Grief Counseling: An Investigation of Counselors' Training,Experience, and Competencies

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.     

Pet Bereavement Support Groups: A Guide for Mental Health Professionals

Companion animals are becoming increasingly important in society. Pets have been recognized for their vast contributions to human lives, including emotional support, social support, health benefits, and connection. However, society does not recognize the significant loss associated with losing a pet, which can contribute to bereaved pet owners feeling isolation and shame as they cope with the loss of their beloved companion. Mental health professionals must be aware of this disenfranchised grief and creatively expand their services to provide support and advocacy for bereaved pet owners. This article includes a framework for clinicians to establish a pet loss support group in their community.     

Complicated grief and suicidal ideation in adult survivors of suicide

While the prevalence of complicated grief has been demonstrated to be elevated in survivors of suicide, the association between complicated grief and suicidal ideation among adult survivors of suicide has not been explored. The purpose of the present study is to examine the association between complicated grief and suicidal ideation in suicide survivors. The Inventory of Complicated Grief and the Beck Depression Inventory were administered to 60 adult survivors within 1 month of a death by suicide of a family member or significant other. Complicated grief was associated with a 9.68 (CI: 1.036, 90.417) times greater likelihood of suicidal ideation after controlling for depression, suggesting that syndromal complicated grief heightens vulnerability to suicidal ideation. Clinicians may provide more comprehensive assessments by recognizing the possibility of suicidal ideation in those with complicated grief.     

Youth Mental Illness and the Family: Parents’ Loss and Grief

Parents and family members whose adult child or relative has a mental illness endure significant losses, to which they respond with grief. Such grief may negatively affect family members’ physical and psychological health and also the relationship with their relative. Yet, research in this field is sparse. Very few studies have examined parents’ loss and grief in the context of the patient being a child or teen. It is not clear the extent to which parents’ loss and grief in response to their child or adolescent’s mental illness is similar or different to the accounts of older parents and family members caring for an adult relative with major psychopathology (e.g., Schizophrenia, Bipolar disorder). Parental loss and grief is not often addressed in child and adolescent mental health services’ provision of care; alarmingly, little is known about how best to support parents who access these services. The present study aimed to bridge this knowledge gap and identify the therapeutic needs of this younger parent population. Comprehensive interviews were conducted with 14 parents and one custodial grandparent of a youth aged 18 years or younger who was currently attending a child and adolescent mental health service. An inductive thematic analysis identified six themes; parents’ narrative of finding out, profound and pervasive loss, complex grief, waning support, the challenges of caregiving and a call for assistance. It can be inferred from these results that youth mental illness can constitute a source of loss and grief for parents. Participants’ loss and grief was largely consistent with the experience of families caring for an adult relative with major psychopathology. Opportunities for mental health practitioners to support families’ loss and grief were identified. Further studies are needed to enhance understanding of this complex and, to a large extent, ignored familial experience. Results do underscore the importance of clinicians acknowledging parents’ loss and grief and working directly with this experience over the course of youths’ treatment, perhaps in conjunction with family psychoeducation approaches.     

Survivor-victim status, attachment, and sudden death bereavement.

This research examines the significance of the survivor-victim relationship in understanding grief following sudden death bereavement. Data for this study come from medical examiner's reports and mailed self-report surveys of survivors of suicide and accidental death. In general, the results show that survivor-victim attachment is more important than survivor's status in explaining grief reactions. Also, suicide survivors experience significantly less emotional distress and shock, but greater feelings of guilt/shame and rejection, than survivors of accidental death. This paper concludes by directing future research to explore more fully the importance of survivor-victim relationships in understanding grief following bereavement.     

THE SURVIVING SIBLING: THE EFFECTS OF SIBLING DEATH IN CHILDHOOD

This paper considers the case of childhood mourning in which there is an increased possibility of a pathological grief reaction, due to an incapacity to sustain mourning and an inability to comprehend death. The death of a sibling in childhood is a complex loss to manage, the outcome of which is inextricably linked with parental grief. Maladaptive parental mourning processes, including the phenomenon of the ‘replacement child’, are explored. The effects of this loss on the surviving sibling can give rise to a variety of symptoms that may impair emotional development. Amongst the main responses experienced by the surviving sibling is that of a guilt reaction, not only for having survived when the sibling did not, but also a fear that harboured death wishes may have caused the tragedy. Premature death anxiety and distorted concepts of illness are further possible outcomes of this event. It is suggested that the primary deprivation a child may experience when their sibling dies is the emotional absence of their parents who are preoccupied with their own grief.     

