Experiences and Coping of Adults with Death of Siblings during Childhood in Chinese Context: Implications for Therapeutic Interventions
The death of a sibling in childhood leads to significant impacts on both personal and family development of the surviving siblings, however, both short-term and long-term effects of sibling loss in Chinese societies such as Hong Kong have been inadequately documented in the literature. This paper explores the experience of encountering siblings’ death during childhood with the use of semi-structured interviews. Through thematic analysis, the author explores the impacts on surviving siblings’ emotions, coping styles, struggles and challenges and personal development. Furthermore, the influences on family dynamics are explored thoroughly, including the changes in family atmosphere, family roles, family relationship, family communication and parenting styles. More importantly, the author identifies (i) existing continuing bonds; (ii) crying; (iii) adequate social support; (iv) hiding own emotions as a gesture of protecting parents as the crucial elements pertinent to surviving siblings’ successful adaptation in the face of sibling loss. In addition, “child-centered” and “family-centered” service implications of families with a sibling's death in a Chinese context are discussed.
[1] Centre for Health Protection (2019). Life Expectancy at Birth (Male and Female), 1971 - 2020. Retrieved from HKSAR, Centre for Health Protection Web site: https://www.chp.gov.hk/en/statistics/data/10/27/111.html
[2] Unicef (2018). A child under 15 dies every five seconds around the world – UN report. Retrieved from UNICEF, Web site: https://www.unicef.org/press-releases/child-under-15-dies-every-five-seconds-around-world-un-report
[3] Child Fatality Review Panel (2019). Fourth Report of Child Fatality Review Panel.
[4] Crehan, G. (2004). The surviving sibling: The effects of sibling death in childhood. Psychoanal Psychother, 18 202-219.
[5] Hogan, N. & Desantis, L. (1996). Basic constructs of a theory of adolescent sibling bereavement. In D. Klass, P. R. Silverman, S. L. Nickman Continuing Bonds: New Understandings of Grief (pp. 235-254). Oxford: Taylor & Francis Group.
[6] Rostila, M., Saarela, J. & Kawachi, I. (2012). The forgotten griever: A nationalwide follow-up study of mortality subsequent to the death of a sibling. American Journal of Epidemiology, 176 338-346.
[7] Centre On Behavioral Health, Hong Kong University (2010). Pioneer Study on Trans-Generational Death Attitudes.
[8] Silver, R. L. & Wortman, C. B. (1980). Coping with undesirable life events. In J. Garber, M. E. Seligman Human Helplessness: Theory and Applications (pp. 279-340). New York: Academic Press.
[9] Offer, D. (1969). The psychological world of teenager. New York: Basic Books.
[10] White, R. W. (1976). The enterprise of living: Growth and organization in personality. New York: Holt, Rinehart, & Winston.
[11] Beck, A. T., Seti, B. B. & Tuthill, R. W. (1963). Childhood bereavement and adult depression. Archives Of General Psychiatry, 9 295-302.
[12] Bowlby, J. (1961). Childhood mourning and its implications for psychiatry. American Journal of Psychiatry, 118 481-498.
[13] D'elia, G. & Perris, C. (1972). Childhood environment and bipolar and unipolar recurrent depressive psychosis. In L. Annel Depressive States in Childhood and Adolescence. Stockholm: Almgvist and Wiksell.
[14] Hilgard, J.R. (1974). Depressive and psychotic states as anniversaries to sibling death in childhood. In Normal and Pathological Responses to Bereavement (pp. 163-177). New York: MSS Information Corporation.
[15] Schowalter, J. E. (1975). Parent death and child bereavement, In B. Schoenberg, I. Gerber, A. Wiener, A. H. Kutscher, D. Peretz, A. C. Carr Bereavement: Its Psychosocial Aspects (pp. 172-179). New York: Columbia University Press.
[16] Balk, D. (1983). Adolescents' Grief Reactions and Self-concept Perceptions Following Sibling Death: A Study of 33 Teenagers. Journal of Youth and Adolescence, 12 (2), 137-161.
[17] Brody, G. H. (1998). Sibling relationship quality: Its causes and consequences. Annual Review of Psychology, 49 1-24.
[18] Cicirelli, V. G. (1995). Sibling relationships across the life span. New York: Plenum Press.
