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Adolescence is known as the transitional period between childhood and adulthood, between the ages of 12-20 (Rider, 2012). According to Erikson (1963), individuation and separation are the primary developmental tasks of adolescence (as cited in Hooyman, 2006). Early adolescence is characterised by a mix of pulling away from the family, rebelling and wanting to be “cool” and hanging out with friends. This stage also includes intense emotional outbursts, alternating between expressing love and hatred towards parents (Hooyman, 2006). Bacho (1995), states that the adolescent self in transition is vulnerable confused and conflicted. Erikson’s psychosocial theory focuses on eight major conflict stages of personality development. Each stage is characterised by a different conflict that must be resolved by the individual (Cramer, 1997). Only when each crisis is resolved does the person have sufficient strength to deal with the next stage (Cramer, 1997). Erikson uses the word ‘crisis’ to describe a series of internal conflicts that are linked to developmental stages (Oswalt, 2013). The way a person resolves the ‘crisis’ will determine their personal identity and future development (Oswalt, 2013). Moreover, if a person is unable to resolve a conflict at a particular stage, they will confront and struggle with it later on in life (Cramer, 1997). Stage five of Erikson’s (1963) psychosocial developmental stage for adolescence is called ‘identity versus role confusion’ (as cited in Rider, 2012). This is a time when an adolescent is trying to forge an independent identity separate from that of their parents (as cited in Rider, 2012). However, Erikson explains that while an adolescent is asserting their independence, it is imperative that they have the stability and security of their parents to return to (as cited in Lenhardt, 2000). However, a parent’s death makes that separation complete, final and irreversible (Hooyman, 2006). Consequently, a parent’s death can often interfere with the adolescent’s inner search for identity and complicate their grieving process making it possible for the adolescent to become ‘stuck’ in a development ‘crisis’ (Oswalt, A. 2013).

Adolescent Grieving Style

Adolescent grief is complex and can be presented in short outbursts followed by the use of withdrawal, denial and avoidance to self-protect. According to Lenhardt (2000), adolescents are a distinct group with very specific developmental needs that complicate the normal grieving process. Sussilo (2005) concedes that “the untimely death of a parent is experienced as an incomprehensible and overwhelming assault that strikes at the core of the adolescent’s intra-psychic and external world” (p.499). Also reported, was more anger at the deceased, sleep disturbances, dream activity and irritability than the adults (Geldard & Geldard, 1999). Ways an adolescent may attempt to cope with their overwhelming grief may be through the use of drugs or alcohol, self-harming or risk taking behaviour. It is not uncommon for the grieving adolescent female to desperately yearn for that re-attachment of unconditional love and therefore find themselves pregnant in late adolescence.

Adolescent Issues That Hinder the Grieving Process and the Consequences

Adolescents have four main issues that can hinder their grieving process and result in them being ‘stuck’ in grief.

1. Firstly, adolescents want to be accepted and have a strong need to belong and not be different from their peers (Dalton, 2006). As a result, many teens do not want people to feel sorry for them or to be treated differently from their friends. For some, to grieve publicly in front of their friends only reinforces that they are different and have become ‘that kid’ whose mother or father has died. Subsequently, the adolescent grieving ‘style’ of denying and avoiding their grief may also result in becoming ‘stuck’ in a developmental crisis or result in complicated grief (Dalton, 2006). Indeed, this form of grieving behaviour may result in delinquent or depressive behaviour (Dalton, 2006). Consequently the adolescent will struggle to develop into an emotionally mature adult and may have mental health issues later on in life (Oswalt, 2013). Cramer (1997) concedes that if a person is unable to resolve a conflict at a particular stage, they will confront and struggle with it later on in life (Cramer, 1997).
2. In addition to the adolescent wanting to ‘appear normal’ in front of their friends they may also be dealing with guilt and shame. Often during adolescence the teen is rebelling and often as stated by Hooyman (2006), is expressing hatred towards their parents. Once the parent has died, this can make the bereaved teen feel incredibly guilty for the way they have treated their parent prior to their death. Teens are often not aware that their adolescent behaviour is normal for their developmental stage and therefore are filled with incredible guilt and shame for the way that they treated the now deceased parent. According to a recent study it was reported that many adolescents felt that their “...bereavement process was hindered by intrusive thoughts and feelings of guilt and shame” (Hooyman, 2006, p.174). This guilt can present itself through depression, anger and nightmares.
3. Another aspect to be aware of is that often after a parent has died, the teen is expected to step into the role of the parent who has died. For daughters whose mothers have died, they are sometimes expected to cook, clean and look after younger siblings. For sons whose fathers have died they are expected to be the man of the house, to provide for the family and undertake manly chores. This can further amplify the already confused adolescent as they search for meaning and identity.
4. According to mid-life adults who had lost a parent during adolescence, they found transitioning into early adulthood difficult. This often coincides with the adolescent getting married and starting a family of their own. This can often ‘trigger’ a fear that the same thing will happen again. Also once the adolescent becomes a parent themselves this can often bring up feelings of loss at not having the missing parent at their wedding or the birth of their first child. This is also a time when the adolescent has now matured and sees their peers enjoying a close relationship and friendship with their parents. In addition, throughout their life cycle, other traumas or grief can re-trigger the trauma of the early adolescent loss, often presenting itself as anxiety or depression.

