Adjustment Mechanisms of Adolescent Girls to the Father's loss

Document Type : Research/Original/Regular

Authors

Department of Psychology and Educational Sciences, Shahid Madani University of Azarbaijan, Tabriz, Iran

10.22051/jwfs.2023.43038.2956

Abstract

Loss of parents in childhood and adolescence is an important stressful event. It seems that the child or adolescent should adjust to it, in several ways, to cope with the therefrom stresses and psychological damages. The aim of this study was to identify adjustment mechanisms of adolescent girls to the father loss in Tabriz. The approache of the research was qualitative and the method was descriptive phenomenology. The context of the research was teenage girls (15-19 years old) of Tabriz city; who had lost their father due to illness in childhood and many years had passed since their father's death. Purposeful sampling continued until data saturation and finally 7 people were selected. Data were collected through semi-structured interviews. Data analysis was done by Collizzi method. The findings of this research included 3 main categories and 6 subcategories. The adjustment mechanisms of girls with the absence of a father in Tabriz included self-control (thought management, emotion management), coping (social coping, economic coping) and growth (managing, growth). Most of the participants, based on their individual characteristics, receiving support from the survivors and having suitable conditions, effectively adjusted to the loss and the resulting conditions, and some others showed incompatibility with the conditions due to many reasons.

Highlights

Background and Purpose

Adolescence is usually a high-stress and sometimes a critical period. Because adolescents face several biological and developmental devolutions; such as puberty and identity formation. So, they have less capacity to regulate their emotions (Weinstock et al., 2021).The early loss of parents is a severe crisis in childhood and adolescence (Anderson et al., 2020), which is added to the usual stresses in the lives of adolescents and has adverse consequences on their socio-psychological health (Hogg et al., 2018). The death of a parent is considered one of the life-changing experiences for children (Giozo & Gobi, 2021).Although most studies have reported the negative consequences of parental absence in children in the short and long term, children in the absence of parents experience positive growth, such as strengthening family relationships, increasing the sense of loving life, and paying attention to their health (Walczak et al., 2018). one in five children who have lost their parents has a psychological disorder that requires treatment, and 80% of them adjust to the loss of their parents for up to 1-2 years (Daudney, 2008; Worden, 2009). Therefore, many children and adolescents may adjust to the loss of their parents (Porter & Clarig, 2021). Since adolescents are exposed to secondary stress, increasing and different challenges after the loss of their parents, the extent of their use of coping responses is different, and these responses affect their current and future adjustment and health (Kampas & Fariz, 1991).

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Received: 21 September 2022                                                           Accepted: 20 February 2022

 

Therefore, knowing the mechanisms of adolescents’ adjustment to the loss of parents is important and necessary for maintaining and improving their mental health. Thus, the research aimed to identify the adjustment mechanisms of adolescent girls to father loss.

Method

This qualitative research method was descriptive phenomenology. The context was teenage girls (15-19 years old) from Tabriz city who had lost their father due to illness in childhood. The participants were chosen by purposeful sampling until data saturation. Finally, seven people were selected. The data were collected through semi-structured interviews and were analyzed by the Colaizzi method using MAXQDA20 software to facilitate the analysis. To check the rigor of the research, credibility, transferability, dependability, and dependability were considered.The instrument was the 22 -items Anxious Thoughts Inventory (AnTI) (Wells, 1994), and the implemented intervention was Pyne's (2016) eight-session protocol.

 

 

 

Results

The results showed that the participants had different coping mechanisms with their fathers’ loss. As a result of the data reduction process, six sub-categories and three main categories were identified. The structure of concepts related to the adjustment mechanisms of adolescent girls to the father’s loss is shown in Table No. 1.

