Hello, and welcome to WVIA, Speaking Grief, part two, Understanding and Advocacy.

I am Teresa Sabecky, I'm WVIA Education Coordinator, and I'm actually joined by my cohort, Vicky Austin.

Vicky is Manager of Grants here at WVIA.

And we are here to talk about grief.

We are talking about what grief looks like, defining grief from infancy all the way to adulthood.

We're also going to be providing a bunch of resources about grief and concerning grief.

I have a set of great panelists here today that I'm going to be, we're gonna be introducing as well to talk about grief.

But first, I want to thank our funder for making this all happen, the Community Giving Foundation of Berwick.

So, thank you to them.

So, let's get started.

Jennifer, I wanna start with you.

Can you just introduce yourself, the organization that you represent, what your role is with the organization, and any credentials?

- Sure, thank you so much.

My name is Jennifer Seechock.

I'm the Director of Counseling Services with Hospice of the Sacred Heart.

I've been there for about 17 years, and initially, started out as the Bereavement Coordinator and recently, moved into the director position.

And we offer a variety of different services to the community or Hospice.

And my role primarily there is to help with the bereavement services aspect of the Hospice agency.

- Great.

Thank you so much.

Welcome.

Kristi, we're going to go over to you.

Same question, just the organization that you are representing, your credentials, and what your role is currently.

- My name is Kristi Nejman.

I work for PAK Pediatrics.

I'm a licensed clinical social worker, and I provide therapy to children and adolescents and their families for a range of issues that they might come in with.

Anxiety, depression, grief, behavioral concerns.

We see it all.

- Awesome.

Thank you so much for joining us, Kristi.

And Beth, can you talk to, I know you're from a school district, so can talk about the school district that you work with, your role at the district, and any credentials.

- Sure.

Hi, thank you for having me.

I am currently working at Crestwood School District.

I'm the Director of Special Education and Student Services.

Student services covers in schools, nursing, guidance counseling, psychologists, social workers.

So I direct and help manage and support that staff here.

I also sit on the Board of Directors for the Wilkes-Barre Area School District.

And I have been employed in the public school system for the last about 15 years as a school psychologist in addition.

So I worked historically, in several districts in Luzerne and Lackawanna County as a psychologist.

So, I'm happy to be here and happy to link all of our professions together to help support our families.

- We're happy to have you.

So, thank you so much all of you for joining us today.

So, I want to get right to the basic definition of what grief is.

Kristi, can you talk about what grief is and give a definition for the people who are watching today?

- So, grief is the feeling that we experience in response to a loss that occurs in our life.

Any change in our life could be considered a loss and it can look different between all people, particularly across ages and cultures, grief can look very different.

- I remember hearing as I was going through school, and I am a certified teacher, so I remember them talking about this briefly when I was in school about the stages of grief.

Is that something that is still a thought of today?

And if so, what are the stages of grief?

- So, the stages of grief is something that is still kind of used today.

It's more used as a guide though, than people progressing through one stage to the next.

We know that grief is not linear like that, and we don't progress through the different stages that way.

So, it is something we still talk about, but it's more used as a model.

There are five stages of grief.

It starts with denial of what has occurred.

Then anger may occur of the event or the loss.

There might be some bargaining, you know, trying to not believe that this happened or trying to kind of make deals.

Depression can occur.

And then ultimately, the last stage of grief is acceptance of the situation and the loss and what has happened and trying to move forward from that.

- Great.

So Jennifer, I wanted to ask you, you know, do you feel that there is a certain time span of how long you could be grieving for?

Is there a time limit or not?

- There's not.

The truth is, you're going to grieve the rest of your life for that person who is no longer here.

There's always something that he or she should be here for to experience with you.

Will it hurt as much as it does when the loss first happens?

No.

We do learn to adapt to life without that person here with us, but there is no particular timeframe for the grieving process.

It's something that we learn to adjust to and create a new normal for ourselves.

- And we use these terms very interchangeably, at least I do in my normal life.

But I just have a question about is there a difference between grief and mourning?

- Mourning is what we show on the outside.

And so, sometimes people who are grieving, they may look like they're okay, you might see them out at the grocery store and they're kind of keeping themselves composed and you might see them out and feel like they're doing okay.

Meanwhile, on the inside, they're in a completely different state.

And that can be very challenging, you know, for people to gauge where somebody is at.

But grief is the internal meaning.

- So that brings me up.

That brings up a different question that I wanted to ask you actually is, you know, when you are, you maybe have a family member who may be in Hospice or in hospital, is there a way to mentally prepare yourself for the grief?

And if you do, does that actually lessen the grief after they pass away or after that event happens?

- So, for families that are in hospice who are experiencing maybe a terminal illness, maybe they're not in hospice, but they're experiencing terminal illness.

There is what we call anticipatory bereavement, and that is the grief that's occurring prior to the patient actually passing away or to the family member passing away.

And that can include a variety of different things.

