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Medicine » Pediatrics » "Pediatric Nursing, Psychiatric and Surgical Issues", book edited by Oner Ozdemir, ISBN 978-953-51-1740-7, Published: February 4, 2015 under CC BY 3.0 license. © The Author(s).

Chapter 5

The Psychological Problems Seen in the Children of Divorced Parents and the Nursing Approach Concerning These Problems

By Şenay Çetinkaya and Emine Erçin
DOI: 10.5772/59166

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The Psychological Problems Seen in the Children of Divorced Parents and the Nursing Approach Concerning These Problems

Şenay Çetinkaya1 and Emine Erçin2

1. Introduction

Millions of years have passed so far today since the appearance of mankind on earth, and people have been struggling quite a great deal in order to cope with life affairs for millions of years; yet, in today’s context, it was in 2000 BC that they were able to comprehend the requirement of being spouses and parents. The proceeding/behaviour to be together or get together as husband and wife has been referred to as “matrimonial action/wedding’’, and this established relationship is called “marriage’’ [1].

Family is expressed as a social league with vital characteristics within a limited extent, which is based on an emotional commitment within a framework of solidarity that cannot be transferred to others [2].

A complete family is a community consisting of a mother, a father and children with mutual love, respect, support/solidarity and the sense of belonging to each other. Such a family is the fundamental factor in the emotional, social and moral development of the child. In sum, a complete family is a natural environment where the child is socialized in the broadest sense [3].

It is seen that the point of view/perspective on the concept of family began to change in the twentieth century. This different point of view on family also caused the parenthood to be considered as something independent of marriage. It has been stated that the differentiation of the point of view on marriage and having children when compared to the past is associated with the developments in technology [4].

A family established by “two different individuals’’ also has the potential of conflict and discrepancy along with it as the natural consequence of being two different individuals. It is too optimistic to expect the two different individuals with various personality traits who were raised in different environments to be always in harmony for years, since a family which is an institution considered to be a harbour against the challenges of life may, itself, sometimes turn into a a stormy ocean and create problems instead of solving them, in which case the spouses end up with the decision to terminate their association and get divorced, which is, today, experienced more and more in increasing numbers [1].

Besides the fact that the widowed woman or man, following her/his spouse’s death, never confronts the various social and psychological negative consequences of having been divorced or widowed in this way within the society, she/he and her/his children even remember the deceased one with love and respect. The widowed spouse, when compared with a divorced one, can get married and start a family much more easily; thus, the child can regain a natural environment once again [3].

A child having an extramarital mother will never have had a complete family. Such being the case, the ability of the child to overcome the problems encountered as s/he grows up is dependent on the understanding/empathy the close environment around her/him will show towards her/his situation [3].

Different from the traditional families, parents in modern families focus all their financial and emotional sources along with all their attention and energy on raising children. For a woman, having a child becomes no more a conventionally inevitable role after marriage; instead, it becomes a period of personal decision/call and responsibility on the part of her. It is argued that the social changes, such as conceiving a child out of wedlock, or even the technological innovations like bearing a child through medium of sperm banks independent of the prospective father lead to a change in the point of view towards marriage and parenthood. It is now pointed out that a woman does not have a child just because she is married, and that having a child is not a marriage routine anymore but a decision independently made by the woman. Hence, it is also put forward that parenthood has lost its traditional relationship/ association with marriage. In the wake of such changes, it is also stated that the emotional value of the child, different from that of the traditional families, has increased even more. The most dramatic change of all the others within a family life throughout the twentieth century is said to have been the rapid increase in the divorce rate [4].

According to The National Survey of Family Growth (NSFG), the divorce rate in the USA is 3.6 per 1.000 population. The divorce rate is the highest in the males and females aged between 20-24, while this rate is the lowest in those aged between 35-39. Almost half of the marriages end up with divorce. The divorce rates have been on the increase since the beginning of 20th century, and particulary since 1970s. According to Brown et al.’s report (2008), the proportion of the nuclear families has declined from 85% to 69% for the last 30 years. Now 3 out of 10 children are living in single-parent homes [5].

It is seen that there has also been a great increase in the divorce rate in Turkey in recent years. According to the data of the State Statistics Institute (SSI), the divorce rate, starting from the years 1990s, have been on the increase to a great extent. The number of the married couples getting divorced in 2011 increased at a rate of 1.3% in comparison to the previous year and reached 120.117.

The rough divorce rate was 1.62 per 1.000 population in 2011. Still, the divorce rates in our country are seen to be quite lower than those in several European countries. However, it is thought that the divorce rates seen to have increased particularly in big cities in recent years have been remarkable, and for this reason, it is important that divorce and the effects of divorce on individuals and the society be analyzed [4].

There are, undoubtfully, a number of reasons for the rapid increase in divorce rates. There are also various and major consequences of divorces, among which, as the sociologists and academicians put forth, is the case of shaking the society to its foundations. The very reason that it is the phenomenon/case shaking the foundations of the society is that it primarily affects the children, along with which the relationships between children and their parents, and between the parents are generally affected from this phenomenon in a negative way [3].

The case of a divorce is a blow inflicted on the self-confidence and self-respect of both the female and the male. However terrible the marriage is, the emptiness/separation experienced in the wake of a divorce is a major problem to be overcome [1].

Divorce is not a process experienced only between spouses. Most of the couples who are divorced have children, as well; therefore, a divorce is also quite an important process for the child. It is pointed out that a divorce potentially brings with it a series of changes that may seriously affect the child. Here, the reason for using the term “potentially’’ is that divorce is not regarded as a process that will inevitably harm children [4].

