中国丧亲个体社会支持体验的质性研究

本研究通过对28位丧亲者进行深度访谈,使用解释现象学分析法对质性数据进行分析,探索中国丧亲个体的社会支持体验。结果显示,丧亲社会支持的内容包括后事处理、情感支持、生活恢复帮助,经济与物资支持等。支持来源除家人和朋友之外,还包括同事、相同经历者,以及相关机构等。社会支持通过调节情绪、改变认知等方式促进个体对丧亲的适应。本研究结果为最新丧亲社会支持模型提供了支持,同时也反映出中国社会对丧亲人群的社会支持特色。     

Support groups: A psychological or social device for suicide bereavement?

This paper examines the psychological studies of bereavement support groups as well as exploring the ways in which people talk about their participation in such groups after their family member's suicide. Rather than reflecting any universal human condition, talk about experiences is considered as a local and contextual social construction, which in this case takes place in qualitative interviews in the modernWest (Finland). The paper draws on a study of 16 interviews with bereaved parents and (adult) children, half of whom had attended a bereavement support group after their family member's suicide. The study makes a contribution to the research field of family suicide bereavement from which sociological analysis has been so far largely missing.     

Network and mutual support for parents bereaved following the violent deaths of their 12- to 28-year-old children: A longitudinal,prospective analysis

Abstract

Social support provided by bereaved parents' networks was examined in this study. Seven dimensions of support were assessed over time. Of special interest to the investigators were the types and frequency of posttreatment contacts among bereaved parents who participated in an experimental support program. The study compared those who reported high versus low social support and high versus low numbers of network confidants on selected outcome and coping variables. The authors recruited a community-based sample of 171 bereaved mothers and 90 bereaved fathers whose 12- to 28-year-old children had died by accident, suicide, or homicide 4 months previously. Parents were randomly assigned to a 12-week bereavement program or control group. It was expected that intervention group parents would report more social network in involvement and greater satisfaction with support received than control group parents. This hypothesis was only partially supported. Only 20% of the parents who participated in the bereavement program remained in contact after the experimental program ended. Finally, significant differences detected between parents who reported high and low support were minimal and not sustained over time. The number of network confidants did not significantly affect the outcomes examined. However, in general, those with more confidants reported lower symptoms. Additional studies are needed to address these complex issues.     

Does differential social support cause sex differences in bereavement outcome?

A study of a sample of bereaved and married individuals tested the prediction from stress theory that sex differences in bereavement outcome are due to differences in social support extended to the bereaved. Previous research had established that compared to same‐sex married controls, widowers suffer greater health deterioration following the death of a spouse than widows. Although there is some evidence that widows receive more social support than widowers, it has never been tested empirically whether differential social support is responsible for the sex difference in bereavement outcome. Two sets of tests were conducted to examine these hypotheses: first, sex differences in bereavement outcome and in the social support perceived by the bereaved were assessed by means of sex×marital status ANOVAs on depressive symptomatology, loneliness and social support; second, an ANCOVA was used to assess whether the marital status×sex interaction on distress was substantially reduced or eliminated when social support was used as a covariate. Although there was evidence of the expected sex differences in bereavement outcome and social support, there was no evidence that social support mediates the sex differences in bereavement outcome. Copyright © 1999 John Wiley & Sons, Ltd.     

On‐Line Support and Resources for People Bereaved through Suicide: What Is Available?

The Internet is a potentially valuable source of information for the bereaved, but the current knowledge regarding the type and quality of online material on suicide bereavement is very limited. This study was designed to explore the types of online information and support available for people bereaved by suicide and the quality of such resources. Four popular Internet search engines were searched using terms related to suicide bereavement and support. Although a wide range of Internet resources exist for people bereaved by suicide, these resources may not meet basic quality standards. It is unknown who uses these sites, how such material is used, and whether it helps people to cope effectively with grief after suicide.     