In addition, ANCOVA results for social anxiety (p 0.01, F = 34.00) indicate that the effect of narrative therapy on the social anxiety of divorced mothers is significant and reduces its level. According to the Eta Squared, this effect's size is 46%; Findings on physical anxiety (p0.05, F = 7.16) indicate that narrative therapy significantly reduces the degree of physical anxiety among divorced mothers. The Eta Squared value for this effect is 15%; In addition, regarding meta-worry (p-value=.01, F = 14.15), the findings indicate that narrative therapy significantly reduces the level of meta-worry among divorced mothers. The Eta Squared value for this effect is 26%.

Table 1. The Adjustment Aechanisms of adolescent girls to the father’s loss

Concepts

S.C.

M.C

forgetting

thought management

Self-control

unexpecting

accepting the condition

entertain yourself

increasing awareness

optimism for the future

review memories

emotions management

crying

sympathizing with the father's grave

self-confabulate

talking to mother

patience

affability

social coping

Coping

reciprocity

cost management

economic coping

financial independence

financial participation

pleasing the father

seeking sense

Growth

religious behaviors

reconciliation with life

self-scrutiny

eloquence

self-reliance

planning

efforting

responsibility

supporting siblings

Adjustment mechanisms of adolescent girls to father loss included three main categories including self-control, coping, and growth which are described below:

  1. Self-control. This category includes the concepts of thought management (forgetting, unexpecting, acceptance of circumstances, entertaining oneself, increasing awareness, and optimism for the future) and emotions management (reviewing the father's memories, crying, sympathizing with the father's grave, self-confabulate, and talking to mother, patience). Most of the participants tried to control themselves by managing their thoughts and emotions after the father’s loss.
  2. This category included the concepts of social coping (affability and reciprocity) and economic coping (cost management, financial independence, and financial participation). The participants showed patient behavior, silence, anger, and discomfort in encountering the inappropriate behavior of others. Also, most of them had problems in providing living expenses, to reduce the economic pressures were contentment in life and trying to find a job in the future to achieve financial independence by contributing financially and studying well.
  3. This component included seeking sense (pleasing the father, religious behaviors, and reconciliation with life) and eloquence (self-scrutiny, self-reliance, planning, effort, responsibility, and supporting siblings). Most of the participants expressed that they could grow by seeking meaning in life through seeking peace with spirituality and religious behaviors and having the right behaviors for the happiness of the father's soul and finally reconciling with life. They benefited from the conditions of loss for eloquence and having hope for life.

 

Conclusion

This study showed that adolescent girls whose fathers passed away in childhood in Tabriz described adjustment mechanisms to the father’s loss with the components of self-control, coping, and growth. Counselors and therapists can pay attention to the findings of this research to teach new skills to fatherless adolescent girls’ adjustment.  Researchers can design models and programs in the field of proper training and counseling of surviving parents and provide effective relationships with bereaved girls.

 

 

 

Ethical Considerations

This study was conducted under ethical criteria and standards.

Funding: Informed consent was obtained from all study participants.

Financial support: The researchers have not received any financial support from any organization.

Authors’ Contribution: This article was prepared with the participation of first and third authors in conducting research, writing, and editing the article. Second author was the supervisor.

Conflict of interest: This research has no direct or indirect conflict of interest with any study.

Acknowledgments: The researchers are grateful to all the participants, parents, and school administrators.

 

References

 

Andriessen, K‌., Krysinska, K‌., Rickwood, D‌., & Pirkis, J. (2020). It Changes Your Orbit: The Impact of Suicide and Traumatic Death on Adolescents as Experienced by Adolescents and Parents. Environmental Research and Public Health, 17(24): 9356. https://doi.org/10.3390/ijerph17249356

Compas, B.E., & Phares, V. (1991). Stress during childhood and adolescence: Sources of risk and vulnerability. E.M. Cummings, A.L. Greene, & K.H. Karraker (Eds.), Life-span developmental psychology: Perspectives on stress and coping (111–129). Lawrence Erlbaum Associates, Inc. [Link]

Dowdney, L. (2008). Children bereaved by parent or sibling death. Psychiatry7(6): 270-275. https://doi.org/10.1016/j.mppsy.2008.04.007

