Transcript for
Supporting children who have lost a parent

Narrator (00:02): Welcome to the Emerging Minds podcast.

 

Dan Moss (00:08): Hello everyone. Welcome to the Emerging Minds podcast. My name is Dan Moss and I’m really pleased today to be joined by Dr Gill Murphy. Gill has worked as a mental health nurse for 20 years with experience in forensic, inpatient, community, and emergency mental health services. Gill is actively engaged with mental health research and her current research programme focuses on mental illness, loss, and recovery. Gill lectures at the School of Nursing and Midwifery at the Western Sydney University and is also the founder of the Childhood Parental Death Ambassador Program, which is what we’re here to discuss today. So Gill, thanks so much for joining us. I’d love to start by hearing more about the programme. What is it and how did it come about?

 

Gill Murphy (00:55): Yeah, sure. And thank you for having me. So the Childhood Parental Death Ambassador Program is a two-day training program that we established after our research working with adults who had experienced the death of a parent during their childhood. And it’s really targeted at all health professionals, social professionals, teachers, or any other disciplines who work with children and families who may have parent who is, what we call anticipated, possible pending death, or who has already died.

 

Dan Moss (01:29): Yeah. Interesting, Gill. What are the program’s key objectives? And how is it currently achieving these?

 

Gill Murphy (01:35): What we’re really hoping to do is to raise awareness around the needs and the experiences of children when a parent is dying or has died, and to really make children visible within that process. So we know often there may be a surviving parent may be caught up in their own grief or people don’t feel comfortable to be able to talk to children about their parent’s death. And so we’re really hoping that children can be visible within this process. But the way that we’re hoping to do that is to look at services making change and developments within their processes and procedures, and within how they train health professionals and their staff to really support children and families prior to, at the time of death, perhaps a paramedic for instance, and then after a parent has died.

 

Dan Moss (02:30): And a big part of your program, I understand, has been the childhood death study. Can you just tell us a little bit about this study and what it has found?

 

Gill Murphy (02:39): Yeah, so we interviewed adults who’d experienced the death of parents during their childhood before they were 18. And what we found was a real sense of distress, not just when a parent has died and soon after, but over a longer-term period. Possibly because of the level of information that they received as children about their parent’s death and how they understood and conceptualised their parent’s death. But also, how they got to know their parent or the lack of information that they had about their parents living and their parents themselves. Things like what their parents liked, what their parents didn’t like, some of the value systems that their parent had. But they also, because their surviving family or surviving parent was trying to get support, maybe they moved areas to get to be closer to extended family, for instance, which involved lots and lots of change for children. So their lives through lots of unpredictability. So they’d move places like schools, house, their friendship groups would change, their networks would change. So it becomes a very challenging time in terms of the child’s distress.

 

Dan Moss (03:56): Yeah. Thanks Gill. A lot of what we find here at Emerging Minds in our research is that in our desire to protect children from upsetting news or events, we as adults can sometimes use secrecy or deprive children of crucial knowledge about what’s happening. This can sometimes, from what we know, impact negatively on children’s mental health. How do you, in your role combat this sort of secrecy or withholding of information from children?

 

Gill Murphy (04:24): Yeah, I think that’s a really important question. And it’s really important to think about the much wider impact that secrecy has for children, because it really adds to their level of confusion and their level of distress. But what it also means is that they’re constantly learning new information and new things even into adulthood.

 

Gill Murphy (04:47): So we found with our study, for instance, that people were learning that their parent had actually died as a result of suicide in adulthood, rather than being given this information during their childhood and having supports around them to be able to help them to conceptualise that. But it really means that we know children have dramatic imaginations at times. And so without the level of correct information that’s provided voluntary by those supports around them about their parent’s death or about their parent when they were living or about their illness, actually it creates this sense of mistrust. Or it can create this sense of mistrust for children or others within their own family network. And it means that other people know more than them or their older siblings might have information that a child hasn’t had been provided to them. So it’s really important because not only do children then experience the loss of their parent who’s died, but then these relationships around them are changing and they get this new sense of mistrust or they can do for those around them.

 

Gill Murphy (06:00): It also means that they may make up these stories in their minds without this right information. And sometimes those stories can be incredibly distressing for them. Or they may hear things from their peer group that they start to absorb and start understand that as being the correct message. So what we really advocate for is early disclosures as soon as we can for children about, for instance, their parent’s illness maybe. So really start building this level of information as early as we can. And then we can scaffold onto that information later. But really providing a time for questions so we give children the information and then we keep checking in with them, if they’ve got new questions or they want to understand something in a different way. So having the idea that we will need to keep on presenting information, but when a child’s ready have that information, or when they’re asking for information that it’s available for them there and there as much as we can.

 

Dan Moss (07:06): Dr Gill Murphy from the Childhood Parental Death Ambassador Program, I know that one of the key processes that your program undergoes is really close connection with practise and what’s some of the exciting, innovative practises that are happening across the nation. Can you tell us about what are some of these exciting practises?

