Document Type



Doctor of Philosophy



Date of Defense


Graduate Advisor

Dr.Roxanne Vandermause


Dr. Wilma Calvert

Dr. Kuei-Hsiang Hsueh

Lisa Merritt, DNP


More than 50,000 child mortalities are recorded in the U.S. each year. As a result, almost 8% of the population experience the loss of a brother or sister before age 25 (Jacobs & Bovasso, 2000). This study was an open conversational exchange with ten Grief Counselors who worked with school-aged children, who had experienced the loss of a sibling, to identify the behaviors and expressions of this group of Disenfranchised Grievers. Three patterns were identified: 1) Grief in children takes different forms, 2) Sibling loss in childhood is a life-changing event and 3) Childhood grief has its own time. Each of the patterns were comprised of three themes. The themes for the first pattern were: Children’s grief differs, wide variety of atypical behaviors and developmental understandings of death. The themes for the second were: Loss of a life-long companion, new normal in the family unit and parents subsumed in grief. The themes for the third pattern were: Grieving periods in children, anniversaries, birthdays and holidays, and loss follows a child throughout life. Based on this study, several changes were formulated for practice, research, education and policy that would benefit this population. It was concluded that early identification is the key to prevent misdiagnosis and assist these children with their grief journey.