Sarah K.* was 7 years old when she first experienced a significant loss. The family’s dog, Otis, died of cancer. Otis had been with the family Sarah’s entire life, and his passing saddened the whole family. After the dog died, the family held several meetings where they talked about death and their beliefs about what happens after one’s passing.

Despite these meetings, Sarah’s parents noticed behavioral changes. Although they believed that time would heal the family’s pain, they began to worry when Sarah’s behavior showed no improvement. After three months, they decided to make an appointment for Sarah to speak with a counselor. The family saw Kathleen Davies, a counselor at Outreach Teen & Family Services.

Sarah’s parents detailed her new behavior, including not listening to rules, arguing about daily routines such as brushing her teeth and refusing to do her homework. Additionally, Sarah’s teachers reported a decline in her overall school performance. Although they initially linked these behavioral changes with Otis’ passing, they felt as though her behavior should have improved with time.

When Davies broached the topic of Otis with Sarah, she began to cry immediately and said she thought about Otis frequently. She also expressed a concern that she may have caused Otis’ death because she sometimes forgot to refill his water bowl. She said she felt anger at her family members because they no longer seemed saddened by Otis’ death.

Davies met with Sarah’s parents individually to offer information on a child’s understanding of death. Davies explained, “At Sarah’s age, she does not yet fully comprehend the concept of death as you and I understand it. Young children have not yet developed abstract thought, and so Sarah is just at the point of learning and understanding important characteristics of death, including that death is permanent and universal, or that it happens to everyone.” Davies helped Sarah’s parents understand that young children often feel guilt and sometimes take responsibility for the passing of a loved one. Davies also explained, “We as parents often want to fix the problem when our children are experiencing pain. However, the pain and loss associated with death is not fixable. It is important to allow Sarah time and space to discuss Otis’ passing, without trying to relieve her pain. Let her know that it is normal to feel sad and angry. Let her see you cry when you discuss how much you miss Otis.”

Davies discussed the importance of funerals and other rituals at the time of a loved one’s death as an avenue for closure. During a session, the family developed a plan of having a funeral for Otis where they could each talk about their memories and say goodbye to their beloved pet. Each family member took part in the funeral, including Sarah who agreed to make a poster full of pictures of Otis and each of the family members.

Sarah’s parents soon noticed a change in Sarah’s behavior. They continued to keep a picture of Otis in Sarah’s bedroom, and over time they noticed that she spoke less about his passing and more about her memories of Otis.

*Sarah K. represents a typical Outreach client. Details do not correspond with any specific case in order to protect client anonymity.