School-Based Bereavement Interventions for Children: A Scoping Review

Background and Purpose: Every year, millions of children are bereaved due to death of loved ones, with some children being orphaned. Bereavement can have a significant impact on children’s psychosocial functioning and academic performance. Schools provide an ideal setting to support children’s grief reactions and may provide the additional support needed, especially when parents and caregivers are not emotionally able at the time. However, studies on school-based psychosocial interventions for bereaved children are limited. The current scoping review aimed to identify and examine empirical school-based interventions for bereaved children to elucidate the outcomes, populations included, providers, and the types of school-based interventions provided.

Methods: The PRISMA guidelines were used to guide the methods for this scoping review, including specifying inclusion and exclusion criteria, information sources, search strategies, selection process, and methods for data collection. Databases used included APA PsychInfo and Social Work Abstracts, and hand search methods were also used. Zotero, a reference management program, was used by two reviewers to search keywords and abstracts. Full-text articles were then reviewed, and data were extracted.

Results: There were 37 articles in the study. The main quantitative behavioral health outcomes from 31 studies include depression, grief, posttraumatic stress symptoms, and emotional/behavioral problems. Outcomes from the nine studies that included qualitative methods included expression/regulation of emotions, feeling more connected with others, shared about experience, improved coping, and better understanding of grief . Outcomes related to school engagement and performance were limited. Most interventions were heterogeneous in terms of type of death experienced. Most studies occurred in the United States, with other studies conducted in 15 regions. The providers were mostly school-based and community personnel. Studies included 19 prevention and 15 psychotherapy interventions, most of which were structured grief and trauma interventions or incorporated art activities.

Conclusions and Implications. Given the limited studies to date, additional research on both CBT and arts-based interventions, as well as prevention and intervention school-based studies, is needed. Importantly, there needs to be appropriate assessment processes and criteria that match bereaved children to the best type of school-based interventions to maximize outcomes, such as to decrease or prevent future psychopathology, to promote well-being and coping, to provide space for grief expression and regulation, and/or to enhance school-related experiences and academic outcomes. Schools may consider offering a continuum of bereavement care including prevention interventions and therapy groups. School social workers and related disciplines are encouraged to evaluate bereavement services and to use current findings from this scoping review to select types of interventions, outcomes to target, assessment measures, and to include more diverse participants. Since there were only three studies that included academic related outcomes, more research is needed to understand the impact of school-based bereavement interventions on school-related outcomes. Findings can inform policymakers, researchers, and school-based personnel to assess the current state of empirical interventions and to develop beneficial programs for bereaved school communities.