The Effects of Bereavement on Children

Research Paper
Lillie Weidner
Ball State University

Abstract
The following paper will discuss the impact of bereavement from the loss of a
sibling during childhood. This traumatic event during such a critical period of
development affects behaviors, relationships and over all well being. The surviving
children tend to show more issues in behavior such as trouble focusing, impetuousness,
insubordination, withdrawal, an incessant need for attention, and changes in temperament
when compared to children who have not experienced such a painful event. The
relationships among bereaving children and parents are also deeply affected. Parental and
marital partnerships are extremely strained after this loss, which in turn, affects the
parents relationship with the children. A childs over all physical and psychological
health can be afflicted as well. Children who are grieving tend to be more fearful,
confused and angry. These thoughts may also play in to the physical difficulties that
children experience after the death of their sister or brother. The discussion section of this
paper examines the research in light of the authors personal experience of losing her
older brother as a child.

The Effects of Bereavement on Children

The death of a son or daughter is said to be the most agonizing pain one can experience.
It takes years for parents to fully grieve and accept their altered lives after a childs death, yet the
affliction of this inconceivable event will never dissipate. However, what about the rest of the
deceased childs immediate family? Children are often overlooked during their equally crucial
grieving process after a siblings death. This deeply affects remaining children within the family
in important, often destructive, patterns. The psychological impact of this traumatic event will be
apparent in childrens behavior, present and future relationships, and overall well-being.
Behavioral Effects
Bereaved children often externalize grief with distinct changes in their behavior. Many
parents report that their children developed problems focusing, impetuousness, insubordination,
withdrawal, an incessant need for attention, and changes in temperament. McCown and Davies
(1995) studied the most common behavioral effects in bereaving children. Following the death,
parents were interviewed about their surviving childrens behaviors. A broad majority of parents,
88.3%, reported that their children did not exhibit these behavioral issues before the sickness or
death of a sibling (McCown & Pratt, 1985, p. 331). Predominantly, the children who were in the
midst of the grieving process fell into the Aggression subscale of the Child Behavior Checklist
(McCown & Davies, as cited in Archenbach & Edelbrock, 1983). These behaviors include
argumentativeness, an incessant need for attention, insubordination in the home and irritability
(McCown & Davies, 1995). However, the intensity of these behavioral changes is dependent on
several factors such as age, gender, and the familys dynamics.
A childs conceptualization of death plays a large role in behavioral outcome. Younger
children, under five years of age, do not fully understand this concept, while older children, over

the age of twelve, are able to understand death and its inevitability. The cognitive capabilities of
these two age groups resulted in less dramatic changes in behavior (McCown & Davies, 1995).
However, those in the school age group, six to eleven, demonstrated considerably more
behavioral problems. McCown and Pratt use theories by Erikson and Piaget to explain this
phenomenon. Erikson would describe this age group as falling within the psychosocial stage of
Industry versus Inferiority. This devastating change may lead to feelings of inadequacy and
susceptibility. Piaget states that children in this age group are still developing concrete
operational modes of thinking and the death of a loved one may cause confusion. These children
understand death in the way that their loved one will not return. However, they are not able to
comprehend why or how this happened. The increased aggressive behavior may be due to the
distortion in the understanding of the death process (McCown & Pratt, 1985).
The gender of both the deceased child and surviving children plays a role in certain
behavioral changes. Children were shown to exhibit more concerning behavior if the sibling who
had passed away was a male (McCown & Pratt, 1985). However, this study did not explain this
finding. A reoccurring behavioral characteristic in grieving females was self- consciousness,
being humiliated easily and mood swings, whereas males were more apt to show difficulties in
concentration and insubordination in school and home (McCown & Davies, 1995). These
behavioral changes may be due to gender specific roles and certain expectations of society.
Family dynamics may also affect the intensity of noticeable behavioral changes. There is
a large correspondence between family size and the number of problems that arose after the
death of a sibling. Children of a large family did not exhibit as many behavioral setbacks as did
those of a smaller family. McCown and Pratt (1985) attribute this fact to not only physically
losing a larger part of their lives, but also the relationship that coincides with that person. The

child then experiences a double loss (McCown & Pratt, 1985, p. 330). The age of the deceased
sibling often attributes to behavioral problems as well. If the child died at a younger age, the
remaining children did not show as many uncommon behaviors as the children who had an
elongated relationship with the deceased child before illness or death (McCown & Pratt, 1985).
Aspects of Relationships
The death of a child reverberates throughout the family system, coloring every
relationship (Bernstein, 1997, p.165). As with any dramatic change, relationships within a
family after a death are forced to alter and succumb to a new reality. The loss of a child has an
enormous impact on the parental and marital relationship, as well as the relationship with the
surviving children. Siblings may also experience a different type of bond after the loss of their
sister or brother.
Parents have explained the pain of losing a child as the worst pain a human being can
bear, the pinnacle of emotional distress (Shwab, 1997). This distress is caused by several factors.
Feelings of guilt are often reported due to the parents sense of responsibility to protect their
child. This, of course, is not true in many situations. However, the innate need to nurture ones
offspring causes these misplaced feelings of guilt (Bernstein, Duncan, Gavin, Lindahl &
Ozonoff, 1989, as cited in Rubin, 1985). Parents may also experience an identity crisis after the
loss of their child. Many parents put future expectations and dreams on their children. When
their son or daughter dies, these aspirations die with them. Zimmerman (1981) describes this loss
as a narcissistic injury to parents (Bernstein, Duncan, Gavin, Lindahl & Ozonoff, 1989). Along
with the emotional stability of each parent, marital relationships are also tested. Parents who are
grieving reported more tension within their relationship. Differing coping styles may be the