Surviving and Thriving After Trauma and Loss

Abstract

Individuals and their communities experience trauma and loss during times of natural disaster. Using Hurricane Katrina as a context, the authors provide an overview of the phases of disaster coping and discuss the ambiguous losses that can occur during these traumatic and life-changing times. The use of rituals as a creative intervention is introduced to help individuals and families facilitate their grief processes.     

Bereavement Group for Parents Who Suffered a Suicidal Loss of a Child

ABSTRACT: This paper describes a supportive group therapy experience for parents who sought relief from the painful grief experienced after the suicide of their child. Parents who felt overwhelmed by feelings of shame, guilt, self-doubt, confusion and isolation found some relief in the universality of their grief and felt accepted and understood. Within three months, they were able to take this experience into their larger social network and felt more integrated.     

A Thematic Analysis of Men's Experience With a Partner's Elective Abortion

Research concerning men's experience with a partner's abortion is limited. To foster understanding of this topic, the authors used online surveys to gather data from men whose partners underwent induced abortion. A thematic analysis of men's comments about their experience revealed 3 salient themes: loss and grief, helplessness and/or victimization, and spiritual healing. Findings are discussed in terms of future research and counseling practices as they relate to pregnancy outcome decisions.     

From Mourning to Action: African American Women's Grief,Pain, and Activism

The Movement for Black Lives has brought particular attention to the experience of grief in the lives of African American mothers and its use in their advocacy for social reform. Grief-inspired activism is historically significant in the African American community. By highlighting the historical connections between Mamie Bradley Till and present-day African American mothers’ grief over their deceased children, we will discuss the role of grief and mourning in the lives of African American mothers and the way in which their grief is pivotal in shaping their involvement in social justice movements. Furthermore, we will provide suggestions on how to promote social activism among African American mothers.     

Challenges for aging Holocaust survivors and their children: The impact of early trauma on aging

ABSTRACT

Is the impact of early trauma continually present or does the negative psychological impact disappear when survivors are younger and then reappear as they age? In Transcending Trauma Project interviews survivors noted the impact of the Holocaust was always present but some stated that it increased as they aged. A small number of children of survivors interviewed observed a dependence upon defense mechanisms to cope with aging which differed from the survivors’ identification of using active and family coping strategies during the war and postwar years. Though children who experienced positive parent-child relationships mentioned the negative coping strategies, they also spoke positively of the impact of their parents in their own lives and expressed empathy for their parents. In the families where tensions existed between the survivors and their children, the children did not express empathy for their aging parents. Several studies supported the importance of family relationships in the aging process. This secondary analysis study further explored the impact of the Holocaust in aging survivors and the views of some children of survivors on aging.     

Suicide survivors' mental health and grief reactions: a systematic review of controlled studies

There has been a debate over several decades whether suicide survivors experience more severe mental health consequences and grief reactions than those who have been bereaved through other causes of death. This is the first systematic review of suicide survivors' reactions compared with survivors after other modes of death. Studies were identified by searching the PsychINFO and MEDLINE databases. Forty-one studies met the eligibility criteria. A qualitative data analysis was performed. There were no significant differences between survivors of suicide and other bereaved groups regarding general mental health, depression, PTSD symptoms, anxiety, and suicidal behavior. The results regarding the overall level of grief are less clear, depending on whether general grief instruments or suicide-specific instruments are used. Considering specific grief variables, suicide survivors report higher levels of rejection, shame, stigma, need for concealing the cause of death, and blaming than all other survivor groups.     

Overcoming Obstacles: Exploring the Use of Adventure Based Counseling in Youth Grief Camps

Bereavement can be confusing and complex for children and adolescents. Supporting youth in their grief may require interventions from helping professionals. Grief camps provide a supported environment designed to address the developmental needs of grieving children and adolescents. Adventure Based Counseling (ABC) provides structure and guidance for ropes course experiences and a theoretical basis for camps. This article explores how ABC on the ropes course addresses the unique needs of children and adolescents within the context of grief camps. An example plan provides guidance to camps hoping to incorporate the ABC framework into programming.     

Comparison Of Narratives Of Loss Experiences Of World War Ii and Vietnam Combat Veterans

Abstract

While their continuing grief now is receiving periodic media attention, for years and even decades, American soldiers who fought in World War II (WWII) and who fought in Vietnam have suffered their life-altering experiences of loss in silence. Many of the WWII generation now have died and cannot share their grief with us. We as scholars of loss and trauma have a special obligation to reach out to the living survivors of WWII for information about their experiences. As has been often noted (e.g., Kuenning, 1990), for years after the conclusion of the Vietnam War, the stories of loss and grief of Vietnam veterans were not welcomed. The purpose of this chapter is to report some comparative narrative evidence from veterans of these two wars. Our major question was whether strong differences between groups in perceived long-term impact of combat experience would be reported.     

