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                 Evaluation of Grief Support Services for Bereaved Youth:
          An Overview and Update on the UCSB Project LOSS National Collaborative
                       Shane Jimerson, Ph.D. & Amber Kaufman, M.A.
                           University of California, Santa Barbara
                        Counseling, Clinical, and School Psychology
                            Child and Adolescent Development


                                         A bit about us...
AMK - Doctoral Student at UCSB, Counseling, Clinical, and School Psychology. Involved with
Project LOSS for over 2 years.
SRJ - Professor of CCSP and CAD at UCSB                         worked with bereaved children and
families for years gathered data from participants for over five years. Used data to inform
development of curriculum and solicit resources for center. In the past two years have begun to
establish the Project LOSS National Collaborative...
The UCSB Project LOSS research team includes:
    Kelly Graydon, Elana Hamovitch, Danielle Drewisch, Jenny Minnich, and Jaclyn Bauer.




                        Mourning Child Grief Support Group Curriculum
                           Lehmann, Jimerson, & Gaasch, 2001


                  Evaluation of Grief Support Services for Bereaved Youth:
          An Overview and Update on the UCSB Project LOSS National Collaborative

                                           OBJECTIVES
I. Brief review of published research
II. Important considerations engaging in this research
III. Overview of relevant measures and methodology of grief support services
IV. Overview and update of UCSB Project LOSS National Collaborative


                            I. REVIEW OF PUBLISHED RESEARCH
Opie, N.D., Goodwin, T., Finke, L.M., Beattey, J.M., Lee, B., & van Epps, J. (1992). The effect of
a bereavement group experience on bereaved children’s and adolescents’ affective and somatic
distress. Journal of Child and Adolescent Psychiatric Mental Health Nursing, 5, 20-26.
Schilling, R., Koh, N., Abramovitz, R., & Gilbert, L. (1992). Bereavement groups for inner-city
children. Research on Social Work Practice, 2, 405-419.
Tonkins, S. M., & Lambert, M. (1996). A treatment outcome study of bereavement groups for
children. Child and Adolescent Social Work Journal, 13, 3-21.
Graham, M. Janzen, Sontag, Bleyl, Prero, and Lyman (2000). An Examination of the
Effectiveness of Two Types of Children’s Grief Groups. Submitted for publication currently under
review. Available from author at the Council on Social Work Education, in Washington, DC.
Sandler, I. and colleagues (2001). The Family Bereavement Program: Efficacy Evaluation of a
Theory-Based Prevention Program for Parentally-Bereaved Children and Adolescents. Submitted
for publication currently under review. Available from author at Arizona State University.


                                 OPIE AND COLLEAGUES (1992)
Examined affective disorders, somatic complaints and the frequency of loss in elementary and
junior high schools – found 61% of elementary school students and 56% of junior high students
reported they had lost a significant loved one in the past two years
Explored the contribution of grief support groups on bereavement experiences of children and
adolescents - Of 16 elementary and junior high support participants, 7 decreased affective
distress & 6 increased affective distress. All but 1 decreased somatic complaints.


                            SCHILLING AND COLLEAGUES (1992)
38 children between 8-12 years of age
Examination of grief support group with pre-test and post-test design (no control group)
Measured depression and attitudes/ concepts of death
Most of the children remained depressed throughout the study
Children appeared to develop more mature concepts of death


                                  TONKINS AND LAMBERT (1996)
16 children (7-11 years of age)
   (10 intervention, 6 wait-list)
Examination of children who attended one of three time-limited therapy groups
Examined two hypotheses:
1) Group participants would have a decrease in grief symptoms as compared to the control
subjects
2) Group participants would demonstrate a decreased grief symptomology compared to their
pretreatment level of grief


                                          Click to add title
RESULTS (TONKINS AND LAMBERT, 1996)
1)Parent’s Bereavement Questionnaire
- decrease in overall emotions for intervention group
     (e.g., sadness, anger, withdrawal, guilt,anxiety, loneliness)
2)Children’s Depression Inventory
- decrease for intervention group relative to control group and also pre versus post
3) Child Behavior Checklist (parent report)
- decrease in report of grief symptoms of intervention relative to control
4) Child Behavior Checklist (teacher report)
- decrease in report of grief symptoms of intervention relative to control



                             GRAHAM AND COLLEAGUES (2000)
57 children (age 6-12 years)
   (38 open, 14 closed, 5 wait-list)
Assessment of the effects of grief and self-concept over time
Examine the type of group model (open or close-ended)
Results indicated:
1) decrease in grief scores for both types of groups
2) increase in self-concept scores for both types of groups
Note: the wait list groups demonstrated similar trends, although these were not statistically
significant



                            SANDLER AND COLLEAGUES (in press)
244 children and adolescents                   (135 intervention, 109 control)
“The Family Bereavement Program: Efficacy Evaluation of a Theory-Based Prevention Program
for Parentally Bereaved Children and Adolescents”
Procedure = pre-test, post-test, 11-month follow-up
Pre-Post analysis showed improved multiple mediators (family and child resources and
adversities)
Follow-Up analysis showed reduced mental health problems



