Chapter 12 Homicide

Death by homicide--the act of one individual willfully killing another--profoundly affects the mental and physical well being of family members and friends of the murdered victim. Its impact, however, quickly expands to include agents of the criminal and juvenile justice systems, allied professionals, victim service providers and caregivers, and the public-at large. This chapter will discuss homicide in the context of the relationship that develops between the murder victim, the victims' family members, and the murderer upon notification of the death to family members, addressing the manner in which they are informed and the types of trauma that can be anticipated. It will consider the specific ways in which homicide is perceived by society, adjudicated by the criminal and juvenile justice systems, and treated by the media; and it will explore research and clinical findings regarding homicide and bereavement. Finally, the chapter will offer promising practices for treatment and support of those most directly affected by homicide.

Upon completion of this chapter, students will understand the following concepts:

• The scope and circumstances of homicide, along with elements unique to the homicides of loved ones that negatively impact co-victims.

• The dynamics of death and spirituality.

• The impact of homicide upon co-victims and their response to it.

• Common problems of co-victims.

• The victim service providers' responses to homicide co-victims and promising practices for the treatment and support of homicide co-victims.

• In 1997, the estimated number of persons murdered in the United States was 18,209. The 1997 figure was down 7% from 1996 and 26% from 1993 (FBI 1998).

• As compared to 1996 figures, reported murders in 1997 dropped 9% in the nation's cities, 7% in suburban counties, and 2% in rural counties. The greatest decrease, 13%, was registered in cities with populations of 250,000 to 499,999 (Ibid.).

• All four regions of the United States showed declines in the number of murders reported from 1996­1997. The greatest drops were in the Northeast and West, which experienced a 12% and 11% decrease in reported murders, respectively. Reported murders decreased in the South by 6% and in the Midwest by 3% in 1997 (Ibid.).

• Down 10% from 1996, the national murder rate in 1997 was 7 per 100,000 inhabitants, the lowest since 1985. Five- and ten-year trends show the 1997 murder rate was 28% lower than in 1993 and 19% below the 1988 rate (Ibid.).

• Based on supplemental data about 15,289 of the estimated 18,209 murders in 1997: 77% of the victims were males and 88% were persons eighteen years of age or older. Forty-four percent were ages twenty through thirty-four. The percentage of whites murdered was 48%; African-Americans, 49%; and other races accounted for the remainder (Ibid.).

• In 1997, according to supplemental data reported for 17,272 offenders, 90% of the offenders for whom sex, age, and race were reported were male, and 87% were persons eighteen and older. Seventy percent were ages seventeen to thirty-four. Of offenders for whom race was known, 53% were African-American, 45% were white, and the remainder were persons of other races (Ibid.).

• Data indicate that murder is most often intraracial among victims and offenders. In 1997, data based on incidents involving one victim and one offender show that 94% of the African-American murder victims were slain by African-American offenders, and 85% of white murder victims were killed by white offenders (Ibid.).

• Males were most often slain by males (88% in single victim/single offender situations). These same data show, however, that nine out of ten female victims were murdered by males (Ibid.).

• As in previous years, firearms were used in approximately seven out of every ten murders committed in the nation in 1997 (Ibid., 1).

• In 1997, over 48% of all murder victims knew their assailants: 13% were related and 35% were acquainted. Fourteen percent of the victims were murdered by strangers, while the relationships among victims and offenders were unknown for 38% of the murders (Ibid., 17).

• Sixty enforcement officers were feloniously slain in the line of duty during 1997, ten more than in 1996 (Ibid., 296).

• Most child murders in 1994 were at the hands of an acquaintance (38%) with family members accounting for 22%, strangers 7%, and unknown offenders 33% (Greenfield 1996).

• Since the mid-1980s, increases in murder among fifteen- to seventeen-year-olds, particularly African-Americans, have outpaced murder in all other age groups (Ibid.).

• About 25% of homicide offenders reported that they were severely intoxicated at the time of the offense. Estimates of their blood alcohol content were 0.22 for probationers, 0.26 for jail inmates, and 0.28 for state prisoners (BJS 1998).

The toll murder takes in the United States is enormous. The magnitude of sorrow is incalculable.

-- Mary White

Homicide is an outrage. It includes all deaths caused by willful murder and nonnegligent manslaughter. It stuns, terrifies, angers, pains, frustrates, and mystifies society, which is repelled by its cruel indignity yet drawn to it as a never-ending source of voyeuristic entertainment. Homicide universally embraces our strongest emotions, our sense of justice, and our concept of death. Most singularly, homicide devastates and unhinges the lives of family members, friends, neighbors, co-workers, and acquaintances of the murdered victim.

We have come to recognize that family members and individuals who had special ties of kinship with murdered victims experience a complex and complicated range of reactions to the deplorable act of homicide. While the term survivor describes the circumstances that family and friends enter following the homicidal death of a loved one, the term generally used to describe the level and intensity of their reactions is "co-victims" of homicide.

The term "co-victim" will be used to emphasize the depth of the homicide infliction. In the aftermath of the murder it is the co-victim who deals with the medical examiner, the criminal or juvenile justice system, and the media. The term co-victim may be expanded to any group or community that is touched by the murder: a classroom, a dormitory, a school, an office, or a neighborhood. Most of the individuals who make up these communities are wounded emotionally, spiritually, and psychologically by a murder, some more deeply than others.

A number of studies conducted on bereavement experienced after homicidal death indicate that co-victims of homicide experience vicarious trauma associated with the murder. On the psychological and mental levels, trauma refers to the wounding of one's emotions, spirit, will to live, beliefs about self and the world, dignity, and sense of security (Matsakis 1996). Co-victims find that their normal ways of coping and handling stress in the past are no longer effective. Co-victims of homicide are initially confronted by the helplessness and finality of the unexpected, unwarranted, and undeserved death of a loved one. The ensuing collection of perceived or actual insensitivities, indignities, and intrusions imposed by police, prosecutors, media, family, and friends constitute an additional wounding. Secondary wounding also occurs when the people, institutions, caregivers, and others to whom the trauma co-victims turn for emotional, legal, financial, medical, or other assistance respond by discounting, denying, and disbelieving (Matsakis 1996).

No one is exempt from the complexities associated with homicide. For law enforcement, homicide presents the dual challenge of regard for and attention to the investigation of the murder events while, at the same time, recognizing and addressing the overriding needs of co-victims of homicide. Law enforcement must become more attentive to the needs of co-victims and more collaborative with victim service providers. To be more effective, victim service providers must be knowledgeable about reactions and needs of victims as well as the investigative and judicial processes involved in homicide cases.

