Article

Grief and Loss Education: Recommendations for Curricular Inclusion

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Abstract

Currently, the Council for Accreditation of Counseling and Related Educational Programs (2009) does not require course work on grief and loss, and it is possible for counselors to practice without any formal training in the area. The purpose of this article is to highlight the need for additional grief and loss education in the curriculum, provide a brief overview of the current literature surrounding grief and loss, and suggest pedagogical strategies for counselor preparation. © 2013 by the American Counseling Association. All rights reserved.

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... As such, grief presents in counseling as a common client concern (Hill et al., 2018) and can stem from the loss of a loved one through death, non-death loss (e.g., relationship loss, loss of lifestyle), or normal life transitions (e.g., retirement, relocating; Sullender, 2010). Given the ubiquity of these experiences, counselors should anticipate working with clients who are facing loss and grief throughout their years of practice (Doughty Horn et al., 2013). ...
... Although calls have been made to more purposefully integrate loss and grief competencies into counselor education (Doughty Horn et al., 2013), we aim to highlight the importance of supporting doctoral students in growing loss and grief competencies related to their roles as future counselor educators and supervisors. As the most recent Council for Accreditation of Counseling and Related Educational Programs (CACREP) standards identify supervision as one of the five core areas of doctorallevel student training (CACREP, 2015), we propose that doctoral students should be trained to identify VG observed within counselors-in-training (CITs) and themselves. ...
... In order to more thoroughly understand counselors' and supervisors' experiences of VG, it is necessary to first explore how loss and grief may present within the therapeutic context. Contrary to traditional stage models of bereavement, contemporary research indicates that grief is a more nuanced, nonlinear psychological response to loss that can vary significantly between individuals with respect to duration of grief and the presentation and intensity of symptoms Doughty Horn et al., 2013). For example, although the majority of individuals experience more normative grief responses, about 10% of bereaved individuals experience a protracted, debilitating, and sometimes life-threatening grief response known as complicated grief (Shear, 2012), also referred to as prolonged grief disorder (Prigerson et al., 1995) or persistent complex bereavement disorder (American Psychiatric Association, 2013). ...
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Article
The COVID-19 pandemic has brought about collective experiences of grief; thus, counselors-in-training (CITs) and their doctoral student supervisors may encounter increases in grief-oriented clinical work. In considering how to support CITs' work with grieving clients, doctoral supervisors should be prepared to help CITs manage experiences of vicarious grief (VG). Given the ubiquity of loss and the limited amount of grief-specific coursework in counselor training, CITs could benefit from exploring their experiences of VG with their doctoral supervisors in clinical supervision-a core area of training for doctoral students enrolled in counselor education programs accredited by the Council for Accreditation of Counseling and Related Educational Programs. In this manuscript, we (a) provide an overview of the literature on VG, (b) discuss the potential impact of VG on CITs, (c) present a case study illustrating attention to VG in supervision, and (d) provide practical strategies doctoral supervisors can employ when addressing VG in supervision, drawing on Bernard and Goodyear's discrimination model.
... There are two challenges to this process that deserve mention. Second, counselor educators' lack of experience or training to provide grief counseling training, as well as their own attitudes and beliefs about grief counseling (Doughty Horn et al., 2013;Eckerd, 2009;Humphrey, 1993), can be another challenge to offering grief counseling training in graduate programs. Given that grief counseling training is not required in graduate counseling programs (Breen, 2010), faculty may not be specifically trained to provide or teach grief counseling. ...
... As noted earlier, there is research to support incorporating grief counseling learning experiences in counselor education programs, but based on the authors' extensive review of the literature there is limited information in the counseling literature about how to develop these learning experiences. The content provided in this section is based on a review of the broader literature (e.g., Doughty Horn et al., 2013;Hunt, 2007;Humphrey 2009;Matzo et al., 2003;Wass, 2004) as well as the experiences of the authors, who have provided students with grief counseling training and supervision. It could be used to infuse grief counseling content into existing courses or to create a stand alone course. ...
... Based on a review of the literature (e.g., Doughty Horn et al., 2013;Humphrey, 2009;Hunt, 2007;Matzo et al., 2003;Servaty-Seib & Tedrick Parikh, 2014), the following topics are important to include in grief and loss counseling training: an overview of models of grief; developmental stages of grief; the role of culture in the grief experience; physical, emotional, behavioral, and spiritual reactions to grief and loss; grief counseling strategies when working with individuals, families, and groups; and counselor self-care. Content can be covered through readings and course activities designed to facilitate experientially-based learning about the role of grief and loss in counseling. ...
