Medical Assignment: Analysis of Parental Loss and Grief in Adolescents

This medical assignment critically analyzes the impact of parental loss on adolescents, focusing on the complexities of grief reactions. The paper explores both normal and complicated grief responses, including the stages of grief as outlined by Kubler-Ross and the tasks of mourning. It delves into the potential consequences of parental death, such as psychological issues, behavioral changes, and the risk of complicated grief, including symptoms like prolonged disbelief, intrusive thoughts, and functional impairment. The assignment also highlights the role of helpers, such as bereavement counselors, and the application of therapies like cognitive behavioral therapy and meaning therapy in supporting adolescents through their grief. The analysis emphasizes the importance of differentiating between uncomplicated grief and clinical depression, while also discussing the use of screening instruments for complicated grief and the dual process model for understanding bereavement.

Running head: MEDICAL ASSIGNMENT
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Name of the Student
Name of the university
Author’s note

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Loss of a parent by an adolescent
INTRODUCTION
Loss is an unavoidable part of life and the grief is the regular response and is also a part
of the process of healing. The reason for grief can be loss of the loved ones, like parents or
spouse, parents, siblings and or loss of wellbeing or letting them go of a long term grief. Dealing
with losses can be extremely difficult.
Adolescence is a crucial period of life, where individuals often have encounter deaths
such as deaths involving death of the grandparents, parents, siblings, teachers, friends, other
family members and many more. They often encounter the deaths of their favourite celebrities or
their role models or cultural heroes (Cerniglia et al. 2014). As stated by Seiffge-Krenke (2013)
adolescence is the only period, where an individual have to encounter a full range of possible
deaths. Premature loss might cater to serious health and psychological issue in adolescent
individuals. Furthermore, bereavement literatures have mainly focused on parental responses to
the death of a child and quite recently special attention has been given to the emotional responses
displayed by the adolescents. Hence, in this paper we will focus on only one type loss that is the
parental loss by an adolescent. This paper will provide a critical analysis of the complicated grief
reactions that might occur. Furthermore, this paper would reflect on the role of three helpers,
who might help an individual to cope up with the loss.
Critical analysis
The death of a parents might bring serious consequences as it means growing up and
understanding that life is more than fun and games. Wolfelt (2013) have provided some

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speculations regarding the tensions that arises from cognitive, biological, social and emotional
factors. The initial concern is the rapid biological and sexual development. Adolescents becomes
aware of their loss and the fact that the physical deterioration are inevitable, which might
ultimately cause their own death or the death of others (Nolen-Hoeksema, Larson and Larson
2013). Two possibilities can be caused due to this. Adolescents might indulge in risky behaviour,
as many might think that life is too short or that that no one is present to care for them. In
contracts, they might also act too cautiously as they are now aware that they are not invincible or
there is nobody left to care for them and hence they will have to care for themselves.
Losses might affect adolescents in different ways like disbelieving of what has happened.
Immediately after the death people often does not realise what exactly has happened. People
often tries to deny this, feel, numb, shocked or expect to see their loved ones. Excessive grief can
even take a toll on the health causing weight loss or gain, depression, anxiety, lack of ability to
fight against the disease and extreme fatigue (Burke and Neimeyer 2013). Death of near and
loved ones causes people to face their own fears about death or others might fear of a life without
their loved ones, taking new responsibilities. Some might feel angry, that their loved ones have
left or have deserted them or the unfairness of death. Again others might feel the need to blame
someone. Individuals have uneven emotions, which can come and go. Some days might feel
better while in the next minute, individuals might feel intense sadness. This reaction is normal
although many might feel it is crazy.
Another concern is that cognitive maturation increases their ability to think and reflect on
their expectations from future that can include both positive and negative components of living
the life all alone. For revaluating the parental values or establish their own identity, the
adolescents have to accept the inevitability of bereavement, accepting the fact that they are just