The first step in this challenging process is to explain to the child what divorce means. Some parents find it unnecessary to inform their children about their intention of getting divorced, and the fact that the age of the child is younger confirms/justifies this behaviour. Whereas, nobody-whether they love their parents or not-never understand the reason why, when they wake up one morning, one of their parents disappears as if s/he never existed. No child deserves to be left to confront such a devastating behaviour. Such thoughtless behaviours or actions may lead to the fact that they make up/imagine things which are unreal in order to compensate the situation or make some sense out of this as well as reinforcing their sense of being rejected [1].

How to tell the child about the decision to get divorced:

  • The parents should explain to their child about their decision to get divorced in a secure and familiar environment the child is used to and should act together in this if possible.

  • They should be totally honest in explaining the matter and use a comprehensible language by considering their age.

  • The children should be listened to when they ask questions, the answers given should be limited to what is asked about and no long explanations should be included.

  • While parents are having a conversation with their child(ren), they should avoid any mutual argument, nor should they blame each other in front of the child.

  • The child should never be asked to take sides in this matter, in other words, s/he should never be put in the position of a referee.

  • Even if one of the parents feel hatred or rage against the other party, no negative criticisms or remarks about him/her should be made behind his/her back.

  • The remarks or expressions likely to hurt the child or make him/her feel guilty should carefully be avoided.

  • The child should be given detailed information as to where s/he will live after divorce, with which parent s/he is going to stay with, how often s/he can see the other parent and what sort of changes will take place in her/his life after all.

  • A child should never be regarded as a fellow sufferer or a shoulder to cry on. Otherwise, such a responsibility will be too heavy on him/her, which may have future consequences. Remember that your task of being a parent to them remains the same; what they need is your parenthood.

  • The fact that the divorce takes place only between the father and the mother should particularly be emphasized. “We are getting separated but we are always your parents’’ [6].

Divorce is both a judicial and a psychological and social process. It is the life-style that may be traumatic for children and is unavoidable for some marriages [2].

When taken as a judicial concept, divorce, to put it simply, is the termination of a marriage contract [1].

In the light of the thought-provoking/challenging facts about the act of divorce and the increasing data suggesting that the children of divorced parents are at more risk than the others in terms of experiencing developmental and psychological problems, more and more couples are beginning to question whether it would be right to disperse/separate the family or not. Some of them, by putting aside their personal desires, consider continuing their marriage until their kids grow up and leave home. The research results have suggested that staying together merely for the sake of their children rarely works. Sometimes staying together for this reason becomes more harmful for the children of those keeping together than the children of those getting divorced due to discrepancy. The researches have revealed that the children who have witnessed various discrepancies/disagreements-from purposefully keeping still/silent or continuous noisy clamor to demonstrating physical violence-become more awkward and unbalanced than the children of those who got divorced. In short, sometimes the only way that seems to solve the problem could be to end the marriage [1].

2. The clinical characteristics of a divorce

  1. The Divorce Process: It was found that the determining factor associated with divorce was the emotional and behavioural problems of spouses, and that the quality of marriage, the socio-economic conditions, postpartum depression and demographic changes were not the determinants for that matter. It was seen that divorce takes place within an average of 3-year-process in between the decision to divorce and the divorce itself. It was determined that the children of the families living together after divorce had more adaptation problems compared to those whose families get married again [7].

In the process of a divorce, the situation reaches the stage of acceptance after having gone through the psychological reaction phases which are developed against a sense of loss witnessed in deadly-ill patients, such as denial, anger, bargaining, and depression, as defined by Elisabeth Kübler-Roos. The children also undergo similar stages as their parents do [7].

  1. The Denial Stage of Divorce: At this stage, the children cannot accept the experiences associated with the divorce. They do not want to accept the separation of their parents. They cannot believe that their father and mother can care for them anymore; instead, they would rather believe that their parents will reunite. At this stage, it is important that parents deal with their discrepancies between each other in a proper way without ignoring the issues agreed upon and be clear about the child care period, as well. The reactions of denial and avoidance exhibited by the child can be overcome through an open communication. If the parents and their child(ren) ever get stuck in the denial period, the child(ren) will, then, not even agree to get any support to proceed with her/his life. The denial is followed by the accusation phase. In this phase, the child is outraged with his parents due to the fact that they do not get back together again, that they destroyed her/his whole life and hampered the realization of their dreams [7].

  2. Bargaining Stage: This stage is the one at which the child makes an effort to fix the damage done by changing his/her own behaviours. S/he starts trying to accomplish her/his lessons without com plaining or quits fighting her/his sister/brother. Her/his belief that the parent who deserted her/him will come back one day. The belief that her/his parent left because of her/his misbehaviour may continue until advanced ages [7].

  3. Depression Stage: The child is commonly seen to be tired, sad and depressed in living environments, at school and at home, where s/he may have difficulty in controlling her/his feelings/emotions. This stage usually lasts for a short time and does not necessitate a clinical intervention [7].

  4. Acceptance Stage: The fact that divorce is a proper solution for parents is ensured by showing that the divorced parents now have individually happier lives compared to the previous one they had together. It may sometimes be possible to reach this stage during young adulthood. In the process of the ending relationship, often more intense and complicated emotions occur. Reconciliation in the wake of a divorce does not mean a reunion. It is the process in which the painful and challenging aspects of the relationship are integrated through experience and are no more obstacles against proceeding with life. The old and sorrowful processes are settled and the journey to the areas of new relationships goes on [7].

The researches carried out among children suggest that children do not accept the case of divorce; instead, they prefer a miserable marriage to a divorce [2].

The relationship of any child with her/his mother-father, in the first years of her/his life in particular, is of great importance. On the other hand, divorce is, doubtlessly, rather a challenging and stressful process for both children and their parents. Considering it from the child’s side, the child will no more be able to reach the two people equally s/he has been mostly dependent on up to that time, that is, her/his parents, and her/his world will split up in a sense. Divorce, besides the changes taking place in the relationship of the patients, is quite important in terms of the parental roles of the divorced couples. When we analyze divorce in terms of parents, we encounter several problems to be coped with, such as re-building a new life following the divorce, developing new ways of contact with both the ex-spouse and the children, and additionally, the financial hardships occurring in the life of the divorced mother and the changes in social relationships [4].

