Grief Issues Research Articles

Suicidal Behavior in Surviving Co-Twins

Recent research has provided strong support for the existence of a familial risk for suicide, and efforts have been made to separate genetic from enviromental risk factors. Twin studies have played a major role in the identification of genetic factors, and the results indicate that the concordance rate for suicide is higher in identical than in fraternal twins (Baldessarini & Hennen, 2004). Moreover, Segal and Roy (1995) reported a significantly higher frequency of nonfatal suicidal attempts by monozygotic (MZ) than by dyzygotic (DZ) twins whose co-twins had committed suicide. However, doubts remain as to whether the increased risk of suicide in MZ twins is a response to the intense grief over the loss of a close relative, or whether a common genotype is associated with suicidal behavior. Sudden loss, which may carry a stigma in the case of a suicide, has been linked to increased persistent emotional stress and physiological changes (Epstein, 1993; Martin & Dean, 1993). A number of researchers have reported greater suicidal ideation among bereaved MZ twins as compared to DZ twins, suggesting that a loss due to suicide may increase the risk of suicidal behavior in the surviving co-twin (Segal & Bouchard, 1993; Segal & Roy, 1995; Segal et al., 1995). The aim of the present article is to address the issue of the intense grief experienced by twins after the co-twin suicide.

The Adjustment Process of Ex-Buddhist Monks to Life After the Monastery

This study explores the adjustment process of five Western ex-Buddhist monks to life after the monastery, using an in depth case study approach and thematic analysis. Participants discussed their initial experience of leaving, the process of creating a new life and their relationship with the past. The findings indicated that while each case was unique, significant common themes emerged as features of the adjustment process. The adjustment had been multi-dimensional, challenging, difficult, confusing, complex and profound for the participants. They had to contend with issues of grief, delayed development, missing out on life experiences, difficulties with intimacy, money, identity, depression, anxiety and confusion. This was combined with the hope and promise of many newly found freedoms involved in establishing a new life and identity. Parallels are drawn to the experience of Catholic priests and nuns who have departed their Orders, Vietnam veterans, ex-cult members and individuals who have left total institutions where their identity and daily lives were highly prescribed. The adjustment experience of ex-Buddhist monks extends the literature on Buddhist monks and provides an example of a life transition of interest to the helping professions because of its potential relevance to a range of major transitions for which clients may seek assistance.

‘Sitting on the Mourning Bench’: Mental Health Workers and an Elderly Client

The present article documents the experience of a first year social work student on fieldwork placement in an Aged Persons Mental Health Service. The student was part of a team providing service to a long-term client of the service when he was diagnosed with a life-threatening illness. The student's compassionate response to the client raises questions about grief and professionalism, which she explored through a journal and in discussion with her supervisor and other team members working with the client. As part of their reflective practice, the student, her supervisor and the client's mental health workers formed a collective to document their experience and present a staff education session. This article is the outcome of these processes and explores important grief issues in Aged Psychiatry and demonstrates the valuable contribution made by a student to the work of the team in the rich learning environment of a fieldwork placement in aged psychiatry. It is published with the kind permission of the client's next of kin.

How's School? Helping Your Teenager Get the Most Out of High School By Erin Shale (2005). Crows Nest: Allen & Unwin. - A Safe Place for Caleb: An Interactive Book for Kids, Teens, and Adults With Issues of Attachment, Grief and Loss, or Early Trauma By K.A. Chara and P.J. CharaJr (2005). London: Jessica Kingsley Publishers. - Bullying in Schools:

How's School? Helping Your Teenager Get the Most Out of High School By Erin Shale (2005). Crows Nest: Allen & Unwin. - A Safe Place for Caleb: An Interactive Book for Kids, Teens, and Adults With Issues of Attachment, Grief and Loss, or Early Trauma By K.A. Chara and P.J. CharaJr (2005). London: Jessica Kingsley Publishers. - Bullying in Schools: How Successful Can Interventions Be? Edited by Peter K. Smith, Debra Pepler and Ken Rigby (2004) Port Melbourne, Victoria: ACER. 334pp, paperback, ISBN 0521528038 - Lost for Words: Loss and Bereavement Awareness Training By J. Holland, R. Dance, N. MacManus and C. Stitt (2005). London: Jessica Kingsley Publishers. $76 - Volume 16 Issue 1

Store-Bought Baby (review)