Traumatic Loss: Conceptual and Empirical Links Between Trauma and Bereavement

Abstract

This article focuses on conceptual issues and empirical studies regarding the topic of traumatic loss (i.e., loss that occurs suddenly and under violent circumstances) as a method for linking the field of trauma, and that of grief and bereavement. Several definitions of trauma are presented that include the concept of loss, and additional concepts are suggested that may be helpful in thinking about the two areas together. Also, modes of death associated with poor recovery are noted, and it is argued that these modes are those that make a bereavement more “traumatic”. Some empirical studies on the psychological outcomes associated with traumatic loss are reviewed, and preliminary findings from a new study of traumatically bereaved women are briefly presented     

The Emotional Reengineering of Loss: On the Grief-Anger-Social Action Continuum

This article deals with the role of bereaved parents' anger as a motivating force for political and public activism. After reviewing the place of anger in the experience of processing loss and bereavement and presenting anger as a factor that leads to public initiative, the article deals with the place that anger occupies in the bereaved sector of Israeli society. The claim is made that Israeli society has changed since its early years, when "the national management of emotions" did not allow anger to be present in the public discourse of bereaved parents, to the current era in which anger is an inseparable part of Israeli bereavement discourse. The following section of the article includes an interpretive analysis of the place of anger among the research subjects, bereaved parents who later became public and political entrepreneurs. All of the research subjects lost a son in one of three circumstances that are part of the Israeli security agenda: operational accidents, terrorist attacks, and IDF combat in Lebanon. Finally, the study attempts to answer how anger structures both public and private bereavement in Israel, shaping the bereaved parents as instant celebrities.     

复杂哀伤丧亲女孩的箱庭疗法个案研究

通过19次个体箱庭和2次家庭箱庭治疗,对一名12岁复杂哀伤的丧亲女孩W进行了个案研究。发现:(1)箱庭治疗能提高丧亲青少年的个体和家庭功能,促进青少年个体和家庭哀伤任务的完成;(2)W的个体箱庭经历了在混乱重复中寻找秩序、重建自我、转化与整合、自我治愈力展现四个阶段;(3)W的哀伤经验经历了在治疗者促进下分享—象征性表达—主动地象征性表达—直接而主动地表达哀伤经验最终获得哀伤任务完成的变化过程。     

Telling losses: Personality correlates and functions of bereavement narratives

How and why do bereaved individuals talk about their loss? What are the personality correlates and social consequences of different kinds of bereavement narratives? Two studies were conducted to answer these questions. In Study 1, participants from online bereavement support groups and memorial websites wrote bereavement narratives. Participants high in Conscientiousness told brief, factual narratives; participants high in Neuroticism told self-focused contamination narratives; and participants high in Extraversion told narratives for social reasons. In Study 2, undergraduate participants responded to twelve narratives from Study 1. Participants felt more sympathetic concern but more social awkwardness and less acceptance towards contamination narrators compared to redemption narrators. The role of personality in the telling and reception of bereavement stories, and social support after loss, is discussed.     

Spiritual Distress and Depression in Bereavement: A Meaning-Oriented Contribution

One key focus of a meaning reconstruction model of bereavement concerns spiritual meanings attributed to the death, whether consoling or troubling. Specifically, previous studies in our research program suggest that religiously inclined violent death survivors are at risk for elevated levels of both bereavement distress and complicated spiritual grief, a crisis of faith following loss that refers to the erosion of the mourner’s relationship to God and/or the religious community. However, more research is needed to understand the convergence of depression and spiritual struggle in the context of violent and natural loss. In this study of a diverse sample of 59 American Christians bereaved less than 5 years, we sought to: (1) determine if individuals bereaved by homicide, suicide or fatal accident differed from those bereaved by natural causes in their levels of depression and spiritual coping; (2) investigate the relation between the latter constructs; and (3) ascertain if cause of death mediates the effect of religious coping on depression. We found that: (a) violently bereaved individuals endorsed more negative religious coping, and (b) depression was associated with greater spiritual struggle, particularly a sense of disrupted relationship with God. Contrary to expectations, positive religious coping was unrelated to post-loss depression, and cause of death did not mediate the relationship between spiritual coping and depressive symptomatology. A clinical case study concludes the article, illustrating the interweaving of spiritual and psychological distress in tragic bereavement, and their implications for a meaning-oriented grief therapy.     

The management needs of the bereaved following loss of a partner

A case of death results in the formation of a social group, the group consisting of the bereaved, which remains in existence for a brief spell only, but which calls for careful attention. 124 widowed persons were questioned about their reaction to their loss, and changes in their habits after bereavement. Factors of influence are indicated, important among them dependence on the deceased, the age of the bereaved person, and physical and mental health.     

