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Table 3 Intervention description

From: When a parent dies – a systematic review of the effects of support programs for parentally bereaved children and their caregivers

Study

Intervention description

Schilling et al. 1992 [36]

(USA)

Group intervention, “Bereavement groups for inner-city children”

Groups consisting of 6–8 children, age 6–12 years

12 sessions divided into 3 phases, each of 4 sessions

Opening phase: rules of confidentiality, conduct, purpose of the group; focus on the children’s relationship to the deceased and the impact of the loss on their family; sharing experiences related to death; supportive environment; normalizing bereavement issues

Working phase: focus on children’s feelings of sadness, anger, ambivalence related to the loss; demystifying irrational thoughts and fears about the death; identifying and expressing painful feelings

Ending phase: the termination of the group as another loss; encourage children to utilize their family as support system; children were reassessed to determine the need for further treatment

McClatchey et al. 2009 [31, 55]

(USA)

Group intervention, camp activities, “Camp MAGIC”

Groups consisting of 5–8 children, separate groups for children age 7–11 and 12–17 years

Camp activities: such as ropes course, canoeing, archery, interacting with new friends

Counseling sessions: 6 counseling sessions during a weekend (Friday-Sunday)

Focus on: trauma experience; trauma and loss reminders; post-traumatic adversities; interplay of trauma and grief; resumption of developmental progression

Grief-oriented tasks and cognitive behavioural aspects such as exposure, cognitive restructuring, stress inoculation techniques

Activities: related to grief processing such as creation, play, puppetry show, memorial service

Psychoeducational workshop for parents about children’s grieving process

Kalantari et al. 2012 [28]

(Iran/UK/Norway)

Group intervention “Writing for recovery”

Intervention for children age 12–18 years

6 sessions in school during three consecutive days, each day consists of two 15-min sessions

Writing about traumatic experiences to decrease negative thoughts and feelings

Writing sessions: Progress from unstructured expressive writing about innermost feelings and thoughts about the traumatic event/loss, to more structured writing where children reflect on what they would have given as advice to another in the same situation as themselves. In the last writing session children are asked to imagine that 10 years has passed and they look back and think about what they have learned from their experience

Black & Urbanowicz 1985 [40]; Black & Urbanowicz 1987 [25]

(UK)

Family intervention, family therapy sessions, with children age 0–16 years and their families

6 family therapy sessions spaced at 2–3 weeks intervals, in the families’ homes

Focus on: help with emotional and practical problems arising from bereavement; promote mourning in both children and surviving parent; improve communication between children and parent; improve communication about death; encourage children to talk about the dead parent and their feelings of loss and grief; encourage expression of grief in the family

Separate sessions for parents alone to enable him/her to talk about his/her own grief, anger, needs

Christ et al. 2005 [26]

(USA)

Intervention directed to the well parent and the family when a parent has cancer and is terminally ill, “The Parent Guidance Program”

Families with children age 7–17 years

6 or more 60–90 min therapeutic sessions during the terminal stage of the parents illness and 6 or more sessions after the parents death, including meetings with parent(s), children and family

Focus on: to affect the children’s adjustment to the loss by enhancing the surviving parents ability to sustain competence in providing support and care or the children; provide an environment in which the children feel able to express painful or conflicting feelings, thoughts, fantasies about the loss; maintain consistency and stability in the children’s environment; support to parents in their own grief work in order to enhance their capacity to function effectively during the family crisis; problem solving around the immediate crisis; communication about illness, loss, grief, reactions; future planning for the family

Sandler et al. 1992 [32]

(USA)

Family intervention “The Family Bereavement Program”

Intervention for families with children age 7–17 years

Program including a total of 13 sessions, consisting of a family grief workshop and a family adviser program

Family grief workshop, with 8 bereaved families per session

Focus on: to fulfil the perceived needs of bereaved families to meet with other families who have similar experiences; to improve warmth in the parent-child relationship; improve communication about grief experiences

Family adviser program, 12 sessions, including 6 individual sessions for parents and 6 family sessions

Focus on: parental support; provide emotional support; decrease parental demoralization; increase warmth of the parent-child relationship; increase positive exchanges between family members; increasing quality time between parent and child; communication in the family; planning of stable events; helping improve coping with stressful family events

Sandler et al. 2003 [33]; Schmiege et al. 2006 [37]; Tein et al. 2006 [39]; Sandler et al. 2010 [34]; Sandler et al. 2010 [35]; Luecken et al. 2010 [29]; Hagan et al. 2012 [27]; Schoenfelder et al. 2013 [38]; Luecken et al. 2014 [30]; Schoenfelder et al. 2015 [41]

(USA)

Family intervention “The Family Bereavement Program”

Intervention for families with children age 8–16 years

Program including a total of 14 sessions, consisting of 12 sessions in separate groups for caregivers, children and adolescents Four of these include conjoint activities for children and caregivers. The program also include 2 individual family meetings

Groups consisting of 5–9 children, separate groups for children age 8–12 and 12–16.

Sessions for caregivers

Focus on: improving positive caregiver-child relationship; positive parenting; effective discipline strategies; coping with grief; talking to children about grief; increase positive activities; reduce children’s exposure to negative events; family routines; family time; one on one time; communication; listening skills; decrease caregiver mental health problems

Sessions for children

Focus on: improving caregiver-child relationship; positive coping; coping efficacy; control-related beliefs; self-esteem; reduce negative appraisals for stressful events; provide opportunities for expression and validation of grief-related feelings; encouraging sharing of feelings with caregivers; individual goals selected by the children