Guzzo, M.F., & Gobbi, G. (2021). Parental death during adolescence: A review of the literature. OMEGA. https://doi.org/10.1177/00302228211033661

Høeg, B. L., Johansen, C., Christensen, J., Frederiksen, K., Dalton, S.O., Bøge, P., Dencker, A., Dyregrov, A., & Bidstrup, P.E. (2018). Does losing a parent early influence the education you obtain? A nationwide cohort study in Denmark. Public Health, 41(2): 296–304. https://doi.org/10.1093/pubmed/fdy070

Porter, N., & Claridge, A.M. (2021). Unique grief experiences: The needs of emerging adults facing the death of a parent. Death Studies, 45(3): 191–201. https://doi.org/10. 1080/07481187.2019.1626939

Walczak, A., McDonald, F., Patterson, P., Dobinson, K., & Allison, K. (2018). How does parental cancer affect adolescent and young adult offspring? Nursing Studies, 77(3): 54–80. https://doi.org/10.1016/j.ijnurstu.2017.08.017

Weinstock, L., Dunda, D., Harrington, H., & Nelson, H. (2021). It’s complicated—adolescent grief in the time of COVID-19. Frontiers in Psychiatry, 12: 166. https://doi. org/10.3389/fpsyt.2021.638940 

Worden, J.W. (2009). Grief counseling and grief therapy: a handbook for the mental health practitioner paperback. Routledge. [Link]

-1797-2020-27-1-80-94 [Link]

