Grief Counseling Research Articles

Long-term care placement: The transitional support needs and preferences of spousal dementia caregivers.

Many spousal caregivers experience stress, depression, loneliness, guilt and grief when placing a partner with dementia into long-term care. However, there is little research about their transitional support experiences, needs and preferences. This study aimed to gain a deeper understanding of these issues from spousal caregiver and long-term care facility staff perspectives, to inform subsequent support and intervention development. Semi-structured interviews and small group discussions were held separately with spousal caregivers (n = 9) and care facility staff (n = 11). Criterion and variation sampling aimed to ensure a range of experiences and perspectives. The 'Framework' approach was utilised for data analysis. Interpretation was with respect to underpinning models of stress-grief process in dementia caregiving. A range of informational, psychoeducational and psychosocial supports were identified to help spousal caregivers cope better with the stressors and losses experienced throughout the transition from home to long-term care. Improved education about disease progression, information relating to long-term care provision, peer support and dementia-specific grief counselling were deemed important. Opportunities for better support within care facilities were also identified. Support should be tailored to individual needs and preferences. The findings suggest a supportive care framework be developed, encompassing the trajectory from assessment for and admission into long-term care to end-of-life and post-bereavement support. Spousal caregivers should have their support needs assessed by trained health or social care professionals and be offered a range of support options as appropriate.

Crafting order and beauty from loss: using found poems as a form of grief therapy

ABSTRACT The death of a loved one can create a tear in the fabric of meaning. Grieving involves remaking meaning. In therapy, events can be emplotted into stories, which can return some sense of coherence to the bereaved. In this paper, I present a way of narrating loss through a narrative therapy approach of retelling. This involved writing found poems, known as rescued speech poems, from the conversations of people who had lost a loved partner. The found poetry sought to bring an order to grieving and to polish the beauty of key moments following loss. For one participant, the found poetry amplified a narrative of the biography of the loved one. For another, the poems added beauty to a memory of her deceased partner. Thus, rescued speech poems—judiciously selected from speech, and sensitively arranged on the page—can provide another way to facilitate vibrant meaning-making of life after loss.

Assimilation in bereavement: charting the process of grief recovery in the case of Sophie

ABSTRACT This theory-building case study examined an application of the Assimilation of Grief Experiences Scale (AGES), a conceptual account of a bereaved person’s process of change in grief recovery, in a case study of a 40-year old woman in bereavement counselling. An assessment session and 44 counselling sessions were analysed intensively, comparing the description provided by the AGES with the details of the case. Results showed how the AGES tracked and described details of Sophie’s recovery.

Surviving the suicide of a loved one: impact and postvention.

Literature review of peer reviewed literature (PubMed, PsycINFO), books about bereavement, suicide, postvention and postvention guidelines. Suicide loss survivors may have an increased risk of developing psychiatric disorders such as post-traumatic stress disorder, depressive disorders, anxiety, and substance abuse; an increased risk of suicide; increased physical complaints; and an increased risk of developing Persistent Complex Bereavement. About postvention, two measures turn out to be very important. An immediate first on-the-spot intervention that includes: specific training for general practitioner and police; to direct survivors to support services; provide proactive and practical support; psychological autopsy. The second intervention is a long-term one and can be delivered in a variety of ways: the most effective therapy for survivors appears to be Complicated Grief Therapy, but in general the therapist must be adequately trained for individual psychotherapy with survivors. Other effective interventions include: writing projects; group psychotherapy; support groups. A public health approach to postvention can allow to tailor interventions to the needs of survivors, and to align postvention with suicide prevention programs.

