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Therapy for Children's Grief
10 CEUs 8 Strategies for Working with Grieving Children

Section 3
Guilt in Grieving Children

Question 3 | Test | Table of Contents | Grief CEU Courses
Social Worker CEU, Psychologist CE, Counselor CEU, MFT CEU

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On the last track we discussed anger.  Three important aspects of anger are anger as a manifestation of grief, anger history, and identifying triggers.  We also discussed two techniques for coping with anger.

On this track we will discuss guilt. Three concepts regarding guilt are guilt is common, unrealistic guilt, and the reassigning responsibility technique. This track contains a case study in which a feeling of responsibility causes the client to feel guilty. If you are treating a grieving client who experiences guilt regarding a death, perhaps he or she could identify with the content of this track. Consider playing this track for that client.

Three Concepts Regarding Guilt

Concept #1 - Guilt Is Common
As you know, feelings of guilt may be common after a client experiences a death. Malcolm, age 15, became overwhelmed with guilt after the death of his mother, Joan. Though Malcolm became sullen, his father described him as unusually well behaved. 

Malcolm’s father Derrick stated, "It’s strange. Ever since the funeral, Malcolm has been doing all his chores and homework on time. He doesn’t talk back to me and hasn’t gotten into any trouble at school. Not that he was ever a trouble maker, but you know how kids are." Do you agree that Malcolm’s sudden change in attitude may be cause for concern? 

I stated to Derrick, "Malcolm may have some guilty feelings. I find that children and adolescents who become "too well behaved" either regret something or feel guilty. Guilt and regret are common among children his age who experience grief."  Think of your Malcolm.  Has he or she become unnaturally well behaved as a result of guilt?  How could you uncover the source of that guilt?

Concept #2 - Unrealistic Guilt
In a later session, Malcolm explained his unrealistic guilt to me. 

First, however, when I spoke with Malcolm regarding his recent behavior change, I asked, "Why have you been behaving so well?"  Malcolm responded by stating, "Can you keep this between you and me?  I mean, don’t tell my dad, OK?  Listen, I think I might have killed my mom. How do you think I feel about it?  I feel like guilty as hell!  She was a good mom, and I was a bad son! She deserved better!" 

Next I asked Malcolm about the role he played in his mother’s death. Malcolm stated, "On the day she died I was at school, but that morning is when I did what I did to her. I got up late, and hadn’t finished my math homework. The book was still lying open on the kitchen table. Then the bus rolled up and I was leaving when she started yelling at me for not taking the trash out. By the time I hit the door, she really looked mad! Three hours later she had a heart attack and died." 

Though he may have regretted not finishing his homework, the guilt he was feeling was unrealistic due to the fact that this minor disagreement did not cause her death. Think of your grieving client.  Do you need to help him or her get relief from unrealistic guilt?  If so, the following technique may help your Malcolm.

Technique:  Reassigning Responsibility
To help Malcolm get relief from his guilty feelings, I used the Reassigning Responsibility Technique.  This is a four part technique which focuses on disputing and replacing guilty feelings.  
-- Step #1 - The first step in the Reassigning Responsibility Technique was to identify the guilty feeling.  For Malcolm, the guilty feeling was that he felt responsible for his mother’s death. 
-- Step #2 - The second step is analyzing the guilty feeling Malcolm stated, "She had been to the doctor a couple times already for heart trouble.  She was taking medicine for it and had these nitro pills she could take if it got real bad.  The doctor told her to avoid stressful situations.  I guess that’s what I am, a stressful situation!" 
-- Step #3 - The third step in the Reassigning Responsibility Technique is to dispute the guilty feeling.  I asked Malcolm why he thought his mother had begun to have heart trouble.  Malcolm stated that it was because she smoked.  Next, I asked Malcolm if his mother quit smoking after her diagnosis.  His answer was no. 
-- Step #4 - This led me to the fourth step in the Reassigning Responsibility Technique, which is responsibility placement.  Clearly, responsibility for his mother’s death was not Malcolm’s.  Instead it was a heart attack based on physical abuse of her body by smoking. 

I find it helpful to allow the client to reassign responsibility. As you can probably guess, Malcolm did not wish to believe his mother was responsible for her own death, so he reassigned responsibility to family history of heart disease and natural causes. By reassigning responsibility for his mother’s death, Malcolm was able to start to escape his unrealistic guilt. 

Think of your Malcolm.  Does your grieving client feel guilty regarding events leading up to a loved one’s death?  How can you help your client find relief so that he or she can start to continue to work through his or her grief work. 

On this track we have discussed guilt.  Three concepts regarding guilt are guilt is common, unrealistic guilt, and the understanding responsibility technique. 

- Dowdney, L. (2000). Annotation: Childhood Bereavement Following Parental Death. Journal of Child Psychology and Psychiatry, 41(7), 819-830. doi:10.1111/1469-7610.00670

On the next track we will discuss involving children in change. Two types of involvement are negative and positive involvement.

Peer-Reviewed Journal Article References:
Colasante, T., Zuffianò, A., Haley, D. W., & Malti, T. (2018). Children’s autonomic nervous system activity while transgressing: Relations to guilt feelings and aggression. Developmental Psychology, 54(9), 1621–1633.

Donohue, M. R., & Tully, E. C. (2019). Reparative prosocial behaviors alleviate children’s guilt. Developmental Psychology, 55(10), 2102–2113.

Stutey, D. M., Helm, H. M., LoSasso, H., & Kreider, H. D. (2016). Play therapy and photo-elicitation: A narrative examination of children’s grief. International Journal of Play Therapy, 25(3), 154–165. 

What are the concepts regarding guilt you might assess in your grieving client? To select and enter your answer go to Test.

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