Article

Ambiguous Loss and the Family Grieving Process

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Abstract

Ambiguous losses are physical or psychological experiences of families that are not as concrete or identifiable as traditional losses such as death. Ambiguous loss could include anything from miscarriage to losing one's spouse to Alzheimer's disease while he or she is still living. Ambiguous loss may include not knowing whether or not a loved one is living or dead, such as cases of child abduction or military personnel who are missing in action. Ambiguous loss is inherently characterized by lack of closure or clear understanding. This article defines types of ambiguous losses and details some of their characteristics. A model for counseling families who are experiencing ambiguous loss is described. Specifically, the model combines family stress theory with narrative therapy techniques to help families define their losses, assess their resources, and develop meaningful narratives about the loss.

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... An additional grief experience that is referenced in the literature is known as an ambiguous loss (Betz & Thorngren, 2006;Boss, 2004). Ambiguous loss is defined as an "unclear loss that continues without resolution or closure" and considered to be relational in nature (Boss & Yeats, 2014, p. 63). ...
... Ambiguous loss is defined as an "unclear loss that continues without resolution or closure" and considered to be relational in nature (Boss & Yeats, 2014, p. 63). Ambiguous loss is a loss that does not fit within the traditional notion of death (Betz & Thorngren, 2006). Boss and Yeats (2014) define two classifications of ambiguous loss: physical and psychological. ...
... Boss and Yeats (2014) define two classifications of ambiguous loss: physical and psychological. Ambiguous loss is typologized to be either loss where there is physical presence but psychological absence or physical absence but psychological presence (Betz & Thorngren, 2006;Boss & Yeats, 2014). Examples of ambiguous loss are child custody loss, foster care, adoption, a significant other experiencing dementia, lost at sea, a significant other leaving without saying goodbye, loss of a pet, perinatal death, infertility, murder, and so on (Betz & Thorngren, 2006;Boss & Yeats, 2014;Gilbert, 2007). ...
Article
Grief could be considered to be the universal experience notwithstanding the cause. For addicted mothers, grief is a constant companion after losing custody of their children often leading them to attempt suicide and engage in self-destructive behaviors. Little is known about the processes and symptoms of grief in these mothers. This hermeneutic study explores the grief of four crack cocaine recovering mothers who lost custody of their children. Thematically, three nonlinear stages were identified that the mothers passed through in an iterative manner: betrayal, soul-ache, and reclamation. Posttraumatic growth was identified as an outcome once the mothers entered recovery. It is imperative that clinicians from all disciplines recognize and respond to the grief that addicted mothers who lose custody of their children experience, through the offering of grief support and grief counseling.
... Previously understood boundaries can become blurred and ambiguous. Boss (2006) suggests that the situation for all within the family can become confusing, with family members becoming stuck in the same role, while others may no longer know what their position and role within the family means or entails (Betz & Thorngren, 2006). ...
... Suhr (2003, p. 30) observes that 'the established models [of grief] do not allow for the never ending, unresolved nature of the grief that accompanies an uncertain loss', such as missingness. Boss and Carnes (2012) assert that ambiguous loss is not amenable to traditional grief therapies that move towards a goal of closure; and that in circumstances that are ambiguous, those left behind experience their grief differently (Betz & Thorngren, 2006;Boss, 2002b). Boss (2006) suggests that a more appropriate support for those experiencing ambiguous loss is to help those affected cope with the stress that stems from the ambiguous situation. ...
... This is understandable given that traditional mourning and recognition for the loss of a loved one requires tangible evidence of what has been lost and what has become of the person (Boss, 2002b), something that is generally not available to the families of missing loved ones. Betz and Thorngren (2006) speak of ambiguous loss lacking closure and, therefore, the opportunity to progress through the typical stages of grief and conventional mourning rituals. ...
Thesis
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This thesis explores the experience of young people who have a long-term missing loved one – a father, grandfather, sibling or cousin - bringing the experience of young people when a loved one is missing into the spotlight, to remind others of their presence in families and communities affected by the loss of a missing person, and to inform practice and service provider responses. The research is informed by the construct of ambiguous loss as a theoretical framework, and the related concepts of trauma and loss, coping and resilience. Each young person sits within a family, a community, and a wider societal context.
... Another article discussed grief associated with pregnancy loss, particularly as related to work with infertile couples who had experienced recurrent miscarriages (Stark, Keathley, & Nelson, 2011). Betz and Thorngren (2006) explored family grief around ambiguous losses, with miscarriage mentioned multiple times as an example of such; they described a family counseling model that includes defining the loss, accessing coping resources, and creating a meaningful narrative of the event. Trepal and colleagues (2005) offered an empathyinfused overview of the topic, including conceptual and developmental perspectives and casespecific examples of diverse reactions to this type of loss. ...
... Sperry and Sperry (2004) presented a brief review of the literature as related to medical and psychological aspects of miscarriage and ectopic pregnancy, as well as a case example illustrating a therapeutic approach with a married, heterosexual couple who had experienced early pregnancy loss. It is noteworthy that four of the six miscarriage manuscripts that were selected for publication by counseling journals did not focus specifically on women clients, instead examining families (Betz & Thorngren, 2006), heterosexual couples (Sperry & Sperry, 2004;Stark et al., 2011), and male partners' experiences as part of such a couple (Wagner et al., 2018). Only three of the six focused on miscarriage specifically (Randolph et al., 2015;Trepal et al., 2005;Wagner et al., 2018). ...
... As previously mentioned, women vary in their responses to miscarriage, which may include relief that an unwanted pregnancy is over, resilience in the face of a setback, or deep sadness at the loss of a child (Engelhard, 2004;Trepal et al., 2005;Wallace et al., 2010). Although grief following early pregnancy loss mirrors other grief responses in intensity and duration, it is unique in its focus on the demise of an anticipated future rather than on memories of the past, leaving the griever to create a narrative of this ambiguous loss (Betz & Thorngren, 2006). Feelings of guilt, isolation, and shame are common (Bardos et al., 2015), exacerbated by cultural taboos regarding the expression of perinatal grief and related responses of minimization and dismissal by others (Markin & Zilcha-Mano, 2018). ...
... Existing literature has theoretically defined miscarriage as an ambiguous loss, but no previous studies have specifically examined the accuracy of identifying miscarriage as an ambiguous loss (Betz & Thorngren, 2006;Lang et al., 2011). The current study aimed to examine women's description of the miscarriage experience through the theoretical lens of ambiguous loss theory with the intention of providing mental health care providers with a greater understanding of how to treat this unique loss. ...
... Typical rituals and the stages of grief do not apply to ambiguous losses because these losses are not as clearly defined or understood as "traditional" losses (Boss, 2010). The ambiguity surrounding the losses is an arduous experience for most individuals because it inhibits normal cognitive coping, heightens anxiety, and makes closure difficult (Betz & Thorngren, 2006;Boss, 1999Boss, , 2007Boss, , 2010. The experience of ambiguous loss has been associated with symptoms of posttraumatic stress disorder as well (PTSD; American Psychiatric Association [APA], 2013) for both men and women (Boss, 2010). ...
... While it did not emerge as a saturated theme, a few participants found grieving a miscarriage to be difficult because no accepted ritual exists for processing grief following a miscarriage. This finding aligns with previous literature on ambiguous loss positing that the grief process remains stalled when a symbolic recognition of the loss does not occur (Betz & Thorngren, 2006;Boss, 1999Boss, , 2007Boss, , 2010. Lang et al. (2011) also found that the uncertainty around a ritual and the general ambiguity of the loss creates stress for couples who experience miscarriage. ...