The person who's dealing with a life limiting illness may not be able to do the things they once did before.

So life changes even prior to the death occurring.

Maybe there's more hospitalizations or they're not, you know, able to get out of bed anymore, not able to do the things that they once enjoyed.

And so, the person that's sitting in front of you, even though they're still here alive and present, they're not necessarily the same person they once were, maybe prior to the illness.

So, there is a difference with anticipatory bereavement and that, you know, unfortunately, that doesn't mean it's necessarily easier than maybe somebody who died of a very sudden death and there was no preparation for that.

They're very different things, but there is, there is that anticipatory bereavement.

- Great.

So, I wanna also talk about depression because a lot of the things that you just said, Jennifer, when I think of unable to get out of bed, when I think of not being myself, I immediately think of depression.

So, is there a correlation between the two?

Are they the same thing or are they actually very clinically different?

- Well, there is clinical depression and then people who are clinically depressed can also have the loss of a loved one and have depression associated with grief.

So, they are different in that respect.

And I don't know if any of the other panel members, I'm seeing some head nods, so I don't know if they wanna jump in on that, but they are two different things, yes.

- They're are two different, Kristi, I see you nodding your head as well.

Did you have anything to add to that?

- Yeah, grief tends to come in waves, whereas depression tends to be more constant.

So, grief may still produce both positive and negative memories of the person who you have lost.

The experience may briefly pause or stop or might become bigger or smaller each day, you can experience grief differently, whereas depression is more of a persistent feeling of sadness.

It lasts for days.

You do have the decreased interest in activities, a loss of energy, fatigue, some feelings of worthlessness and hopelessness, which you might not see with someone who is grieving but not depressed.

So, there are differences between the two that you can see.

- Okay, okay.

So, I wanna get into some examples that may cause grief.

This panel, I wanna talk about at home and in your family.

And I also wanna talk about in the classroom.

So, we're gonna start with Beth and I want, Beth, if you could just kind of give some situations that students may feel that causes grief in students from your experience.

- Students experience grief in lots of different ways.

Obviously, a loss of a loved one, a parent, a pet, a caregiver, an extended family member.

Grandparents, a lot you see is typically one of the first members of a family to pass away.

It's usually the first loss that a child experiences typically, but we have incarceration that sometimes causes grief, where parent, you know, we have students who are struggling with the loss of a parent due to being in prison or sometimes rehab facilities or halfway houses, things like that where they're just, it's a separation.

The same thing with a child being placed in foster care.

So, they're grieving the loss of a loved one due to separation more so than death.

So, I think that those would be probably the primary things that we see is in addition to death would be loss or separation of a caregiver.

- So, when I think separation, I think we all could remember the pandemic.

We are just now poking our heads above water with the pandemic.

In your experience back in the past year or so, two years even, you know, what kind of grief are you seeing in students that is pandemic related?

- I would say, we lost a lot of, you know, same thing, the ability for family members that were once close at a certain time that maybe, you know, grandchildren with grandparents that spent a lot of time together.

There was a lot of separation happening there.

Same thing if they, you know, we had family members who were in hospitals or in nursing homes and they weren't able to access them.

Prison's the same thing.

The visitation was very limited during that time.

And then of course, obviously, people, you know, passing away from COVID, loss of loved ones during that time, we experienced an increase, obviously, nationally on that level.

And so, that impacted our kids and impacted our classrooms.

- Okay, so, we are going to now talk about some of the signs of grief.

I wanted to kind of get into what grief looks like for the developments of stages as one grows up.

And Kristi, I wanna ask, I've always wondered this, I'm a mother of a two-year-old.

Can infants and toddlers experience grief?

- Yes, infant and toddlers can experience grief.

Actually, everyone experiences grief, they just experience it differently and they express it differently.

So, for children two and under, you usually see an increase in fussiness.

They're usually clinging to the adult or caregivers in their lives, kind of like a separation anxiety.

You may see some regressive behaviors, changes in sleep patterns, eating patterns, and two-year-olds who may be able to speak full sentences, you may see a regression to kind of baby talk or more immature talk for their age.

And then for children ages two to five, you could see a regression in the form of bedwetting or thumb sucking, kind of trying to find some self soothing for themselves.

You could see some regressive behaviors, again, changes in sleep and eating, nightmares, aggression, some non-compliance.

So not following directions, not following rules, challenging different limits that have been put in place that they maybe were not challenging before.

With young children, behavior is a way they can communicate to you what is going on because a lot of children don't have the words to say, I'm sad or I'm grieving, or I miss whoever the loss just was.

They display it through their behavior 'cause that's the best way they can communicate and get someone to pay attention to them.

- Okay, okay.

So Beth, in your experiences, how about children, middle school, school-age children, teenagers, you know, what kind of, how do they express grief to us?

- I think developmentally, what we usually see in that pre, like six through nine year old, they do a lot of blaming.

They have a really unique ability at that age, I think, to figure out a way to make everything their own fault.