Studies show that great numbers of people in America have experienced the death of an immediate family member, relative, or close friend to criminal homicide, including violent deaths caused by drunk driving. This does not include the multitudes of people traumatized by exposure to reports of killings in the press. Most people in the United States have experienced, in a vicarious or secondhand way, hundreds, perhaps thousands of violent or traumatic deaths. As each murder is served up in the media for information, evaluation, or sometimes just entertainment, there remains a population of grieving and often forgotten co-victims of homicide who may be consumed by rage and saddled with pain.

In order to understand the breadth and depth of homicide, it is necessary to recognize that

(1) death by homicide differs from other types of death due to a number of specific reasons and (2) cultural attitudes toward death and spirituality influence societal perceptions of homicide. Just as there are unique physical, mental, emotional, social, and financial components to every sudden death, there are spiritual ramifications as well. Those who have never thought much about God before will often do so after a loved one has died under traumatic circumstances. Persons of faith who assume that what happens to them is God's will are forced to reshape their faith positions to incorporate the fact that bad things do indeed happen to good people (Lord 1996).

We have been conditioned throughout the ages to accept that each life is destined for the inevitability of death, which is as natural and predictable as birth. The normal repetitive circumstances of death are disease and old age. When death is due to the unnatural circumstance of homicide, it is sudden and without forewarning. It is now widely accepted that there are specific elements associated with homicidal deaths that distinguish the impact upon the surviving family members from other forms of dying. They include:

• The intent to harm. One of the most distinguishing factors between homicidal death and other forms of dying is the intent of the murderer to harm the victim. Co-victims must deal with the anger, rage, and violence that has been inflicted upon someone they love.

• Stigmatization. Because society sometimes places blame on murdered victims for their own death which translates into blame on the victim's family when it is believed that they should have controlled the behavior that led to the death, "co-victims of homicide often feel abandoned, ashamed, powerless, and vulnerable" (Redmond 1989).

• Media and public view. Regardless of public sympathies surrounding homicidal deaths, they almost never remain private. Co-victims are quickly thrust into public view and become fair game for public consumption. While some journalists exercise consideration and objectivity in their reporting of homicidal events, the degree of intrusion into the lives of co-victims of homicide constitutes a major homicide differential.
• Criminal or juvenile justice system. Unlike family members of individuals who die of natural deaths, co-victims of homicide are the most likely population of victims to be thrust into a complex system of legal players and jargon. Co-victims must quickly become acquainted with a world of crime scenes, evidence, and autopsies. Co-victims of homicide have much to learn about the investigative, prosecutorial, and judiciary branches of the criminal justice system in a very short time. They are often expected to quickly comprehend a system that may in some instances be insensitive and specifically designed to protect the rights of the accused (with little regard for the victim). In addition, co-victims may encounter many cognitive and environmental stimuli that remind them of the crime such as contact with the defendant and/or reviewing the traumatic details of the crime in the courtroom. This experience often results in the kind of avoidance behavior that leads co-victims to cancel or not show up for appointments with criminal justice system officers or victim advocates.

• Bereavement. As early as 1983, E. K. Rynearson, M.D., determined that bereavement after homicide is so prevalent that it deserved clinical attention. His clinical studies involving the family members of murder victims revealed that all of his subjects had previously experienced bereavement following the natural death of a relative; and the psychological processing of homicide was accompanied by cognitive reactions that differed from previously experienced forms of bereavement. Rynearson's research forms the basis for the shift from viewing the co-victims' grief issues separate and apart from the impact of trauma associated with the death of a family member. Traumatic grief over homicidal death distinctly differs from other forms of grief.

Homicide begins as an act. It is committed under individual conditions, within certain parameters, and eventually classified into general categories. Each case has its own circumstances that vary as greatly as each single act. Victim service providers working with co-victims should be knowledgeable about some of the general types of homicides.

SPOUSAL HOMICIDE

The killing of a spouse, life partner, or other significant individual of the same or opposite sex with whom one has lived for some time and formed a stable relationship.

The FBI reported in 1997 that twenty-six percent of female homicide victims are slain by husbands or boyfriends, and three percent of male victims are slain by wives or girlfriends. Among legally married persons, regardless of geographic region in the U.S., African- American females were at greatest risk of being killed by African-American spouses or partners. Specifically: in the West, African-American males were eleven times more likely to be victims of spousal homicide than white males, almost seven times more likely than white females, and 1.4 times more likely than African-American females. (Segall and Wilson 1993).

In a study by Christine Rasche (1993) of 155 "mate" homicides in Jacksonville, Florida, between 1980 and 1986, the most salient motive for spouse murder was possessiveness (48.9%) that included the inability of the offender to accept the termination of the relationship and/or the sanctity or security of the relationship (jealousy, infidelity, and rivalry). Feelings arising out of arguments (20.7%) and self-defense (15.5%) were second and third principal motives respectively.

CHILD HOMICIDE

The killing of a person under the age of eighteen.

Sixty percent of child murders in 1994 were at the hands of family members (22%) or acquaintances (38%). During this year, 11 percent of all murder victims were under the age of eighteen (Greenfield 1996).

Based on forty-five states reporting in 1996, the National Center on Child Abuse and Neglect (1997) states that 996 children were known to have died as a result of abuse or neglect. The majority of these deaths were children three years of age or younger.

Pediatric deaths as a result of handgun violence have also risen as an issue of significant concern during the last few years. Between 1980 and 1994, pediatric (age zero to nineteen) firearm deaths in Chicago more than doubled from 116 to 247 (Chicago Department of Public Health 1995). The greatest increases were between 1987 and 1994. In 1994, 306 teens between the ages of fifteen and nineteen died in Chicago from all causes. Of these, 70.5 percent (216) were caused by firearms. African-Americans predominated the Chicago firearm deaths, both as perpetrators and victims. Of the 216 firearm deaths in this age group, 195 of the victims were African-American. Other large cities with gang problems report similar increases in pediatric firearm deaths.

SHAKEN BABY SYNDROME

The violent shaking of a young child that causes permanent brain injury or death.

