Rehab Kids

The Epidemic of Grief:

Innovative Tools for Grieving
Children and Their Families
Liana Lowenstein, MSW, RSW, CPT-S

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The Epidemic of Grief:
Innovative Tools for Grieving
Children and Their Families
Liana Lowenstein, MSW, RSW, CPT-S

Rehab Kids

ZNM059723
1/24
Copyright © 2024

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86pp

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Rehab Kids
 Materials Provided By

Liana Lowenstein is a Licensed Clinical Social Worker, Certified Play Therapist-

Supervisor, and Certified TF-CBT Therapist who has been working with
children and their families in Toronto for over 35 years. Her areas of specialty
include treating trauma, bereavement, divorce, anxiety, and ADHD. She
integrates play therapy into evidence-based models such as CBT and TF-CBT.
In addition to her clinical practice, she provides supervision and consultation
to mental health professionals. Liana’s 14 books are used by mental health
professionals and children’s support workers all over the world, and several
have been translated into Chinese, Korean, and Turkish. Her best-selling
titles include Creative Interventions for Bereaved, Creative Interventions for
Children of Divorce, Creative CBT Interventions for Children with Anxiety, and
Cory Helps kids Cope with Sexual Abuse. Her latest book, Cory Helps Kids Cope
with Grief: Playful Activities for Young Children, helps young grievers impacted
by suicide, homicide, drug overdose, natural disasters, mass violence, war,
military casualties, and other types of loss.

Liana is a frequent keynote speaker at international conferences and agency

training events, and has provided workshops throughout North America
and abroad, including China, South Africa, Israel, England, New Zealand,
Australia, and Slovenia. Liana has trained mental health professionals
and grief group facilitators on innovative ways of supporting bereaved
children, including presentations at the ADEC conference, The International
Death, Grief, and Bereavement Conference in La Crosse, and Canada’s Grief
Certificate Program run through the Learning Institute at the Sick Kids
Centre for Community Mental Health.

Liana is winner of the Monica Herbert award for outstanding contribution to

play therapy in Canada.

For speaker disclosures, please see the faculty biography in activity advertising.

Materials that are included in this course may include interventions and modalities that are beyond the
authorized practice of certain professionals. As a licensed professional, you are responsible for reviewing
the scope of practice, including activities that are defined in law as beyond the boundaries of practice in
accordance with and in compliance with your profession’s standards.
 As required by several accrediting boards, speaker and
activity planning committee conflicts of interest
(including financial relationships with ineligible
organizations) were disclosed prior to the start of this
activity. To view disclosure information, please see
activity advertising.

Please note: Following links (including QR code scanning) in this

document may take the user outside of the educational activity.
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21
 The Red or Black Card Game
This game will help me get to know you better. Pick the top card. If
it’s red, answer the question. If it’s black, pick from the Get Moving
Grab Bag and follow the instructions. Play until all the questions
have been answered.
1. Make a happy face. Then say something that makes you happy.
2. Make a sad face. Then say something that makes you sad.
3. Make a scared face. Then say something that makes you scared.
4. Make an angry face. What makes you feel angry? What makes
your (caregiver) feel angry? What do they do when they’re
angry?
5. What do you know about when, where, how (the deceased) died?
6. What are your questions or worries since the person died?
7. What are 2 changes that have happened since the person died?
8. Who helps you when you have a problem or worry? How do they
help?

Get Moving Grab Bag

Jog on the spot 5 seconds then take 3 deep breaths
Hop on L foot 3 x then take 3 deep breaths
Small arm circles 5 x then big arm circles 5 x then 3 deep breaths
Squeeze R hand with L hand 5 x then take 3 deep breaths
March in place knees high 10 x then take 3 deep breaths
Touch head, shoulders, knees, toes then take 3 deep breaths
Cross L foot over R foot, hold 3 seconds then take 3 deep breaths
Touch R foot with L hand then take 3 deep breaths
Jump to left then jump to right then take 3 slow deep breaths
3 jumping jacks then take 3 deep breaths

22
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Peo
o ple in My World
This activity will help you talk about the important people in your
world. The first step is to fill in the picture of the world by
writing the names of the important people:
1) Put yourself in your world
2) Put the people you live with and others in your family
3) Put relatives who you spend a lot of time with or who help
take care of you
4) Put your teacher
5) Put other important people who you feel especially close with
or who have hurt/upset you a lot

25
 People in My World
Put happy faces on anyone who feels happy a lot. How come they’re happy?

Draw sad faces on anyone who feels sad a lot. How come they’re sad?

