Week 7: Discussion on Rituals of Bereavement

CHAPTER TWELVE: PERSONAL LOSS:

BEREAVEMENT AND GRIEF

Terms Critical to Understanding Loss

 Bereavement  Uncomplicated bereavement

 Grief  Complicated grief/prolonged grief  Traumatic grief  Disenfranchised grief

 Loss  Primary loss  Secondary loss  Ambiguous loss

 Mourning

Dynamics of Bereavement

 Cultural Dynamics  Culture  3 patterns of response:

 Death accepting  Death defying  Death denying

 Sociocultural Mores

 Spirituality and Religion

Conceptual Approaches to Bereavement

 Stage/Phase Models  Kubler-Ross’s Stages  Bowlby’s Attachment Theory  Schneider’s Growth Model

 Counterpart to Traditional Models  Dual Process Model

 Loss orientation  Restoration orientation

 Adaptive Model  Intuitive grieving Instrumental grieving

Assessment Tools

 Texas Revised Inventory of Grief (TRIG)  Current Grief  Past Disruption

 Grief Experience Inventory (GEI)  Nine clinical scales

 Hogan Grief Reaction Checklist (HGRC)  Can discriminate variability in the grieving process as a

function of cause of death and time elapsed since death

 Inventory of Complicated Grief (ICG)  Targets symptoms of grief that are distinct from

bereavement-related depression and anxiety, and predicts long-term functional impairments

Types of Loss

 Death of a Spouse  One of the most emotionally stressful and disruptive events

in life  More widows than widowers

 Loss Due to Caregiving

 Death of a Child  Perhaps the ultimate loss for a person to endure regardless

of the age of the child

Types of Loss Cont.

 Bereavement in Childhood  Toddlers  Primary school age  Middle school age  Intervention and treatment

 Bereavement in Adolescence  Value of connectedness  Intervention and treatment

 Bereavement in the Elderly  Present more somatic problems than psychological problems  No indication that the intensity of grief varies significantly with age  Grief among older people may be more prolonged than among

younger people  Tend to be lonelier and to have far longer periods of loneliness than

younger people

Types of Loss Cont.

 HIV/AIDS

 Job Loss

 Separation and Divorce

 Death of a Pet

 Complicated Grief

 Traumatic grief

Being There for Grievers

 Empathic Presence

 Gentle Conversation

 Providing Available Space

 Eliciting Trust

Fitting Technique to Style of Grief

 The Dual Process Model  The griever sometimes confronts and sometimes avoids the

stressors of both orientations

 Adaptive Model  Affective  Behavioral  Cognitive  Spiritual

Fitting Technique to Style of Grief Cont.

 Cognitive-Behavioral Approaches  Most commonly used therapies for those who suffer from

complicated grief

 Narrative Therapy  Reconstructs the relationship with the deceased rather than

abandoning it

 Attachment Theory and Therapy  One of the oldest theories that deals with grief and loss  “Coherent narrative”

Case Examples for Dealing with Loss

 Sudden Death of a Spouse  Stuart

 Traumatic Death of a Child  Helen and Brad

 Bereavement in Childhood  Makeena

 Separation and Divorce  Nancy

Case Examples for Dealing with Loss Cont.

 Death of a Pet  The Thompsons

 Bereavement in Elderly People  Lenore

 Bereavement in an HIV-Infected Client  Clint

 Complicated Grief: Death of a Mother  Ann Marie

The Crisis Worker's Own Grief

 Emotional investment in the client  Bereavement overload  Countertransference  Emotional replenishment  Facing one’s own mortality  Sense of power  Tendency to rescue