Background:The death of a parent is a highly stressful life event for bereaved children. Several studies have shownan increased risk of mental ill-health and psychosocial problems among affected children. The aims of this studywere to systematically review studies about effective support interventions for parentally bereaved children and toidentify gaps in the research.
Methods:The review’s inclusion criteria were comparative studies with samples of parentally bereaved children.The focus of these studies were assessments of the effects on children of a bereavement support intervention. Theintervention was directed towards children 0–18years;butitcouldalsotargetthechildren’s remaining parent/caregiver.The study included an outcome measure that dealt with effects of the intervention on children. The following electronicdatabases were searched up to and including November 2015: PubMed, PsycINFO, Cinahl, PILOTS, ProQuest Sociology(Sociological Abstracts and Social Services Abstracts). The included studies were analysedandsummarizedbasedonthefollowing categories: type of intervention, reference and grade of evidence, study population, evaluation design, measure,outcome variable and findings as effect size within and between groups.
Results:One thousand, seven hundred and-six abstracts were examined. Following the selection process, 17 studieswere included. The included studies consisted of 15 randomized controlled studies, while one study employed a quasi-experimental and one study a pre-post-test design. Thirteen studies provided strong evidence with regards to thequality of the studies due to the grade criteria; three studies provided fairly strong evidence and one study providedweaker evidence.The included studies were published between 1985 and 2015, with the majority published 2000 onwards. The studieswere published within several disciplines such as psychology, social work, medicine and psychiatry, which illustratesthat support for bereaved children is relevant for different professions. The interventions were based on various formsof support: group interventions for the children, family interventions, guidance for parents and camp activities forchildren. In fourteen studies, the interventions were directed at both children and their remaining parents. Thesestudies revealed that when parents are supported, they can demonstrate an enhanced capacity to support theirchildren. In three studies, the interventions were primarily directed at the bereaved children. The results showedpositive between group effects both for children and caregivers in several areas, namely large effects for children’straumatic grief and parent’s feelings of being supported; medium effects for parental warmth, positive parenting,parent’s mental health, grief discussions in the family, and children’s health. There were small effects on several outcomes, for example children’s post-traumatic stress disorder (PTSD) symptoms, anxiety, depression, self-esteem andbehaviour problems. There were studies that did not show effects on some measures, namely depression, presentgrief, and for the subgroup boys on anxiety, depression, internalizing and externalizing.
Conclusions:The results indicate that relatively brief interventions can prevent children from developing more severeproblems after the loss of a parent, such as traumatic grief and mental health problems. Studies have shown positiveeffects for both children’s and remaining caregiver’s health. Further research is required including how best to supportyounger bereaved children. There is also a need for more empirically rigorous effect studies in this area.