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Article
This conceptual manuscript describes how counselor education programs can benefit from integrating grief counseling content into existing curricula, as well as the issues that make that implementation challenging. The authors offer practical strategies and suggestions for course content and activities, and discuss implications for future research in this area.
... There are two challenges to this process that deserve mention. Second, counselor educators' lack of experience or training to provide grief counseling training, as well as their own attitudes and beliefs about grief counseling (Doughty Horn et al., 2013;Eckerd, 2009;Humphrey, 1993), can be another challenge to offering grief counseling training in graduate programs. Given that grief counseling training is not required in graduate counseling programs (Breen, 2010), faculty may not be specifically trained to provide or teach grief counseling. ...
... As noted earlier, there is research to support incorporating grief counseling learning experiences in counselor education programs, but based on the authors' extensive review of the literature there is limited information in the counseling literature about how to develop these learning experiences. The content provided in this section is based on a review of the broader literature (e.g., Doughty Horn et al., 2013;Hunt, 2007;Humphrey 2009;Matzo et al., 2003;Wass, 2004) as well as the experiences of the authors, who have provided students with grief counseling training and supervision. It could be used to infuse grief counseling content into existing courses or to create a stand alone course. ...
... Based on a review of the literature (e.g., Doughty Horn et al., 2013;Humphrey, 2009;Hunt, 2007;Matzo et al., 2003;Servaty-Seib & Tedrick Parikh, 2014), the following topics are important to include in grief and loss counseling training: an overview of models of grief; developmental stages of grief; the role of culture in the grief experience; physical, emotional, behavioral, and spiritual reactions to grief and loss; grief counseling strategies when working with individuals, families, and groups; and counselor self-care. Content can be covered through readings and course activities designed to facilitate experientially-based learning about the role of grief and loss in counseling. ...
... Bolstering these expectations is the reliance on increased grief training and education for teachers in much of the literature. Some research recommends an understanding of traditional models that promote objective, systematic responses to grief processing (Doughty Horn et al., 2013;Dyregrov et al., 2013). Mitchell (2005), in their work with student midwives, advocates for a focus on 'best practices' and 'evidence-based interventions' around grief management that evoke universal, objective approaches to grief and loss. ...
... Moreover, much of the work here references medical understandings and pathology, rather than a view of grief as a human process. All of the literature from this perspective is presented as universally applicable, save a few mentions of diversity that only rise to the extent of demarcating difference and/or deviance under 'cultural considerations' (Doughty Horn et al., 2013;Poole & Galvan, 2021, p. 69). Further, there is no critical engagement with the concept of grief; rather, it is treated as a monolith that refers to a specific, measurable, and tangible loss that, even when it affects a collective, is largely managed individually. ...
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Article
COVID-19 has saturated many spaces in loss and grief. Higher education has been saturated too, despite ongoing institutional demands that educators mitigate and manage the grief away. Such demands expose the colonial and carceral logics that operate in much of so-called higher education, logics that may often create what we call 'transcarceral grief'. Inspired by abolitionist activist scholarship, we understand transcarceral grief as an involuntary response to the surveillance, compliance, discipline, and punishment practices (or carceral logics) that have made education a site of restriction and confinement. Such a lens demonstrates how dangerous many of the 'must-do's' of grief and pedagogy can be and changes how we understand our own pandemic pedagogy. Thus, in this piece, we draw on scholarship, activism, theory, and narrated experiences to identify and work against transcarcerality while teaching/learning with grief in our Canadian and American institutions. Rather than mitigating, managing or recovering from grief, we offer a grief-facing praxis that has the potential to disrupt and reform how we metabolize grief in higher education. Further, we posit that our anti-transcarceral grief pedagogy has the potential to move us closer to the life-affirming space that we crave more than ever both in and out of the classroom.
... Social media, pop culture, and family norms often impact the ways that individuals believe they should be grieving, and feelings outside of those norms can cause discomfort, shame, or isolation. It is vital for all HSPs to explore cultural backgrounds for insight into their normative grief reactions (Doughty Horn, Crews, & Harrawood, 2013). It is not a matter of a right or wrong way to grieve, but rather the client's exposure to others' grieving processes and their internalization of how they believe they should be responding to a loss. ...