Reviewed by: Store-Bought Baby Deborah Stevenson Belton, Sandra Store-Bought Baby. Greenwillow, 2006 [256p] Library ed. ISBN 0-06-085087-6$16.89 Trade ed. ISBN 0-06-085086-8$15.99 Reviewed from galleys R Gr. 7-10 Leah is devastated by the death of her beloved older brother, Luce, in a car accident, and she's enraged when she overhears a family friend suggest that her parents' grief is tempered by the fact that Luce was their adopted, not biological, child. In her [End Page 441] yearning for her lost brother, however, she begins to wonder about his first set of parents, who don't know that they too have lost something; to this end, she begins searching for information about her brother's adoption and his birth parents. This is an unusual direction for a story of bereavement, but it's written with great emotional wisdom. Belton makes skilled use of the adoption component to explore common grief issues: Leah's mother's unleavened mourning causes Leah to wonder if she's insufficient ("Maybe you're disappointed that your natural child/ is ordinary/ not beautiful like your adopted one?" she says in one of several interpolated poems); Leah's determination to find Luce's blood relatives is really her desire to find Luce again. Both the characters of Luce and of Leah's gentle new boyfriend, Aaron, are somewhat idealized, but Luce is understandably viewed through the golden lens of longing, and readers won't begrudge Leah the staunch and supportive comrade in Aaron that she richly deserves. A poignant and loving story, this celebrates the strength of family even in the face of loss. Copyright © 2006 The Board of Trustees of the University of Illinois

Nursing Home Social Worker Skills and End-of-Life Planning

Little empirical information exists on nursing home social worker's involvement in advance care planning and end-of-life decision-making with nursing home residents and their family members. The purpose of this exploratory study was twofold: (1) to identify the frequency of skills associated with advance care planning that social workers use, and (2) to explore the factor structure of the scale used in the study. Results from 138 nursing home social worker respondents from New York State showed high frequency of advance directive discussions, care planning, and conflict resolution with families. The instrument factors clustered around administrative duties, and grief issues. There was substantial interest in continuing education in grief counseling with families.

Encore Parenting: When Grandparents Fill the Role of Primary Caregiver

This literature review explores the issues of grief and the interruption of developmental stages often experienced by grandparents who raise their grandchildren and presents a case study to illustrate that structural family therapy can address and combat these issues. An evaluation of the use of structural family therapy in relation to grief and loss issues is offered.

When Patients Die: Grief Amongst Health Care Professionals

Much of the literature pertaining to grief and bereavement focuses on the grief experienced by patients and their family members. Little has been written concerning grief amongst health care professionals. Many health professionals care for terminally ill patients on a daily basis. Often they follow the patient throughout the course of their illness, forming a relationship with both patient and family. The impact of a patient's death is often not addressed, nor are coping strategies to prevent stress and burnout. This paper will address the issue of grief amongst health professionals and offer strategies for coping.

Students' Opinions on Autopsy and Death

Background: Autopsies are commonly seen on television, but are less common in real life. Worldwide, the autopsy rate has declined drastically over the past half century, from approximately 50% to only five to 22% in the 1990s. These percentages are inflated by the number of forensic autopsies, which suggests that hospital autopsy rates for other purposes are very low. Some students graduate without witnessing a formal autopsy, and some students and medical practitioners consider the autopsy to be of little value. The purpose of this study was to assess the thoughts and feelings of students towards autopsies at the end of their medical training.Method: A survey of final-year medical students' thoughts and feelings on the autopsy, death and grief was performed by means of a self-administered questionnaire. Informed consent was obtained and the study was approved by the Ethics Committee.Results: Of the 164 respondents, 64 were female and 100 male. Their ages varied from 22 to 40, with a mean of 27,7 years. Only 11% had discussed their wishes with regard to an autopsy on themselves with their family, while 33% had discussed funeral arrangements. Most students thought that aspects of the autopsy should be changed, e.g. the deceased should remain anonymous, the number of students observing an autopsy should be reduced, the atmosphere should be more respectful and the organs should be handled with more care. During training, students have insufficient opportunities to discuss their thoughts and feelings about the autopsy, and issues of grief and death are insufficiently dealt with.Conclusions: Students' emotional reactions are an important, but unfortunately neglected, aspect of medical training. Student teaching needs to deal effectively with expected reactions through the understanding and management of these emotional responses towards cadaver dissection and other medical procedures. At both undergraduate and postgraduate levels, medical education must emphasise the importance of the autopsy. This means that academic institutions need to perform a sufficient number of autopsies for students to have the opportunity to observe and participate in them.