One of the psychological variables that may cause a risk for the divorce of parents is the life satisfaction. Life satisfaction comprises the cognitive aspect of the concept of subjective well-being used as a synonym with happiness in the field of positive psychology. Accordingly, the subjective well-being (SWB) has two dimensions as the emotional/affective dimension consisting of positive and negative emotions and the cognitive dimension known as life satisfaction. Life satisfaction is also the cognitive judgement and evaluations made by the individual regarding her/his life. The conducted studies suggest that as the positive relationships of the adolescents with their parents increase along with the increase in the positive attitudes of a mother-father, commitment to parents and the socio-economic level, so does the life satisfaction escalate with such aspects. Thus, the familial variables are the important determinants of an adolescent/pubescent life satisfaction, and the changes within the family structure, like divorce, may affect the children’s quality of life and the ways of perceiving their lives as is true for all the members of the family, as well [8].

It may be expected that the change in the life-style and circumstances also affect a child’s life satisfaction in a negative way. As a matter of fact, the limited number of studies analyzing the life satisfaction of the children with divorced and undivorced parents show that the life satisfaction and general well-being levels of the children coming from broken families are lower than those coming from complete families. To sum up, the separation or the divorce of a child’s parents causes a striking disadvantageousness due to the challenging life experiences brought to children’s lives in terms of both their psychological developments and life satisfaction [8].

Another point to be highlighted is the extreme tolerance the mother shows towards her child in order to compensate the separation with her/his father, which may pave the way for the development of different behavioural problems in the child. For this reason, the balance should be maintained well, and the children should not be allowed to experience such borderline problems. In the wake of separation or divorce, the parents should not speak out against each other, nor should they reflect any problem they may be having with each other on the child. Such is the case commonly seen in divorced families, which may bring major problems with it. The child should also be allowed to see her/his parent living away from her/him frequently (unless there is some problem) and thus, the communication between the child and the other parent should be sustained [1].

Following the divorce, the relationship of the child with both of her/his parents will differ as compared to that in the past. After the divorce, the child will start living with this single parent, which is usually the mother in such cases. Therefore, major changes take place in the relationship between the child and the father who has left home after divorce. These major changes occurring in the child’s and the parents’ lives in the wake of the divorce are seen in a number of areas, such as the frequency of the meetings with both the parent living together with the child and the other parent living away, and the parents’ responsibilities towards their child(ren) as well as fulfilling the tasks regarding them. Thus, it is required that both the mother and the father, after having been divorced, adapt to the new circumstances while maintaining their relationship with their children and re-structure this relationship for their new life-style [4].

Many children but the little ones know what divorce means due to the fact that the termination of marriages today is a commonly-seen incident. If there is tension and unhappiness within a family, it is greatly likely that the children within that family circle become aware of the fact that something is going wrong. Within the families where fightings, particularly the physical violence and alcoholism are often seen, the children learn to read the psychological states of their parents without any awareness. They can find the best time to approach an angry or an unhappy parent by starting from various details. In the same way, they know when to get away from the clamour. Even knowing something more or less about divorce and witnessing the continuous fight between their mother and father do not prepare most of the children to the news that her/his parents are separating ways or getting divorced. Once the incident breaks out-which often happens with one of the parents leaving home-the child literally gets shocked. If the child has been kept away from her/his parents fights up to that time, s/he even experiences a greater shock. Drifting away from a parent, even if it may be an abusive one, horrifies a child. It is natural for a child to miss the parent who left the family. The separation of the parent does not annihilate the children’s sense of commitment [1].

The best time to explain the case of divorce to children should be at least one week before the day when one of the spouses will leave home, since the children will have quite a lot of questions and worries preoccupying their mind once they have got the news [1].

Divorce may occur as a major transformation in a child’s life. If, for instance, the child has a chronic disease, the divorce in question poses an extra load/burden on the stress experienced in struggling with the disease. Witnessing the loss of love between parents, the abandonment of matrimonial obligations by parents, getting used to travelling between two different homes and the feeling of daily absence of a parent while living with the other one all cause new familial circumstances for the child. Divorce is a turning point in a child’s life, since the ongoing life has changed to a considerable extent [5].

Brown et al. (2008) assume that 20-30% of the children and adolescents in the USA suffer from chronic diseases. The parents of the children with severe or chronic diseases may confront a higher risk of divorce. The data regarding the effect of the diagnosis of a child with a chronic disease on the marriage relationship are inadequate. As the result of the research, the reasons supporting a negative impact involve the communication problems, increased role tension, decreased relationship satisfaction and spending less time with a parent [5].

Syse et al. (2010) did not find any difference in the divorce rates between the couples who had a child with cancer and those who had a child with no cancer. They found out that when the educational levels of the mothers having children with cancer were higher than the average, the divorce rates in those parents proved to be higher, as well [5].

The age of the child, the gender, parental attitudes, educational status of parents, the socio-economic level of the family, the parents’ professions, the number of sisters-brothers and the success status of the child are the factors affecting anxiety. The situations causing anxiety/worry in little children pave the way for the psychological reactions in the advanced ages. The ongoing disputes/conflicts between the separated parents even after the divorce may give rise to the occurrence of anxiety in the child. Anxiety may manifest itself in children in the form of different reactions. Some children withdraw in order to avoid any worrying situation and abstain from joining any groups of their peers, while others develop defense mechanisms, such as retreat, rejection, repression and projection [2].

