Grief Counseling Research Articles

Let's Talk About Grief: Building a Theoretical Framework for Grief Counseling with Systematic Literature Review

Grief is a universal life experience characterized by the loss of an affective bond, leading to Normal Grief responses. Grief Counseling is a specialized therapeutic intervention aimed at facilitating adaptation to the new reality and preventing complications from prolonged grief. A systematic literature review was conducted to inform the development of a curricular program for training in Grief Counseling in the Portuguese context. From Research Summit 2022.

Influence Of Grief Counselling On Psychological Wellbeing Among Widows At Africa Inland Church, Nairobi Area Church Council, Kenya

The death of a spouse can be extremely unbearable and even psychologically incapacitating. Widows face challenges that deeply affect their psychological wellbeing. The church has remained the best place for most widows in seeking consolation. This study investigated the influence of grief counselling on psychological wellbeing among widows at the Africa Inland Church, Nairobi Area Church Council, Kenya. Materials and Methods: The study was informed by the Cognitive Behavioral Theory and the Dual Process Model of Coping with Bereavement. The study used a causal research design, and census sampling technique was adopted. The sample size of the study was 114 widows. The Brief Grief Questionnaire (BGQ), the Multidimensional Scale of Perceived Social Support (MSPSS) and the Psychological Well-being Scale (PWB) were used for data collection. The data was analyzed using SPSS version 25. Results: The findings showed that most (n = 66, 64.1%) of the widows were at high grief reaction, 22.4% (n = 31) of the widows had moderate grief reaction, while 13.5% (n = 15) were at low grief reaction. Also, 62.2% (n = 50) of the participants scored a high level of psychological wellbeing, 24.3% (n = 34) were at moderate level of psychological wellbeing, while 13. % (n = 28) of the participants were at low level of psychological wellbeing. Conclusion: The study established that grief counseling influenced the psychological wellbeing among widows (F- value (1, 5013.255) = .208, p = .030 ≤ 0.05). The study recommended that the leadership of the Africa Inland Church could work in collaboration with psychologists to formulate programs to reach out to the widows for psycho-education and possible coping strategies with regards to grief reaction

Experiences of family caregivers of patients with end-of-life cancer during the transition from hospital to home palliative care: a qualitative study

BackgroundThe transition of family caregivers of patients with end-of-Life cancer receiving palliative care from hospital to home is a complex and challenging process. This phase of care involves not only the physical and psychological health of the patient but also the role adaptation and emotional support of the family caregivers. To gain a deeper understanding of the various experiences and feelings during this process, we conducted a qualitative study.MethodsThis study employed a descriptive phenomenological research method. The interviews focused on the specific experiences, challenges faced, support received, and coping strategies of family caregivers of patients with end-of-life cancer during the transition from hospital to home palliative care. All data were treated with strict confidentiality, and recordings and transcriptions were made with the participants’ consent.ResultsA total of 15 family caregivers participated. Four main themes and nine sub-themes were identified: complex transition process (anxiety about uncertainty, resistance to transition), discontinuity in care (insufficient discharge guidance, lack of continuous communication mechanisms), post-discharge continuous care needs (need for home care knowledge and skills, social and emotional support, grief counselling and death education), and personal growth and gains (enhanced coping ability, increased psychological resilience).ConclusionFamily caregivers face numerous emotional, cognitive, practical, and social support challenges during the transition from hospital to home care. To improve the caregiving experience and quality of life, appropriate training and support should be provided to better meet the caregivers’ needs.

Perinatal Grief Counseling and Its Effect on Grief Levels in Women Who Underwent Pregnancy Termination: A Comparative Experimental Study.

This study was designed as a two-group pre-test post-test comparative experimental study to examine the effects of grief counseling on perinatal grief levels in women who underwent pregnancy termination before discharge from the clinic. This study was conducted with 70 women who underwent medical termination of pregnancy. The intervention group (n = 35) received perinatal grief care, while the control group (n = 35) received only routine hospital care. In this study, the Introductory Information Form, Perinatal Grief Scale, and evaluation form of the care received were completed. While the perinatal grief level of the intervention group decreased after the application of grief care, a significant difference between the groups was detected only in women with a history of medical termination according to obstetric characteristics (p < .05). The findings obtained from this study showed that perinatal grief care support decreased grief scores on perinatal grief instruments and their sub-dimensions in the intervention group.