Article
Full-text available
This study aims to explore miscarriage through the theory of ambiguous loss. The sample consisted of 10 females currently seeking support services related to their miscarriage experience. From the data, six primary themes emerged from the miscarriage experience, including: Emotional Toll; Stolen Dreams; No One Understands; He Loves Me in a Different Way; Why? I Don’t Understand; and In the End, I Have My Faith. The findings in the current study suggest ambiguous loss theory may not fully capture the experience of miscarriage. Clinical implications and future research directions for this population are discussed.
... Disappearances of persons affect thousands of people around the world yearly, especially in the context of war and/or state terrorism 3 (i.e., acts of cruelty conducted by a state against its own people Aust, 2010, p. 265). A frequently cited assumption (e.g., Betz & Thorngren, 2006; originating from family stress theories (Betz & Thorngren, 2006) and family systems theories (Carroll, Olson, & Buckmiller, 2007), is that "Ambiguous loss is the most stressful loss because it defies resolution and creates confused perceptions about who is in or out of a particular family" (Boss, 2004, p. 553). ...
... Disappearances of persons affect thousands of people around the world yearly, especially in the context of war and/or state terrorism 3 (i.e., acts of cruelty conducted by a state against its own people Aust, 2010, p. 265). A frequently cited assumption (e.g., Betz & Thorngren, 2006; originating from family stress theories (Betz & Thorngren, 2006) and family systems theories (Carroll, Olson, & Buckmiller, 2007), is that "Ambiguous loss is the most stressful loss because it defies resolution and creates confused perceptions about who is in or out of a particular family" (Boss, 2004, p. 553). ...
... Socijalna Psihijatrija, 29(1), 3-8. Betz, G., & Thorngren, J. (2006). Ambiguous loss and the family grieving process. ...
Thesis
Full-text available
This dissertation provides insights in consequences of, and psychological care after the disappearance of a significant other. In contrast with previous research on this topic, we focused on disappearances outside the context of armed conflict. A survey-study among 137 Dutch and Belgian people showed that 58% passed clinically relevant thresholds for prolonged grief disorder, posttraumatic stress disorder, and/or depression, on average 15 years post-disappearance. In contrast with an assumption that the disappearance of a significant other is the most traumatic loss, a comparative study showed that prolonged grief and posttraumatic stress levels were significantly higher in homicidally bereaved individuals than in relatives of long-term missing persons. Findings from three correlational survey-studies indicated that, similar to bereaved individuals, relatives of missing persons who experience more negative cognitions, and engage in more avoidance behaviors and ruminative thinking are more likely to experience elevated distress. Our findings also suggested that enhancing positive affect and being more self-compassionate are potential protective factors for experiencing distress post-disappearance. An interview-study among 23 people indicated that, according to relatives with little to no symptoms looking back on responses to the disappearance, learning to tolerate uncertainty is of utmost importance. These findings offer tentative support for our efforts to develop and evaluate the feasibility and potential effectiveness of cognitive behavioural therapy with elements of mindfulness (CBT+M) for relatives of missing persons with elevated distress-levels. Based on a pilot study among 17 people we concluded that CBT+M yields promising effects and that more research on this approach is justified. See for more information: https://www.rug.nl/staff/l.i.m.lenferink/research/publications.html?filter=thesis
... Because ambiguous loss is a "relational disorder … [where] ambiguity ruptures the meaning of loss, … [and] people are frozen in both coping and grieving" (Boss, 2007, p. 106), it has been applied to the experience of illness and disability. In this case, someone is physically present, but their body has undergone a significant change (Betz & Thorngren, 2006;Harris, 2011;Patrick-Ott & Ladd, 2010). I've experienced fatigue, insomnia, anxiety, depression, irritability, and anger, all symptoms of ambiguous loss (Harris & Gorman, 2011). ...
... I remember thinking that if I were driving, I could just speed up and smash into the tollbooth and end my life. Betz and Thorngren (2006) wrote that "when people lose their previous state of health because of illness or injury, they may no longer be able to do the things most important to them. ... They lose their identity and way of being in the world" (p. ...
Thesis
This uniquely formatted split-page autoethnography tells my story of learning to live with disability for more than 40 years. It presents the results of my personal narrative inquiry in the form of a layered account of embodied learning. This account offers an evocative autoethnography and analyzes disability in the context of an ableist society. It begins with my diagnosis of diabetes. Then it describes the effect of my disability on my identity, my marriage, my role as mother, my friendships, and my career. Finally, it closes with my near-death experience. I have reflected on my experiences as lived and as written. I set these experiences within the body of research on disability and within the context of adult education and lifelong learning. I examined the culture that has shaped who I have become/am becoming as a disabled person, as a researcher, and as a writer.
... Disappearances of persons affect thousands of people around the world yearly, especially in the context of war and/or state terrorism 3 (i.e., acts of cruelty conducted by a state against its own people; Aust, 2010, p. 265). A frequently cited assumption (e.g., Betz & Thorngren, 2006;) originating from family stress theories (Betz & Thorngren, 2006) and family systems theories (Carroll, Olson, & Buckmiller, 2007) is that "Ambiguous loss is the most stressful loss because it defies resolution and creates confused perceptions about who is in or out of a particular family" (Boss, 2004, p. 553). ...
... Disappearances of persons affect thousands of people around the world yearly, especially in the context of war and/or state terrorism 3 (i.e., acts of cruelty conducted by a state against its own people; Aust, 2010, p. 265). A frequently cited assumption (e.g., Betz & Thorngren, 2006;) originating from family stress theories (Betz & Thorngren, 2006) and family systems theories (Carroll, Olson, & Buckmiller, 2007) is that "Ambiguous loss is the most stressful loss because it defies resolution and creates confused perceptions about who is in or out of a particular family" (Boss, 2004, p. 553). ...
Article
Full-text available
Objective The disappearance of a loved one is claimed to be the most stressful type of loss. The present review explores the empirical evidence relating to this claim. Specifically, it summarizes studies exploring the prevalence and correlates of psychological symptoms in relatives of missing persons, as well as studies comparing levels of psychopathology in relatives of the disappeared and the deceased. Method Two independent reviewers performed a systematic search in Psychinfo, Web of Science, and Medline, which resulted in 15 studies meeting predefined inclusion criteria. Eligible studies included quantitative peer-reviewed articles and dissertations that assessed psychopathology in relatives of missing person. Results All reviewed studies were focused on disappearances due to war or state terrorism. Prevalence rates of psychopathology were mainly described in terms of posttraumatic stress disorder and depression and varied considerably among the studies. Number of experienced traumatic events and kinship to the missing person were identified as correlates of psychopathology. Comparative studies showed that psychopathology levels did not differ between relatives of missing and deceased persons. Conclusions The small number of studies and the heterogeneity of the studies limits the understanding of psychopathology in those left behind. More knowledge about psychopathology post-disappearance could be gained by expanding the focus of research beyond disappearances due to war or state terrorism.
... The disappearance of a beloved person can be a particularly stressful form of loss. Scholars have observed that grief reactions following a disappearance are a normal response to an abnormal situation [4,5]. If the type of grief experienced by a bereaved family reflects the circumstances of their loss, then an unresolved grief may be the result of an unresolved loss [6,7]. ...
... Moreover, it turns out that the community is unable to sustain this kind of uncertainty for a long time. It is also unable to support the families living this experience, because it is perceived as destabilizing [4,9]. In fact, the closeness of the community is generally felt only in the first weeks after the disappearance. ...
