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Many children and teens are referred for and participate in therapeutic counseling, often for extended periods of time. And yet, the effectiveness of this treatment approach for children and teens, living in out-of-home care, has been inconsistent. One variable to therapeutic intervention is related to the consistency of responses to their experiences and feelings of loss. Children live in the moment. While they may not be expressing grief on a 24 hour basis, they are, nevertheless in mourning. Feelings are expressed through behaviors at the time they are felt. Rarely do they verbally identify that these behaviors are connected to the pain of the losses. The grief may be expressed as, “not feeling good”, uncommon fears, or, feeling sleepy or tired. It may be an over or under reaction the anything.

Children and teens who have had traumatic and multiple losses have layers of grief to express. We see it in their chaotic-ness. One moment they can be playing or talking in a “normal” context, and then quickly change into behaviors that seem to have not basis or logic to the current context. At these times, it is essential that those who are present to these behaviors respond to then to the child/teen feelings associated with loss. If nothing is done to acknowledge the hurts, the opportunity has passed. Their resulting experiences may be feelings of being alone, not being seen; they often experience feelings of rejection believing that no one cares about them. When feelings are not validated, they may feel abandoned or ignored.

When they are presenting their behaviors, questions, or fears, they are giving us their hurt, wanting us to respond to their need for comfort and assurance that their feelings are real. In therapy/counseling sessions, therapists are put at a disadvantage when they do not have the opportunity to experience the child’s emotions in the moment, unless they are able to recreate those feelings in the child/teen during the session. This requires the child/teen to conjure up these past feelings, out of context, or to be in a “holding memory” to talk about the event putting them in a cognitive process to “talk” about their feelings. Often, when they choose not to talk about previous events, they are identified or labeled as resistive or unmotivated to engage in treatment.

Children and teens do not grieve by appointment.

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