3. The adaptation of children after divorce can be analyzed in 2 stages

  1. The short-term adaptation of the child towards divorce: This is the adaptation process within the first few years. The existence of negative factors, such as the conflicts experienced by the child within the family, the lack of communication between parents, economic difficulties and stress factors, makes it hard for the child to adapt to the new stage in her/his life. Having been influenced very negatively in cognitive, emotional, social and behavioural ways during this period, the children enter a short period of mourning/lamentation against this process of change within the family. In consequence of the inner conflicts they experience, they may suffer from fear, sorrow, anger, guilt, loneliness, rejection, sense of being unloved, and physical problems like stomachache, headache and chest pain, and psychosomatic disorders like oversleeping and overeating, particularly within the first year following the divorce [9].

  2. The long-term adaptation of the child towards divorce: This period starts after the first two years following the divorce and may continue until adulthood. In general, the adaptation to the process of change experienced within the family is provided in this process. If, in this process, the conflicts between the mother and father continue, the children’s adaptation to this period becomes challenging, as the result of which there may be emotional and behavioural problems exhibited by the child [9].

The vulnerability that a divorce creates on the child is associated with, particularly, age, gender, the stress level experienced within the family in the divorce process and whether the parental functions are sufficiently fulfilled or not [9].

It was reported that the most important factor regarding the child’s adaptation to this new state was his/her age at the time of divorce. Children, either at very young ages or in late adolescence, are influenced less by the long-term negative effects of divorce when compared with the other periods of age [9].

The children of the divorced parents experience a much more challenging process during adolescence when several developmental changes are being experienced, such as acquiring a social, sexual and occupational identity, having the capacity of getting independent, acquiring competence and being able to establish close relationships. It is reported that in comparison to the adolescents in the undivorced families, the risk of getting expelled from school, antenuptial conception and exhibiting antisocial actions increased 2-3 times more in those with the divorced parents [10].

The comparative studies conducted on the matter suggest that the children with divorced or separated parents, compared to those living with their families, develop a distrustful way of commitment towards their parents, and that their tendency to exhibit instant rage, constant rage, self-accusation, desperateness, depression and the tendency to commit suicide is higher than the others. The social adaptation, self-esteem and psychological resilience levels of those with divorced parents were found to be lower [8].

While some research results suggest that boys are much more influenced by a divorce when compared to girls, other research results show that this is just the other way round. In the study conducted by Aslıhan (1998) with a group of children belonging to broken and complete families, it was determined that male students had a higher level of anxiety in comparison to female ones. A significant difference was determined between the levels of anxiety in terms of the genders of children whose parents were not divorced. No significant difference was ascertained between the self-esteem levels in terms of the anxiety level ages of the children with divorced/separated parents [2].

As is seen, it is impossible to make generalizations as to how the act of divorce influences children, since each divorce case is indeed a unique, complex and multi-faceted event. However, despite all, the psychologists and academicians claim that several generalizations can be made as to how a divorce may affect a child by considering her/his age at the time of divorce [3].

4. Reactions to divorce that are unique to age

4.1. Between birth-age one (age of confidence/trust)

  • They constantly show bad tempers.

  • It is difficult for them to adapt to a change.

  • Babies and those in their infancy feel the pain whenever they are separated from their parents.

  • They do not feel themselves secure/safe during the times when the parents are together or when they feel the changes in the emotional state of one of the parents. They may react to such changes by crying, clinging or showing bad tempers [11].

4.1.1. What do they need?

  • The environmental changes should be limited as much as possible.

  • Parents must be particular about setting arranged time for their children’s nutrition and sleep.

  • A great deal of closeness should be shown as much as possible, both verbally and physically.

  • Parents should spend a good deal of time by cradling, holding, caressing their babies and singing songs to them.

  • Babies should be often allowed to contact with both parents.

  • A parent should be able to communicate with the other parent about what to do in order to act in accordance/consistently.

  • Once the baby utters her/his first word or takes her/his first step, the parent involved should share this experience with the other one.

  • The new-born babies, particularly the premature ones, are oversensitive. It is highly necessary not to shout or fight when the baby is close.

  • A calm/soothing tone of voice should be used while speaking to the other parent at the time of changing hands in holding the baby [11].

Thus, for instance, it is argued that a nurseling does not suffer much from a divorce. The reason for this is considered as the inability of the nurseling to understand the dispute between parents, and besides being incapable of taking sides, s/he is usually left to her/his mother’s care [3].

The thought that the babies in their infancy will be least influenced by a divorce with the assumption that s/he is yet unaware of many things is wrong. In the babies at these ages were prominent changes in behaviours observed after divorce. The most striking ones were crying and crying jags, sleep disorders and malnutrition, and the loss of interest in toys. Hence, even at this age group, the couples getting separated after a divorce should do a good planning to share their responsibilities for the baby and come together with him/her. In the meantime, they should never attempt to fight or argue in front of the baby [12].

4.2. Between the ages of one-three (the world revolves around them)

  • Change is hard/challenging for them.

  • They are scared of separation and the visits from one parent’s home to another’s could be rather traumatic.

  • They may show bad tempers or may cry for the other parent.

  • They may want you stay with them and never get out of their sight, and when you attempt to go, they may desperately cling to you.

  • They may suffer from such problems as falling asleep or staying awake the whole night [11].

4.2.1. What do they need?

  • As the kids at this age range have no accurate comprehension of time, the separations may appear to be dreadful to them and seeing her/his parent that separated a week later may feel like eternity to him/her. That’s why, a kid at this age gets into a tantrum and cries while getting apart from the other parent.

  • Being in contact with both of the parents may help the kid’s fears of separation diminish.

  • Make sure that s/he fully trusts your love and that you will meet his/her needs.