... These findings mimic the culturally competent approaches helping professionals should take when providing services to grieving clients. Scholars have stressed the need for cultural awareness when understanding one's grieving process, especially for individuals with non-Western cultural backgrounds, along with cultural sensitivity when developing appropriate interventions and treatment modalities (Doughty Horn et al., 2013;Waldrop, 2012). Stroebe and Schut (2010) emphasized the need to be culturally competent when using the Dual Process Model in order to understand cultural responses to a loss and normative expression to others. ...
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Culturally relevant addiction treatment options incorporating Native Hawaiian cultural themes rest mostly on a stand-alone acute service delivery model detached from the broader Native Hawaiian healthcare system. Federal policy changes and funding shifts in the addiction treatment marketplace have placed a greater emphasis on the medicalization of substance use disorders. Normative mainstream treatment and prevention literature hold that the current status of stand-alone, acute care treatment is largely an anachronism. This paper proposes new directions for human services professionals who wish to advocate for viable culturally responsive treatment models in the foreseeable future. By aligning specialty substance use disorder treatment providers with the expectations and requirements of the broader healthcare funding legal framework, service providers can help usher in a sustainable, transdisciplinary and integrated model of culture-adapted addiction treatment in the era of health care reform.
... Death is a universal process that impacts all living beings. It is imperative to self-evaluate one's own perceptions, beliefs, and biases about its occurrence from a cultural context (Doughty Horn et al., 2013). Furthermore, death is a seemingly frequent event in the addictions field given the nature of the work, requiring counselors to be diligent in reflecting on how they are professionally and personally impacted by the experience to maintain their own wellness (Gutierrez et al., 2019;Urmanche, 2020). ...
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This study explored the experiences of addictions counselors who have undergone client death and the immediate and long‐lasting impacts of client death on addictions counselors through the consensual qualitative research (CQR) method. We conducted semistructured interviews with 10 participants exploring their lived, in‐depth, experiences in working with clients with addictive disorders with focus given to the death of clients and how they responded to the experience. Results from a data analysis process using the CQR method indicate eight domains: (a) professional ethics, (b) coping skills, (c) client care, (d) preparation for profession, (e) experience of addiction, (f) agency impact, (g) exploring the death experience, (h) recommendations, and 28 categories embedded in each of these domains. Implications for counselor education, training, and practice are discussed.
... The use of popular movies is one of the techniques that are frequently used in counselor training (Toman & Rak, 2000). Counseling theories (Koch & Dollarhide, 2000;Peoples & Helsel, 2013), family counseling (Alexander & Waxman, 2000;Shepard & Brew, 2005;, developmental stages (Corcoran, 1999;Ello, 2007;Pierce & Wooloff, 2012), group counseling (Armstrong and Berg, 2005;Moe, Autry, Olson, & Johnson, 2014), ethics in counseling (Bradley, Whiting, Hendricks, Parr, & Jones, 2008;Koch and Dollarhide, 2000) grief counseling (Doughty Horn, Crews, & Harrawood, 2013;Hannon & Hunt, 2015), addiction (Warren, Stech, Douglas, & Lambert, 2010), psychopathology (Chambliss & Magakis, 1996;Toman & Rak, 2000) and multiculturalism (Nittoli & Guiffrida, 2017;Villalba & Redmond, 2008) stand out as the subjects of popular movies that are used. Studies examining the effects and functionality of the use of popular movies in counselor training point out that it provides enriching experiences to counselor candidates in recognizing the dynamics of the behaviors in multiple dimensions (Kağnıcı, 2015), being active learners through observation (Warren, Stech, Douglas, & Lambert, 2010), empathizing with various topics, gaining awareness and sensitivity through strong emotions (Pinterits & Atkinson, 1998;Kağnıcı, 2015;Nittoli & Guiffrida, 2017). ...
... Furthermore, adding a social and cultural diversity component on loss, grief, and exploration of cultural rituals for grieving would be helpful. Adding to the human growth and development section of curriculum, students could create a lifeline of losses, journal about their losses (written or via video), or tell a story about their experiences pertaining to loss and grief (Doughty Horn et al., 2013;Parikh, Janson, & Singelton, 2012). ...