Because shaken baby syndrome is still a relatively new classification of death or injury, it is difficult to say for certain how many children are victims of it each year. However, one source reports that 10 to 12 percent of all deaths due to abuse and neglect are attributable to the syndrome (National Information Support and Referral Service 1998). Perpetrators of shaken baby syndrome are about 80 percent male--37 percent biological fathers and 20.5 percent boyfriends. The remaining 17.3 percent were female babysitters, and 12.6 percent biological mothers. Sixty percent of the victims are male. Between 1,000 and 3,000 children are diagnosed with shaken baby syndrome every year, and about 100 to 120 of them die. Outcomes for victims who live include cerebral palsy, blindness, deafness, seizures, learning disabilities, and vegetative states (Shaken Baby Alliance 1998).

PARRICIDE

The killing of one's parent.

The Bureau of Justice Statistics reports in the study Murder in Families (Dawson and Langan 1994) that 1.97 percent of murder victims were killed by their children. This translates to about 300 cases per year. Relatively rare when compared to other forms of homicide, parricide has begun to attract the attention of family violence researchers.

In a review of ten studies that examined adolescents who had killed their parents, Kathleen Heide (1993) discusses three types of parricide offenders: the severely abused child, the severely mentally ill child, and the dangerously anti-social child. She points out that ascertaining the driving force behind a parricide is complex but factors in the family that often contribute to the homicides include a pattern of violence, easy access to guns, and alcoholism or heavy drinking. Adolescent offenders expressed helplessness in coping with stress in the home and feelings of isolation and suicidal ideation. They had failed in their attempts to get help with little (if any) adult intervention, and had failed in their efforts to escape, with a history of running away.

Heide (1993) acknowledges that adolescent parricide offenders do include the severely mentally ill and dangerously antisocial, but in smaller frequencies compared to severely abused children. Components of child maltreatment pervasive in some families that also may lead to parricide are physical, sexual, emotional, and verbal abuse, and physical, medical and emotional neglect.

Weisman and Sharma (1996) found in their more recent review that of sixty-eight parricide cases, 69 percent of the offenders had a prior inpatient psychiatric hospitalization with diagnoses of psychosis (usually schizophrenia or schizo affective disorder); 74 percent had known criminal convictions; and 64 percent had been convicted of a violent crime.

STRANGER HOMICIDE

The killing of a person or persons by an individual unknown to the victim.

In 1993, for the first time in history, Americans were more likely to be killed by a stranger or unknown killer (53% of cases) than by a family member of friend. By 1996, the trend had reversed slightly with 49 percent of homicide victims killed by strangers (FBI 1998).

MASS MURDERS

The murder of several victims within a few moments or hours of each other.

Currently in the United States, there is approximately one mass murder per week, including public homicidal events in shopping malls, government offices, schools and random street shootings as well as families annihilated by a troubled parent or sibling. Although researchers have only begun to collect data on mass murders, certain commonalties have begun to emerge (Hickey 1991). The offenders are primarily white, male, and span a wide age range; they use semiautomatic guns and rifles to kill swiftly; and their victims are often but not always intentionally selected by the killer.

Those who commit multiple homicides appear to do so in an irrational effort to regain, even for a brief moment, a degree of control over their lives. To the observer, the severe mental imbalance behind these horrible acts is clear. To the killer, however, his or her thoughts and actions may make perfect sense, given his or her psychological disorientation. Feelings of rejection, failure, and loss of autonomy create frustrations that inevitably become overwhelming, and the murderer cultivates a psycho-pathological need to strike back.

SERIAL KILLING

An offender who kills over time. They usually have at least three to four victims, and their killing is characterized by a pattern in the type of the victims selected or the method or motives used in the killings.

Serial killers include those who, on a repeated basis, kill within the confines of their own home, such as a woman who poisons several husbands, children, or elderly people in order to collect insurance. They may operate within the confines of a city or a state, or even travel through several states as they seek out victims. Some murderers select their victims because of their status within their immediate surroundings such as vagrants, prostitutes, migrant workers, homosexuals, missing children, and single and often elderly women.

Some argue that anyone who kills, especially serial killers, must be mentally ill. However, the vast majority of serial killers are not only judged sane by legal standards, but are indistinguishable from non-offenders as they move about and within our communities.

To better understand the homicide differential, the phenomenon of death in society should be examined. Definitions, descriptions, and interpretations of death have been around since the beginning of recorded time. There is no absolute explanation for death as each culture offers its own interpretation. Nevertheless, death is ingrained in an individual's beliefs, values, and thinking and determines how he or she experiences life. One's spiritual values of life are shaped by one's attitudes about death. Different views of death, as in different religions, influence the lives of those who hold those views. Attitudes about death are complex because death is so integral to human life that its finality without spirituality is difficult to accept.

Co-victims of homicide often express that they feel disconnected from the universe, explaining that all previous means of coping are no longer effective in light of the unfair death of a family member. Co-victims often relate instances of extreme anger and betrayal by God. For them, death due to homicide defies all that is meaningful in society. Responding to the special needs created by the death experience requires careful attention from caregivers.

There are always two parties to a death; the person who dies and the survivors who are bereaved . . .

-- Arnold Toynbee

In order to explore the impact of homicide on the lives of co-victims, the trauma, grief, bereavement, and their resultant impact on co-victims must be explored. Grief is a normal response to loss. The word "grief" signifies one's reaction, both internally and externally, to the impact of the loss. The term arises from the grave or heavy weight that presses on bereaved co-victims (Simpson and Weiner 1989). One's response to loss is not merely a matter of feelings, but a highly complex and deep-seated human response.

Grief can manifest itself in numerous ways (Worden 1991):

• Feelings: sadness, anger, guilt, self-reproach, numbness, and fatigue.

• Physical Sensations: hollowness in the stomach, tightness in the throat or chest, oversensitivity to noise, shortness of breath.

• Cognitions: disbelief, confusion, preoccupation, a sense of presence of the deceased.

• Behaviors: sleep or appetite disturbances, absentmindedness, social withdrawal, dreams of the deceased, crying, loss of interest in activities that previously were a source of satisfaction.

• Spiritual: searching for a sense of meaning, hostility toward God.

For those experiencing grief in the aftermath of criminal homicide (including deaths caused by drunk driving), the grief reactions are intensified because of the wounding or trauma inflicted by the death. Historically, the focus of caregivers has been on the co-victim's grief issues, often without considering the impact of trauma issues that may also be present. Without recognition of the traumatic components of the experience, co-victims have been provided with services and treatment that primarily emanate from the grief model. This often causes co-victims to feel uncomfortable and anxious because their type of grief is not addressed by current models of treatment (Spungen 1998). Spungen suggests that treatment and support to co-victims of homicide must be an amalgam developed from the fields of both trauma and grief. She notes "the co-victim's grief is different--not just complicated but different: a traumatic grief."