So, I think that there is a lot of that in that age range that we try to work through, but it can really manifest and look like anything.

We see everything from anger and aggression to crying, isolation where they really, you know, kind of come into themselves and stop doing or stop participating in things that they usually participated in.

Embarrassment.

Sometimes, we'll see from kids that they, you know, aren't getting better as quickly as they kind of get like frustrated with themselves that they're still feeling this way after so long.

I see that a lot in, I think like the middle school population.

So, it really depends, you know, on the student and their experience and, but it can, a lot of times as Kristi mentioned, look like behavior.

And so that's really important, you know, in your fact finding as a child's study team at school to really get the information about a student before, you know, kind of developing plans to put in place.

Because a lot of times, things that look like one thing can really be another.

So, treatment is guided by that.

- Okay, that's very interesting that even when they're in middle school or high school, behavior is really the key to being able to seeing that they are struggling with grief.

I find that very interesting.

Jennifer- - I'm sorry.

- Go ahead.

Go ahead.

Also, behavior changes too, you know, in grades.

So, a lot of times older, you'll start to see those grades slip.

So, that's another thing when you just looking for changes and things, that this used to be a straight A student and now, all of a sudden, we have a kiddo who's got, you know, Cs and Ds.

That's a red flag for us.

What's going on?

Let's ask some more questions.

- Interesting.

Okay, so Jennifer, let's talk about adults and the elderly.

What are some, what are some, how do they experience grief?

How do they outwardly show grief?

- You know, a lot of times, again, it varies person to person.

And a lot of times, if it's a parent with children and either it's a grandparent who's passed away or maybe it's, you know, another parent who has passed away, they can become hyper focused on their children and not really tend to their own grieving process.

It can become very focused on, I have to help my child grieve and not really focus on their own grieving.

I think a lot of people are surprised.

We all expect to be sad when a loss occurs, but we're not necessarily prepared for the physical reactions in the grieving process that we might experience.

And this goes for children through adulthood.

There is a true lack of concentration and that's something that kind of frightens people because they don't feel like themselves.

And so, a task that maybe took 10 minutes to do, now takes 45 minutes to do.

Or if they're reading something, whether for pleasure or school or work, they read something, they turn the page and realize, I have no idea what I just read.

And don't really associate that with grieving, but that is actually a part of the grieving process as is lack of motivation to do things we once enjoyed.

So, there can be a real lack of, especially as we enter into the holiday season, people maybe who enjoyed decorating for the holiday season, now don't wanna do it or say what's the point.

And that can be, again, children through adulthood.

- So, you mentioned the physicality of how it could outwardly show in grief.

Can grief affect you, your health, and that can it affect your teeth?

Can it affect your hair?

Do you, can you experience hair loss?

I remember when I was a teenager, everyone would tell me that stress brings you acne.

Can grief bring you acne?

Can it affect your skin color?

Are all those things possible?

- Absolutely.

Stress, you know, grief is a stressor.

And so, if we don't have healthy ways of coping with it, if we internalize all of it, then yes, it's gonna manifest itself through us physically.

So again, it can affect our blood pressure, it can affect our hair as you mentioned, teeth, acne, we can have, I mean, people physically feel their heartbreaking, you know, that's one of the things that they talk to us about.

There's a tightness in their chest, a weight on their shoulders, physical symptoms of the grieving process.

Absolutely.

- So, we've talked about the outward signs of grief, but I wanna talk about somebody who maybe doesn't outwardly show those signs.

So Kristi, I'm gonna ask you, you know, what if somebody is hiding their grief, is that something that is possible or would it, eventually come out anyway?

- It is possible for people to hide their grief inside in terms of not talking about it, but it will manifest itself in different ways.

I found with the kids I work with who aren't ready to talk about what has happened, they will often complain about not being able to sleep or stomach aches, headaches, they're frequently sick, you know, they'll have a cold, they'll get over it, then they get another cold or they get a stomach bug, and that's really grief playing out for them, but they're just not able to make that connection yet.

So, even though they're not speaking about it, it will manifest itself in different ways.

- Speaking of manifesting itself, that brings me back to in the classroom.

So Beth, you already mentioned some of these, but I just wanna kind of go over as an educator, you know, when you walk into a classroom, you see these students six to eight hours, five days a week, sometimes even longer.

What could teachers look for, educators look for in their classroom for signs of grief in students?

- Sure, we actually were really lucky in the state of Pennsylvania, we have something called the Student Assistance Program, and that's a state-mandated program.

It's our SAP team.

So those are up and running in all of our buildings.

So we have a team of professionals that include our guidance counselors, our psychologists, or social workers that meet weekly.

And we have a referral form that anyone in the school can submit to our team.

And in that referral form, it asks, loss of interest, sleeping more in class, declining grades, increased attendance concerns, so not coming to school, increased visits to the nurse.

