Helping Children With Traumatic Reactions to Parental Suicide

We would like to thank Dr. Romanowicz et al.¹ for highlighting that children whose parents commit suicide could be at increased risk for developing depressive, posttraumatic stress, or traumatic grief reactions.² Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) shows promise for improving these outcomes for children with traumatic grief including those who experience parental suicide.^3,4 TF-CBT helps children develop individualized coping and safety skills, guides children to describe the details and make new meaning about their parents' deaths, grieve the parental loss, and enhance attachment to current caregivers. Consistent with the treatment described by Romanowicz et al., TF-CBT therapists help caregivers provide children with accurate information about how their parents died in a supportive age-appropriate manner and provide psychoeducation about underlying causes such as depression or addiction (eg, "Your parent had a serious disease called depression. He was not able to think right when he made the decision to end his life."). Resources for helping children after suicide or other traumatic deaths are available from the National Child Traumatic Stress Network at https://www.nctsn.org/what-is-child-trauma/trauma-types/traumatic-grief/nctsn-resources.