E. K. Rynearson, M.D., Clinical Professor of Psychiatry at the University of Washington, conducted important and consistent work in recognizing that bereavement patterns experienced by individuals after having lost a loved one to homicide differed from those patterns experienced where the death was not sudden, violent, or transgressive. His observations have been consistent with some of the earlier work conducted by A. Adler and V. Frankl relative to bereavement and horrific death. His findings are also consistent with other current researchers such as Kilpatrick, Amick, and Resnick who identify the link between trauma and the experiences of the co-victim. Rynearson and Favell developed a clinical battery for screening patients for treatment based on separation and loss, which can be used by support group leaders in working with co-victims of homicide. They observed that separation distress is associated with the loss of the relationship because of the finality of the death while trauma distress is associated with the unnatural manner of dying. Additionally, along the way, Rynearson discovered the following:

Any one whose family member has been killed by a homicide will be changed. Homicide is a "change" that is, to some extent, dialectic rather than homeostatic. The internalized trauma and reenactment imagery will diminish with time but it will not go away. It will change from a horrific and private chronicle into a bearable narrative that can be shared and revised--but it will always be. The family member may reprocess the homicide and try to connect this homicidal narrative with the narrative of the family member before they were killed and their own ongoing narrative as well. The task of somehow weaving this thread of homicide into a coherent and balanced pattern is as impossible as it is inevitable. When something within or without resonates or pulls at that homicidal thread it will kindle an inner awareness of being torn or uneven. The subjective and internalized flaw is private. It is difficult to express through a standardized measure--perhaps impossible. However, this inner confound remains and can have long term effects. Relationships, values, life purpose, hope, and confidence in the future, spiritual stability--all these idiosyncratic supports may be reassessed and challenged by the homicidal experience (Rynearson and McCreery 1993).

Victim service providers must be aware of the aspects of traumatic grief (the emotional experiences, cultural and gender influences, and mental health issues) resulting in new strategies for treating the co-victim of homicide (Spungen 1998). To overlook or discount the importance of bereavement following homicide is to fail to understand the major impact of the murder upon family members and friends. Victim service providers need to be aware of this tremendous impact and take precautions in providing appropriate services that will not be harmful or destructive to co-victims.

Although many emotional responses are shared by family members when a loved one is murdered, each surviving family member will experience distinct emotional responses. In addition to the sudden, violent death of a loved one, co-victims may experience additional stress if the deceased was subjected to acts of torture, sexual assault, or other intrusive, heinous acts. They may have a constant need to be reassured that the death was quick and painless and that suffering was minimal. If the death was one of torture or of long duration, they may become emotionally fixated on what the victim must have felt and the terror experienced. They may fixate on the race of the offender to try to understand the motive behind the murder, and may develop a biased view of a certain race or culture based on the actions of the offender. If the offender was a family member or friend, co-victims may experience additional interfamilial discord as family members choose sides for support.

PLACEMENT IN THE FAMILY

Murder of a child. In the natural order of things, parents precede their child(ren) in death. The death of one's child is one of the least expected experiences in life. Parents serve as protectors for their child(ren). This sense of protectiveness often promotes parental guilt and self-blame. The feelings even occur when the deceased child is an adult.

The killing of a child is particularly complex when there are other small children in the family whose needs must be met as well. It is not uncommon for a parent (or parents) to idealize the deceased child, attributing qualities that are idealistic, not real. This can cause siblings to conclude that the "wrong child died."

Fathers often deal with their emotions by retreating into silence and denying the presence of intense emotions. This may be their way of remaining strong for the mother, and this motive may be misunderstood or interpreted as a lack of caring or concern. If the family structure incorporates stepparents, the roles and display of appropriate emotions may be even further complicated. The biological parent may feel that the stepparent could not possibly understand the type of pain he or she is feeling. This may lead to alienation of the stepparent in the grieving process.

Murder of a sibling. Younger brothers and sisters of murdered children are often unintentionally overlooked by parents who try to protect them from painful information and experiences. In addition to losing a sibling, they may also have lost their best friend. Parents simply do not have enough energy to deal with them. Initial community and extended family support usually focuses on helping the grieving parent, what they are feeling or what they need.

Siblings may worry about their own safety and possible death. They may become overly fearful of losing a parent or other sibling in the same manner. Many younger siblings have an extremely difficult time when they reach the age at which their sibling was murdered.

Adult siblings may worry that the stress of their sibling's murder may hasten their parents' deaths. They may also resent their parents' pre-occupation with the victim and their idealization of the deceased.

Murder of a spouse. The feelings and emotional needs of a surviving spouse will depend on the nature of the marital relationship. If there was discord or dissension, co-victims may suffer intense guilt feelings. If it was a loving partnership, the feelings of loss may be overwhelming. The age of the spousal co-victim will also play an important factor in the emotions of the co-victim. Elderly co-victims and younger co-victims may not do as well as the middle-aged co-victim (Steele 1992). Steele's study of sixty widows and widowers found that spouses between ages twenty and thirty-five faced significant financial stress and became exhausted with working, rearing grieving children, and attending to maintenance of the home and family. This anger is then followed by guilt. Murder of a young spouse also may leave the surviving spouse choosing never again to remarry because of the fear it will happen again. They may feel they have lost their future. Those sixty-six to eighty-five in the Steele study also experienced more stress than the middled-aged group. They may be displaced from their home because they are not able to care for themselves. They may have lost partners of many years and, with their lives so intertwined, feel that they are no longer needed or important.

Murder of a parent. Young surviving children naturally worry about who will care for them. Smaller children tend to experience the death as desertion since they have little ability to understand what has happened or to conceptualize death. They are angry because the parent was not the "superhuman" they envisioned. They wonder why the parent did not fight harder or run faster, and may blame the victim for his or her own death.

Traumatic death in the family is especially hurtful to children and youth. Bradach (1995) studied 181 young people aged seventeen to twenty-eight and found that those who had experienced a traumatic death in the family when they were children had greater depression, more global psychological stress, and lower individuation and separation from the family than those who had experienced more common losses. They also had more difficulty forming intimate relationships (Bradach and Jordan 1995).

For older or adult children, anger levels may increase because they feel their parent's death was not the dignified one that they deserved or expected. If the family was experiencing discord, children may feel intensely guilty there was not enough time to rectify the familial problems.