So somatic complaints, you know, my stomach doesn't feel good and those kind of things, but, you know, coming and there's never a fever, but just kind of saying, hey, I don't feel good in showing up, crying changes in behavior, aggression, mood, sudden changes in mood, those kind of things.

So, we sort of try and provide and be proactive in providing a checklist to teachers so they can indicate to us what it is that they're seeing and we can initiate a process in order to identify the concern and provide some help.

So, and anything could be a trigger in the classroom and especially, there's so many things that happen in a school, you know, graduations and father daughter dances, which I'm not sure they do those so much anymore, but senior days where they get to and all of these things, a lot of the time I think sometimes trigger students a feeling of loss or a feeling of missing out.

So we try to identify those students and make sure that they have support systems in place.

- Jennifer, how would you address grief with family members that may not be children, that may be adults?

What tips would you give somebody if you think they're experiencing grief and you wanna talk to 'em about it?

- I think the important thing to know is that we're not all talkers.

And so, people do handle, they have different coping skills, children, adults.

And if you weren't a talker, if that wasn't your go-to coping skill before, it's certainly not gonna become your go-to coping skill after a significant loss.

And so, I think some of the questions we can ask, whether it's children or whether it's, you know, adults when you're feeling sad or when you're feeling stressed or angry, what do you do?

What helps you?

What soothes you?

And allowing that child or allowing that adult to tell you what it is that they they do.

And then we can be more aware if it's listening to music, if you start to notice that your loved one is now hanging out in their room a lot, listening to music more often, that could be a signal to you that they're struggling with something with part of their grief.

Or the other hard part is, is that we're not, we're not insulated from having other life stressors when we've had a loss.

Bills are still due, you know, tests are still gonna happen in the school system, work.

There's still work deadlines and so, on top of our grief, many times we still have other life stressors going on.

And so it's important for us to have some good healthy coping skills.

And again, they don't always include talking, but some good healthy coping skills that we can use when those moments hit.

- That actually brings up another thought I had and a question I had is, you know, when would you suggest somebody use work as a coping skill for an adult who is maybe grieving a loved one?

Is there a specific time or the best time to go back to work if you feel like as if you need that coping skill of being able to take your mind off of it?

Or do you stick to just waiting a certain amount of time?

- There's no hard and fast rule.

Again, everyone, everyone is different.

There's a couple of different things that we can do to help transition back to work or even for children to transition back to school.

You know, one of the things is recognizing whether or not we wanna talk about our loss.

Do you want people in the workplace coming up to you and offering condolences?

For some people, that's very comforting.

For other people, they kind of want everyone to back up a little bit, allow them their breathing room and just focus so that they can come in and focus on their work.

Or children the same way in the classroom, you know, are all the students and the teachers gonna come up and ask that child, how are you doing?

Some people get more uncomfortable with that sort of attention.

And so that's not helpful.

So learning, you know, what do we need to do when we return back into work or back into school?

What's going to make us most comfortable?

It might be as simple as, you know, the day before or a couple of days before returning back to work or returning to school, doing a dry run.

Go drive up to the building, kind of put your car in park and just see what your reaction is before you actually have to enter in and do the whole day.

And maybe it's, you know, starting out with half days if possible and when appropriate.

- We're talking about triggers and when you go into, let's say you have a child going back into the classroom and it's Mother's Day or it's Father's Day or you know, they're having a school-wide event that puts emphasis on the parents and the caregivers, but that child is dealing with isolation from those parents or they unfortunately have lost those parents in some way, shape or form.

What is the best way in the classroom as an educator to handle that so that you don't trigger the child but also, you acknowledge that the child is going through something, but you also don't want to overstep your boundaries.

Kristi or Beth or Jennifer, do you have any tips and tricks for any educators who are listening?

- Kristi, (chuckles) I'll say, I think it's always, you kind of said that acknowledgement, you know, acknowledging the student, letting the child know that hey, we're gonna be doing this and I know, you know, this might be hard for you, but do you have any other ideas of how you'd like to celebrate, make them a part of the process and give them a leadership role?

I think teachers do a really great job of knowing the personalities of their kids in front of them.

So again, you know, a lot of this is individualized, but doing something active with the child, acknowledging them and where they are in their process and giving them kind of ownership and control over what it is that they would like to do to participate or honor that person, even though it might look a little different than what the other kids are doing.

That would be my suggestion.

Kristi, I'm not sure (chuckles) you have any other ideas.

- Yeah, no, I completely agree with that.

I mean, the best thing you can do too is just continue to validate that child and their feelings 'cause they're going to be feeling a wider range of feelings during those events or on those days.

So really just validating for them that what they're feeling is okay and kind of normalizing that experience for them can go a long way also.

- Should you involve the caregivers or parents beforehand, before something like this event happens?

Should you tell them beforehand and let them know that this may be happening, that their child may be agitated when they come home?

Or should you just handle it?

Is it at the policy normally to just handle it within the classroom?