"Teares of the vertuous soule a blisse": guérir ou comprendre la douleur ? les sources classiques dans la littérature protestante du deuil et de la consolation en Angleterre (c. 1590-1640)

In their Christian responses to the different classical Greek and Latin psychological theories, early-modern English consolatory writings reveal deeply divergent approaches to the issues of grief and mourning. The unanimous rejection of Stoic apatheia in favour of Academic and Peripatetic metriopatheia serves the purpose of promoting two rival paradigms of mourning - eschatological, with a devotional and even ascetic thrust, and compassionate, echoing preoccupations of this world. These divergent models bring out the intrinsic value of grief, making it a means of conveying the relation of the self to the visible and invisible worlds. Consolatory writings consequently develop a hermeneutic as well as a therapeutic approach.

Promoting Self-Care and Daily Living Skills among Older Widows and Widowers: Evidence from the Pathfinders Demonstration Project

While most bereavement intervention programs for the recently widowed focus primarily on loss and grief issues, few, if any, specifically address ways to engage in necessary self-care activities, to assume new responsibilities that once belonged to their deceased spouse, and to remain socially connected to the larger community. The Pathfinders demonstration project was designed to provide important health and wellness information in a supportive environment where the participants could develop self-care and daily living skills and learn how to access additional community resources to meet their specific needs. This article describes changes in self-care and daily living abilities reported by the Pathfinders participants and ways in which they used what they learned in the classes to achieve health and independence and to meet the daily challenges of widowed life. Eight-four widows and widowers (age 50+) participated in one of five 11-week class sequences. Statistically significant, although incremental improvements over time were reported in active coping, health care participation, household management, home safety, and nutritional self-care skills. Almost all the participants reported applying at least some of the class content in their daily lives and nearly 70% sought additional information from sources outside the classes. After completing the program, many participants believed they were better prepared to take care of themselves and to address the daily challenges of widowed life. The results of the Pathfinders demonstration project suggest a promising new line of research focused on bereavement interventions other than those that traditionally address grief and loss issues alone.

Resources for the Elderly and Their Caregivers

ABSTRACT Objective: This article presents resources helpful to the elderly and their caregivers, covering healthy aging, physical conditions and mental health, end-of-life care, grief, housing options, and legal issues. Method: A query was sent to the MEDLIB-L e-mail discussion list to find out what information on aging would be useful to the subscribers' patrons. After private responses were received, resources recommended by MEDLIB-L subscribers were reviewed. Then a search of consumer literature and websites was undertaken to fill in gaps in information needed. Results: Resources that accommodate physical disabilities are mentioned, as are resources that provide information in more than one language. A recommended reading list is appended. Conclusion: This compilation responds to the needs stated by MEDLIB-L subscribers. It is not a comprehensive review; no Medicare and Medicaid information is included and only a few housing care options are discussed. There is no information about sleep disorders, or legal issues other than elder abuse. Lastly, resources outside the United States were not mentioned.

The Utilization of a Psychoeducational Group Approach for Addressing Issues of Grief and Loss in Caregivers of Individuals with Alzheimer's Disease

Abstract The examination of grief and loss associated with caregiving for individuals with Alzheimer's disease is just beginning to receive necessary empirical attention. With the increase in the number of people developing Alzheimer's disease, it is critical that social workers in aging specific agencies and in long-term care facilities identify strategies to assist caregivers with a variety of psychosocial reactions, including feelings of grief and loss. This article will present a model for a psychoeducational grief group specifically designed for caregivers of individuals with mid to late stage Alzheimer's disease. The model contains a curriculum for a 5-week group that allows caregivers to confront their personal grief and loss reactions, while also learning coping strategies. Recommendations for evaluation and replication of the group are identified.

Perspectives on Nonresidential Paternal Involvement and Grief: A Literature Review

This article reviews literature regarding nonresidential paternal involvement postdivorce. Attempts have been made to understand nonresidential fathers’ contact with their children from a variety of perspectives including level and quality, theoretical, sociocultural influences, legal, maternal, childhood, paternal, and paternal postdivorce grief. In most cases, the authors found elements of grief throughout the literature. However, current literature has not integrated these elements into a framework for understanding fathers’ postdivorce contact through a grief lens. Thus, this article explores the issue of familial and paternal grief and makes suggestions for future areas of research.