Article
Full-text available
This article presents the results of a qualitative study aiming to consider the relationship between ambiguous loss and anticipatory mourning amongst relatives of missing people in Italy. Eight people participated in the research, narrating their experiences of losing a beloved person (one found alive, three found dead, and four still missing). Findings suggest the presence of a particular form of ambiguous loss, characterised by traits typical of both prolonged and traumatic grief. These findings describe how families are faced with an emotional vortex related to a never-ending wait, and how the mourning is solved only when the missing person is found dead or alive. The discovery of a corpse is traumatic but it allows mourners to fully recognise their grief. When a person is found, it changes the relationship in a positive way. When neither of these events happen, mourners have two different kinds of reactions: they experience either a prolonged grief or a drive to solve their suffering by helping other people (post-traumatic growth). In this study, it is highlighted how a community can be useful or detrimental in this process, and the importance of psychological and social support to prevent significant clinical outcomes is stressed.
... It was difficult to plan for, hope for, and anticipate future joy as the pandemic stretched on and there seemed to be no end in sight. Betz and Thorngren (2006) wrote that "when people lose their previous state of health because of illness or injury, they may no longer be able to do the things most important to them. ... They lose their identity and way of being in the world" (p. ...
... We are still dealing with the pandemic, and we do not yet know the losses that may be in our future. Betz and Thorngren (2006) described storytelling as a form of narrative therapy that can offer individuals a place "to be heard and validated and also to explore alternate meanings around their experience of ambiguous loss" (p. 363). ...
... - Betz and Thorngren (2006) note that the family's capacity to 'move on' is 'not a sign of immobility or inability to deal effectively with a situation, but the powerlessness exacerbated by the uncertainty' (p. 362). ...
... Lenferink (2018) notes that the inclusion of this intervention may be important especially in terms of the presentation of negative cognitions and avoidance behaviours of families of missing people.' ABC-X model of family stress -most suited for family groups responding to the loss of a missing person. The model, as noted by Betz (2006), is useful due to its broad systemic approach where people can have shared perceptions of loss and helping people redefine or create new meaning and rituals surrounding their loss. ...
Article
Full-text available
2019 marks the twentieth anniversary of the 1999 landmark publication Ambiguous loss: learning to live with unresolved grief by Emeritus Professor Pauline Boss. The book, and its exploration of uncertainty, has invited ambiguous loss into the grief counselling space, as a way to provide specialised care for families and friends of missing people. This scoping review aims to examine the breadth of literature regarding counselling interventions from the previous work of Boss to the present day, as a way to enhance quality of life for people left behind when someone is missing. The literature highlights the experience of trauma relating to complicated mourning, as well as opportunities for post-traumatic growth while people wait for news of their loved ones. The results of the review, and suggestions for future research and therapeutic interventions, demonstrate that families of missing people need specialised support when they access grief counselling. The review demonstrates how counsellors can extend their knowledge of grief interventions and learn to tolerate uncertainty themselves in order to provide support to this important group of individuals post-loss and potentially prior to a confirmed bereavement.
... Aligned with the concept of family stress, the theory of ambiguous loss focuses on the tendency for individuals to respond to stress both positively and negatively (Betz & Thorngren, 2006). Boss (2006) highlighted the notion of resilience as a way of managing and preventing stress. ...
Article
This phenomenological study elicited the narratives of young adult women about their childhood experiences with ambiguous loss due to physical paternal absence. Ambiguous loss is defined in this research as a non-death-related loss that is confusing, complicated, or unresolved (Boss, 2006). Semi-structured interviews were conducted with ten women between the ages of 22 and 32 for this study. They were selected because they had grown up with a biological father who had been physically absent before they had turned 18 years old. Four themes emerged related to the following: Parental messages and responses to paternal absence; Impact of being “there” but not there; Making sense of identity; and resilience and redefining family. Each theme built upon one another and represented an over-arching story of the phenomenon of paternal absence due to ambiguous loss. Many of the participants expressed a sense of relief when they learned from the researcher that there was a term to describe their experiences of loss related to paternal absence. Participants shared that they felt their experiences with paternal absence were nebulous and unformed prior to learning about the concept of ambiguous loss. This research adds a retrospective lens to the existing literature on paternal absence and ambiguous loss. The current study has many implications for how clinicians can appropriately address confusing or unresolved losses in therapeutic practice.
... Therefore, narrative therapy might be a useful theory to use with children after a few years have passed, or with adults who are still impacted by 1 3 having their parent deported. Other scholars have cited narrative therapy techniques as useful for families who have gone through ambiguous loss as a way of exploring alternate meanings around their experience (Betz and Thorngren 2006). It would be helpful to create space for them to share their full narrative about the experience, with an emphasis on learning, change, and positive growth. ...
Article
Full-text available
Around 4.5 million U.S. citizen children are at risk of being separated from a parent due to deportation. This means that many citizen children who have a deported parent are growing up with fragmented families and long-distant parents. These children are often in the care of their remaining family members. Therapists need to understand what remaining family members can do to ease the transition for children and help them to make sense of their parent being deported. A retrospective lens is employed to explore adult experiences of their family post-deportation. Findings show that family went through a reorganization process after parental deportation which impacted how the child understood the deportation and affected the child’s perceptions and experiences of their parental loss. Implications are offered through the Family Resiliency Framework.
... However, studies of absence, especially as a psychological and social phenomenon at work are scarce (Kahn, 1990). Although studies exist that explore social absence for example as a symptom of a disease or grieving (Baxter et al., 2002;Betz and Thorngren, 2006), the term social absence or absent-mindedness 9 (see for example Fisher and Hood, 1987), is not commonly used in organisational literature. However, I argue that social absence and social presence present different ends of a continuum; this axis can be seen as a range of states varying from full social absence through medium levels of attention and engagement to full social presence. ...
Chapter
Global work is often organised around virtual meetings. Different time zones and schedules, plus competing priorities and roles, pose challenges for virtual team members. Social presence in a team does not automatically equate with physical or virtual presence. Therefore, the notions of being physically, virtually, and socially present or absent in global team meetings are important, and affect the collaboration of global work groups. This chapter examines the dimensions of presence and absence in global virtual work and presents a propositional model to study predictors and effects of presence and absence in virtual meetings. The physical, virtual, and social dimensions of presence are examined in both co-located and virtual settings.
... A sense of confusion may persist in which the uncertainty created by the absence fosters a climate of personal indecision whereby important decisions cannot be taken. Roles, routines and family rules may also be frozen in time and the absence of a body also denies the family the social licence to grieve, making it impossible to perform the religious or personal rituals, which can break down denial and allow the family to move through the grieving process (Betz & Thorngren, 2006;Boss, 2002). ...
Article
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Ten mothers of men and boys who were abducted and listed as missing during the war in Kosovo in 1998/1999 were interviewed in Kosovo in the spring of 2012. Although the missing are presumed dead by the authorities, the mothers continue to live in a state of emotional ambiguity where a presumption of death is balanced with the hope of being reunited. In the absence of absolute proof, finding the remains of their loved ones becomes a major preoccupation. Using a social phenomenological approach, this study explored the social and political complexities existing within the life-world of these women. The findings suggest that they live in a continual state of psychological distress, and even when remains are returned, the unknown elements of the narrative of their abduction and murder only add to their distress and force many into self-imposed emotional exile away from community and close family.
... Once symptoms of ambiguous loss (prolonged grief, depression and anxiety to name a few) have been identified by a practitioner, they can assist families in the process of change by facilitating a safe environment in which the adolescent can explore his/ her feelings. Possible interventions dealing with ambiguous loss include support groups, play therapy, expressive arts, narrative therapy and psycho-education (Betz & Thorngren, 2006;Wood & Lacto, 2010). Play therapy has been concluded to be beneficial for youth and adolescents experiencing grief and symptoms of ambiguous loss. ...