Complicated Grief: An Evolving Theoretical Landscape

The bereavement literature has proliferated in recent decades, generating a shift from conceptualizing grief as a stepwise, uniform process to an idiosyncratic experience that varies among individuals. Among the most notable developments is the empirical exploration of complicated grief—a protracted, debilitating, sometimes life‐threatening response to the death of a loved one—and the testing of novel interventions to treat it. This article provides counselors with recommendations for identifying and treating complicated grief.     

‘Who am I?’

The dreams and existential questions of those, who came into being in order to replace a dead person, pivot around a central cry: ‘Who am I?’ If conceived, born or designated as a replacement child, such an individual may suffer—even as an adult—from a rarely recognized unconscious confusion of identity, compounded by grief and survivors’ guilt. From before the child is born, the archetypal forces of death and life are joined in a fateful constellation; the soul of the replacement child bears the shadow of death from the very beginning of life. Hope for the replacement child lies in an emergence of true self as soul recreates original life. Analysis can help the replacement child experience a ‘rebirth into true life’, not as ‘the one who returned’, but as a psychologically newborn individual; the path of individuation countering the replacement child‘s identification with the dead. Jungian analysis offers unique concepts for understanding and healing the replacement child; C.G. Jung himself was born after two stillborn babies and an infant that lived only five days.     

Families and children with hearing loss: grief and coping

Parental coping with the diagnosis of their child's hearing impairment has not received a great deal of research attention, despite the evident importance of it. Parental coping has been changing with the inception of newborn screening as we move from a parent-initiated model of diagnosis to an institution-initiated model. Coping now begins without any preparation, and without any time for parents to "enjoy" their child as "normal." The grief models, based on the death experience, usually employed to describe parental reactions to the diagnosis may also be inappropriate. Death grief is terminable whereas parental grief is chronic. There is not sufficient research on the long-term effects of chronic grief and how that impacts on parent-child bonding. There is evidence that our screening endeavors have far outstripped our habilitation efforts, leaving parents with a diagnosis but without support. This gap must be closed.     

Ongoing: On grief’s open-ended rehearsal

Peter Goldie’s account of grief as a narrative process that unfolds over time allow us to address the structure of self-understanding in the experience of loss. Taking up the Goldie’s idea that narrativity plays a crucial role in grief, I will argue that the experience of desynchronization and an altered relation to language disrupt even of our ability to compose narratives and to think narratively. Further, I will argue that Goldie’s account of grief as a narratively structured process focus on the process having come to an end. By contrast, I will propose the idea that grief can be understood as an open-ended rehearsal of our capacity to be alone in the company of an absent other. This makes grief a relational activity that differs from composing narratives about one’s past and about one’s process of grieving. Thus, grief is not primarily a process of recollecting our past narratively; rather, it can be seen as a dedicational activity which involves a future-oriented and open-ended rehearsal of relatedness despite irrevocable absence.     

Fracturing drive or fracturing connections—relational considerations commentary on paper by Paul Williams

We tend to conceive of mourning primarily in intrapsychic terms. In this commentary I highlight how Harvey Peskin’s paper (this issue) helps us to appreciate that grief is not only the product of the individual mind but is also constituted relationally. Both what we experience in our grieving and how we express it is shaped by and through those around us whose grief we bear witness to, as we ourselves grieve and are witnessed by them.

I elaborate further on Peskin’s view of the role of witnessing during grieving and mine another profound implication in his discourse by pointing to the bidirectional influence between mourning and relationality. Not only is mourning fostered through relational engagement, but our grieving together can provide the mortar for the building and sustaining of community.     

Mental ghosts and the process of grief

Abstract

Grieving the death of a loved one is an experience that many people will face at least once in their lifetime, but the lack of widely accepted guidelines as to what constitutes “normal” grieving results in mourning being a common experience with little universality. Memories may keep the deceased alive in the minds of the survivor and may even interfere with the formation of new relationships. This article considers the process of grieving the loss of a spouse and some of the individual factors, such as age, sex, and personal beliefs, that may account for variability in grief experiences. While several modeh detailing the grief process are discussed, the inappropriateness of establishing expectations for the nature and duration of grief is argued for.