Maggie McKay (Host): It's hard enough as an adult to grieve, but what about how children process loss? Today, we're going to find out how to help them through it with Nicolle Conley, Licensed Bereavement Coordinator.

Welcome to Putting Your Health First. I'm your host, Maggie McKay. Thank you so much for being here today, Nicolle.

Nicolle Conley, LMHC: Thank you for having me.

Host: So to kick things off, can you please introduce yourself and share a little bit about your role at Hospice of Health First?

Nicolle Conley, LMHC: Sure. So, my name is Nicolle Conley. I'm a licensed mental health counselor. And at Health First, I fill the role of licensed bereavement coordinator and I head up the Bright Star Program.

Host: Can you tell us more about the Bright Star Program and how it supports families?

Nicolle Conley, LMHC: Our Bright Star Program that's offered through Hospice of Health First provides free support for Brevard children and their families, grieving the loss of a loved one. It's a place where kids can connect, laugh, and heal together with others who understand their journey. Because of the generous donations we've received from the Health First Foundation, we can offer this free bereavement support to children, teens, and their guardians via individual, family, and group support sessions, as well as our camps and special events throughout the year.

Host: Nicolle, why is it important to address grief with children, and how does their grieving process differ from adults?

Nicolle Conley, LMHC: Children and adults grieve very differently, although we're looking at grief as big emotions, feelings that people have when they've had a loss, children grieve as they develop. So, a child is going to experience these big emotions of grief several times throughout childhood as they develop. A child that starts off having a loss at three or four is going to experience that loss once. And then, as they develop and change, they're going to experience that loss again and again. We're going to see different reactions and symptoms as they go through childhood.

Host: What are some common signs that a child may be struggling with grief? How could we tell?

Nicolle Conley, LMHC: Probably the biggest sign that we see is regression at any age. They tend to look younger developmentally than they actually are. Sometimes if grief is a traumatic experience, it's important for us adults to note that some of the stuff that kids will do, how they respond, first of all, we know every behavior is for a reason. A child does not act out for no reason at all. We may see a child who's had trauma look very similar to a child who has attention deficit disorder, but those similar symptoms may just be a result of that grief or trauma. So, it's important to look at the child's developmental age as well as what they've experienced when we're talking with them.

Host: And how can parents and caregivers initiate a conversation about loss and grief with a child? Because it's sensitive the way you go about it.

Nicolle Conley, LMHC: Yeah. I think adults kind of fear that conversation. It's important that we're truthful with kids. It's one thing we tell every parent, every caregiver. You have to be truthful with them. They know what's going on. At their developmental level, they know what's going on. So, the more we can share with them, the better. An eight or nine-year-old child, especially, in that age range, they really want information. That's the kiddo that's going to probably tell you 60 times that their person died and how they died. It's important for their processing that, how they're processing that information for them to be able to talk about it and ask questions. When parents grieve separately than their children, when they hide their grief from their children, their children are experiencing a huge deficit. We need to be truthful with our kids and we need to cry with our kids.

Host: Well, that's good to know. Because yeah, you always hear like, "Just carry on as normal," the parents, and that's not a good thing, right?

Nicolle Conley, LMHC: Right. And we say things to kiddos like, "Oh, they're in a better place" or "They've gone to heaven." Sometimes that's so confusing for a child, especially a five or six-year-old child who's like, "Wait a minute, I don't understand the permanence of this loss," right? So, they don't know that that person's not coming back. And when we say things like, "well, They've passed on or they've gone to a better place," that child's like, "Oh, great. How do I get myself there?"

Host: Yeah. Right. And what's your thought on the theory that you should just tell kids as much as they need to know, like you don't need to overshare depending on their age?

Nicolle Conley, LMHC: You don't want to tell a young child the maybe gruesome details of a situation, but you do want to tell them what happened. "This person has died," "They can't breathe anymore," "They're not with us anymore," "They're not coming back," those types of statements for young children, it's really important because they're learning that permanence.

As kiddos get older, the details become more important to them. So surprisingly, children hear, see, experience exactly what we do. So when we have conversations that are adult conversations within earshot of a child, that child hears it more often than not. Even with suicide, they know what has happened long before the parent sits down and verbally tells them the details.

Host: Are there any specific phrases or approaches that are especially effective when explaining death to a young child?

