The Grieving Process and Stages | Understanding these in Adolescents

The Grieving Process and Stages | Understanding these in Adolescents Black with one line white line down it and text about loss, grief and interconnections | Smith Clinic

Grief: A Process

A Clinical Insights Blog Series

The stages of grief and processes represent a complex emotional journey that teenagers navigate with unique intensity and nuance.

The interconnected Grieving Processes and Stages for Adolescents

While traditionally conceptualized as a linear progression, grief is actually a dynamic, recursive process that adolescents experience through multiple developmental lenses.

The Five Primary Stages and Processes of Grief

1. Denial: The initial stage where teenagers may struggle to accept the reality of loss. This represents a critical psychological defense mechanism, allowing adolescents to protect themselves from overwhelming emotional pain. During this phase, teens might pretend nothing has changed, creating a protective emotional barrier.

2. Anger: Characterized by intense emotional volatility, anger can manifest through boundary-pushing behaviors, disrespect, fighting, and unexpected outbursts. Teenagers may direct anger toward the deceased, themselves, or their support systems, experiencing complex emotional turbulence.

3. Bargaining: In this stage, adolescents often engage in hypothetical thinking, wrestling with statements like “If only I had…” or “What if I had done something differently?” This phase involves profound emotional processing and potential guilt about circumstances surrounding the loss.

4. Depression: Marked by withdrawal, feelings of hopelessness, and significant emotional regression. Teens might experience decreased academic performance, social isolation, and intense sadness that disrupts their typical developmental patterns.

5. Acceptance: The final stage represents not an elimination of grief, but a fundamental adaptation. Acceptance means learning to continue living while honoring the memory of the lost individual, understanding that grief becomes an integrated part of one’s life experience.

Unique Adolescent Grief Characteristics

Teenage grief differs significantly from adult experiences. Adolescents process loss through a lens of emerging emotional complexity, simultaneously developing cognitive capabilities while lacking comprehensive emotional regulation mechanisms. Their grief can be more intense, impulsive, and unpredictable.

Emotional and Behavioral Manifestations

Grieving teenagers may exhibit diverse responses, including

  • Physical symptoms like chest heaviness
  • Unexpected emotional outbursts
  • Difficulty concentrating
  • Sleep disruptions
  • Potential engagement in risky behaviors
  • Intense mood fluctuations

Critical Considerations

Understanding adolescent grief requires recognizing its non-linear nature. Grief is not a problem to be solved but a journey to be supported. Each developmental stage requires reinterpretation of loss, meaning teenagers will repeatedly process their grief as they mature.

Professional support, compassionate listening, and creating safe emotional spaces are paramount in helping adolescents navigate this profound experience.

References

https://www.compassionatefriends.org/grief/

https://www.hatcherfoundation.org/about/news/teen-grief-guide-navigating-loss-and-supporting-teens-through-the-healing-process

https://www.vitas.com/family-and-caregiver-support/grief-and-bereavement/children-and-grief/experiencing-grief-as-a-teenager

https://smct.org.au/blog/how-to-support-grieving-adolescents

https://onlinegrad.syracuse.edu/blog/how-to-process-unexpected-death

https://griefsharing.ca/death-of-teenage

https://pmc.ncbi.nlm.nih.gov/articles/PMC8794619

https://www.nhs.uk/mental-health/children-and-young-adults/help-for-teenagers-young-adults-and-students/bereavement-and-young-people

https://uknowledge.uky.edu/cgi/viewcontent.cgi?article=1120&context=pediatrics_facpub

https://dergipark.org.tr/en/download/article-file/3509398

https://uknowledge.uky.edu/cgi/viewcontent.cgi?article=1120&context=pediatrics_facpub https://pmc.ncbi.nlm.nih.gov/articles/PMC8794619/

https://pmc.ncbi.nlm.nih.gov/articles/PMC3384440

https://www.mhanational.org/bereavement-and-grief

https://injoser.joln.org/index.php/123/article/download/142/180

https://scholarworks.waldenu.edu/cgi/viewcontent.cgi?article=16204&context=dissertations

https://www.nctsn.org/sites/default/files/resources/sibling_death_and_childhood_traumatic_grief_families.pdf

Brent, D., Melhem, N., Donohoe, M. B., & Walker, M. (2009). The incidence and course of depression in bereaved youth 2 months after the loss of a parent to suicide, accident, or sudden natural death. American Journal of Psychiatry, 166(7), 786-794. https://doi.org/10.1176/appi.ajp.2009.08081244

Burns, M., Griese, B., King, S., & Talmi, A. (2020). Childhood bereavement: Understanding prevalence and related adversity in the United States. American Journal of Orthopsychiatry, 90(4), 391-405. https://doi.org/10.1037/ort0000442

Cerel, J., Fristad, M. A., Verducci, J., Weller, R. A., & Weller, E. B. (2006). Childhood bereavement: Psychopathology in the 2 years postparental death. Journal of the American Academy of Child & Adolescent Psychiatry, 45(6), 681-690. https://doi.org/10.1097/01.chi.0000215327.58799.05

Dillen, L., Fontaine, J. R., & Verhofstadt-Denève, L. (2009). Confirming the distinctiveness of complicated grief from depression and anxiety among adolescents. Death Studies, 33(5), 437-461. https://doi.org/10.1080/07481180902805673

Flemming, S. J., & Adolph, R. (1986). Helping bereaved adolescents: Needs and responses. In C. A. Corr & J. N. McNeil (Eds.), Adolescence and death (pp. 97-118). Springer.

