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Old 18.08.2009, 20:50
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English Counselling Service Switzerland Adults Coples Children Families

ENGLISH COUNSELLING SERVICE


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A fully qualified and highly experienced adult counsellor and child behaviour therapist with over 20 years NHS mental health experience.


I support clients with a wide variety of difficulties from adult depression, stress, mental illness, relationship therapy, anxiety, bereavement, relationship problems, illness, self harm to child behaviour and family problems.




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Old 18.08.2009, 20:51
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Re: English Counselling Service Switzerland Adults Coples Children Families

Special Thanks to Caroline Garrod - Child Behaviour Therapist for supplying the information


Tel: 0041 91 600 1873
Email carolinegarrod@hotmail.com Web: www.confidentialcounselling-therapyonline.co.uk/counselling.html



SUPPORTING YOUNG CHILDREN WHEN SOMEONE SPECIAL DIES
It is a shattering blow when someone close to us dies. Whilst some of us can be prepared in some way psychologically (or as much a possible I guess ) for an impending death of a loved one there are often times when this is not the case, when the death is sudden and unexpected. Whilst any death of a loved one is an immense and shattering blow a sudden death where there has been no psychological preparation at all makes it all the more difficult. A common concern that my clients complain of was not being able to say goodbye or at least tell that person important things that we would want them to know for example “Sorry” , “I love you” “Why?“ or simply “thank you!”
My reason for writing this article today was following the dreadful news about the murdered policewomen Sharon Beshenivsky . I could not help but wonder like the rest of us I am sure , what experiences her children are going through at this time (and of course her other family members and close friends) and it lead to me to think about us as adults, how well equipped are we at helping children cope with the loss of a loved one especially that of a parent. Was there a school that we went to or a book that we read on this subject that told us what we needed to do?
Whilst I am sure it is always in the back of our minds, about the day we as parents will die and leave our children, the majority of us I would assume consider and indeed hope it would be something for older age. But what if it were to happen to you or the other parent - sooner than you anticipate and suddenly at that - would you or others know how to support your child in the most useful way? How do young children handle bereavement ? What is normal and what should we expect? As adults how do we support them or help them understand?
Firstly it is helpful to have an understanding of the Childs world in relation to their age and stage of development. By understanding this we can begin to explore what type of grief reactions we would consider to expect and the type of questions the child may ask. I thought it may be helpful to provide a brief synopsis of what to expect and how you can help. Please note that this is intended as a guide only, as we are all unique individuals in our grief reactions. This information is taken from my training as a child bereavement counsellor and also my individual experience with working with bereaved children as a child behaviour therapist.
On the whole the younger child ( approx age 2 -5 ) sees death as something that is reversible or temporary. It is not uncommon for the child to expect the deceased person to come back into their life. A common question a child may ask is when they visit the grave of a loved one why are they not coming back home with them or will they be home for tea? They believe that bodily functions continue after death and may be curious to know how the person goes to the toilet or will they be having their food . They may become clingy and dislike separation - possibly through fear of loosing you too. Nightmares and regressive behaviour such as bed wetting may occur. Do not punish the child for this - try to ignore it as it usually stops after a month or so. Of course if it doesn’t then do talk to your G.P for advice.
Also because they may be too young to articulate correctly a particular question or worry it is not uncommon for them to demonstrate this through other forms of behaviour with verbal or physical aggression being quite common. The also can bounce around with their emotions for example one moment being on the floor in floods of tears and the next minute asking for their power rangers DVD on. Some parents find this confusing and feel the child is being insensitive , yet this is totally normal and common behaviour for this age group.
Children are naturally inquisitive and have enquiring minds so expect them to ask plenty of questions about the death, often repetative. Be patient with them and repeat your answers as often as they ask. It is important that you answer the children’s questions as honestly and appropriately as possible. Keep your answers short and simple - not too long either because if the child wants to know more they will ask again. Also when they ask a question , ask them what they think as this will give you some idea about what is going through their minds as well and can help you dispel any myths or confusion they may have.
They will also feel very frightened and need plenty of reassurance that you are not going to die and will keep them safe. Be honest with your child and tell them that whilst everyone dies one day, hopefully you won’t die for a very, very, very, long time and that you will do your best to keep them safe. Try as much as possible to keep to the child’s usual routine when you can as this demonstrates some return to normality back in the home. If you as an adult closed your eyes and imagined yourself in a dark room with no lights on or walls around you to keep you safe, it would feel pretty scary wouldn’t it? Therefore if you imagine this for the small child then your job as the adult in helping them feel safe is too put that light back on in their room and the walls back up - hence the reason for keeping to usual boundaries and routines as much as possible.
