Abstract
This study explores how Danish students experience returning to school following parental bereavement. Eighteen focus group interviews with 39 participants aged 9 to 17 years were conducted. All participants had experienced the loss of a primary caregiver. Data collection was divided into two phases. In Phase I, 22 participants from four grief groups were interviewed 4 times over the course of a year. During Phase II, confirmatory focus groups were undertaken with the 17 participants. This article explores findings related to the four themes of initial school response, long-term support, challenges within the class, and academic challenges. The study found that (a) students struggle to reconnect with classmates following the return to school and often feel alone, (b) schools fail to have guidelines in place for what they are allowed to do if becoming sad the class, and (c) schools seem to forget their loss as time passes.
Introduction
In the country of Denmark, over 1,700 children annually lose a parent to death (Eland, 2016). This loss has been characterized in the international literature as one of the most traumatic incidents a child can encounter (Cerel, Fristad, Verducci, Weller, & Weller, 2006; Melhem, Moritz, Walker, Shear, & Brent, 2007). Research (e.g., Cerel et al., 2006; Parson, 2011) has further established that bereaved children are at increased risk of depression, underachievement in school, and frequently feel isolated from their peers.
Returning to school following the loss of a parent leads to further challenges for the child. International studies (e.g., Nielsen, Sørensen, & Hansen, 2012; Worden, 1996) have found that children often struggle with the return to class. However, within Danish and international literature, there has been relatively little research focused on evaluating the issues bereaved children encounter when returning to school. This is problematic when considering the important role schools play in the lives of most children. The research that is available (e.g., Dyregrov, Dyregrov, Endsjø, & Idsoe, 2015; Holland & Wilkinson, 2015) has mainly focused on questioning teachers, parents, and other professionals about the support they believe bereaved children need. Few studies have elicited the views of the bereaved children themselves. This is paradoxical considering the prevalence of “student voice” in contemporary schools (Flutter, 2007) and the claim by Coleman (2013) that few British projects aimed at changing school policies have been truly successful without including the opinions of students. The gap of knowledge in studies on childhood bereavement was further recognized in an editorial by The Lancet (2013) that called for more research to examine the long-term well-being of children who have experienced traumatic events.
To help fill this gap in the literature, this study interviewed 39 Danish students aged between 9 and 17 years. Eleven themes were delineated that focused on the experiences of returning to school as well as suggestions for desired changes to the Danish school bereavement response. The article limits itself to exploring the four themes, which were related to the experience of returning to school. As such, the aim of the research described in this article was to explore how children experience their return to school and the support received following bereavement.
The article begins with a brief overview of the Danish bereavement response in order to provide an understanding of the system that the students are subject to on their return. The study methodology and ethical considerations are then summarized, followed by a discussion of the four identified themes: initial school response, long-term support, challenges within the class, and academic challenges.
The Danish School Bereavement Response
The Danish bereavement response system was cultivated in the early 1990s. Based on practical experience rather than scientific research, it was here pioneered by the Danish Cancer Society, into becoming the Danish bereavement response plans 1 (b-plans; Lytje, 2013). These plans are created from a template by the teachers themselves in order to ensure that they are tailored to the specific needs of the individual school. Today, 96% of all Danish schools are in possession of a custom-made b-plan (Eland, 2016). Although every plan is unique, they mainly focus on the practical aspects of having to respond to different scenarios of bereavement. This often includes themes such as who should contact the family, who should be notified about the bereavement, and how to inform other students (Lytje, 2013). While little scientific research has been undertaken to evaluate the effectiveness of the b-plans, interviews with teachers (Lytje, 2013) suggest that the Danish model has been successful as a supporting mechanism for teachers.
Method
The current article is based on data from a PhD study by Lytje (2016). This study explored how 9- to 17-year-old Danish students experienced returning to school following parental bereavement. Eighteen focus group interviews were conducted with a total of 39 participants. All participants had experienced the loss of a primary caregiver. The study utilized a pragmatic, multimethod design framework. Participants were recruited from five different grief groups from various regions in Denmark.
The primary data analysis method was a thematic analysis of focus group discussions, supported by document analysis of 60 Danish school bereavement response plans. To remedy some of the critiques that have been levied against thematic analysis, the study utilized an adapted version of the framework proposed by Braun and Clark (2006).