Guldin, M. B., Li, J., Pedersen, H. S., Obel, C., Agerbo, E., Gissler, M., Cnattingius, S., Olsen, J., & Vestergaard, M. (2015). Incidence of suicide among persons who had a parent who died during their childhood: A population-based cohort study. JAMA Psychiatry, 72(12), 1227-1234. https://doi.org/10.1001/jamapsychiatry.2015.2094

Guzzo, K. B., & Gobbi, P. E. (2023). Prevalence and correlates of childhood bereavement in the United States. Journal of Family Issues, 44(4), 1059-1084. https://doi.org/10.1177/0192513X211069062

Hill, R. M., Kaplow, J. B., Oosterhoff, B., & Layne, C. M. (2019). Understanding grief reactions, thwarted belongingness, and suicide ideation in bereaved adolescents: Toward a unifying theory. Journal of Clinical Psychology, 75(4), 780-793. https://doi.org/10.1002/jclp.22731

Hillis, S. D., Unwin, H. J. T., Chen, Y., Cluver, L., Sherr, L., Goldman, P. S., Ratmann, O., Donnelly, C. A., Bhatt, S., Villaveces, A., Butchart, A., Bachman, G., Rawlings, L., Green, P., Nelson, C. A., & Flaxman, S. (2021). Global minimum estimates of children affected by COVID-19-associated orphanhood and deaths of caregivers: A modelling study. The Lancet, 398(10298), 391-402. https://doi.org/10.1016/S0140-6736(21)01253-8

Kaplow, J. B., Layne, C. M., Pynoos, R. S., Cohen, J. A., & Lieberman, A. (2012). DSM-V diagnostic criteria for bereavement-related disorders in children and adolescents: Developmental considerations. Psychiatry: Interpersonal and Biological Processes, 75(3), 243-266. https://doi.org/10.1521/psyc.2012.75.3.243

Kaplow, J. B., Saunders, J., Angold, A., & Costello, E. J. (2010). Psychiatric symptoms in bereaved versus nonbereaved youth and young adults: A longitudinal epidemiological study. Journal of the American Academy of Child & Adolescent Psychiatry, 49(11), 1145-1154. https://doi.org/10.1016/j.jaac.2010.08.004

Kentor, R. A., & Kaplow, J. B. (2020). Supporting children and adolescents following parental bereavement: Guidance for health-care professionals. The Lancet Child & Adolescent Health, 4(12), 889-898. https://doi.org/10.1016/S2352-4642(20)30184-X

Keyes, K. M., Pratt, C., Galea, S., McLaughlin, K. A., Koenen, K. C., & Shear, M. K. (2014). The burden of loss: Unexpected death of a loved one and psychiatric disorders across the life course in a national study. American Journal of Psychiatry, 171(8), 864-871. https://doi.org/10.1176/appi.ajp.2014.13081132

Layne, C. M., Kaplow, J. B., & Youngstrom, E. A. (2017). Applying evidence-based assessment to childhood trauma and bereavement: Concepts, principles, and practices. In M. A. Landolt, M. Cloitre, & U. Schnyder (Eds.), Evidence-based treatments for trauma related disorders in children and adolescents (pp. 67-96). Springer.

Lerner, R. M., Tirrell, J. M., Dowling, E. M., Geldhof, G. J., Gestsdóttir, S., Lerner, J. V., King, P. E., Williams, K., Iraheta, G., & Sim, A. T. (2019). The end of the beginning: Evidence and absences studying positive youth development in a global context. Adolescent Research Review, 4(1), 1-14. https://doi.org/10.1007/s40894-018-0093-4

Melhem, N. M., Moritz, G., Walker, M., Shear, M. K., & Brent, D. (2007). Phenomenology and correlates of complicated grief in children and adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 46(4), 493-499. https://doi.org/10.1097/chi.0b013e31803062a9

Myers-Coffman, K., Baker, F. A., Daly, B. P., Palisano, R., & Bradt, J. (2019). The resilience songwriting program for adolescent bereavement: A mixed methods exploratory study. Journal of Music Therapy, 56(4), 348-380. https://doi.org/10.1093/jmt/thz011

Oosterhoff, B., Kaplow, J. B., & Layne, C. M. (2018). Trajectories of binge drinking differentially mediate the association between adolescent dating violence victimization and psychological distress in adulthood. Addictive Behaviors, 85, 175-181. https://doi.org/10.1016/j.addbeh.2018.06.011

Pynoos, R. S., Steinberg, A. M., & Wraith, R. (2014). A developmental model of childhood traumatic stress. In D. Cicchetti & D. J. Cohen (Eds.), Developmental psychopathology: Risk, disorder, and adaptation (pp. 72-95). John Wiley & Sons.

Spuij, M., Reitz, E., Prinzie, P., Stikkelbroek, Y., de Roos, C., & Boelen, P. A. (2012). Distinctiveness of symptoms of prolonged grief, depression, and post-traumatic stress in bereaved children and adolescents. European Child & Adolescent Psychiatry, 21(12), 673-679. https://doi.org/10.1007/s00787-012-0307-4

https://www.ncbi.nlm.nih.gov/books/NBK217849

the Clinical Insights Blog by Stephanie and edited by Michael

With A little AI and OI | @smithclinic.eng

Other Reads about Grief

Please go to here for Grief overview

Please go here for Loss analysis overview and support tips.

Please go here for The Profound Impact of Peer Loss in Adolescence: A Neuropsychological Perspective

Please go here for Navigating the Turbulent Waters of Adolescent Grief, Coping with Unexpected Death |  Understanding Unexpected Loss, and Emotional Resilience

Leave a Comment

Your email address will not be published. Required fields are marked *

Scroll to Top