The nurse sees it first 1
Jolene Oppawsky, PhD, LPC, ACS, DAPA, RN
University of Phoenix Faculty
Social Sciences
Tucson Campus
3824 N. Soldier Trail
Tucson, Arizona 85749
Tel: 520 7493469
[email protected]
The Nurse Sees it First
The Effects of Parental Divorce on Children and Adolescents
Abstract
The high divorce rate involves, and negatively affects, many children and adolescents. Studies
and clinical reports of the effects of divorce on children show that these children and adolescents
respond to parental divorce with an array of symptoms. Nurses are some of the first professionals
to see these reactions. Identifying symptomatology as an effect of divorce on them is the first
step toward dealing with and ameliorating these effects. The nurses’ requisites for ameliorating
and intermediary functions are identified.
Keywords: divorce, children, adolescents, symptomatology of divorce, nurses’ requisites
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The Nurse Sees it First
The Effects of Parental Divorce on Children and Adolescents
Identifying Symptomatology as an Effect of Divorce on Children
The high divorce rate involves, and negatively affects, many children and adolescents.
Studies and clinical reports of the effects of divorce on children and adolescents show that these
children and adolescents respond to parental divorce with an array of symptoms. Nurses at every
level are some of the first professionals to see the effects of divorce on them. Major goals of the
nurse are to identify and expose the symptoms of children and adolescents seen in the nursing
arena as effects of divorce. Nurses can then facilitate the prevention of psychological and
physical damages, repair damage already done, and facilitate the children’s normal growth from
infancy to adolescence and adult years (Oppawsky, 2000).
Significant Symptomatology
Nearly all children and adolescents react to and are affected by parental divorce;
therefore, age is not a safeguard against effects experienced by children (Cohen, 2002; Harvey &
Fine, 2010; Wallerstein & Lewis, 2004). Although the number of children under one year of age
subjected to divorce is not well researched, the notion that even small infants react to parental
divorce is supported by reports of parents and professionals (Clarke-Steward, Vandell,
McCartney, Owen, and Booth, 2000; Cohen, 2002; Oppawsky, 1987, 1989, 1991, 1999).
Children’s reactions to divorce seem to be of three types. The first type are those reactions that
appear to be normal reactions to the crisis, such as fear, anger, grief, and yearning for the
departed parent, and for a family in general. The second type are those reactions that appear to be
age-specific, exaggerated behaviors, such as increases in obstinate behaviors, masturbation, and
aggression in younger children, and strategic physical, and emotional distancing, and changes in
child-parent relationships by older children and adolescents. Third are those reactions that
suggest psychopathology, such as night terrors, tics, enuresis, depressive signs, and symptoms,
regression, and failure to cope (Oppawsky, 1989, 1991; 2009).
Early work by Longfellow (1979) substantiated by later studies (Clarke-Stewart, et al.,
2000; Pagani, Boulerice, Tremblay, & Vitaro 1997; Japel, Tremblay, Vitaro, & Boulerice, 1999;
Roseby & Johnston, 1998) among others, show that professionals and researchers on divorce
understand that developmental and age-related patterns correspond with children and
adolescents’ responses to divorce. Therefore, a developmental perspective helps to conceptualize
the effects of divorce on them. An understanding of the children’s or adolescents’ ongoing
lifespan development (Santrock, 2010) and how the process mediates the divorce experience for
children, as well as how their ongoing development is mediated by the process is necessary. A
The nurse sees it first 3
developmental perspective also helps in preparing a treatment plan to ameliorate the effects and
aids in follow-up and discharge planning.