[19] Mchale, S. M., Kim, J. Y. & Whiteman, S. D. (2006). Sibling relationships in childhood and adolescence. In P. Noller, J. A. Feeney Close relationships: Functions, forms, and processes (pp. 127-149). New York: Psychology Press.
[20] Packman, W., Horsley, H., Davies, B. & K, R. (2006). Sibling bereavement and Continuing bonds. Death Studies, 30 (9), 817-841.
[21] Birenbaum, L. K. (1999). Assessing children’s and teenager’s bereavement when a sibling dies from cancer: a secondary analysis. Child: Care, Health, and Development, 26 (3), 381-400.
[22] Worden, W., Davies, B. & Mccown, D. (1998). Comparing parent loss with sibling loss. Death Studies, 23 1-15
[23] Baker, S. E., Sedney, M. A. & Gross, E. (1992). Psychological tasks for bereaved children. American Journal of Orthopsychiatry, 62 (1), 105-116.
[24] Cain, A. C., Fast, I. & Erickson, M. E. (1964). Children’s disturbed reactions to the death of a sibling. American Journal of Orthopsychiatry, 34 741-752.
[25] Davies, B. (1991). Responses of children to the death of a sibling. In D. Papadatou, C. Papadatos Children and death, Philadelphia: Hemisphere.
[26] Hogan, N. S. & Desantis, L. (1992). Adolescent sibling bereavement: An ongoing attachment. Qualitative Health Research, 2 159-177.
[27] Hogan, N. S. & Greenfield, D. B. (1991). Adolescent sibling bereavement in a large community sample. Journal of Adolescent Research, 6 (1), 97-112.
[28] Martinson, I. M. & Campos, R. G. (1991). Adolescent bereavement. Journal of Adolescent Research, 6 (1), 54-69.
[29] The National Child Traumatic Stress Network Child Traumatic Grief Committee (2009). Sibling Loss Fact Sheet Sibling Death and Childhood Traumatic Grief: Information for Families. LA, CA & Durham, N.C: National Centre for Child Traumatic Stress.
[30] Nolbris, M. & Hellstrom, A. L. (2005). Siblings' needs and issues when a brother or sister dies of cancer. Journal of Pediatric Oncology Nursing, 25 227-233.
[31] Sood, A. B., Razdan, A. & Weller, R. A. (2006). Children’s reactions to parental and sibling death. Current Psychiatry Reports, 8 115-120.
[32] Shipkey, N. (2008). Impact of sibling death on older adolescents. Dissertation Abstracts International
[33] Worden, J. W. (1996). Children and grief: When a parent dies. New York: Guilford Press.
[34] Worden, J. W. (2018). Grief Counselling and Grief Therapy. A Handbook for the Mental Health Practitioner (5th ed). New York: Springer Publishing.
[35] Minuchin, P., Colapinto, J. & Salvador, M. (1998). Working with families of the poor. New York: Guilford Press.
[36] Sullender, R. S. (1985). Grief and growth: Pastoral resources for emotional and spiritual growth. New York: Paulist Press.
[37] Hurd Clarke, L., Korotchenko, A. & Bundon, A. (2012). The calendar is just about up: Older adults with multiple chronic conditions reflect on death and dying. Ageing and Society, 32 1399-1417.
[38] Braun, V. & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3 (2), 77-101.
[39] Labov, W. (1972). The transformation of experience in narrative syntax. In W. Labov Language in the inner city: Studies in the Black English vernacular (pp. 354-396). Philadelphia: University of Pennsylvania Press.
[40] Connelly, F. M. & Clandinin, D. J. (1990). Stories of experience and narrative inquiry. Educational Researcher, 19 (5), 2-14.
[41] Crabtree, B. & Miller, W. (1999). Doing Qualitative Research (2nd ed.). London: Sage
[42] Xu, H. (2013). Family co-decision making under Confucianism. In International Journal of Chinese & Comparative Philosophy of Medicine,11(1). Retrieved from The Hong Kong Baptist University, Centre for Applied Ethics Web site: https://repository.hkbu.edu.hk/cgi/viewcontent.cgi?article=1098&context=ijccpm
[43] Balk, D. (1983). Adolescents' Grief Reactions and Self-concept Perceptions Following Sibling Death: A Study of 33 Teenagers. Journal of Youth and Adolescence, 12 (2), 137-161.
