Childhood Traumatic Grief for Mental Health Professionals and Providers

Each child grieves the death of a significant person in his or her own way. As reactions can vary according to age, ability to understand death, and personality, even children in the same family may react differently. Some children develop traumatic grief responses, making it harder for them to cope with their grief. If this happens, any thoughts—even happy ones—of the person can lead to upsetting images or memories of the way that person died. These images may occur repeatedly in the child’s mind and—because they are so upsetting—the child may avoid thinking or talking about the person or even going places or doing things associated with the person or the death. Traumatic reactions may exacerbate existing mental health issues, disrupt learning, and be misinterpreted by parents, teachers, and others.

Mental health professionals play an invaluable role in recognizing children who may be struggling with reactions to traumatic loss, assessing their needs and helping them and their caregivers receive appropriate intervention.

The following NCTSN resources provide information on the signs, symptoms, and treatments for childhood traumatic grief for Mental Health Professionals and Providers.

Page Contents:

NCTSN Resources for Mental Health Professionals and Providers

Children with Traumatic Separation: Information for Professionals (2016) (PDF)
The relationship with a parent or primary caregiver is critical to a child’s sense of self, safety, and trust. However, many children experience the loss of a caregiver, either permanently due to death, or for varying amounts of time due to other circumstances. Children may develop posttraumatic responses when separated from their caregiver.

Recognizing and Responding to Childhood Traumatic Grief
Helping Teens with Traumatic Grief: Tips for Caregivers (PDF)
Describes the feelings of teens struggling with the death of someone significant and what you can do to help.

Helping Young Children with Traumatic Grief: Tips for Caregivers (PDF) 
Outlines the feelings of children struggling with the death of someone meaningful and what you can do to help.

Helping School-Age Children with Traumatic Grief: Tips for Caregivers (PDF) 
Explains the thinking of school-age children with traumatic grief and ways you can help.

Childhood Traumatic Grief Additional Resources—For Caregivers (2010) (PDF)

Childhood Traumatic Grief Additional Resources—For Children and Teens (2010) (PDF)

It's Okay to Remember (Video)
In this video, a moving first-person narrative illustrating how a family can cope with the pain of death and eventually heal, family members share their story of the traumatic grief of one daughter after her sister's sudden death. The video helps parents, educators, pediatricians, and others who care for children to understand childhood traumatic grief.

Ready to Remember: Jeremy's Journey of Hope and Healing (PDF)
Ready to Remember tells the story of a 10-year-old boy following the tragic death of his father. Jeremy has reactions to traumatic reminders, and he struggles at school and at home. Developed for the school-age reader, with a caregiver guide, the illustrated book describes Jeremy's journey as he and his family get help and are able to enjoy happy memories together.

Rosie Remembers Mommy: Forever in Her Heart (2015) (PDF)    
Rosie Remembers Mommy: Forever in Her Heart is the story of a young girl who is struggling after the death of her mother. We follow Rosie as she expresses wishes to see her mom, feels reluctant about school, finds no pleasure in activities she formerly found enjoyable, wonders whether she could somehow have caused her mother’s death, and even refuses her favorite meal that Daddy has made. Rosie and Daddy go to meet Anna, who works with children after someone dies. Through play, song, and art, Anna helps Rosie eventually cope with the loss of her mother. The story also helps illustrate how a parent can provide solace and support to a child after a death.
This book is dedicated to the memory of Dr. Patricia Van Horn who championed the care of traumatized young children and families. She will stay forever in our hearts.
This training video for mental health professionals presents critical core components of trauma-focused cognitive behavioral therapy for children who suffer from childhood traumatic grief. The video includes helpful demonstrations of each treatment component through role-plays conducted with children. The material represents the results of significant advances in the field of childhood traumatic grief and the unique collaboration of researchers and clinicians in academic and community settings throughout the country. To order a free CD of the video from the Substance Abuse and Mental Health Services Administration's store, click here.
The Courage to Remember Curriculum Guide (PDF)
     >Japanese: 思い出す勇気 (2015) (PDF)
Developed as a companion to the training video The Courage to Remember, the guide presents an in-depth description of the treatment components (both individual and group interventions) for children and caregivers affected by traumatic grief. Clearly organized and labeled for ease of use, the guide includes main therapeutic concepts, therapeutic activities, case examples, handouts, and resources. The material represents the results of significant advances in the field of childhood traumatic grief and the unique collaboration of researchers and clinicians in academic and community settings throughout the country.

Childhood Traumatic Grief Educational Materials
The following materials on childhood traumatic grief present general information for parents and in three formats: (1) an overview in 4 pages; (2) an in-depth guide to Childhood Traumatic Grief in six-pages; and (3) a brief information sheet in a one-page, two-sided handout.