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the part of life. Another tension that is formed is when the social relationships among the
families and peers alter. Due to loss of parent adolescents might be forced to develop a social life
outside the family. If adolescents are bullied or ostracised by the peers, they might feel alone
both outside and at the home.
The death of a parents adds tension and stress in an adolescent’s life. It has been found that
feelings of adolescents about development and the death are often interwined and that
achievement of autonomy might threaten the self-esteem of an adolescent.
Normal grief for parental loss can be explained by the Theory of Kubler Ross, who has
developed a five staged model based on his observations. According to this model people under
grief generally travels through stages of denial, where the person refuses to believe about the loss
(Hall 2014). The next stage and necessarily an important stage in the healing process. Anger
helps individuals to dissipate their feelings. Next stage is the bargaining stage, where individuals
might bargain, which might takes the form of a temporary truce. Individuals thinks that if they
bargain, things would get back to the normal. This stage is followed by the depression and
acceptance, where a grieved individual gradually realises the emptiness and the grief enters out
life into a deeper level (Hall 2014). The depressive stage might feel that it would last forever. At
this stage, it is important to understand that depression is not a signs of mental illness and is only
a part of the recovery process. Acceptance can sometimes be confused with the notion of being
“all right” or being all right with whatever that has happened. This stage is all about accepting
the reality that the one who has gone will never come back, which is the permanent reality and
the new norm that needs to be accepted. According to Supiano and Luptak, (2013) adolescence
at this stage, begins to learn more about who they are, trying to get acceptance and belonging
with the peers, improving the sense of connection outside the home. Another model has

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been proposed by the J. William named as “Tasks of mourning”. According to him, grief is a
work that needs commitment and active participation on part of the person, who is grieving. The
tasks that are faced by an individual who is grieving are – acceptance of the reality of the loss,
coping through the pain of loss, adjusting to an ambience where the deceased one is missing and
finding an enduring connection with the deceased person.
Although following the steps of grief, teenagers growing up and merging in to the world
of adult is quite hard enough. Coping with peer groups, school pressures might add up to these
challenges. This formation of the identity becomes important task for the individuals.
Normal grief progresses more or less by following these stages, but complicated grief
generally does not strictly follow these stages, but may show variable symptoms, disturbed
behaviour and serious depression. According to Crunk, Burke and Robinson III, (2017).
Adolescents who have witnessed parental death are forced to mature more quickly than that of
other kids. They might be forced to accept the household responsibilities like cooking, cleaning
and shopping that might get quite hectic after managing the school work.
The grieving person might travel the on for a long time and should be allowed to recover
at their own pace. For some adolescents this grieving process might continue for a long time
without any progress and is termed as unresolved grief (Burke and Neimeyer 2013). Some of the
symptoms of complicated grief includes continued disbelief in the death of the parent or inability
to accept the death. Some might feel preoccupied with the loved ones or how they died,
development of intrusive thoughts about the loved ones , extreme feelings , feelings of emptiness
and isolation, avoiding doing things that reminds them of their lost ones ,express guilt of living,
sleep deprivation, having not interest in activities, development of eating disorders. Bereavement

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rumination is another clinical symptoms of complicated grieving. This can the accompanied by
functional impairment. Adolescents have a greater risk of developing clinical depression and
post-traumatic stress Disorder (PTSD) (Pitman et al. 2015). Adolescents might react to the loss
of the loved ones by attempting suicide. The death of a parent has been found to be associated
with psychological problems in almost 25 % of the affected teens (Stikkelbroek et al. 2016).
However not much is known whether the mental health problems of parents-bereaved teens had
pre-existing mental problems.
Berg, Rostila and Hjern (2016) have suggested a comprehensive model for associating
parental death to physical and mental health problems. The post bereavement risk factors are bad
eminence of parent-child relationship, deleterious life events. Again Braet et al., (2013) have
stated that history of depression, psychiatric disorder and pre-existing mental problems are
correlated to depression after a parental loss. Adolescents might get addicted to drugs in order to
cope up with the extreme symptoms of grief.
Screening of grief
While screening for the grief, it is necessary to differentiate between uncomplicated grief
and clinical depression. It should be noted that a fully depressing reaction should accompany a
grief response that is normal after the demise of a loved ones. It should be understood that grief
does not necessarily means loss of self-esteem. Depressed person will generally have low mood
or might lack emotions, little enthusiasm for activities, which he used to enjoy previously. On the
contrary grieving person will show inconstant reactions. They are likely to deviate from being
able to enjoy or accomplish activities and less interest in others or preferring to be alone
(Supiano and Luptak 2013). Complicated grief are generally intense but variable, whereas