[44] Osterweis, M., Solomon, F., Green, M. & (1984). Bereavement: Reactions, Consequences, and Care. Washington, D.C.: National Academy Press.
[45] Rosenberg, A. R., Postier, A. & Osenga, K. et. al., (2014). Long-term psychological outcomes among bereaved siblings of children with cancer. Journal of Pain Symptom Management, 49 55-65.
[46] Lovgren, M., Sveen, J. & Nyberg, T. (2018). Care at end of life influences grief: A nationwide long-term follow-up among young adults who lost a brother or sister to childhood cancer. Journal of Palliative Medicine, 21 (2), 156-162.
[47] Hauksdottir, A. (2009). Towards improved care and long-term well-being of men who lose a wife to cancer: a population based study. Stockholm: Karolinska Institute.
[48] Doka, K. J. (2012). Therapeutic ritual. In R. A. Neimeyer Techniques of grief therapy: Creative practices for counseling the bereaved (pp. 341-344). Philadelphia: Taylor & Francis.
[49] Doka, K. J. (1984). Expectation of death, participation in funeral arrangement, and grief adjustment. Omega: The Journal of Death and Dying, (15), 119-130.
[50] Woo, S. P. (2016). About Grief Counseling: Some Reflections and Inspirations from Traditional Funereal Rituals. Guidance Quarterly, 52 (1), 1-13.
[51] Klass, D., Silverman, P. & Nickman, S. L. (1996). Continuing bonds: new understanding of grief. Washington, DC: American Psychological Association.
[52] Bank, S. & Khan, M. (1982). The sibling bond. New York: Basic Books.
[53] Hartman, A. & Laird (1983). Family centred social work practice. New York: The Free Press.
[54] Sandelowski, M. (1996). One is the liveliest number: the case orientation of qualitative research. Research in Nursing & Health, 19 (6), 525-529.
[55] Denzin, N. K. & Lincoln, Y. S., 1994. Handbook of qualitative research, New York: Sage Publications, Inc.
[56] Sullender, R.S., 1985. Grief and Growth: Pastoral Resources for Emotional and Spiritual Growth, New York: Paulist Press.
[1] Centre for Health Protection (2019). Life Expectancy at Birth (Male and Female), 1971 - 2020. Retrieved from HKSAR, Centre for Health Protection Web site: https://www.chp.gov.hk/en/statistics/data/10/27/111.html
[2] Unicef (2018). A child under 15 dies every five seconds around the world – UN report. Retrieved from UNICEF, Web site: https://www.unicef.org/press-releases/child-under-15-dies-every-five-seconds-around-world-un-report
[3] Child Fatality Review Panel (2019). Fourth Report of Child Fatality Review Panel.
[4] Crehan, G. (2004). The surviving sibling: The effects of sibling death in childhood. Psychoanal Psychother, 18 202-219.
[5] Hogan, N. & Desantis, L. (1996). Basic constructs of a theory of adolescent sibling bereavement. In D. Klass, P. R. Silverman, S. L. Nickman Continuing Bonds: New Understandings of Grief (pp. 235-254). Oxford: Taylor & Francis Group.
[6] Rostila, M., Saarela, J. & Kawachi, I. (2012). The forgotten griever: A nationalwide follow-up study of mortality subsequent to the death of a sibling. American Journal of Epidemiology, 176 338-346.
[7] Centre On Behavioral Health, Hong Kong University (2010). Pioneer Study on Trans-Generational Death Attitudes.
[8] Silver, R. L. & Wortman, C. B. (1980). Coping with undesirable life events. In J. Garber, M. E. Seligman Human Helplessness: Theory and Applications (pp. 279-340). New York: Academic Press.
[9] Offer, D. (1969). The psychological world of teenager. New York: Basic Books.
[10] White, R. W. (1976). The enterprise of living: Growth and organization in personality. New York: Holt, Rinehart, & Winston.
[11] Beck, A. T., Seti, B. B. & Tuthill, R. W. (1963). Childhood bereavement and adult depression. Archives Of General Psychiatry, 9 295-302.
[12] Bowlby, J. (1961). Childhood mourning and its implications for psychiatry. American Journal of Psychiatry, 118 481-498.
[13] D'elia, G. & Perris, C. (1972). Childhood environment and bipolar and unipolar recurrent depressive psychosis. In L. Annel Depressive States in Childhood and Adolescence. Stockholm: Almgvist and Wiksell.