Co-victims themselves provide the most accurate information regarding their experiences during this period. They become experts in explaining their problems and needs. In addition to personal trauma, Parents of Murdered Children, Inc. (1989) lists eight additional problem areas co-victims must endure.

1. Financial considerations. Expenses related to funeral, burial, medical treatment, psychiatric care for family members, and other costs are all part of the aftermath experienced by co-victims. These considerations are grave and contribute in a major way to the continuing distress experienced.

1. The criminal or juvenile justice system. Co-victims of homicide have a vested interest in participating in the criminal or juvenile justice system and understanding the complex issues of a cumbersome legal system.

When members of a homicide support group (Fairfax Peer Survivors Group) in Fairfax, Virginia, were polled about their needs during the legal process, the single most important issue for them was their ability to obtain information from the prosecutors, detectives, and other professionals. They--

• Wanted to know exactly how, when, and why their loved one was murdered and who committed the murder.

• Wanted to know if their loved one suffered.

• Wanted to know the truth about the events of the death and elements needed to support the charge.

• Expected to feel better if the case was successfully prosecuted.

Discounting the family's contribution to a case discounts the pain of their victimization. Co-victims feel devalued when they are not allowed input into plea decisions and when they are barred from criminal or juvenile justice proceedings. They are distraught when the imposition of a technical rule, e.g., a "gag order" which prevents them from attending the trial, may in turn eliminate their last opportunity to do something for their loved one (Sobieski 1994).

1. Employment. A co-victim's ability to function and perform on the job is diminished. Motivation is sometimes altered. They experience emotional bursts of crying or losing their tempers. They are impatient with trivia. Having to explain or apologize can create additional stress. Some co-victims use work as an escape to avoid working through their grief. They resist dealing directly with their pain by placing it on hold while at work.

1. Marriages. It is common for marital partners to have difficulty relating, and they may even separate after a death due to homicide. (Divorces, however, are not as common as once believed.) Each partner may grieve differently. They may blame each other for the loss, particularly in the case of the death of a child. They may each wish to turn away from the memories that the other partner evokes. They are sometimes unable to help each other because they cannot help themselves.

1. Children. Parents often fail to communicate with their children by either ignoring them when they are preoccupied with their own issues or hoping to protect them from unnecessary trauma. The children, in turn, fear adding to their parents' pain and simply withdraw. Children who witness the killing of someone they love experience profound emotional trauma, including posttraumatic stress disorder, and may not readily receive adequate intervention.

Furthermore, young people who report having to perform tasks associated with the fatal injury, such as telephoning for police or emergency medical services, or responding to the immediate needs of the injured person or the perpetrator, are often traumatized. When the issue of blame or accountability for the death is not resolved through police investigation, children may re-examine their behavior, believing that if they had done something differently, they could have prevented the death. Without support and an opportunity to explore the feasibility of such alternatives, children often continue to unnecessarily blame themselves.

1. Religious faith. Questions for, anger at, and challenges to God surface regarding the reason for the death. How could a loving God allow it to happen? Where is the loved one? Some conclude, at least for a while, that "if there were a God, then God would not have let this happen. Since it happened, there must not be a God." Faithful co-victims seeking to understand sometimes look for answers from unorthodox sources. Over-simplistic comments and "answers" by clergy and church members sometimes create problems for co-victims who take their spiritual pilgrimage seriously.
2. The media. Many homicide co-victims are subjected to the intrusion of what they perceive to be an insensitive media. The competitive quest for sensational, fast-breaking news items may override the need for privacy of anguishing families who may be experiencing prolonged scrutiny, inaccurate reporting, and gruesome reminders of the violence associated with the death.

1. Professionals who do not understand. Co-victims report that too many professionals (police, court personnel, hospital personnel, funeral directors, clergy, school personnel, psychologists, and psychiatrists) demonstrate by their comments and actions that they do not fully understand the impact of death by homicide upon the remaining family members.

Substance Abuse. Working with co-victims through the Separation and Loss Services, a program he founded in 1989 to address the special needs of co-victims of homicide, Dr. Ted Rynearson estimated that 30 percent of his clients had substance abuse problems (Rynearson and McCreery 1993).

Professionals working with surviving members of homicide victims must be prepared for their personal intense reactions to the impact of homicide, which are often frightening. Such personal reactions can be more extreme than those experienced in working with other crime victims. Victim service providers must be aware that there is no fixed way or timetable for the victim's comfort and well-being to be achieved. Experiencing a wide range of responses that may continually resurface, co-victims of homicide sometimes feel that there is no recovery, closure, or healing from the ravages of homicide. While they develop the skills to cope with their pain, they live with an encompassing fear of strange, new reactions that control their behavior. Their grieving process can be interrupted and delayed by elements and events of the criminal or juvenile justice system. Co-victims sometimes put their grief on hold to focus on the arduous task of seeing that justice is served.

NOTIFICATION

The cornerstone of the recovery process is the initial death notification. -- Deborah Spungen

Co-victims of homicide report that the way they were informed about the homicidal death of their loved one affected their relationships within the criminal or juvenile justice system and affected their lives in profound ways from that moment on. The role of the victim service provider in notifying families is one of challenge and demand but it is essential to the family that the process be based on protocol. Victim service providers are generally in proximity to the criminal or juvenile justice process where they can be most effective offering this service in conjunction with law enforcement. Victim service providers can work along with an officer in providing notification of the death that is timely and in keeping with a protocol of sensitivity, compassion, and delivery of correct information.

When life-altering information is delivered by inexperienced and untrained messengers, the results increase the distress experienced by co-victims. There are several models for death notification training. The following are core elements of the widely used and profession-specific program developed by Mothers Against Drunk Driving (MADD) (Lord 1997):

Background. Notification to family members of deaths that result from violent crime are among the most challenging. Survivors may attempt to harm themselves or others, physically act out, and/or express anger. Victim assistance professionals whose responsibility it is to make death notifications can greatly benefit from focused training on the delivery of a death notification, and assistance in learning how to manage their own emotional reactions to these highly stressful situations.

In 1995, the U.S. Department of Justice, Office for Victims of Crime supported Mothers Against Drunk Driving (MADD) in revising their death notification curriculum to state-of-the-art status and tested it in seven sites. Seminar teams presented the revised curriculum to participants between November 1995 and January 1998. Those who had previous experience in death notification expressed that their greatest unmet educational needs were:

• Specific details on how to deliver a notification.

• How to manage immediate reactions of the family.

• How to manage their own reactions.

