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7 August 1998 Vol. II, No. 3 Feature Article Good Grief helps children cope with death and loss of loved ones by Marion Sawey When a teenager died recently at a New England residential treatment center for adolescents, a unique children's bereavement training and consulting service at Boston Medical Center was contacted. The Good Grief Program, which is attracting growing interest, trains teachers and child-care professionals nationwide to help children face loss by mastering coping skills. "Our training focuses on a systemic approach to grief and loss in the school setting, particularly as schools are challenged by the increasing effects of violence in their communities," says program director Maria Trozzi, MED assistant professor of pediatrics. "We do not provide grief counseling as such, but rather, show teachers, administrators, and other professionals what children need in order to face loss and how they can give them support during a crisis. The objective is to assist children as they accomplish the psychological tasks of understanding, grieving, commemorating, and moving on." Maria Trozzi, director of the Good Grief Program at Boston Medical Center. BU Photo Services A unique aspect of the program, according to Trozzi, is its proactive approach in training teachers how to cope with a crisis before one occurs. "Then when a death or tragic event takes place, teachers will be poised and ready to deal with it. Bringing in counselors from the outside for a brief period doesn't really work," she says. "We think that when a community suffers a loss, then everyone needs to make sense of it. We want teachers and administrators not just to contain the crisis by normalizing the situation within a 24-hour period, say, but to deal with the effects of the crisis on the children for as long as it takes." The program's emphasis on training educators familiar with the pupils is also important, she says. "The children see a welcoming face they recognize, and therefore are more likely to be responsive and open. And when they receive understanding and support from familiar adults, they learn that they can get through difficult times. This in turn prepares them to face future losses." Trozzi points out that the recent upsurge of violence in schools seems to have fed a growing public perception of the need for the kind of counseling and training the program provides. "Recently I sent out a flyer urging school principals to consider our program," she says. "Within two weeks we were receiving approximately 30 calls a day from schools seeking more information. I am sure that the principals suddenly realized they had failed to consider the possibility of a crisis occurring and felt that it was time they took some action." The Good Grief Program is available to health-care and mental health professionals as well as educators, and Trozzi provides training to medical students and pediatric residents at Boston Medical Center. She also works closely with doctors, nurses, and social workers who treat children and their families facing a life-challenging illness. "We don't focus just on cop-ing with sudden or impending death, but also on any huge loss that a child might face," explains Trozzi. "That could be a divorce, grandma going into a nursing home, or a relative with Alzheimer's disease." Although currently running Good Grief almost single-handedly, Trozzi hopes to recruit more staff in order to respond to the growing demand for the program's services. She also anticipates expanding by running grief groups for children, called CRIKETT (Creating Resiliency in Kids Experiencing Tough Times). Further plans are under way for the Good Grief model to be replicated, with possible training programs in the Columbia Hospital for Babies and Children in Manhattan, and in centers in Missoula, Mont., and Tulsa, Okla. Stressing the importance of the program's objectives, Trozzi warns that children who fail to learn the coping skills needed to deal with loss will "limp around" as adults. "We can't make tragedy go away," she says, "but a child who suffers a loss and is not allowed to understand, grieve, commemorate, and go on turns into an adult who has lost his or her capacity to mourn."