Table 1.

Synoptic Results Table

	Participants
Themes	Denise 8a	Justin 5a	Delani 1a
Memories of Experiences Leading up to the Suicide	Despite awareness of parents’ marital issues and father’s depression, recalls words of reassurance that he loved her.	Described his father as being emotionally unavailable to Justin and his siblings as well as being physically absent from home.	No personal memories, mother describes to Delani that her father went through what seemed like a goodbye ritual the morning of his death.
Memories of Finding out About the Suicide	The day Denise found out about the suicide, she was going to go visit her father at her grandparents’ home. Although she had the initial impulse to check the grandparent’s barn for her dad, Denise decided instead to go to her aunt’s house, to play with a cousin when she heard sirens from five or six cop cars Denise and her aunt were among the first to arrive at the house after the emergency vehicles. Denise asked the police officers what happened. One officer, not realizing the victim was Denise’s father said’Yeah, he’s dead. You need to go away.’ Denise had a difficult time believing he was dead.	Justin remembered being at his grandparent’s house not feeling concerned as he and an uncle searched for his dad. After searching the basement, the search continued outside in the barn. Justin was behind his uncle and felt something was terribly wrong when his uncle yelled, ‘Go home! Run home now!’ Terrified, Justin started running, thinking there was a monster in the barn. Hours later, Justin’s mother came home and told the children their father was dead and young Justin’s first reaction was to ask, “Who killed him? Was it the monster in the barn?”	Delani grew up knowing her father had died, but not knowing the cause of death was suicide until she was much older. The information Delani gleaned about the suicide was bits and pieces her mother shared with her across time.
Memories of Mother’s Support	Although her mother spoke to her about her father’s death, Denise did not receive professional counseling in the aftermath of her father’s suicide. While trying to make sense of her father’s death, Denise simultaneously witnessed her mother’s emotional reaction to the suicide. Following the suicide, as time passed, a pattern of Denise wanting to reach out, support, and comfort her mother continued.	Justin did not remember much support available to him. He describes a gradual process over time of learning that his father died by suicide. Even after being told that his father died by suicide, young Justin continued to have questions about his father’s death. Eventually, Justin’s mother was the one who answered his questions of Why? She explained that his father struggled with mental illness.	Delani worried that she had somehow contributed to her father’s death. Hearing stories of how difficult Delani was as a baby, exacerbated the feeling that she was somehow responsible for causing her father to complete suicide.
Memories of Support Following Mother’s Remarriage	Denise identified her mother’s remarriage a year after her father’s suicide, as healing and supportive for her and the family.	Justin described his mother’s remarriage soon after his father’s death as positive.	Delani attributed her mother’s hasty remarriage as a necessity due to her mother having small children and limited financial resources. Although Denise reports the mother remarrying after a year, Delani reported that her mother remarried “within six months.”
Memories of Religious and Spiritual Support	Denise described how her faith community offered support in the form of meals, money, and visits. Following her father’s death by suicide, Denise also found comfort in spiritual dreams in which her father was present. Denise expressed her beliefs that she would see her father again and that he continually watched over her.	In contrast to Denise, Justin did not seem to find the same solace in his religious beliefs. A Sunday School teacher’s quick matter-of-fact response that his father could not go to heaven, fueled Justin’s fear that he would never see or be close to his father again.	In coping with her father’s suicide, Delani did not specifically identify faith or religious beliefs as helpful or unhelpful.
Memories of Support from Extended Family	Denise pointed out extended family members specifically being an important source of love and support following her father’s death and felt surrounded by extended family members’ loving help.	Unlike Denise, Justin did not perceive his extended family as being helpful or very supportive. He recalled his father’s brother blatantly blaming Justin’s mother for the suicide. The anger and resentment were to the point where at the time of the interview Justin had not interacted with his father’s side of the family in many years.	Delani not only described extended family as not supportive, she disclosed suffering long term abuse perpetrated by an extended family member.
Memories of Support from School Community and Neighbors	Denise felt supported by classmates, teachers, neighbors, and people in her school community.	Justin suggested that returning to school quickly helped to normalize his life after the suicide.	Delani did not talk about school or community support to her or her family after her father’s suicide.
Ongoing Challenges After the Suicide	Although Denise felt loved and supported by her family, had a positive experience with her mother’s remarriage, and felt that her faith supported her after her father’s death, she still felt shame when people asked about her father’s death.	Justin had difficulty in knowing how to tell others of his father’s death. He continues to deal with ongoing resentment towards his father. He also continues to question his own bereavement process.	Delani focused on dysfunctional extended family relationships following the suicide, such as the long-term negative effects of the abuse perpetrated by her male cousin.
Survivors’ Response to Children’s Books	Denise immediately identified with the explanations about chemical imbalances in the brain as a factor in a person choosing to die as explained in After a Suicide: An Activity Book for Grieving Kids. Denise appreciated the metaphor in, The Little Flower Bulb. She indicated that the idea of endowing a growing, living object with the memory of the father who died by suicide, was positive and seen as potentially helpful for CSoPS.	Justin displayed a strong negative, visceral reaction to The Little Flower Bulb. As soon as Justin saw the cover of the book, he immediately reacted negatively to the illustration style. The book’s cover included an illustration of a small boy surrounded by flowerpots and a toy bear. The boy’s head was tilted to one side. This was particularly off-putting for Justin who connected a cause of death to the dead-looking boy on the cover, based on the boy’s body posture. Justin went on to say that the overall feeling of the illustrations was completely negative.	Delani was drawn immediately to the mom in The Invisible String telling the children that no matter how she feels whether angry or not, their connection could never be broken. Delani also responded positively to the idea of the invisible string applying to separations caused by death and other traumatic situations. In contrast to her older sister Denise, Delani had a strong negative reaction to After a Suicide: An Activity Book for Grieving Kids. She described this book as very “cold.”

^aDenotes age of participant at the time of the father’s death