Week 8: Coping With Grief and Loss If you visit the National Archives, you can view the names of thousands of brave men and women who gave their lives for their country. Many names are forever engraved into monuments and in the hearts of families everywhere. With military service comes the increased risk of experiencing grief and loss. It can come in all forms from traumatic to ambiguous loss. This week, you examine how military families cope with grief and loss. Learning Objectives Students will: Identify loss related to military families Identify coping strategies related to grief and loss Learning Resources Required Readings DeCarvalho, L. T., & Whealin, J. A. (2012). Healing stress in military families: Eight steps to wellness. Hoboken, NJ: John Wiley & Sons. Step 6, “Process” (pp. 85–102) Cohen, O., & Katz, M. (2015). Grief and growth of bereaved siblings as related to attachment style and flexibility. Death Studies, 39(1-5), 158-164. Kristensen, P., Weisaeth, L., & Heir, T. (2012). Bereavement and mental health after sudden and violent losses: A review. Psychiatry: Interpersonal and Biological Processes, 75(1), 76-97. Holmes, Allison K.; Rauch, Paula K.; Cozza, Stephen J.(2013). When a parent is injured or killed in combat. Future of Children, 23(2), 143-162. Required Media Laureate Education (Producer). (2014d). Coping with grief and loss [Video file]. Baltimore, MD: Author. Note: The approximate length of this media piece is 1 minutes. Accessible player –Downloads–Download Video w/CCDownload AudioDownload Transcript Discussion 1: Coping With Grief and Loss In film, there are many depictions of war, loss, and grief, but it in no way can it encapsulate every aspect of loss. Military families are susceptible to loss and multiple losses at that (e.g., loss of a limb, loved one, or a relationship). Therefore, helping professionals need to understand the types and depths of losses military families can experience. In addition, they need to understand how to approach military families who are grieving. Grief is the response to loss and it can be very intense and very painful; the more significant the loss the greater the grief. Smaller losses also can lead to grief, such as moving or retiring. Military families also can experience ambiguous loss, such as a family member who is missing in action. For this Discussion, think for a moment about all the changes, experiences, and losses a military family may experience in military life. As a helping professional, consider what you should know about losses for military families and how you can best support them through the lens of your specialization. By Day 3 Post a description of a type of loss specific to military families. Explain what you might need to consider in dealing with a military spouse or family members dealing with this type of loss. Provide one coping strategy you might recommend to deal with this type of loss. Cite a scholarly resource to support your response. Read a selection of your colleagues’ posts. By Day 5 Respond to two or more colleagues with your insights to any aspect of their posts. Return to this Discussion to read the responses to your initial post. Note what you have learned and/or any insights you gained as a result of the comments your colleagues made. Response 1 Lorissa Baker RE: Discussion 1 – Week 8COLLAPSE Losing something that you are so use to having, can be a very traumatic experience. A blog stated that 1,558 military personnel lost a limb as a result of being deployed in Afganistan or Iraq (Access Prosthtics, 2017). The depoyed loved one can expieriece trauma from missing a limb and so by remembering how they lost their limb. The soldier who lost their limb will have to go through extensive therapy to learn how to walk again on prostetic legs or using a prostetic arm. This therapy can be frustrating and it will cause stress on the patient. As a health care professional, I would bring each member of the family in for possible one on one sessions just to get an insight on how their life in like. Getting to know more about the family and their outlook on how life is for them will help you better access them. For the client that lost thier limbs, I would look into some groups that the miltary has to offer. Support groups are a great way to deal with traumaic expieriences. There are many veteran-focused and veteran-run support groups for PTSD, traumatic brain injury, and other conditions. The Wounded Warrior Project is a good example, as is This Able Veteran, which is a private, non-profit organization that provides trained service dogs to veterans suffering from PTSD (Military Benifits, 2020). 