Article
As grief can be considered a critical life event, unresolved grief can interfere with quality of life, affecting lifestyle, behavior, emotional strength, and cognitive function. Unresolved grief can even result in suicidal ideation. Counselors can and often do work with grief issues in clients and can promote positive outcomes for grieving clients by addressing personal loss and helping clients process grief related issues. This study was based on an analysis of students within counseling programs accredited by the Council for Accreditation of Counseling and Related Educational Programs based on earlier research conducted by one of the authors. Self-perception of competency in counseling clients who are having grief-related issues from loss was assessed using the Grief Counseling Competency Scale. By analyzing results of the Grief Counseling Competency Scale, participants showed a need for further training in grief counseling skills and theory. Results and implications of the quantitative analysis as well as suggestions for further study are discussed.
... Counselor educators and supervisors should help students to monitor the ways in which their emotional responses to significant loss impact their self-awareness as well as their empathic responses to clients. Particularly in cases of unreconciled grief, students may unwittingly avoid exploring their clients' emotional responses to loss because of potential reminders of their own grief that could arise (Doughty Horn, Crews, & Harrawood, 2013). Conversely, students acutely experiencing their own grief may overidentify with grieving clients and inadvertently cause harm by way of inappropriate self-disclosure and countertransference. ...
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Three assumptions guiding research and clinical intervention strategies for people coping with sudden, traumatic loss are that (a) people confronting such losses inevitably search for meaning, (b) over time most are able to find meaning and put the issue aside, and (c) finding meaning is critical for adjustment or healing. We review existing empirical research that addresses these assumptions and present evidence from a study of 124 parents coping with the death of their infant and a study of 93 adults coping with the loss of their spouse or child to a motor vehicle accident. Results of these studies indicate that (a) a significant subset of individuals do not search for meaning and yet appear relatively well-adjusted to their loss; (b) less than half of the respondents in each of these samples report finding any meaning in their loss, even more than a year after the event; and (c) those who find meaning, although better adjusted than those who search but are unable to find meaning, do not put the issue of meaning aside and move on. Rather, they continue to pursue the issue of meaning as fervently as those who search but do not find meaning. Implications for both research and clinical intervention are discussed.
Book
"Grief & Loss Across the Lifespan: A Biopsychosocial Perspective" is a book that covers the evolution of grief theory while addressing each life phase through the lenses of the normal developmental trajectory of that life phase, the issues of risk and resiliency, the typical and maturational living losses experienced at that age, the experience of the death of loved others during that developmental phase, and the experiences of others when a person of that age dies. Interventions are also addressed in each chapter and each life phase chapter ends with brief readings by people describing losses they experienced in that age. Framed around the idea that loss is painful but not pathological, this text seeks to remedy a tendency toward incorrect beliefs about one-size-fits-all grief theory
Article
The loss of a loved one carries serious consequences for the physical and emotional well-being of many of the bereaved. It is therefore not surprising that to mitigate the impact of loss and promote successful adaptation, various forms of grief therapy have been proposed. However, controversies about the effectiveness of bereavement interventions have arisen, in part because previous reviews have relied on small samples of studies, which makes drawing inferences about the evidence base for bereavement interventions precarious at best. Drawing on a recent comprehensive analysis of over 60 controlled studies, we attempt to offer a more definitive view, and we discuss moderators associated with more effective bereavement interventions. Finally, we conclude by considering several theoretically informed approaches that hold promise for the further refinement of evidence-based therapies for bereavement complications, and we suggest some future directions for grief research and intervention.
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The primary purpose of the present article is to provide an overview of three theories of mourning--The Dual Process Model of Coping with Bereavement, Meaning Reconstruction and Loss, and Attachment Theory and Loss: Revisited. These are linked both by their emphasis on the phenomenological and by ideas such as balance and flexibility. Connections are drawn between the mourning theories and counseling theories that are commonly employed by mental health counselors.
Article
The present investigation utilized coping capacities as desired outcomes and sought to evaluate the effects of one death education seminar. An experimental group (N = 24) experienced the entire seminar while a control group (N = 30) participated in only two class sessions. All completed the “Coping with Death Scale” at the beginning of the semester and again three weeks later. Results indicated significant changes in coping capacity on twenty-three out of thirty items for the experimental group. The control group revealed significance on only one item. Implications for students and death educators were discussed.