Keywords

Main Subjects

References
Abdelnoor, A‌., & Hollins, S. (2004). The effect of childhood bereavement on secondary school performance. Educational Psychology in Practice, 20(1), 43-54. https://doi.org/10.1080/0266736042000180401 [Link]
Aguiar, A., Pinto, M., & Duarte, R. (2020). Grief and mourning during the COVID-19 Pandemic in Portugal. Acta Medica Portuguesa, 33(9), 543–545. https://doi.org/ 10.20344/amp.14345 [Link]
Ahmadi, A., Mirfardi, A., Aghayari Heer, T., Karwani, A.L, Delavar, M.E, Grvand, F., & Amiri, E. (1401). Analyzing the meaning of child labor from the perspective of social experts, Social Issues of Iran, 13(1), 368-339. https://doi.org/10.22059/ijsp.2022.90890  [Link] (Text in Persian)
Ahmadi, Kh. & Darayi, A. (2016). The effectiveness of patience training on reducing grief and facilitating post-stroke growth. Cultural Psychology, 1(1), 114-131. 20.1001.1.25887211.1396.1.1.7.4 [Link] (Text in Persian)
Akbari Dastak, F. (2015). The position of the culture of contentment (action and action) and its functions in explaining and consolidating the foundations of resistance economy from the perspective of Islamic teachings. Islamic Insight and Education, 13(36), 27-47. [Link] (Text in Persian)
Amodi, A. (1378). Gorarol-Hekam and Dorarol-Kalem. Translated and explained by Seyyed Hashem Rasouli Mahalati. Volume 1, Tehran: Farhang Islamic Publishing House.[Link] (Text in Persian)
Andriessen, K., Krysinska, K., Hill, N. T., Reifels, L., Robinson, J., Reavley, N., & Pirkis, J. (2019). Effectiveness of interventions for people bereaved through suicide: a systematic review of controlled studies of grief, psychosocial and suicide-related outcomes. BMC psychiatry, 19, 1-15. https://doi.org/10.1186/s12888-019-2020-z [Link]
Andriessen, K‌., Krysinska, K‌., Rickwood, D‌., & Pirkis, J. (2020). It Changes Your Orbit: The Impact of Suicide and Traumatic Death on Adolescents as Experienced by Adolescents and Parents. Environmental Research and Public Health, 17(24), 9356. https://doi.org/10.3390/ijerph17249356 [Link]
Arnold, R. (2020). Navigating loss through creativity: Influences of bereavement on creativity and professional practice in art therapy. Art Therapy, 37(1), 6-15. https://doi.org/10.1080/07421656.2019.1657718 [Link]
Asgari, Z., & Naghavi, A. (2020). The experience of adolescents’ post-traumatic growth after sudden loss of father. Loss and Trauma, 25(2), 173-187. https://doi.org/10.1080/15325024.2019.1664723 [Link]
Bellini, S., Erbuto, D., Andriessen, K., Milelli, M., Innamorati, M., Lester, D., Sampogna, G., Fiorillo, A., & Pompili, M. (2018). Depression, hopelessness, and complicated grief in survivors of suicide. Frontiers in Psychology, 9, 198. https://doi.org/10.3389/fpsyg. 2018.00198 [Link]
Berg, L., Rostila, M., & Hjern, A. (2016). Parental death during childhood and depression in young adults – a national cohort study. Child Psychology and Psychiatry, 57(9), 1092–1098. https://doi.org/10.1111/jcpp.12560 [Link]
Bergman, A.S., Axberg, U., & Hanson, E. (2017). When a parent dies–a systematic review of the effects of support programs for parentally bereaved children and their caregivers. Palliative Care, 16, 1-15. https://doi.org/10.1186/s12904-017-0223-y [Link]
Blank, N.M‌., & Werner-Lin, A. (2011). Growing up with grief: revisiting the death of a parent over the life course. Death and Dying63(3), 271-290. https://doi.org/10.2190/OM.63.3.e [Link]
Birgisdóttir, D., Grenklo, T. B., Kreicbergs, U., Steineck, G., Fürst, C. J., & Kristensson, J. (2023). Family cohesion predicts long-term health and well-being after losing a parent to cancer as a teenager: A nationwide population-based study. Plos one, 18(4), e0283327. https://doi.org/10.1371/journal.pone.0283327 [Link]
Bishop, L. (2018). Resilience and Complicated Grief. Doctoral dissertation, Loma Linda University. [Link]
Brannon, L‌., Feist, J‌., & Updegraff, J.A. (2013). Health psychology: An introduction to behavior and health. Nelson Education. [Link]