Article
Full-text available
Shifts in U.S. immigration policy over the past two decades have resulted in increased deportations of unauthorized persons residing in the United States. As a result, a disproportionate number of Latinx families have been subjected to forced family separations. While previous studies have focused on the effects of parental deportation on young children, this study uniquely contributes to the literature by exploring how adolescents experience and cope with a forced family separation. Drawing upon ambiguous loss theory, in-depth, semi-structured interviews were conducted with Latinx youth (n = 8) and their mothers (n = 8) who experienced a forced family separation, and school-based staff (n = 11). The analysis revealed four main findings: 1) Following the deportation of a parent, youth experienced symptoms of trauma; 2) fear of additional family separation; 3) behavioral changes; and 4) academic disruptions. Implications include developing culturally-based, trauma-informed, and contextually situated assessments and interventions for youth and families affected by deportation .
... Once symptoms of ambiguous loss (prolonged grief, depression and anxiety to name a few) have been identified by a practitioner, they can assist families in the process of change by facilitating a safe environment in which the adolescent can explore his/ her feelings. Possible interventions dealing with ambiguous loss include support groups, play therapy, expressive arts, narrative therapy and psycho-education (Betz & Thorngren, 2006;Wood & Lacto, 2010). Play therapy has been concluded to be beneficial for youth and adolescents experiencing grief and symptoms of ambig- uous loss. ...
Article
Shifts in U.S. immigration policy over the past two decades have resulted in increased deportations of unauthorized persons residing in the United States. As a result, a disproportionate number of Latinx families have been subjected to forced family separations. While previous studies have focused on the effects of parental deportation on young children, this study uniquely contributes to the literature by exploring how adolescents experience and cope with a forced family separation. Drawing upon ambiguous loss theory, in-depth, semi-structured interviews were conducted with Latinx youth (n = 8) and their mothers (n = 8) who experienced a forced family separation, and school-based staff (n = 11). The analysis revealed four main findings: 1) Following the deportation of a parent, youth experienced symptoms of trauma; 2) fear of additional family separation; 3) behavioral changes; and 4) academic disruptions. Implications include developing culturally-based, trauma-informed, and contextually situated assessments and interventions for youth and families affected by deportation .
... Nurse Education Today j o u r n a l h o m e p a g e : w w w. e l s e v i e r. c o m / n e d t these do not meet all of the psychological needs faced by service children ( Fossey, 2012). These voluntary sector organisations are clearly essential ( Cruse Bereavement Care, 2013), but there is limited support for those service children who may have a sense of ambiguous grief in which they have 'lost' a parent to illnesses such as PTSD as the outcome of service in the Forces ( Betz and Thorngren, 2006). This literature review aimed to explore and provide a better understanding of the experience of military children when a Forces veteran family member has PTSD and the impact of this, specifically from the child perspective. ...
... Generally, when dealing with grief, an individual seeks closure as a means of coping with loss. One of the most difficult aspects of dealing with ambiguous loss is that this type of loss does not have a perceived natural or societal closure event associated with it, such as a funeral (Betz and Thorngren 2006). Many individuals experiencing ambiguous loss cannot fully express their loss due to the uncertainty surrounding their circumstances, which can cause ambivalence and denial (Boss 1999). ...
Article
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• By using financial therapy techniques, mental health theories can be applied to the financial planning process to equip financial planners with tools to assist families with a member suffering from Alzheimer’s disease while remaining within their scope of competence. • Through the lens of ambiguous loss theory, this paper provides guidelines for financial planners working with families living through the experience of having a family member present but psychologically and cognitively absent. • Implications of these guidelines are that financial planners will be able to develop better communication skills, deepen their relationships with clients, develop more empathy for families experiencing ambiguous loss, and understand the importance of a financial planners’ own self-care to ensure that they do not experience burnout.
... The disappearance of a significant other, also described as an ambiguous loss (Boss, 2006), is a unique type of loss to deal with because of the intersection of grief and holding on to hope (Wayland, Maple, McKay, & Glassock, 2016). Many researchers have suggested that a prolonged and debilitating grief process following the disappearance of a loved one is a normal response to an abnormal situation (Betz & Thorngren, 2006;Boss, 2006;Hollander, 2016). Interestingly though, several studies have shown that a considerable number of relatives of long-term missing persons do not suffer from long-lasting psychological complaints, such as prolonged grief, posttraumatic stress, or depression (see for an overview Lenferink, de Keijser, Wessel, de Vries, & Boelen, 2017). ...
Article
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Twenty-three nonclinical relatives of long-term missing persons were interviewed. Patterns of functioning over time were studied retrospectively by instructing participants to draw a graph that best described their pattern. Patterns most frequently drawn were a recovery and resilient/stable pattern. Participants were also asked to select five out of fifteen cards referring to coping strategies, which they considered most helpful in dealing with the disappearance. Acceptance, emotional social support, mental disengagement, and venting emotions were most frequently chosen. This study provided some indication of coping strategies that could be strengthened in treatment for those in need of support.
... ABC-X model of family stress: this is most suited to family groups responding to the loss of a missing person. The model, as noted by Betz (2006), is useful due to its broad systemic approach where people can have shared perceptions of loss and can help people redefine or create new meaning and rituals surrounding their loss. ...
Book
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Through a mixed methods research design the study sought to explore: • What might be the best practice guidelines for providing crisis and ongoing counselling to families of missing people? • What advancements have there been in the counselling field that may be relevant to families and friends of missing people in Australia? • How can information regarding supportive interventions be conveyed appropriately to health professionals seeking to support this population group?
... Os pais podem censurar-se por não ter protegido a criança, e nos irmãos verifica-se um importante impacto pessoal (Clark, Warburton, & Tilse, 2009), já que as crianças são sensíveis às emoções e mudanças familiares. A família pode ter medo de trair a criança ausente por a considerar morta, quando a deveria continuar a procurar; as fases do luto e os rituais relacionados com o mesmo não se podem aplicar do mesmo modo no contexto do desaparecimento (Betz & Thorngren, 2006). As consequências de um desaparecimento são variadas e englobam fatores psicológicos (e.g. ...
Article
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Objetivo O desaparecimento de uma criança pode ser caracterizado por uma perda ambígua em que a criança está ausente fisicamente mas presente psicologicamente. No contexto da literatura atual não é ainda claro como é que indivíduos e famílias se adaptam a este evento adverso, verificando-se um escasso investimento na investigação sobre este tema. Deste modo, realizou-se uma revisão sistemática com o objetivo de identificar as áreas sobre as quais incidem os estudos existentes sobre crianças desaparecidas, com maior foco na compreensão da sua vivência e impacto na família. Método No presente estudo realizou-se uma revisão sistemática dos estudos empíricos relacionados com a temática do desaparecimento de uma criança. Resultados Foram incluídos na revisão 37 estudos analisados a partir de uma análise qualitativa, surgindo quatro temáticas: programas de prevenção de rapto; características do desaparecimento; implicações no reconhecimento de pessoas desaparecidas; impacto psicossocial do desaparecimento. Conclusão A revisão permitiu concluir que a investigação sobre crianças desaparecidas é escassa e apresenta uma grande dispersão de temas. Verificou-se a necessidade de examinar as características e o impacto dos diversos tipos de desaparecimento. A intensidade deste fenómeno não normativo justifica a necessidade de investigações que possam informar práticas de prevenção e de intervenção empiricamente sustentadas.
... 148 The APA's TFMHA proposed four models: (a) abortion as a traumatic experience, (b) abortion within a stress and coping perspective, (c) abortion within a socio-cultural context, and (d) abortion as associated with co-occurring risk factors. 7 Additional models could be built on biological responses, 149,150 attachment theory, 151-154 bereavement, 153,155-158 complicated, prolonged or impacted grief, [159][160][161][162][163] ambiguous loss, 156,161,[164][165][166][167] or within a paradigm of psychological responses to miscarriage. 74,[168][169][170] The complexity of considering so many models, or pathways, combined with the multiplicity of symptoms women attribute to their abortions, 45 contributes to discord in the literature produced by AMH proponents and AMH minimalists. ...
Article
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The abortion and mental health controversy is driven by two different perspectives regarding how best to interpret accepted facts. When interpreting the data, abortion and mental health proponents are inclined to emphasize risks associated with abortion, whereas abortion and mental health minimalists emphasize pre-existing risk factors as the primary explanation for the correlations with more negative outcomes. Still, both sides agree that (a) abortion is consistently associated with elevated rates of mental illness compared to women without a history of abortion; (b) the abortion experience directly contributes to mental health problems for at least some women; (c) there are risk factors, such as pre-existing mental illness, that identify women at greatest risk of mental health problems after an abortion; and (d) it is impossible to conduct research in this field in a manner that can definitively identify the extent to which any mental illnesses following abortion can be reliably attributed to abortion in and of itself. The areas of disagreement, which are more nuanced, are addressed at length. Obstacles in the way of research and further consensus include (a) multiple pathways for abortion and mental health risks, (b) concurrent positive and negative reactions, (c) indeterminate time frames and degrees of reactions, (d) poorly defined terms, (e) multiple factors of causation, and (f) inherent preconceptions based on ideology and disproportionate exposure to different types of women. Recommendations for collaboration include (a) mixed research teams, (b) co-design of national longitudinal prospective studies accessible to any researcher, (c) better adherence to data sharing and re-analysis standards, and (d) attention to a broader list of research questions.
... The framework of double awareness helps us explore with caregivers the many current or anticipatory tangible and intangible losses associated with a cancer diagnosis in the family. In addition to discussing fears related to dying and death , we discuss other tangible losses such as a loss of income or fertility and intangible or ambiguous losses, namely losses that caregivers experience on an ongoing basis and that are often not recognized or legitimized as they are not as clearly definable or certain as death (Betz & Thorngren, 2006). Common intangible losses that we discuss with caregivers include the loss of the illusion of certainty or the loss of the vision (whether it was implicit or explicit) that one had for the future. ...
Article
Full-text available
Family caregivers make significant contributions to the overall care of cancer patients and are the “invisible backbone” of the health care system. Family caregivers experience a wide range of challenges and can be considered patients in their own right, requiring support and dedicated attention, which may benefit them, the patients they are caring for, and the health care system. Despite consistent evidence on caregiver distress and unmet needs, most cancer care is organized around the patient as the target of care and caregiver distress is not screened for or addressed systematically. This article describes the development of a novel clinical, educational, and research program dedicated to supporting family caregivers at the Princess Margaret Cancer Center, Toronto, Canada and presents a model for a brief psychosocial intervention for caregivers. The objective of this article is to assist others in developing services to address the needs of family caregivers as a standard of care.
... The attribution of these mental capacities and character traits might be explained by a complex grieving process called ambiguous loss. Ambiguous loss is characterized by the experience of a loss that is unclear and that, in turn, impairs progression in the grieving process (26)(27)(28). Ambiguous loss has been observed in a variety of contexts, including when military personnel are missing in action, or when families care for an individual with a neurodegenerative disease. In the former case, ambiguous loss occurs because it is unknown if the loved one will ever be seen again. ...
Article
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Objective: To explore the ways in which health care professionals and families understand terms and concepts associated with disorders of consciousness. Methods: Open-ended, semi-structured interviews were conducted with 20 health care professionals and 18 family caregivers affiliated with a disorders of consciousness program within a nationally ranked rehabilitation facility in the United States. Results: Analysis revealed that: (1) disagreement between some health care professionals and family caregivers regarding the presence of consciousness can arise due to differing beliefs about a patient experiencing pain, and differences in the length of time family caregivers spend with patients relative to clinical staff; (2) some health care professionals and family caregivers use nonclinical terms and concepts to describe consciousness; and (3) some family caregivers might attribute complex mental capacities to patients, which extend beyond the clinical evidence. Conclusion: The beliefs of health care professionals and families regarding disorders of consciousness are complex and could be influenced by broader psychological proclivities to “see minds” in patients who have a liminal neurological status. Awareness of these dynamics may assist health care professionals when interacting with family caregivers.
... Cultural rituals and the support system of the loved ones facilitate the grieving process to some extent (Betz and Thorngren, 2006). However, what happens when people have no information about the loved one who is reported missing? ...
Article
Full-text available
The research was conducted with the aim of understanding the far-reaching psychological consequences of the war that took place in the territory of former Yugoslavia (1991-1995). The study examines the relationships between wartime traumatic experience of loss, the quality of life and mental health, and the role of social support across three categories of respondents: the first consisting of the respondents who had lost a close family member in the war and whose remains have not been found to date; the second category consisting of the persons who had lost a close family member in the war, and the third category including the respondents who participated in the war socialization but did not experience the loss of a close family member in the war. The survey used the Psychosomatic symptoms lists, the Depression Symptoms Questionnaire, the Subjective Happiness Scale, the Life Satisfaction Scale, and the Social Support Significance Assessment Scale. The results show that the respondents who continue to search for the body of a missing family member have a lower quality of life than the other two categories of respondents, as well as a more pronounced presence of depressive and psychosomatic symptoms. The role of social support in the trauma recovery process remains unclear. The results of the study are discussed in relation to completed and prolonged traumatic loss, and point to further research into the complex emotional dynamics as a consequence of war socialization and the importance of professional psychological support.
... Without a clear understanding of the absence of parents, children with incarcerated parents are often left feeling abandoned, confused and depressed about the ambiguity until an explanation is given. This ambiguous loss and separation from parents could bring physical, behavioral, emotional and social problems to children, such as sleep loss, headaches, fatigue, fear and avoidance, anxiety, depression, anger, over-activity, crying, apathy and difficulty or inability to make and sustain friendship or trust in incarcerated parents and caregivers (Betz & Thorngren, 2006;Erozkan, 2016;Murray & Murray, 2010). ...
Article
Full-text available
The externalizing and internalizing behavioral impacts of parental incarceration on their children has been widely examined. However, understanding the breadth and depth of possible negative impacts on children at different developmental stages, and whether protective factors can be identified to offset such impacts, has been limited. This review systematically reviewed 57 articles and extended the developmental outcome to six key impact themes, with some articles identifying more themes than others: behavioral (n = 34), mental health (n = 26), social relationships (n = 17), academic performance (n = 17), substance use (n = 10), and short-term and long-term physical health (n = 6). To provide a global review, this study examined research across nations from Western to Eastern countries, consisting of 126,690 children and adolescents with incarcerated parents against 577,445 peers with no parents of such histories. Most children and adolescents exposed to parental incarceration are vulnerable to mental health impacts including anxiety, behavioral issues and school performance. The earlier the exposure to parental incarceration, the greater the risk of marijuana use, sexually transmitted infection and multiple partnerships in adolescence. These challenges often continue into emerging adulthood. This review found that the well-being of parents, positive family relationships and successful co-parenting can offset some adverse impacts. Future research lines and implications for preventive support to such children, adolescents and families are discussed.
... It is well documented that changes to these expectations, such as in the case of illness or disease, can lead to grief of that loss. 23 In addition to expectations about a child's life including activities and experiences, in the MHS, there may often be expectations of the child's intended career path. The idea of legacy can be very important in military families. ...
Article
Genetic counseling for military beneficiaries poses unique challenges and counseling opportunities. In order to fully meet the needs of this population, genetic counseling involves critical ethical and psychosocial considerations. This article reviews some elements of genetic counseling that must be considered when working with beneficiaries in the military health system.
... This enables the process of reconstructing the life history while simultaneously helping the griever construct a more adaptive and empowering identity. However, in cases where the relationship with the deceased was an ambiguous one, additional challenges may emerge: the distorted re ection of who we are in the eyes of the deceased remains frozen, and an opportunity to evolve and recover that repaired sense of self is lost (Betz and Thorngren 2006). ...
Chapter
This chapter is part of a broader study that aims to prospectively assess the long-term effects of ayahuasca on bereavement. The qualitative reports shown here are from participants who attended workshops at the Temple of the Way of Light while processing grief over the death of a loved one. Several themes emerged: emotional processing, making meaning of the past, reconstructing identities, continuing bonds with the deceased, and finding existential meaning. These psychological processes have been described as mediators in grief adaptation in scientific literature. Adding to this evidence, we also explored the perspectives of four Shipibo onaya healers. This way, we understood that the observed therapeutic effects of ayahuasca cannot be described solely in terms of psychological and intrapersonal dimensions, since they are embedded in a particular ceremonial and ethnomedical context, with many experiences being reported in relation to the participant’s perception of the role of the work of the Shipibo healers and the icaros.
... This enables the process of reconstructing the life history while simultaneously helping the griever construct a more adaptive and empowering identity. However, in cases where the relationship with the deceased was an ambiguous one, additional challenges may emerge: the distorted re ection of who we are in the eyes of the deceased remains frozen, and an opportunity to evolve and recover that repaired sense of self is lost (Betz and Thorngren 2006). ...
Chapter
Jorge Ochavano Vasquez, also known as Soi, is a Shipibo onaya (“one who knows”: a healer who works with oni, meaning wisdom or knowledge, the Shipibo name for ayahuasca) from the Ucayali River Basin in the Peruvian Amazon. Heir to a long line of Shipibo onayabo, he was initiated into this medical system while growing up in a region of rainforest undergoing rapid globalization and urbanization. Soi belongs to a generation of young Shipibo healers whose practice has been heavily informed and influenced by the increasing interest, attention, and presence of Western ayahuasca seekers. Working regularly in retreat centers that cater to Western clients (including the Temple of the Way of Light as well as his own family center in the native community of Nueva Betania). In this interview, we explore Soi’s perception of illness and well-being as it emerges from the encounter between two worldviews and their related medical systems. Amazonian diagnostic categories such as “daño,” “susto,” or “cupia”—some of the most common complaints among indigenous or mestizo Amazonians—imply a degree of external agency and are usually attributed to sorcery, magic, or disharmonious relationships with the plant, animal, or spirit realms. Yet, the majority of Westerners seeking ayahuasca usually complain of depression, anxiety, posttraumatic symptoms, and a variety of other self-reported experiences that, whether as diagnostic constructs or subjective narratives of affliction, are mostly prevalent in industrialized and individualistic societies. In this interview, we offer the perspective of a young healer, who dialogues with both indigenous etiologies and Western diagnostic constructs, working on the frontline of the controversies surrounding the tension between tradition and innovation, and who has lived experience of the paradoxical nature of “development” in a rapidly Westernizing world.
... As noted in Betz and Thorngren (2006), the families of missing relatives might go through cycles of hope, only to be disappointed once more. Even in the situation when the woman is missing for almost 20 years, the relatives cannot fully accept the loss. ...
Technical Report
Full-text available
This study is a preliminary estimate of the cost of doing nothing to prevent many Indigenous women and girls from going missing and being murdered. It gives an insight into the emotional journeys of the families left behind. It also assesses the current financial cost of dealing with this tragedy based on calculations drawn from the literature and estimates of the number of MMIWG in Manitoba.
... The resulting ambivalence is a hallmark of ambiguous loss and contributes to the ways that it defies the common grief cycle. As it happens, ambiguous loss has been associated with post-traumatic stress disorder (Boss, 2010), disenfranchised grief (see Doka, 1999), and a myriad of psychological issues that makes finding closure difficult (Betz & Thorgren, 2006). Furthermore, ambiguous loss fundamentally disrupts a person's identity (Boss, 2006). ...
Article
Women who have an abortion experience a major disruption to their identities in addition to being at a higher risk for deleterious health outcomes such as depression, anxiety, and suicidal behavior. These identity and health implications become even more complicated when a woman terminates a wanted pregnancy due to health complications. In the present study, we took an interpretive narrative approach to explore the identity (re)constructions of 33 women who terminated a wanted pregnancy due to fetal health complications. Narrative thematic analysis revealed five distinct identities: (a) the political mother, (b) the devastated mother, (c) the grieving but hopeful mother, (d), the self-sacrificing mother, and the (e) every mother. Implications for how these identity constructions can inform both theory and practice are discussed.
... When loss disrupts life, mourning has a way of bringing healing and restoration to the disruption (Neimeyer, 2015). The opportunity to culturally appropriately mourn losses such as friend networks, familiar social structures, and access to cultural resources within the host country is a powerful tool for healing and helps promote positive mental health outcomes in immigrant populations (Betz & Thorngren, 2006;Bhugra & Becker, 2005). ...
Article
Over 16 million people in the United States belong to a mixed‐status family in which at least one member of their household is undocumented. The current study will explore adult reflections on childhood experiences of parental deportation in order to elucidate their meaning of the loss and if their experiences resemble an ambiguous loss. Interpretative Phenomenological Analysis was utilized to analyse in‐depth retrospective meaning‐making narratives of adult children who lost a parent to deportation. Findings indicate that the children of detained or deported parents experienced difficulty not knowing what was happening, believed their parents would return, and noted family practices that they found to be helpful or unhelpful in processing their loss.
Chapter
Social workers are key interdisciplinary team members who support oncology patients and their families across the continuum of cancer care, from the time of initial diagnosis through end-of-life and in various care settings. The roles of the emergency department (ED) and palliative care social worker are both complex and complementary in providing support to oncology patients/families in the ED. To ensure continuity of care and avoid duplication of services, social workers in the fields of ED, oncology, and palliative care work together to employ strategies and initiatives that improve cancer care across all settings. Among other positive outcomes, such interdisciplinary care serves to minimize unnecessary ED visits and hospitalizations. This chapter examines social work’s involvement with oncology patients in the ED, as well as the oncology social work role in the outpatient setting, and suggests psychosocial interventions that may be utilized with this population. Current and future initiatives are proposed among ED, oncology and palliative social workers for patients/families with oncologic emergencies.
Article
In the bereavement literature, prolonged grief, described in the new DSM-5 as persistent complex bereavement disorder, is considered a pathological disorder affecting a small but significant minority of bereaved persons. In the ambiguous loss literature, in contrast, prolonged grief is viewed as inevitably linked to the ambiguity of the bereaved person, and its causes are linked to the ambiguity, such as persistent hope, the absence of cultural and religious rituals to provide meaning to a loss, and the grief being so large as to disenfranchise community members. Based on a literature review and qualitative fieldwork with parents of missing persons in Uganda, this article examines the emotional, social, cultural, and socioeconomic aspects of the ambiguity that relatives of missing persons experience in the aftermath of wartime disappearances. I argue that, in such contexts, explanations of prolonged grief as a pathological disorder cannot be sustained.
Article
Indigenous storytelling is an important site of knowledge for Indigenous peoples around the world. It is imperative that studies of Indigenous people incorporate a style that matches the interconnectedness of Indigenous knowledge. We use an inter-disciplinary approach to examine how Indigenous storytelling can inform current social work practice and pedagogy with the end goal of promoting healing for Indigenous people. Utilising an Indigenous research paradigm, we locate Indigenous knowledges through modern storytelling outlets, including novels, graphic novels, poetry and podcasts. Through conventional content analysis, we identify how a sample of Indigenous storytellers based in a settler-colonial state (Canada) navigates through traumas such as residential schools and sexual violence. For the people whose stories we examine, these traumas prove to be only a part of the grief they experience at the loss of their connection to family and culture. Through this sample of Indigenous storytelling, we see that the best possibility for healing comes from reconnecting with cultural practices and by resisting settler-colonial social work practices.