EMS experience caring and communicating with patients and families with a life-limiting-illness

Introduction: The Emergency Medical Services (EMS) system was designed to reduce death and disability and EMS training focuses on saving lives through resuscitation, aggressive treatment and transportation to the Emergency Department. EMS providers commonly care for patients who have life-limiting illnesses. The objective was to explore EMS provider challenges, self-perceived roles and training experiences caring for patients and families with life-limiting illness. Methods: Qualitative content analysis of semi-structured interviews with EMS providers (n = 15) in Alameda County, CA. Purposive sampling was used to ensure a variety of perspectives including provider age, years of EMS experience, emergency medical technicians and paramedics, fire-based versus private, transport versus non-transporting. Recorded and transcribed interviews were analyzed using a thematic approach. Results: In their work with patients with life-limiting illness, participating EMS providers were interviewed and reported challenges for which their formal training had not prepared them: responding to grief and emotion expressed by families during traumatic events or death notification, and performing in the moment decision-making to determine the course of action after acute, unexpected, and traumatic events. Many participants reported becoming comfortable with grief counselling and death notification after acquiring some clinical experience. In the moment decision-making was eased when patients and families had had advance care planning discussions, however many patients, especially those from vulnerable and underserved populations, lacked advance care planning. In the face of situations where the course of action was not immediately clear, EMS providers voiced two frames for their role in caring for patients with life-limiting illness: transportation only (“transport people”) versus a more “holistic” view, where EMS providers provided counseling and information about available resources. Conclusions: EMS providers interface with patients who have life-limiting illness and their families in the setting of traumatic events where the course of action is often unclear. There is an opportunity to provide formal training to EMS providers around grief counseling as well as how they can assist patients and families in in the moment decision-making to support previously identified goals and align care with patient goals and preferences.

Emotional processing during the therapy for complicated grief

Objective: Prior research, mainly conducted on depression, observed that clients’ improved capability to process their emotions predicted better therapeutic outcomes. The current comparative study aimed to investigate whether emotional processing was related to therapeutic change in complicated grief. Method: We analyzed two contrasting cases (good or poor outcome) treated with grief constructivist therapy. In both cases we investigated the association of emotional processing (Experiencing Scale) to (1) therapeutic outcome (Inventory of Complicated Grief), and (2) change in the type of grief-related emotions (Emotions Episodes). Results: The session-by-session growth of clients’ emotional processing and the change of grief-related emotions were qualitatively explored throughout both cases. Compared with the poor outcome case, the good outcome case achieved more improvement in the ability to process emotions. Such improvement occurred alongside a deeper change in the type of grief-related emotions aroused, from maladaptive to more adaptive responses. Conclusion: Our findings suggest that a higher emotional processing capability may be associated with the transformation of grief-related maladaptive emotions and with the improvement of complicated grief condition.

Trauma‐Informed Grief Counseling With Older BIPOC Individuals

As Black, Indigenous, and people of color (BIPOC) endure losses throughout the life span, their grief can impede daily functioning and interactions. This is especially true for older individuals (age 65 and over) who have a history of losses and traumatic experiences. We describe BIPOC's common losses, along with practical implications for integrating grief counseling and trauma-informed principles.

‘Phantom Letters’ in Various Cultures

Cross-Сultural communication cannot exist without interaction, both oral and written. One of the types of written communication is epistolary text. This paper considers one kind of epistolary texts, the so-called ‘dead letter’, i.e. a letter which cannot be delivered to the recipient because this person does not exist. The author introduces the term ‘phantom letter’ since a corresponding term has not been found in the Russian language, besides the existing English term ‘dead letter’ does not fully reveal the phenomenon under discussion. The materials of the article are 14 personal letters and 24 literary texts in the English language belonging to the cultures of Ancient Egypt, the USA, Great Britain and Israel. The methodology of the research is based on the discourse analysis of the personal and fiction discourses. The following types of ‘phantom letters’ have been studied: letters to the dead, letters to the future generations and literary texts which are letters to some famous historical or fictional characters. Special attention is paid to various reasons why people have been writing such epistolary texts: the writer may do it on practical grounds, as a form of trauma counselling and/or resurrecting the loved one or information. As for the literary texts, the author’s aim is to create a humorous effect since all these letters are parodies. Chronotope is also considered, which is especially important in letters to the dead and letters to the future. Discourse formulas typical for some types of phantom letters have been analyzed. The last part of the paper deals with precedent texts, because understanding of fictional dead letters is drawn entirely from the knowledge of precedent. The conclusion states that there are various types of phantom letters in various cultures, they are normally personal and they are written for various reasons, however, they possess common features. Some prospects for further study in this area are also outlined.

