CHAPTER TWELVE: PERSONAL LOSS: BEREAVEMENT AND GRIEF

Terms Critical to Understanding Loss  Bereavement (sorrow)  Uncomplicated bereavement  Grief (mental anguish)  Complicated grief/prolonged grief  Traumatic grief  Disenfranchised grief (a loss that one is unable to share)  Loss  Primary loss (death)  Secondary loss (resulting from the death)  Ambiguous loss (physically or psychologically missing)  Mourning (social or cultural state or condition expressing grief)

Dynamics of Bereavement  Cultural Dynamics  Culture  3 patterns of response:  Death accepting  Death defying (dreading/avoiding)  Death denying  Sociocultural Mores  Spirituality and Religion

Conceptual Approaches to Bereavement  Stage/Phase Models  Kubler-Ross’s Stages (denial, anger, bargaining, depression, and acceptance)

Assessment Tools  Texas Revised Inventory of Grief (TRIG)  Current Grief  Past Disruption  Grief Experience Inventory (GEI)  Nine clinical scales  Hogan Grief Reaction Checklist (HGRC)  Can discriminate variability in the grieving process as a function of cause of death and time elapsed since death  Inventory of Complicated Grief (ICG)  Targets symptoms of grief that are distinct from bereavement-related depression and anxiety, and predicts long-term functional impairments

Types of Loss  Death of a Spouse  One of the most emotionally stressful and disruptive events in life  More widows than widowers  Loss Due to Caregiving  Death of a Child  Perhaps the ultimate loss for a person to endure regardless of the age of the child

Types of Loss Cont.  Bereavement in Childhood (age related)  Bereavement in Adolescence  Value of connectedness  Bereavement in the Elderly  Present more somatic problems than psychological problems  No indication that the intensity of grief varies significantly with age  Grief among older people may be more prolonged than among younger people  Tend to be lonelier and to have far longer periods of loneliness than younger people

Types of Loss Cont.  HIV/AIDS (anticipatory, complex, page 430)  Job Loss  Separation and Divorce  Death of a Pet  Complicated Grief  Traumatic grief

Being There for Grievers  Empathic Presence  Gentle Conversation  Providing Available Space  Eliciting Trust

The Crisis Worker's Own Grief  Emotional investment in the client  Bereavement overload  Countertransference  Emotional replenishment  Facing one’s own mortality  Sense of power  Tendency to rescue