When Does a Grieving Child Need Counseling? Signs to Watch

A grieving child may need counseling when the hard reactions do not ease over time: weeks of withdrawal or lost interest in play, trouble sleeping or eating, acting much younger than their age, refusing school, or saying they want to be with the person who died. Sadness, anger and clinginess after a death are normal; it is when these signs persist, or get in the way of everyday life, that a counselor can help.

Watching your child grieve while you are grieving yourself is one of the hardest things a parent does. This guide covers how children grieve at different ages, the signs that mean it is time to get support, and what counseling for a grieving child actually looks like.

How Children Grieve at Different Ages

Children do not grieve the way adults do, and they do not grieve the same way at every age. The American Academy of Child and Adolescent Psychiatry (AACAP) explains that "Preschool children usually see death as temporary and reversible." It adds that "Children between five and nine begin to think more like adults about death, yet they still believe it will never happen to them or anyone they know" (AACAP, Grief and Children).

In everyday terms, that often looks like this:

• Ages 3 to 5: asking the same questions again and again ("When is Grandpa coming back?"), playing out the death with toys, and swinging from tears to play within minutes.
• Ages 6 to 9: more questions about what happened and why, worry that someone else will die, and feelings that come out as stomachaches or trouble at school.
• Ages 10 to 12: a clearer understanding that death is permanent, and sometimes a wish to look fine in front of friends while struggling in private.

Grief also comes in waves. A child can seem settled for weeks and then fall apart before a birthday, a school event or a holiday.

What Normal Grief Can Look Like

Many reactions that worry parents are part of ordinary grief, especially in the first weeks and months:

• Anger. AACAP notes that anger is a natural reaction and "may be revealed in boisterous play, nightmares, irritability, or a variety of other behaviors." It is often aimed at the parent who is still there, because that is the safest person.
• Acting younger for a while. Bedwetting, baby talk or wanting to be held more are common after a loss.
• Guilt. Young children often believe they caused what happened, for example because they once wished the person would go away when they were angry. Saying plainly that it was not their fault helps, and it may need saying more than once.
• Sadness that comes and goes. Feelings showing up at unexpected moments, months later, is part of how children grieve.

None of these on their own mean something is wrong. They mean your child is grieving.

Signs a Grieving Child Needs Counseling

AACAP lists signs that a child is having serious problems with grief and loss. Its list includes:

• "An extended period of depression in which the child loses interest in daily activities and events"
• "Inability to sleep, loss of appetite, prolonged fear of being alone"
• "Acting much younger for an extended period"
• "Excessively imitating the dead person"
• "Repeated statements of wanting to join the dead person"
• "Withdrawal from friends"
• "Sharp drop in school performance or refusal to attend school"

AACAP's guidance is direct: "If these signs persist, professional help may be needed." The key word is persist. A bad week after the funeral is expected. The same sign lasting for weeks, or getting worse, is the time to call.

If your child talks about wanting to die or to join the person who died, take it seriously and talk to someone the same day. Call or text 988 for guidance, or call 911 if your child is in immediate danger.

What Child Grief Counseling Looks Like

Counseling for a grieving child rarely looks like an adult sitting and talking. For younger children, much of the work happens through play, drawing and stories, because that is how children make sense of things they do not yet have words for. Our guide to what play therapy actually is explains how that works.

A first session usually includes time with you as the parent: what happened, how your child has changed, and what you are seeing at home and at school. Then the counselor spends time getting to know your child at their own pace. Parents are usually part of the process, with regular check-ins and practical ideas for home. Children cope better when the adults around them have support too, so it is worth looking at grief counseling for yourself if the loss is yours as well.

How to Support Your Child at Home

Alongside counseling, or while you decide whether you need it, a few things help most children:

• Use clear words. Say "died", not "went to sleep" or "we lost her". Gentle phrases can confuse young children or make bedtime frightening.
• Answer the same question again. Repeating questions is how young children process. Short, honest answers are enough.
• Keep routines steady. Meals, bedtime and school give a grieving child something predictable to hold on to.
• Let them choose how to take part. AACAP advises that a child who is frightened about attending a funeral should not be forced to go, and suggests other ways to remember the person, such as lighting a candle, making a scrapbook or telling a story.
• Plan for the hard days. Talk ahead of birthdays, anniversaries and holidays like Thanksgiving and Christmas about how your family wants to remember the person.
• Tell the school. A short note to your child's teacher or school counselor helps them understand changes in mood or focus.

Child Grief Counseling in Humble and Atascocita

At Atascocita Counseling Associates, our children's therapy is for ages 3 to 12, and it includes support for children grieving a parent, grandparent, sibling or friend. On our team:

• Nicole Brown, LCSW, RPT, works with children, adolescents and families, including grief, and uses play therapy. She also sees Spanish-speaking families.
• Krissy Cotten, MA, LPC, works with children, parents and families, and uses play therapy and family systems therapy. She offers faith-based counseling for families who want it.

You can read more about each of them on our team page. Sessions are in person at our office on West Lake Houston Parkway in Humble, close to Atascocita, Kingwood and the Lake Houston area, with teletherapy available in Texas when it suits your family. A free 15-minute consultation is a low-pressure way to talk through what you are seeing and whether counseling would help your child. Call (832) 576-5538 when you are ready.

If You Need Help Now

If you or your child is having thoughts of self-harm or suicide, call or text 988, the Suicide & Crisis Lifeline, available 24 hours a day. In an emergency, call 911 or go to your nearest emergency room.