Caregiver Responsiveness to the Family Bereavement Program: What Predicts Responsiveness? What Does Responsiveness Predict?

OMEGA - Journal of Death and Dying, 2014

This article describes a preventive intervention to promote resilience of parentally bereaved youth. This intervention includes separate but concurrent programs for youth and caregivers that were developed to change empirically-supported risk and protective factors. We first discuss the risk that parental death confers to youth mental health and social adaptation outcomes. Next, we discuss the theoretical framework underlying this program. After describing the content and structure of the program, we describe the results of an experimental field trial and discuss directions for future work.

Journal of Palliative Medicine, 2002

have designed and run a randomized experimental trial to evaluate the Family Bereavement Program, an intervention for parentally-bereaved children and the surviving parent. The program is derived from clinical observations and research showing that loss of a parent is a highly stressful event, which can lead to future mental health problems in the child. Specifically, these researchers note that the death of a parent can lead to further family stressors, which may increase mental health problems of the surviving parent and have a negative effect on the parenting received by the child. This education and support program is designed to build coping skills within children themselves and to promote the parent's use of healthy and effective parenting skills. For children, the intervention aims to teach problem solving and emotional regulation skills to help them recognize and deal with their feelings as well as the stressful situations that can follow the death of a parent. For parents, the targeted parenting skills include fostering a warm and responsive relationship with the child, maintaining positive routines, and using effective discipline. To achieve these goals, the researchers designed separate courses for parents, children, and adolescents, which take place over twelve consecutive weeks. These sessions include group "homework" so that all family members are developing and practicing dovetailed skills. Sandler, Ayers, and Wolchik are reporting on their findings from the experimental evaluation of this group intervention elsewhere. Here they focus on the details of what they did, barriers they faced and strategies for overcoming them, as well as how the Family Bereavement Program might be adapted to other non-experimental settings.

American Journal of Community Psychology, 1992

We have illustrated how our “small theory” (Lipsey, 1990) of bereavement guided the development and evaluation of a preventive intervention for bereaved children. Our small theory, based on prior empirical research, enabled us to identify family processes that appeared to mediate the effects of parental death on child mental health. Our intervention was designed to attempt to change these processes. The evaluation of our experimental trial of the intervention assessed changes on these processes as well as the more distal mental health outcomes. The experimental trial showed some-what encouraging results, in terms of the program's ability to modify the warmth of the parent–child relationship and to decrease symptomatology in the adolescent children. We also obtained further empirical support for our underlying theoretical model. Finally, implications for redesign of the program were derived from assessing the adequacy of the program components to change each of the mediators in the theoretical model.

Journal of Child and Family Studies, 2017

Objectives: Self-compassion, which involves mindfulness, self-kindness, and common humanity, has been found to be related to individuals’ mental health. Few studies have examined caregivers’ self-compassion in relation to parenting behaviors and child adjustment in addition to its relation their own mental health. In the current study we examined caregivers’ self-compassion as a protective factor related to parentally bereaved children’s internalizing and externalizing problems and further tested whether these relations were mediated by caregivers’ mental health (complicated grief and psychological distress) and parenting. Methods: The sample consisted of 74 caregivers (female = 78.4%) who participated in a larger study designed for bereaved families. At T1 (baseline) and T2 (20 weeks later), caregivers completed measures on demographic information, self-compassion, complicated grief, parental warmth, and consistent discipline, as well as child internalizing and externalizing proble...

Death Studies, 2020

The Grief Facilitation Inventory (GFI) is a newly-developed measure of caregiver behaviors theorized to facilitate or hinder children's adaptive grief reactions. We examine its factor structure, reliability, and validity. An exploratory factor analysis identified four factors: Ongoing Connection, Existential Continuity/Support, Caregiver Grief Expression, and Grief Inhibition/Avoidance. Both child-and caregiver-report versions had adequate-to-good internal consistency. The child-report GFI showed evidence of criterion-referenced validity via significant correlations with measures of child maladaptive grief and other psychological symptoms. Results provide preliminary evidence of the reliability, validity, and clinical utility of the GFI as a measure of caregiver grief-facilitation behaviors.

Death Studies, 2020

Parents and children risk developing psychological health problems following the death of a partner/parent and may need professional support. This study used the reliable change criterion and clinically significant change to examine the outcomes of the Grief and Communication Family Support Intervention, comprising three family meetings with a family therapist, among 10 parents and 14 children, using pre-post outcome scores. The results provided preliminary evidence that the Grief and Communication Family Support Intervention may improve self-esteem and reduce anxiety in some parents and may improve communication and reduce internalizing and externalizing problems in some children.

Journal of Abnormal Child Psychology, 2006

Investigated whether three self-system beliefs, fear of abandonment, coping efficacy, and self-esteem, mediated the relations of stressors and caregiver-child relationship quality with concurrent and prospective internalizing and externalizing problems in a sample of children who had experienced parental death in the previous 2.5 years. The cross-sectional sample consisted of 340 children ages 7-16 and their surviving parent/current caregiver; the longitudinal analyses employed a subset of this sample that consisted of 100 children and their parents/caregivers who were assessed at three time points. A multirater, multimethod measure of caregiver-child relationship quality and a multirater measure of children's mental health problems were used. The cross-sectional model supported a mediational relation for fear of abandonment, coping efficacy, and self-esteem. The three-wave longitudinal model showed that fear of abandonment at Time 2 mediated the relation between stressors at Time 1 and internalizing and externalizing problems at Time 3. Implications of these findings for understanding the development of mental health problems in parentally bereaved children and designing interventions for this at-risk group are discussed. KEY WORDS: mental health problems of parentally bereaved children; negative life events; self-system beliefs; fear of abandonment; self-esteem; coping efficacy. Currently, there are approximately 2,213,000 children and adolescents younger than 18 (3.4%) in the United States who have experienced the death of a parent (Social Security Administration, 2000). Recent reviews have provided consistent evidence that bereavement is significantly related to depressive symptoms, withdrawal problems, and academic problems (

Journal of Pain and Symptom Management, 2017

Context and Objectives. Screening and baseline data on 170 American families (620 individuals), selected by screening from a palliative care population for inclusion in a randomized controlled trial of family-focused grief therapy, were examined to determine whether family dysfunction conferred higher levels of psychosocial morbidity. We hypothesized that greater family dysfunction would, indeed, be associated with poorer psychosocial outcomes among palliative care patients and their family members. Methods. Screened families were classified according to their functioning on the Family Relationships Index (FRI) and consented families completed baseline assessments. Mixed-effects modeling with post hoc tests compared individuals' baseline psychosocial outcomes (psychological distress, social functioning, and family functioning on a different measure) according to the classification of their family on the FRI. Covariates were included in all models as appropriate. Results. For those who completed baseline measures, 191 (30.0%) individuals were in low-communicating families, 313 (50.5%) in uninvolved families, and 116 (18.7%) in conflictual families. Family class was significantly associated (at ps # 0.05) with increased psychological distress (Beck Depression Inventory and Brief Symptom Inventory) and poorer social adjustment (Social Adjustment Scale) for individual family members. The family assessment device supported the concurrent accuracy of the FRI. Conclusion. As predicted, significantly greater levels of individual psychosocial morbidity were present in American families whose functioning as a group was poorer. Support was generated for a clinical approach that screens families to identify those at high risk. Overall, these baseline data point to the importance of a family-centered model of care. J Pain Symptom Manage 2017;54:126e131.

Objectives-This paper reports on results from a randomized experimental trial of the effects of the Family Bereavement Program (FBP) on multiple measures of grief experienced by parentallybereaved children and adolescents over a six year period of time.