[14] Hilgard, J.R. (1974). Depressive and psychotic states as anniversaries to sibling death in childhood. In Normal and Pathological Responses to Bereavement (pp. 163-177). New York: MSS Information Corporation.
[15] Schowalter, J. E. (1975). Parent death and child bereavement, In B. Schoenberg, I. Gerber, A. Wiener, A. H. Kutscher, D. Peretz, A. C. Carr Bereavement: Its Psychosocial Aspects (pp. 172-179). New York: Columbia University Press.
[16] Balk, D. (1983). Adolescents' Grief Reactions and Self-concept Perceptions Following Sibling Death: A Study of 33 Teenagers. Journal of Youth and Adolescence, 12 (2), 137-161.
[17] Brody, G. H. (1998). Sibling relationship quality: Its causes and consequences. Annual Review of Psychology, 49 1-24.
[18] Cicirelli, V. G. (1995). Sibling relationships across the life span. New York: Plenum Press.
[19] Mchale, S. M., Kim, J. Y. & Whiteman, S. D. (2006). Sibling relationships in childhood and adolescence. In P. Noller, J. A. Feeney Close relationships: Functions, forms, and processes (pp. 127-149). New York: Psychology Press.
[20] Packman, W., Horsley, H., Davies, B. & K, R. (2006). Sibling bereavement and Continuing bonds. Death Studies, 30 (9), 817-841.
[21] Birenbaum, L. K. (1999). Assessing children’s and teenager’s bereavement when a sibling dies from cancer: a secondary analysis. Child: Care, Health, and Development, 26 (3), 381-400.
[22] Worden, W., Davies, B. & Mccown, D. (1998). Comparing parent loss with sibling loss. Death Studies, 23 1-15
[23] Baker, S. E., Sedney, M. A. & Gross, E. (1992). Psychological tasks for bereaved children. American Journal of Orthopsychiatry, 62 (1), 105-116.
[24] Cain, A. C., Fast, I. & Erickson, M. E. (1964). Children’s disturbed reactions to the death of a sibling. American Journal of Orthopsychiatry, 34 741-752.
[25] Davies, B. (1991). Responses of children to the death of a sibling. In D. Papadatou, C. Papadatos Children and death, Philadelphia: Hemisphere.
[26] Hogan, N. S. & Desantis, L. (1992). Adolescent sibling bereavement: An ongoing attachment. Qualitative Health Research, 2 159-177.
[27] Hogan, N. S. & Greenfield, D. B. (1991). Adolescent sibling bereavement in a large community sample. Journal of Adolescent Research, 6 (1), 97-112.
[28] Martinson, I. M. & Campos, R. G. (1991). Adolescent bereavement. Journal of Adolescent Research, 6 (1), 54-69.
[29] The National Child Traumatic Stress Network Child Traumatic Grief Committee (2009). Sibling Loss Fact Sheet Sibling Death and Childhood Traumatic Grief: Information for Families. LA, CA & Durham, N.C: National Centre for Child Traumatic Stress.
[30] Nolbris, M. & Hellstrom, A. L. (2005). Siblings' needs and issues when a brother or sister dies of cancer. Journal of Pediatric Oncology Nursing, 25 227-233.
[31] Sood, A. B., Razdan, A. & Weller, R. A. (2006). Children’s reactions to parental and sibling death. Current Psychiatry Reports, 8 115-120.
[32] Shipkey, N. (2008). Impact of sibling death on older adolescents. Dissertation Abstracts International
[33] Worden, J. W. (1996). Children and grief: When a parent dies. New York: Guilford Press.
[34] Worden, J. W. (2018). Grief Counselling and Grief Therapy. A Handbook for the Mental Health Practitioner (5th ed). New York: Springer Publishing.
[35] Minuchin, P., Colapinto, J. & Salvador, M. (1998). Working with families of the poor. New York: Guilford Press.
[36] Sullender, R. S. (1985). Grief and growth: Pastoral resources for emotional and spiritual growth. New York: Paulist Press.
[37] Hurd Clarke, L., Korotchenko, A. & Bundon, A. (2012). The calendar is just about up: Older adults with multiple chronic conditions reflect on death and dying. Ageing and Society, 32 1399-1417.
[38] Braun, V. & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3 (2), 77-101.
