Both multidimensional grief theory and multidimensional grief therapy (MGT) draw upon a rich history of the clinical and scientific study of child and adolescent (hereafter youth) bereavement. This history offers a diverse array of conceptual lenses and therapeutic tools that support a broad, integrative approach to understanding, assessing, and intervening with bereaved youth and families. As a theory derived from decades of field study and clinical practice, multidimensional grief theory is both practical and powerful in its ability to describe, explain, predict, and therapeutically address a broad range of grief reactions. As we will discuss, the theory is an outgrowth of three major streams of clinical research, theory, and practice: attachment theory, existential philosophy, and disaster mental health (Layne, 2021b).

It is not surprising that parents and caregivers play a critical role in helping their child adjust to a “new normal” following the death of a loved one. One of the most challenging aspects of assisting a child after a death is that the caregivers themselves are usually grappling with their own personal grief reactions at the same time. The reality is that observing one’s own child in emotional distress is extremely painful under most circumstances, but bearing witness to this emotional pain within the context of a death can greatly add to the sorrow and devastation that a bereaved caregiver is likely already experiencing. In addition, it is often hard for caregivers to separate their own intense emotions from those of their child. This tendency can predispose caregivers to believe that their child’s experiences are similar to their own. However, members of the same family can grieve in very different ways as a result of many contributing factors.

Multidimensional Grief Therapy (MGT) is a strength-based intervention designed to carry out a range of important therapeutic tasks with bereaved children and adolescents. These tasks include (1) reducing unhelpful grief reactions (grief that keeps kids “stuck” and unable to adjust); (2) promoting adaptive grief reactions (grief that helps kids to feel and cope better after a death); (3) reducing associated symptoms of psychological distress (e.g., posttraumatic stress and depressive symptoms), and (4) helping bereaved children and adolescents to lead healthy, happy, productive lives. Consistent with its assessment-driven, flexibly tailored design, MGT is divided into a pretreatment assessment interview and an assessment feedback interview, followed by a two-phased treatment approach.

Note: The pretreatment assessment interview is usually conducted on an individual basis between a MGT clinician who will be facilitating the individual sessions and a prospective client. Primary aims of this interview include (1) gathering information needed to determine whether MGT is an appropriate treatment for this particular youth, or whether a referral for other services is appropriate; if MGT is indicated, (2) gathering information regarding losses and (in cases of multiple deaths) ranking them according to their severity/current impact to decide which should be a primary focus of treatment; (3) beginning to build a shared vocabulary for describing losses, grief reactions, and their consequences; and (4) building trust and therapeutic rapport, which you will draw on in subsequent sessions.