CT Children & Adolescent Loss 3 — Questions and Answers
Question 1: In Worden's Task Model applied to children, 'Task IV' involves:
- Accepting the reality of the loss
- Working through the pain of grief
- Adjusting to an environment without the deceased
- Finding a way to maintain a connection with the deceased while embarking on a new life (Correct answer)
Correct answer: Finding a way to maintain a connection with the deceased while embarking on a new life
Worden's revised Task IV reflects the continuing bonds concept, emphasizing that children can maintain an ongoing relationship with the deceased while continuing to live and grow.
Question 2: Which factor is MOST protective against complicated grief in bereaved children?
- Immediate return to school and routine activities
- Access to a consistent, emotionally available surviving caregiver (Correct answer)
- Prompt introduction to a therapist specializing in CBT
- Participation in large-group grief support programs
Correct answer: Access to a consistent, emotionally available surviving caregiver
Research consistently identifies the quality of the surviving caregiver's relationship and availability as the strongest protective factor in children's grief outcomes.
Question 3: A school counselor notices that an 8-year-old bereaved student is performing well academically and showing no behavioral problems. The counselor should:
- Conclude the child has successfully completed the grief process
- Recognize this as possible masked or internalized grief warranting periodic check-ins (Correct answer)
- Refer the child immediately for psychiatric evaluation
- Notify parents that no further grief support is needed
Correct answer: Recognize this as possible masked or internalized grief warranting periodic check-ins
Children who appear unaffected may be masking grief or internalizing it, and should still receive periodic support rather than being assumed to be fine.
Question 4: The 'dual process model' of grief (Stroebe & Schut) applied to children suggests that healthy coping involves:
- Focusing exclusively on loss-orientation tasks until grief resolves
- Oscillating between loss-oriented and restoration-oriented coping (Correct answer)
- Avoiding grief reminders to build resilience
- Prioritizing restoration-oriented tasks to maintain functioning
Correct answer: Oscillating between loss-oriented and restoration-oriented coping
The dual process model holds that adaptive coping involves moving back and forth between confronting the loss and engaging in restorative activities, with this oscillation being especially natural in children.
Question 5: When a teenager experiences the death of a close friend by suicide, the bereavement counselor's PRIMARY concern should be:
- Assessing for survivor guilt and the adolescent's own suicidal ideation (Correct answer)
- Encouraging the teen to attend the funeral to achieve closure
- Facilitating group discussion with all classmates simultaneously
- Referring the teen directly to a psychiatrist for medication evaluation
Correct answer: Assessing for survivor guilt and the adolescent's own suicidal ideation
Postvention after a peer suicide requires immediate assessment of the bereaved adolescent's own safety and suicide risk, as exposure to peer suicide increases vulnerability.
Question 6: Which approach is MOST developmentally appropriate when explaining death to a 4-year-old?
- Use euphemisms like 'passed away' to soften the concept
- Use clear, concrete language such as 'died' and explain biological finality simply (Correct answer)
- Defer all explanation until the child is older and can understand better
- Explain death in terms of a long sleep to avoid frightening the child
Correct answer: Use clear, concrete language such as 'died' and explain biological finality simply
Clear, honest, concrete language avoids confusing euphemisms and helps young children begin to grasp the reality of death without creating additional fears.
Question 7: A bereaved 12-year-old expresses that the death of her mother was 'her fault' because they had an argument the day before the death. This reflects:
- A psychotic symptom requiring immediate hospitalization
- Magical thinking and egocentric grief-related guilt common in this age group (Correct answer)
- Complicated grief disorder as defined in DSM-5-TR
- A manifestation of parentified child syndrome
Correct answer: Magical thinking and egocentric grief-related guilt common in this age group
Guilt and magical thinking about causation are common in bereaved children and adolescents, who may believe their thoughts, words, or actions caused the death.
CT Children & Adolescent Loss 3
In Worden's Task Model applied to children, 'Task IV' involves: