Strategies for assessment and intervention

Based on the constructs discussed, an initial consideration for assessment is to determine present and past individual and family functioning. Effective strategies are based on a clear understanding of pre-morbid functioning. One of the first areas to evaluate is an individual's prior independence and differentiation from their family of origin in which the loss has occurred. As stated, families in grief are more vulnerable and have the tendency to become less differentiated as individuals. In...

Special considerations

Redmond (1989) discussed several characteristics of issues underlying a homicide that must be understood and considered in assessment and interventions 1. Cognitive dissonance refers to the inability of the mind to comprehend something that does not match one's perception of reality as it had been previously known.The violent act of murder is difficult to comprehend and place within one's framework of personal reality and understanding. It goes beyond the normal coping mechanisms of shock,...

Day 4 Need to say goodbye in meaningful and personal ways

Bereaved children are often shielded from the death and funeral of a loved one. The grieving adult is often overwhelmed with his or her own emotions and wants to shield their child by keeping him or her away from the hospital or funeral. However, as previously stated in this chapter, many children are concrete thinkers with a limited ability to comprehend death. Therefore, many benefit by tangible evidence such as a funeral. Funerals can also reveal how to have a meaningful goodbye. Day 4 of...

Reasons for Problems with Grief Resolution

Numerous reasons have been proposed as to why grief becomes complicated or unresolved. Often the risk of developing complications during bereavement depends on both the immediate circumstances of the death and the background against which it occurs. For example, PTSD is more likely to occur following a loss that is traumatic. However, complications can also occur following losses that are not traumatic. Often grief becomes complicated based on how an individual copes with their loss. Those who...

Early Sessions

Counselling during the early sessions entails ongoing assessment, encouragement of their personal narrative, expression of emotions, and the provision of needed support (non-judgmental listening). During the acute experiences of grief, clients initially experience an incredible sense of aloneness and meaninglessness. Many Table 3.2 Case examples using perspectives perspectives can contribute both positive and negative influences simultaneously Early counselling sessions (acute) Karen death of...

Communications Systems and Structural Theories

Communication theory includes concepts from cybernetics and general systems theory. This theory encourages exploration of patterns of communication within a family setting in order to assess present behaviours and issues. Messages sent among family members are said to have report (content) and command (defining relationships) functions. Jackson (1965) observed that one can discern what the family rules are by listening to the report and command functions and the regularity of these types of...

Grief with complications

When any of the aforementioned aspects of healthy grieving do not occur, children may experience grief with complications. They do not explore the emotions or the implications of the loss, and therefore do not learn to accommodate the loss into their daily living. As a result, children with complicated grief may manifest maladaptive or regressive behaviours. Dora Black (2002) has revealed pre-morbid characteristics and environments that are risk factors for future grief with complications....

Agebased Conceptualization of Death and its Behavioural Manifestations

A task-based theory to death conceptualization implies individuality to each child's death awareness. Still, generalizations can be made based on observations, studies, and developmental theories. These generalizations are important, for they provide a framework with which to observe and interact with a grieving child. They are also milestones that grieving children must acquire to assure healthy development. Infants who experience a death do not comprehend it, yet still react. Bereaved infants...

Definitions

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (American Psychiatric Association, 1994) defines unresolved grief in terms of symptoms that can be identified as not being characteristic of a normal grief response. Moreover, these bereavement symptoms can be differentiated from symptoms of a major depression. The symptoms of unresolved grief include Guilt about things other than actions taken or not taken by the survivor at the time of death. Thoughts of death other than the...

Constructivism

Lastly, principles from constructivism add insight and offer practical applications to family therapy. This theory has had a variety of interpretations, many of which have been controversial. One of the basic premises of this theory is that reality does not exist as a singular entity, but that there is more than one reality. This concept is a core principle of postmodern thinking. Within family therapy this philosophy has been used to facilitate a different way of assessing and conceptualizing...

Philosophical

Questions should explore how this loss has affected one's outlook on life if there is a personal philosophy that is helping at this time what holds meaning and purpose at this time if there is any sense of connection or relation to anyone or anything if there have ever been similar feelings from past losses what questions about life this loss has triggered and what this loss has made the client more aware of These questions are not all inclusive rather, they suggest a starting Illness and loss...

Resolution and Growth

Within the broader considerations of resolution there is an understanding and an acceptance that life will never be the same again and that certain realities and assumptions must be relinquished in order to survive the pain, to integrate the experience, and to rebuild a future existence. Resolution, like reinvestment, is not replacement. This notion may be difficult for a client to comprehend. Many modern societies are based upon the replacement of objects and relationships. Often grief...

The Grieving Process Grief with healthy responses

Just as children perceive death differently to adults, children's grief is also distinct. As reviewed above, they have an incomplete understanding of death that impacts their grieving. Additionally, they possess insufficient coping skills, so they have an increased need to rely on others. Finally, children, unlike adults, need to continue their psychosocial development and must learn how to do this alongside their grieving. All of these factors cause children to grieve differently to adults yet...

Session 2 Understanding the Multiple Perspectives of Grief

Introduce this session with comments that promote an understanding of the perspectives involved with loss and the tremendous power of grief. Comments should reflect the fact that every aspect of an individual is affected by a loss event, and that in the process, one must continue to assess which perspective is emerging at the present time and affecting the bereavement experience. The philosophical, spiritual, psychological, sociological, and physical perspectives can emerge at any time and on...