cause of this tension. Mothers are usually more overt in their emotions, whereas the fathers tend
to be more detached (Bernstein, Duncan, Gavin, Lindahl & Ozonoff, 1989). The significantly
higher divorce rates among bereaving parents may be due to the strains put on their relationship
(Lehman, Lang, Wortman, Sorenson, 1989).
The relationship between the parents and children is also dramatically altered after the
death of an immediate family member. Due to parents preoccupation with their own grief,
children may view them as being withdrawn or constantly sad. Losing this availability of their
parents plus the loss of their sister or brother may become overwhelming (Bernstein, Duncan,
Gavin, Lindahl & Ozonoff, 1989). This in itself presents a traumatic experience for children
because of their reliance on their parents. A five-year-old who had just lost her three- year old
little brother stated, But it has to be a secret. Its going to be a secret because if mommies hear
secrets that make them too sad, they get sick and cant be mommies anymore (Schwab, 1997,
p261). Children often develop a strong sense of protectiveness and faithfulness to their parents
after the death of a sibling. They recognize the extreme temperament differences and feel the
need to do all they can to help and protect parents from further pain. This increase in shielding
the pain can go both ways. Parents may become overbearing in an attempt to protect their
surviving children (Schwab, 1997).
The relationship between surviving children is also affected by this deep agony.
Relationships become much more complex than they were before the death (NCTSN, 2009).
There are often conflicting feelings toward each other. They may become jealous and
combative; yet they may feel a strong sense of protection towards one another (NCTSN, 2009, p.
3).

Psychological Ramifications
The death of a sibling in childhood may cause the surviving children to feel adrift,
fearful, bewildered, and/ or bitter (Lehman, Lang, Wortman, Sorenson, 1989). This confusion is
often caused by a lack of communication about the death, leading to misconceptions (Schwab,
1997). Without effective communication surrounding the death, children tend to make up their
own reasons and causations for the death. These delusions are often rife with error and may
cause harm to their development as well as their understanding of death (Schwab, 1997).
Although parents concede the need for effective communication, in the chaos surrounding a
childs death, it is often neglected (McCown & Pratt, 1985). When the misery and grief of the
family is openly talked about, children will be more likely to work through the critical grieving
process of losing a loved one (Schwab, 1997).
As well as externalizing troublesome behaviors, bereaving children may also internalize
feelings that they hadnt before the death. These feelings of self-consciousness and humiliation,
as well as physical body aches fall in to the Depression subscale of the Child Behavior Checklist
(McCown & Davies, as cited in Archenbach & Edelbrock, 1983). Psychoneuroimmunology
(PNI) is the study of the interaction between psychological processes and the nervous and
immune systems of the human body. This concept helps us to understand why children also tend
to complain more about somatic pains, such as headaches, stomach aches and minor illnesses
(Bernstein, Duncan, Gavin, Lindahl, & Ozonoff, 1989). The stress, confusion and magnitude of
this unfamiliar situation may be the root cause of these somatic complaints.
Psychological and physical difficulties may persist until one fully grieves. After the death
of a child, this is extremely important for both the parents and surviving children (Schwab, 259).

Children who have not adequately mourned tend to show extensive fear of closeness with others,
although they may mask the pain behind feigned normalcy (Charles & Charles, 2006). A child
must accept the actuality of death, rather than the fantasy that this person will come back.
Children must also fully succumb to the agony of grieving. Without this crucial period, feelings
may become buried, causing the psychological and physical issues mentioned above. Adapting to
a world that no longer contains their sibling is also considered to be vitally important. The last
stage of grief work is to move forward while seeing to it that the memory of the deceased is
not a neglected topic (Schwab, 1997, p 259). The surviving children need to resume being the
kids they are. Without their sibling, the world is different and diminished, but they can learn to
adjust and eventually enjoy life again.
Discussion
I found this research to be incredibly accurate. After the death of my brother I remember
getting in to trouble all of the time. I never did as I was told, my academic performance began to
suffer and my older sister and I always seemed to be at ends. I faintly knew that all of these
things were the repercussions of this dramatic change in my life. However, it was not until I read
this research that I understood why this was so. I was exhibiting the externalizing behaviors of
disobedience and an extreme need for attention. At the time, I did not realize that my parents had
become withdrawn in some ways. I believe I was acting out in order to attain their attention. For
example, my brother died at the beginning of August, right before school started back up. I was
going in to the fifth grade and excited about being the top dog of the elementary school.
Naturally, I expected my mother to take me back-to-school shopping. When she informed me
that a friends mom would be accompanying me that year, I remember I threw a temper tantrum,
a very uncharacteristic thing for a fifth grader. I understood that my mom was incredibly sad and

needed time for herself and I was willing to give that to her, but only on my terms. Looking back
on similar situations, I see how the death of brother really colored all of our actions differently.
The research on relationships after a siblings death between parents and children was not
as fit to my situation. I found that parents tended to become either withdrawn or over-bearing.
Aside from a few situations, I remember my parents being the same as they always were. My
mother tried very hard to keep her sanity for our sake. When asked about the situation, she
stated, The only thing that kept me together was you two girls and seeing to it that you were
safe, working through the grief and thriving in this new environment as best you could.
Another common theme I found within the research was the feelings of confusion, anger
and fear. I believe this to be true of all age groups. My brother was electrocuted while mowing a
lawn with a friend. I remember asking why his friend hadnt been hurt and why the down power
line had not been fixed. Although no one can answer these questions, this caused a lot of anger
and confusion with my sister and I. Fear is also something that is deeply internalized. To this
day, when an unfamiliar number calls us, we still fear it is the hospital with some sort of horrible
news.
Limitations of These Studies
There are several limitations to the studies performed after sibling death. Most of these
studies are dated by at least fifteen years. There is no recent research in the field. The way in
which the results were found may have also created some error within the research. Most
answers were found through questionnaires of parents soon after their child had died. There may
be some bias within this research. Teachers, coaches, peers and the children themselves need to

be questioned as well. Parents may also not be able to provide valid answers when their mind is
still so preoccupied with the death of their child.
Different circumstances may have led to skewed results as well, only one study stated
having families from different races, socioeconomic statuss and regions. Culture plays a big part
in the psychological adjustment to such an event. It would be interesting to see how different
types of people deal with this pain.
Conclusion
The serious and often harmful effects of bereavement in childhood often go under the
wayside after the loss of a child because of the severe grief the parents are feeling. However, this
period of grief is just as crucial for children to work through as it is for adults. It is vitally
important for families to recognize the often-misconstrued signs of childhood grief.

References
Bernstein, J. (1997). When the bough breaks: forever after the death of a son or daughter.
Kansas City: Andrews and McMeel.
Bernstein, P. P., Duncan, S., Gavin, L. A., Lindahl, K. M., & Ozonoff, S. (1989). Resistance to
psychotherapy after a child dies: The effects of the death on parents and siblings. Psychotherapy:
Theory, Research, Practice, Training, 26(2), 227-232. doi:10.1037/h0085423
Charles, D. R., & Charles, M. (2006). Sibling loss and attachment style: An exploratory study.
Psychoanalytic Psychology, 23(1), 72-90. doi:10.1037/0736-9735.23.1.72
Darlene E. McCown & Clara Pratt (1985): Impact of sibling death on children's behavior, Death
Studies, 9:3-4, 323-335
Donatelle, R. (2012). Promoting and preserving your psychological health. In L. Sandra (Ed.),
Access to Health San Fransisco: Pearson.
Lehman, D. R., Lang, E. L., Wortman, C. B., & Sorenson, S. B. (1989). Long-term effects of
sudden bereavement: Marital and parent-child relationships and children's reactions. Journal Of
Family Psychology, 2(3), 344-367. doi:10.1037/h0080505
McCown, D. E., & Davies, B. (1995). Patterns of grief in young children following the death of a
sibling. Death Studies, 19(1), 41
National Child Traumatic Stress Network Child Traumatic Grief Committee. (2009). Sibling
Loss Fact Sheet Sibling Death and Childhood Traumatic Grief: Information for Families. Los
Angeles, CA & Durham, NC: National Center for Child Traumatic Stress.

Schwab, R. (1997). Parental mourning and children's behavior. Journal of Counseling and
Development : JCD, 75(4), 258-265. Retrieved from
http://search.proquest.com/docview/219018326?accountid=8483

Lillie Weidner
Educational Psychology 355
Dr. Huffman
Analysis and Reflection Paper

Stress Management for Parents Rearing Children with Disabilities

Parenting is a complex and stressful, yet rewarding experience that most adults will
encounter at some point in their life. This challenge is encompassed with a wide variety of
inevitable stress. However, are these stressors enhanced when rearing a child of special needs?
All of the research points to a clear answer. Bayrakli and Kaner (2012) state, The parents of
children with disabilities confront many difficulties caused by the disability in addition to the
stress all parents have. There are many factors investigated when developing theories on how
parents cope with the adversity of raising a child with either physical or mental disabilities, as
well as the most effective routes to take. Resilience, coping mechanisms, social support,
personality styles, and overall well-being are all factors in the amount of stress a parent may feel.
Literature Review
Resilience, as defined by Walsh (2006), is a course of action one takes following a
misfortunate situation resulting in newfound wisdom and practicality that leads to successful
thinking and outcomes. Masten (1994) describes resilience as a successful adaptation.
Hastingss research (as cited in Bregman, 1991; Dykens, 2000; Rutter, Graham & Yule, 1970)
found that parents of children with special needs are faced with more behavioral, physical and
emotional problems than those parents of normally developing children. The two most common
coping mechanisms are either in an emotion-focused or a problem-focused way (Weiten, Dunn
& Hammer, 2012). In an emotion-focused appraisal, the parent may view the challenge as
irreversible, and therefore they tend to experience more negativity than one who uses problemfocused coping. Within this type of appraisal, the parent views the disability as something they
have control over and can help their child with (Bayrakli & Kaner, 2006, as cited in Folkman &

Lazarus, 1985; Lazarus & Folkman, 1984). Hall, Neely-Barnes, Graff, Krcek, & Roberts (2011)
conducted a study determining specifics between clinically stressed parents and parents who
reported having lower stress due to their special needs child. Overly stressed parents stated that
they felt ostracism and disappointment from members in their community, as well as an
overall lack of support (Hall et al., 2011). Another coping mechanism found in some highly
stressed caregivers was an escape-avoidance tactic (Glidden, Billings & Jobe, 2006). This way of
coping is characterized by avoiding the stressful situation all together. Parents may be in a state
of denial that ultimately hurts their child and their own psyche. The parents who have reported
lower stress levels and shown to be the most resilient are those seeking additional information
and training regarding their childs condition (Bayrakli & Kaner, 2012). This problem-focused
appraisal allows the parents to remain in control of the situation. The increase in social support
and services opens up communication allowing the parents the opportunity to educate themselves
and others about their childs condition, as well as planning for their familys future (Hall et al.,
2011).
Having a disabled child does not only affect the parents, but the whole family dynamic as
well. Olsen (2000) created the circumplex model to illustrate the theory that in order for a family
to successfully function, they must be a cohesive and adaptable unit (Rieger & McGrail, 2013).
Cohesive refers to the emotional closeness and support of the family, while adaptability refers to
the familys ability to adjust in any hardships (Rieger & McGrail, 2013). A child with any type
of special needs is going to require more time and energy. The parents and family must learn to
accept and embrace this challenge for the health and successful functioning of their family unit
(Dyson, 1996). The behaviors of the parents and children reciprocally affect each other
(Hastings, 2002). For example, the childs increased needs causes elevated stress levels in the

parents. In turn, the parents behavior towards the child may inversely affect him or her. DeaterDecker (1998) proposed a model that shows this relationship (as cited in Hastings, 2002).

Child Behavior
Problems

Parenting Behavior

Parental Stress

As the model above shows, all three components are highly correlated. If the parent encounters
depression or another mental health obstacle due to the stress, the childs behavior may suffer in
a negative way, which will only cause more stress. In order to combat this relationship, behavior
and stress management skills must be learned for the sanity and well-being of the family
(Hastings, 2002).
A relatively new path to successful coping proposed by Rieger and McGrail (2013) is the
use of humor and laughter. Humor is a potential strategy for reducing the stressors that exist in
challenged families, and hence contributes to healthy functioning and adaptation (p. 99). The
results of their study revealed a positive correlation between families who kept their

environments warm and playful and those who did not. The families who habitually incorporated
humor in their everyday lives said they saw humor as a way of:
Reducing stress, gaining new perspectives and learning experiences, increasing problem
solving skills, enhancing communication skills, improving social interactions, preventing
put-downs, focusing on the positive, rediscovering playfulness and gaining a sense of
freedom. (p. 90)
The emotional benefits of humor help to keep the family a cohesive and adaptable unit, which as
stated earlier is vital to the whole familys well-being. The parents efforts of seeing the lighter
side of life may also encourage the children to do the same resulting in their own stress levels
going down (Hastings, 2002).
There are, however, benefits to rearing a child with disabilities. These families tend to
show more organization and control, as well as self-efficacy (Dyson, 1996). There is also a
higher emphasis on personal growth. This can elicit a sense of purpose in the parents and other
family members (Hall et al, 2011). Siblings of these children are often eager to help their brother
or sister in anyway they can. Furthermore, there is data to show that families of this type are
more active in cultural and recreational activities (Dyson, 1996).
Discussion
Application to Future Career
I am a senior double majoring in Child Development and Family Studies with minors in
Developmental Psychology and Interpersonal Relations. My career aspirations are to work in a

preschool for a while and then to attend grad school to further my education so I can work with
families and children who have recently experienced some kind of trauma.
The research regarding stress management and effective coping mechanisms for parents
rearing children with disabilities will be advantageous for me in numerous ways, not only in my
future, but right now as well. I work/ volunteer for a lot of different types of children and
families. The one that comes to my mind most is a family that attends my church and that I
babysit for weekly. This family has four children and the eldest boy has a variety of physical and
mental challenges. He is ten years old, yet still in diapers and unable to communicate. Along
with their other young children, they have daily obstacles to overcome regarding this boy. For
instance, he has an IV and a very particular diet he has to adhere to. The father is a full time
pastor, and while the mother has a degree, she feels that she needs to put her career aside in order
to fill the childs needs efficiently. In this specific circumstance, I would advise her to a problemfocused appraisal and seek social support. There are many organizations that will help guide both
parents in a positive way. A website, supportforfamilies.org, provides online brochures,
educational workshops, support groups and even a phone line. She could also talk to the doctor
and local schools to see what the childs options are. When I asked them what has helped most
with the stress of having a highly disabled child, they said; Knowing we have people that love
Malachi for who he is a big thing. But, also knowing that we have family and friends that aren't
afraid to take care of him is also helpful. We need to get away some. We are fortunate to have
people in our lives that love Malachi and us enough to help. This response agrees completely
with all the research. Social support, along with a cohesive and adaptable family will allow the
parents to deal with the stress in a useful way.

This information will also be advantageous in my future as a preschool teacher. There is

no doubt that I will have at least one child with some sort of disability. Most likely I will be
dealing with minor complications such as Aspergers Syndrome or Attention Deficit
Hyperactivity Disorder. After this research, I will know to provide the families with
informational brochures, as well as emotional support. That this is one of the best ways to help
the family. By supporting the parents, the entire family will benefit.
Once I finish my Masters and working with bereaving families and children, the coping
mechanisms and stress management will also be practical when helping these people. Although
losing someone you love is a heartbreaking situation, it is also incredibly stressful. I lost my
brother when I was eleven years old and I know that it was a very stressful thing. The
adjustments you have to make add more strife into daily living. One way that my family coped
was through humor. We used to tell funny stories about my brother and the camaraderie really
helped us keep our sanity. I will encourage them to use humor as a way of acceptance.

