Beck Ferrari:
Hi Jaime, thank you so much for joining me today. I know that in your role kind of across phase and working with children and young people with social emotional health needs, that would be really important for us to think about the important role that schools can play in supporting children who’ve been traumatically bereaved
Jaime Cronk:
Absolutely. Thanks Beck. So I work with primary and secondaries with SENCOs, class teachers, school leaders. But, obviously with children with traumatic bereavement, they won’t worry sometimes that they’re not doing enough; are they doing the right things; are they doing the wrong things? But, I think all schools are fantastic at making sure they’ve got positive relationships with their students, but I think we have to ask the question sometimes is that enough? Do we have to do other things apart from just have a good relationship with the student?
0:55 Build on relationships
Beck Ferrari:
Thank you, Jaime. That’s really important that relationship is absolutely fundamental. We know that in traumatic bereavement the meaning the child has made from the death might mean that they now see the world as a scary place or somewhere they can’t trust and therefore we’ll probably need to do more than we would do and if we were supporting a child in a bereavement where that wasn’t that kind of trauma component, aspect to what they’ve experienced.
1:16 Engage with home
Jaime Cronk:
Thinking about the video and the animation, I think is really, really important one of the key things that came out of it for me for me was that relationship with home and that importance about keeping that going because without that we can’t really do much else. Because a lot of the information comes from there.
Beck Ferrari:
I would absolutely agree with you there. We know for all bereaved children engaging with home is going to be important, but with those that have been traumatically bereaved that becomes even more important. Potentially, the circumstances around the death have been quite difficult or the way the child has made meaning from what happened in the death and what it means for them is difficult. So, us knowing what the child and young person knows, what’s been explained to them, the language that’s been used, can really help school be in a better position to have effective communication with the child. And recognizing that it’s probably not going to be a one-off conversation with the family. And of course, it won’t be with the young person. We want to keep checking in to find out how things are, has new information being explained. There is a potential for misinformation — that children didn’t quite understand what was being explained to them. So, being able to pick on that can be a way that we can help minimize some of the difficulties they might have making sense of the death and finding out exactly what language has been used.
Jaime Cronk:
Yeah and I think we see in the video that Jeanie has those conversations at home about Wesley, don’t we. We need to make sure that we have those little insights of information, so that Jeanie can use those in her communication with Wesley. You know, what football team does he support. Those little nuggets of information can’t be underestimated, really.
Beck Ferrari:
Definitely. And recognizing that the family are also likely to be grieving and may be affected by the trauma as well. So, in our efforts to communicate, we want to be gentle and sensitive and in pace — at the right pace with the family as well.
3:21 – Actively monitor
Jaime Cronk:
So Beck, that communication, that keeping that relationship going with home is so important really because obviously we need to have those insights. We need to have that information, so that we can monitor what’s happening. So that we can look for the differences, look for those patterns of behaviours.
Beck Ferrari:
That can be really helpful to keep that communication going with home and that providing us with an overview. Jeanie might have recognised with Wesley in the animation that he’s struggling with PE, that he’s not engaging, but actually they’ll also want, school will also want to look at other parts of the school day, what’s he like in maths what’s he like at lunchtime what’s he like on arriving at school.
But equally checking with mum. How is he engaging at home? Is the lack of motivation we’re seeing in school and withdrawing from peers also something that mum has seen at home?
One of the things that’s quite helpful when we’re wondering about traumatic bereavement for a child or young person is to have some ideas in our mind – domains that help us monitor the level of difficulty. So we might monitor for persistence. How long has this been going on for? A few days, weeks or is it many months? And then frequency – how often is it happening? For Cara, is this every now or are her angry outbursts happening several times a week or pretty much every day? And then severity: how serious are these difficulties? Is Wesley feeling pretty low or can we see that he is utterly despondent. We can also think about duration: how long do these difficulties last? Is this a few minutes and then the child or young person can get on with everyday life or are there much more lengthy periods of distress? And then, change: do things seem to be changing and getting better or getting worse? How does this compare to them before the death occurred?
One of the other things that can be helpful is think about if they’re grieving: are they able to dip in out of puddles? We see Prisha in the animation who’s able to. She feels really sad when she’s missing her mum, but then she’s able to enjoy the distraction of hanging around with her friends and having
some kind of typical and fun with her peers. Whereas for Wesley, we’re seeing it’s not so much a dip in and out of puddles. It’s that I’m stuck in the well — I don’t know how to get out.
Jaime Cronk:
The staff in school they might be able to see that. But, perhaps because obviously Wesley’s in the secondary school, they might just see in his in their lesson. But I think that monitoring is so important because are they the same in my lesson? That communication between staff then is really important, isn’t it?
Beck Ferrari:
Yeah. Obviously with so many pressures on time, that can be really difficult to achieve. But just having a joined-up conversation with the people that know Wesley and see him across the school day and across the week, so that we can start to join those dots and get a picture of what he’s like.
