Dealing With Death, Dying, and Grief During Adolescence provided rich statistics on the causes of death adolescents are faced with. As the course textbook explains, more of the common deaths for adolescents are violent, such as suicide, homicide, and unintentional injuries (also known as accidents) (Balk, 2014). Even though it is important to acknowledge the deaths of these adolescents, we must focus on the survivors, the friends that the deceased have left behind (my own note: maybe find a different verbiage, this sounds too mean). Through past course lectures, the course textbook, research articles, and our own personal experiences, one could see the importance a friend could be, especially during our adolescent years. Balk (2014) mentions numerous studies in the course textbook where strong peer relationships could bring great benefits to an individual. With this in mind, it’s understandable that there are ramifications a death of a friend could have on an adolescent, especially if that death is most likely is due to some act of violence. This research will present three interventions that have the capability of helping bereaved adolescents who have experienced a death of a friend.
Before assessing the potential interventions, it is pertinent to understand what realms the death of a friend affects the surviving adolescent. Over “sixty percent” of people reported a death of a friend by the time they reached college (Mash, Fullerton, & and Ursano, 2013, p.1203), and when looking at the statistics, those deaths were most likely be due to some act of violence (Balk, 2014). This is concerning considering how a death through a violent event leads to the risk of developing a plethora of mental disorders, such as panic disorders and anxiety disorders (Johnsen & Dyregrov, 2016). Aside from developing a mental disorder, adolescents are faced with the threat of having their grief disenfranchised. Balk (2014) addressed this issue in the course textbook, stating how the grief of adolescent from a death of a friend may be trivialized because they weren’t blood relatives with the deceased. The social realm of an adolescent’s life could be negatively impacted as well, as “engagement with friends” could be hindered by a death of a friend (Fiore, 2016, p. 208). Finally, adolescents are also vulnerable to experiencing complicated grief. Johnsen & Dyregrov (2016) noted that a violent death held an increased probability of the adolescent developing complicated grief. One must address these factors when developing suitable interventions for this grieving group.
As we’ve discussed multiple times in our lectures, adolescents adore music, so it is no surprise how music therapy could be the key component in helping adolescents grieving over the death of their friend. Specifically, songwriting in music therapy has a significant affect in alleviating the symptoms associated with the death of a friend. Jennifer Fiore (2016) mentions how songwriting promotes expression of one’s “thoughts and feelings” (p.207). As addressed previously, adolescents’ grief could be disenfranchised. Corr & Balk (2010) explained how those who experienced disenfranchised grief are often seen as “forgotten mourners” (p.226). This shows how the forgotten mourner doesn’t have an outlet to express their grief; this is how songwriting in music therapy could provide a way in allowing an adolescent to express their grief. In a published article discussing the benefits of music therapy, Fiore (2016) presents how songwriting allows the grieving adolescent to share their thoughts and memories regarding their deceased friend. Not only does this benefit the adolescent by providing them a voice to share their grief, but the sharing of memories also promotes the continuing of bonds with the deceased. Corr & Balk (2009) mentioned how using memories could “help maintain a continuing bond” with the deceased (p. 190). Although in their textbook Corr and Balk primarily focused on the importance of how the continuing of bonds is important for adolescents grieving over the death of a parent or sibling, I argue it is just as important for adolescents grieving over the death of a friend.
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Another intervention that has the capability to help an adolescent grieving over the death of a friend is group therapy. As previously explained, adolescents’ peer relationships may be strained when faced with a death of a friend. As discussed in past lectures and our course textbook, adolescents who are bereaved often report feeling “more mature” than their peers, which could be affiliated with a sense of not being able to fit within particular social groups (Balk, 2014, p.146). Therefore, one should promote forging peer-relations with those who’re are going through similar experiences through group therapy. In a study conducted in South Africa, support groups had significant positive effects on bereaved adolescents’ mental well-being. Within the article, it states how adolescents in South Africa are expected to be bereaved of a loved one, usually due to AIDS or other violent incidents (Thurman, Luckett, Nice, Spyrelis, Taylor, 2017).