Put bees on anyone who feels angry a lot. How come they’re angry?

Put spiders on anyone you feel afraid of. How come you’re afraid of them?

Put dots on anyone who did something very wrong or very bad. What did
they do that was very wrong or bad?

Put bears on anyone who takes good care of you or helps you when you have
a problem or worry. What do they do to help you?

People in My World
Draw yellow happy faces on anyone who feels happy a lot. How come they’re
happy?

Draw blue sad faces on anyone who feels sad a lot. How come they’re sad?

Draw purple X’s on anyone who feels angry a lot. How come they’re angry?

Draw green X’s on anyone who feels scared a lot. How come they’re scared?

Draw black X’s on anyone who did something very wrong or very bad. What
did they do that was very wrong or bad?

Draw red hearts on anyone who helps you when you have a problem or worry.
What do they do to help you?

26
 People in My Life
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Life and Death

All people are born, they live, and eventually they die. Death
happens when a person’s body becomes so old, sick, or injured
that it stops working forever. Dead people don’t breathe
because their bodies don’t work anymore. Dead people don’t
move because their bodies don’t work anymore. Dead people
don’t hurt because their bodies don’t work anymore. Dead
people don’t need to eat or sleep because their bodies don’t
work anymore.

46
 Life and Death
•Dead people don’t breathe because their bodies don’t work
anymore. You are alive which means you can breathe. Breathe
in and out three times.

•Dead people don’t move because their bodies don’t work

anymore. You are alive which means you can move. Jump up
and down three times.

•Dead people don’t feel hurt or pain because their bodies

don’t work anymore. You are alive which means you can feel
hurt or pain. Pinch your arm (not too hard!)

The Funeral
1. Describe the funeral the animals planned for their friend
the zebra.

2. What do you remember about your special person’s

funeral?

3. Did you see the body of your special person after s/he
died? What was that like?

4. Were you there when your special person’s body was

buried (or cremated)? How did you feel about that?

5. What did you feel at the funeral and were you able to
show your true feelings?

6. Is there anything you wished was different about the

funeral? Write about it:

47
 The Funeral (Adaptation for Cremation)
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Messages In Art

Sometimes it can be difficult to verbally express thoughts

and feelings. Expressions through art can be a helpful way to
release and communicate feelings. Choose a family member
with whom you would like to communicate a message. Use the
art supplies to create your message. Once completed, explain
your message and the meaning of the materials you selected.

49
 Messages In Art: Process Questions
1.What was it like to communicate your message through art?
2.How did you feel during the message creation and message
delivery part of this activity?
3.How did it feel to receive the message from your family
member?
4.What did you learn through this activity about ways to
communicate with your family about your thoughts and
feelings?

Emotional Pie Chart

Parent: Draw a large circle on the paper. Choose at least five
emotions that you think your child is experiencing the most. Select
a different color marker to represent each emotion. If you think
your child is experiencing the emotion a lot, then draw a large slice
on the pie chart. If you think your child is experiencing the emotion
a little, then draw a small slice on the pie chart. Use a darker
marker or crayon to write the feeling word inside the pie slice, and
write why you think your child is feeling the emotion. For example,
you might draw a large slice in blue to represent sad, and then write
the word SAD in black inside the blue slice, and underneath SAD,
write: the death, nobody to play with at recess, best friend moved
away.

50
 Emotional Pie Chart
Child: Pay close attention to your parent’s drawing to see how much
of it they get right. After your parent is finished, look at the
emotional pie chart and correct it to change the size of slices, add
or take slices away, etc. This can be done by remaking the pie chart
on a second sheet of paper.