Some specific examples of the connection between lifespan development and the children
reactions to divorce are seen in the different age groups (Oppawsky, 1989, 1991). The infants
from birth to one year react to parental divorce with, among other symptoms, irritability, increase
in crying, increase need for physical contact, and acute separation anxiety, just as person
permanence is developing before object permanence (Bell, 1970). Also diffuse attachments shift
to specific attachment (usually the mother) at about six months. Basic trust versus mistrust is
developing as well where a sense of trust, usually toward the mother or caretaker parent, depends
on his or her ability to meet the infant’s needs (Erikson, 1963; Santrock, 2010). The children
from one to three react with clinging behaviors, calling, and searching for the missing parent,
need for proximity to and physical touching by the parent who had custody, and more serious
reactions such as night terrors (Herzog, 1980), tics, and other psychosomatic reactions. At these
ages, parental divorce comes at a time when Mahler’s (1968, 1975) separation-individuation,
rapprochement process is in force, which means that there must be a normal movement from the
symbiotic relationship with a caretaker, usually the mother, toward separation, and individuation.
According to Erikson’s (1963) stage of autonomy versus shame and doubt, children at these ages
should be establishing their independence by developing a sense of self-control and autonomy
with parental support. Children from three to six respond with similar reactions that the younger
children have. Some are late to potty train or experience relapses. Children three to six express
themes of sadness, aggression, death in their play, and imitation of behaviors of reactions
displayed by the divorcing parents such as yelling, screaming at one another, and fighting
(Oppawsky, 2000). These reactions come at a developmental stage where the Oedipal conflict is
played out. This means that the child is struggling to move away from a dyad system between the
mother and child to a triad relationship between the child and the parents. The superego
development is in its final stage (Freud, 1923, 1924), which means that the children have
developed a conscience and form ideals. They also can self-observe their behaviors and make
judgments for themselves. Supporters of Erikson’s stage theory think children are confronted
with the hurdle of initiative versus guilt during these ages where they identify with the parents
because they are powerful; they want to be like them, and to imitate them. The children from six
to 12 respond with an array of reactions that affect their normal development, such as reaching
school age, and attending school but experiencing lack of concentration, nervousness in school,
and lower academic success. Additionally, the children in this age group experience feelings of
hopeless, helplessness, sadness, and depression. They have lapses in toilet training, and
experience enuresis, and nail biting. Also tempers flare, and they experience anger and hate
feelings toward both parents. Loyalty ties are strained. Some children have bad dreams and
feelings of not being loved or lovable, among a host of other negative reactions, such as
emotional and physical distancing from the situation and the parents, intensified sibling
aggression, secret crying, and acceptance of faulty roles by trying to help the parents cope with
the situation (Oppawsky, 1998). Adolescents ages 12-18 are in puberty, their self-image is under
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stress, and there is a shift in focus from same-sex groups to opposite-sex groups, then to opposite
sex peers. Sexual maturity is achieved in the older adolescents. These adolescents experience
sexual acting out, tics, enuresis, angst, and some bad dreams, to name just a few negative
reactions to parental divorce (McCormick & Kennedy, 2000; Oppawsky, 1998). “At all ages,
children frequently have psychosomatic symptoms as a response to anger, loss, grief, feeling
unloved, and other stressors” (Cohen, 2002, p. 1020).
The Role of the Nurse
Many children and adolescents’ reactions to divorce mimic reactions to or symptoms of
physical ailments and illnesses. Because of the nature of the effects of divorce on children and
adolescents and their reactions, nurses in many areas of nursing are some of the first
professionals to see these effects and reactions. The health facility is the focus of attention for
many people, a community focal point. Parents and children may even seek out the facility or
nurse for help with problems stemming from the divorce. Thus, the medical faculty can become
a resource center for dealing with the problems that face these family members. The important
tasks for all nurses, whether they find themselves in well-baby clinics, in the home, on pediatric
or adolescent units, or in mental health faculties are to identify and assess these effects and
reactions as stemming from parental divorce. By correct identification of the etiology of
symptoms and assessment of the children and adolescents’ reactions, nurses provide appropriate
nursing for these patients, and education for their parents as well as direct amelioration for their
problems. This means that the nurse becomes a vital force in the lives of these patients.