  • Show him/her that you understand her/his yearning/longing for the other parent. Show him/her when to meet or call the other parent again by using the calendar.

  • Hug him/her with love to make the separation easier and tell her/him that you will always be there and love him/her.

  • Set predictable, reliable boundaries and prescribe coordinated programs.

  • Ensure that s/he goes to bed at the exact hour in both homes.

  • Reading him/her the same bed-time story and letting him/her sleep with the most beloved blanket and toy of his/hers could be useful [11].

4.3. Between the ages of three-five (age of curiosity)

  • Fear of being abandoned.

  • Feeling guilty, angry, nervous, scared, sad and confused.

  • Being anxious/concerned about whether or not they are safe or loved.

  • Blaming themselves for the divorce.

  • Believing that their hostile thoughts or bad tempers caused their parents to split up.

  • Dreaming about the reunion of their parents.

  • Making futile efforts in order to unite their parents.

  • Extreme obedience.

  • Thinking like “I’m not good enough’’ or “I’m an evil person’’.

  • Having difficulty in making visits between homes.

  • Returning to behaviours, such as wetting the bed, thumbsucking, etc.

  • Anxi4ety may lead them towards masturbation, whereas some others may develop tantrums or experience sleep disorders.

  • Since the concept of continuity in little kids has not yet been developed, they may repeatedly ask when their mother or father will come back home although you have told them you will not be living together anymore [11].

The preschoolers may be seen as those who are most intensely influenced by a divorce. The kids of these ages consider themselves as the focus of attention in life and thus, within their family circle. This notion prompts them to the feeling of guilt, with the presumption that they are responsible for a possible divorce. With the child’s mind, they may tussle with the ideas like “mum and dad are fighting because I do not behave well, and they got separated because of me…’’. Ultimately, the most commonly seen problems emerge once again, such as wetting the bed, thumbsucking, finding the shelved and already-worn out teddy bear to sleep together with. Such behaviours reveal the extent to which the child is tormented with the insecure, defenseless feelings of neediness [12].

4.3.1. What do they need?

  • Talk to your child about your divorce issue and let them ask questions about it.

  • If the kid repeatedly asks whether or not her/his mother/father is coming back, just answer him/her calmly and tell him/her that you have already got divorced and her/his mother/father is now living in a new place.

  • Tell him/her when s/he could see the other parent.

  • Kids express their emotions indirectly. They need help in order to express their emotions properly. (Parents may help their kids by reading them decent stories about other kids whose parents got divorced.)

  • When you see your child sad or worried, ask her/him to draw or paint pictures regarding their emotions and thoughts on what has been happening. Hand them baby dolls and puppets to help them cope with their emotions. (Watch them while they are playing games and listen to their speech. In this way, you can get clues as to how they adapt to the case of divorce).

  • Teach your children new words about emotions. (Use your daily experiences as the chance to define the emotions).

  • The little kids need explanations as to the fact that it is not they who have caused a crisis within the family and that it is not their task to solve it.

  • Show them you love them with a physical closeness and ensure them that you will undertake any care they need any time.

  • If they are still dreaming about the reunion of the family, tell them that their wish is natural and ok but impossible to come true again.

  • In order to prepare your child for the change between homes, play games with them related to these visits to both homes. (By placing chairs in two separate rooms, tell your child that one of the rooms belongs to her/his mother and the other to her/his father. While you are performing imaginary visits with your child between the rooms, tell her/him what to do and what to bring with her/him during these visits. Make it a fun game to play in order to make the real visits become sort of fun for the child) [11].

In this age and during the time until preschool period, if the child has been left under the negative impact of the main divorce in particular, the negative behaviours to be observed in the child are fear, stubbornness, sleep disorders, poor feeding, bed wetting, stuttering, etc. [3].

4.4. Between the ages of six-eight (age of sparse teeth)

  • Kids feel themselves split in two.

  • They may blame themselves for the divorce.

  • They assume they will be deprived of food and toys or will be neglected by their parents.

  • They usually feel abandoned/deserted.

  • They may have feelings of rejection, loss, and the contradiction as to whom they should be loyal to, along with the feelings of guilt.

  • They have the anxiety that they have lost the separated parent eternally, and they get scared of the idea of another person taking their place.

  • They often cry and show bad tempers.

  • They feel emptiness and have difficulty in concentrating at school.

  • They may regard the divorce as a battle requiring them to take sides.

  • They long for the parent living away from home and try to unite them again, and they even write notes full of love, pretending to be the other parent sending the note to his/her spouse.

  • They do not state that they are stressful /tense. The problems caused by divorce result from several nervous attitudes, such as nose-picking, hair-twisting, making face/frowning, stuttering, nail-biting and chewing pencils, etc. They may withdraw cry, get furious and aggressive or become extremely placid/ meek.

  • If the cause of divorce is not explained to them, they will find a way in their own way to get it explained. Since they are still unable to comprehend that there are two sides to both of the stories, they may totally put the blame on a single parent. If, for instance, one of the parents start seeing somebody else right after the divorce, then s/he may be the one to be blamed for [11].

No matter how understanding they may seem towards the reasons for the divorce explained to them, the kids at this age, in fact, subside into the intense feeling of loss for the matter involved. Nevertheless, the kids at this age, contrary to the little ones, do not take the blame on themselves but put it on their parents. They feel rage against their elders, get disappointed and consider themselves rejected. From time to time, with the notion that they have to take sides, either that of the father or the mother, they may exhibit behaviours like bearing a grudge against the other parent. Almost all of them have trouble at school after the divorce, and their success at school declines, as well [12].

4.4.1. What do they need?

  • Since their skills to think logically has not yet been improved, it may be useless to try to make cool and reasonable explanations to them.

  • They need help in defining their emotions and expressing them verbally. (Look through the magazines with your child. Mark the sad, angry, scared or happy faces and comment on what that person might be feeling at that time).