Thurman et. Al (2017) found that bereaved adolescents who had taken part in the group therapies showed a noticeable decrease in “depression and maladaptive” (p.610). This is a welcoming finding as this research paper has already established how adolescents grieving over the death of a friend usually experiences complicated grief and symptoms associated with depression. Interestingly, Thurman et. Al (2017) also explained how adolescents in South Africa had their grief disenfranchised due to the stigma linked to HIV. Even though adolescents in the United States don’t experience the death of a friend due to HIV/AIDS, their grief is still disenfranchised nevertheless. The group therapy treatment helped the adolescents of South Africa by having them receive the social support (Thurman et. Al, 2017), thus giving a voice to those who are grieving. However, an issue Thurman et. Al (2017) ran into was how adolescents still felt a sent of embarrassment or shame due to deaths related to a stigma, which could result in them not disclosing specific information. I do believe this is a hindrance group therapy could face, and it could result in an adolescent not utilizing the full treatment. Perhaps a solution could be to have a specific support group for adolescents (ex, a support group that is only dealing with the death of a loved one who had died from AIDS).
Finally, this paper will address how the intervention of cognitive behavioral therapy (CBT) could support bereaved adolescents, specifically trauma-focused cognitive behavioral therapy (TF-CBT). Although the available research done on the effects of TF-CBT on bereaved adolescents is quite minute, there is still research on TF-CBT that could be applied to this particular targeted group. This form of CBT was attended for the treatment of those suffering from post traumatic stress disorder (Webb, Hayes, Grasso, Laurenceau, Deblinger, 2014). Luckily, as Webb et. Al (2014) explains in their article, TF-CBT has been implemented in treating those who have experienced a traumatic loss. With this information presented, it’s understandable why TF-CBT could become a prominent intervention for this particular group, as the death of a friend has the potential to traumatize the surviving adolescent (especially when considering the violent deaths adolescents are prone to face) and addressing PTSD (which as previously mentioned is associated with violent deaths); both of these factors are discussed within TF-CBT. Findings on the effectiveness of TF-CBT has shown that this therapy reduced the symptoms associated with post traumatic stress disorder (Webb et. Al, 2014). Webb et. Al (2014) also found how the TF-CBT treatment helped diminish “internalizing symptoms” (such as depression) (p.559). The findings of this research has shown how TF-CBT could be helpful to this group of adolescents, as it addresses the mental disorders that could plague them over the death of their friend.
While conducting my research, I’ve come across with a few interesting notes. Although there were a decent amount of research conducted on interventions aimed to treat adolescent bereavement, most of the research attempted to study bereavement as a whole and didn’t look into interventions on specific bereavements. For example, there were many articles on helping adolescents cope with the death of a loved one (such as a friend, sibling, or parent), but rarely on a specific type of person. In my opinion, the best way to come up with effective treatment plans is to conduct research on specific sub-groups of adolescent bereavement. Also, I hoped to find more research articles on specific interventions, but these articles were either considered too old or required a payment to access. It’s disappointing as I feel the only way one could provide the appropriate support to this group of adolescents is through having easy access to fresh, new peer-reviewed articles.
In conclusion, the death of a friend could cause numerous effects on adolescent, like developing a mental disorder. The risks of developing a mental disorder mixed in with having their grief disenfranchised causes the grieving process of an adolescent to become significantly more difficult. The interventions presented within this paper have the potential to appropriately treat the adolescents faced with this type of death. However these interventions are not perfected, and require more extensive research and need to focus on specific sub-groups (like the death of a friend).
References
- Dealing With Death, Dying, and Grief During Adolescence
- Suicidal Behavior in Children and Adolescents
- Impact of Grief on Academic Performance among Adolescents in Secondary Schools in Kenya: A Survey of Public Schools in Nakuru Municipality
- Child and Adolescent Psychiatry: The Essentials, Second Edition
- Association of Violent Death With Risky Behavior Among Adolescent Survivors
- Friendship and Grief: Examining Peer Response to Bereavement
