A preventive approach to adolescent grief does not, however, imply that the grief is preventable, but rather that the potential negative consequences can be minimized by providing bereaved teens the support they need to develop into mentally healthy adults. Importantly, according to Donna Schuurman, Ed.D., national director of the Dougy Center for Grieving Children and Families in Portland, Ore., “Grief is not an illness that needs to be cured. It's not a task with definable, sequential steps. It's not a bridge to cross, a burden to bear, or an experience to recover from. It is a normal, healthy, and predictable response to loss.”
In this regard, grieving children and adolescents need to be allowed to grieve and to make their own meaning in a safe, healthy environment, Dr. Schuurman said.
The above song lyrics represent what can happen when bereaved adolescents are supported in their grieving process. The lyrics are a product of an integrated grief model and music therapy protocol called the Grief Song-Writing Process (GSWP) developed and implemented by Mr. Dalton, the music therapist and mental health counselor, and Robert E. Krout, Ed.D., head of the music therapy department at Southern Methodist University, Dallas (Music Therapy Perspectives 2006;24:94-107).
The development of the GSWP comprised three phases: a descriptive, thematic analysis of songs previously written by bereaved adolescents in individual music therapy; a comparison of existing grief models with the song theme areas, and the identification of an integrated grief model, including five grief process areas (understanding, feeling, remembering, integrating, and growing); and the actual songwriting protocol through which bereaved adolescents created music and wrote original lyrics that focused on each of the five grief process areas. The 7-week GSWP protocol was implemented with four groups of bereaved adolescents ranging in age from 12 to 18 years old. Each of the seven sessions had a specific purpose. The first session was designed to develop group cohesion, clarify guidelines, and explore instruments and recording technologies. Education about grieving myths and normal grief reactions was incorporated into this session. In the second session, which focused on the grief theme of understanding, group members were encouraged to share their stories and individual experiences using the following chorus lyric from a precomposed song as a guide: “This is how it happened.”
Sessions three, four, and five, respectively, focused on the themes of feeling, remembering, and integrating, also using a precomposed lyric as a starting point. The focus of the sixth session was the theme of growing. Finally, session seven was a memorial and celebration of the lives of the loved ones who had died, according to the authors.
“Songwriting using the GSWP proved to be engaging and offered a safe, creative method of addressing the difficult subject matter of a loved one's death,” the authors wrote. The findings of a pilot study measuring progress in the five grief process areas addressed by the GSWP using a 30-item measure called the Grief Processing Scale developed and validated by the authors suggested positive changes for participants in the treatment groups relative to controls in overall scores as well as in scores from each of the five grief subscales, the authors reported.
Healthy, adaptive grief will be an ongoing challenge for bereaved adolescents. But the development of flexible interventions such as the GSWP should be promoted in order to provide adolescents with “creative ways in which to progress through their own unique journeys of healing,” the authors stressed.
Perspective
If you have models for how life works, you feel a sense of mastery and power because, as a result of knowing, you can adjust your thinking and behavior to make yourself less vulnerable. This is a critical component of building resiliency in bereaved adolescents.
Helping adolescents develop and understand models of how life and death operate, for example, aids in the development of their cognitive capacity to understand where overwhelming feelings originate and how to control them. By being able to talk about patterns in life–that predictability marks some but not all events and that fairness and justice mark some but not all outcomes, as per the Fleming/Adolph construct–an adolescent gains some frontal lobe understanding of the emotional storm that has been set off by the death.
Through that understanding, the adolescent becomes better equipped to actively respond to the emotional storm rather than passively reacting to it. Thus, instead of “feel and react,” the adolescent learns to “feel, stop, think, then act consciously.” In this way, therapy can help guide youth to engage in acts of mastery and self-control over their grief, which translates into a sense of power and self-confidence.