• General aspects of death notification.

MADD has always believed that the "voice of the victim" is most instructive in developing programs to serve them. Thus, the personal experiences of hundreds of survivors formed the development of the Practices for Death Notification.

Selection of the notifier. Selection of the notifier is as crucial as the practice itself. Stressed individuals are not ideal deliverers of death notification because they are focused on themselves, experiencing the task as one more layer of stress. The best attitude for delivering a death notification is a positive, calm, confident one, believing that it is an opportunity to do a good job with an extremely difficult task.

Beliefs in developing death notification practices. Theoretical development of the Death Notification Practices is based on factors affecting stress reaction and general survivor needs during stress. Factors affecting stress reaction include (a) intensity of the event, (3) suddenness of the event, (c) ability to understand what is happening, and (d) stability at the time of the stressful event. Death notification is obviously a very stressful event because it is highly intense and the survivors had no time to psychologically prepare. Their cognitive ability to comprehend what has happened is diminished due to shock. The only differing variable is individual stability which varies due to survivor's physical, mental, emotional, and spiritual health. General survivor needs include (a) opportunity for ventilation of emotion, (b) calm, reassuring authority, (c) restoration of control, and (4) preparation. These beliefs, along with survivor experiences and recommendations, served as the theoretical foundation for the following practices.

Death notification practices.

1. Be absolutely certain of the identity of the deceased. Notifiers should use more than one means of identification to assure correct identity. This becomes difficult when deaths occur in different jurisdictions and notifiers who were not at the scene must locate and notify. Notifiers must have the following information at a minimum before conducting the notification: how the victim was identified, where the death occurred, how the death occurred, where the body is now, and the name and phone number of an involved investigator who can answer questions.

2. Obtain medical information on the family to be notified if possible. Business cards, prescription bottles or other information on or around the body of the victim may help identify the name of a physician or other professional who can inform the notifier about the family. Law enforcement can often obtain the name of the primary care physician from local hospital records and contact the physician before conducting the notification. In some jurisdictions, emergency medical personnel are called to stand by when a notification is made in the event that a family member goes into a crisis condition.

3. Go. Do not call. Make every effort to deliver death notifications in person. Many people notified by phone have been alone and gone into a critical medical condition upon notification. If the family is outside the jurisdiction where the death occurred, call police in the family's jurisdiction to deliver the notification in person. Hospitals should make greater use of law enforcement or their advocates to notify in person or at least transport families to the hospital where the attending physician or nurse can notify in person. Notifiers should never inform a neighbor of the death before the family knows. Ask neighbors if they know where to locate the family because of a medical emergency. If the family member is at work, ask the supervisor for a private place to speak with the person. Only tell the supervisor if he or she insists on a reason.

4. Notify in pairs. The best notification team is probably an officer who was at the scene and a victim advocate or chaplain who can stay with the family until other support arrives. It is crucial that one of the team members was at the scene in order to answer questions of the family. More than one notifier assures proper support in the event one or more of the family members goes into crisis. If a large group is to be notified (for example, someone is killed on the way to a family gathering), more than two notifiers may be required, especially if children are among those to be notified. If there are multiple families involved (for example, a car crash involving several teenagers), notify each family at about the same time.

5. Talk about personal reactions on the way to the notification. It is impossible to not feel anxious on the way to deliver a death notification. It is healthy to own those feelings and ventilate them with the notification partner before arriving at the notification scene. This allows for more focus on the family and less attention to one's own fear and anxiety. During this discussion, plan who will handle various aspects of the notification.

6. Present credentials (if not in uniform) and ask to come in. Credentials are necessary now because few people allow strangers into their home. Never deliver a notification at the door. Don't be formal in your introduction. Memorized notification messages are uniformly resented.

7. Sit down. Ask them to sit down. Be sure you have the next of kin. Use the victim's name; for example, "Are you the parents of Johnny Smith?" This is one more step in preparing the family for a traumatic event. Your identity has raised their anxiety, as well as your asking to come in and be seated. That anxiety is uncomfortable but it begins psychological preparation as chemicals in the brain begin their numbing effect. Never notify a child and never use a child as a translator for a death notification. It is too much stress for them to handle and places on them the burden of notifying adults. Try not to notify siblings, even if they are adolescents, before notifying parents or spouses.

8. Inform simply and directly with warmth and compassion. Do not engage in small talk before notifying. They already know something is wrong and will be angry at attempts to distract from it. Do not use words like "expired" or "passed away." Use "dead" or "killed" to ensure lack of confusion. If the death was a suicide, use "took his own life" rather than "completed suicide" or "committed successful suicide." Say something like, "I am afraid I have come with bad news." (Your last effort to prepare) "Your son, Johnny (use name), has been involved in a very serious car crash, and he has died." (Pause for their ventilation of emotion.) "I'm so sorry." (A feeling reaction on your part is appreciated and sometime triggers emotional ventilation by a family member who has not yet done so.) "They did everything they could to save him." (If you know this to be true). As you talk further with the family, do not describe the death in professional jargon but use common language. Use the victim's name rather than "body," "corpse," "remains," or "the deceased." At this time, do not blame the victim in any way for what happened, even though you may know he or she was partially or fully at fault.

9. Don't discount feelings, theirs or yours. Expect fight, flight or freeze reactions and understand that they are normal reactions to one of life's most abnormal experiences. Intense reactions are normal. Understand that people cry only because they need to cry. If a family member goes into shock, help them lie down, elevate their feet, keep them warm, and call for medical assistance.

10. Join the survivors in grief without being overwhelmed by it. Families do not resent genuine displays of emotion. In fact, they seem touched by them. On the other hand, it is not appropriate to become so upset that focus is diverted to the notifier. Avoid discounting or patronizing comments such as the following:

I know just how you feel. (You don't.) Time heals all wounds. (It doesn't.) You'll be over this some day. (They will be better, but full recovery should not be expected.) She was in the wrong place at the wrong time. (Trite) You must go on with your life. (They will, the best they can.) He didn't know what hit him. (Never use this unless you know for sure.) You can't bring him back. (Trite)

Avoid disempowering comments such as: It's better if you don't see him and remember him the way he was. (How do you know? The survivors know what they need.) You don't need to know that. (Perhaps they do.) I can't tell you that. (There may be aspects you cannot discuss because of the criminal case. If this is so, explain why you cannot discuss it.)