As the child grows a little older from age 5 onwards they start to have more of a conscience . Sometimes they may feel that it was their fault that the death occurred. Many think that their bad thoughts influence real life outcomes for example once thinking or saying to the parent “I wish you were dead” or because they had been naughty they were being punished by having their mummy / daddy taken away from them. They may also test out this belief they have as they may think if they are horrid to you then you will also die - therefore when they do certain behaviours such as these make sure that whilst you are clear on what your behaviour expectations are that you are still there for them and will keep them safe.
Watch out for the child who shows little emotion to the loss -often they hide their grief through fear of upsetting the remaining parent /relatives further -this often mislead adults into thinking the child seems to be coping well. It is also ok to cry and show your feelings of sadness tin front of the child as they need to know you are sad too.
Try to avoid phrases that mean the child is some ways takes on the role of the deceased such as “look after mummy” or “you’re the man of the house now” because these are incorrect it is the carers job to look after the child and the child and remaining parents need to stay in their correct roles .
Some children use physical aggression as an anger outlet - often due to being unable to correctly articulate their true feelings of the situation or attempting to find some control over a helpless and scary situation . It is common to take it out on the ones we are closest to ( the kick the cat syndrome) why? -because it is safer to do it to you than other people they are not as sure about. If the child does show aggressive or irritable behaviour, a good idea is to find something that enables them to channel this energy safely ( don’t let them suppress it) - for example physical exercise or perhaps an anger wall in their bedroom . Fill a bag up with rolled up socks and allow the child to throw them at the wall ( which could perhaps be painted with bricks or something of the child’s choosing) when they are feeling cross or frustrated -this way it keeps everyone safe but also lets the child vent out his frustration and gives them control of what seems at the time like a hopeless and scary situation for them .
Some other ideas that work well especially on anniversary’s of the event or birthdays etc is a balloon ceremony. The child and invited others get together perhaps in their loved ones favourite place, a small ceremony is held and each person writes and ties a message to a helium balloon that gets sent up into the sky - depending on if you believe there is a heaven I guess but this is usually one that works well. Planting bulbs that flower at special times of the year is also a good idea, as is making a memory box and putting in reminders about the deceased.
I also encourage carer’s to invite the child to the funeral - there is a temptation to protect or shield them from any “further suffering” but most children manage quite well and this is also a necessary task of the mourning process. I once worked with a family who had two children aged 2 and 4. Their father had been killed in a road traffic accident. The mother decided that the children were too young to attend so instead we asked a family friend to video the funeral. Whilst some may find this rather strange and perhaps inappropriate it actually has proved helpful - the children now aged 8 and 10 have been able to see their fathers funeral in the comfort of their own home and still felt part of the process.
In my opinion grief and the reactions that occur following a loss is a normal process and healthy response. Of course for all concerned it is a devastating blow and terribly sad time, but it does not mean that the child is unwell emotionally. From my experience of supporting bereaved children both in the N.H.S as a children’s community psychiatric nurse and also in my private practice as a Child Behaviour Therapist I have found that all too often people tend to rush out to get the professionals in, believing that “the child must have counselling“. I often wonder if the real reason is because the carers feel ill equipped in knowing how to support the child. Yet I consider it they who have the most important and useful role. Therefore unless the grief is complicated , I tend not see individual children until at least 6 months after the death as they need to time to go through the natural grieving process. I do however offer the carers immediate advice and support and work with them in advising on how to support the child. I find that by educating and empowering them to support the child in the first instance is the most useful, after all it they who the child feels closest too and looks too for advice and support, not me!
Caroline Garrod is highly trained and an experienced adult counsellor and child behaviour therapist, she is now living in Switzerland and accepts telephone and e mail consultations from all over the world including the UK on any aspect of child behaviour. QUALIFICATIONS:
BA (Hons) Adult Psychiatric Nursing
BA Child and Adolescent Psychiatric Nursing
Diploma in Person Centred Psycho-Dynamic Counselling
Qualified Bereavement Counsellor for Children
Qualified Bereavement Counsellor for Adults
Qualified N.H.S Major Accident Counsellor (Post Traumatic Stress Disorder)
Registered Mental health Nurse (R.M.N.)
Registered General nurse (R.G.N.)
Registered Sick Children’s Nurse (R.S.C.N.)
Member of the British Association of Counsellors and Psychotherapists.</B>