 

Gill Murphy (07:28): Oh yeah. Well, there’s lots going on in some of the particular services like intensive care units. I know we’ve had different ambassadors attend our program, nurses particularly, and social workers that are working in intensive care units, to really be looking at their processes and how they support children and possibly informing children around a parent’s pending death and having children involved. But also at the time of death and being able to make memories with children about their time with their parent.

 

Gill Murphy (08:05): We think this memory making is really important for children because over the course of time after a parent has died, it’s really difficult for children to work out which were their own memories with their parents and which were memories that have been passed on from other people. And it’s really important that we differentiate those memories because a child can lose the positive emotion that they had with their parent. So we really want them to be able to give their memory, but also to be able to remember the emotion and the connectivity that they had in a positive way.

 

Gill Murphy (08:45): But it’s also, we know that there are some charities as well that are working some of the children’s grief charities. We know that there are weekend camps, for instance, that are really looking at bringing children and surviving parents together, but also children and other children together to bring some commonalities of experience for children to share. And we know as well that there will be hopefully a growth in areas such as online children coming together to really be able to enhance the experiences of peer support as well.

 

Dan Moss (09:21): Thanks Gill. So fascinating to hear you talk about memory making there for a child. This really stands in contrast, doesn’t it, to traditional notions of overcoming grief by forgetting or moving on from the emotions attached to a loved one who’s deceased in accordance with this. How can practitioners who might be feeling anxious about ways that they can keep that memory making alive, what can they do? How can they start to take small steps in their own practises for children who are experiencing significant grief?

 

Gill Murphy (09:55): Yeah. Well, that’s a really good point and brings me to the idea of this preparedness. If services are having contact with children and families, that they really start those conversations now. So that when they do have a child or family present or a parent dies, that they’re really clear within their service about what their policies and procedures are to really support children. But really what we want is that services are thinking about how do they identify children after a parent’s died. So not just a child who may present until hospital, for instance, if a parent is dying, but those children that may well not be present. How do they talk to the surviving parent to identify those children? And so then how do they support children at the scene of death, but then after as well?

 

Gill Murphy (10:48): So when we talk about preparedness, we’re thinking around how services consider who should be involved and how they should be involved and really to think about how they want to support surviving parents. What do they think surviving parents need or will want? Or what services can they offer? The best service that they can offer depending on where that person may be within that journey. So it may be for instance, a paramedic who visits a home and there’s an emergency situation, but the parent actually dies on scene. And so what we’ve been asking paramedics to do is really think about that may be the very last time that a child is with their parent. So how can they facilitate the best that that can be for a child to spend time with their parent at that point in a very supportive way? And how can they facilitate a surviving parent to notify a child that their parent has died?

 

Gill Murphy (11:49): But also things like making sure that there are supports for staff as well. So we’re taught there’s preparedness, but also facilities for supporting for staff. And one of the most important things is to make sure that we don’t disenfranchise the surviving parent. So what we really need is that we’re having really open discussions with all of those people involved in a very supportive way as early as possible. That maybe with the person who’s dying, with the surviving parent. So we’re really understanding what their conceptualizations of death may be from a cultural background. And we understand what their desires are for the death related practises, such as being with a person or where a person wants to die and who they would like to be with them after death, for instance. And so having information that’s readily available for them and letting a parent know, a surviving parent know where they can go for support would be really helpful.

 

Gill Murphy (12:56): But it’s also making sure that when I do the ambassador program, I often talk to service staff around making sure that you follow up with people. And so we’re offering more assertive service provision. Rather than waiting for a parent to make contact with us, that we reach out, with consent obviously, to make sure that we’re able to facilitate more support if needed as we’re going along.

 

Dan Moss (13:24): Thanks Gill. What you are talking about, seems about making and continuing to build on a parent’s legacy even after they’ve deceased. This obviously does take some time. I imagine that there’re supports that children and families need directly after death, but also for a time after this. Why do you think it’s important that these supports remain in a child’s life however long that they need them?

 

Gill Murphy (13:52): Yeah. Well, we know that grief comes in waves over a period of time. So obviously we have this real big acute kind of nature of grief and adjustment, but then this may go on for some time. People are grieving at different stages and they have different needs at different times. So if we just think about, for instance, the use of photographs or the use of videos. Some people can find it at different times really enormously difficult to look at photographs of their loved one who has died, depending on where they are in their grief journey. And that may be different for different people, different members of the same family. So it’s really important that children have access to, for instance, their own photographs of their parent who died. So when they’re feeling ready and able, they can then look at pictures or of videos at that time.

