Dying Matters Week – Play Therapy is essential in helping bereaved children process their grief and loss.

When most people think about what we do here at ellenor, they will think of the symptom management and end-of-life nursing we offer patients. But we know it’s essential, too, to work to support the mental health of those they leave behind. For children especially, grief can be a massive, bewildering issue. Fail to help them deal with it, and the implications for those children and young people – not to mention the NHS’s already overburdened CAMHS (Child and Adolescent Mental Health Service) - can be enormous.

This has never been more true than it is today during the current Coronavirus pandemic.

ellenor has a multi-disciplinary approach to working within our local community of north and west Kent, using our limited charitable funds as prudently as possible to support a range of children’s bereavement services, always remembering that everyone experiences grief differently. Here, one of ellenor’s play therapist, Jolanta, talks about her work with children.

“I’ve worked as a play therapist at ellenor for over four years. As a psychologist,I specialise with working with children aged from two to 12– it’s the period of their lives during which this sort of therapy will have the biggest impact because, at this stage, they often use play as an expression of what they’re feeling. Children are referred to us through a variety of routes: via their own families if we’re looking after their relatives; via GP's or local hospitals, and via local schools, which can also access our support in helping their staff understand bereavement better through our outreach programmes.”

“We offer as standard 12 play sessions,each lasting for 30-45 min.– but we can and do extend that time frame if the child has more complex issues.Around each activity-based session,a multi-disciplinary approach involving parents, family, schoolteachers, counsellors-even social workers if appropriate–is designed to give each child the best,most helpful support given their individual circumstances. Safe-guarding issues are of course always at the forefront of anything we do involving children, too.”

What happens at a play session?

“First and foremost, the child has a safe space in which to express, through play, what’s going on in their emotional lives.We work one-on-one and,though I will interact with the child,absolutely it is him or her who sets the agenda.I want to see, through play,where the child will take me,with a range of activities helping them to express anything they might be feeling, any worries they might have.It’s all about finding the best method for each child to explore, process and cope with grief and the stresses it brings.In play therapy, children use a variety of means to express themselves including figures and toys, art materials or creative writing. In my experience play is the free expression of a child’s innermost feelings and they will engage in activities that’s best expresses these feelings.

We can also offer feedback to parents and guardians, empowering them through sessions to use play to listen to and communicate more effectively with,their children in ways they may not have considered before”.

“Children process so many things in bereavement, including anger, loss and loneliness. And sometimes that bereavement brings additional traumas and fears to the fore as well as anxiety about any changes in their own circumstances– a house- or school-move, for instance– that the bereavement may bring.Play therapy and how we use it to help children process their grief is vital, complicated and challenging work that really does make a positive difference, both to children’s day-to-day lives and to their future emotional wellbeing.”

What is GEMS?

GEMS stand for Grief: Every Memory is Special. It’s a group we runabout four times a year for around twenty children aged seven to 16, all of whom will have lost either a sibling, a parent or someone very close to them.The children come together to share their emotions about loss,and the group interaction is a powerful antidote to any loneliness they may suffer at home or school, where perhaps no one else has been through what they’re going through. Here, everyone gets it.Friendships are formed,the kids can talk about issues they’re facing, and we can prepare them for questions and situations they might have to deal with.But GEMS days are also about having fun together,so we combine creative therapeutic activities with fun, team building type outdoor activities such as survival skills in the forest, trips to the seaside or boxing training teaching resilience and perseverance. As with all the work ellenor does, it’s about equipping people to cope with the here-and-now and to know they can handle, or can get help in handling, whatever the future brings –difficult times, yes, but much to enjoy, too.”

In the current situation, more than ever before, we must find appropriate and perhaps new ways of working with children and their families. This is a time of considerable change for children; their home, school and social lives are all being significantly disrupted. At ellenor we are trying to manage the therapeutic connection with the child in different ways, like sending therapeutic letters, using transitional objects and planned telephone calls. In some situations, changing to a video call therapeutic intervention would be beneficial and I think it would work in a group setting. We are in the process of developing this kind of support for bereaved children who are in our GEMS group.

Most children are incredibly resilient and technologically advanced. Perhaps it is time to ask them to teach us how best to communicate at a time where we cannot meet face to face?

We continue to offer supportive services such as online and telephone counselling as well as Family Support, so please contact the Wellbeing Service at ellenor if you are struggling. If your child or if you know someone who could benefit from our hospice services, please contact Dawn Miller on 01474 320007.