Improving Grief Counseling: Enhancing the Education and Confidence of Psychology Graduate Students

Most therapists do not receive formal graduate training in grief counseling and may rely on outdated knowledge and questionable skills when working with grieving clients (Dodd et al., 2022; Jankauskaite et al., 2021). This study aimed to develop a virtual intervention to educate psychology graduate students about grief counseling and evaluate whether this training can increase knowledge in grief and grief counseling and self-efficacy in working with grieving individuals. This mixed-methods study compared participants in three conditions (full video intervention, partial video intervention, and control). When controlling for prior grief counseling training and experience, those randomized to the full video intervention had higher grief and grief counseling knowledge and self-efficacy in working with bereaved individuals than those in the partial intervention and control groups. Further, qualitative results highlighted the assessment and treatment approaches that therapists-in-training would use with a bereaved client across conditions. Overall, the full intervention is a feasible and efficacious way to teach psychology doctoral students about grief counseling and increase their confidence in working with bereaved clients. Future research considerations and recommendations are discussed.

Bereavement guilt among young adults impacted by caregivers' cancer: Associations with attachment style, experiential avoidance, and psychological flexibility.

This paper focuses on the experiences of bereavement guilt among young adults bereaved by a caregiver's cancer, examining associations with attachment style, experiential avoidance, and psychological flexibility with the aim of informing psychosocial interventions for this population. Ninety-seven young adults (18-25 years) bereaved by a parent/guardian's cancer completed an online survey, including measures of bereavement guilt, attachment style, experiential avoidance, and psychological flexibility. Mediation analyses explored the associations between attachment style (anxious, avoidant) and bereavement guilt, and if these associations were mediated by experiential avoidance or psychological flexibility. Bereavement guilt was significantly positively associated with anxious, but not avoidant, attachment to the deceased; the relationship between anxious attachment and bereavement guilt was partially mediated by experiential avoidance. Bereavement guilt was also negatively associated with psychological flexibility and engagement with bereavement counseling. Given the limited literature on cancer-related bereavement in young adulthood, this study offers important theoretical and clinical insights into factors associated with more complex aspects of grief in this population. Specifically, this work identified that anxious attachment is associated with ongoing bereavement complications in the years following the death of a caregiver to cancer, with experiential avoidance partially mediating this relationship. While further research is needed to better understand the interaction between these factors and other related constructs, such as psychological flexibility, these findings may be helpful in selecting therapeutic approaches to use with this population.

"You might be nice, but where you take me, they're not gonna be": Preferences for field-based post-overdose interventions.

Emergency medical services (EMS) systems are piloting interventions to respond to overdoses with additional services such as leave-behind naloxone and medication for opioid use disorder, but little is known about the perspectives of people who use drugs (PWUD) on these interventions being delivered by EMS during an overdose response. The Consolidated Framework for Implementation Research guided the development of data collection tools, the analytic strategy and the organisation of results. A community engaged method was used which included both academically trained researchers and community trained researchers who are also PWUD. This study used semi-structured interviews to gather data from 13 PWUD in King County, Washington in June 2022. Data were analysed using thematic analysis. The people interviewed for this study viewed EMS distribution of leave-behind naloxone and field-based buprenorphine favourably. They viewed EMS facilitation of hepatitis C virus and HIV testing in the field less favourably and were concerned about stigmas associated with those results. Additional themes emerged regarding: the need for different approaches to post-overdose care; the need for new services, including post-overdose trauma counselling and an alternative destination to the emergency department; and the harms of law enforcement presence at overdose responses. This study found strong support for leave-behind naloxone and field-initiated buprenorphine. Further training for EMS should include trauma-informed care and strategies to address burnout and increase compassion. Alternatives to the emergency department as a post-overdose destination are needed. These strategies should be considered by jurisdictions revising overdose response protocols.

Efficacy of Therapeutic Photography for Resolving Symptom Coherence in Prolonged Grief

Prolonged grief disorder (PGD) is a complex and debilitating condition that arises from the inability to adapt to the loss of a significant individual. Symptom coherence, meaning-making, and emotional processing are key symptom domains for individuals experiencing prolonged grief. The integration of photographic interventions within grief counseling practices offers a unique and powerful tool for emotional expression, emotional processing, and overall grief management. This literature review aims to synthesize current research on the efficacy of this innovative approach, primarily focusing on how photographic interventions impact symptom coherency, psychological healing mechanisms, and psychological healing.

Forming our grief rhythm: The relational window of tolerance for bereaved parents.

The shared loss of a child can present challenges to couple relationships as both partners attempt to cope with their own grief and their partner's grief. In this longitudinal qualitative study, five bereaved parent couples participated in 13 total interviews, revealing coregulatory interactions surrounding their shared loss. Using thematic coding and grounded theory analysis, their reflections were organized into three interrelated process themes: regulating self, regulating other, and forming our grief rhythm. This article explores the complexity of the last theme "forming our grief rhythm" in-depth, and a new theoretical orientation, the relational window of tolerance, is introduced to examine how couples coregulate both fragile and stable states within their shared grief. The reflections of bereaved parents indicated that prolonged "dual fragile states" and prolonged "imbalanced states" may hinder relationship quality. In order to regain relationship stability, couples learned to trade off supporting one another and/or to resonate with one another in their shared pain. Implications for future research and clinical practice are discussed, focusing especially on how to integrate individual and relational needs into grief therapy frameworks.

