Robinson@bep. education Mandy. mccrohon@bep. education anna@halcyon. education

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