A child's adjustment to the death of a parent is greatly influenced by the surviving parent's ability to attend to his or her own grief-related needs, to create and sustain a consistent and nurturing environment, and to encourage the child to express distressing or conflicting thoughts, feelings, and fantasies about the loss. Yet, the surviving parent's grief often compromises their ability to parent consistently and empathically. This article will illustrate how, by providing a holding environment for whole families, clinicians can help parents to facilitate children's grief reactions and, thus, mitigate long-term adverse mental health outcomes. Family Matters programs, designed and implemented in a community agency, use a holistic approach to family support and treatment in a milieu setting. Combining therapeutic work with surviving spouses and bereaved children supports children's grief while facilitating newly single parents as they adapt the structure of family life. When clinical work with families begins before the ill parent dies, the clinicians may build a relationship with the dying parent, prepare the child and surviving spouse for life after loss, and support continuity in family culture. We introduce a curriculum for simultaneously supporting bereaved children and parents, present a series of common challenges faced by surviving parents, and suggest avenues for intervention research.

The death of a parent precipitates a number of profound losses and transitions for children, disrupting their sense of safety and security. Children who have lost both parents or who, due to divorce, are relocating across great distances following the death of their custodial parent incur a number of profound secondary losses, including place attachment disruptions. Work with this population should aim to create a holding environment for children to normalize and validate their experiences while keeping them on track academically, socially, and psychologically. The paper will present two case studies and will offer family-, developmental-, and attachment-based interventions to help prepare children for these inevitable transitions. The paper will suggest a unique role for clinicians when working with this population.

Family life is altered irrevocably when a young parent is diagnosed with or dies from cancer. This article tracks the genesis and transformation of a comprehensive psychoeducational support and bereavement program for children, adolescents, and parents affected by cancer. From the inception of the program, families with parents in active treatment participated in time-limited support groups. When a parent died, families transitioned out of support and into bereavement groups. As the cancer experience became more chronic, families remained in these respective groups for longer periods of time. This required clinicians to reconsider group structure to avoid the additional losses incurred as newly bereaved families transitioned from one group to another. Restructuring the program allowed participants to remain in familiar environments and to experience greater support and continuity in their care. Children, teens, and parents made clinical gains in communicating their needs and feelings to loved ones. Further, children and teens stayed on track developmentally, academically, and socially. Clinicians structuring these programs must be skilled in working simultaneously in both support and bereavement modalities. Recommendations for self-care and supervision are suggested.

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