Avoid God-clichés such as It must have been his time, Someday you'll understand why, It was actually a blessing because . . . God must have needed her more than you do, God never gives us more than we can handle, or Only the good die young. If survivors utilize these beliefs themselves, it is fine. However, it is highly intrusive to attempt to impose one's own theological beliefs on someone who needs months or years to accommodate what has happened into their belief system.

Finally, avoid placing unhealthy expectations on family members such as You must be strong for your wife/parents/children. No one should be required to be strong in the face of a trauma such as death notification. Likewise, avoid You've got to get hold of yourself. They are doing the best they can.

What have survivors found helpful in terms of notifier comments? I'm so sorry is almost universally appreciated. It may be over-used, but it is simple, direct and validating. They did everything they could to save her, if you know it to be true, is very helpful for families. However, if this is not true, it will likely come out in court and the family will be deeply resentful if you lied to them. Facing something like this is harder than most people think normalizes their reaction and validates the difficulty they are having. After ventilation of emotion has resolved somewhat, it is helpful to ask Is there anything else you would like to tell me or ask me? Sometimes, there are none, but the family will appreciate your asking. They may have many more questions the following day. Therefore, when preparing to leave, tell the family that you will check back with them the next day. Leave your business card.

11. Answer all questions honestly. Many notifiers tell the family what they think they want to hear. This is universally resented. Families want to know the truth. Do not volunteer information, but when asked a question answer it to the best of your knowledge. If you do not know the answer, say so and tell them you will try to find out.

12. Offer to make calls; arrange for child care; call pastor, relatives, employer. Family members will need this kind of help and will appreciate your offer. If you do make calls for them, write down whom you called, when you called, and what you discussed. Family members will be in a daze by this time and may not remember whom they asked you to call. They may request additional personal notifications, such as grandparents or adults in other jurisdictions. Do what you can to accommodate these requests. When a child is killed and only one parent is at home, tell that parent and then invite him or her to go with you to notify the other parent. It is crucial that both parents be personally notified in situations of separation or divorce.

13. Talk with the media only after discussion with the family. You represent the voice of the victim, so never speak to the media until you have first discussed with them what you are going to say. Families feel betrayed when they hear things on television of which they were neither informed nor involved. In high profile cases, warn them that television, radio, and newspaper coverage may be dramatic so they can avoid these media outlets if they choose.

14. Do not leave the survivors alone. Wait until personal support persons are notified and arrive.

15. Give written information. Depending on the emotional state of the most direct survivor(s), leave written information including autopsy information, how to obtain a copy of the crime report, the primary investigator's name and number, and the phone number of the prosecutor's office. It may be better to bring this information the following day.

16. If identification of the body is required, transport the identifying family member. Be sure this procedure is absolutely necessary. Often it is not because several means of identification have already been processed. Never expect someone to drive safely while on their way to identify their loved one's body. Transport them and tell them what to expect such as where the body is, what the room will look like, what their loved one's body may look like. Upon arrival, the notifier or transporter should look at the body first and then describe obvious injuries to the family member first. Instruct hospital or medical examiner personnel to clean the body as much as possible before family viewing. If in a hospital, some have advised leaving some of the medical equipment attached which may assure the family that every effort to revive was utilized. If you are unable to transport the family member back home, arrange for a cab or other transportation.

17. Next day, call and ask to visit again. The family is likely to have more questions the second day than they did at the initial notification. Call and offer to visit the family again. If they do not feel it is necessary, offer again to answer questions. This is a good time to try to correct misconceptions about the criminal justice system such as the right of the offender to bail. If they knew the offender and wish to attend the bail hearing, inform them that they have the right to do so. The second day is also a much better time than the time of notification to give the family personal possessions of the victim such as clothing or jewelry. Try not to deliver these things in a trash bag (apparently the mode of choice for most hospitals). It is appreciated if clothing is nicely folded and placed in a box. Do not launder clothing, but do inform the family of the condition of clothing and jewelry before presenting it. If some items have been retained as trial evidence, explain their absence. If there is anything at all positive about the death, such as "I was there at the moment of death and he did not struggle," tell the family at this visit. However, do not say anything untrue.

18. Let the survivors know you care. The most loved professionals and other first responders are those willing to share the pain of the loss. Attend the funeral if possible. After the trial, send the family a note, perhaps about how the death of their loved one affected you. Do not send such sentiments before the trial, because if you are required to testify they could be used as evidence of biased opinion about the case.

19. In summary, remember: In time; In person; In simple language; and With Compassion.

While the victim service provider may not be responsible for the actual delivery of the death notification, they need to be aware of who delivers death notifications and endeavor to see that they are adequately prepared for the task. Developing and delivering sensitive homicide notifications cannot be accomplished until there is greater recognition of the grief and traumatic response to homicide (Spungen 1998).

GENERAL

• Co-victims should be allowed to grieve in whatever manner they wish and for as long as they wish.

• Co-victims should be allowed to cry freely. It is a healthy expression of grief and releases tensions.

• Co-victims should be allowed to talk about and personalize the victim. Allow the co-victim to criticize the victim and to talk about the good times and the bad times.

• Allow co-victims to get angry at the criminal or juvenile justice system, the criminal or juvenile murderer, the victim, or simply the unfairness of life. Anger needs to be expressed.

• Let the co-victims know you remember, too, by remembering them at holiday times, on the anniversary date of the murder, and the victim's birthday.

• Allow the co-victims some occasional "time out" from day-to-day pressures. Encourage them to take a day off from work or a day out of the house, etc., and if possible, offer to help with the children.

• Reassure the co-victims that the murder was neither their fault nor the victim's fault.

• Tell co-victims that you are sorry the murder happened and it is horrible that someone they loved was killed.

• Support co-victims in their efforts to reconstruct their lives, even if it means a major change in lifestyle.

• Let co-victims know that you will remain their friend and they mean a great deal to you.

FOR VICTIM SUPPORT PROFESSIONALS

• Learn as much as possible about the case before speaking with the family. If the information is not flattering to the deceased but may affect the investigation of the case, alert the family to these facts as tactfully and sensitively as possible. Prepare them for media reporting of such information.

• Determine co-victims' needs for contact. Some will require constant contact, while others will want minimal intervention. Temper your need to help if assistance is not needed or wanted.

• Become familiar with the stages of grief and additional stress factors.

• Personalize the deceased. Ask the family to tell you stories or show you pictures. Ask about the victim's hobbies, dreams, and desires.

• Protect the co-victims from unwanted media attention but assist those victims who wish to speak to the media.
• Determine if co-victims need assistance with funeral arrangements or other family notification responsibilities. If yes, offer to help.