  • The children at this age would like to make their parents pleased. (Since they may be wishing to be loyal to both sides, it is of utmost importance not to talk negatively against the other parent).

  • Early school age kids need the assurance/guarantee that they be taken care of and their needs be met. (Make them sure that they are safe and that you have plans to protect her/him against any vice.).

  • If you need to cut down on expenses due to financial problems, explain to your kid that they will always have a secure place to eat and live in.

  • The kids at this age are in need of physical closeness/affinity. (Hug/hold them when their peers are not around) [11].

It is best to explain to the kids at this age the reasons for the divorce without any lies in it. They should be treated like an adult rather than like a child. Separately, since many children tend to hide this family issue from their friends and teachers, their teachers must definitely be informed about the issue, at least, in order to avoid the problems that may occur at school [12].

4.5. Between the ages of nine-twelve (age of success)

  • The processes of divorce and remarriage is particularly difficult for the children at these ages.

  • They begin to understand the family/parental relationships and are more sensitive to conflicts.

  • Divorce causes anger and shame in many children, and the changes to take place makes them really anxious. (Anxiety is reflected through their behaviours, such as bad tempers or challenges they encounter in their lessons).

  • They may fight with their peers or just keep away from them.

  • They may start having nightmares.

  • They may get offended or nervous without knowing the underlying cause. (They may feel a sense of anger, pain, anxiety and weakness).

  • Emotions like the feeling of loneliness, loss and deprivation may lead to depression or other emotional problems.

  • Since the children at this age distinguish everything as black or white, they are quite sensitive to the pressures put by their parents with respect to taking sides in the matter.

  • They become worried/anxious about their parents. (They may try to substitute the parent who left and behave as if they were mature enough to handle things).

  • They understand the psychological states /moods of their parents more easily and wonder whether they will be able to take care of their children or not [11].

For all that, a child is influenced by the divorce during the school age at most. S/he has begun to understand the discrepancy between her/his mother and father and to take sides between them already. The divorce results in losing her/his trust/confidence in her/his father or mother, or both [3].

4.6. Between the ages of thirteen-eighteen (the age of enraged hormones)

  • During this period, it may be rather painful and shocking for a child to see their parents divorce.

  • They may show reluctance in getting involved in emotional relationships. Besides, with the feeling of having been deserted, they may get away from home often and spend more time with their peers.

  • They experience sense of loss and anger/rage.

  • They may be scared of getting hurt, or assume that their own marriage, one day, will also fail and they may be afraid of repeating the same mistakes their parents made.

  • The financial matters and the psychological states of their parents worry them a great deal.

  • They may have difficulty concentrating on their lessons at school.

  • They may complain about physical health problems or experience chronic fatigue.

  • They may easily sink into a depression because of the fact that family is now no more a safe harbour to rely on.

  • Inappropriate/unbalanced behaviours can be observed in the children who have difficulty in understanding the divorce or accepting this fact. (Fleeing from school, making friends with children exhibiting improper actions, using alcohol, committing suicide, etc…) [11].

The adolescents who are affected by the divorce at most are those who cannot find a peaceful home in their new lives. If there was an uncomfortable environment prior to the divorce which may have psychologically shocked the adolescent, then the impact of divorce may increase more and more. The adolescent may consider himself/herself as the cause of divorce. S/he creates the psychological problem with which s/he assumes that his/her parents quarreled because of his/her actions and, therefore, it is s/he who has caused this separation [13].

4.6.1. What do they need?

  • The children in this period require proper ways to reveal their emotions and also need encouragement from their parents.

  • It is important to arrange family gatherings and have one-to-one conversations with both of the parents.

  • Writing poetry, painting, keeping a diary, writing and sending letters to the parents may help them express their urge to throw things away or hide them.

  • You should be honest to your child about your divorce without giving too much detail. Never ask them to take sides.

  • You must never rely on them for a psychological support.

  • Encourage them to spend time with their peers. You can also support their friends’s visits to both homes.

  • While the calendar is being marked for mutual visits or some sorts of changes are being made, the opinions of the children of this period should also be taken into account, however, the final decision should be made by the parents.

  • It is indeed a difficult situation for the children aged 11 and above to observe their parents get interested in the opposite sex and to see them get engaged in an emotional relationship, because they have already started to be aware of their own sexuality. Thus, before showing any physical affinity/ intimacy towards the person you are interested in right in front of your child, spare some time for them to get to know that person and get used to him/her.

  • You should continue setting clear, reasonable and steady boundaries without letting him/her take shelter in the other parent’s home by running away from house chores and responsibilities [11].

This is the age group in which divorce is mistakenly thought to have the least impact on children. Whereas, at this age, the child who already carries the burden of puberty/adolescence with him/her becomes faced with an additional stress factor with the divorce of his/her parents. Their initial reactions are generally centered on starting to behave more distant towards their parents, spending most of their time with their friends rather than their parents and feeling, in their environment, ashamed of this incident experienced within the family [12].

Female children usually give more sensitive reactions compared to male ones. The increasing interest towards the opposite sex due to the loss of confidence experienced against their parents and having a sexual experience at an early age as the result of confiding in a protective male companion are the possible consequences to occur in this respect. Male children, on the other hand, show more aggressive reactions [12]. The negative behaviours exhibited by the children at this age are failure at school, telling lies, stealing, sexual perversion, etc.. Moreover, starting from this period, the child begins to encounter various problems that cannot be resolved only by his/her parent and him/herself, against which s/he may be carried away with the sense of insufficiency [3]. The most important outcome to be expected and be careful about is their ending up in a youth detention center due to their tendency to commit crimes at an early age. Further problems in both of the genders, such as becoming drug addicts and giving harm to themselves should also be taken into account [12].