Counselling strategies for bereaved people offered in primary care

The aim of this study was to identify strategies that general practice-based counsellors used when offering support to bereaved clients. Over the last decade, there has been a rapid growth in the provision of counselling services associated with British primary care services. A study was designed involving qualitative methods of data collection (semi-structured interviews) and analysis (a grounded theory approach). Counsellors were recruited from two cities in Southern Britain (Plymouth and Southampton). Twenty nine (76% response rate) counsellors agreed to participate (Southampton n = 15, Plymouth, n = 14). Semi-structured face-to-face audio-taped interviews elicited information about their perceptions of the appropriateness of general practitioner referrals, counselling strategies and models of bereavement. Analysis indicated that counsellors saw bereavement counselling within a broader agenda of work concerned with loss and relationship management. Many drew on eclectic approaches to bereavement counselling and specific strategies included: facilitating telling of the 'story' of the loss; engaging in active listening and valuing allowing people to talk; establishing a supportive relationship; and enabling the bereaved person to deal with unfinished business and to say 'goodbye'. Counsellors drew on implicit stage/phase models of grief that assumed levels of distress reduced over time. The value of these strategies requires more exploration.     

Primary Care for the Elderly Bereaved: Recommendations for Medical Education

The aim of this study was to explore the current practices of primary care physicians (PCPs) in providing bereavement care to elderly patients, with implications for medical education. A total of 63 PCPs answered a brief online survey about their typical practices, barriers, comfort level with bereavement, and confidence in their ability to diagnose prolonged grief disorder (PGD). They were recruited through an online newsletter and contacts of one of the authors. The results found that two-thirds of the PCPs do not routinely screen their elderly patients for recent losses, nor do they refer to mental health clinicians when loss is identified. Barriers included not learning of the deaths in patients’ lives and lack of time during clinic visits. Those PCPs who had experienced their own losses were significantly more comfortable in speaking to patients about recent losses and more confident in their ability to diagnose PGD. We recommend bereavement education be incorporated into the medical school curriculum from the outset, utilizing the psychological principle of graded exposure to bereaved individuals.     

The Group as a Training Device and Treatment Method in a Private Pyschiatric Hospital

Clinical and research evidence indicates that the recently bereaved represent a large at-risk population. Bereavement groups constitute a particularly efficient preventive intervention for this high-risk population and thus represent excellent preventive mental health practice. In this paper, we report specifically on the technical and thematic considerations of four bereavement groups that met weekly for eight weeks. Group members were recruited from a consecutive series of individuals who had lost a spouse to cancer and who were undergoing normal grief and mourning. We found that we were able to be most technically helpful to the groups by being aware of the issues and themes that preoccupy bereaved spouses and by facilitating the emergence and discussion of these themes in the group setting. Many members, for example, struggled with complex questions of growth, identity, and responsibility for the future, questions that have not often been identified in discussions on bereavement groups as being of particular therapeutic import.     

Bereavement Group Therapy in School: the role of a belief in a post‐death existence within adolescent development for the acceptance process of loss[1]

As adolescents move away from parents towards peer group support, they develop their sense of self through challenge and reaction against authority. The parent/ guardian stands as the authority, but if the rule‐imposing figure is unexpectedly taken away the progress towards a sense of self is affected. School provides a social context for normalcy, but rarely is support found for bereaved youngsters in school. Adolescents in bereavement group therapy are able to share their experiences and begin to confront their loss through discourse, and such an approach in school serves to prepare pupils for later in‐depth individual counselling to work on guilt and maladaptive behaviour. Beliefs of an after‐life existence, which move from literal to figurative motifs, serve as coping mechanisms to help guide the youth through towards an acceptance and a sense of hopefulness. A model is presented that is in‐keeping with the developmental stage of adolescence, that utilizes peers as a therapeutic resource — those who have similarly been bereaved of loved ones.

     

Strategies of professional assistance after traumatic deaths: Empowerment or disempowerment?