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Old 18.08.2009, 20:56
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Re: English Counselling Service Switzerland Adults Coples Children Families

BEHAVIOUR MODIFACTION FOR YOUR KIDS AND TEENAGERS

Adolescence is a time of immense emotional upheaval and psychosocial strain....and that is just for the parents! Teenager’s are at such a difficult stage in their life, part of them wants to do more “grown up” behaviours and yet when it suits them they want to revert back to being that small child. Very confusing and challenging for even the most patient of parents. It’s almost like they are going on 20 going on 2!! They feel such a victim in life and no/one understands them. It is very similar to being a toddler when they are wilful, inquisitive, challenging and wanting to explore and master new experiences.
Numerous challenges are faced between the parent and teenager and it is a time of adjustment and transition for all. Words such as “It’s not fair “ or “But why can’t I do....” etc are familiar words in households with teenagers. The boundaries change and parents often struggle to change them in a way that suits both them and their child or they feel worn out having to reinforce them or experience fear of being accused of being a horrible parent. It often seems a no win situation for both parents and the child.
A good idea is to consider changing the way you phrase your words. For example if your child asks if they can go out and you reply “no ....not until you have done your homework” the child usually just hears the words “no” and does not listen to the rest of what is being said, even if it is a reasonable reply . So perhaps try considering how you phrase your words and change it to a positive way such as “Yes, after you have done your homework”.
An idea I use when working with teenagers and families in conflict is the implementation of a system of rewards and consequences that reflects positive and negative behaviour. It offers clear messages to all involved.
It is like a reward chart, that you may have used when your child was small. The difference this time it’s using tickets as the reward. They are given to your child each time they achieve an objective or rule. The reason for using tickets and not a chart tick system is that it is not only visual but the child can collect them, save them and cash them in at their choosing.
So here’s what you do.........Arrange a family meeting with your child. Perhaps phrase it in a non threatening way such as “It seems like lately we are having problems all of us agreeing what behaviours and rules we as parents think we should have in the home. I wondered if maybe we have a family meeting which gives both us as your parents and you as our child to speak and explain how we are feeling and talk about how we can ALL change things to make home life a happier environment for us all “. Once you have the meeting spend time with each of you discussing what behaviours you don’t like and what you want to see more of. Allow time for everyone to speak including your child, set the agreed ground rules such as no interrupting until that person finishes speaking, respecting one another’s feelings. Maybe use a timer with an agreed amount of time each person has to speak if needed. It is very important to understand how things “feel” for each other, even if they are not true or correct. If the child refuses to participate then you remind them of the date and time the meeting has been scheduled for and the consequences if they do not attend then will have the meeting without them but that this is their chance to explain how they feel and contribute towards making changes. I stress the word contribute because it is essential they are empowered into feeling that their voice is being heard , valued and respected when making joint decisions and choices.