Personal Reflection
The research conducted on the best ways for parents to cope with a child with disabilities
was very helpful to me. In my experience, it is all very accurate. As I stated earlier, the family I
have the most experience with completely agreed with the research I had found. Through
working in various childcare facilities, I have also experienced parents who were escaping/
avoiding the situation. We had a toddler who was unable to walk. Even though we had
encouraged the parents to see a doctor several times, the parents insisted that the child would
learn eventually. When the child reached two and a half, the parents decided to take her in. She

had to receive physical therapy in order to walk. The parents of this little girl kept hoping that it
would go away and it wouldnt. Their refusal to accept this situation ultimately hurt their
daughter and her progress in walking.
While this research was very interesting to me, I feel as though there could have been
more depth. Most of the stress management tactics were very similar to every other type of
stress. I am interested in more specifics, such as, whether or not the socioeconomic status plays a
role in stress levels and the size and dynamic of the family. I would also like to know how
schools and other public institutions could help. However, this is a developing area of research. I
will be interested to see how this information changes and becomes more specific over time.

References
Bayrakli, H., & Kaner, S. (2012). Investigating the factors affecting resiliency in mothers of
children with and without intellectual disability. Educational Sciences: Theory and
Practice, 12(2), 936-943.
Dyson, L. L. (1996). The experiences of families of children with learning disabilities: Parental
stress, family.. Journal Of Learning Disabilities, 29(3), 281.
Folkman S., & Lazarus, R.S. (1985). If it changes it must be a process: Study of emotion and
coping during the three stages of a college examination. Journal of Personality and
Social Psychology, 48 (1), 150-170.
Glidden, L. M., Billings, F. J., & Jobe, B. M. (2006). Personality, coping style and well-being of
parents rearing children with developmental disabilities. Journal Of Intellectual
Disability Research, 50(12), 949-962. doi:10.1111/j.1365-2788.2006.00929.x
Hall, H. R., Neely-Barnes, S. L., Graff, J., Krcek, T. E., Roberts, R. J., & Hankins, J. S. (2012).
Parental Stress in Families of Children with a Genetic Disorder//Disability and the
Resiliency Model of Family Stress, Adjustment, and Adaptation. Issues In
Comprehensive Pediatric Nursing, 35(1), 24-44. doi:10.3109/01460862.2012.646479
Hastings, R. (2002). Parental stress and behaviour problems of children with developmental
disability. Journal Of Intellectual & Developmental Disability, 27(3), 149-160.
doi:10.1080/1366825021000008657

Masten, A. S. (1994). Resilience in individual development: Successful adaptation despite risk

and adversity. In M.C. Wang & G.W. Gordon (Eds.) Educational resilence in inner-city
America. Hillsdale (pp. 3-25), New Jersey: Lawrence Erlbaum Associates, Inc.
Olson, D. H. ( 2000). Circumplex model of family systems. Journal of Family Therapy, 22, 144
167. doi: 10.1111/1467-6427.00144
Rieger, A., & McGrail, J. (2013). Coping humor and family functioning in parents of children
with disabilities. Rehabilitation Psychology, 58(1), 89-97. doi:10.1037/a0031556
Weiten , W., Dunn, D., & Hammer, E. (2012). Psychology applied to modern life. (pp. 11-112).
Belmont, CA: Cengage Learning.

Lillie Weidner
CPSY 420
Final Analysis Paper
Trauma-Focused Cognitive Behavioral Therapy for Families

Introduction
Throughout the semester, this class has provided me with a basic understanding of
interviewing and counseling, as well as a feel for how the clinical psychology world works. As a
Child Development major with minors in Developmental Psychology and Interpersonal
Relations, I had a foundation of the key elements and theories within psychology, especially
pertaining to children and adolescents. However, this course allowed me to expand my
knowledge to include adults as well. Upon completing a graduate degree, I will be working with
families and children who have experienced trauma. While there are many different approaches
to helping children and families cope with these hardships, one that I found particularly helpful
was Trauma-Focused Cognitive Behavioral Therapy, an extenuation of Cognitive Behavioral
Therapy.
Literature Review
Cognitive Behavioral Therapy (CBT) is a blend of two different types of psychotherapy.
Cognitive therapy refers to a persons thoughts and beliefs and how these collaborate or
influence how they interact with their individual environment. Behavioral therapy focuses on
changing and preventing damaging behaviors (CWIG, 2012). Cognitive behavioral therapy
integrates these two perspectives to identify problems and solutions, as well as altering the
underlying thoughts responsible for damaging behaviors. Trauma Focused Cognitive Behavioral
Therapy, or TF-CBT, is specialized development of CBT used specifically for children and
families who have experienced trauma.
International studies have shown that one fourth of children have experienced a traumatic
event (Cohen & Mannarino, 2008). These events include instances of sexual and physical abuse,