And then of course for Cara, in the animation her grief looks quite different. We see a little bit about her having angry outbursts and being quite overwhelmed with her emotions in a different way. So I guess our monitoring is going to be across the school day: what’s she like at lunchtime? What’s she like in assembly? What’s she like outside on the playground? How is this impacting on her relationships with her peers as well as her relationships with school as well as her learning. And checking in with her carers at home as well. Maybe finding out that actually at night there’s she’s bed wetting again and she’s having lots of nightmares. Those kind of things would start to form a fuller picture for us that that maybe that we’re worried quite a bit more.
06:52 – Referral
Jaime Cronk:
So, Beck, after the school has done the monitoring and the communicating with the home to make sure that, it then shows, it is. Wesley, for example, is in his in his well and he’s finding it really difficult to come out of it. I think it’s at that point we need to really consider who we refer on to. Who we could then ask and seek special support because school staff aren’t specialists in bereavement and specifically not traumatic bereavement. So, I think it’s important for schools to have the confidence to know or to think about when they know when to refer on.
Beck Ferrari:
You’re absolutely right that all that information that’s been used during that monitoring period can be really helpful then in kind of pulling it all together and working at that actually, we are very worried about this young person. One of the things we know about traumatic bereavement is there is an increased risk of children developing mental health difficulties as well as their grief. So we may see presentation of post-traumatic stress symptoms. We might see some anxiety or some low mood kind of depression symptoms. We can even have difficulties with conduct. So being mindful of that and that those needs are best met by mental health professionals really.
If there’s a safeguarding concern, we’re going to want to go straight away because we’ve got concerns about the child’s ability to look after themselves and keep themselves safe, if they’ve got some kind of self-harming or suicidal thinking.
If we’re thinking about a referral without that kind of urgent safeguarding need, then we want to talk about it with a young person and say: “Look, we can see that this is really tough for you and we’d really like to see whether there’s some more specialist help we can get you.” And of course we’ll bring the family in as part of that engagement to work with them on that.
I think one of the important things is then working out: “Who do we go to?” With traumatic bereavement it’s quite likely that the trauma is disrupting the ability to grieve and therefore we might need some specialist help with that trauma to enable that young person to grieve. That support may be available from a local bereavement charity that can manage to help address both of those.
There may be times when it’s best placed with a local CAMHS service and therefore schools following all their usual kind of procedures to make that referral to CAHMS.
9:12 – Supporting a trusted adult
Jaime Cronk:
I think at that point as well, the schools really need to be mindful of support supporting themselves because obviously this isn’t an everyday occurrence. So for Jeannie in particular, you know Wesley’s key person, she needs to be mindful of her own thoughts, feelings and emotions around this. Who’s she getting support from? I think that team around supporting each other because if we want her to be able to support Wesley, we need to support her. So she needs to make sure that she has somebody to go to and for her to be brave sometimes and think: “Actually I’m not the right person today to manage Wesley.” And for her to be mindful of herself in this in this situation at all times.
Beck Ferrari:
Yeah, I think that’s really important. We can’t underestimate the impact that supporting a bereaved young person can have on an individual. And it probably should have a bit of an impact, you know? We should be connecting with the emotions of that person and what they’ve they’re going through, but we want to keep ourselves safe and able to do a good job. Therefore, we hope that Jeannie’s got her SENCO team around her. We hope she’s got her colleagues looking out for her and that when she needs to step back from supporting Wesley, someone else can say: “I can step ahead. I’ve also got a good relationship. Let me come alongside and Wesley for a while and keep that relationship going.
10:38 – Holding the hope
Jaime Cronk:
Hopefully then, that monitoring, when the specialists team is involved, that monitoring must still continue because he would he will still have bad days. But, hopefully, we’ll start to see some glimmers of hope and glimmers of light. So that the well is starting to, that he is coming out of the well, and for people to recognise that he may have bad days, but we obviously want a pattern of more good days than bad. That hope is always there that he will be able to feel supported and loved and safe and secure again.
Beck Ferrari:
I really like that you’ve mentioned that hope. I think that’s one vital thing that might seem insignificant that schools can do. They can hold that hope and they can keep that belief in the young person that even you’re in the well right now, that doesn’t mean I think you’re always going to be in the well and I’m going to keep offering support. I’m going to keep offering and holding on to the future that I want you to have and I believe you can have as you begin to manage your trauma.
Jaime Cronk:
There’s glimmers of light isn’t it? That those glimmers of hope. Looking for that positivity and that’s why that monitoring needs to continue because he might not be in every maths lesson, but if he’s in one more this week than he was last week, then that’s a glimmer of hope. We need to really hold on to those little glimmers.
Beck Ferrari:
Definitely. Thank you. I think that really highlights how important and significant the role of schools can be.