Book Review of Counseling Children and Adolescents Through Grief and Loss

Book reviewed in this article: Counseling Children and Adolescents Through Grief and Loss by Jody J. Fiorini & Jodi Ann Mullen, 2006     

Book Review of In the Presence of Grief: Helping Family Members Resolve Death,Dying, and Bereavement Issues

In the Presence of Grief: Helping Family Members Resolve Death, Dying, and Bereavement Issues by Dorothy S. Becvar, 2001, New York: Guilford Press, 284 pages, $23.00, ISBN 1–57230–937–7.     

Introduction to the Special Issue on Grief

In the Introduction I present an overview of the changes that take place in conceptualizing the psychological purpose of the grief process following death of a loved one, and their effect on defining adaptive and maladaptive outcomes of grief. One of the most significant ones is the shift from breaking bonds to continuing bonds—the process of reorganizing the inner relationship with the deceased. New models of developmental grief have evolved. These are empirically-based and evidenced-based studies within which Cognitive Behavior Grief Therapy has gained significant reputation and the collection of articles in this special issue are representative of these changes. Also, a URL link of my article “Cognitive Behavioral Grief Therapy”, published in this journal in 1996 is provided for interested readers.     

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.     

Religiosity is an Important Part of Coping with Grief in Pregnancy After a Traumatic Second Trimester Loss

Women (n = 15) who were pregnant after a traumatic late pregnancy loss (termination because of fetal death or serious anomalies) completed psychometric screening tests and scales, including the Perinatal Grief Scale (PGS), the Impact of Event Scale (IES), the Duke Depression Inventory (DDI), the Generalized Anxiety Disorder-7 (GAD), and the Hoge Scale for Intrinsic Religiosity (IR). Despite a mean elapsed time since the prior loss of 27 (range, 7–47) months, half (7/15, 47%) of the combined groups had high levels of grief on the PGS. Multiple positive scores on psychometric tests were frequent: Sixty percent (9/15) had high scores on the PGS Active Grief subscale or on the IES. Forty percent (6/15) had a high score on the DDI, and 17% (3/15) on the GAD. IR scores significantly and negatively correlated with scores on the Despair subscale of the PGS. The results from this pilot study suggest that high levels of grief and PTS symptoms are significant problems for pregnant women who have suffered late loss of a wanted pregnancy. Religiosity may play an important part in maternal coping during these stressful pregnancies.     

Grief and Recovery: The Prevalence of Grief and Loss in Substance Abuse Treatment

Grief from various losses can underlie the process of recovery from substance abuse disorders. This study identified losses that clients encountered prior to abusing substances, losses that occurred as a result of addiction, and losses that occurred upon entering treatment.     

Consulting With Teachers in Two Areas: Grief and Mourning: Relaxation Techniques

Consultation with teachers remains untried by many counselors despite mandates, role definitions, and models for consultation. Barriers include the preference for the status quo and the lack of information and preparation. Involvement and training can help overcome these barriers. Two possible consultation areas are grief management and relaxation training. Grief is the normal reaction to any kind of loss. Being aware of the various stages is the first step in helping someone through the grief process. Relaxation techniques can be learned with proper guidance. Before tying any new ideas, however, counselors and teachers must have sufficient information and training.     

Field Trial of a Complicated Grief Psychosocial Program for Adolescents in Occupied Palestine

The current study evaluated the new “Children and Grief” program for Palestinian adolescents (n = 158), aged 10–18, referred to counselors for complicated grief. A mixed methods quasi-experimental design involved non-randomized intervention group (n = 79), waitlist (n = 79), and measures of program fidelity and cost. Traumatic loss was identified from case files. Standardized measures assessed complicated grief, posttraumatic stress, and depression at pre and post-test. Interviews of 9 adolescents and 9 presenters explored subjective experience of program delivery. Analysis involved multivariate analysis of variance (MANOVA) and quasi-qualitative analysis of interviews. A large effect size was found for reduced complicated grief. Randomized control trials, longitudinal research, and studies that explore the impact of martyrdom on coping with grief are needed.     

Author Response to Reviews of Grief: Contemporary Theory and the Practice of Ministry

The purpose of this article is to respond to three reviews in Pastoral Psychology of the author’s text, Grief: Contemporary Theory and the Practice of Ministry (Kelley 2010). This article considers in particular the grief born of injustice, the need for pastoral caregivers to cultivate skills and sensitivities for grief ministry in multicultural and multireligious settings, and the centrality for many of a secure relationship with the Divine as a primary source of hope after loss.     