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clinical depression are intense but are persistent and not variable. Periodic weeping or crying can
be observed, whereas the clinical depressions are sometimes self-directed. Apart from this, there
are certain instruments available to screen complicated grief. They are Inventory of the
complicated grief, Pathological grief questionnaire and Texas Revised Inventory of Grief , that
are mainly used by the mental health professional and in clinical research. Different stages of
grief are also assessed by the practitioners by using these paper and pencil survey tests. The
Utrecht Grief Rumination Scale (UGRS) has been found to be useful to assess grief rumination
(Doering et al., 2018). An approach to treat grief is the dual process model that endorses the
bereavement process as being the dynamic struggle the between the pain of the loved ones.
Analysis and evaluation of the role of the helper
Adolescents already go through a kind of bereavement, with hormonal changes and
emotional turmoil, losing a part of themselves with the onset of puberty. Loss of a parent might
serve as a double blow. This is because, it is the patents, whose attitudes, actions and beliefs
helps to measure the place of an adolescent in the world. Losing a parent can have some serious
physical as well as mental consequences on teenagers. Extreme conditions like rumination,
suicide, drug addiction and clinical depression might occur (Berg, Rostila and Hjern 2016). Lack
of necessary psychosocial support might have some serious impact on the teenagers that might
affect their quality of life, peer relationships, future professions. It is important that the other
family members should be able to grieve with one another, to cope up.
Professional help can be taken in order to cope up with grief. Bereavement cancelling is a
special type of professional the helps that can be found through hospice services or a referral
from the health care provider. This type of counselling has been found to reduce the level of

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distress that the mourners encounter after the death. Counsellors can apply a number of therapies
for managing complicated grief, like cognitive behavioral therapy, exposure therapy and
meaning therapy. The main of these treatments would be to expose these teenagers to people and
events that is included in their lives. Meaning therapies ensues that the grieved individual accepts
the permanent reality of death. Berg, Rostila and Hjern (2016) have admitted that healing therapy
in group environment can be successful for the adolescent groups as they will be able to interact
with people having similar issues and might become motivated to cope up with the stress and
realize that there are many other who share the same pain or even worse than what the concerned
person had been facing.
Apart from professionals, there are spiritual healers that might help children to cope up
with the parental loss. These spiritual healers might use certain imagery techniques or relaxing
techniques to calm the grieved person ad develop mindfulness. Certain meditations and exercises
can loosen the grip and bring the resolution (Klass 2013). Visualizing and focusing on positive
and good memories, spending few minutes saying whatever there is to say needs to be said from
the heart. On the contrary Maddrell, (2016) have argued that the memorizing the person over and
over again, delays the process of recovery as the child does not get the time to get out of the
grief.
Another type of helper that can be involved to help teenagers cope up with parental grief
are the siblings. Elder siblings might take initiatives to develop a nurturing environment at home
where children might be able to express their emotions freely (Khodyakov and Carr 2019). The
concerned adolescent should not feel that they have to keep their emotions private and hence
keeps the lines of communication open. A vast number of researches have stated that the adult
sibling relationships after a parental death are affected by the bereavement of the parents. When

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adults think that they are giving thorough parental care than their siblings, then relations might
get strained after the death of a parent. Again Maddrell, (2016) have stated that siblings may
come closer after the death of a parent. Parents might be the cause why siblings were not in
contact with each other. Parental death might remove the main foundation of the continuing
tension among the siblings. Common grief amongst the survivors can foster empathy and
communication. Again, siblings who have lost parents can restructures the family roles
(Khodyakov and Carr 2019). The elder sibling might assume the role of the kin keeper, helping
out the other children with the grief. All these negotiations can bring the sibling closer as they
together coordinate their parent’s care. This close relationship helps them to cope up with the
problem and adjust with the new roles. In case of terminally ill parent, siblings might act
collaboratively in the advanced care planning. Supiano, and Luptak, (2013) have stated the role
of gender suffering sibling relationships. Sisters tends to be closer than that of the brothers and
cope up together.
Conclusion
Loss of a profound relationship at a tender age, whether an internalised object or a person
in the external world might interfere in whatever seems to be a general progression of the
intellectual-emotional- psychological ‘growing up”. The entire family functioning alters after
any parental loss. Consequences of parental loss can be severe, giving rise to complicated grief.
Complicated grief in adolescents can be addressed by a people like professional healers, spiritual
healers and their own siblings.
However, being a human being it is our duty to try our best to heal anybody who is in
pain. This can be done by simple gestures like using empathetic words, active listening to their

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grievances, trying to assure them without hurting their self-esteem, providing them with an
insight to the meaning of life . In case of severe cases, many referral services can be
recommended such as hospice services, spiritual healers, social networking.

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References
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