Social Support Experiences of Spousally Bereaved Individuals in a South African Township Community: The Botho/Ubuntu Perspective.

Bereavement is a deeply personal experience that is also shaped by one’s socio-cultural context. This qualitative study explored the social support experiences and needs of spousally bereaved individuals in a South African township. The botho/ubuntu philosophical framework was used to interpret participants’ experiences in this regard. Six ethnically diverse, bereaved spouses aged 55–67years, residing in a predominantly Setswana-speaking township in the North West Province of South Africa, were interviewed. Thematic analysis was used to analyze the data. An indigenous knowledge consultant was interviewed to situate participant experiences pertaining to mourning rites and traditions within the indigenous socio-historical and contemporary cultural context. The following themes were identified: (i) Sources of social support during bereavement; (ii) Inadequate social support after spousal death; (iii) The need for grief counseling; and (iv) Social restrictions and systematic isolation during the traditional mourning period: “It is as if you smell.” Broadly, bereaved spouses drew on their support networks at various stages of their bereavement, which included family members, in-laws, friends, burial societies, their surrounding communities, and religious communities and figures. However, some experienced ostracization and stigmatization during the mourning period, which was invariably longer for the widows in this study, in line with conventions across Black South African cultures. Some participants reported withdrawal of support by their in-laws and harmful attitudes and assumptions rooted in patriarchal ideology by family members and in-laws. As pertaining to botho/ubuntu, the study also showed that communality or relationality entailed both positive and negative aspects, including support, co-operation, care, lack of support, stigmatization, and ostracization. Unlike conventional conceptualizations of botho/ubuntu, the study findings illustrate the human experience as comprising varying dimensions of relationality, ranging from harmony to disharmony. Findings regarding the negative aspects of communality are compatible with those relating to relational interdependence in African and East Asian settings. The findings also expand our understanding of the nature of disharmony alongside harmony in interdependent socio-cultural contexts.

A Case Study of Trauma Counseling in the Undergraduate Course

목적 본 연구는 4년제 대학에서 7년간 ‘트라우마상담’ 전공 교과목을 개발·운영한 사례연구이다. 방법 이를 위해, ADDIE 모형에 기반하여 교과목을 설계하였고 매년 형성평가를 적용하여 교과목 내용을 수정하였다. 2015년부터 2021년까지 7년간 7학기에 걸쳐 경북 소재 K대학 심리치료학과포함 16개 학과의 194명이 수강한 트라우마상담 수업의 내용·운영을 분석하여 사례연구로 제시하였다. 결과 범죄피해케어 현장전문가의 심리학적 유능성을 함양하는 것을 교과목 목표로 설정하였다. 이를 구현하기 위해, 교과목 내용 중 지식역량으로 트라우마상담 이론을 구성하였고 실습역량으로 안전지대 그리기, 그라운딩 실시 및 녹음, 한국판 사건충격척도 개정판(IES-R-K) 실시 및 해석, 모의 면접평가 촬영을 고안하였다. 또한 전문 직무역량으로 범죄피해면접평가보고서 작성, 면접평가 역할극 실시 및 촬영, 발제자료 편집 등을 포함하였다. 본 교과목은 프로젝트기반학습(PjBL), 문제기반학습(PBL), 사례기반학습(CBL), 팀기반학습(TBL)의 통합적 형식으로 운영되었다. 본 교과목의 7년의 수업만족도 평균은 개설학과의 평균보다 높게 나타났으며, 주관식 수업만족도에서도 실습역량 향상과 현장과 높은 연결감을 나타냈다. 결론 국내 학부과정에서 최초로 개설되어 7년간 운영된 트라우마상담 교과목을 개발하여 그 프로토타입을 제시하였다. 이론과 실습역량, NCS역량 등을 획득하기 위해 PjBL 등을 통합적으로 활용하여 학부 수준의 실습교육 운영의 실례를 남겼다. 16개 학과생의 참여는 향후 트라우마(상담)교육에 있어, Trauma Informed Care의 적용가능성을 볼 수 있었다. 향후, 유사교과목 개설을 원하는 대학에서 참조할 수 있는 사례로서의 의의를 지니며, 학부교과목으로서의 적합성과 실효성을 비교 및 검증하는 연구가 이어지길 제안한다.