- I think, you know, for certain students when the loss has been very soon especially, the school takes an active role in reaching out to that family pretty immediately when we know of the loss to ensure that the guidance counselor is hooked up with the family to offer any kind of additional services that may be available for the family.

And so, making sure you establish that relationship right from the beginning and continuing that conversation leads to sort of a flawless, hopefully, conversation when those events do come up.

So making sure you establish that relationship right away with that family, letting them know that the school is there to support in whatever way possible will help.

- Okay, so we've identified that somebody in our life, whether it's a student, whether it's a coworker, or a family person, someone in our family or a friend is grieving in some way.

I wanna talk about some ways that we can support them.

What are some responses that we could give to them that we could verbally do to them, give them, and also, how can we physically support them in whatever ways?

Jennifer, I'll start with you.

What would you recommend somebody who has know someone who's experiencing grief?

How could we support them?

- Really, the best way to support them is to just be present.

People mean well and will say things like, you now have an angel or your loved one's in a better place, or be grateful for the time that you had with 'em.

And they're coming from a good place, they want to provide comfort to that person who is grieving.

But most times, and for any of us that have been on the receiving end of that, it's not helpful.

And so, really, what we can just say is, you know, I'm sorry instead of just saying, call me if you need anything.

'Cause chances are that grieving person is not going to call, but maybe calling and saying, hey, I'd like to take you out for dinner Tuesday.

Would that be, would that work for you?

Or, you know, we're thinking of going for coffee, would that work for you?

I think that those things are more helpful to adults and to also children to give specific ways of helping and being supportive.

And oh, I'm sorry.

The only other thing that I would add is with children and teens especially, they don't wanna be different than their peers.

And so sometimes, when a lot of attention is given to them because they're the student who lost their mom, that becomes a tension that's not necessarily comfortable for them.

And so, you know, trying to provide support to them with, and again, respecting the boundaries that they have.

Some children are more comfortable talking about it, but if they're not, being respectful of that as well.

- You know, I also wanted to address maybe, maybe it's some, maybe it's a presence, maybe is there validity to being able to express, like if they don't wanna see us, if they don't wanna talk to us, the student, the teenager, the friends, the family member, they don't really want to come out of the house, they're not answering our calls.

Is there something else that we can do other than being in their presence, Kristi, Beth, Jennifer, or anybody, you know, any ideas that you may have?

- I think when we, it's important to continue to reach out, you know, so if we have a family member who's not ready to come out to dinner with us or to attend a family function, being respectful of that and not, you know, asking once or twice and saying, okay, nevermind.

They, you know, they keep saying no to us, but really continuing to offer that support, offering supportive text messages, hey, I'm thinking of you, not necessarily looking for, how are you today?

Because chances are, they're not great and it's hard sometimes for them to respond to that.

But just text messages I think of reminding them that they're thought of, that prayers are being sent in certain cases.

Comforting words like that.

- Okay, so.

Go ahead.

- Oh, I was just gonna say, I think for children, a lot of times, just because it's a lot of their first experience with death, they have a lot of questions.

So as a teacher and as an educator, just being very simple, truthful, on their level, like don't, you know, took a long walk or, you know, not using phrases that are metaphorical in nature, but really letting the child ask the questions and being responsive to their trust, their questions is a way just to show that you're, that you're there for them.

If you knew the person, sharing any positive memories that you had of the person with the trial to validate the experiences that they, you know, that they had and just, just letting them really lead by their questions.

- That actually brings me to my next question because we've been talking about, you know, at home of how we can support them.

We've talked a little bit of how, how we can support them in the classroom.

What kinda services can a school district provide for grieving students and their families?

Beth, can you speak to what kind of services school districts can usually provide?

- Sure, absolutely.

So there are systems in place in most school districts that are capable of dealing with any kind of mental health situation that may come up with students or their families.

So your guidance counselors, your school counselors are always the best place to start with those kind of concerns.

The guidance counselor will be your center point and then from there, they can refer you to services.

A lot of schools partner with outside mental health agencies already.

We have here at Crestwood, we participate with the Children's Service Center.

We have Luzerne Intermediate Unit where we can make referrals to staff and they actually have outpatient clinics right here on campus that operate most, I know Wilkes-Barre Area also has outpatient clinics already operating where, so the students family doesn't even have to drive them to get that counseling after school.

They can actually access that counseling here.

In addition, our school is fortunate, we were able to hire our own licensed clinical social worker.

Last year after COVID, we were trying to be preemptive understanding that, you know, kids were gonna be coming back and struggling in a lot of these ways.

And so, that person is able to touch base with the family, link the family up with any kind of outside services that they might need, whether it be counseling for their own grief or additional services.

Our social worker can provide, you know, weekly, monthly check-ins and support to the student on campus as well.

So there's definitely lots of avenues to access support and to coordinate services through the school.

And I actually think it's a great place to start if a family needed any kind of additional services to reach out to your school, your school's guidance counselor, and ask for more information.

We've got a lot.

- Yeah, that was my next question.

