Counselling children `can add to grief'

THE COUNSELLING of bereaved children may do more harm than good, according to an expert in child psychiatry.

Children are extremely resilient and those with good self-esteem and strong relationships with surviving family members get through bereavement surprising well, said Richard Harrington, professor in child psychiatry at the University of Manchester.

In a paper published today in the Journal of the Royal Society of Medicine he said it "may not be necessary to encourage children through the painful process of crying and expressing sadness". In fact, children separated from a parent by divorce have a higher risk of mental illness than those who experience parental death.

Estimates suggest that each year more than 100,000 British children lose a parent, brother or sister. The belief among professionals that such deaths have a detrimental effect on their emotional development has led many health authorities to offer specialist bereavement programmes for children.

But Professor Harrington, who has reviewed a wide range of child bereavement and counselling studies, says there is no evidence that counselling is effective or that children who suffer bereavement are more likely to become depressed or have social problems.

"We cannot be confident that the theory behind some childhood bereavement programmes is sound," he said. "Most children do not show the period of withdrawal and despair that some theories would suggest, and failure to mourn does not seem to be linked to later psychological disorders."

But one of Britain's leading experts in the field, Dr Jean Harris-Hendriks, a consultant in child and adolescent psychiatry at the Traumatic Stress Clinic in London, said children should not be left alone after a death in the family.

"Counselling may not be the right thing for some children but they should receive psychological first aid and be evaluated," she said. "There is often a conspiracy of silence when someone in the immediate family dies. The adults do not want to upset the child and the child in turn does not want to upset their parent, which can be very damaging for children."

Children who saw a violent death, either a parent committing suicide or one parent killing the other, were particularly in need of help. "The effect of such a trauma is to hinder mourning. Children can get stuck emotionally. They do not grieve and tend not to form attachments with other people."

Winston's Wish, a grief support programme based in Gloucestershire, helps about 250 children a year.

"We only counsel about 10 to 15 per cent of the children," said a spokesman. "Our main purpose is to put children in contact with other children in a similar position and give them room to talk about it if they wish in an informal way. If their grief becomes complicated or pathological then we will offer professional counselling.".

Leading article, Review, page 3

Virginia Ironside,

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