Making meaning with metaphor in grief therapy

Abstract Metaphors play an important role in contemporary approaches to grief therapy by helping clients (re)construe their continuing relationship with the deceased. Relevant studies have illustrated the substantive elements of metaphors (i.e. sources, targets, and mappings) in this regard, often focusing on localized bursts of intense metaphoric activity. This paper highlights the extended nature of metaphoric conceptualizations and their relationship with key meaning-making processes, following the principle of ‘correspondent analysis’ as a collaborative move between language analysts and therapy practitioners. Three specific phenomena are detailed through a mixed methods analysis of 18 motivated segments in a single session of grief therapy: (i) sporadic sources, (ii) persistent sources, and (iii) metaphor ‘chaining’ across embodied and verbal activity. Their respective links to treatment objectives and processes demonstrate how metaphor theoretic constructs dovetail with therapeutic work, and suggest future avenues for modeling unfolding metaphoric activity as a time series.

Childhood traumatic grief counselling: A South African case study

This study explored the efficacy of a culturally adapted childhood traumatic grief counselling treatment with a 6-year- old South African male child who lost his mother to accidental electrocution. Based on data analysis of his case file, we discerned five themes to characterise his recovery: (i) gradual exposure to trauma memory; (ii) strengthening the child-caregiver relationship; (iii) self-managing trauma emotions; (iv) trauma narrative competencies; and (v) grief symptoms recognition and expression. Findings support the efficacy of a culturally adapted childhood traumatic grief treatment intervention with a young South African child.

Psychoanalysis and Tango: Complex Arts of Grief Therapy-- Psychoanalysis and Tango Dancing during This Pandemic

ABSTRACT This essay describes several resonances between psychoanalysis and Argentine tango. Both disciplines are premised on the establishment of an intimate emotional relationship, however different this intimacy and emotional connection might be, with their different temporal dimensions, methods, and aims. Clinical theory and tango technique both concern the effective management of this relationship for their divergent purposes. I contend that both are complex arts of grief therapy, especially during this period of COVID-19 sheltering, and the restriction on bodily touching, hugs. The iconic figure in tango is The Embrace, a formal stance, part of the art of the dance, as opposed to the ordinary human gesture of a hug. Several perspectives converge to inform my thesis. Firstly, I summarize some of the notable historical links between tango and psychoanalysis. Then, I describe the context for the development of tango in Argentina, the conditions – both objective and subjective – of grief, for which tango became the prevailing therapy for an entire population. Lastly, I account for my personal interest in exploring the connections between these two of my enduring passions.

Discussion of the Paper “Psychoanalysis and Tango: Complex Arts of Grief Therapy” by Dawn Farber

ABSTRACT This discussion focuses on one aspect of Farber’s work: the birth of the tango (this issue). The tango was created as a fusion of African and European immigrant culture in Argentina between the second half of the nineteenth century and the first twenty years of the twentieth century. The tango was one of the tools used by immigrants to socialize the pain of the loss of common roots, the lack of identity, and the sense of loneliness. The author reflects on the overlaps between tango and relational psychoanalysis, and muses on the impact of the loss of hugs and embraces in this worldwide pandemic caused by Covid and the collective trauma that it entails.