Can the parents just request that a student receive services?

- Absolutely.

Yeah, absolutely, yep.

- Also, if let's say a teacher notices that the student needs a service, but a parent disagrees.

Is that something where, what kind of boundaries do a teacher, do educators have when in that instance?

- So for our SAP referral process, the referral gets put in, it can be put in by anybody.

So let's say that in that instance, it was a teacher that was noticing, she referred it or he or she referred it to the team, we then reach out to the family and ask for a meeting.

So we get the family to the table virtually or in person, and have a conversation about what it is that we're seeing and what kind of services that we do have to offer.

At age 14, students are able to consent to those services themselves.

- Okay.

And does it, what would you suggest for school districts to be able to create protocols?

Because you mentioned that your school district actually took the proactive approach and during the pandemic, started to hire social workers, started to hire people to help with the grief that the pandemic was going to inevitably cause.

What kind of tips do you suggest for school districts, to create their own protocols in place?

- I think a lot of it, just making sure you have a really strong, identifying a strong crisis team within your district, the people that you count on to be able to have that information within your school to access those services and in whatever situation, whether it be grief or some other sort of mental health crisis that you need to address to establish a coarse set of individuals within your district.

And then a flow of communication that comes out from there and a really strong referral process.

That is the policy that I find and see most effective in the districts that I've been in.

And luckily, because the Pennsylvania Department of Education is so strong in SAP and the Student Assistance Program, and that's funded by the state and all of our schools starting with your SAP team is probably the best way to go.

And they go through a three-day training for SAP, anyone, you have to be trained to be on the team.

So it's a pretty intense training to make sure that you have the tools that you need to make the correct referrals.

- Can parents also use the resources that the school has for themselves?

- Yep, absolutely.

So that's sort of the benefit of having the social worker, but hopefully your crisis team in addition would have the resources to obviously, if we were making a referral to outpatient counseling, that can be a part of the counseling, the family system counseling.

But we also have CAS team meetings where you can do, make recommendations for family functional therapy or we have connections with Victims Resource Center or domestic violence locally.

Just really strengthening the partnerships that the school has with your outside agencies and making sure you know what those agencies have to offer so you can then provide that information to your families and the school can actually directly make those referrals for those families as well.

- So it sounds like if you are experiencing something that is a sense of a loss or that your family is grieving, that the first place you should really turn to - Is the school.

- if you are (indistinct) is the school.

Is the school.

- Absolutely, absolutely.

- Okay, Kristi, can you, so I wanna talk about, these are very specific situations, but I think we've all, especially during this pandemic and after this pandemic, I think we've all have experienced these in one way or another.

What if you have a caregiver and a parent and a child in the home simultaneously grieving?

How can you support somebody else when you need support yourself?

Do you have any tips on that?

- It's really drawing on the resources you have around you.

So friends, family, the school, maybe sports teams, a church you're involved in, trying to pull those people together and gather their support in any way you need, taking your time, using your own self care.

It's very hard to support someone who's grieving when you yourself are grieving.

So making sure you're really taking care of yourself first so that you can also be there for the other person.

Showing your child that it's still okay to be hurting can be great.

A lot of children, as we've said, don't wanna feel different from their peers.

So letting them know it's normal that this is a process and it can take a longer time than maybe they expected it and that that's okay, can really help them.

Grief can be enormously painful for everyone and it doesn't have a timeline.

Some people take more time to heal than others.

So really just normalizing that and modify your expectations of kind of what you expect of the children.

As adults, we have a hard time sometimes going through day-to-day life when we're grieving.

Our children are going to have that same tough time.

So really looking at what expectations you have of your children and how can you kind of meet them where they're at in the process.

And remember, that everyone's grief is unique so it's gonna look different and every day it may look different.

- There's an aspect of grief that I wanted to kind of hit on as well.

It's the sense of shame.

People who feel grief oftentimes feel shame and parents feel like it's, if they feel shame when they grieve in front of their, in front of their children, they don't wanna cry in front of their children.

They wanna remain strong in front of their children.

Jennifer, can you speak to that what would you recommend when people feel that sense of shame?

- Actually, the best thing that we can do is show our emotions in front of our children.

We can model healthy coping, healthy grieving for our children.

If a child, if all the adults around that child appear like they have it together and they're fine, and that child is experiencing all these different feelings and he is looking around and saying, how come everyone else seems okay, then the child starts to feel like there's something wrong with them.

So I, we really recommend for parents, any adult in a child's life, to share how they're feeling, it's okay to cry in front of a child, it's okay to cry together, you know, really have actual family moments of grieving together.

And then also showing that it's okay to be okay, you know, that grief isn't always sadness 100% of the time.

There might be something else that's joyful that happens, and it's okay for adults to be okay for a little bit and it's okay for children to be okay.

I think Kristi talked earlier about grief comes in waves and so, when we're having moments where we're managing or we're doing okay or again, we're even experiencing some joy, that's an okay thing.

