Friday, 14 January 2005 - 10:00 AM

This presentation is part of: Trauma and Bereavement

The Long Road to Reconstitution: FDNY Family Bereavement in the Wake of 9/11

Purpose: This five-year study is developing an in-depth understanding of the recovery process of families with dependent children whose firefighter father was killed in the 9/11 World Trade Center attacks. Previous research shows that these families, among the highest risk survivors of the disaster, do not engage with traditional mental health services, while normal and complicated grief are present in both children and widows.

Methods: Due to the high stress of affected families and the unknown nature of their responses to this very public event, we designed a mixed-methods approach of parent guidance intervention, consisting of four evaluation sessions, feedback to the children and parent, followed by monthly contacts in years one through three and quarterly contacts in years four through five. All interviews are conducted in the home at the request of the parent and audiotaped and transcribed for qualitative analysis. Children and parents completed standardized measures at six-month intervals in years one through two and annually during years three through five. Standardized measures for children include the CBCL, completed by child, parent and teacher, measures for depression, anxiety, and self esteem, and the Expanded Grief Inventory (EGI) for children and adults, a measure designed to separate complicated, uncomplicated and traumatic grief symptoms. The Perception of Parenting Competence Measure (POPM), a process measure developed in a previous study, provides a rating of parents’ general and bereavement-specific competence. Parents complete the BSI, the EGI, and a parenting confidence measure for general and bereavement issues.

Results: Of 46 families who enrolled between five and 18 months after 9/11/01, 35 families with 111 children remain connected for long-term follow up. All families requested home interviews. Qualitative analysis of the interviews revealed distinct themes for families in years one, two, and the beginning of three. Year one was filled with shock, horror, numbness, and chaos as families waited for remains to be found, planned funerals, attended memorials of other firefighters, and attempted to provide support for children within a highly public context. All widows viewed year two as more difficult than the first as they confronted the permanence and experienced the pain of loss. Children struggled to catch up in school and with friends as the majority of students fell behind in schoolwork in year one. Many adolescents began the second year saying, “We don’t want to be 9/11 kids any more.” What was once “special” was now “different.” In year three widows showed greater assertiveness in parenting and dis-synchrony with their children’s grief responses, often evasive and non-verbal. Some widows began dating, and forming a new identity. The program continues to assess longer-term trajectories of widows and children with normal and complicated (traumatic) grief.

Implications: Home visit interviews with clinician feedback on observations and standardized measures was found to be a valued model for intervention with traumatically bereaved families, gave widows and their children a sense of control and provided in-depth understanding of their experiences for analysis.

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