Dyregrov, K. (2004). Strategies of professional assistance after traumatic deaths: Empowerment or disempowerment? Scandinavian Journal of Psychology, 45, 181–189. Referring to research and theory in the field, this discussion paper addresses the more overarching question of current strategies for professional assistance to populations bereaved by traumatic death. The issues and controversies that have long surrounded the “medicalization” of mental health arise anew with respect to the medicalization and professionalization of psychosocial help for people who have been traumatically bereaved. Who should provide what help and how? To what extent should the bereaved be expected to help themselves, receive help and support from friends and family, or even the wider community; and to what extent should the bereaved be able to access appropriate professional help when they are in crisis? Recent studies have indicated that bereaved parents want to receive help from mainstream crisis psychology, and this is not always available. Families experiencing traumatic bereavement are not able to access appropriate services along the same lines as those suffering similar levels of somatic complaints. It is argued that the main factors contributing to this situation are the lack of knowledge and inadequate organization of services; the fact that somatic issues take priority over psychosocial difficulties and dysfunction, and curative services over prophylactic intervention; and particularly the de‐medicalization ideology. By not listening to the needs of user groups, the de‐medicalization movement disempowers rather than empowers users – the very opposite of the desired effect.     

Experiences of Healing Touch and Counseling on a Bereaved Population: A Grounded Theory

Grounded theory was selected as a way to develop a theory about the potential adjunctive use of energy healing in the form of healing touch (HT) along with counseling on a bereaved population. Semi-structured interviews were conducted twice with clients and once with the counselors and HT practitioners. Results indicated that the participants agreed that both counseling and HT operated well together to provide bereavement support. The themes of trust, openness, intention, and spirituality within the holistic context seemed to make this model possible. Potential ethical concerns are discussed, as well as areas for future research and clinical applications.     

Psychological Capital,Team Resources and Organizational Citizenship Behavior

The study aimed to examine the impact of team resources – learning values and team leader optimism – as moderating variables affecting the relationship between team psychological capital (PsyCap) and organizational citizenship behavior (OCB), measured as a team outcome. Eighty-two management teams involving 395 participants from educational organizations responded to a quantitative questionnaire. Hierarchical regression analyses confirmed interactive effects of both moderating variables, which serve as positive resources for the team by enhancing the impact of team PsyCap on the willingness of the team to engage in OCB. Team PsyCap functioned as a positive team resource that brings about an environment that induces exhibition of high levels of OCB. This relationship is strengthened when both team learning and team leader’s optimism are high. The findings provide support for the relevance of contingency theories by emphasizing the necessity of certain situational features existing in order to have an impact on organization outcomes. Theoretical and practical implications of the findings are discussed.     

Approaching Complex Cases With a Crisis Intervention Model and Teamwork

Patients referred for genetic counseling may be in a state of crisis, feeling as though they are incapable of making decisions about the management of their pregnancy, genetic testing options and/or life planning issues. The role of the genetic counselor is to assist a patient through this crisis state by increasing the patient's understanding and by helping to facilitate decision making and adjustment to those decisions. In this paper we present a clinical genetic counseling case that was complicated by numerous medical and psychosocial issues. The wide scope of this case required the involvement of both a prenatal and a medical genetic counselor. Working as a team we utilized a crisis intervention model. Our counseling focused on identifying and isolating the issues, providing factual information, setting a time frame for decisions to be made, and encouraging social support and emotion-focused coping strategies.     

The broken heart phenomenon: An examination of the mortality of bereavement

Bereaved people are at greater risk of losing their lives than the non-bereaved. This paper explores the evidence on this ‘bereavement—mortality relationship’, to establish who among the bereaved are most vulnerable to such dire consequences of loss. Information is drawn from several sources, including epidemiological research on sociodemographic variables, analyses of causes of death and recent empirical studies that have identified differences between bereaved decedents and survivors. The survey shows that risk factors interact in complex ways to determine level of vulnerability. A simple explanation in terms of ‘broken heart’ cannot account for the pattern of results. Some bereaved subgroups are more vulnerable to death than others, excess risk occurs across a variety of causes of death (suggesting different underlying processes), and personal characteristics in combination with circumstantial factors lead to high vulnerability. It is concluded that two types of process underlie the bereavement–mortality relationship. These are related: (a) to the direct effects of grief (broken heart); and (b) to secondary consequences associated with the stress of bereavement.