- So, I have a question for all of you and I think it's really important that we address this, is when should you seek professional help?

Do you have a specific barrier in mind where, in your opinion, someone should seek help if they've been really struggling for a long time, and how would you address that with someone who you think needs professional help?

What are the best ways and resources that we could, that they could, that we could recommend to them?

- What we, so at hospice, when we provide bereavement support to the community and also to the families that we serve, one of the things that we utilize is that if your grief is interfering in your daily life, if you can't get out of bed, if you are not eating, and you're gonna have days where you kind of crash on the couch all day, and that's okay, but if you start to find that that's multiple days in a row or that you're not getting outta bed or you're not showering or you're not eating, like I said, or if you're a parent and you have young children and you're not really being able to care for them, that's absolutely when we would, you know, recommend that, that you're seeking some more intensive care.

- And I think the hard thing is that in reality, we can only really encourage someone to get help.

We can notice all of these things, but ultimately, they have to make the decision on their own to go and seek that help.

So in those moments where you're noticing someone maybe needs a little more help but they're not willing to, is really being supportive, being present with them and if they do reach out to you, listening non-judgmentally and just encouraging them through the process until they're ready to take that next step.

- Okay, excellent.

So, I wanted to address some of the questions that we received in the chat.

The first question is, how can I help someone who has never grieved the loss of a loved one and are feeling the effects years later?

- I think that that, I'm not sure I fully understand the question, but we have people who have experienced a loss and at that period of time, maybe have some really good support systems in place, maybe they're working, it doesn't mean that the loss doesn't affect them, but that they have some good coping skills in place.

They might have family activities and things to kind of help keep moving them forward and then maybe years later, they retire and now all of a sudden, that support system of work, you know, our coworkers who might be supportive, a job we enjoyed, even though retirement's a good thing, it can cause us to re-grieve.

And I think that the key too is understanding that as we hit different developmental stages in our life, the loss means something else.

So if you lose your mom at age seven, what it means to you at age 18 is something different and you re-grieve it, it doesn't mean you fall back into the intense grieving, but you re-grieve it, you re-grieve it again at 25, at 37, at 50.

So the loss changes over time and I think maybe somebody's hitting a different developmental stage and the loss has a different meaning for them at that point.

- I think little things like, you know, if you feel like you need to do something, if you're a friend and you wanna do something, little thing like sending a note or a small gift, just you know, if the person's not ready to really see you or have a visit, just letting them know, hey, I'm thinking of you, being there to listen, just being present.

Those are all little things that if someone feels like they really need to get out there and do something that I think would help.

- Next question that I received is, what if the caregivers don't agree on how to help a child grieve?

Meaning what if the two caregivers who live in the home or are raising this child don't agree on how to help?

What are your suggestions for the family?

- My first suggestion would be to look to the child as to what they need to feel better, to feel supported, to feel loved.

The children will tell you what they need and I think we need to look to them rather than arguing amongst each other as to what is best.

Each individual knows what they need in different circumstances for help.

So really turning to the child and saying, how can we support you?

And then being okay with their response to that because it's more about what the child needs and not what the parents need in that moment.

So really just looking at asking the child and helping them through it.

- Okay, the next question I have here is, how can I help my child put words to their feelings of grief so that I can better understand them?

And what if they don't want to put words to those feelings?

- Well, one thing that we use with the children we work with, we've done weather mobiles, so if you wanna say, you know, how is today?

It's partly sunny, you know, we have actual visuals to go along with that.

We can use emojis, we can do, because sometimes the truth is adults have a hard time putting words to our emotions and so, it's that much harder for children and I think coming up with some creative visual things might be very helpful.

Or even audio in terms of let's play a song that shows how we're feeling and you know, is it an upbeat song?

Is it, you know, a slower-paced song?

And that kind of thing can be helpful for adults and for children to express how they're feeling.

- I was gonna say the same thing, arts and crafts in general, anything art related is usually pretty therapeutic and just kind of giving them some paper, you know, to journal or to draw a picture can start to get some of those emotions out if they're not able to use their words.

- Okay, so the next question is actually about resources.

So I actually wanted to go and ask each of our panelists to kind of talk about some of the resources their organization or school district offers currently and anything that you can think of online, all of these resources that these panelists are going to name including and even the ones that they're not going to name on this panel, we are actually going to provide a sheet that you're gonna be able to access these resources, but I just wanted each of the panelists to kind of talk about some of the resources that they know of that they offer that may be of help.

So Jennifer, we'll start with you.

Any resources that your organization currently offers?

- Sure, so we offer a variety of different programs for the bereaved and they're open to the community as well as the families of our hospice patients.

We offer, all of our groups are support based and education based and so, we offer groups for loss of a spouse, loss of a parent, that's for adult children, loss of a parent.

We have a variety of different children's groups.

We do the Dragonfly Program which is a series for kids ages six to 12 who have had the loss of a significant person in their life.

