The inner world of bereaved children: A qualitative approach to understanding how children from three to seven-years-old experience the death of a parent

Child bereavement is not an easy or popular topic to study because of taboos in discussing death, and complex issues involved in doing research with young children. This study aims to let these "forgotten mourners" speak and be understood. The research explored how children from Hong Kong express grief over losing a parent through illness. The subquestions focus on how grief manifestations may be revealed in children's sandplay, artwork, and interpersonal interactions. A Jungian framework was included in interpreting the symbolism in the sandplay and artwork. Cultural and societal influence of child bereavement is also addressed.;Participants were 21 children between the age from 3 to 7, each bereaved for one year or less. They were selected through convenience sampling for four case studies and stratified sampling for a drawing-and-interview subsection for 19 children (two children took part in both segments). The study was divided into two parts: (a) case study across five sessions of play/sandtray therapy plus one interview with the surviving parent; and (b) a drawing-and-interview single session focused on expression of grief and related experience through their drawings and narratives.;Qualitative results from the case studies and analysis of the drawings and interviews showed that the experience and expression of grief had unique components for each individual. Nonetheless, there were common grief experiences and expressions including: (a) need for nurturance; (b) need for protection; (c) need to be in control; (d) helplessness; (e) loneliness; (f) frustration; (g) melancholy; (h) reminiscence; and (i) resilient coping. The grief experience was not all negative but could also reveal a child's inner strengths.;It was concluded that play/sandtray and art each showed their own value in facilitating grief expression symbolically; some feelings and thoughts are more readily expressed by one modality or another. Some differences could also be the result of length of contact and the therapeutic relationship. Findings support the value of multiple approaches in understanding and helping bereaved children. Finally, results suggest helping professionals be sensitive to the cultural, religious, and societal factors influencing children's understanding of death, and their experiences and expressions of grief.