Phyllis R. Silverman

Parental Death and the Adjustment of School-Age Children

Findings on the emotional impact of parental death for dependent children have not been consistent due to serious methodological limitations. The Child Bereavement Study investigated a community-based sample of parentally bereaved children and compared their responses to those from matched non-bereaved controls. Children and their surviving parent were assessed four months, one year, and two years after the death using standardized instrumentation. Most of the difference between the two groups was not obvious until two years after the death. The bereaved showed higher levels of social withdrawal, anxiety, and social problems as well as lower self-esteem and self-efficacy. Although most bereaved children do not show signs of serious emotional/behavioral disturbance, there is a significantly large group of bereaved children who show serious problems at one year (19%) and at two years (21%).

Handbook of bereavement: Children's reactions to the death of a parent

There is general agreement that the death of a parent for school-age children is a very stressful experience (Antonovsky, 1979; Garmezy, 1987). Some researchers have shown that such a loss can lead to depression or other behavior problems in children and also later on as adults (Furman, 1974; Birtchnell, 1980; Bowlby, 1980; Brown, Harris, & Bifulco, 1986). In contrast, other studies have not been able to point to any consistent findings supporting the hypothesis that the death of a parent in childhood leads to an increase in problem behaviors or to an increased risk of subsequently developing psychological problems (Van Eerdewegh, Bieri, Parilla, & Clayton, 1982; Osterweis, Solomon, & Green, 1984). Berlinsky and Biller (1982), in an extensive review of the research literature, observed that this lack of consistent findings may be due to an oversimplification of outcome measures, such as the presence or absence of psychiatric symptoms or other problem behaviors. Also contributing to the confusion is the use of a singleevent model, which obscures the complexity of the situation. The death of a parent cannot be viewed as a single stressful event but as a series of events that occur before and after the death (Berlinsky & Biller, 1982; Norris & Murrell, 1987). Brown et al. (1986), in their study of depressed women who, as children, lost their mother, and Elizur and Kaffman (1983), who studied Israeli children who lost fathers in war, suggest that factors other than the loss need to be in place before a bereaved child can be considered at risk.

The Effects of Negative Legacies on the Adjustment of Parentally Bereaved Children and Adolescents

This is a report of a qualitative analysis of a sample of bereaved families in which one parent died and in which children scored in the clinical range on the Child Behavior Check List. The purpose of this analysis was to learn more about the lives of these children. They were considered to be at risk of developing emotional and behavioral problems associated with the death. We discovered that many of these “high risk” children had a continuing bond with the deceased that was primarily negative and troubling for them in contrast to a comparison group of children not at risk from the same study. Five types of legacies, not mutually exclusive, were identified: health related, role related, personal qualities, legacy of blame, and an emotional legacy. Coping behavior on the part of the surviving parent seemed to make a difference in whether or not a legacy was experienced as negative.

Children's Understanding of Funeral Ritual

One hundred-twenty children who experienced the death of one of their parents were interviewed about their view of the funeral ritual. Ninety-five percent of them attended the funeral. Shortly after the death they recalled little about the funeral. Two years later, children reported that it was important to them that they had attended. Attendance helped them to acknowledge the death, provided an occasion for honoring their deceased parent, and made it possible for them to receive support and comfort.

Parent-Child Communication in Bereaved Israeli Families

The nature of surviving parent-child communication in bereaved Israeli families is examined in terms of the culture of Israeli society. Concern is with the way the culture frames the parent-child relationship in the period shortly after the death. Twenty-three surviving parents and their forty-three children between ages of six and sixteen were interviewed four months after the death. Both parents and children seemed concerned with protecting each other from the pain and sadness associated with the loss. Two types of families were identified. In the open family, language is used to console and inform. Parents see themselves as able to respond to their child(ren)s needs. Less open families used language to influence the child to avoid their feelings and confronting the death. These surviving parents often saw the deceased as the competent family caregiver.

The Widow's View of Her Dependent Children

This paper reports observations made as part of the Widow-to-Widow program, an experiment in preventive intervention in which every newly-widowed woman under the age of 60 in a community of 250,000 was contacted by another widow to provide her with friendship and help during the critical period immediately after the death of her husband. Data presented here concern the widows view of her childs reactions to the death, and her ability to maintain her own maternal role. The availability and utilization of helping resources in the community was also studied. Discussion centers around the widows difficulties in responding to the childs communications and needs following the bereavement.

Transitions and Models of Intervention

All transitions are associated with change. People, basically conservative by nature, tend to resist change. Any intervention needs to consider that reactions to a transition are affected by prior experience, by the way transitions are viewed in an individuals social network, and by what learning opportunities are available. Responses can be viewed as typical under the circumstances, with rites of passage and helpers available to guide people in coping; or they can be viewed as a result of deficits in the individual for which treatment is prescribed. To facilitate change, seen as an expected event, individuals need to be linked to resources and information. They need role models and legitimation of their feelings. Learning, at such times of stress, seems to be facilitated by the availability of a peer, in the sense that the helper has had a similar experience. This help is available in mutual help groups. However, many kinds of help need to be available. The goal of any help is to empower the individual to cope in ways that promote growth and change.

Social work in health care: Directions in practice

As technological advances within biomedicine uncover more complex and confusing situations, social workers are forced to deal with the patient and family with greater uncertainty. To competently address todays biomedical environment with an anticipation of tomorrows advances is an incredible challenge. The focus of the theoretical framework necessary as the foundation for health care practice has shifted from an emphasis on psychopathology to a focus on what people do well, on their adaptive capacities with the goal of preventing maladaptive behavior. Therefore, the focus of practice must be on factors that affect normal or typical growth and development in the course of living and must include an understanding of the interaction between the biological, psychological, cognitive, social, cultural, and environmental dimensions of social functioning.

Services to the widowed: First steps in a program of preventive intervention

A target population of widowed people under 60 years of age is singled out as having a high risk of developing mental illness. Initial steps taken before developing a program of preventive intervention for this population are reported. Existing services are related to the various stages in the bereavement process. The abilities of existing mental health agencies to do preventive work and ideas on how other caregivers might be more helpful in programs of early intervention are discussed.A target population of widowed people under 60 years of age is singled out as having a high risk of developing mental illness. Initial steps taken before developing a program of preventive intervention for this population are reported. Existing services are related to the various stages in the bereavement process. The abilities of existing mental health agencies to do preventive work and ideas on how other caregivers might be more helpful in programs of early intervention are discussed.

Course Content for Social Work Practice in Health Care

Abstract The challenge faced by social work faculties interested in education for health care practice is to develop curricula which integrate health-specific content with traditional foundation content. This paper presents guidelines for developing such curricula. The authors propose specific course content for practice in human behavior, social environment, organization, and policy sequences which are essential to prepare social work students for careers in health care.