Emotional Pie Chart: Process Questions

• Child: What did your parent get right?

• Child: What parts of your parent’s emotional pie chart needed to

be changed, and why?

• Parent: What did you learn about your child’s emotions?

• Parent: What can you say to your child to validate their

emotions?

• Parent: What can you do at home to help your child open up with
you about their emotions?

51
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Meme Your Mood

Invite the the client to choose memes that express some of
their emotions and experiences in recent weeks. Encourage
the client to find memes that relate to their happy times,
stressors, worries, proud moments, etc.

Next, have the client use the identified memes to create a

timeline of these emotions and experiences. For each meme,
discuss what occurred, how the client felt while it was
occurring, and how they handled the situation.

52
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Feeling Like It’s My Fault

You may think that you somehow caused your special person to die. Maybe you
believe your words caused your special person to die, like if you thought or
said, “I hate you! I wish you were dead!” Maybe you think your special person
would still be alive if you would have been better behaved. You may think, “I
could have done something to stop the death from happening.” Or maybe
there’s another reason why you think you caused your special person to die. Fill
in the sentences below to show how you are feeling:

I think my special person’s death is my fault because…

I feel badly that I…

My special person would still be alive if I would have…

I wish I could tell my special person that…

56
 G etting Rid of Guilt Comic Book

When someone dies, children often feel guilty about it.

Guilty means feeling bad for something we think we did
wrong. The cartoons on the next pages are about children
who feel guilty because of their special person’s death.
These children received some helpful words of advice
from other children to help them get rid of their guilty
feelings. Read the comics, then answer the questions on
the next page. Once you have answered the questions,
color in the comics, cut them out, and staple the pages
together to make a comic book.

Getting Rid of Guilt Comic Book

1. What are some reasons why children blame themselves when
someone dies?

2. What words of advice helped the children in the cartoons get

rid of their guilt?

3. Have you ever felt guilty for your special person’s death? If
yes, why did you feel guilty?

4. What words of advice can you give yourself to help get rid of
your guilt?

57
 Helpful Talk Puppets
Helpful talk is what you say to yourself to feel better. So when your
favorite toy breaks, if you say now I have nothing fun to do, this will
make you feel sad. But if you say I have other fun things to do, this
will make you feel better. Let’s learn helpful talk so you can make
yourself feel better. We’re going to use puppets to help you learn to
do helpful talk.
First, let’s make puppets. I will make a puppet to talk for me, and
you will make a puppet to talk for you.
let’s use our puppets to do helpful talk. Let’s pretend your puppet is
upset. My puppet is the helper. My puppet will show you how to do
helpful talk to make your puppet feel better. Then your puppet will
copy what my puppet says.

Helpful Talk Puppets

CHILD’S PUPPET: There’s no more cereal. I have nothing good to eat.
HELPER PUPPET: I can eat something else.
CHILD’S PUPPET COPIES THE HELPFUL TALK: I can eat something else.

CHILD’S PUPPET: I’m worried my (caregiver) won’t come back.

HELPER PUPPET: When my (caregiver) goes out, I know they will come
back soon.
CHILD’S PUPPET COPIES THE HELPFUL TALK: My (caregiver) will come
back soon.

CHILD’S PUPPET: I’m worried about who will take care of me.
HELPER PUPPET: There will always be a grown-up to take care of me.
CHILD’S PUPPET COPIES THE HELPFUL TALK: There will always be a
grown-up to take care of me.

58
 Helpful Talk Puppets
CHILD’S PUPPET: I did something bad. Now my (caregiver) doesn’t love me
anymore.
HELPER PUPPET: Even when I don’t listen or I break rules, my (caregiver)
loves me no matter what.
CHILD’S PUPPET COPIES THE HELPFUL TALK: My (caregiver) loves me no
matter what.

CHILD’S PUPPET: I did something bad to make my (deceased) get dead.

HELPER PUPPET: I didn’t do anything bad to make my (deceased) get dead.
CHILD’S PUPPET COPIES THE HELPFUL TALK: I didn’t do anything bad to
make my (deceased) get dead.

CHILD’S PUPPET: I don’t feel safe. I’m scared.