15 Limb Loss Statistics that May Surprise You. (2019, March 01). Retrieved July 21, 2020, from https://accessprosthetics.com/15-limb-loss-statistics-may-surprise/ PTSD Resources for Veterans & Families. (2020, June 01). Retrieved July 21, 2020, from https://militarybenefits.info/ptsd-resources-veterans/ Response 2 Kimberly Morgan RE: Discussion 1 – Week 8COLLAPSE There is never an easy way to deal with death or grief. Any type of loss pertaining to active military families will be trauma impacted and will leave a long-lasting effect on the family members left behind. In this case a husband was recently deployed and left a wife after being married for 1-year. He was killed in a car accident and needed emergency surgery. He was conscious arriving at the hospital. In the ambulance before surgery he requested for his sergeant to give a sealed letter to his wife. He informed his sergeant if he doesn’t make it out of surgery alive, the letter was in his room under his pillow. The letter thanked his wife for always being there for him and being a good wife. As a professional and dealing with death, the professional must understand and respect there are levels to death. As a professional being aware there is no quick cure. The wife left behind never received a chance to say good-bye, or get a final kiss. Utilizing the social work skills such as motivating interviewing, focused listening, and compassion can benefit this family. Undavalli, C., Das, P., Dutt, T., Bhoi, S., & Kashyap, R (2014) reports family’s members that has experienced such trauma can turn into Post-traumatic stress disorder (PTSD). According to the article “Assessment and treatment of PTSD after a motor vehicle collision: Empirical findings and clinical observations” states providing services to family’s members that are suffered from PTSD requires re-direction of their thought process to help them focus on receiving treatment. Some coping skills I would encourage the wife to get involve with some social groups with other military wives that has loss husbands. Secondly, some spiritual practices such as meditation and prayer. Lastly some emotional regulation coping skills which includes getting adequate sleep and being aware of personal negative thoughts. Beck, J. G., & Coffey, S. F. (2007). Assessment and treatment of PTSD after a motor vehicle collision: Empirical findings and clinical observations. Professional psychology, research and practice, 38(6), 629–639. https://doi.org/10.1037/0735-7028.38.6.629 Undavalli, C., Das, P., Dutt, T., Bhoi, S., & Kashyap, R. (2014). PTSD in post-road traffic accident patients requiring hospitalization in Indian subcontinent: A review on magnitude of the problem and management guidelines. Journal of emergencies, trauma, and shock, 7(4), 327–331. https://doi.org/10.4103/0974-2700.142775 To complete your Discussion, click on Discussions on the course navigation menu, and select “Week 7 Forum” to begin. Submission and Grading Information Grading Criteria To access your rubric: Week 8 Discussion Rubric Post by Day 3 and Respond by Day 5 To participate in this Discussion: Week 8 Discussion Discussion 2: Children Coping With Grief and Loss “Why isn’t daddy the same? He used to play with me before he left. Now he’s angry all the time and he ignores me. I miss him.” “My mom has a blast injury. She doesn’t remember things as much anymore and she lost her arm. We all try and help her now. It scares me to look at her arm.” “We were all watching television, me, my mom, and my brothers when the doorbell rang. It was two marines in uniform. I heard mom start to scream. I knew dad was never coming home. I was cold and scared. How come my hero isn’t coming home?” How do you begin to help a child to cope with grief and loss related to military service? Even though children may be aware that death is a possibility, what might a child think and feel and how might that child behave when dealing with the loss of a parent? For this Discussion, review this week’s resources, and consider the answers to those questions. By Day 4 Post two common reactions of children dealing with loss of a parent. Through the lens of your specialization, what considerations might you need to keep in mind as you provide support for children coping with grief and loss? Recommend one strategy for children coping with grief and loss of a military parent. Provide a scholarly resource to support your recommendation. Read a selection of your colleagues’ posts. By Day 6 Respond to two or more colleagues with your insights to any aspect of their posts Response 1 Kenechukwu Menakaya RE: Discussion 2 – Week 8 Main PostCOLLAPSE Research has shown how military children adapt to a parent’s injury or death in a war situation. However, because service members nowadays wear body armor that protects their vital organs, most severe physical injuries affect their arms, legs, and psychological abilities (Holmes, 2013). The loss of a parent or acute injures uniquely affects the children in different ways. Most reactions affect the children negatively, while some can be positive. Younger children commonly express what they feel through behavior, such as aggression, greater dependency, or regression to actions more typical of a younger child. They also develop depression, increase maladaptive behavior, and face emotional and practical difficulties like exhibiting sadness, anxiety, and confusion. While some older children, who witness their parent care in a hospital setting might react positively by taking up some caregiving responsibility to help the parent or take up some household responsibilities (Holmes, 2013). Through the lens of my specialization, the considerations that I need to keep in mind as I provide support to children coping with grief and loss are that I have to bear in mind that after losing a military parent, the family has to move to civilian life. At this