Brent, D‌., Melhem, N‌., Donohoe, M.B‌., & Walker, M. (2009). The incidence and course of depression in bereaved youth 21 months after the loss of a parent to suicide, accident, or sudden natural death. Psychiatry, 166(7), 786-794. https://doi.org/10.1176/appi.ajp.2009.08081244 [Link]
Bylund Grenklo, T‌., Kreicbergs, U‌., Valdimarsdóttir, U.A‌., Nyberg, T‌., Steineck, G‌., & Fürst, C.J. (2014). Self‐injury in youths who lost a parent to cancer: nationwide study of the impact of family‐related and health‐care‐related factors. PsychoOncology, 23(9), 989-997. https://doi.org/10.1002/pon.3515 [Link]
Compas, B.E., & Phares, V. (1991). Stress during childhood and adolescence: Sources of risk and vulnerability. E.M. Cummings, A.L. Greene, & K.H. Karraker (Eds.), Life-span developmental psychology: Perspectives on stress and coping (111–129). Lawrence Erlbaum Associates, Inc. [Link]
Currier, J.M‌., Mallot, J‌., Martinez, T.E‌., Sandy, C‌., & Neimeyer, R.A. (2013). Bereavement, religion, and posttraumatic growth: A matched control group investigation. Psychology of Religion and Spirituality5(2), 69-77. https://doi.org/10.1037/a0027708 [Link]
Dalton, T.A‌., & Krout, R.E. (2005). Development of the grief process scale through music therapy songwriting with bereaved adolescents. The Arts in psychotherapy32(2), 131-143. https://doi:10.1016/j.aip.2005.02.002 [Link]
DeRidder, D‌., Geenen, R‌., Kuijer, R‌., & Van Middendorp, H. (2008). Psychological adjustment to chronic disease. The Lancet372(9634), 246-255. https://doi.org/10.1016/S0140-6736(08)61078-8 [Link]
Distelberg, B.J‌., Martin, A.V.S‌., Borieux, M‌., & Oloo, W.A. (2015). Multi dimensional family resilience assessment: The individual, family, and community resilience profile. Human Behavior in the Social Environment, 25(6), 552-570. https://doi.org/10.1080/10911359.2014.988320 [Link]
Doka, K.J. (2011). Helping bereaved children: A handbook for practitioners. New York: Guilford. [Link]
Dowdney, L. (2008). Children bereaved by parent or sibling death. Psychiatry, 7(6), 270-275. https://doi.org/10.1016/j.mppsy.2008.04.007 [Link]
Duplace, C. (2023). Understanding Grief Through the Eyes of a Child (Ages 3-12): Mindfulness and Other Mindful Modalities as Supportive Tools. Mindfulness Studies Theses. 75. [Link]
Earlix, K., Shive, N., & Coats, H. (2022). Unpacking characteristics of spirituality through the lens of persons of colour living with serious illness: The need for nurse based education to increase understanding of the spiritual dimension in healthcare.  Clinical Nursing, 31(15-16), 2354-2364. https://doi.org/10.1111/jocn.16055 [Link]
Ebrahimi, M., Karami, J., and Barazandeh Chaqaei, S. (2014). An intervention in social adjustment and reduction of impulsive behaviors of male students with math disability: effectiveness and efficiency of parent training with Adlerian approach. Learning Disabilities, 5(1) 31-7. [Link] (Text in Persian)
Eppler, C. (2008). Exploring themes of resiliency in children after the death of a parent. Professional School Counseling11(3), 189-196. https://doi.org/10.1177/2156759X0801100305 [Link]
Eisma, M.C., Janshen, A., Huber, L.F., & Schroevers, M.J. (2023). Cognitive reappraisal, emotional expression and mindfulness in adaptation to bereavement: a longitudinal study. Anxiety, Stress, & Coping, 13, 1-13. https://doi.org/10.1080/10615806.2023.2165647 [Link]
Eskandari, E., Jalali, A., Mousavi, M. & Akrami, N. (2018). Predicting psychological resilience based on social support and attachment style with the mediation of self-efficacy and meaning in life. Positive Psychology, 5(2), 17-30. https://doi.org/10.22108/ppls.2019.116694.1721 [Link] (Text in Persian)
Feghhi, H‌., Saadatjoo, A‌., & Dastjerdi, R. (2013). Psychosocial adaptation in patients with type 2 diabetes referring to Diabetes Research Center of Birjand in 2013. Modern Care10(4), 249-256. [Link] (Text in Persian)