HELPER PUPPET: I am safe right now.
CHILD’S PUPPET COPIES THE HELPFUL TALK: I am safe right now.

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What I Liked / Didn’t Like

Nobody is perfect, not even the person who died. Chances

are, there are things you liked and didn’t like about the

person who died. Fill in the questions below by drawing a sad

face beside the things you didn’t like, and drawing a happy

face beside the things you liked about the person who died.

61
 What I Didn’t Like

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Memory Tape
Yoou shared many times with your special person before they died. It is
important to capture these memories so you don’t forget them. Video
yourself talking about your memories. Below is a guide you may want to
follow. Keep your video in a safe, private place. Watch it every once in a
while—it will help keep your memories alive forever!

1. Begin by telling who your special person was and what they meant to you
2. Describe in as much detail as possible what your special person looked like
3. Record some of your memories. Here are some ideas of what to include:

Your earliest memory of your special person

Holidays, birthdays, trips, or other special celebrations

Things your special person used to say

Times you and your special person hugged or cuddled together

Special moments when you made your special person proud

Nicest thing the person ever did for you

4. End by talking about your best time with your special person

63
 Memories
Please share your favorite memories of my mom
so I can add them to my memory book.

1) What is your name and how did you know my mom?

2) Share some of your favorite memories of my mom, for

example, holidays or special occasions spent together,
funny moments, a time she did something nice for you.

3) Describe my mom’s best qualities and what you think was

special about her.

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Making Tear Soup

Read the book Tear Soup: A Recipe for Healing after Loss
and briefly discusses it with the client. Process questions
might include:

1.Why was Grandy making tear soup?

2.What was the purpose of her tear soup?
3.How did the people in Grandy’s life try to help her feel
better?

Provide the client with a soup pot and cover (round plastic
container with cover) and write TEAR SOUP on the outside
of the container.

65
 Making Tear Soup
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Picture This
This activity is completed partially outside the session. The
client is asked to take pictures of different items and places
that bring them joy and that trigger their painful emotions
of grief. The client prints the pictures and brings them to
the session to create a collage and to discuss and process.
(NOTE: Discuss with the youth ways they will cope with
painful emotions that may be triggered while doing this
activity.)

If possible, the client should do this activity with a support

person (adult or friend) or with the therapist via zoom.

66
 Tear Art
Tear the paper into shapes or strips while thinking about
what's upsetting you. You can then use the torn pieces to
create a new piece of art on a separate sheet, focusing on
transforming your feelings of loss and sadness into
something unique and creative.

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67
 Letter to the Person Who Died
Starting the letter: Since your death I have been feeling…
Early memories: When I think back to our times together, one of
the first memories is when you/we…
Positive memories: Some of my happiest memories together are
when we…
Upsetting memories: One of the worst times is when you/we…
Apologies: I am sorry that I…
Forgiveness: I forgive you for…
Yearning: What I miss most about you… I will miss that we will never
be able to…I feel sad that you won’t be there when I…
Unsaids: If you were here now I would tell you…I wish I would have
told you…
Other: I also want to tell you…
Gratitude: I feel good knowing that…
Future: One day I will tell my children that you were…
Thank you: Thank you for…

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68
 Build-A-Teddy-Bear Puzzle
Your sadness about your special person’s death will come and go.
There will be times when you feel happy and other times when you
feel sad. Even long after the death, certain things will remind you of
the person who died, and this may make you feel sad. These are
called grief bursts. Holidays or other special occasions may be even
more difficult, because you will wish your special person could be
with you. On these special days, you might feel happy if it’s a fun
day, and you might also feel sad, angry, or other upset feelings
because you will miss the person who died. When you miss the
person who died, there are things you can do to cope with these
hard days.
First, put the teddy bear puzzle together, then tape it on all sides.
Read the ideas written on the bear. You can draw a happy face
beside the ideas you like best! Then you can decorate your teddy
bear.
Put the teddy bear beside your bed. When you’re feeling sad or
upset, choose one of the ideas on your bear that will help you feel
better.

