VIEWPOINT
Grief in the school: A review of a participatory project in Argentina
Rafael Wainer
PhD, University of British Columbia, IPA Foundation
Alejandro Nespral
Pediatric Palliative Care specialist, IPA Foundation
Dario-Iván Radosta
PhD, UNSAM, IPA Foundation
Abstract
When a member of the education community (student, teacher, administrator) dies, there have historically been few options to process these distressing experiences inside the education environment. In this viewpoint article, we recount the historical and conceptual journey the organisation Fundación IPA (Palliative Ideas in Action) took to actively intervene in the often silenced (and frequently stigmatised) experiences of grief and bereavement in the City of San Carlos de Bariloche, Argentina.
Keywords
grief, bereavement, children, education, school system, Argentina
Implications for practice
•Despite the exposure to information about death and dying during the COVID-19 pandemic, students, teachers, and administrators in Argentina lack personal and communal grief literacy. We suggest grief and bereavement be included in teacher’s professional development.
•A grief-centred approach, in both schools and community contexts, is imperative to provide valuable tools for children, families, teachers, and administrators to proactively handle bereavement within the school system.
•Children, families, and schools would vastly benefit from: grief-focused interventions; a culture which normalises death, dying, grief and bereavement; and emotional support during the aftermath of the death of a member of the educational community.
Introduction
‘We got a call. On the other side, a stressed voice tells us that one student from our school has suddenly died in a car accident. It happened a couple of hours ago. The news left us speechless. We do not know what to do. We can barely believe what just happened. What should we do? How should we react? We began to inform others in the schools (teachers, families, and administrators). We began to receive some messages; social networks confirm the fact. We cannot believe it. Where should we begin? How can we face students tomorrow? What kinds of activities should we do in school tomorrow? We got no training to manage death and grief in the school system. We do not know whether we should call a psychotherapist or someone that works in health. Should we call the technical team? Should we talk about these issues at school? If the topic does not come up spontaneously, should we bring it up? Or should we respect students’ silences?’ (Female School Principal, 52-years-old, Primary School, S.C. de Bariloche).
During the last nine years, Fundación IPA (‘Palliative Ideas in Action’ in Spanish) has developed an integrated approach, both to support those who experience bereavement, and to better prepare schools to handle death and grief within the public educational system in the City of San Carlos de Bariloche, Río Negro, Argentina. Our aim is to create awareness of the human experience of sickness, suffering, dying, and grieving. We have different projects to help expand and deepen conversations about death and grief in several community spaces and for different audiences: education (public, private, and special needs), health (hospitals and clinics), and science (researching, publishing, and presenting in academic conferences).
There are two basic approaches to teaching about death and grief in Fundación IPA: one preventive (trying to normalise death and grief, adapting resources and pedagogies to children’s age and their overall cognitive-emotional development, and supporting the needs of teachers and administrators), and one postventive (systemic approaches focused on tackling the loss of a member of the educational community after the death occurred). We have developed approaches for both of these, offering online and in-person preventive interventions workshops about death and grief in primary and secondary schools, and interventions targeted to help institutions navigate the processes of institutional grief in the aftermath of a death of a teacher, administrative staff, student or caregiver.
The journey we are narrating here began in 2014. Since then, Fundación IPA has expanded from two professionals to a multi-disciplinary team from medicine, psychology, education, communication, and anthropology, and (as of October 2023) have assessed and assisted more than 100 educational institutions across Argentina and Uruguay.
The historical absence of death education
Phone calls, such as the one quoted above from a primary school principal in 2014, sparked the question: how can we promote an understanding of death, dying, grief, and bereavement within the public educational system? The school principal asked members of the Palliative Care team at the public hospital to give a talk about death and grief after the death of a student. That first school was the catalyst for a series of interventions over the years that led to the creation of a succession of workshops, consultancy work, and expertise-informed grounded recommendations at both the school level and at the level of educational curricula at the provincial ministry of education. For example, we recommended that schools: include death and grief in the curricula; design protocols and intervention guides in situations of grief; find key members of each school that show special interest for further training; and register the institutional grief protocol so that schools can learn from it.