Article
The purpose of this phenomenological study was to examine seven school counseling students’ experiences of creating reflective video journals during their first internship course. Specifically, this study focused on capturing the essence of the experiences related to personal reactions, feelings, and thoughts about creating two video journal entries. Qualitative analysis revealed that reflection as a developmental process, authenticity, parallel process, and apprehension with the process were significant themes related to the video journaling experience. Implications for counselor education and training and directions for future research are presented.
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As workers face a changing and ever-complex employment landscape, traditional career theories and approaches may not be sufficient in meeting career challenges. Calls for integrated career theories have emerged as more people seek meaning and purpose in their lives and careers. This article proposes a career counseling option that integrates existentialism and Super's (1990) life-span, life-space approach to establish a foundation for a broader approach to career development that views clients holistically by exploring life and career meaning and purpose from a developmental perspective. A case example and interventions are provided to demonstrate practical application and a contextual framework, along with implications for counselors.
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The authors discuss the use of motion pictures to provide learning experiences for students in counselor education programs. A review of the counseling literature revealed many references to teaching with films; only 2 articles, however, recommended using film in counselor education. This article includes activities for teaching diagnosis, counseling theories, interventions, and ethics. Positive feedback was received from 182 graduate students who responded to a 5-item qualitative and quantitative follow-up questionnaire after they completed such a course.
Article
This study reviewed how attitudes of counselors-in-training toward death develop after completing a course on death education. Participants included 11 graduate counseling students enrolled in a 2-credit-hour course addressing death and dying, and grief and loss. Qualitative results from a content analysis of free-response narratives suggest the emergence of 3 themes: openness to examining death and death constructs; increased understanding of death; and reduced negative emotional state, namely, fear of death. Implications of the findings for counselor education and limitations of the study are discussed.
Article
This study investigated relationships among factors hypothesized as related to job loss grief. A summary grief score correlated positively with time since job loss and number of dependents, and negatively with length of notice. Perceived reemployment prospects and income loss related positively to some grief index subscales, as did the condition of living on one's own. Job duration correlated negatively with some grief responses. Implications for counseling and avenues for future research are discussed.
Article
Grief is prevalent in counseling, but little is known about the current status of counselors’ preparation and competencies to provide effective care. This exploratory study surveyed counselors (N= 369) on grief training, personal and professional experiences with grief, and grief counseling competence. Multiple regression analyses found training and experience were statistically significant predictors of competence. The strong relationship between variables suggests these concepts may be understood as synonymous. Implications for training, practice, and research are discussed.
Article
This article summarizes the author's original research, which sought to discover the elements necessary for using death-related ritual as a psychotherapeutic technique for grieving people who experience their grief as "stuck," "unending," "maladaptive," and so on. A death-related ritual is defined as a ceremony, directly involving at least 1 person and the symbols of the loss, and usually directly and indirectly involving others. Suggestions for counselors and psychotherapists are discussed.
Article
In this article, the authors introduce the virtual dream, a technique that entails writing a brief spontaneous dreamlike story on themes of loss, using a flexible set of assigned elements of setting and characterization to scaffold the writing. After providing several examples of virtual dreams written by workshop participants, the authors analyze the frequency of important narrative features in a diverse sample of 143 stories to demonstrate the feasibility and reliability of coding such accounts for clinical or research purposes. Finally, we conclude with some remarks on the therapeutic use of the virtual dream, whether as a prompt for personal reflection on themes of loss, as an exercise in the context of grief workshops or support groups, or as a homework assignment in grief counseling or therapy.
Article
Although pervasive throughout counseling psychology and other training programs that incorporate experiential activities, reflective journals have sparse, fragmented and disparate theoretical bases to support their use. Coming from the fields of counseling and professional education, the authors use counselor education as a template to explore the use of reflective journaling in higher education. This article reviews literature supporting the use of reflective journaling, presents descriptions of various types of reflective journals, and proposes a method that allows instructors and students to critique journal entries collaboratively.
Article
Death-related attitudinal changes in students enrolled in a Psychology of Death and Dying course were compared to those of students enrolled in Introduction to Psychology and Introductory Communication. Results indicated that communication apprehension regarding dying persons (CA-Dying) was more highly correlated with many death-related variables than was generalized communication apprehension (CA). In addition, those in the Death and Dying class were more death accepting, and more likely to covertly express fears about death and dying than those in the remaining classes. While death acceptance and unconscious fears of Pain/Injury/Disease increased among those in the Death and Dying class, such scores decreased over a three month period of time in the Introduction to Psychology and Introduction to Communication classes. These findings suggest that CA and CA-Dying are independent, and indicate that individuals' likelihood of interacting with dying persons is a factor in the reduction of death fears via dea...