Dilemmas in brief therapy

This paper examines three central concerns for the short-term therapist at a time when therapy is widely available free of charge in the community, in a model that has been called ‘ serial life-span therapy’. Issues of referral-on, topping-up or extending contracts are experienced as dilemmas or as temptations, depending on what therapists believe their clients need and what their clients may demand of them. Short-term therapy has become accepted in many contexts, with therapy no longer used as a once-and-for all solution to clinical problems, but as a serial method over time which includes topping up and re-contracting. After an initial agreement of brevity, depending on the client's disturbance levels at assessment and on availability, there may be the need for referral-on at the end of a brief contract, when clients may be offered a different, long-term service, or they may be recommended to return later in life for more, if and when this becomes necessary. Flexible contracts rather than rigid rules about the termination of therapy are being practiced in many contexts, depending on ‘what works’ and how methods can be adjusted to new evidence. There is danger of collusion or control, and this can lead to therapeutic dilemmas, which involve taking acceptable risks, or to therapeutic temptations, which are due to the desire for narcissistic gratification, benefiting the therapist rather than the client in terms of power or Eros. Being able to let go of clients and manage issues of loss, grief and greed requires a measure of maturity in the therapist that aims for good-enough results rather than striving for perfect endings.

The Concerns of School Counselors‐in‐Training About Working With Children and Adolescents With HIV Disease: Training Implications

As the number of children and adolescents who have or are affected by HIV disease increases, so does the need to examine the preparation of counselors to work with this population. This study assessed (a) the knowledge, beliefs, and social comfort of school counselors‐in‐training, as related to working with this population, and (b) these students' concerns and perceptions about their preparedness. Participants reported high levels of general knowledge and positive beliefs; however, they also demonstrated deficits in specialized knowledge and discomfort in counseling situations. Participants expressed concerns about their preparation and ability to deal with grief issues. Implications for training counselors are discussed.

THE IMPACT OF ILLICIT DRUG USE ON NON‐USING SIBLINGS IN THE VIETNAMESE COMMUNITY

This study explored the issues facing young Vietnamese who have a sibling with an illicit drug addiction and the coping strategies that they and their families employ. This paper concentrated on the results from interviews/focus groups of Vietnamese parents and young people. There were some areas of commonality between the responses of the parent and youth cohorts. Issues of shame, guilt, grief and lack of support were raised by both groups. The reactions of parents and siblings change over time, as the negative impact of the user's behaviour intensified and family systems become strained. There were significant differences in the responses of the two cohorts in relation to parental behaviour. The youth cohort generally was critical of parental behaviour towards both children who are using illicit drugs and their non‐using siblings.

The object and the dream: Mark Rothko.

An exploration of unconscious determinants provides useful insights in considering Mark Rothko's creativity and behavioral characteristics. A basic focus is the issue of childhood loss and unresolved grief. The studies of Martha Wolfenstein on preadolescent and childhood parent loss are paramount in considering Rothko the man. Rothko, as a result of early losses, was predisposed to recurrent depressions and bouts of anger which created difficulties in his intimate relationships. Rothko evidenced a lifelong mistrust of male authority figures which may also account for his antipathy toward psychoanalysis. His psychological life was complicated by his experiences of institutionalized anti-Semitism which further diminished his trust in others.

Survivors of suicide. Emerging counseling strategies.

1. Effective intervention with survivors of suicide requires knowledge of the diverse sequelae of response including blame, anger, guilt, shame, search for why, and feelings of stigmatization. 2. Fearing blame and stigmatization, survivors of suicide may be reluctant to contact helping professionals. 3. Duration and intensity of bereavement is mediated by the survivors' nature of the relationship with the deceased and their perception of the preventability of the death. 4. Group counseling is an effective intervention because it addresses the issue of disenfranchised grief.

OBTAINING AGE-RELATED MENTAL HEALTH COMPETENCY: WHAT IS NEEDED?

A survey was administered to Department of Veterans Affairs (DVA) mental health professionals to determine whether they perceived themselves to be competent in addressing the needs of older veterans, and if not how they believed their deficits could be remedied. Forty-two percent of the 803 surveys were returned and answered in a valid manner. Results indicate that DVA mental health professionals spend 30% of their time with older veterans. Although most have had geriatric training, one-third had none. Almost three-fourths say that they desire more education in geriatrics, particularly in the areas of dementia, depression, grief, substance abuse, and legal and ethical issues. Preferred formats for training varied, suggesting that a number of different venues should be offered to address the geriatric training needs of mental health staff. It appears that most public sector mental health professionals spend a significant portion of their work day with older adults, have received some geriatric training, and would like more training.