Nicolle Conley, LMHC: Again, we just go back to that. We tell everyone, be truthful, use the word death, use the word died. When we use those other phrases, those popular cultural phrases, it's so confusing for a child. They're learning that vocabulary just like they learn other vocabulary in their world. So, them understanding that someone has died, that means that their body doesn't work anymore, they're not going to breathe anymore, they're not going to be with us anymore. Those kinds of statements are more important than a parent saying, you know, they've gone off to a better place, they've passed on, they're in heaven. Those confusing statements for children are more harmful than not.

Host: What role does a child's age and developmental stage play in how they understand and process grief? I know you have touched on this a little bit, but what do we need to know about that?

Nicolle Conley, LMHC: Couple things, one, understanding that a child who has a death at four or five is going to re experience symptoms throughout their development. A child who is young, like three, four or five, they're not understanding the permanence of death. I know I've said that a couple times, but they're not going to understand that that person cannot come back.

Now, when you're talking to an eight or nine year old, that child is the one that's going to tell you over and over again that their person died and they want to know those details. Like how does the heart stop working? What happens when someone has cancer in their body? Why does that cancer stop their life from living?

And then, again, puberty sets in, right? So now, these kids are looking more to their peers for information. They're less likely to take the word of an adult than they would a peer. So, we have to carefully navigate how we communicate with them as well. And those kids are looking more at the spiritual aspect of death, like how do we come to be humans on this planet? That's what they're looking to understand, right? Is there faith? Is there spirituality involved in why we live or not live? So when we're looking at the kids from all those different developmental stages, it's important that we have some knowledge of how to speak to that before we sit down with them.

Host: And how can parents and caregivers provide ongoing support to a grieving child? You've told them what you need to, but it's not like it's over after that. It's a process.

Nicolle Conley, LMHC: Yeah. I know that that's my profession, so I'm going to say it, but counseling, finding support, professional support children is vital through this process. I'm going to say it's a vital for adults too. I think anyone who experiences a loss has an opportunity to really process that loss at a deeper level and be able to function throughout life without it having some detriment to their life better if they have found support.

What we do here at Bright Star is provide individual support to children and families. We provide group support to children and families. We do events that are memorializing their loved ones, as well as remembering, situations and special times with that person. All of those things are so supportive to learning healthy coping strategies and really processing grief.

Host: What are some activities or therapeutic techniques that can help children express their feelings?

Nicolle Conley, LMHC: We use movement. We use art. We use play. Children really communicate their thoughts and feelings through their play, through their activities. If a child sits in front of a dollhouse with dolls, they're going to act out their scenarios that they're trying to process in their mind through that play. So, sitting with them and playing with them is going to help them communicate with you, help them move those feelings.

Host: Nicolle, what resources or support services are available through Bright Star to help families navigate this challenging journey?

Nicolle Conley, LMHC: Because we are provided for by the Health First Foundation, everything that we do here is free to families. We provide individual bereavement support with children through play therapies, through art therapies, through movement and play sessions. We provide families with support to come in and do activities that will help them all process together. And we do camps twice a year, which the kids have a blast. We do offer groups as well, twice a month for children and their guardians to come in and be among a community of other grievers.

Host: That's so smart, especially for children, right? So, they don't feel alone or special, like they don't stand out.

Nicolle Conley, LMHC: Yeah. At the end of each each school year, we kind of talk with the kids like, "What was it that really stood out for you in coming to groups? And so often, what we hear is just that, "I'm not alone in this. I found other kids are feeling the same way I feel. I find other kids have had the same experiences I have had, and I thought I was in this alone." So, it gives them a great community.

Host: Well, thank goodness you guys are there and that you have so many wonderful people to support these kids. In closing, Nicolle, would you like to share something, anything we didn't cover that you'd like people to know about Bright Star?

Nicolle Conley, LMHC: It's so rewarding to offer this support to kids. Kids are kids, right? They want to play. They want to laugh. They want to have fun. And when they're going through those really difficult times, you know, Giving them an outlet to feel all the feelings that they feel and know that every feeling is okay to have. it's really how we respond to those feelings that could help us or hurt us. Giving kids those opportunities here has been just an amazing opportunity. And I know that this is all because of donations that we can provide this service. So, I'm just so grateful to be a part of it.

Host: Thank you so much for sharing your expertise with us. This has been so informative and helpful. We really appreciate it.

Nicolle Conley, LMHC: Thank you.

Host: Again, that's Nicolle Conley. Would you like to explore free resources to support grieving children? Call 321-434-7622. That's 321-434-7622 or visit hf.org/brightstar to learn more about the Bright Star Program and how we can help your family. And if you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you. I'm Maggie McKay. Thank you for listening to Putting Your Health First, a podcast from Health First.