Dancing with the Shadow of the Object: Tango as a Means of Embodied Symbolization– Commentary of Dawn Farber’s “Psychoanalysis and Tango: Complex Arts of Grief Therapy”

ABSTRACT In my discussion of Dawn Farber’s evocative essay on Tango and Psychoanalysis (this issue) I focus on the body and its affective repertoire as well as its sensorial physicality as our first means of knowing and the primary channel for the symbolization of affect that remains unformulated and is connected to the loss of primary attachments.

Challenges of Assessing Community Mortality Due to Respiratory Viruses in Children Aged Less Than 5 Years.

BackgroundEstimating the real impact of respiratory syncytial virus (RSV) disease is key for the development of vaccines and treatments. Ascertaining the burden of community mortality due to RSV is challenging due to the lack of primary data. Therefore, conducting observational studies to determine the factors associated with community mortality due to the virus in developing countries is important.ObjectiveOur aim in this study was to describe the obstacles, gaps, and challenges that investigators face in low-income, vulnerable regions in 4 developing countries on 3 continents.ResultsThe main obstacles and challenges of ascertaining community mortality due to RSV were defining strategies to consent families for testing before burial, sampling individuals at the household level, supporting bereaved parents with different cultural and religious backgrounds, establishing tailored strategies for studies in challenging settings, and integrating RSV mortality data from nasopharyngeal samples.ConclusionDetailed logistical planning based on population sociodemographic information, grief counseling, staff training, and a multidisciplinary approach with adequate laboratory infrastructure is critical to successful observational community-based RSV studies.

The experience of facility isolation by children infected with COVID-19

연구목적: 본 연구는 코로나19 확진아동이 겪은 격리경험을 아동권리 관점에서 다각도로 분석하고자 하였다. 방법: 코로나19 확진 경험을 가진 아동과 확진아동의 양육자를 대상으로 일대일 면접하였다. 면접은 온라인으로 진행하였으며 면접의 주요내용을 격리 전, 격리, 격리 후 단계로 구분하여 분석하였다. 결과: 첫째, 확진판정과 격리시설 이송과정에서 아동에 대한 배려나 발달특성을 고려한 설명은 없었으며 격리시설에 대한 입소안내도 일관적이지 못하였다. 둘째, 격리시설 입소 후 제공되는 식사는 아동의 영양상태나 성장을 고려하지 못하였다. 격리시설에서 아동은 놀잇감이 부족하여 부득이하게 미디어에 노출이 되었다. 학습준비에 대한 정보가 부족하여 온라인 수업 참여에 어려움을 겪었다. 셋째, 격리해제 후 일상복귀에서 낙인으로 인한 상처를 받았다. 넷째, 격리생활의 개선점으로 장난감 등의 비치와 일관성 있고 충분한 정보제공, 격리해제 후 아동의 트라우마 상담지원을 제안하였다. 결론: 확진 아동의 권리를 보장하기 위하여 아동의 발달단계 특성을 고려한 서비스 제공, 아동만을 위한 아동 친화적 격리지침 제공, 아동의 코로나19 관련 정보에 대한 접근보장, 일상생활 복귀를 위한 심리적 지원과 더불어 코로나19 관련 아동실태조사 및 관련 연구 수행 등 미래지향적 아동권리 증진 방안 검토를 제안하였다.Objectives: The purpose of this study was to investigate the experience of facility isolation by children infected with COVID-19 in various ways from a children’s rights perspective. Methods: One-on-one interviews were conducted between caregivers and children infected with COVID-19. The interviews were conducted online and the main contents of each interview were sorted into stages, in this case before, during, and after facility isolation. Results: First, there was no consideration of or explanation given to children during the process of infection confirmation and quarantine transfer. Second, there was no meal service suitable for the developmental characteristics of children. There was no provision for play by the children in the isolation facilities, and they were exposed to the media as a result. Participation in online classes was also difficult due to a lack of information regarding such preparation for learning. Third, after being released from isolation, the children suffered from stigmatization in their everyday life. Fourth, as a point of improvement during their isolation, it is proposed to provide consistent and sufficient information as well as toys and other comforts, and to support trauma counseling these children. Conclusions: In terms of children s rights, it is necessary to provide services considering the developmental characteristics of children, to provide child-friendly guidelines about the isolation facility, to guarantee access to relevant informations about COVID-19, and to provide psychological support to ensure their successful return to their normal lives.