And during that program, we provide education to parents on how to help their their child through the grieving process.

We do Camp Healing Hearts in the summer and that's a week-long camp for kids ages eight to 14.

And then the other program that we're offering is the Anchor Project, and that is where we can actually go into the schools.

We've gone into many different schools within the Northeast and we provide a four to six-week series depending on the needs of the school for kids who have had a loss and it's primarily geared toward middle school and high school students.

And we do one on, I'm sorry, we do one-on-one support with individuals and we are also, we have the MONICA Project, which is for parents who have had the loss of a child.

- That sounds awesome, really awesome.

Kristi, anything that you could recommend as well?

Any services that you could recommend?

- So if anyone is interested in therapy, you can go to Psychology Today and find a therapist in your area.

You can actually search for one who specializes in grief and you can do it by male or female if you have a preference.

You can also call your insurance provider and they can give you a list of therapists in your area who are in network with your insurance who again, can provide that resource for you.

In Luzerne County, we do refer some individuals to The Lands at Hillside Farms Grief Camp that they have for children.

Candy's Place also has a grief support group as well as the Shavertown United Methodist Church.

So those are some referrals we will give to families if they come in and there is some grief going on and their seeking additional support.

- Great, great.

Beth, anything that you could recommend?

- Within your school, obviously, I know I mentioned a couple of them already, but reaching out to your guidance counselor for support immediately is always a great first step.

We've partnered up with Camp Koala over the years, that's a camp for grieving children.

They were previously located in the Back Mountain.

This year, for the summer, they will be in Mifflinburg and they offer vouchers for kids to come and it's a really neat experience.

The students that I know who have gone through it, a lot of the time, it was the the first experience where they really realize that other people, other children are in their same boat, that they're not alone in their grief.

And so, they're able to really share those stories and I think that that's very powerful for the students who go through that camp.

They have a website and they also offer support groups for families outside of their overnight camp experience.

They have a lot of information and support groups available.

They reach out to the school districts themselves to try and fill slots for those.

So that's something that you can also get information if you reach out to your school, if you're a parent who's interested and has a grieving child.

We partner a lot with Victims Resource Center depending on the type of grief and the type of traumatic event that may have occurred, that could be a good resource for you.

Any outside agency, locally, Northeast Counseling, Children's Service Center, if you're looking for more behavior intervention or therapeutic type support.

Domestic Violence, I know I mentioned them previously as well.

Again, you know, specific to your situation and what it is that you're experiencing, there may be more specific types of resources available.

Our social workers also run a grief group daily and so if your school doesn't have one, reaching out to your school and seeing if there's something like that that they can organize like lunch bunch with other students who have had a loss of a parent or a grandparent, that's something that we can easily put together in a school.

And again, it kind of mimics that same idea of not being alone in a situation 'cause that feeling of isolation can be negatively impacting.

- That actually brings me up to another question I wanted to ask you Beth, is, can a parent or a caregiver reach out to the school and request that they start the protocol for the grief process when a school district, maybe an entire school district has a loss in a teacher or a student that's well loved, or maybe it's just one of the students in the particular class has experienced a loss and is coming back into the school after a period of being out of school to grieve, can parents and caregivers request that?

And if they could, who do they go to to talk about it?

- Sorry if I feel like a broken record, but absolutely, they can request it.

They can request it from anyone at the school, but your school counselor is definitely the best place to start with those specific types of requests.

But if you know, if you have a relationship already with a teacher or a principal, I would say reach out to whoever you feel most comfortable with because those people internally will know who to go to.

- Great, awesome.

I just wanted to make sure we asked that question.

My last question for all of you, is there anything else that you think that we missed in this panel or you didn't get a chance to talk about that you wanted to kind of put out there before we end this panel, looks like we covered a lot.

We covered a lot and I really wanted to thank you all for attending this panel.

It was a great pleasure to talk with you.

I think that we have covered so much information and anybody who watches this or participated in this for the past hour, probably received a ton of information and support and resources.

This panel is going to be recorded and is recorded.

It's going to be available on WVIA.org, so anybody can watch it back if they need to or share it to somebody who thinks that they would benefit from watching it.

We're also going to be including a resource of all of the different resources that we have mentioned during this panel and anything else that may, we think may be of help for families, caregivers, and of course, for educators as well.

I'll also be including some of the things, resources at PBS, also, includes as well in their grief and loss section.

The other thing that I wanted to mention before we exit is that there is going to be a feedback survey for anybody who's attended.

We really appreciate if you take five minutes out of your time to give us some feedback because we're always trying to give the public and our viewers and our members what it is that they need, the resources that they need.

So we really appreciate it if you take some time to do that as well.

I'd like to thank our panelists for attending today and also, I want to thank our funder, the Community Giving Foundation of Berwick for making this all possible.

I hope you all had a very informative and well-rounded hour with us today.

Be safe, be well.

And from all of us here at WVIA, thank you so much for attending, and we'll see you next time.

- Thank you.