Our team consists of health and educational professionals and researchers who are focused on investigating death and dying processes, public health policy interventions, and education approaches to death and dying. These are difficult and complex issues to work on within society in general, and even more so within the educational field (Colomo-Magaña & Cívico Ariza, 2018). This is not new. Many scholars have shown how Western cultures have historically erased and denied death and dying from everyday life (Ariès, 2008). Although death is an unavoidable aspect of life, there are not enough social and cultural spaces to explore death and grief in a supported environment. Educational institutions and their socialising apparatuses are no exception. Death and grief are subjects that are not included in pedagogical planning, and in general educational institutions refrain from engaging with these topics head on.
However, we argue that institutions and participants will learn more if they engage with those experiences more explicitly (De la Herrán et al, 2019; Colomo-Magaña & Cívico Ariza, 2018; Colomo-Magaña et al, 2021). In many cases, the ‘taboo of death’ (Feifel, 1963) in educational institutions is evident through the absence of teaching focused on death and grief (Rodríguez Herrero et al, 2020; Dutil, 2019). Lack of access to grief and bereavement education and support can deepen traumatic experiences (Capewell, 1994). Social support is a strong marker of biopsychosocial integration following the death of a loved one (Logan et al, 2018). Thus, in the last two decades, there has been a push to increase death and grief education in schools (even to make it mandatory, see Dawson et al, 2023) using different tools such as photovoice (Raccichini et al, 2023), storytelling (Blake et al, 2020), psychodrama (Testoni et al, 2018), and music (Tsiris et al, 2011), to mention a few approaches.
From our experience working in educational fields (from kindergarten to secondary) in S.C. de Bariloche, we realised that although people talk about death and grief, this tends to be only when a member of the education community dies. There is a lack of pedagogical resources to systemically tackle death and dying as part of the school curricula in Argentina. When a death or end-of-life situation occurs, teachers and administrators often engage in a-systematic, reactive, and improvised interventions. Those responses frequently use extemporaneous practices, oversimplified knowledge, and stereotypical beliefs instead of providing theoretically sound approaches on death education to manage and reflect upon death and grief. This reactive approach (referred to as ‘palliative’ in the Spanish literature; see: Ramos-Plá et al, 2018) is implemented without sufficient training and planning, and also is not supported by scientific rigour. Thus, we argue that death and grief are talked about in school, but only in an ad-hoc, a-systematic way.
Given the lack of death education, we created a series of workshops, usually between 20 and 40 teachers and administrators per meeting, where we work with them to explore their ideas, assumptions and beliefs about death and dying. We situate them in scenarios to help them develop a plan of action when a death in the school occurs. We also develop post-death consultancies when a death occurs, supporting teachers, students, and administrators when they experience death and grief within the school system.
Pandemic paradox
The COVID-19 pandemic brought death and grief centerstage, with an explosion of research in the global north; yet, paradoxically, few grief-specific literacy approaches emerged in the school system in Argentina (for research on grief and death following the pandemic, see Rice, 2023 and Asgari et al, 2022, among others).
The first question we asked was: Can we support students virtually, without face-to-face contact? With that question, in 2020 we began to advise educational institutions during the many months of lockdowns, social confinement, and the closure of educational spaces that followed. We provided educational tools to support school members during the aftermath of the death of a child, teacher, administrator or parent. Our first hypothesis was that the pandemic would make offering emotional institutional support to schools a complex endeavour in virtual environments (it is worth mentioning that no grief therapists are available to do this work online in S.C. de Bariloche).
More than three years later, having completed more than twenty consultancies with different schools, we can say that requests have not decreased (we are evaluating those consultancies as we write this). Instead, virtual environments helped reach larger audiences and support educational teams in provinces beyond our own. We are currently developing one preventive workshop per month and about six to nine consultancies per year. Our consultancies have two parts: first, to share the emotional impact after the death of a school member, and second, to plan a systematic institutional approach. From what we have seen, the virtual environment offers a good alternative to face-to-face training; teachers and principals express themselves in the same ways in both environments. We also created clear agreements with schools and used technology to create safe spaces to explore these issues (for instance, we asked participants to leave the camera on during the encounters).
Another question we asked was whether the pandemic, as a social phenomenon that generated discussions about death and grief, would ‘facilitate’ (or hinder) tackling these issues. Although we did not conduct any quantitative reviews, our impression based on anecdotal evidence is that talking about death and grief is as complex and a-systematic within education fields as before March 2020. We observed how the ‘omnipresence’ of death in educational spaces, especially during the pandemic peaks, made the lack of death and grief education within the school system much more obvious (for comparison, see Dawson et al (2023) discussing the need for mandatory grief education in the UK).
