Education of Death and Trauma Grief in Schooling Systems

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Children who undergo the death of a love one may experience depression, anxiety, sadness, loneliness, guilty, among other feelings. These symptoms may be different depending of children’s gender, age and dead of a love one. For instance, boys are more likely to be aggressive and to develop oppositional behavior, while girls are more likely to show depression and anxiety. Depending of the child’s age, young children may experience difficulty to separate from adults and teenagers may feel guilty and may suffer from dysphoria. To help children to cope with death and loss, death education and/or death counseling are necessary. Some children may not experience symptoms right away after a loss, but receiving prompt mental health treatment will help them to avoid or reduce future mental health problems (Brown, Pearlman, & Goodman, 2004).

Death Education and the School System

American children grow in a society where death is a taboo and it is avoided. Death is never mentioned in American schools except when a national trauma happens, such as the shooting in Sandy Hook elementary school who killed 20 students and six adults (Payne, 2013), or someone died by suicide because of bullying, such as Joel Morales, a twelve-year-old boy who hanged himself inside his apartment in East Harlem (Beekman, Kemp, & Hutchinson, 2012).

Death education should be incorporated in school curricula as topics such as nutrition, sex education, physical education, etc. are included. Teachers should keep classes creative, understandable and connected to real life. Some activities that they can use are talking about personal experiences about death and dying, reading obituaries in newspapers, writing letters of sympathy, making living wills, and writing what students want written on their tombs. Death education curricula should include problems in life and skills to solve those problems, love of oneself and others, copying skills to manage anger, tactics to develop tolerance and strategies to develop compassion to others.

Death education does not have to be taught in a serious, dark and isolated way. Children can learn about death by drawing, scribbling, reading books, coloring and storytelling. In sociology for instance, topics such as suicide, peer support and burial customs in different cultures are topics that talk about death and dying. In biology and chemistry, death education can be incorporated by talking about body decomposition and the effect in earth and land when someone is buried. In mathematics and economics, the cost of funeral services can be addressed as well as death trends and graphs (King-McKenzie, 2011).

Parents should also educate their children and focus on talking why and how people die instead the emotions and seriousness involved in death experiences. They can also use teachable moments, which are learning opportunities that arise out of experience in life (DeSpelder & Strickland, 2011). If a pet died, parents can teach their children about death and dying and they can also explore their feelings and believes about it.

Death education is considered a taboo and a prohibit topic in various countries. For instance in Taiwan, when death education curricula started to be thought in schools, the name of the class was changed from “life and death education” to “life education.” In 2000, government provided economical resources to teach death education in universities and secondary and primary schools and ten years later death education was extended to the national defense and campus safety. Up to date, there are difficulties to clearly define life education, and educators still have difficulty to agree in its definition. The Education Bureau mentions that the main objective of death education is to help students to develop positive values towards life and enhance them with problem solving skills so they can confront adversities and live a happy and fully life with an enhanced meaning of life.

Teachers should consider cultural beliefs and views about death and dying in the communities that they practice their professions, as well as strategies to teach death subjects. Those strategies should be based on students’ age and assessments of their knowledge of death. In addition, such strategies should impact students in a way that they can apply knowledge learned in class to real life situations. Teachers should go into training and obtain adequate credentials to teach death subjects.

According to Mak (2012) medical staff and school counselors would be the most appropriate to teach death education, but most people prefers spiritual guides or people with moral and ethics background. In addition, people who teach death studies should be comfortable of sharing their own experiences, so they can provide an open environment where students can ask questions and share their own experiences as well. Being open to talk about death it also demonstrates that the person has been working on their own healing process which it will be transmitted to students and communities. It has been found that most teachers even though have been experienced a loss, they are uncomfortable talking about death and they bring up the topic only when students ask questions; some teachers even avoid the topic.

In Taiwan, teachers do not receive appropriate counseling. More often, they receive help by consulting work colleges, community faith organizations, and some of them grieve by themselves because they do not receive the support needed from their employees. When talking about death, some teachers avoid the word this word because they think that it may make people uncomfortable. Death education curricula should review information about death and dying, students’ values, clarification, development of effective coping behaviors, and adoption of a positive attitude toward death.