domestic violence, natural disasters, car wrecks, community violence and accidents. An event of
this caliber within the crucial years of childhood may result in negative effects continuing into
adulthood. TF-CBT is a family and phase-based approach for developing individualistic
strategies to help cope with the aftermath. It is a flexible and short-term intervention for children
ages 3-17 years old (Lang, Ford, & Fitzgerald, 2010).
The TF-CBT model operates under the acronym of PRACTICE (Psychoeducation and
Parenting skills, Relaxation skills, Affective regulation skills, Cognitive coping skills, Trauma
narrative and cognitive processing of the traumatic event, In vivo exposure, Conjoint parent and
child sessions, and Enhancing personal safety and future growth) (CWIG, 2012). The therapist
begins by providing the parents with an overview of how the therapy works, while emphasizing
that parental involvement is key within this type of therapy. This helps to facilitate meaningful
relationships between the parent(s) and child(ren). The first stage, psychoeducation and
parenting skills, involves giving the parents information regarding what the child may be
experiencing. For example, a foster child suffering from Posttraumatic Stress Syndrome due to
circumstances before adoption may externalize behaviors such as aggressiveness and
noncompliance (Cohen & Mannarino, 2008). It is also common for children to withdraw from
seemingly normal activities, such as sleep and eating, due to their traumatic experience. It is vital
for parents and caregivers to be aware of the root of these behaviors and how to deal with them.
Skills such as praising children and selective attention may help to reinforce positive behaviors
with the child. In some cases, it may be necessary to create a more specialized plan of action for
certain behaviors (Cohen & Mannarino, 2008).
The next step is introducing relaxation skills. Within this stage, the therapists intention is
to heal any physiological ailments due to the childs experience, as well as to instill a sense of

control over emotions for the family. These skills include deep breathing, progressive muscle
relaxation and/or yoga. The therapist may work one on one with family members to discuss
hobbies, such artistic expression, that may be cathartic for the individual (Cohen & Mannarino,
2008).
Affective modulation skills are those that help the child and parent to identify feelings
and ways to expand upon emotions and how to manage reactions (CWIG, 2012). With children,
games can be a useful tool for determining over or under responsive emotional reactions (Cohen
& Mannarino, 2008). These responses may be indicative of skills, such as problem solving or
social skills, which need to be built on.
The fourth component of PRACTICE is cognitive coping and processing. Within this
stage, the therapist assists the parents and children in recognizing connections between thoughts
and behaviors. This is also where any misconceptions on the childs end may be corrected. One
may be encouraged to generate alternative thoughts leading to exploration of feelings and
behaviors relating to new thoughts. These may prove to be more beneficial or calming for the
clients (Cohen & Mannarino, 2008, p. 160). This exercise instills a sense of hope, as well as
teaching to self-soothe.
The next steps are perhaps the most pivotal within this process. Trauma narrative and
processing, in vivo exposure and conjoint sessions provide the children and parents with an
expressive approach to developing a relationship and coping strategy. The first element is asking
the child to prepare a comprehensive narrative of the trauma. This may be through writing,
drawing, or other creative measures. This provides an outlet for talking about the trauma, rather
than avoiding the topic. It also allows for any misinterpretations to be ironed out. The in vivo

mastery of trauma reminders gradually introduces aspects of the event back into the childs life
(CWIG, 2012). For example, if a child witnessed violence at a gas station, the child may be
apprehensive about all other gas stations. The therapist works with the child to recognize that the
violence is due to a specific person, rather than the gas stations themselves (Cohen & Mannarino,
2008). The narrative is then shared with the parent (only with the childs permission). The
therapist and family then partake in conjoint sessions where open communication and sharing
takes place. In this phase, the therapist acts as a facilitator, rather than a leader. The parent and
child communicate their thoughts with each other in a supportive manner.
The last phase in TF-CBT is enhancing safety and future growth. Many traumatized
children may become fearful. Within this stage, education on personal safety relating to the
trauma is given. This provides the child with stability in their home life so they are not living in
constant fear. The skills learned in this stage may also help with future complications. These
skills could include plans for domestic violence, refusal to drugs, healthy sexuality or risk
management skills (Lang, Ford, & Fitzgerald, 2010).
This model has shown to be incredibly effective with children showing symptoms of
PTSD, depression and anxiety, as well as children with behavioral problems. Throughout the
empirical studies performed, the best predictor of success was parental involvement, although,
the results of TF-CBT are still helpful for children receiving therapy without a caregiver present
(Lang, Ford, Fitzgerald, 2010). Because TF-CBT is a flexible model, this allows for many
different types of traumas and families to be treated.
Discussion/ Conclusion

I found this research to be incredibly insightful and interesting. However, all of the
research I read was with typically developing children with stable home lives. I would like to
know more about the therapies provided to children with special needs or in an unstable
environment, such as poverty. Mental health counseling is a middle-class benefit. While people
with money need help too, I have found that the children who have experienced the most traumas
are the ones living in poverty. Traumatic events may happen habitually, yet they are never
treated for anything. I would like to know if this model could be adapted for schools or parents to
perform to mitigate the financial expense, yet also reaching out to the hurting child.
One of the key aspects in this model is providing psychotherapy for the parents. While I
am comfortable providing care to children, I lack information relating to common mental
disorders in adults and the various therapies and techniques to combat these, as well as the skill
of working with other adults in a beneficial way. Throughout the rest of my academic career, I
would like to make it a goal to be able to provide help to adults in the same way that I can for
children
All in all I found this research is incredibly helpful for someone pursuing a career in grief
therapy. This is not a particularly common aspiration, but I was excited to learn more about how
to help these families and the science behind each step. Some of these skills are also beneficial to
children who have not experienced trauma. Creative expression can be a great way to mend the
gap between adults and children, as well as proving the child with an outlet. I hope to learn more
about the other techniques that are helpful for children who have experienced trauma.