During the meeting, decide with child 6 behaviours that you would like to see more off from them or expect to see. Remember though to take on board they may want you to change as well so please take this into consideration. Once the changes or expectations (a nicer non threatening word) are agreed, write them on a piece of paper (parent changes included!) and get everyone to sign and place somewhere everyone can see such as the fridge. This is useful so that when there is confrontation you can merely direct one another to what you have agreed. Parents often forget the rules too and it is only fair that they consider changing when appropriate, none of us are perfect!
An idea when instigating the agreed expectations is to initially choose at least one behaviour they do well already as it gives your child an incentive to achieve. You must also make sure each rule is clear and concise. For example just saying “do as I say is not clear enough”. It would have to be more specific, such as “when I ask you to get up in the morning I expect you to do so within 5 minutes of me asking without arguing or having to be reminded”. Also make sure that the behaviours expectations are small at first because this gives the child encouragement and a chance to see the rewards they can get if they co operate. Don’t change the rules until after the first 2 weeks, because this is the practice time. After then have another family review meeting and change some of them as you all agree but it is better to not change too many in one go. The rules you remove are still expected rules by the way, but hopefully they will do this anyway by then.
Inform the child that for every time they achieve an expectation then they get a ticket. A small piece of paper the size of a raffle ticket is appropriate and can be kept in a clear glass jar for the child to actually see the positive re enforcement. Each ticket has to have an agreed value such as money or time, eg time on the computer or play station, or out with friends or social occasions. They can decide how they use the ticket to cash in. As parents you are the bankers. An added advantage is perhaps if they achieve a certain amount of tickets in week they get a bonus, eg, a rental DVD, and an extra hour out with friends etc.
If they complain that they don’t have enough money or time, or that they are being treated like a child, remind them “when you achieve your required objectives then you will have what you wanted and agreed” and “I am sorry you feel like I am treating you like a child, that is not the way it is meant to be. It seems like we have all been having lots of arguments and this seems the way to make us all happier in agreeing the rules. If you don’t like this approach then I suggest you cooperate with the rules then we don’t have to do this method.” or " it seems like you are having difficulty with these rules, what can we do to help you maintain, adhere to them " Do not enter into a vocal battle, just state your case and say something like “when you achieve your required objectives then you will have”. “That’s what we all agreed, maybe go back and see the contract we all signed” and walk away or be a broken record and repeat these types of phrases
Be careful of fraud, the child may copy the tickets; a simple solution is to write your signature on each ticket or use some special craft paper design that they cannot copy!
It takes commitment and energy and you must be consistent.
GOOD LUCK !!!
[FONT='Verdana','sans-serif']Caroline Garrod is highly trained and an experienced adult counsellor and child behaviour therapist, she is now living in Switzerland and accepts telephone and e mail consultations from all over the world including the UK on any aspect of child behaviour. [/FONT]
[FONT='Verdana','sans-serif']WWW.EXPATCOUNSELLING.COM[/FONT]
[FONT='Verdana','sans-serif']Tel 0041 91 600 1873[/FONT]

[FONT='Verdana','sans-serif']QUALIFICATIONS:[/FONT]
·[FONT='Verdana','sans-serif'] BA (Hons) Adult Psychiatric Nursing [/FONT]
·[FONT='Verdana','sans-serif'] BA Child and Adolescent Psychiatric Nursing [/FONT]
·[FONT='Verdana','sans-serif'] Diploma in Person Centred Psycho-Dynamic Counselling [/FONT]
·[FONT='Verdana','sans-serif'] Qualified Bereavement Counsellor for Children [/FONT]
·[FONT='Verdana','sans-serif'] Qualified Bereavement Counsellor for Adults [/FONT]
·[FONT='Verdana','sans-serif'] Qualified N.H.S Major Accident Counsellor (Post Traumatic Stress Disorder) [/FONT]
·[FONT='Verdana','sans-serif'] Registered Mental health Nurse (R.M.N.) [/FONT]
·[FONT='Verdana','sans-serif'] Registered General nurse (R.G.N.) [/FONT]
·[FONT='Verdana','sans-serif'] Registered Sick Children’s Nurse (R.S.C.N.) [/FONT]
·[FONT='Verdana','sans-serif'] Member of the British Association of Counsellors and Psychotherapists.[/FONT]
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