Older Bereaved Individuals’ Experiences of Cognitive-Behavioral Therapy for Complicated Grief Reactions: A Qualitative Multistage Focus Group Approach

Bereavement is particularly common in old age. A small proportion of bereaved people develop complicated grief reactions (CGR) characterized by elevated symptoms of depression, prolonged grief disorder, anxiety, and/or posttraumatic stress. Cognitive-behavioral therapy for CGR (CBTgrief) is found to be an effective treatment. Detailed knowledge about older adults’ experiences of CBTgrief is needed to optimize treatment and to give recommendations to practice. To explore older adults’ experience of CBTgrief to gain insight into elements that were helpful or less helpful. Four multistage focus group interviews were conducted with nine older adults who lost a partner and received CBTgrief and three researchers. Five participants received group therapy and four individual therapy (mean age = 69.67 years, 89% women). The participants found exposure exercises, psychoeducation in grief, and letter writing particularly helpful. The participants requested options for family sessions, a combined individual/group format, and follow-up sessions. Awareness of potential memory problems and adapting to new practical tasks should receive greater focus in therapy. This study gives important insights into older adults’ experiences of CBTgrief and evaluates the helpful and less helpful elements in grief therapy. This may guide improvements in the treatment of bereaved older adults with CGR.

Efficacy of Therapeutic Letters for Grieving Peers After Teen Suicide

Adolescents grieving the loss of a peer to suicide experience a significant decline in their quality of life. Among the various approaches undertaken to facilitate emotional processing and resilience in these adolescents, therapeutic letter writing has emerged as a promising avenue. This literature review seeks to examine the efficacy of therapeutic letters as an intervention for grief following teen suicide. Specifically, this review examines the impact of this method on emotional processing, meaning-making, and long-term adjustment to the loss. The review also considers the potential challenges and ethical concerns associated with implementing therapeutic letters, including issues of confidentiality and the cognitive capacities of adolescents. In conclusion, this literature review highlights the significant promise and complex nuances of using therapeutic letters for adolescence grief counseling. As clinicians strive to offer more comprehensive and compassionate care to adolescents dealing with loss due to teen suicide, therapeutic letters can assist them in doing so.

Mental health and humanitarian crisis: Moral stress in trauma therapy.

This articleoffers a narrative analysis of the contributing factors of moral distress (MD) and moral injury (MI) among mental health clinicians working amidst humanitarian crises. It discusses the impact of moral stress on therapeutic relationships in mental health trauma. The articleoriginated from the author's experience developing a peer-to-peer support program at a nongovernmental organization (NGO) and conducting peer-to-peer support for mental health clinicians and healthcare providers in Ukraine and Turkey. A significant amount of literature has documented the detrimental effects of MD and MI on mental health, job sustainability, and resilience of healthcare providers and first responders. The negative effects of MD and MI are particularly relevant in trauma counseling, where clinicians must draw upon the use of self to develop therapeutic relationships with their clients. This process demands a high level of moral reasoning and self-awareness, which can be severely tested under the morally challenging conditions of a humanitarian crisis. There is an imperative need to deepen our understanding and to swiftly address the factors that precipitate MD and MI in mental health clinicians working in crisis zones. By doing so, we aim to bolster their resilience and the enduring nature of their commitment to help and save others. This, in turn, will not only contribute to saving more lives but also enable those who are affected by trauma to flourish in the aftermath of their experiences.

Comparing Public Perceptions of Child and Adult Grief Responses to Familial Incarceration.

Children of incarcerated parents may grieve this loss, yet perceptions of their grief are understudied. Using vignettes varying by age (adult/child) and grief response (prolonged/resilient), we examined differences between perceptions of adults and children grieving parental incarceration. Participants rated grief response appropriateness, comfort providing support, and grief therapy recommendations for the grieving person in the vignette. Participants perceived resilience as more appropriate than prolonged grief [F (1, 224) = 9.02, p = .003, η2 = .04]. Age did not predict outcomes. Recommending grief therapy was higher for prolonged grief, yet 53% of participants with resilient vignettes recommended the person should seek grief therapy, which is concerning given possible iatrogenic effects. Thus, laypeople may have stigma toward individuals grieving parental incarceration, regardless of age.

Using ChatGPT as a grief counseling tool in end-stage cancer diagnosis

With the advent of Artificial Intelligence, the healthcare system around the world has a golden opportunity to improve the quality of care and efficiently enforce the management of patients. It is the need of the hour to explore and learn what AI, and by extension, the Large Language Models like ChatGPT, can do to make the process of healing a better experience.

Promising for patients or deeply disturbing? The ethical and legal aspects of deepfake therapy

Deepfakes are hyper-realistic but fabricated videos created with the use of artificial intelligence. In the context of psychotherapy, the first studies on using deepfake technology are emerging, with potential applications...