Works Cited
Cohen, J. A., & Mannarino, A. P. (2008). Trauma-Focused Cognitive Behavioural Therapy for
Children and Parents. Child & Adolescent Mental Health, 13(4), 158-162.
doi:10.1111/j.1475-3588.2008.00502.x
Lang J, Ford J, Fitzgerald M. An algorithm for determining use of trauma-focused cognitive
behavioral therapy. Psychotherapy: Theory, Research, Practice, Training [serial online].
December 2010;47(4):554-569. Available from: PsycARTICLES, Ipswich, MA.
Accessed April 18, 2014.
Trauma-Focused Cognitive Behavioral Therapy for Children Affected by Sexual Abuse or
Trauma. (2012). Retrieved April 16, 2014, from
https://www.childwelfare.gov/pubs/trauma/

Lillie Weidner
Educational Psychology 350
Dr. Mucherah
Analysis and Reflection Paper

Abstract
Several studies have been conducted throughout the last few decades concerning the
correlation of birth order and how that influences a childs personality and identity. It is found
that first-born, later-born and only children all develop drastically different characteristics and
personalities due to the varying environments in which they were brought up. This paper
analyzes the research findings with specific concern to how this influences childcare and
counseling to children.

Birth Order and the Effect on Personality Development

Stereotypes and popular beliefs regarding birth order typically distinguish the
eldest child as a domineering personality, whereas the youngest child is seen as a
nonconformist with higher emotional intelligence when compared to older siblings in a
specific family. However, are these notions supported by research or are they simply
stereotypes? Although some researchers argue against the correlation of birth order and longterm development, research does show a connection between the sequence of children in a
family and the development of their personalities and identities during childhood.
Literature Review
Research has shown that a childs birth order has a significant impact on their personality
and identity development. McCrae and John (1992) have assessed distinctive traits of first-borns
and later-born children using the Five-Factor Model (McCrae and John, 1992 as cited in
Jefferson, Herbst, &McCrae, 1998). This model represents certain personality characteristics
through five broad categories: Neuroticism (N), Extraversion (E), Openness to Experience (O),
Agreeableness (A) and Conscientiousness (C). First-borns generally score higher in N, E and C,
which accounts for characteristics such as being vulnerable to anxiety, practical, and the
tendency to be a leader. These children often receive a lower score in O and A, which explains
the conventionality and competitive attitudes in these children (Jefferson, Herbst, &McCrae,
1998). For the most part, later-born children score higher in O and A, while receiving a lower
score in N, E and C. These findings go hand-in-hand with the playful, rebellious and social
tendencies of children with older siblings (Nowicki, 1967).

Frank Sulloway, a California psychologist, has done a lot of research on this topic. His
observations include the diverse personality trait differences in first-born and later born children.
He notes that first-born children are typically more responsible, goal-oriented, self-assured,
scholarly, and traditional than their younger siblings (Sulloway 1996, as cited in Eckstein et al.,
2010). Researchers offer several suggestions as to why the eldest child may possess these traits.
Price (2008) suggests that these characteristics might be due to an increased amount of parentchild quality time. On average, the first-born child may receive up to 3,000 more hours with
parents than younger siblings (Price, 2008). This is because the eldest child is the only child for a
certain amount of time. The parents do not have to allocate their time and resources among
multiple children (Hanushek; Lindert, as cited in Price, 2008). The oldest child also strives to
win parental approval, which often results in a higher verbal ability and increased cognitive
development (Heiland, 2009).
Sulloway (1996) found that later-born children often exhibit opposite traits of their older
siblings, such as nonconformity, rebelliousness, and flexibility (Sulloway 1996, as cited in
Eckstein et al., 2010). These characteristics may stem from a lack in parent-child quality time.
Studies have shown that parent-child interactions slowly decrease as time progresses. A parents
time input is often determined by the age of the oldest child, and then split between the other
children, leaving later-born children with limited parent-child quality time (Price, 2008).
Younger children may also possess these traits because they spend a great deal of time
with older siblings and are exposed to a different type of environment. From an early age, the
younger child is exposed to socialization and the opportunity to observe and learn from the firstborn, which may be the cause of the ambitiousness or diligent nature found in later-born children
(Eckstein et al., 2010). While the eldest children strive to impress their parents, younger siblings

often strive to impress their older siblings, as well as proving to them and their parents that they
are no longer inferior (Eckstein et al., 2010).
Adding another child to the family also results in a differentiation of parental behavior.
When there is only one child, a parent is able to tolerate a high activity level in their child.
However, when multiple children are together, parents tend to try and minimize the activity level
in order to manage chaos (Eaton, Chipperfield, Singbeil, 1989). As a result, later-born children
typically are not as active or curious.
Only children share several characteristics with the eldest child. They tend to be very
high achievers, show a greater need for affiliation, and highly motivated (Eckstein et al., 2010).
However, only children are strongly influenced by their parents and often seem overly mature for
their age because their socialization is with their parents (Parks, 1995). With so much adult
attention and expectation, only children tend to outdo their peers in intellectual development.
However, only children are more apt to develop a lack of empathy, high sense of entitlement, or
other narcissistic personality traits (Eyring & Sobelman, 1996).
Although research supports the characteristics found in first-born, later-born and only
children, these are not one size fits all labels (Eckstein et al., 2010). Several environmental
factors play into the personality development of children. Shulman and Mosak (1977) strongly
emphasize the role of ordinal and psychological birth order:
It is not, of course, the childs number in the order of successive births which influences
his character, but the situation into which he is born and the way in which he interprets it
(Shulman & Mosak, 1977, as cited in Eckstein et al., 2010).