With the proposed participants being considered highly vulnerable, all children were recruited from existing child grief support groups. These are voluntary discussion groups where children can share their worries with others in a similar situation. The advantages of recruiting participants from these groups were as follows:
Participants would have previous experience discussing bereavement. The interview would therefore be less likely to affect them in unexpected ways than for participants without prior experience. Previous experience with group discussions would improve the participants’ ability to partake constructively. Existing support mechanisms already implemented in the grief groups would ensure participants had access to postinterview support.
Interviews were conducted and analyzed in Danish before descriptive quotes were translated into English. The study was divided into two phases of data generation. In Phase I, 22 participants from four grief groups were interviewed 4 times over the course of a year. Phase II was based on questions arising from Phase I. Here, one confirmatory focus group was undertaken with 17 participants divided into three groups. In Phase I, 11 themes were identified which related to the adolescents’ experiences of returning to school and the support they wanted from this organization. This article limits itself to discussing the findings associated with the experience of returning to school, while a second article will explore student suggestions for how to improve school bereavement responses.
Ethical Considerations
It is particularly important to maintain high ethical standards when working with vulnerable participants. One dilemma encountered in the current study was whether parents or children should provide written consent for participation. While the aim of the study was to provide bereaved students with a voice, Danish laws maintain that children under 18 cannot legally consent to participate in a study; only parents and guardians can do so.
To address this, parents and guardians were given a form which stated that they would allow their children to decide whether or not to participate. Following this, an introductory video was sent to the grief groups which included a 5-minute presentation of the project. After the video was shown, children were asked whether they might be interested in participating in the study. If they were interested, the project was discussed once more with the children in person before they were asked to sign a consent form. Besides these initiatives, the study adhered to regulations provided by the British Association of Counselling and Psychotherapy (Bond & Griffin, 2013) and has been approved by the ethical committee of the Faculty of Education at the University of Cambridge.
Themes
The following section presents the four themes that are associated with the children’s experience of returning to school following the loss of a primary caregiver. The themes are initial school response, long-term support, challenges within the class, and academic challenges.
Initial School Response
The topic of initial school response called forth strong emotions. Not only did most students come back at a time where their families were in complete disarray, but they also had to realize that their loss had changed how they were perceived by their classmates. Some participants returned to a school that had prepared itself to receive them. Sofie said: I returned the day after my father’s death … I was received by the whole school, who had been told … Everyone was saying ‘hi’ to me … The teachers were too … “How are you feeling?” and things like that, so I was received really, really well. (Sofie, 12)
When asking the participants what they felt was most important to them during their return, it often centered on the class and teacher showing some understanding of their experience. Siv stated: My situation was often taken into account and how I was feeling and things like that and of course, the teachers approached me and said “hello” properly … asked how I was doing and said that they were sorry about what had happened … They were very considerate of my situation. (Siv, 15) They, the teacher in my school approached me and asked if they should raise it in the class. Then I told them, that they should wait a little while. I would like to just properly return and that was okay … They received me really well … and we talked sometimes … it was okay and mostly about if I wanted some support and how. (Dennis, 15) You just have to remember that communication is the most important thing … and you have to talk about it and that sometimes all it takes is a little talk … so that you don’t feel like you need to keep some things secret or that there are some [things] you are not allowed to talk about. (Freja, 14) Lis, 12: The worst my teacher can do for me is … you know, take you over to a corner and kiss and hug you … because, urgh, it is your teacher and that’s just wrong! Interviewer: You don’t need a big hug? Lis, 12: … you just think that your teacher should not act like … she is not your aunt … or what do you say … they are just your teacher.
While not all issues encountered by the bereaved participants were due to schools failing to respond to the bereavement or being inadequately prepared, these seemed to play a significant role in how well the child was initially received.