junction, we need to help find adequate housing, aid with childcare, schooling, navigate military regulations and paperwork, the transition to civilian medical care, and finding a job. Also, because of the delay in diagnosing TBI and its long-term effects, Some younger children affected by a parent’s TBI can be expected to exhibit disruptive behaviors, poor academic performance, and substance abuse years later middle school and high school (Holmes, 2013). Social workers need to keep these considerations in mind by expanding community support from schools’ and providing therapists and clinicians even after their parents retire from the military (Holmes, 2013). The strategy that I will recommend for children coping with grief and loss of a military parent will be, family-centered intervention strategies. This strategy includes family care management and the provision of instrumental support. It is a collaborative care evidence-based approach developed by Zatzick et al. (2004 as cited by Breadslee, 2013) that addresses childcare, educational and social concerns along with continuous coordination of services with military children. The strategy helps children develop emotional regulation skills and provides disruptive behavior preventive strategies. Finally, the approach assists in educating children about the impact of injury and the normal recovery process, where they are in the recovery, and where they are going (Beardslee, 2013). Reference Holmes, A. K., Rauch, P. K., & Cozz, S. J. (2013). When a parent is injured or killed in combat. Future of Children. 23(2). DOI: 10.1353/foc.2013.0017 Beardslee, W. (2013). Military and veteran family-centered preventive interventions and care: Making meaning of experience over time. 16(3). DOI: 10.1007/s10567-013-0151-1 Response 2 Johnny Aragon RE: Discussion 2 – Week 8COLLAPSE I know the directions were for two, but I think that there are three reactions that I am going to look for: Silence, Reclusive and Rebellion. After the loss, all involved have to get through a period of grief (Kelly, 2001, as cited by Barbara Coloroso, n.d.). For children, “the key is getting through it, not getting around it or over it or denying it (Kelly, 2001, as cited by Barbara Coloroso, n.d.). The social worker is not there to manage the child’s(ren’s) pain, but be there for them, helping them walk through the dark period. Silence: during the periods of piercing grief and intense sorrow (up to about 6 months), children are going to go through a range of reactions. As they do, they are not always going to want to talk to someone. This is okay, but attention needs to be paid that their silence doesn’t turn into a platform where their feelings are expressed in bouts of explosive, impulsive and destructive behavior. In my opinion, it is during this time that family, friends, teachers and social worker needs to be watching for potential danger signs: taking on the identity of the deceased, angry outbursts, or signs of depression, like lack of affection and lack of interest (Fitzgerald, 2001). Reclusive and Rebellion: these are coping strategies, of course, but they both carry with them dangers that I think are worth considering. The military child already learned how to guard their heart because of the constant moving. This is really visible for military children that attend a public (non-military) school. They may be outgoing, but they are distant; they may talk, but they keep to themselves; they may discuss emotions and try to help others, but they don’t share their deepest emotions. When the parent dies, they will fall back on this behavior as a form of protection and strength, after all, it has worked up to that point. This needs to be addressed with the child. They need to know that hiding themselves (being reclusive) is an effective tool in some situations, but this is not one of them. Next, rebellion. It is natural for the child(ren) to just feel angry. Why did he/she have to die!? (I know what I said in my other post. I do believe that for the military family, they know why. Without going into great detail here, what is meant by the why is an expression of their grief and pain, not a confusion.). Based on attachment theory, the child just lost someone that they had a strong attachment to, who they felt unconditional love for and from. In that new feeling of deep emptiness, their anger is a cry, an expression of their pain. That anger becomes a rebellion when the child’s hope for their future prospects becomes oppressed by the pain, so they stop believing that better times are to come. As a result, they sabotage their life. Possible interventions The child(ren) of the deceased service member cannot be allowed to grieve in a vacuum. That is, they need to be in contact with children who are currently grieving and who have gone through the grief. Those who have gone through it are essential. They are the presence that says: life does go on and the hope is not dead. There are many organizations that focus on the children of deceased service members. Reference Fitzgerald, Helen. (2001, September 1). Children and Death: Help Grieving Students Return to School. Momentum. Kelly, Katy. (2001, January 8). After a loss, kids need to mourn-and be reassured. U.S. News & World Report. 130(1).