Flahault C., Dolbeault S., Sankey C., Fasse L. (2018). Understanding grief in children who have lost a parent with cancer: How do they give meaning to this experience? Results of an interpretative phenomenological analysis. Death Studies, 42(8), 483–90. https://doi.org/10.1080/07481187.2017.1383951 [Link]
Glozah, F.N‌., & Pevalin, D.J. (2014). Social support, stress, health, and academic success in Ghanaian adolescents: A path analysis. Adolescence, 37(4), 451-460. https://doi.org/10.1016/j.adolescence.2014.03.010 [Link]
Guzzo, M.F., & Gobbi, G. (2021). Parental death during adolescence: A review of the literature. OMEGA. https://doi.org/10.1177/00302228211033661 [Link]
Haine, R.A., Ayers, T.S‌., Sandler, I.N‌., & Wolchik, S.A. (2008). Evidence-based practices for parentally bereaved children and their families. Professional Psychology39(2), 113-121. https://doi.org/10.1037%2F0735-7028.39.2.113 [Link]
Hawthorne, D.M., Youngblut, J.M., & Brooten, D. (2016). Parent spirituality, grief, and mental health at 1 and 3 months after their infant’s/child’s death in an intensive care unit. Pediatric Nursing, 31(1), 73–80. https://doi.org/10.1016/j.pedn.2015.07.008 [Link]
Hilliard, R.E. (2001). The effects of music therapy-based bereavement groups on mood and behavior of grieving children: A pilot study. Music Therapy38(4), 291-306. https://doi.org/10.1093/jmt/38.4.291 [Link]
Høeg, B. L., Johansen, C., Christensen, J., Frederiksen, K., Dalton, S.O., Bøge, P., Dencker, A., Dyregrov, A., & Bidstrup, P.E. (2018). Does losing a parent early influence the education you obtain? A nationwide cohort study in Denmark. Public Health, 41(2), 296–304. https://doi.org/10.1093/pubmed/fdy070 [Link]
Huang, F.Y. (2022). How emotion regulation mediates the relationship between dispositional mindfulness, depression and complicated grief among the bereaved population. Mindfulness, 13(8), 2092–2100. https://doi.org/10.1007/ s12671-022-01944-1 [Link]
Hurd, R.C. (2004). A teenager revisits her father's death during childhood: A study in resilience and healthy mourning. Family Therapy31(3), 167-184. [Link]
Jakobsen, I.S‌., & Christiansen, E. (2011). Young people’s risk of suicide attempts in relation to parental death: A population‐based register study. Child Psychology & Psychiatry52(2), 176-183. https://doi.org/10.1111/j.1469-7610.2010.02298.x [Link]
Jayawickreme, E., Infurna, F.J., Alajak, K., Blackie, L.E., Chopik, W.J., Chung, J.M., & Zonneveld, R. (2021). Post‐traumatic growth as positive personality change: Challenges, opportunities, and recommendations. Personality89(1),145-165. https://doi.org/10.1111/jopy.12591 [Link]
Koblenz, J.(2016). Growing from grief: Qualitative experiences of parental loss. Death and Dying73(3), 203-230. https://doi.org/10.1177/0030222815576123 [Link]
Lin, K.K‌., Sandler, I.N‌., Ayers, T.S‌., Wolchik, S.A‌., & Luecken, L.J. (2004). Resilience in parentally bereaved children and adolescents seeking preventive services. Clinical Child and Adolescent Psychology33(4), 673-683. https://doi.org/10.1207/s15374424jccp3304_3 [Link]
Lytje, M., & Dyregrov, A. (2023). When young children grieve: Supporting daycare children following bereavement—A parent’s perspective. OMEGA-Journal of Death and Dying86(3), 980-1001 https://doi.org/10.1177/0030222821997702 [Link]
McFerran, K‌., Roberts, M‌., & O'Grady, L. (2010). Music therapy with bereaved teenagers: A mixed methods perspective. Death Studies34(6), 541-565. https://doi.org/10.1080/07481181003765428 [Link]
McLaughlin, C., Lytje, M., & Holliday, C. (2019). Consequences of childhood bereavement in the context of the British school system. University of Cambridge. [Link]
Pham, S., Porta, G., Biernesser, C., Payne, M.W., Iyengar, S., Melhem, N., & Brent, D.A. (2018). The burden of bereavement: Early-onset depression and impairment in youths Bereaved by sudden parental death in a 7-Year prospective study. Psychiatry, 175(9), 887–896. https://doi.org/10.1176/appi.ajp.2018.17070792p [Link]