Long-Term Support
The children’s grief was not something that disappeared overnight. Rather, it was a constant companion. While students had good as well as bad days and did not spend every waking hour thinking about their loss, it was something that never left them for long. It’s a little like you will miss this person for the rest of your life. You can still be mourning without being completely lost and crying. I am still grieving and thinking about the person … but you can also be feeling okay and be thinking about it in a positive way for a while and then being sad later on. It depends. (Siv, 15) When I returned … we had to talk about it [the loss] … it was a little difficult to sit there and listen to it, right! The girls all said, “if you need to talk, you must tell us”, so they were good at dealing with my return … but then … little by little, then they stopped. They did not know what to say, and there were many [times] where I had to say … “You are allowed to [ask], it’s okay!” In the end, I had to sit and cry in the class before they realised that I was not doing well. (Lisa, 15)
During the discussion of long-term support, a few students proposed that the bereavement response needed to be more than just approaching the student when he or she was feeling down. Sometimes it could also be important to acknowledge when the opposite was happening: I also think that they do not only have to ask when you are not feeling well … If they can see you have been happy for a long time then they could also say, “It’s lovely that you are happy.” (Majken, 16) Jo, 17: That is what I have missed the most … that people came and asked me, “how you are doing?” You know, apart from your family … The first week people were really good at approaching me … but now it is totally forgotten. I miss the, “How are you actually doing?”, and now when you try raising the topic of your dad’s death, or whatever, then they sidestep the issue. Interviewer: Why do they do that? Jo, 17: I think that in a way they are afraid of it … it’s the same if you meet someone downtown, you know they sometimes try to go in a circle to avoid you, because of it … they don’t know what to say to you. I just think it is easily forgotten while you yourself will never forget it … and it might be that even a long time after, you still have a need to know that there are people who … you know … [cares]. (Siv, 15) Freja, 14: … I was sitting there in the first physics lecture and having to discuss cancer and I just ended up having a complete breakdown and it was just … Interviewer: a bad situation? Freja, 14: an embarrassment for the school … Freja, 14: Of course, you still need to receive education on these topics … I just feel like they should be better at taking it into consideration … and you know … Grief counsellor: Show more awareness? Freja, 14: Yes, it can still hurt even if several years have passed. Sofie, 12: But you know, also … now just in your situation where somebody has chosen to discuss cancer, perhaps you could better prepare classmates that such things can affect us highly … I have experienced when there were three [classmates] or something like that who had to do a presentation about religion … about death and then they discussed the different things you could die from … and I was like … you could have avoided it [the illness her parent died from] … or just show a little more consideration. If you are abruptly reminded … it is like getting something stuck in your throat. Freja, 14: I have experienced that … it’s like someone hit you and you are just sitting there and thinking okaaay … Sofie, 12: … it seemed a little like a month after my class had been told and all that … then it was not relevant anymore … that kind of from one day to another … it was like … “Now she doesn’t care anymore.” I knew, it was not like I was reminded or whatever, but I knew that I could always leave the class if I needed to, and they have always taken it into consideration, even though it is now some years ago. They are still a bit like: “She can still be upset”, so yes, it has always been like, my teacher has always been very considerate of it. (Siv, 15) Siv, 15: Um … I have now changed schools … Interviewer: Ah…and what about the new school (talking about new rules). Siv, 15: (mumbles) don’t know it yet. Interviewer: They don’t know it yet? Siv, 15: … It’s just because the right time has not come … Interviewer: Does that make it more difficult? Siv, 15: … Um … A little … I think it becomes more difficult the longer you wait …
Challenges Within the Class
Often the first day back in school was a combination of looking forward to returning to a place of relative normalcy, followed by a realization that the bereavement had also changed things in the school. There was some variation in how classmates received the bereaved, and it mainly seemed to be influenced by whether or not the school had helped prepare them for the return. Siv explained: It was like being new in the class. You know, because they looked out for me a lot … even though I had never changed schools, then I felt a little new … I could feel that people were afraid to ask questions about it … but it was only to protect me. (Siv, 15) It was like normal … I was already playing football again in the first break, together with all the boys … and had something to do the first day after school. I have never felt kind of alone, unless I wanted that myself (Jarl, 13) I have always been very happy about my school. I have always been one of the best performers, academically, but now my social life has collapsed somewhat. After my father died … I spend more time with other people … I am not together with my class, because they don’t really know how to handle it. (Sofie, 12) So, in my old school, it was a bit like, in the start people were kind of, they treated me sort of a bit different … then, well, little by little, then they became like … the school I attended, there was bullying and teasing and such … you know if I was quarrelling with someone … then sometimes they would use that my mum had died against me. (Amara, 12)
To understand these feelings of difference, participants were encouraged to reflect on what they believed had been the primary factors leading to these feelings. They here acknowledged that most of the time the issue did not arise because of insensitive classmates but rather because no one knew how to deal with the situation. One participant elaborated, “The girls, and yes, the class, did try to show understanding. I just think they had difficulties … they don’t know … what can they say?” (Lisa, 15).
