Grief in Children and Adolescents - A Developmentally Informed Clinical Review With Illustrative Cases

Sep 30, 2026

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Grief in children and adolescents is a complex process that differs from adult mourning in both expression and developmental impact. Young people may struggle to verbalize emotions, leading to behavioral and somatic changes that are often misread or missed in clinical settings. This developmentally informed review maps how grief presents across developmental stages, outlining age-specific responses, common clinical presentations, and influences on resilience versus vulnerability, with assessment strategies, tailored therapeutic approaches, and illustrative case material.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Introduction

Developmental Perspectives on Grief in Childhood and Adolescence

REVIEW ARTICLE J Korean Acad Child Adolesc Psychiatry 2026;37(1):44-50 [https://doi.org/10.5765/jkacap.250036](https://doi.org/10.5765/jkacap.250036) eISSN 2233-9183 Grief in Children and Adolescents: A Developmentally Informed Clinical Review With Illustrative Cases Vanessa Budiawan Soetioso1,2 and Izzatul Fithriyah1 1Department of Child and Adolescent Psychiatry, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital Surabaya, East Java, Indonesia 2Department of Psychiatry, Faculty of Medicine, Widya Mandala Catholic University, Surabaya, Indonesia Grief in children and adolescents is a complex and often misunderstood process, distinct from adult mourning in both its expression and developmental impact. Young people may struggle to articulate their emotions, leading to behavioral changes that are frequently misinterpreted or overlooked in clinical practice. This review explores how grief manifests across developmental stages, highlighting agespecific responses, common clinical presentations, and factors that influence resilience or vulnerability. Drawing on current evidence and clinical insight, we examine assessment strategies and therapeutic approaches tailored to the needs of grieving children and adolescents. Case illustrations are used to provide context and deepen understanding. By emphasizing a developmentally sensitive, emotionally attuned, and culturally aware perspective, this article aims to equip clinicians with practical tools to better support children and adolescents coping with loss. Keywords: Bereavement; Child; Adolescent; Mental health; Well-being; Developmental psychology. Received: June 19, 2025 / Revised: September 24, 2025 / Accepted: October 30, 2025 Address for correspondence: Izzatul Fithriyah, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Jl. Mayjen. Prof. Dr. Moestopo, 47, Surabaya, Jawa Timur 60286, Indonesia Tel: +62-31-5020251, Fax: +62-31-5022472, [E-mail: izzatul-fithriyah@fk.unair.ac.id](E-mail: izzatul-fithriyah@fk.unair.ac.id) INTRODUCTION Grief in children and adolescents is often overlooked or misunderstood in clinical settings. A child’s distress may not manifest as tears or verbal expressions of sadness, but instead through stomach pain, school refusal, irritability, or unexpected changes in behavior [1]. These signs are frequently interpreted as anxiety, oppositional behavior, or stress related to developmental transitions. When the loss isnot recent or openly discussed in the home, the connection between grief and symptoms becomes even more difficult to trace. The difficulty is not that children and adolescents do not grieve, but that their way of grieving does not follow a predictable or easily recognizable pattern. Their expression of grief also shifts depending on age, cognitive development, and relational context, and is often concealed beneath more outwardly disruptive concerns [2,3]. Losses in childhood and adolescence may arise from diverse experiences, including parental illness, the death of a sibling or peer, suicide, traffic accidents, and other sudden incidents. The relational context of the loss, whether it involves a parent, sibling, or close friend, This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ([https://creativecommons.org/licenses/by-nc/4.0](https://creativecommons.org/licenses/by-nc/4.0)) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. can profoundly shape the grieving process, and witnessing a traumatic event may further intensify symptoms [1]. For many clinicians, especially those working in general practice, pediatrics, or emergency care, the signs of grief maybe missed simply because they do not present in a way they are trained to recognize. There is no stand

FAQs

How can children’s grief be mistaken in clinical settings?

Children may not show tears or clearly verbalize sadness. Distress can appear as stomach pain, school refusal, irritability, or behavioral changes that are often interpreted as anxiety, oppositional behavior, or stress.

What factors influence whether a grieving child becomes resilient or vulnerable?

Resilience or vulnerability is shaped by age-related expression, cognitive development, and the relational context of the loss. The review also notes that traumatic experiences can intensify symptoms.

What does the review recommend clinicians focus on for assessment and treatment?

Clinicians should recognize grief even when it is not explicitly named, use developmentally sensitive assessment strategies, and offer therapeutic approaches tailored to the needs of grieving children and adolescents, informed by cultural and family environments.

Sep 30, 2026

Uploaded by Mia