Growing up with grief: revisiting the death of a parent over the life course.

In the era of managed care, evidence-based practice, and short term, solution focused interventions, clinicians in agency based settings generally do not have the luxury of long-term contact with bereaved children. Although a substantial, yet controversial, literature argues that children cannot fully resolve early loss until adulthood, limited attention is given to how children's understandings of early loss shift as their cognitive capacities mature. This article argues the emotional experience of grief shifts: 1) as children grapple with both normative life changes and the tasks of mourning, and 2) as their cognitive and emotional development allow them to understand and question aspects of their deceased parent's life and death in new ways. This article will present an overview of longitudinal and cross-sectional research on the long-term impact of childhood grief. We then suggest the ways bereaved children and adolescents revisit and reintegrate the loss of a parent as their emotional, moral, and cognitive capacities mature and as normative ego-centrism and magical thinking decline. To demonstrate these ideas, we draw on the case of a parentally bereaved boy and his family presenting across agency-based and private-practice work over the course of 14 years. This case suggests the need for coordinated care for children who are moving beyond the initial trauma of parental loss into various stages of grief and reintegration. While the loss of a parent is permanent and unchanging, the process is not: it is part of the child's ongoing experience. (Worden, 1996, p. 16).