Course in Creative Play Therapy Interventions for Grieving Children, Youth and Families

Two sisters, eight and six, are asked in separate sessions to finger-paint how they feel about their father's death. He was shot dead on the basketball court beside their apartment block. The older girl paints the summer, the sun and swimming, and inside the sun a small blue fingerprint: her father, in heaven. The younger paints the man who shot him. Same death, same family, two entirely different griefs. That is the observation the whole course is built on, and the reason it insists that every child's grief has to be understood on its own terms before anything is done about it.

Liana Lowenstein has spent over thirty-five years working with bereaved children in Toronto, and what she brings is a body of play-based, concrete and immediately usable material for the parts of this work that clinicians most often postpone: telling a five-year-old the truth about how a parent was killed, making room for a child's anger at the person who died, letting a family talk to each other about a suicide. The course is built almost entirely on recorded sessions and real case material, so the techniques are seen being used, including the moments where they are hard.

Its framing is deliberately non-diagnostic. Grief is presented as a normal response to a complex situation rather than a disorder to be classified, and the course takes an openly cautious position on the recent arrival of prolonged grief disorder in the diagnostic manuals, arguing that with children the evidence is thin and the developmental picture too mobile. What replaces the label is careful observation: pay attention to the signs that this particular child is struggling, to what else has been happening in their life, and to the conditions around them.

Objectives

• Distinguish typical grief from childhood traumatic grief, and know why the order of intervention changes when trauma responses are present.
• Assess a grieving child through play-based activities, caregiver intake and information from school.
• Support caregivers to tell a child the truth about a death, including suicide, homicide and overdose.
• Use art, sand tray, stories and games to help a child tell the story of the death.
• Make room for ambivalence, guilt and anger towards the person who died.
• Work with the whole family to open communication that has closed around the loss.

Grief that is not allowed to be grieved

Two concepts organise much of the course's assessment thinking. Disenfranchised grief is grief that is not openly acknowledged or socially sanctioned: the child of the drunk driver who caused the crash, the child grieving a pet, the fourteen-year-old whose sand tray showed her father surrounded by fire because everyone around her believed he should rot in hell. Suffocated grief, following the work of Tashel Bordere, describes what happens when normal grief reactions such as distraction or anger are read as misbehaviour and punished rather than supported, which falls hardest on children from marginalised backgrounds. Both concepts move the clinical question outwards, from what is wrong with this child to what has been permitted to them.

Traumatic grief and why sequence matters

When a child perceives a death as terrifying, trauma responses interfere with mourning: they become fixed on the horrifying details, and any thought of the person, even a happy one, brings back the way they died, so they avoid thinking about them at all and the grief cannot move. The course teaches the distinction through paired case material, including two children in the sand tray whose responses separate cleanly along the line the literature draws — sadness and yearning on one side, anxiety and danger on the other. The clinical consequence is a rule about order: where trauma responses are present, they are addressed and partially resolved before grief work proper begins, and the trauma narrative itself is named as a technique only for those trained to use it.

Telling children the truth

A substantial part of the course addresses the reluctance of caregivers to say what actually happened, and the evidence that increased disclosure correlates with increased trust and decreased distress. It works through how to prepare a caregiver for that conversation, what words to offer them, and how to support them through it. The centrepiece is a recorded session in which a mother, who had originally told her five-year-old that her father died in an accident, explains with toys that he was shot by a friend during an argument — and in which the child, having first flinched away, takes the figures and shows what happened herself.

Making the difficult sayable through play

The working assumption throughout is that a concrete, playful format takes the fear out of subjects a child cannot approach through conversation. The course moves through psychoeducation about what death is and what happens to the body, a card game with versions adapted to suicide, homicide and substance-related death, an animal story told in burial and cremation versions, family games that get parents and children talking to each other, art activities for sadness, and play reenactment for telling the story of the death. Each activity is presented with its process questions, because the activity is treated as the beginning of the conversation rather than the whole of it.

Culture, family and the people around the child

Mourning rituals are approached as something to be learned from each family rather than assumed, and then explained to the child, since a ritual nobody has explained can frighten a child more than the death itself. Beliefs about what happens after death are taken from the caregiver and written into the stories and games rather than supplied by the therapist. Alongside this runs continuous work with the system around the child: caregiver intake and coaching, daily feelings check-ins at home, information gathered from teachers, and a tiered view of what level of support a given child actually needs, which for some is psychoeducation for their parents rather than therapy for them.