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Children’s books are great tools to teach death and dying education. According to Malcom (2010), in an analysis done to 49 children’s story books it was found that they present death in a simplistic way and can be use to help bereaved children to cope with the death of a love one, including family members, friends and pets. It was also found out that books avoid any religious concentration, but heaven is seen as a place to rest and to continue life.

Death Counseling

Besides including death and dying into school curricula, group work can be a good way to teach children about this topic. Group counseling does not need to be done only after someone has experienced a death. Groups can be created to teach children about death and to explore feelings, fears and believes about it. According to Berg (1978), feelings associated with taboos such as fear and embarrassment that are recognized and treated at their early stages can potentially be overcome by clients.

Teens that discover that their peers are also dealing with fears and similar emotions can create a bond and a network of support. Berg (1978) recommends that group facilitators should be guided by participants. They may ask one question such as: Can you remember the first time that you thought about death and dying? and wait for the response of group's members to move through the discussion.

When children experience a death of a love one, family members may used words such as “went to heaven,” and “It is in a better place” It is important that counselors bring up the word “death” into their counseling process and explain what happened, so children can work towards accepting death.

When someone dies, families may use religious explanations, but children may have difficulty to understand these types of explanations. Berg (1978) recommends that children should receive information based on facts; otherwise misinformation may increase the taboo and mystery about death that surround our society.

According to Harrawood, Doughty & Wilde (2011) counselors who are new in the mental health field are uncomfortable of discussing death issues with their clients. The attitudes that they have towards death and their fears about dying may impact their work in therapy. Counselors need to have a broad perspective of death and dying, know services available in funeral homes and know how to talk to children about death subjects.

Professionals who attend training are able to incorporate in their vocabulary the word “death” instead using words such as “passing away,” They are able to provide more assistance to clients in grief, and to be less fearful and more open to talk about. It is suggested that besides providing information to students, educators need to help them to process such information. Otherwise, the outcome may be an increase of death anxiety.

A type of intervention that has been proved to be helpful is bereavement camps. According to McClatchey & Wimmer (2012), in semi-structured interviews with 19 children and 13 guardians, that were carry out between three months and nine months people’s participation in a camp was found out that, the program reduced posttraumatic stress disorder and childhood traumatic grief. Some of the activities that were included in the camp were painting feeling masks, construction of board games, attending memorial services and writing letters. Even though these activities helped children, it was found out that anxiety and sadness were not reduced. Some teens mentioned that attending grief camps helped them to normalize their feelings, increase their knowledge about death and self-worth and helped them to behave better. Adult family members referred that the camps helped to increase communication among family members and increase acceptance of the loss.

Cognitive Behavioral Interventions have also been proved to be effective to treat children who have experience childhood traumatic grief, which is defined as the experience following a death of someone in traumatic circumstances (Brown, Pearlman, & Goodman, 2004). CBT has demonstrated to reduce the symptoms of PTSD, anxiety, sadness, fear and depression and increases social and behavioral competence. It is also suggested that copying skills should be taught to asymptomatic children to prevent future mental health problems.

Trauma Grief –Cognitive Behavioral Therapy (TG-CBT) is divided into trauma-focused and grief-focused modules, each of them is eight weeks in length. Both, children and parents, participate in individual sessions and a joint session at the end of each module. The firs module is based in psychoeducation were the term of traumatic grief is defined; children identify their emotions and review the relationship between emotions, thoughts and behaviors. Stress inoculation training, cognitive restructuration, trauma narrative, and cognitive and affective processing are techniques used.

During the Grief-Focused module, the initiation of the grief is conducted with a discussion of the relationship with the death person. During memory making, children identify positive memories of the deceased and finally the importance of redefine the relationship with the deceased and with people alive. The meaning of trauma and loss is reviewed and copying skills for future events, such as anniversaries and birthdays.

Other type of counseling intervention is Family Matters. It is a therapeutic work for children and families who loss a love one of cancer (Werner-Lin, & Biank, 2012). Through holistic approach, the clinical work begins before the ill patient dies, so clinicians may build a strong relationship with the dying parent to prepare the survivors, including the child. It is believe that the connection among clinician and a dying parent increases the bond with family members and make the grief work more powerful for survivors. There are three types of interventions in this model: 1) Kids I, it is designed to help families whose love one has a new diagnosis; 2) Kids II, provides support when the ill person is having treatments, relapse or terminal illness; and 3) Turtles, it is a combination of grief work and family therapy.

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