[39] Labov, W. (1972). The transformation of experience in narrative syntax. In W. Labov Language in the inner city: Studies in the Black English vernacular (pp. 354-396). Philadelphia: University of Pennsylvania Press.
[40] Connelly, F. M. & Clandinin, D. J. (1990). Stories of experience and narrative inquiry. Educational Researcher, 19 (5), 2-14.
[41] Crabtree, B. & Miller, W. (1999). Doing Qualitative Research (2nd ed.). London: Sage
[42] Xu, H. (2013). Family co-decision making under Confucianism. In International Journal of Chinese & Comparative Philosophy of Medicine,11(1). Retrieved from The Hong Kong Baptist University, Centre for Applied Ethics Web site: https://repository.hkbu.edu.hk/cgi/viewcontent.cgi?article=1098&context=ijccpm
[43] Balk, D. (1983). Adolescents' Grief Reactions and Self-concept Perceptions Following Sibling Death: A Study of 33 Teenagers. Journal of Youth and Adolescence, 12 (2), 137-161.
[44] Osterweis, M., Solomon, F., Green, M. & (1984). Bereavement: Reactions, Consequences, and Care. Washington, D.C.: National Academy Press.
[45] Rosenberg, A. R., Postier, A. & Osenga, K. et. al., (2014). Long-term psychological outcomes among bereaved siblings of children with cancer. Journal of Pain Symptom Management, 49 55-65.
[46] Lovgren, M., Sveen, J. & Nyberg, T. (2018). Care at end of life influences grief: A nationwide long-term follow-up among young adults who lost a brother or sister to childhood cancer. Journal of Palliative Medicine, 21 (2), 156-162.
[47] Hauksdottir, A. (2009). Towards improved care and long-term well-being of men who lose a wife to cancer: a population based study. Stockholm: Karolinska Institute.
[48] Doka, K. J. (2012). Therapeutic ritual. In R. A. Neimeyer Techniques of grief therapy: Creative practices for counseling the bereaved (pp. 341-344). Philadelphia: Taylor & Francis.
[49] Doka, K. J. (1984). Expectation of death, participation in funeral arrangement, and grief adjustment. Omega: The Journal of Death and Dying, (15), 119-130.
[50] Woo, S. P. (2016). About Grief Counseling: Some Reflections and Inspirations from Traditional Funereal Rituals. Guidance Quarterly, 52 (1), 1-13.
[51] Klass, D., Silverman, P. & Nickman, S. L. (1996). Continuing bonds: new understanding of grief. Washington, DC: American Psychological Association.
[52] Bank, S. & Khan, M. (1982). The sibling bond. New York: Basic Books.
[53] Hartman, A. & Laird (1983). Family centred social work practice. New York: The Free Press.
[54] Sandelowski, M. (1996). One is the liveliest number: the case orientation of qualitative research. Research in Nursing & Health, 19 (6), 525-529.
[55] Denzin, N. K. & Lincoln, Y. S., 1994. Handbook of qualitative research, New York: Sage Publications, Inc.
[56] Sullender, R.S., 1985. Grief and Growth: Pastoral Resources for Emotional and Spiritual Growth, New York: Paulist Press.
@article{"International Journal of Business, Human and Social Sciences:80756", author = "Sze Yee Lee", title = "Experiences and Coping of Adults with Death of Siblings during Childhood in Chinese Context: Implications for Therapeutic Interventions", abstract = "The death of a sibling in childhood leads to significant impacts on both personal and family development of the surviving siblings, however, both short-term and long-term effects of sibling loss in Chinese societies such as Hong Kong have been inadequately documented in the literature. This paper explores the experience of encountering siblings’ death during childhood with the use of semi-structured interviews. Through thematic analysis, the author explores the impacts on surviving siblings’ emotions, coping styles, struggles and challenges and personal development. Furthermore, the influences on family dynamics are explored thoroughly, including the changes in family atmosphere, family roles, family relationship, family communication and parenting styles. More importantly, the author identifies (i) existing continuing bonds; (ii) crying; (iii) adequate social support; (iv) hiding own emotions as a gesture of protecting parents as the crucial elements pertinent to surviving siblings’ successful adaptation in the face of sibling loss. In addition, “child-centered” and “family-centered” service implications of families with a sibling's death in a Chinese context are discussed.", keywords = "Surviving children, sibling’s death, child-centered, family-centered.", volume = "16", number = "4", pages = "179-9", }