Camp Lost and Found

In Canton, Ohio, The Grief Support and Education Center had similar goals when it designed Camp Lost and Found. Camp Lost and Found was a day camp for children and adolescents who had lost a loved one. Its mission was to create a sense of normalcy for bereaved children while they learned to experience grief safely and gain the necessary resiliency tools to continue their grief work throughout their development. The goals of the camp (Table 6.5) all reflected its mission statement. Table 6.5...

Therapeutic Factors in Groups

A group is a representation of the family and community to which individuals belong. Issues that emerge in a group often have origins in past and present family and community relationships. Often the dynamics of interpersonal relationships are not on a conscious level of awareness. For many, the group experience will offer the initial experience of personal insight into their relationships with others. Within the format of the group, a process occurs that is not possible in individual...

Symbolic interaction

Symbolic interaction was the first theoretical construct utilized by Nadeau in her research that investigated the process by which grieving families constructed meanings and the nature of those meanings. In her 1998 research she studied patterns of ten non-clinical, multigenerational families. Her thoughts guiding the research were that we know very little about the manner in which families construct meanings. Most of what we know comes from an individual's perspective. Yet individuals don't...

Absence inhibition or delay of bereavement

Definitions and examples will be given for the types of distorted manifestations, using the works of a number of theorists. Raphael (1983) stated that absence, inhibition, or delay of bereavement have similar characteristics when considered on a continuum of avoidance of the pain of loss. 'True absent mourning is rare because it requires that the mourner either maintain complete denial of the death or remain in a total state of shock - two quite difficult feats' (Rando, 1993 155). Usually what...

Organizations

American Academy of Grief Counselors, American Institute for Health Care Professionals, 2400 Niles-Cortland Rd SE, Suite 3, Warren, OH 44484, USA. Tel (330) 652-7776 www.aihcp.org aagc.htm. Offers certification and fellowship programs for professionals who practice grief counselling. American Association of Suicidology, 5221 Wisconsin Ave NW, Washington, DC 20015, USA. Tel (202) 237-2280 www.suicidology.org. Education organization that serves as a national clearing house on suicide. American...

Session 1 Getting Acquainted and Goal Setting

Open this first session with introductory statements of welcome and acknowledgment of the strength that it takes to become part of a group that takes the *Although this group is for death-related loss, it can be redesigned to address any loss. For example, this format has also been used for divorce and work-related losses. The sessions can use the same themes, but address the specific issues of the loss involved. risk to explore their grief and share it with others who are strangers. State that...

Arenas for intervention the Bronfenbrenner model

There is the adage that it takes a village to raise a child. Similarly, it can be stated that it takes a community to heal a bereaved child. This sentiment is embodied by school counsellors, ministers, and neighbors who rally around bereaved children in their time of need. Children who best maximize this support are those with the resiliency skills to maximize the support provided by the community. However, if the child lacks resiliency, then the community should create a bereavement...

Theories of Death Conceptualization

One cannot assume that a bereaved child accurately conceptualizes death. Rather, most theorists agree that conceptualization of death occurs in a sequential fashion. It is theorized that there are three basic concepts to understanding death as an entity universality, irreversibility, and the non-functionality of the deceased. Universality refers to the understanding that death happens to all living things, is inevitable, and is usually not predictable. Understanding irreversibility signals that...

Evolution of Models of Loss and Bereavement

Models and theories have attempted to explain the complex process experienced after significant loss and change in our lives. Evaluating the models of bereavement over time shows more of an evolution of theory and practice than the creation of distinct models. The focus has gone from theories of attachment and loss, to concepts of acute grief, to tasks, to stages, to psychological processes and phases. There are numerous models and it is beyond the scope of this book to identify all of them or...

Distorted and conflicted mourning

Distorted and conflicted mourning have similarities. Conflicted mourning is highlighted by ambivalence in a relationship. Distorted grief also involves ambivalence however, what differentiates the two is the intensity of specific emotions in the latter. Intense manifestations of guilt and anger are the primary grief responses in distorted grief. Research from Parkes and Weiss (1983) and Rando (1993) offers insight into these mourning responses. All human relationships have ambivalence (i.e.,...

Session 9 Assessing Support Systems and Rebuilding and Reconstruction

Introduce this week's theme by connecting it to the homework assignment. Bereaved individuals need to give and receive support. Giving support to those who are also in pain or experiencing difficulties is a form of altruism, which facilitates healing and reconstruction. Receiving support is an important concept in resiliency (I HAVE) and an integral part of the bereavement processes. It is important to assess what is currently available, and determine if these systems are effective. Often...

Psychological perspective

The loss of some aspect of self is a core issue to be explored. If one has invested a part of his her identity and energy, this is a loss that has to be acknowledged and grieved. Included in this perspective is the loss or compromise of meaningful roles. Contributing factors include personality, coping styles, affective and cognitive domains, present stressors, and overall mental health. Another consideration within this perspective is the idea that relationships are not created in a linear...

Community interventions

The community is a macrosystem that defines the spirit of its microsystems. As with the various microsystems reviewed above, a community can impact on a child's resiliency by its level of support, its expectations for each citizen, and by providing opportunities. Through its governing body, a community chooses the level of financial and political support it will provide children's organizations, thereby impacting the quality role support structures that exist for its children. Through its...