Article
The field of grief therapy is currently in a state of conceptual revolution, opening the prospect of reconfiguring our understanding of the human experience of loss along constructivist lines. In this article I outline some of the tenets of such an approach, proposing that the reconstruction of a world of meaning is the central process in grieving. I then present several narrative strategies for assisting bereaved people in making meaning of loss, and discuss indications, illustrations, variations, and precautions pertinent to each.
Article
The contexts of loss are as numerous as they are varied. This article reflects upon loss within the context of the helping relationship and illustrates how storytelling, journaling, and correspondence can be used to process the experience of a counselor's loss. The richness of personal accounts, interwoven and connected, provides voice and place to the experience of the deceased and their loved ones. Through such a process, the counselor is assisted toward an integrative healing intervention that can be used to work through their shattered dreams following the death of their clients.
Article
The authors argued that death competence, defined as specialized skill in tolerating and managing clients’ problems related to dying, death, and bereavement, is a necessary prerequisite for ethical practice in grief counseling. A selected review of the literature tracing the underpinnings of this concept reveals how a robust construct of death competence evolved. Using the vehicle of a case study, the authors analyzed an example of empathic failure resulting from an apparent lack of death competence on the part of a mental health provider to illustrate the importance of this characteristic in delivering clinically effective and ethically sensitive grief counseling.
Article
This article describes an 8-week, curriculum-based traumatic death support group program that is offered at Bo's Place, a grief and bereavement center in Houston, Texas. The program was implemented in 2006 in an effort to help family members who had experienced a death in the family by suicide, murder, accident, or sudden medical problem. The program provides the opportunity for families to come to the center and engage in selected activities as a unit, while also providing adults and children the opportunity to participate in separate support groups with curricula adapted to different age levels. The program uses an integrated conceptual framework that draws upon elements from a variety of theoretical and conceptual models related to grief. The purpose of the program is to provide multiple paths for progress in the grief journey for the bereaved. In 2008, Bo's Place incorporated a brief questionnaire into the weekly meetings, in an effort to gain a better understanding of the perceptions of adult participants of the program and their own progress in their grief. The questionnaire asked adults to provide self-ratings of their perceptions of support from the program and of their progress in their grief journey. The positive results from this pilot study have encouraged Bo's Place to develop plans for more rigorous research into the mechanisms that contribute to progress in the grief journey for bereaved adults and children.
Article
As scientific research on grief and loss has grown, so too has the need to evaluate the methods with which it has been studied by investigators in psychology, medicine, and nursing, the major disciplines producing this literature. This review provides a comprehensive survey of the most widely used and most promising scales for the quantitative assessment of grief responses, including several recent instruments that were not considered by earlier reviewers. In addition, the authors draw attention to the possible contributions of alternative qualitative methods that deserve greater consideration by grief researchers and conclude with recommendations for the more progressive study of bereavement in the future. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Existential therapy in groups for older adults can help to provide life meaning; to facilitate social support; and to improve coping with grief, loss, chronic illness, and ultimately death. A scenario is presented that provides a clinical illustration of the use of existentialism in groups with older adults.
Article
The Handbook of Bereavement Research provides a broad view of diverse contemporary approaches to bereavement, examining both normal adaptation and complex manifestations of grief. In this volume, leading interdisciplinary scholars focus on 3 important themes in bereavement research: consequences, coping, and care. In exploring the consequences of bereavement, authors examine developmental factors that influence grief both for the individual and the family at different phases of the life cycle. In exploring coping, they describe new empirical studies about how people can and do cope with grief, without professional intervention. Until recently, intervention for the bereaved has not been scientifically guided and has become the subject of challenging differences of opinion and approach. Chapters in the care section of the volume critically examine interventions to date and provide guidance for assessment and more theoretically and empirically guided treatment strategies. The Handbook provides an up-to-date comprehensive review of scientific knowledge about bereavement in an authoritative yet accessible way that will be essential reading for researchers, practitioners, and health care professionals in the 21st century. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
This study attempts to explore the attitude toward death, which ranges from fear of death to its acceptance, held by students of one of the universities in Hong Kong. It also tries to examine the relationship between their attitude toward death and their ratings of life and death. Another aim of this study is to evaluate the efficacy of a death education course offered in that university. It is found that the present death attitude of Hong Kong university students is not satisfactory and that it has been significantly improved after students took a death education course.