As is seen, it is almost impossible to find out in families with children the ideal age of the child during the period of divorce. The separation of parents will bring with it the problems considered to be rather intense for any child at any age group, since the dream about a “holy and healthy family’’ remains the same for any child, from infancy to adolescence [12].

4.7. The grown-up children (what would i like to do?)

  • Those who left home, and those who even have kids have difficulty in understanding the divorce of their own parents. They keep asking, “why now?’’.

  • Since divorce has undermined their feeling of confidence, they may avoid making long-term promises.

  • Considering that life has no guarantee, and since they are scared of being betrayed or deserted, they turn to interdependent relationships and choose the people who will need them most so that they can never be abandoned.

  • Those living away from home may feel anxious and angry as to which parent they are going to spend their vacation with.

  • The married ones may question the stability of their own marriage due to their parents’ current situation.

4.7.1. What do they need?

  • You should tell them that both parents contribute to the problems within the marriage, that it is hard after all to continue like that and people can change in time.

  • Still, it will be your responsibility to give them some hope to be able to establish positive relationships and to sustain their own marriage and explain to them how important it is to have communication and agreement and to solve problems in marriage.

  • It is necessary that you not complain about the other parent and not force the grown-up child to take sides in this matter by blaming the other one.

  • If the other parent is not communicating with your child and not visiting him/her regularly, do not force him/her to establish a relationship with the child, because it is important that s/he develop their relationships without your influence.

  • You should tell your child that you will maintain your relationships with her/him and your grandsons/granddaughters, and that you will continue their school activities and other activities, as well. You should also talk to them about how you will spend the vacations together [11].

The Reactions to the Loss of the Beloved Parent
Dysphoric Reactions Reactions to the other Parent The Expressive Reactions
Pain and hopelessnessComforting one’s selfDependencyFear of LossAnger/RageRestlessness
Infancy Sorrowful, crying, mourning, apathyThumbsucking, Caressing and holding the toysClingingConcern
/worry about separation
Similar angerAgitation
Preschool period Crying (yet, decreased), sadness, withdrawalMasturbationClinging, desire to be taken care of.Concern
/worry about separation
expressing anger and rage in games
Middle Childhood Crying, sadnessClinging, whining, childish speech, independenceSchool fobiaDisobedience, fleeing from school, committing crimesRestlessness, decline in school success
Tearful state, sadness, fatigueSchool fobiaRebellion, sexual acts, belligerence, rudeness, drug abuse, use of alcohol, escape from home Restlessness, decline in school success

Table 1.

The Reactions Shown by Children Against the Loss of the Beloved Parent After Divorce

Parents should try to learn how to approach their children. Even though they decide to get a support from a mental health specialist, the child who particularly fails to accept the separation of his/her mother and father or rejects it may, of course, refuse to get such a support. In order to enable their child to adapt him/herself to the divorce process, parents should be able to do the following:

  • To make their child understand what it means for a family to live under the conditions unique to themselves and what divorce means in that sense, which should be done together and without ever blaming each other.

  • To tell them that it is not their fault when parents get divorced in accordance with their age, and to explain with tangible/concrete expressions in what way it will affect them.

  • To encourage the children in maintaining a happy and warm relationship with the other parent and to do his/her best in this respect.

  • To make their children believe that they will always be loved and taken care of in the best way and to do the best in this respect.

  • To maintain the relationship with the ex-spouse as smoothly as possible. To co-operate with each other in the issues involving the child. If this is not possible, it is better not to reflect any problems to the child.

  • To encourage the children in asking for assistance and guidance from other people in their lives or from the specialists [7].

  • Motivate your children in expressing their emotions. Avoid your impulse to tell him/her how to feel. Your child may withdraw and once s/he does that, the possibility of sharing the emotions diminishes.

  • Avoid attempting to get engaged in any legal battles as to how your child shall stay with which parent. Such court issues may cause the child to consider the future from an insecure perspective. Do not separate the sisters/brothers from each other unless one of the children in his/her puberty period clearly states that he wants to live away from her/his sister/brother [14].

5. The nursing approach to the children of divorced families

Children may require a professional health team in order to minimize their negative emotions and misunderstandings and to get help in trying to cope with the problems experienced in the wake of the divorce. The psychiatric nurses within this team have a major position due to the fact that they can directly reach children and know the dynamics within the family and are aware of the way the child is influenced [15].

The main purpose of the nurses working in this field is to determine the high-risk groups within the society and improve their ability to cope with problems and aid them to manage the state of crisis they encounter. In this context, they deal with the problems experienced by the children of the divorced parents by using the nursing process [15].

The first stage of this approach is the one known for the term “determining the situation’’-the stage where the data that could form the basis to the care of the individual are collected. The second stage comprises the analysis of the collected data and the determination of the nursing diagnosis through the interpretation of the data, while the third stage consists of the plan of attempts/interventions prepared for the problems of the patient and based on the knowledge and ability of the nurse to make a decision. The fourth stage, on the other hand, is the stage at which this plan is put into effect. The final stage is the one at which there are reviews as to whether the attempts have resolved the individual’s problems or not and an evaluation is performed with respect to it [15].

The problems experienced by the children of the divorced families were formulated by using the nursing diagnoses determined by NANDA (North America Nursing Diagnosis Association), and the nursing attempts in accordance with these diagnoses have been explained [15].