Article
In this article I analyze the collective management of ambiguous emotions in the case of grief arising from perinatal loss/stillbirth. Based on a content analysis of selected Polish discussion lists for bereaved parents and interviews with moderators of these lists, I conceptualize the experience of grief arising from miscarriage/stillbirth as both culturally "disembedded"-not regulated by a coherent set of feeling and display rules, and interactionally "disenfranchised"-framed by the immediate social surrounding of the bereaved as illegitimate. This study then focuses on subsequent social processes surrounding the collective management of such emotions through interactions within online bereavement communities, leading to the creation of local definitions of the situation of loss and formation of subcultural feeling and display rules of grief. I posit that in a wider perspective these community processes can be seen as grassroots mechanisms that agents use to transform the existing emotional culture of grief. © 2016 Society for the Study of Symbolic Interaction. All rights reserved.
Article
VSO is an international development charity that uses the skills of experienced professionals to work along side local colleagues. VSO sends trained and qualified education practitioners to share their experience in a diverse range of professionally challenging roles - working as in-service teacher trainers or as District Education Advisors - in some of the world’s poorest countries. This research examined how time spent on VSO aids the professional development and practice of teachers upon their return to the UK, and explored how the experience was perceived to impact on career prospects. The research design comprised two stages: firstly, 21 returned teachers participated in face-to-face in-depth interviews; and, secondly, an on-line survey of 87 returned teachers was conducted. The majority of participants in the study were female and trained for primary teaching, a quarter was ‘secondary-trained’, and the remainder were from specialist teaching roles or had Further / Higher education backgrounds. The quantity and quality of the information provided in the interviews and questionnaires paid testament to the high regard that the volunteers had for their placements and VSO.
Chapter
Social workers are key interdisciplinary team members who support oncology patients and their families across the continuum of cancer care, from the time of initial diagnosis through end-of-life and in multiple care settings. The roles of the emergency department (ED) and palliative care social worker are both complex and complementary in providing support to oncology patients/families in the ED. To ensure continuity of care and avoid duplication of services, social workers in the fields of ED, oncology, and palliative care work together to employ strategies and initiatives that improve cancer care across all settings. Among other positive outcomes, such interdisciplinary care serves to minimize unnecessary ED visits and hospitalizations. This chapter examines social work’s involvement with oncology patients in the ED, as well as the oncology social work’s role in the outpatient setting, and suggests psychosocial interventions that may be utilized with this population. Current and future initiatives are proposed among ED, oncology, and palliative social workers for patients/families with oncologic emergencies.
Article
Parental abduction of a child occurs when the child is removed, by one parent, from the custody of the other parent or legally appointed guardians. The absence of the child has a profound impact on family members and significantly affects their lives. Also, parental abduction of a child is a relevant social problem which calls for further understanding. The aim of this research was to characterize the experiences of left behind parents in the context of parental abduction of a child. The data for this exploratory qualitative study were analyzed through thematic analysis of the semi‐structured interviews carried out with eight male participants in Portugal. Participants' perceptions were organized around three main themes: the impact of this adverse event on different areas of their lives, recovery strategies, and perspectives regarding the future. Findings and their implications for professionals working with these families are discussed in light of the ambiguous loss and ambiguous boundaries frameworks.
Article
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The loss of a child comes with trauma, which affects parents and the entire family. Yet, there is limited support for parents who lose their child and little empirical research has been devoted to the experiences of parents who lose a child in the Ghanaian context. Based on interviews with 20 participants purposively sampled from the Accra Metropolis, this study explored parents’ psychosocial experiences of child loss using a qualitative approach. The study’s findings indicated that bereaved parents showed signs of complicated grief and experienced spousal neglect, self-blame, and emotional pain. Bereaved parents may become sensitive to child comments years after child loss. The quality of interaction after child loss influences how parents experience the loss. Findings underscore the need for a joint effort by government and other stakeholders in the health sector to address issues related to child loss and provide improved services to those who suffer child loss.
Chapter
The music plays over images of missing persons posters. Posters layered over more posters of forgotten faces. Pictures of young girls, boys, and assumed run-aways flash across the screen. Worn and torn posters peeled from wooden poles, as weathered as the rusty nails which once secured them in place.
Article
While the AMBER Alert system is intended to facilitate the rescue of abducted children, it has practical and psychological limitations. Participants indicated their emotions and perceptions about Alerts before and after reading a vignette that manipulated details about a child abduction. Results indicate that the Alert system fits some criteria of Crime Control Theater (CCT). CCT polices are emotion-based legal actions that appear to address crime but fail to do so and have unintended consequences. Participants experienced panic about child abduction and believed the system is an effective tool which should be used no matter the unintended consequences. Emotions and panic positively related to perceptions of the system. Still, perceptions were not particularly positive, indicating that some participants recognize the system's limitations. Female and community participants generally had more positive perceptions than males and students, especially when experiencing high emotions or panic. Reading about an abduction reduced emotions overall and led to more positive perceptions (but only in the ‘AMBER Alert success’ condition). Reading about an ‘Alert failure’ did not affect perceptions. Results highlight the role of emotion in shaping perceptions of the system. As with other CCT policies, lawmakers should rely less on community sentiment and more on science when adopting legislation.
Article
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El presente documento consiste en un estudio de corte descriptivo, el cual, atiende desde un análisis teórico de revisión de la literatura, el proceso de aflicción detonado en los padres y madres tras algún tipo de discapacidad presente en hijos e hijas, el cual hasta el momento ha sido ampliamente asociado al proceso de etapas del duelo por muerte. Por lo que en este documento se plantea el análisis del concepto de duelo en padres y madres de hijos con discapacidad desde el concepto de pérdida ambigua y el termino de duelo y sus etapas; con el objetivo de proponer un nuevo termino a la dinámica de aflicción ambigua que sufren los padres y madres de hijos e hijas con discapacidad. The present document analyzes the process of grief caused by disability in sons and daughters, which recently has been associated with the process and stages of mourning for death. This document suggests the analysis of the concept of grief in parents of children with disabilities from an ambiguous loss perspective.
Article
Nearly one in five clinically confirmed pregnancies ends in a loss before 20 weeks (Bardos et al., 2015). Despite the prevalence of miscarriage, many women and partners experience a lack of acknowledgment and support while also encountering complicated concerns related to the intersection of perinatal loss, culture, religious and spiritual issues, medical treatment, their reproductive stories, and grief (Randolph et al., 2015). Counselors working with these clients must address complex cultural considerations. As such, we review key cultural and religious/spiritual issues related to early pregnancy loss and offer recommendations for practice based on the current literature in the context of the Association for Spiritual, Ethical, and Religious Values in Counseling (2009) counseling competencies.
Article
The purpose of this research was to explore women’s experiences of pregnancy loss. The following five themes were identified: (a) grief and new emotions, (b) social aspects, (c) meaning making, (d) subsequent pregnancies, and (e) what was and would have been helpful. The results indicate that counselors can be instrumental in the healing of women who have experienced pregnancy loss. Specifically, counselors can help clients communicate effectively with their families, partners, and social networks post-loss.
Article
Every year, many medical schools across the USA and abroad hold memorial ceremonies to honor anatomical donors. While the impact of memorial ceremonies to honor anatomical donors on students has been explored, the impact on donor family members (DFM) is less understood. The purpose of this study was to evaluate the impact of the Convocation of Thanks (CoT) on both donor family members and students at the University of Vermont (UVM). From 2011 forward, donor family members were invited to attend and participate in the annual CoT at UVM. Each year, a survey was sent out to attendees after the ceremony to collect feedback about the ceremony. In 2015, surveys were sent to the first-year medical students. Inquiries and registration for the Anatomical Gift Program were tracked before and after each ceremony. Between 2011 and 2015, responses from 38 family members in attendance, and responses from 34 students were evaluated. Analysis of family comments revealed the CoT helped them to gain an understanding of the importance of anatomical donation of their loved one (42%), and find closure for their loss (29%). The main theme that emerged from students was appreciation of the personhood of the donors (44%). Data suggest that the CoT had a positive impact in both families and students. For family members, it provided closure of the loss of a loved one for family members, while also highlighting the importance of anatomical donation, which family members may not have previously recognized.
Article
Full-text available
This book describes the clinical application of the growing body of ideas and practices that has come to be known as narrative therapy. The primary focus is on the ways of working that have arisen among therapists who . . . have organized their thinking around 2 metaphors: narrative and social construction. [This book is a text] for anyone curious about narrative, ready to have customary ways of seeing the world challenged, and eager to adopt clinical practices that give precedence to people's voices and stories. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Despite their core place in family life, grief and loss have received only sporadic attention in the family therapy literature. In examining this neglect we briefly revisit earlier family therapy understandings of grief and loss in families, and present a theoretical framework (drawing on Worden, 1982; Walsh & McGoldrick, 1991) that comfortably integrates a wide range of family grief experiences including death and more ambiguous losses.
Article
In At the Will of the Body, Arthur Frank told the story of his own illnesses, heart attack and cancer. That book ended by describing the existence of a "remission society," whose members all live with some form of illness or disability. The Wounded Storyteller is their collective portrait. Ill people are more than victims of disease or patients of medicine; they are wounded storytellers. People tell stories to make sense of their suffering; when they turn their diseases into stories, they find healing. Drawing on the work of authors such as Oliver Sacks, Anatole Broyard, Norman Cousins, and Audre Lorde, as well as from people he met during the years he spent among different illness groups, Frank recounts a stirring collection of illness stories, ranging from the well-known—Gilda Radner's battle with ovarian cancer—to the private testimonials of people with cancer, chronic fatigue syndrome, and disabilties. Their stories are more than accounts of personal suffering: they abound with moral choices and point to a social ethic. Frank identifies three basic narratives of illness in restitution, chaos, and quest. Restitution narratives anticipate getting well again and give prominence to the technology of cure. In chaos narratives, illness seems to stretch on forever, with no respite or redeeming insights. Quest narratives are about finding that insight as illness is transformed into a means for the ill person to become someone new.
Article
A review of Families & Change: Coping With Stressful Events and Transitions-4th edition by Sharon J. Price, Christine A. Price and Patrick C. McKenry.
Article
ABOUT THIS BOOK In At the Will of the Body, Arthur Frank told the story of his own illnesses, heart attack and cancer. That book ended by describing the existence of a "remission society," whose members all live with some form of illness or disability. The Wounded Storyteller is their collective portrait. Ill people are more than victims of disease or patients of medicine; they are wounded storytellers. People tell stories to make sense of their suffering; when they turn their diseases into stories, they find healing. Drawing on the work of authors such as Oliver Sacks, Anatole Broyard, Norman Cousins, and Audre Lorde, as well as from people he met during the years he spent among different illness groups, Frank recounts a stirring collection of illness stories, ranging from the well-known—Gilda Radner's battle with ovarian cancer—to the private testimonials of people with cancer, chronic fatigue syndrome, and disabilties. Their stories are more than accounts of personal suffering: they abound with moral choices and point to a social ethic. Frank identifies three basic narratives of illness in restitution, chaos, and quest. Restitution narratives anticipate getting well again and give prominence to the technology of cure. In chaos narratives, illness seems to stretch on forever, with no respite or redeeming insights. Quest narratives are about finding that insight as illness is transformed into a means for the ill person to become someone new.
Article
While death is a biological event, the ways in which we make sense of it are shaped by the social discourses of the worlds in which we live. A narrative and social constructionist therapeutic approach opens new practices of conversation with those who are dying or bereaved. These practices emphasize the ongoing story of relationship. Stories are encouraged to bring forth and develop positive connections following death to support a position of agency, hopefulness, and legacy. From this perspective, grief too becomes an evolving and creative opportunity for story development rather than an unpleasant task to be worked through as quickly as possible.
Article
This paper summarizes the chief issues and findings in "family crisis research" as viewed by family sociologists. 5 areas are covered: (a) the conceptual framework used by family sociologists in their study of crises; (b) a catalogue of the stressful events that have been studied, as well as those that remain unstudied; (c) findings which indicate kinds of families which thrive and those that wilt under stress; (d) generic phases and methods of adjustment to stress; (e) assessment of short-run and long-run effects of stress on families. The article concludes with a discussion of the implications of the preceding data for agency policies and practice. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Chapter
There are three principal sections to this book. This first section is an introduction that provides the theoretical and political frame for the material presented in the other two sections. In this first section, I have presented an overview of some of the more recent developments in social theory that David and I have found of compelling interest, and some of what we believe to be the implications of those ideas for therapy. The discussion of theory includes some of Michel Foucault's thought on power and knowledge. It is our hope that the material that we have included in this book adequately reflects our exploration of practices of the literate tradition in a therapy that is situated in the text analogy and in Foucault's thought, and fairly represents the experience of these practices on behalf of those persons who have sought therapy. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
In mastery-oriented societies and cultures the tendency is to seek »closure«, find the answer, fix the problem quickly. The situation of »ambiguous loss« is a most deeply challange. The situation of September 11 in New York City is especially complicated because the people search for evidence of their missing. The therapeutic challenge is the question: How can we help families to resolve their losses when they never have verification of death or a body to bury. The concept of ambiguous loss can in this situation be helpfull also in nontherapeutic context.
Echoes from the past: Helping families deal with their ghosts
  • M Mcgoldrick
McGoldrick, M. (2004). Echoes from the past: Helping families deal with their ghosts. In F. Walsh & M. McGoldrick (Eds.), Living beyond loss (2nd ed., pp. 310-339). New York: Norton.
Diagnostic and statistical man-ual of mental disorders Ambiguous loss: Learning to live with unresolved grief Working with families of the missing
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American Psychiatric Association. (2000). Diagnostic and statistical man-ual of mental disorders (4th ed). Washington, DC: Author. Boss, P. G. (1999). Ambiguous loss: Learning to live with unresolved grief. Cambridge, MA: Harvard University Press. Boss, P. G. (2002). Working with families of the missing. Family Process, 41, 14-17.
Counselling for loss and bereavement
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Tshudin, V. (1997). Counselling for loss and bereavement. Philadelphia: Bailliere Tindall.
Working with the stories of women's lives
  • K Weingarten
Weingarten, K. (2001). Working with the stories of women's lives. Adelaide, Australia: Dulwich Centre.
Coping with loss Unacknowledged and stigmatized losses
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  • T Moro
Weiner, I. (1999). Coping with loss. Mahwah, NJ: Lawrence Erlbaum. Werner-Lin, A., & Moro, T. (2004). Unacknowledged and stigmatized losses. In F. Walsh & M. McGoldrick (Eds.), Living beyond loss (2nd ed., pp. 247-271). New York: Norton.
Grief as a family process
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Shapiro, E. (1994). Grief as a family process. New York: Guilford.
The externalizing of the problem and the re-authoring of lives and relationships
  • M White
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