                                  Limitations in previous research
Sample sizes are small, this limits generalization
Selected instruments often do not measure the process or design of groups themselves
No commonly used instruments across these studies


              IMPORTANT CONSIDERATIONS ENGAGING IN THIS RESEARCH

Systematic Data Collection
Documenting Services Provided
Comparison Group




               OVERVIEW OF RELEVANT MEASURES AND METHODOLOGY

Appropriate Measures of Grief Reactions and Outcomes
Measures of general behaviors and adjustment
Pre-, Post-, and Follow-up Designs


            APPROPRIATE MEASURES OF GRIEF REACTIONS AND OUTCOMES
Bereavement Rumination Scale (BRS)
Hogan Sibling Inventory of Bereavement (HSIB)
Hogan Grief Reaction Checklist (HGRC)
Hogan Inventory of Bereavement (HIB)
Texas Revised Inventory of Grief - child report (C-TRIG)
Jimerson Youth Common Grief Reactions Checklist - caregiver report (JYCGC-CR) & self report
(JYCGRC-SR)
Jimerson Loss Outcomes Checklist
The Grief Interview – Dr. Fristad
                 MEASURES OF GENERAL BEHAVIORS AND ADJUSTMENT
Child Behavior Checklist (CBCL)
Behavior Assessment Scale for Children (BASC)
Jimerson Facilitator Rating of Child’s Adjustment (FRA)
Jimerson Caregiver Rating of Child’s Adjustment (CRA)
Harter Self Perception Profile for Children
The Behavior and Emotion Rating Scale (BERS)
Childhood Depression Inventory (CDI)
Jimerson General Intake Survey


                                    UCSB PROJECT LOSS,
                                 NATIONAL COLLABORATIVE
Overview of the basic design of the collaborative
Update on the progress of the collaborative
Discussion about other programs joining the collaborative


                                             Basic Design
Establish a multi-site national collaborative with centers that provide services to bereaved
children to evaluate the processes and efficacy of grief support groups
Implications for understanding grief reactions of children


                                        Update on Progress
Centers already involved:
Center for Grief, Minnesota
Bo’s Place, Texas
Our House, California
Camp Begin Again, Florida
Fairview Ridges, Minnesota
Center for Grieving Children, Maine


                                          Click to add title

                                        Common Measures
                                  (used currently across all sites)
Caregiver:
Grief Support Groups General Information Sheet
Jimerson Caregiver Rating of Child’s Adjustment
Jimerson Youth Common Grief Reactions Checklist - Caregiver Report
Child:
Jimerson Youth Common Grief Reactions Checklist -    Self Report
Child Depression Inventory
Hogan Inventory of Bereavement
Jimerson Loss Outcomes Checklist
Facilitator:
Jimerson Facilitator Rating of Child’s Adjustment


                                     Multiple Levels of Analysis
1) FORMATIVE
   Refers to the design of the intervention      (i.e., the process of the support group)
2) SUMMATIVE
   Refers to the degree to which it influences outcomes the participants
   (i.e., the effectiveness of the support group)


                                       Some preliminary results
The Loss Outcomes checklist reveals many teens indicated experiencing more positive outcomes
from loss than negative outcomes, for example, out of 24 teens:
83% indicated a deeper appreciation for life
79% indicated greater caring for loved ones
75% indicated developing emotional strength
66% indicated putting priorities in different order
Only 8% indicated they isolated themselves socially and emotionally


                                  Some preliminary results, con’t
Jimerson Youth Common Grief Reactions Checklist - Caregiver Report reveals that based on 25
caregivers reporting on their youth at intake:
30% of teens were seen as experiencing depressive symptoms often and/or it is currently a
problem
19% of teens were seen as being aggressive often and/or it is currently a problem
19% of teens were seen as having school problems often and/or it is currently a problem
5% of teens were seen as having somatic problems often and/or it is currently a problem




                                Some preliminary results, con’t
Jimerson Youth Common Grief Reactions Checklist - Self Report
Results are based on 25 youth self-reporting on duration and intensity of 4 problem areas:
   Results reported as percentage of teens




4%
17%
79%
School Problems
4%
40%
56%
Somatic Problems
12%
26%
62%
Depression
12%
16%
72%
Aggression
High level problems
Medium level problems
Low level problems
Composite


Questions ???
Comments !!!
Discussion ...


                 Evaluation of Grief Support Services for Bereaved Youth:
          An Overview and Update on the UCSB Project LOSS National Collaborative

                         Questions??? Comments!!! Discussion...


                       Shane Jimerson, Ph.D. & Amber Kaufman, M.A.
                           University of California, Santa Barbara
                        Counseling, Clinical, and School Psychology
                            Child and Adolescent Development

805 893-8000

Shane Jimerson 805 893-3366

								
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