When addressing the issue of isolation, many participants had very concrete suggestions. The importance of the role of the teacher in creating an open environment where the class felt comfortable raising concerns was emphasized. A discussion exemplifying this follows: Jo, 17: Some people consider staying away, and it would be nice if there was someone who saw that … because it is not exactly what you need … that people stay away from you. Siv, 15: No, and even though you, kind of, want to say it yourself, then you don’t always have the energy to go and tell the person: “Hey, I would actually still like to talk to you”. So … it would be nice if there were others than yourself, who saw … I believe it would have been beneficial if we had received some form of preparation about what it means to live with an ill parent. That you put some focus on what cancer is … so that it does not become a taboo. I don’t think we are good enough at doing so because we fear talking about it … It’s is death and that is something uncomfortable … we are not invincible. Cancer should not be a taboo, especially not when there is someone sitting in the class who might be feeling horribly because the classmates are afraid of hurting the person. (Freja, 14)
Two other challenges were mentioned in the interviews, albeit only by a few participants. These were jealousy and classmates who attempted to compare their own experiences of grief with that of the participants. Sometimes an additional consequence of the bereavement would be that the child received a sizeable inheritance. Jarl mentioned this and the jealousy it could lead to among classmates: I inherited his boat and his apartment and his car, and so forth and there were many: “Oh, you’re so lucky that you got that”. Then I tell them, “but I would much rather have him [dad],” you know! (Jarl, 13) Freja, 14: It just reminds me about when people show up and tell you they know exactly how you are feeling … because my grandmother died last year … she also had cancer. Interviewer: I can’t help think whether that is better than never asking about it? Freja, 14: Not at all! Sofie, 12: Then I think that I would rather have no comments at all! A girl one day came over to me and said: “Sofie, I know how you are … I know the feeling … I lost my hamster”. Freja, 14: How awful *laughs*. Sofie, 12: *laughs* I have also lost a hamster … it lasted 10 minutes, then it was over. Freja, 14: You don’t want that kind of comparison. Losing a grandmother … it is going to hurt … and of course it is a loss … but it is not the same as losing a parent … It should not be compared to losing a parent.
Academic Challenges
The reactions and thoughts which followed the loss had a significant influence on school performance. Participants were asked about issues related to doing homework following the loss, and students from all groups endorsed having experienced difficulties with concentration and handing in homework. When this led to missed deadlines for homework, a majority of them reported receiving full support from their teachers, at least in the beginning. Jo elaborated: There is some homework I can’t do and I sometimes struggle to follow lectures in the school, but … they understand that and it’s very nice. That is, I do hand in all my essays, but sometimes it is difficult to maintain focus during classes because you can only think about something else. (Jo, 17) More generally, it seems to depend on what teacher you have and how they feel about such things, but if you approached them and said “OK, I have not done my homework because of one thing or another” then they did show understanding. Then of course there are some who have a greater understanding than others. (Majken, 16) So, the thing about being able to leave and catch a break, I would … I would really believe that that could help me a lot and such … not having to sit in the class and be sad, where everyone is looking at you and so on … It would be nice to get such … to go out and kind of become happy again … like feeling better and such … but it would be nice if I could … (Lykke, 12) Freja, 14: Also, when talking about students being exempt from homework after they [parents] have died, then I think this also has to be in place before. Sometimes we had to go straight into the hospice or hospital and such … and then there was simply no time left for homework … and you could not concentrate … you know, you are thinking … you know when you only have a little time left with your dad. Interviewer: Then homework does not seem like the most important task? Freja, 14: No, exactly!
Participants were generally strong supporters of bereaved students receiving extra support and the possibility of exemptions from homework in the time following bereavement. While one group did toy with the idea of using such privileges as excuses, those who had done so were not proud of it and seemed to reject the idea of doing it again. Following the earlier discussion, participants were also asked whether they thought any special exemptions should be made for examinations. The participants were presented with a system used in England, where a note is sent to the examiner before an examination if a student has recently lost someone.