The problems experienced by the children of the divorced parents can be dealt with the following nursing diagnoses:

  1. Situational Low Self-Esteem

  2. Change in interparental processes

  3. Insufficiency in individual coping

  4. Failure in Communication [15].

6. Situational low self-esteem

Self-esteem is one of the four elements of the self-concept and is the sum of an individual’s skills, the value attributed to himself/herself and to others by him/her, the skill to be able to overcome hardships, and the feelings and thoughts s/he has in regard to respect for others. The development of a healthy self-esteem in children is dependent on their closeness/ affinity to the most significant figures in their lives, who are their parents. The children of divorced families have witnessed the separation of the two most important people in their lives and have been emotionally affected by it through experiencing the feeling to lose them. For this reason, such can be the case in a child who once had a positive self-esteem but experienced negative emotions as the result of their parents’ divorce [16]. The objectives and the general nursing attempts to be performed for the diagnosis dealt with as the situational low self-esteem are as follows:


  1. The ability of the child to express the emotions s/he has felt regarding the divorce.

  2. The ability of the child to sort/sequence the changes that the divorce brought into his/her life.

  3. The ability of the child to express his positive and negative thoughts and the social areas s/he succeeds in [16].

Nursing Attempts

  • The child is allowed to express his/her emotions about divorce through medium of emotion cards, pictures or puppet games.

  • The changes that the divorce may bring into the child’s life are explained through illustrative materials and the changes in the life of the child are discussed.

  • The child is allowed to define himself/herself through various games s/he could be fond of according to the age group and to become aware of her/his positive traits via such activities; therefore, the advantages of sparing time for the activities s/he is talented in or does with delight, such as sports, music, etc., are discussed [16].

7. Change in interparental processes

Divorce causes a number of changes within the present family structure and functioning and also brings about the separation of the family members, leading to the formation of a single-parent family. The changes taking place in the life of the child along with his/her parents’ divorce (Moving to another house, a new school, living in two different homes, spending less time with the parent, etc.) are the situations that are difficult to accept. All these transformations also cause a change in the interparental processes [17]. The objectives and the general nursing attempts to be performed for this diagnosis are as follows:


  1. The ability of the child to express and become aware of the changes/transformations s/he has experienced in the wake of divorce.

  2. The ability of the child to reveal his/her emotions regarding the changes experienced.

  3. The ability of the child to comprehend that there are different types of families.

  4. The ability of the child to describe her/his emotions about the family members s/he is living with and those s/he is away from.

  5. The ability of the child to arrange the frequency of the meetings with her/his parent living away [17].

Nursing Attempts

  • The experiences of the child are discussed by making use of the books which describe the changes that the kids of the divorced families undergo. As the result of these changes, the emotions experienced by the child are discussed through the group process.

  • By using the pictures illustrating different family types, the structure of a single-parent family is focused on, and the child is aided to reveal his/her feelings about this.

  • By co-operating with the parents after divorce, the responsibilities undertaken by both parents in regard to the child’s routine activities (Going to school, seeing the parent who lives apart from him/her,etc.) are reviewed, and the child is assisted to balance the frequency and period of the meeting with the separated parent.

  • The child is encouraged to talk about his/her feelings and thoughts related to the parent living away from him/her [17].

8. Insufficiency in individual coping

With the divorce, the children experience the feeling of losing both their mother and father.

The fact that one of the parents leave home during this period and the changes in the new school environment, new friends and the house order make it difficult for the child to adapt himself/herself to these changes and they negatively affect their skill to cope with such issues [16]. In such a period of time, the objectives and the general nursing attempts to be performed for supporting the child in coping with the problems can be as follows:


  1. Allowing the child to become aware of the methods s/he uses in coping with the divorce and to express them.

  2. Allowing the child to define the concept of problem solving and to sequence/sort the problem solving steps.

  3. The ability of the child to comprehend the realtionships between problems, resolutions and emotions.

  4. Allowing the child to become aware of the problems s/he can solve in his/her life and those s/he cannot.

  5. Allowing the child to comprehend the ways of coping with problems that s/he is unable to solve [16].

Nursing Attempts

  • The problems experienced by the child with respect to the divorce are reviewed, and the ways to cope with them while solving them are discussed.

  • The best and the most proper method to cope with issues are stated to be problem solving ones, and by using the illustrated materials, the problem solving steps and their relationship with the emotions are discussed.

  • How various issues encountered in his/her daily life can be resolved through the problem solving steps is discussed.

  • Several cards on which the problems to be experienced by the children of the divorced parents are written are prepared, and the child is made to exercise the problem solving skills through games [16].

  • The child is helped to understand that there may be problems in his/her life that s/he can solve as well as those s/he will be unable to solve. (Re-union/re-marriage of the parents, providing reconciliation between them, etc.).

  • It is explained through the examples of real life events that people may get offended or enraged against the problems they are unable to solve; however, anger or rage can, of course, be expressed in a constructive way, as well [16].

9. Failure in social relationships

Divorce and the changes it brings along affect the social relationships in a negative way as well as the the child’s interaction within the family circle [16]. The objectives and the general nursing attempts to be performed for this diagnosis are as follows:


  1. The ability of the child to share his/her feelings about the divorce with his parents.

  2. Allowing the child to comprehend the importance of the regularity and permanency of the days when s/he is together with her/his parent living apart and the one living with her/him.

  3. Allowing the child to take part in the events that may improve his/her social relationships [16].

Nursing Attempts

  • Following the divorce, the importance of sharing feelings with parents is discussed, and the child is encouraged about the importance of sharing his/her emotions with his/her parents in that matter.

  • Discussing with the child about the necessity and importance of establishing positive relationships with the parent living apart and the one living with him/her together. In this case, both parents are worked with in coordination, and the necessity of the quality time they spend together with their children and its positive effects on children are explained.

  • The child is encouraged/motivated to participate in the activities s/he is interested in, both within and outside the school [16].

As a result, the nurses help the children of the divorced families cope with the crisis they experience in their lifetime by dealing with the problems the children undergo through the nursing process; thus, they can also assist the future generations to grow up as healthier and more conformable individuals that have acquired skills in coping with the problems of life [15].


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