EFFECTS OF ETHNIC CONFLICT ON ACCESS AND PARTICIPATION OF CHILDREN IN PRIMARY EDUCATION

Purpose: Lowering the risk of dropout requires a broad set of policies aimed at reducing underlying vulnerabilities, including poverty-related factors and problems linked to education quality. Increasing the income of poor families through cash transfers can help enhance education prospects. The general objective of the study was to evaluate effects of ethnic conflict on access and participation of children in primary education.
 Methodology: The paper used a desk study review methodology where relevant empirical literature was reviewed to identify main themes and to extract knowledge gaps.
 Findings: The study concludes that ethnic conflicts are caused by competition over scarce and shrinking resources, favoritism, discrimination; tribal animosity, historical land injustices, voting along ethnic lines, during general elections, politics of exclusion, and biased resource allocation among communities. The causes of ethnic conflicts disrupted education activities and programs; impoverished communities, caused school dropout by children, closure of schools, absenteeism and poor enrolments and attendance levels in schools
 Recommendations: There is need for trauma counselling to be offered to victims of the post-election violence. The relevant governments needs to seriously address the problem of land and put policies in place for citizens regarding owning land and property anywhere to avoid recurrence of ethnic violence in various parts of the country. On the effects of ethnic conflict on access and participation of children in primary education the researcher recommended that the relevant stakeholders should seriously address the issues related with distribution of resources, marginalization, favoritism and discrimination

Investigation on Sudden Unexpected Death in the Young (SUDY) in Europe: results of the European Heart Rhythm Association Survey.

The aims of this centre-based survey, promoted and disseminated by the European Heart Rhythm Association (EHRA) was to investigate the current practice for the investigation of Sudden Unexplained Death in the Young (SUDY) amongst European countries. An online questionnaire composed of 21 questions was submitted to the EHRA Research Network, European Cardiac Arrhythmia Genetics (ECGen) Focus Group members, and European Reference Network GUARD-Heart healthcare partners. There were 81 respondents from 24 European countries. The majority (78%) worked in a dedicated clinic focusing on families with inherited cardiac conditions and/or SUDY or had easy access to a nearby one. On average, an autopsy was performed in 43% of SUDY cases. Macroscopic examination of the body and all organs were completed in 71% of cases undergoing autopsy, and expert cardiac examination in 32%. Post-mortem genetic testing was requested on average in 37% of Sudden Arrhythmic Death Syndrome (SADS) cases, but not at all by 20% of survey respondents. Psychological support and bereavement counselling for SADS/SUDY families were available for ≤50% of participants. Whilst electrocardiogram (ECG) and echocardiography were largely employed to investigate SADS relatives, there was an inconsistent approach to the use of provocative testing with exercise ECG, sodium channel blocking drugs, and/or epinephrine and genetic testing. The survey highlighted a significant heterogeneity of service provision and variable adherence to current recommendations for the investigation of SUDY, partly attributable to the availability of dedicated units and specialist tests, genetic evaluation, and post-mortem examination.

Counselor preparedness to counsel grieving clients: Insights and implications

Given grief’s ubiquitous nature, counselors will inevitably engage with grieving clients. However, research suggests that counselors are not receiving adequate training in grief counseling. In this qualitative research study, 11 counselors shared their training and experiences counseling clients grieving a death-related loss. Five themes—Personal Dynamics of the Counselor, Missing Preparation and Desired Training, Perceived Counselor Responsibilities, The Client-Counselor Relationship, and Revolving Systemic Factors—were identified to capture the experiences influencing their perceived preparedness for counseling this population. The findings highlight the need to infuse grief and loss into course curricula and supervision to promote foundational understanding.