 

Gill Murphy (14:48): But what we also talk around is about the sharing of grief. So it’s really important that, as we’ve mentioned earlier, children have an understanding of why an adult has died. For instance, their parent died. We really also want them to have an understanding of what their parent was like as a living person. And so that may mean that they share those stories with their family members when people are ready, but that that’s a repeated sharing because it’s not just giving a child information about their parents, it’s also building this sense of connectivity with their family members who are with them at that time. And that’s really critical.

 

Dan Moss (15:28): You talked before about the importance of not disenfranchising the surviving parent. I imagine for that surviving parent, there’s often a great deal of anxiety dealing, of course, with their own sense of grief, but also about how they communicate with their child in a way which best supports them. How do you help that surviving parent? And in particular, how do you help them to overcome communication barriers, which might exist because of their sense of just not knowing what to say?

 

Gill Murphy (15:57): Yeah. I think that’s something that we talk a lot about on the ambassador programme is around how we can work with surviving parents to really give them the terms to use and how to explain that in a really open in way. So we know that children will have lots of different ways of understanding death depending on their age and their capacities and abilities. But we also know that people from different cultural backgrounds for instance, have different understandings of death. So it’s really important that as practitioners, we talk to a surviving parent to really work out what information is it that they would like their child to know at that time. And then really to facilitate them to find those words.

 

Gill Murphy (16:44): So that may take some time for us to spend with a parent just working through that initially, if they’re going to give a child notification of the death of a parent, for instance. But it is really important that we spend some time just thinking about what are your conceptualizations of death and grief and how do you want to present that to the children?

 

Gill Murphy (17:09): It’s a really interesting conversation because actually what we find is families only have these conversations when a parent has died. But actually what we would say is it’s really important for families to have the proper words, to have conversations about what would they want their legacy for their children to be? How would they want their child to be notified about their death? And how we can do that in the best possible way to really be respectful as well about the cultural understandings within each family unit.

 

Dan Moss (17:44): So Dr Gill Murphy, you’ll be talking today to many practitioners out throughout Australia who do not specialise in this particular type of work and they might be feeling reluctant or anxious about asking children or families about the death of a loved one. What advice would you give to these practitioners?

 

Gill Murphy (18:05): I think it’s really about saying actually when someone’s in a real heightened state of distress, what we worry about as practitioners will be very different to what they’re actually thinking and feeling as a person in distress. So if you think about yourself when you’ve been distressed, actually what we want is to know that somebody is with us and to know that someone will be with us and somebody will take their time to talk to us in a supportive way, but also listen. And I think the more open we are with people in the opening phase of our conversations with people, then the easier it is for us to build that connectivity and to share this basis of humanity. When someone’s distressed, what they want most is to know that there is someone present with them and so I think it really is about stripping back our own anxieties as practitioners to be able to be with somebody and to let them feel that this a sense of togetherness, because that’s what we want when we’re distressed.

 

Gill Murphy (19:11): And I think if we say the same principle for children. The more we let our own anxiety be in the space where we avoid talking to children, then that in itself can be generating more distress for the child. So the more we are open with children and we ask how they’re feeling, how things are going, what would they like to do at this point in time, the more we facilitate surviving parents to have those really open discussions with children and to be really open to answer questions and be open to information.

 

Gill Murphy (19:48): Then we know that it’s almost like the circle of all of those people involved in this grief process, the practitioner, surviving parent, other children and other family members, and then the team that the practitioner comes from. The more open discretions we have in all of those interactions, then the least distress people will experience and the most humanity and sharing of grief they will have. And that will be really helpful in itself. So I know a lot of people feel that it’s a very complex area of work and for sure it can be complex thinking through and considering lots of different people involved. But actually the more everyday conversations and the more we connect with people, then the more support people will feel in themselves.

 

Dan Moss (20:41): Great. Thanks Gill. So you’ve talked to us today about the Childhood Parental Death Ambassadors Program, and really thank you for that because it’s been a fascinating insight into what the programme does and what it aims for. If people are wanting to find out more about the ambassador program or express an interest in intending, how do they go about doing that?

 

Gill Murphy (21:02): Yeah. So anybody can email me directly. My email is g.murphy, that’s M-U-R-P-H-Y, @westernsydney.edu.au. And I can provide information about the programme and when the next sessions are. The programme has been a two-day face to face programme so far, but because of the obvious difficulties with COVID and wanting to make a wider reach for people who may be in other states of Australia, we are going to be offering the programme over Zoom sometime in the very near future. So people can email me directly and I can let them know when the programme will be running again as well.

 

Dan Moss (21:45): Great. Gill, that conversation has been really fascinating today and we really thank you for your time.

 

Gill Murphy (21:50): Thank you. Thanks for having me.

 

Narrator (21:54): Visit our website at www.emergingminds.com.au to access a range of resources to assist your practise. Brought to you by the National Workforce Centre for Child Mental Health, led by Emerging Minds. The National Workforce Centre for Child Mental Health is funded by the Australian Government Department of Health under the National Support for child and Youth Mental Health Program.