• Realize that financial considerations are paramount in any murder, but especially those in which the victim contributed significantly to the family's coffers. Help co-victims to file for insurance benefits, crime victims compensation, co-victims benefits under Social Security, etc., and to seek restitution orders through victim impact statements and pre-sentence investigation reports.

• Provide co-victims with the names of mental health counselors or support groups.

• Provide co-victims with information about the investigation and criminal or juvenile justice process. Keep them informed of its progress. (Please note that although most victims will want to know even the smallest detail, not all victims will want this information. Find out the victim's desire for information and act accordingly. It is helpful to identify one family member who will disseminate information throughout the family; however, do not focus all of your attention on this one family member.)

• Realize that each family member will have individual needs. Work with all family members to determine their need for information and support. Do not forget to include grandparents, siblings (where age appropriate), or other extended family members.

• Be aware that coping with the trauma of homicide can lead to substance abuse problems for co-victims. Make appropriate referrals, when indicated, to qualified mental health professionals who specialize in the assessment of substance abuse problems.

• Review, as necessary, all autopsy and/or murder scene photographs to determine the suitability of family members remaining in the courtroom. Some co-victims will want to remain no matter how graphic the evidence is. Remember, the final decision is up to the co-victim.

• Consider using an family friend or distant relative to identify the victim in any court proceedings if using an immediate family member will disqualify him or her from remaining in the courtroom throughout the trial. (Check beforehand with the prosecutor concerning state laws or court rules allowing this.)

• Provide all court services to co-victims that are available to victims of other crimes such as court accompaniment or secure waiting rooms. Assistance in preparing victim impact statements, documenting restitution, or completing pre-sentence investigation reports is appropriate.

• Alert the prosecutor or law enforcement representative of co-victims' concerns for safety or other emotional or physical concerns.

• Inform co-victims of their rights to file civil suits against the offender or third parties, where applicable.

• Prepare a brochure explaining the emotional ramifications of murder on the co-victims and, with permission of the co-victim, send materials or meet with co-victims' employers so that allowances can be made for missed days from work due either to court or emotional needs.

• Be prepared to provide long-term victim assistance in cases involving the death penalty.
• Help co-victims understand the appellate process and provide guidance through any/all appeals that the offender may file. An excellent resource guide to the appellate process is available from the Office of the Attorney General in Missouri.

• Provide guidance to co-victims about rights and services available in the postsentencing phases of their cases. Nearly all states and the federal government have corrections-based victim advocates who provide information and assistance regarding victim protection, notification of offender status and location, restitution, victim input, and parole release hearings.

• Ensure that co-victims know their rights regarding parole release hearings (in applicable cases). These include notification of parole consideration hearings; victim protection to address real and perceived fears; restitution and other financial/legal obligations; the provision of victim impact statements (including both a record of the VIS at sentencing as well as oral, written, videotaped, or audiotaped VIS at parole hearings); and information and referrals to supportive services in the community.

• In death penalty cases, determine if the co-victims have the right to witness the execution. Many states provide specialized services and separate viewing areas for co-victims. It is also important to provide follow-on supportive services, such as accompaniment to the cemetery in which the victim is buried, and media intervention.

• Determine if surviving family members have any desire to meet face-to-face with the criminal who murdered their loved one. While this concept may seem much too painful to some people, the state of Texas has over 300 surviving family members of homicide victims who want to meet with the murderers of their loved ones through its highly structured victim-offender mediation program. It is the victim's choice and, if the opportunity is available, it is important to offer co-victims this option.

• For surviving family members who have reached a point of reconstructing their lives in the aftermath of homicide, determine if they would like to participate in programs such as victim impact panels. Some of the most powerful speakers about victim trauma and the injustices victims endure, for both convicted offenders and justice professionals, are people who have suffered the most immeasurable loss of a loved one through violent means.

Life can continue after the homicide of a loved one. As painful as a co-victim's journey may be, the human spirit can (and will) by nature endure. The loss of a loved one in this painful manner is abhorrent, traumatizing, and difficult in terms of providing aftercare. One survives because it is the course of human development to do so. It is in the natural order of things that people, nations, and worlds persevere and continue to go on. Those who are dedicated to helping to restore the lives of co-victims of homicide must accept that the real work is accomplished not only through guiding but also through learning and understanding.

• Separation And Loss Services, Seattle, Washington. This program provides assistance to co-victims through a variety of services, including family and community crisis response; individual, family, and group therapy; psychiatric consultation and pharmacotherapy; advocacy during the investigative and judicial process, and media management.

• Homicide Support Project, Seattle Washington. The purpose of this project is to train professionals across the country to provide effective assistance to crime victims experiencing grief and loss. Supported by a VOCA grant, the Homicide Support Project team, consisting of a psychiatrist, crisis counselor, bereavement specialist, victim advocate, and prosecuting attorney, has written a training manual. It includes a battery of screening instruments to guide clinicians in assessing and recommending appropriate intervention for posttraumatic stress, depression, substance abuse, and other mental health problems caused by or co-existing with the victim's traumatic grief.

• Parents of Murdered Children (POMC) was founded in 1978 by Charlotte and Robert Hullinger in Cincinnati, Ohio, after the murder of their daughter Lisa. What was once a small group is now a large organization with over 300 chapters and contacts through the United States and abroad. POMC provides the ongoing emotional support needed to help parents and other survivors facilitate the reconstruction of a "new life" and to promote a healing resolution. Not only does POMC help survivors deal with their acute grief, but with the criminal justice system as well. The staff of the National Headquarters of POMC will help any survivor, and if possible, link that survivor with others in the same vicinity who have survived their loved one's murder. In addition, the staff is available to provide individual assistance, support, and advocacy. POMC will provide training to professionals in such areas as law enforcement, mental health, social work, community services, law, criminal justice, medicine, education, religion, the media and mortuary sciences who are interested in learning more about survivors of homicide victims and the aftermath of murder. POMC can be reached toll-free at 888­818­POMC.

Homicide Self-Examination

a. Latino males

b. White females

c. African-American males

d. African-American females

e. White males

2. Name five key issues that most co-victims of homicide victims will have to confront.

3. How and why does death due to homicide differ from natural forms of death?

4. What is traumatic grief, and why is bereavement a major factor in homicidal deaths?

5. What are five support factors anyone can provide to a co-victim of homicide?

Chapter 11 References

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Chapter 11 Additional Resources

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