Unconfirmed Death and Childhood Traumatic Grief
An unconfirmed death occurs when a family does not know if a missing person has died and whether or not that the person will return. Such situations can occur during war, through kidnapping, or during natural disasters such as floods or earthquakes. In such cases, children may continue to hope, imagine, or plan for the person's return and feel guilty or disloyal during rituals or holidays spent without the missing person. The uncertainty of the death can be confusing and can mean that traditional and potentially comforting rituals, such as a funeral, cannot take place. Unconfirmed death can also lead to traumatic grief reactions in children.

Coping with Unconfirmed Death: Tips for Caregivers of Children and Teens (2009) (PDF)
Unconfirmed death can be traumatic for children and teens, in part because the uncertainty about the death makes it difficult for them to complete many of the tasks of normal bereavement. This publication offers caregivers advice on helping children deal with the complex emotions that arise when the death of family member or other meaningful person in a child's life is suspected, but unconfirmed.

Sibling Death and Childhood Traumatic Grief
The death of someone significant can be very difficult and sad for a child or teen, but when a sibling dies, the family faces a unique set of challenges. Siblings often have very complicated relationships, with conflicting feelings for each other. When a sibling dies, past interactions and feelings can affect the surviving child's grief and the family's bereavement process.

Sibling Death and Childhood Traumatic Grief: Information for Families (2009) (PDF)
This publication offers caregivers information about the particular grief reactions that a child may have when a brother or sister dies and provides tips to help the grieving child. It includes an extensive listing of books—organized by age of the intended audience—websites, and videos. Sibling Death and Childhood Traumatic Grief also offers self-care advice for caregivers to help them cope with their grief reactions.

Sibling Death and Traumatic Grief Additional Resources—For Caregivers (2010) (PDF)
Sibling Death and Traumatic Grief Additional Resources—For Children and Teens (2010) (PDF)

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Learning Center for Child and Adolescent Trauma: Child Traumatic Grief Webinar Speaker Series

Childhood Traumatic Grief: Issues and Interventions Related to Military Children  
In this webinar, Heather Campagna and Robin Goodman address child traumatic grief within the context of a military family, including why a military death is different, the use of TF-CBT, and the Tragedy Assistance Program for Survivors.

Cultural and Contextual Considerations in the Treatment of Childhood Traumatic Grief  
In this webinar, Chandra Ghosh Ippen and Susana Rivera discuss culture, context, and perspective as related to the treatment of child traumatic grief. Questions addressed include “Does the child need treatment?” “How is death experience affected by cultural and contextual factors?” and “How is the experience influenced by family values?”

Grief, Loss, and the Path of Healing among American Indian Youth and Communities  
Webinar presenters—two clinicians who are native to Montana tribes and two non-native clinicians who have worked in an American Indian community—discuss the unique experience of loss and grief of American Indian children and communities, review death and loss within an intergenerational context, and teach participants about grounding interventions, assessments, and research in culture and community. Presenters demonstrate how to adapt interventions to accommodate culture and evaluate instruments for cultural effectiveness.

Growing Up with Traumatic Grief  
In this webinar, speakers address child traumatic grief and loss through the experience of a young woman whose parent died in a tragic accident. Presenters provide a knowledge base for individuals in systems that serve children, adolescents, and their families who have experienced traumatic grief, including parents, teachers, child welfare workers, resource parents, caregivers, and mental health providers.

Holidays, Celebrations and Traumatically Bereaved Children
Webinar presenters discuss ways holidays and other personally meaningful dates can serve as trauma/grief reminders, including how culture can dictate children's reactions to reminders and the need for therapists to understand their clients' culture. The presentation also addresses personal, public, and school-related reminders, and the presenters offer ways parents, teachers, and other adults can support traumatically bereaved children.

Ready to Remember: Helping Children with Traumatic Grief  
Webinar presenters describe childhood traumatic grief and introduce their book, Ready to Remember: Jeremy’s Journey of Hope and Healing. Along with the authors, family members answer questions about the experience of processing their grief, the treatment they received, and the coping skills and resilience of their families.

Schools and Grief: Helping Students Cope with Death  
In this webinar, presenters focus on childhood grief in the school setting: physical and behavioral responses, the effects of development and culture, and the difference between CTG and grief. Presenters also provide strategies for helping children cope with grief in school.

Treatment of Childhood Traumatic Grief with Infants, Toddlers, and Preschoolers  
Webinar presenter, Chandra Ghosh Ippen provides an overview of the effects on clinicians of working with bereaved children. She discusses loss from the child and caregivers' perspectives, details how traumatic grief effects development, and describes assessment and treatment options.

You are Not Alone: Helping Children with Traumatic Grief  
In this webinar, presenters explain traumatic grief in preschool- and school-aged children, introduce resources for children and caregivers developed by Sesame Workshop and the NCTSN, and describe how clinicians and caregivers can use these resources to help children in their process of grieving.

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