This paper considers the initial phases of work with a family who suffered the death of one parent and the threatened loss of another parent, both from cancer. In this case, the children were ‘double bereaved’, not only by the actual and anticipated losses, but by the impact of these circumstances on their internal worlds, as manifested by their somatic symptoms and suicidal ideation. The need for a co-ordinated and supportive approach to families in these circumstances is emphasized, as is the importance of addressing individual concerns while maintaining a family perspective.