Greater age differences between children, disabilities or even a death in the family can confuse
the ordinal position a child associates with, making the psychological order much more
influential on his or her development. Varying parenting styles and home environments are also
crucial to a childs outcome. Typically, a first-born child will receive more time from the parents,
but not as much financial support, whereas parents tend to make up for the lack of time with
later-born children with a more generous demeanor, especially regarding wealth (Price, 2008).
Although most researchers in this field of study agree that a childs birth order will
greatly influence character, there have been critics of this theory. Sulloway concluded that
childrens personality traits due to their place in the family would continue in to adulthood.
However, Block (1993) and Siegler (1990) found that the traits children possess may alter and
change as they become more mature, making the birth order less significant (Block, 1993 &
Siegler, 1990, as cited in Jefferson, Herbst, &McCrae, 1998). Parker (1998) also conducted his
own research concerning first-born, later-born and only children. He found that the birth order
did not correlate with a childs personality (Parker, 1998, as cited in Jefferson, Herbst,
&McCrae, 1998).
Discussion
Application to Future Career
As a Child Development major and a Developmental Psychology and Interpersonal
Relations minor, I will be working with children of all different types. I also plan to further my
education in the field of Counseling Psychology, specializing in children who have recently
experienced some kind of traumatic event. The personality and identity of the children I will be
working with will influence the ways in which I will be teaching and counseling them.

One of my career aspirations is to teach preschool. I currently work in a childcare setting,

and I really enjoy my job there. One of the most challenging tasks of being a teacher is learning
each childs personality and understanding the ways in which this may affect individual learning
patterns. The research findings on birth order will help me to discern certain characteristics, as
well as to understand why a child may think in that way.
For first-born and only children who may tend toward conformity and rigidity, an
effective teaching strategy would be to emphasize individuality and openness. The research
shows that these children may make themselves susceptible to unnecessary stress in order to
impress the parents and to hold their attention. As a teacher, it will be important for me to see to
it that these children utilize their creativity, while giving them support so they may develop their
own sense of confidence, rather than relying on the parents approval. It will also be beneficial to
reinforce the childs nature of being goal-oriented and self-assured. These characteristics are
constructive for a healthy personality in childhood, as well as adulthood. However, I will need to
be particularly careful with only children, seeing to it that I do not support a sense of entitlement
or selfishness. I will also need to be aware of the lack of socialization and push these children to
make friends with other children, allowing them to simply be kids, as well as teaching them
empathy.
While working with later-born children, I will need to be aware of their playful,
sometimes rebellious attitude. While play is one of the best ways a child can learn, this tendency
to be rebellious or to stretch the rules may result in danger for the child. I will need to make sure
that these children use their imagination in a helpful way. Also, opposing these defiant
inclinations at an early age may reduce any risk-taking behaviors they may have later in life.

Children with different personalities will react to trauma in completely different ways. As
a counseling psychologist, the research will help me to recognize the specific coping patterns of
children with different birth orders, while helping me to understand varying family dynamics.
When faced with trauma, first-born children may be reduced to a state of shock. Their lives have
always been so constant in their eyes that this drastic difference may lead to confusion. It will be
important to instill a sense of stability, while listening to and supporting the grieving process so
that they can return to a semi-normal life.
Later-born children tend to be more emotionally intelligent; that is, they understand the
way they feel, as well as being able to sense what others are feeling. This skill is particularly
helpful during any traumatic experience because these children are able to recognize their own
grief, perhaps making it easier to return to their prior life. However, later-born children may hide
their feelings in front of family in order to appear strong (Shwab, 1997). While the child may
view this as a strength, it is important to oppose this tendency and to explain why undergoing the
grieving process is so crucial to their well-being, as well as the familys.
Personal Reflection to Research Findings
I found the research over birth order and personality to be interesting and in my
experience, I found it to be accurate. I am the youngest of three children, and I am the
quintessential baby of the family. I have always been a little more outgoing, as well as very
sociable when compared to my older brother or sister. The research over psychological birth
order was also very interesting to me. My brother was killed when I was eleven, making my
fifteen-year old sister the eldest child in our family by the ordinal positioning. However, my
sister will always, psychologically, be the middle child.

One of my articles stated that there is a flaw concerning birth order and personality
development in to adulthood. I would have to disagree with this finding. In my experience, the
personality traits you develop because of your birth order will stay with you. My tendency to be
a nonconformist, and diligence in trying to impress my siblings has stayed with me into
adulthood. My aunt stated that she had the same experience and that she feels her baby of the
family inclinations will never go away.
Overall, the popular belief about first-born, later-born and only children tends to be
accurate. Children are a product of their environment. The children in a specific family will
experience a different set of norms and experiences due to their positioning, making them all
possess different characteristics.

References
Schwab, R. (1997). Parental mourning and children's behavior. Journal of Counseling and
Development : JCD, 75(4), 258-265. Retrieved from
http://search.proquest.com/docview/219018326?accountid=8483