While the note does not have a major effect on the grade given, it can sometimes be a mediating factor if a student’s work hovers between two marks. This example sparked some lively debate in the groups. Generally, most participants seemed to think that some form of special treatment was acceptable. However, there was less agreement regarding the form of such support, how long it should be available, and whether it should only affect certain topics.
Discussion
This study confirmed that parentally bereaved children often struggle with returning to their class following the loss. Many reported that classmates seemed uncertain about how to welcome them back. This often made for an awkward experience, leading the bereaved to feel different from their peers. In such situations, the bereaved student was often faced with two choices: pretend as if nothing had happened or try to overcome this new situation. Choosing the second and deciding to talk about the loss could lead to instances where classmates try to avoid them, a subsequent feeling of isolation, and, in rare cases, taunting.
In Danish literature, similar findings are described in two recent studies on bereavement by Mandag Morgen (2013), which surveyed 2,700 participants, and Nielsen et al. (2012), who interviewed 3,481 participants. Both found evidence of groups of students feeling alone and that they had no one with whom to talk. In Nielsen et al. (2012), 10.8% of bereaved students reported experiencing isolation. In Mandag Morgen’s (2013) sample, 13% of participants were identified as having weak social networks. These numbers seem much lower than those reported in this study, where many students seemed to feel alone. This is especially striking considering that the participants in this study were receiving support from a grief group, something the majority of the surveyed participants in the other studies were unlikely to have been offered. The difference may be due to the longer amount of time that this study was able to spend with the participants, leading them to share more than they would in data collections conducted via a telephone interview or survey.
In international literature, little research has explored feelings of isolation among bereaved students. While many books on bereavement (e.g., Butler, 2013; Corr, Nabe, & Corr, 2008) mention the issue of children feeling different from their classmates, few provide evidence for these claims. Those who do (e.g., Davenson, 2004; Meagher & Balk, 2013) generally refer to the Harvard Child Bereavement Study by Worden (1996). Interviewing 125 children aged 6 to 17 years, the study found that participants were reporting feeling different from their classmates and feeling poorly understood by their peers 2 years following parental bereavement. Similar conclusions were reached in a study by Pitcher (2002). A few articles have further reported that students being taunted about their loss are not uncommon. For example, Sandler (in Cain & LaFreniere, 2015) in a life events scale study of 340 parentally bereaved children found that 13.8% reported having been teased about their loss. This was supported by Cain and LaFreniere (2015) who in a smaller study found 7 out of 35 participants to have experienced such taunting. As such, while there is a need for further research, the current body of evidence supports the finding of this study that parental bereavement can lead to issues in reconnecting with classmates, feelings of difference, and taunting on the return to school.
In relation to teacher support, the majority of participants did report their teachers actively trying to support them on their return to school. Sometimes such support could become overwhelming, and there was a surprising agreement among participants that they felt worse when teachers tried to do too much. Participants elaborated on this by explaining that it was difficult when teachers asked them about their loss too often or highlighted special privileges in front of the class. Similarly, overly emotional teachers made the participants feel uncomfortable. However, when the loss led to deadlines for homework being missed, a majority of participants reported receiving full support from their teachers, at least in the beginning. The focus on initial support can be confirmed from the document analysis of 60 bereavement response plans. Here, the majority of plans had a primary focus on providing direct support during the initial weeks of return.
It was also clear from my interviews that participants felt that their school had a duty to provide support in such instances. In Norway, Dyregrov, Gjestad, Wikander, and Vigerust (1999) interviewed 26 participants in Year 8 and found that the primary teacher seemed to be the main reason for students having a generally positive view toward the support they had received from their school. Furthermore, a study by Dyregrov (2009), who surveyed 32 participants aged 13 to 24 years following parental suicide, reported that it was important to the bereaved students that the teacher approached their loss with caution, indicating discreetly and in private that they understood the severity of the situation rather than doing so in front of other students. This is an interesting finding, as it is the only other study found to report children being afraid of teachers doing too much.