A programme evaluation conducted by Shaffer (2007) on the success of a programme entitled ‘growing through loss’ focused on 300 incarcerated teenagers in California who had experienced a recent loss. This study revealed that 98% of the adolescents who completed the 12 session programme showed a reduction in depressive symptoms and greater integration of their loss into their lives. The study by Shaffer (2007) also revealed that unless the adolescent is given proper attention and grief support that the loss may affect them later in life. Hooyman (2006) concedes that the lack of support from peers and adults can complicate an adolescent’s grief process. In addition, Hooyman (2006) further explains that counsellors need to understand the distinctive developmental tasks so they can support and understand the distinctive ways an adolescent expresses their grief (Hooyman, 2006). Finally Shaffer (2007) posits that little support and very few resources are available for grieving adolescents.

An Australian study conducted by Cubis and colleagues (1990) revealed the impact parental loss had on the social and emotional development of an adolescent. The data revealed a pattern of poorer adjustment of adolescents who had lost a parent, as well as lower self-esteem. The data also revealed more emotional problems and higher rates of mental health concerns in teens that had lost a parent (Cubis et al., 1990). Furthermore, this study demonstrated that parental death did impact on adolescent development (Cubis et al., 1990). In addition, Noppe (2004) states that bereaved adolescents may follow a life-long developmental trajectory and continue to feel the loss throughout their lifespan. A further study by Speisman (2006) suggests that unsupported childhood grief can lead to adulthood depressive symptoms. According to Kivalae (2006), the psychological and emotional trauma that develops due to an early parental loss are directly related to depression in adults (as cited in Speisman, 2006).

These studies are limited in the fact that they relate to early childhood bereavement and fail to take into account the specific adolescent age group. Research by Hurd (1999) on adults that experienced childhood bereavement revealed that two thirds of participants were clinically depressed at some time from late adolescence up to the present time. The study was conducted on 43 middle aged adults, consisting of 32 woman and 11 men aged between 23-56. This study also revealed that most of the participants still suffer emotionally from their experience of bereavement as a child. The data revealed a pattern of poorer adjustment of adolescents who had lost a parent, as well as lower self- esteem. The data also revealed more emotional problems and higher rates of mental health concerns in teens that had lost a parent (Cubis et al., 1990). Bowlby further confirms this stating that there is strong evidence of the relationship between acute loss and increased vulnerability to psychiatric disorders and an important factor in adult depression (as cited in Holmes, 1993). Finally it is interesting to note that according to Rubin (1999) the loss of a [parent] will generally cause permanent effects in personality and /or life course of the bereaved individual.

Adolescent Interventions

Interventions may be required to address the four specific needs of the adolescent griever: peer approval, guilt and shame, identity crisis, early adulthood transition.

• Adolescent grief peer group work or to create a space with other adolescents where one can feel accepted and safe to express their grief, thus removing the need to deny their grief and in turn perhaps avoiding complicated grief and other complications.
• To facilitate a safe space for the grieving teen to express their guilt and shame. Giving them the opportunity to say sorry and goodbye to the deceased parent, by way of Gestalt empty chair, or use of visualisation or letter writing to parent. It is important to encourage them to express their feelings and say good-bye (Hooyman, 2006).
• To reinforce to the teen a sense of who they are and explore with them their values, beliefs and goals for the future.
• In addition, a therapist needs to ‘check in’ with the adolescent again upon transitioning into young adulthood. This often coincides with the adolescent starting a family of their own. This can often ‘trigger’ a fear that the same thing will happen again. Also once the adolescent becomes a parent themselves this can often bring up a feeling of loss at not having the missing parent around to ask for help and advice.

Other forms of grief therapy may be different forms of art therapy, such as drawing, painting, song writing, symbol work and story writing just to name a few (Geldard & Geldard, 1999). Other work may include grief work, resilience and self-esteem. When possible, such as when the parent is known to be ‘dying’ the parent may like to facilitate with a therapist or close family member a ‘living message’ to the adolescent. Armed with the knowledge of the four issues that can complicate an adolescent’s grief, the parent may address those issue to the adolescent. Thus reducing any feelings of guilt or shame that may arise after the parent’s death. The living message may also allow the adolescent a smoother transition through their grief process.

In conclusion, this article has bought awareness to the unique grieving style of the adolescent. The adolescent world was then explored through the lens of Erikson’s psychosocial development stage. The adolescent’s distinctive grieving style was presented which included their need to ‘fit in’ with their peers, which may result in denying their grief. Secondly the guilt and shame they may feel about the way they treated their parent prior to their death. Thirdly the adolescent may feel forced into the parental role following the death of the parent, thus complicating their search for identity. Lastly, follow up with the adolescent as they transition into young adulthood, a stage that may trigger feelings relating to the loss of their parent. Research revealed the need for specific adolescent grief work and the impact unresolved and complicated grief may have on the adolescent.