Nurses’ Ameliorating and Intermediary Functions
There are several requisites for nurses to accomplish the ameliorating or intermediary
functions. These are:
1. The nurses at every level and in all medical facilities must be aware of the symptoms
children and adolescents experience arising from parental divorce. This can be
accomplished by keeping abreast of the newest literature on the effects of divorce on
these patients and their reactions to divorce. Continuing education and workshop or
seminar participation is mandatory for nurses.
2. Nurses should focus their efforts on identifying the reactions and their causes, as well as
what factors positively or negatively affect adjustment.
3. Nursing care should not only include ameliorative measures but also education of the
children or adolescents and their parents.
4. Nurses should be aware that age is not a safeguard against negative effects of divorce on
these patients.
5. An understanding of the children and adolescents’ ongoing development and how this
process mediates the divorce experience for them, as well as how development is
mediated by divorce is mandatory.
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6. Nurses must provide in-services to instruct medical personnel at all levels to identify
responses and assess effects of divorce on these patients.
7. Nurses need up-to-date knowledge of available community agencies and resource centers
dealing with the problems of divorce to facilitate referrals and follow-ups.
8. Future nursing research projects are needed which investigates the effects of divorce on
children and adolescents seen in the nursing arena. Research projects on adults and
families of divorce are also needed.
9. Future nursing textbooks, Internet articles, and peer-reviewed articles should include the
dynamics of divorce, children’s and adolescent’s reactions to divorce, and the effects of
divorce on them; as well as the role of the nurse in treatment.
Conclusions
The spiraling divorce rate involves and negatively affects many children and adolescents.
Studies and clinical reports on the effects of divorce on them show that these children and
adolescents respond to parental divorce with an array of symptoms. Nurses are some of the first
professionals to see these reactions. Identifying symptomatology as an effect of divorce on these
children and adolescents is the first step toward dealing with and ameliorating these effects.
Many old and new studies on the effects of divorce on children and adolescents provide evidence
that developmental and age-related patterns correspond with the children and adolescents’
responses to divorce. These range from expected reactions to the stress of parental divorce such
as fear, anger, grief, and yearning for the departed parent, and a family in general to
magnification of age-specific behaviors. These include increases in masturbation, obstinate
behaviors, and aggression in younger children, and in older children and adolescents, strategic
physical, and emotional distancing from the situation and the parents. Other changes in childparent relationships were evident, such as the older children and adolescents assuming faulty
roles in the family. The most severe reactions such as night terrors, enuresis, depressive signs,
and symptoms, regression, and failure to cope with the situation indicate psychopathology.
Therefore, a developmental perspective helps to conceptualize the effects of divorce on them. An
understanding of the children’s and adolescents’ ongoing lifespan development (Santrock, 2010)
and how the process mediates the divorce experience for them as well as how their ongoing
development is mediated by the process is necessary. A developmental perspective also helps in
preparing a treatment plan to ameliorate the effects and aids in follow-up, and discharge
planning. Nurses are prime professionals to do this because of their education in lifespan
development, their diagnostic training, and their experiences in clinical practice.
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Dr. Oppawsky
Dr. Oppawsky is a faculty member at University of Phoenix, Tucson, Arizona, and a faculty
advisor for the Master’s of counseling students. Dr. Oppawsky teaches a full array of counseling
courses in the graduate program, and selected courses in the undergraduate program in Human
Services. She also teaches graduate and undergraduate courses in Psychology at the University of
Phoenix. Formerly, she supervised the LPN to BSN students in their mental health clinicals.
Before joining the UOPX faculty, she taught counseling for Boston University in the overseas
program and has taught psychology courses at the University of Warsaw, Poland, and at the
University of Lithuania.
Dr. Oppawsky has her PhD in Clinical Psychology from the Elite University of Munich,
Germany, and a Master’s degree in Counseling and a Master’s degree in Human Services from
Boston University. She is a licensed Clinical Psychologist and a licensed Psychotherapist in
Germany. In the USA she is a licensed professional counselor and a Diplomate member of the
American Psychotherapy Association. She is a registered nurse in Arizona.
Dr. Oppawsky has years of clinical experience abroad, and in Tucson, with diverse populations
and several professional publications to her credit.