Given that professional void, we got a request from the Ministry of Education of Río Negro to design an education programme for middle-school students (between twelve-years-old and fourteen-years-old) in the province. Between October 2021 and November 2022, we offered several workshops and courses that included specific customised tools and guidance to help students and staff acknowledge and help process grief within the school system, to train schools to provide fast, efficient, and empathetic responses, and to help them understand the characteristics of grief among children or adolescents (stages, necessities, red flags).
We reached an audience of 300 teachers from more than fifteen municipalities in the province. Since June 2020, and given the rise in teenage death from suicide, we became part of a trans-institutional mechanism under the Direction of Inclusive Education (Ministry of Education) which aimed to address suicide within the school system. We developed these new curricula in partnership with the provincial team called ‘I care for you; we all care for each other’, which tackles suicide and suicidal ideation among teenagers and adolescents within the school system.
A grief-centred participatory approach
Over the years, the team grew. We are now a multi-disciplinary team that:
•Provides consultancy on grief education and interventions
•Develops preventive workshops and open courses
•Conducts post-death reviews (and interventions)
•Researches death education
•Creates resources for knowledge translation for educational professionals and the community.
Our main aim is to generate preventive and postventive interventions that allow schools to take a whole institutional approach and integrate discussions of death and grief in the education field as a learning opportunity. All these years of experience have helped us understand the localised needs of the educational teams and school administrators. From that knowledge, we design approaches according to the particular needs of specific actors within the education field. We know that death, dying, and grief are unavoidable human experiences in the institutions we participate in. Thus, schools become strategic places to develop a deeper grief-centred approach of these experiences.
In 2015, when this project began, our conceptual interest was grief within the educational field. We still called it the ‘Grief in the Schools’ project. The talks and workshops aimed to promote an understanding of the varied and individual experience of grief. Although any loss (pets, moving, divorce) can involve grief, we primarily focused on grief in connection with the death of a member of the educational community. We promote an understanding of grief by sharing knowledge about grief and bereavement, including: vocabulary and definitions, characteristics of grief among children, types of grief experiences, and different approaches to managing grief within the educational field.
The normalisation of death, dying, and grief
Since 2019, Fundación IPA has systematically explored death as both a social phenomenon and a pedagogical theme worth thinking about within the education field, one that is particularly beneficial to those going through death and grief processes. It became apparent that the ‘theme’ to tackle in the school system was death, and that one among many sub-themes within this subject was grief. We argued that grief should be incorporated in education as a pedagogical theme in the larger context of death education. By doing so, we aimed to normalise death not only at the cultural level (a matter of everyday life that will occur to all of us) but also at the experiential and phenomenological level as a way to provide customised tools to teachers, administrators, students, parents and caregivers. Recognising the finite nature of our existence can have wider mental health benefits, as scholars suggest we can have a more fulfilled life when we are conscious of our mortality (Mèlich, 2003; Pedrero-García, 2019) and also better support people who are grieving (Stylianou & Zembylas, 2016, 2018).
Focusing on death gave us a thematic and conceptual horizon filled with vast pedagogical and cultural challenges and rewards. Additionally, we changed our framing as we witnessed how students, families, teachers, and administrators became more interested in these issues. They repeatedly told us that they were not trained on grief-centered approaches but had lots of interest. In particular, teachers and administrators thought it was essential for their professional development to be able to talk to students about death and their losses.
Conclusions
We want to finish this work by going back to the introductory vignette. Death and grief, as pedagogical themes, are not discussed within the educational curricula in Argentina. They only appear when someone dies, and the school needs to react quickly. The school develops interventions that are not adequately planned nor systematic. In fact, based on the intuition of teachers and administrators, this reaction provokes reactive involvement with minimum theoretical framing. There is a lack of specific knowledge about these issues, and Fundación IPA is filling that gap.
Another element that might complicate tackling death and grief within the educational field is the lack of clarity on who should be in charge of these issues. Since the mid-20th century, through an increasing process of biomedicalisation of death, it seems that death (the personal and cultural experience of dying) is no longer an individual and communal process, but one carried out by the medical system and its agents. However, death, dying, and grief are human experiences that affect and transform us into subjects embedded in a network of relationships. Thinking about these issues as pedagogical themes within the education system opens up the possibility of facilitating healthy gateways in which children, adolescents, and adults can transform the experiences of death and grief.
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