Another noteworthy finding was the need for structure on the return to school. This seemed especially important to participants in the initial period following the return to school, when everything could be chaotic and boundaries could be comforting. This is a very interesting and perhaps unique finding of this study. While several books (e.g., Holland, 2003; Rowling, 2003) have been authored with recommendations on school bereavement support, most of them do not mention such specific rules.
When considering the long-term school bereavement response, the vast majority of students found that schools neglected to attend to the loss as the months passed. This could lead to incidents such as when a teacher forgot about there being a bereaved student in class. Furthermore, it was often difficult for participants to be in a school where it felt like everybody around them had forgotten about the loss. The document analysis of bereavement response plans confirm this view, as the majority of these focused on organizing the bereavement response in the immediate time following the loss, while seldom containing guidelines on how to deal with long-term consequences of the loss.
Internationally, little research has been done on exploring school short-term and long-term bereavement responses. Most likely this is due to the small number of countries worldwide who have structured responses (Holland & McLennan, 2015). However, once again the study by Dyregrov (2009) supports this finding, as her participants also reported their schools forgetting about their loss. The same issue was discovered in a study by Lytje (2012). Surveying 967 teachers, the author found that while 85% of the sample agreed that the b-plans were an efficient response in the initial weeks; this number was reduced to 61% when asked about the long-term response (Lytje, 2012). While this highlights that most teachers found the current system successful, it also indicates that others are aware that the long-term response is not as effective as the initial response.
With less emphasis on school bereavement responses in most English-speaking nations, few studies were available in relation to school bereavement responses. Most of these (e.g., Holland & McLennan, 2015; Tracey & Holland, 2008) report very little structured support. The exception is Australia, which has structured responses in 94% of their schools (Rowling & Holland, 2000). In a study of 36 bereaved girls, Tracey (2011) did find that support from teachers was considered a positive factor by the students. Nevertheless, Holland (2001) reported that British teachers generally were wary of engaging bereaved children as they were worried about “causing an upset” (p. 121).
Conclusion
This study endeavored to explore how children experience their return to school and the support received following bereavement. When considering the presented findings, it is clear that the return to school is difficult and full of challenges for bereaved children. However, most of the participants in this study did report receiving some form of support. In fact, many of the issues reported in the earlier sections seem linked to areas that could be considered issues or “holes” in the current Danish bereavement response.
The issues of teachers doing too much or making the children uncomfortable seem to be linked to a lack of training and understanding regarding the needs of a bereaved child. This is a common issue found both in Norway (Dyregrov, 2009) and England (Holland, 2001). In both these studies, as well as in previous work (Lytje, 2012), there is no evidence available to indicate that teachers do not care about the bereaved student. On the contrary, students highlighting issues with teachers offering too much support indicates that teachers are doing their best to be supportive, although they may lack the necessary tools.
The solution offered by Holland (2001) and Dyregrov (2009) is that better training should be provided to the teachers. While this might be an ideal solution, it might not be a realistic one. It will likely be very difficult to get any government to spend the necessary funds needed to provide such training, especially when it is a fair argument that such funds might be equally well spent on training teachers to deal with other issues such as bullying or divorce. Nevertheless, it will be highly challenging to offer a support system that can compensate for a lack of knowledge or understanding.
The issue of long-term grief being forgotten by teachers has been confirmed in this study. In some ways, it speaks to the quality of the Danish system that this is an issue at all. As such, there has to be a working short-term response in order for issues in the long-term response to have any meaning. However, it is clear that this finding lends weight to the argument that the current b-plans need to be updated in order to better address this scenario.
Participants also reported issues in regards to peer relations, such as feeling isolated and different from classmates. These issues seemed to be of much concern to many participants. However, responses did include some ambivalence about whether and how to approach peers for support. At the same time, the current Danish school bereavement response plans seldom deal with peer responses. This might be a relic of past times, where little attention was given to the importance of student-to-student support. Nevertheless, some studies (e.g., Holland, 2001; Worden & Silverman, 1996) have found that peer-to-peer support and having peers to talk to can help with better adjustment and higher self-esteem among bereaved students. An updated bereavement response system could benefit from relying on student-to-student relations as well as teacher-to-student support.
Footnotes
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Funding for the research project has been provided by the Egmont Trust.