Porter, N., & Claridge, A.M. (2021). Unique grief experiences: The needs of emerging adults facing the death of a parent. Death Studies, 45(3), 191–201. https://doi.org/10. 1080/07481187.2019.1626939 [Link]
Rutter, M. (2012). Resilience: Causal pathways and social ecology. In The social ecology of resilience. A handbook of theory and practice (33-42). Springer, New York. https://psycnet.apa.org/doi/10.1007/978-1-4614-0586-3_3 [Link]
Sandler, I.N‌., Wolchik, S.A‌., & Ayers, T.S. (2008). Resilience rather than recovery: A contextual framework on adaptation following bereavement. Death Studies, 32, 59-73. https://doi.org/10.1080/07481180701741343 [Link]
Santos, M.C., Magramo C.S‌., & Oguan F‌. (2014). Establishing the relationship between general self-efficacy and subjective well-being among college students. Management Sciences & Education, 3, 1-12. [Link]
Şimşek Arslan, B., Özer, Z., & Buldukoğlu, K. (2022). Posttraumatic growth in parentally bereaved children and adolescents: A systematic review. Death studies46(1), 111-123. http://dx.doi.org/10.1080/07481187.2020.1716886  [Link]
Smith, P.C‌., Range, L.M‌., & Ulmer, A. (1992). Belief in afterlife as a buffer in suicidal and other bereavement. Death and Dying24(3), 217-225. https://doi.org/10.2190/HME4-G1XE-9HXL-TJ96 [Link]
Tang, S., Eisma, M.C., Li, J., & Chow, A.Y.M. (2019). Psychometric evaluation of the Chinese version of the Utrecht grief rumination scale. Clinical Psychology & Psychotherapy, 26(2), 262–272. https://doi.org/10.1002/cpp.2348 [Link]
Tedeschi, R.G‌., & Calhoun, L.G. (2004). Posttraumatic growth: conceptual foundations and empirical evidence. Psychological inquiry15(1), 1-18. [Link]
Tan, J., & Andriessen, K. (2021). The experiences of grief and personal growth in university students: a qualitative study. Environmental Research and Public Health, 18(4), 1899. https://doi.org/10.3390/ijerph18041899 [Link]
Thompson, R.J‌., Gustafson, K.E‌., Hamlett, K.W‌., & Spock, A. (1992). Stress, coping, and family functioning in the psychological adjustment of mothers of children and adolescents with cystic fibrosis. Pediatric Psychology17(5), 573-585. https://doi.org/10.1093/jpepsy/17.5.573 [Link]
Tureluren, E., Claes, L., & Andriessen, K. (2023). Personal growth in bereaved students: Associations with support, grief, and distress. Death Studies, 47(3), 307-314. https://doi.org/10.1080/07481187.2022.2063457 [Link]
Walczak, A., McDonald, F., Patterson, P., Dobinson, K., & Allison, K. (2018). How does parental cancer affect adolescent and young adult offspring? A systematic review. Nursing Studies, 77(3), 54–80. https://doi.org/10.1016/j.ijnurstu.2017.08.017 [Link]
Wilcox, H.C., Kuramoto, S.J‌., Lichtenstein, P‌., Långström, N‌., Brent, D.A‌., & Runeson, B. (2010). Psychiatric morbidity, violent crime, and suicide among children and adolescents exposed to parental death. Child and Adolesent Psychatry, 49(5), 514-523. https://doi.org/10.1097/00004583-201005000-00012 [Link]
Weinstock, L., Dunda, D., Harrington, H., & Nelson, H. (2021). It’s complicated—adolescent grief in the time of COVID-19. Frontiers in Psychiatry, 12, 166. https://doi. org/10.3389/fpsyt.2021.638940 [Link]
Woodward, K. P., Yu, Z., Chen, W., Chen, T., Jackson, D. B., Powell, T. W., & Wang, L. (2023). Childhood bereavement, adverse and positive childhood experiences, and flourishing among Chinese young adults. Environmental Research and Public Health20(5), 4631. https://doi.org/10.1111/jocn.16055 [Link]
Worden, J.W. (2009). Grief counselling and grief therapy: a handbook for the mental health practitioner papernack. Routledge. [Link]
Worden, J.W. (2018). Grief counseling and grief therapy: A handbook for the mental health practitioner. Springer. [Link]
Yahya Mahmoudi, N., Naseh, A., Salehi, S. & Tizdast, T. (2012). The effectiveness of storytelling-based social skills group training on children's externalizing behavioral problems, Developmental Psychology, 9(35), 249-257 [Link]. (Text in Persian)