Grief Burst Calendar

Your sadness about your special person’s death will come and go.
There will be times when you feel happy and other times when you
feel sad. Even long after the death, certain things will remind you of
the person who died, and this may make you feel sad. These are
called grief bursts. Holidays or other special occasions may be even
more difficult, because you will wish your special person could be
with you. On these special days, you might feel happy if it’s a fun
day, and you might also feel sad, angry, or other upset feelings
because you will miss the person who died. When you miss the
person who died, there are things you can do to cope with these
hard days. Circle on the calendar the days of the year you think will
be more difficult for you. Then on each of those days, write down
something you can do to help yourself feel better. Here are some
ideas…

69
 Grief Burst Calendar
• Honor your special person’s memory on the anniversary of their
death, for example, look at family photos, eat your special
person’s favorite food, participate in one of your special person’s
favorite activities.
• You can still celebrate your special person’s birthday even though
they are dead. Honor your special person by making them a
birthday card and eating birthday cake. You can even blow out
candles and make a birthday wish on behalf of your special
person!
• On your birthday, write down or draw a picture of a special
memory you shared with your special person. Let this memory be
a gift you give to yourself each year.
• Decorate your calendar with helpful thoughts such as, "I miss my
special person but I'm going to be okay."

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 Brainstormers
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Divide the group into two teams. Explain the activity as follows:
We are going to play a brainstorming game that's going to help us
talk about anger. The object of the game is for each team to come
up with as many items as they can for each category. For example,
if the category is 'things that make people laugh' then each team
must make a list of things that make people laugh, and the team
with the longest list wins that round. Each round lasts three
minutes. At the end of each round, each team reads aloud the
items on their list. If both teams have the same item on their lists,
it gets crossed off. Each remaining item counts for one point. The
points are accumulated each round, and the team with the most
points at the end of the game wins.

Brainstormers
• Things that make kids your age angry
• Things that make adults angry
• Things that happen to your body when you feel angry
• Unsafe ways to express anger
• Ways to help your body relax when you feel angry
• Positive messages kids can say to themselves to calm down when
they feel angry

74
 Garden of Growth
  

  
  

  
 
  



  

Provide group members with flower templates and have them cut
out their flowers. Depending on the size of the group or mural,
participants can be given one or more flowers. Explain that they
are to think about what they have learned and how they have grown
over the course of the group. Have participants write about their
new learning or growth on the flowers. The flowers are taped onto
the mural paper to create a garden. Members can work together to
decorate the mural by adding accents to the garden such as a sky,
sun, butterflies, etc. Group members then take turns sharing what
is written on their flowers. The end product results in a beautiful
visual of accomplishments for the group members. A picture can be
taken of the mural and a copy made for each group member.

Garden of Growth: Process Questions

• How have you grown since coming to this group?
• How have others in the group helped you to grow?
• What goals do you have for your future so you can bloom into
the person you wish to be?
• What decisions do you need to make in order to bloom into the
person you wish to be?
• What else/who else can help you bloom into the person you wish
to be?
• How can you care for yourself when you feel like you’re wilting?

75
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76
 Cookie Jar
You have done a great job talking about your feelings and learning
ways to feel better! This means you’re almost ready to stop coming
here. This activity is called Cookie Jar. It will help you understand
why you’re almost ready to stop coming here. Open the cookie jar,
take out one cookie and eat the cookie. The remaining cookies in the
jar show how many more times you will be coming here. There are
four cookies left in the jar. So you will be coming here four more
times, and then you and I will be saying our last goodbye to each
other. Place the lid on the cookie jar. Ask me to say some of the
important things you have learned here and to explain why you are
almost ready to stop coming here. We’ll do this activity again at the
end of our next three sessions (eat one cookie from the cookie jar,
count the remaining cookies in the jar, and say how many more times
you will be coming here). At the end of the three sessions, there will
be one cookie left in the cookie jar, which means you will come here
one last time. The last time you come will be a time for us to say a
last goodbye to each other. We will do a special activity the last
time you come to help us say a last goodbye to each other. At the
end of your last session, you will get to eat the last cookie left in
the jar.

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