Impacts of a spherical video-based virtual reality-integrated problem-based learning mode on working staff’s counseling competences in professional training

ABSTRACT Immersing learners in authentic scenarios to prompt them to apply what they have learned to problem solving is an essential learning approach in medical and nursing education. However, nurses often do not have the opportunity to experience many specialized or emergency situations in the real world, such as providing grief counseling to terminally ill patients and their families. Therefore, this study proposed a model of Problem-Based Learning (PBL) in Virtual Reality (VR) which allowed learners to experience the sorrowful scenario of dealing with families facing a “patient nearing end of life,” and to learn grief counseling strategies. To validate the effectiveness of this learning method, a quasi-experimental design was conducted in a nurse preceptor training course in a teaching hospital. The participants were 34 nurses from a teaching hospital in Taiwan, randomly assigned to two groups; the experimental group adopted a Spherical Video-based Virtual Reality-integrated Problem-Based Learning (SVVR-PBL) model, while the control group utilized a Conventional PBL (C-PBL) model. Experimental results indicated that the SVVR-PBL model can better enhance nurses’ professional knowledge in palliative care, and supports superior memory retention. Simultaneously, in terms of attitudes toward palliative care, problem-solving orientation, and perceived value, it also significantly outperformed the C-PBL model.

Elephants, Ecological Grief, and Art Therapy

Climate change is a well-documented challenge for human societies where human actions have spurred global warming leading to climate breakdown. Ecological disasters are already affecting the mental health of many people, and this is escalating. By painting elephants, I address ambiguous loss and demonstrate the power of art therapy to inform grief work and ecological grief as humanity’s shared trauma. Seen through the lens of elephants, one realizes the many connections between elephant and human societies, including ancestral memories, experience of attachment and trauma, and capacities to heal. Maintaining a consistent art practice helps one make sense of the senseless and deal with grief as an act of resilience, self-and-planetary care, and ethics, thereby having implications for art therapists.

Toward Multispecies Mourning: Imagining an Art Therapy for Ecological Grief

Witnessing the devastating impacts of climate change and species loss has left many of us grappling with inexpressible grief for our more-than-human world. The importance of creating therapeutic environments to facilitate ecological grieving is greater than ever. This article examines the potential benefits of art therapy in this context. These include: reducing the risk of disenfranchized grief through connection; containing and externalizing complexity; providing regulation; and empowering participants to continue engagement. Grief counseling frameworks offer solid foundations for future directions. However, First Nations perspectives provide richer understandings of our multispecies interdependencies, and will be central to forging collective and localized responses to ecological grief that build communities of healing—not just between cultures, but between species, too.

Social Determinants of Mental Health for Posttraumatic Stress Disorder

Recognizing and addressing the social determinants of mental health (SDoMH) for posttraumatic stress disorder (PTSD) is essential for the effective practice of psychiatry. Experiencing traumatic events and subsequent development of PTSD profoundly affects individuals, families, and society, making it one of the most common mental health disorders with substantial psychiatric comorbidity. This article delves into the bidirectional aspects of the SDoMH in PTSD and reviews the diagnostic criteria, prevalence rates, and repercussions of PTSD on both an individual level and within society. PTSD assessment, interventions, and treatment are reviewed, including Prolonged Exposure, Cognitive Processing Therapy, Eye Movement, Desensitization and Reprocessing, trauma-focused and grief therapy. Primary prevention of PTSD, public health considerations, and positive psychiatry tenets are reviewed. [ Psychiatr Ann . 2024;54(7):e209–e215.]

The meaning in loss protocol: A clinical trial of online grief therapy

For a minority of the bereaved, the loss of a significant other can trigger an overwhelming emotional reaction and impaired functioning across life domains, known as prolonged grief disorder (PGD). Hence, ongoing efforts have been made to refine existing treatments to increase their efficacy and to accommodate the idiosyncrasies of grief reactions. This study presents the results of an open clinical trial of the feasibility and effectiveness of the Meaning in Loss (MIL) protocol in an online format. The brief intervention of 12 to 16 sessions combines constructivist and narrative strategies to explore and work through impediments to meaning reconstruction in loss. The sample included 25 participants diagnosed with PGD who were treated by six therapists. Baseline and post-therapy comparisons showed a significant improvement in all clinical measures (grief symptomatology, depression and general distress) and an increase of meaning making regarding the loss. Meaning making was found to be a prospective mediator of symptomatic improvement in grief across the course of therapy. These findings suggest the effectiveness of the MIL protocol in decreasing grief specific and associated symptomatology and argue for the relevance of further controlled evaluations of its efficacy. Moreover, results confirm previous findings that meaning making is a relevant factor in the evolution of grief reactions, including in the context of psychotherapy.