Letter: Talking cure works

Sir: You report Professor Richard Harrington's doubts, expressed in his article in the Journal of the Royal Society of Medicine, about the value of counselling for bereaved children ("Counselling children `can add to grief' ", 10 May). Professor Harrington rightly states the need for longer-term evaluative studies. This does not explain why he has chosen to use a research study on delinquent boys that is more than 20 years old to support his case.

He fails to mention the most recent and comprehensive research to date, the "Harvard Child Bereavement Study" reported in Children and Grief by W Worden, published by Guilford, New York, in 1996. This study, which followed 125 children for two years after the death of a parent and used matched control groups of non-bereaved children, found that the bereaved children were at greater risk of emotional and behavioural difficulties and that this effect was greater at two years after the death (21 per cent compared with 6 per cent).

Our experience at St Christopher's Hospice demonstrates that the idea of most children being effortlessly well supported by family and friends is unrealistic. Adults are often overwhelmed by their own feelings of grief and worry that they will make things worse for their children by doing or saying the wrong thing.

The St Christopher's Candle Project was established last year in response to requests from such families. We provide telephone advice for parents, teachers and health professionals. We publish books and tapes for children themselves. We see some children on an individual basis and all the children have a chance to meet other bereaved children on a group day and share their feelings, thereby lessening their sense of being "different".

Professor Harrington and myself debated the issues in his paper at the Royal Society of Medicine last year and I invited him to visit St Christopher's to see our work for himself. The invitation is still open.

BARBARA MONROE

Director, Patient and Family Services

St Christopher's Hospice

London SE26