Submitted in fulfilment ofthe requirements for the degree of D.Phil in psychology in the Faculty of Arts at the University of Zululand, South Africa, 2005. / Increasingly, hundreds of thousands of children under the age of seven are experiencing the death of their parents in South Africa. Scholarly debate pertaining to childhood bereavement has been and continues to be an arena lacking in clarity, particularly with respect to how this experience impacts upon the young child. To this end, this inquiry attempts to capture an in-depth understanding of this experience and stimulate awareness regarding the needs of bereaved children. Through a phenomenological approach this investigation focuses specifically on the personal experience of six children who experienced the death of a parent during their pre-school years, in the context of a group format. An aspect of the inquiry explores the debate around intervention and service provision for bereaved children. Six core themes are derived which reflect perceptions of this loss. The value of a phenomenological approach with relevance to the study of early bereavement is illuminated. Some limitations of this study are recognized and suggestions for future research are proposed. Based on the insights gleaned through this study, implications are brought to the fore that pertain to the general experience of parental bereavement and service delivery, with particular regard to the context of South Africa.

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To date, researchers who have explored the complexity of childhood bereavement have utilized unstandardized assessment instruments and/or have independently evaluated specific constructs rather than factoring in the dimensionality of loss. The purpose of this study was to use parents' completion of established instruments--the Child Behavior Checklist and the Parenting Stress Index--to examine the multivariate shared relationship between characteristics of bereaved children referred for counseling--their ages, genders, ethnicities, types of loss, and life stressors--and their behavioral manifestations as well as the relationship between these characteristics and levels of parent-child relational stress. Utilizing archival clinical files, I examined these characteristics from bereaved children (N = 98) whose parents sought counseling services from two university-based counseling clinics. The sample consisted of 67 boys and 31 girls between the ages 3 and 11 years old (M = 6.28). The majority of participants (67%, n = 66) identified as Caucasian, 10% (n = 10) as African American, 10% (n = 10) as Hispanic/Latino, 6% as Bi-racial (n = 6), 4% as Native American (n = 4), and 2% as Asian (n = 2). A canonical correlational analyses (CCA) was conducted to examine relationship between characteristics of children and their subsequent behavioral manifestations. The full model was found to be statistically significant using the Wilks’s λ = .611 criterion, F(25, 328.41) = 1.862, p = .008. The R2 type effect size was .389, which indicates the full model explains about 39% of the variance shared between the two variable sets. A second CCA was conducted to explore the relationship between characteristics of bereaved children and levels of parent-child relational stress. The full model was found statistically to be significant using the Wilks’s λ = .790 criterion, F(10, 154) = 1.926, p = .045. The R2 type effect size was .210, which indicates the full model explains about 21% of the variance shared between the two variable sets. Overall, correlational findings from this study provided insight into bereaved children’s manifestations of loss and levels of parent-child relational stress as contingent upon specific characteristics. Specifically, results indicated a strong relationship between age and bereaved children’s behavioral manifestations. This finding reinforced the importance for clinicians to understand developmental implications when working with bereaved children. Furthermore, caregivers who reported minimal overall external stressors also reported less parent-child relational interference. This finding further emphasizes the importance for caregivers to maintain utmost stability for bereaved children.

Varje dag förlorar åtta barn en förälder i Sverige. En större del av dem bevittnar detta efter en förälders sjukdom och kanske en kontakt med palliativ sjukvård. 2010 kom en ny lagändring i Hälso- och sjukvårdslagen som kräver att sjukvården särskilt ska beakta barnens behov av råd, stöd och information i samband med en förälders sjukdom eller om en förälder avlider. Det förekommer kunskapsbrister om hur läget kring stöd för barn som har förlorat en förälder ser ut. Syftet med uppsatsen är att undersöka hur kuratorer inom palliativ sjukvård upplever sitt arbete med stöd till barn i samband med en förälders död. I en kvalitativ intervjustudie med fyra kuratorer som jobbar inom palliativ sjukvård kom det fram att de upplever sin roll i arbetet som bestående av många olika moment. Kuratorerna uppmärksammar barnet i dess sociala sammanhang, till exempel familj och skola och försöker se till att stödet därifrån fungerar. Detta görs genom att till exempel ge föräldrastöd till föräldrarna och att försöka informera föräldrarna att det gynnar barnens utveckling att de görs delaktiga och informeras. Att hänvisa till vidare kontakter som gruppverksamheter för barn i sorg eller dylikt är också en viktig del av kuratorers arbete. Kuratorernas arbete präglas av ett systemteoretiskt förhållningssätt/en helhetssyn vilket kan vara ett sätt att handskas med den komplexitet som arbetsuppgifterna innebär: att uppmärksamma barnens men även familjens behov i olika sammanhang och på olika nivåer. Vissa problemområden, till exempel motsättningen mellan barnens behov av information/delaktighet och föräldrars rätt att bestämma över sina barn har identifierats och inbjuder till vidare diskussion. / Eight children loose one of their parents every day in Sweden. The bigger part of them witness the death of the parent after a long-term illness and maybe after being in contact with the palliative care. The Swedish law of Health- and Healthcare was changed in 2010 due to emphasize that the healthcare institutions have to take into account children rights for information, counseling and support in case of a parental illness or death.  Knowledge about how the system of support for these children is functioning is limited until this day. The goal of this thesis is to examine how counselors in the palliative care experience their work with supporting the children who have lost a parent. The result of the interview study with four counselors in the palliative care implies that these counselors experience their job being complex with many different tasks. The counselors try to take into account the children and their needs in their social environments, such as family and school. To reassure that they get the support needed from these environments the counselors try to support the parents in their parenting and also by informing the parents that informing and including the children in these situations has a positive impact on their development. Another important part of the counselors’ job is referring the children to different support groups or another alternatives for support. The counselors job is characterized by the system theoretical/holistic approach which possibly can by explained as a way to work with children but even parental needs in different social environments and on different levels. Some new problematic issues arose from the interviews, such as the contradictive relationship between the children rights to information and support and the rights of the parents to decide for their children, which invites to further discussion and research in the area.