Article
The certainty of facing death and bereavement and the complex personal and societal issues involved argue for the importance of death education. The current study addresses a gap in knowledge by beginning to assess the extent of dying, death, and bereavement (DD&B) course offerings by U.S. psychology departments. This article reports on data collected from an initial survey of psychology departments in nine Midwestern states. Approximately 20% of respondents have offered a DD&B course in the last 5 years. Reasons for lack of DD&B courses include faculty and curriculum issues, as well as DD&B topics being covered elsewhere. These issues are discussed, and data are compared with DD&B course coverage in health-related fields.
Article
There has been an evolution in the understanding of the nature of grief since S. Freud's initial work, Mourning and Melancholia (1917/1953). Mental health practitioners and researchers have established new models to aid in the conceptualization and treatment of grief issues. The purpose of this study was to examine the opinions of experts in the field of grief regarding elements of a new model of adult bereavement, Martin and Doka's (2000) adaptive grieving styles, using the Delphi Method to identify points of consensus. A survey of 20 experts in the field of thanatology reached consensus on 21 items in which the panelists addressed the uniqueness of the griever, recognized there are multiple factors that influence the grieving process (i.e., culture, personality, and gender), that most bereaved individuals use both cognitive and affective strategies in adapting to bereavement, and that bereaved individuals experience both internal and external pressures to grieve in particular ways.
Article
This article reports the continuing development of a brief paper-and-pencil measure of the extent of unresolved grief, the Texas Inventory of Grief (TIG).
Article
It has commonly been assumed by thanatologists that client problems centering on death and dying are particularly demanding and difficult for the mental health professional. The present study tested this assumption by asking 81 beginning counselors to rate their degree of comfort with 15 counseling scenarios, 5 of which involved death or loss (e.g., terminal illness, suicide, AIDS, grief) and 10 of which concerned other focal issues (e.g., rape, marital problems). As predicted, counselors rated situations involving death and dying as substantially more uncomfortable than other presenting problems. However, counselors' levels of experience and personal death threat were unrelated to their response to death situations, leaving the cause of their discomfort with such situations unexplained.
Article
Beginning counselors' levels of discomfort and ability to respond empathically to clients presenting with death-related issues was investigated. Fifty-eight masters-level counseling students completed the Threat Index and the Multidimensional Fear of Death Scale and viewed a series of 8 videotape vignettes depicting clients with death-related (e.g., grief, AIDS) and non-death-related problems (e.g., marital discord, physical handicap). As hypothesized, significantly higher levels of counselor discomfort were found in responding to client situations involving death and dying, especially when these involved serious illness in the client. In addition, personal fear of death predicted counselors' distress in death counseling. Contrary to expectations, counselors were actually slightly more empathic in responding to grief and loss than other conditions, although the overall level of empathy displayed was low in absolute terms. The least empathic responses were provided by counselors who construed death in fatalistic terms on the Threat Index, and who were "saturated" with death themes by the completion of death attitude questionnaires prior to viewing the videos. The authors concluded that death and loss counseling presents unique challenges to beginning mental health providers, especially for those whose personal death anxieties leave them vulnerable to such work.
Article
There are shortcomings in traditional theorizing about effective ways of coping with bereavement, most notably, with respect to the so-called "grief work hypothesis." Criticisms include imprecise definition, failure to represent dynamic processing that is characteristic of grieving, lack of empirical evidence and validation across cultures and historical periods, and a limited focus on intrapersonal processes and on health outcomes. Therefore, a revised model of coping with bereavement, the dual process model, is proposed. This model identifies two types of stressors, loss- and restoration-oriented, and a dynamic, regulatory coping process of oscillation, whereby the grieving individual at times confronts, at other times avoids, the different tasks of grieving. This model proposes that adaptive coping is composed of confrontation--avoidance of loss and restoration stressors. It also argues the need for dosage of grieving, that is, the need to take respite from dealing with either of these stressors, as an integral part of adaptive coping. Empirical research to support this conceptualization is discussed, and the model's relevance to the examination of complicated grief, analysis of subgroup phenomena, as well as interpersonal coping processes, is described.