Development and validation of a Christian-based Grief Recovery Scale

The purpose of this study was to develop and validate a Christian-based Grief Recovery Scale (CGRS) which was used to measure Christians recovering from grief after a significant loss. Taiwanese Christian participants were recruited from churches and a comprehensive university in northern Taiwan. They were affected by both the Christian faith and Chinese cultural beliefs. The CGRS is developed through replicated factor analyses in three stages. The final version of the CGRS retains 35 Likert-type items and consists of six factors: spiritual well-being; recovering meaning and sense of control; ongoing physical and emotional responses; reassuring faith; strongly missing a deceased loved one; and life disturbance. The evidence for CGRS reliability and validity is highlighted. Implications for research and counselling practice are suggested.     

Development of the Grief Experience Questionnaire

The development of the Grief Experience Questionnaire (GEQ) is reported. This questionnaire is an instrument for measuring various components of grief, including somatic reactions, general grief reactions, search for explanation, loss of social support, stigmatization, guilt, responsibility, shame, rejection, self-destructive behavior, and reactions to a unique form of death. Initial results with the GEQ suggest its potential to differentiate grief reactions experienced by suicide survivors from those experienced by survivors of accidental death, unexpected natural death, and expected natural death. Conclusions support its use in redressing common methodological criticisms of suicide survivor research. Six additional benefits derived from use of this instrument are discussed.     

Divergent and Convergent Validation of the Complicated Grief Prototype Narrative

Although there is a prototype narrative for complicated grief (CG), there are neither divergent nor convergent validity studies of its clinical value. We evaluated the CG prototype narrative using a sociodemographic questionnaire and the Clinical Interview for Complicated Grief Diagnosis. We first conducted a convergent validation analysis followed by a divergent validation analysis. Results showed that participants with CG identified significantly more with the complicated grief prototype narrative than participants without CG.     

Pastoral Theological Reflection on Grief: Contemporary Theory and the Practice of Ministry by Melissa Kelley

This article highlights four of Melissa Kelley’s contributions in her book Grief: Contemporary Theory and Practice. The author identifies these as: 1) Kelley’s capacity to distill and synthesize the most important areas of contemporary grief theory; 2) her work on attachment theory and its relationship to people’s ways of coping with grief; 3) the focus on the research of Bonanno et al. (Journal of Gerontology Series B: Psychological Sciences and Social Sciences 60:67–73, 2005) and showing us who is most vulnerable and in need of pastoral care during grief; 4) her emphasis on meaning making as the core of the grieving process. The article also lifts up questions concerning communal practices for grieving loss born of injustice and the need for prevention and fostering coping mechanisms so that the worst effects of grief might be mitigated.     

Yearning and Its Measurement in Complicated Grief

Persistent intense yearning for the deceased is a core clinical feature of complicated grief (CG) that distinguishes it from other mental disorders that develop following loss. The Yearning in Situations of Loss Scale (YSL) is a recently developed assessment of yearning. To assess the psychometric properties of the YSL in those with CG, we administered the YSL, Inventory of Complicated Grief, and Quick Inventory of Depression Symptomatology to 303 treatment-seeking bereaved adults with CG. Our results suggest the YSL is a reliable assessment with acceptable convergent and discriminant validity as a measure of yearning in those with CG.     

Grief experiences and expectance of suicide

Suicide is generally viewed as an unexpected cause of death. However, some suicides might be expected to a certain extent, which needs to be further studied. The relationships between expecting suicide, feeling understanding for the suicide, and later grief experiences were explored. In total, 142 bereaved participants completed the Grief Experience Questionnaire and additional measurements on expectance and understanding. Results supported the prediction of a link between expecting suicide and understanding the suicide. Higher expectance and understanding were related to less searching for explanation and preoccupation with the suicide. There was no direct association with other grief experiences. We conclude that more attention should be brought to the relation between expecting the suicide of a loved one and later grief responses in research and in clinical practice.     

Psychometric Properties of the Grief Cognitions Questionnaire (GCQ)

Cognitive behavioral conceptualizations of complicated grief propose that negative cognitions play a core role in the development and persistence of emotional problems after bereavement, because they generate negative emotions and cause mourners to engage in counterproductive attempts to avoid the implications and the pain of the loss. To facilitate the assessment of potentially problematic cognitions after bereavement, the Grief Cognitions Questionnaire (GCQ) has been developed—a 38-item questionnaire representing 9 categories of cognitions. Building on a previous study that supported the reliability and validity of the GCQ, the current study further examined its psychometric properties, with data of 531 bereaved individuals who completed research questionnaires online through the Internet. Confirmatory factor analyses supported the nine-factor structure with 9 interrelated factors. The reliability and convergent and discriminative validity were found to be adequate. Altogether the GCQ seems to be a useful tool for the assessment of negative thinking after bereavement in research and clinical practice.     

Use of Bibliotherapy in the Treatment of Grief and Loss: A Guide to Current Counseling Practices

Grief is a complex and dynamic process influencing individuals of all ages. This article provides an overview of historical and contemporary constructs of grief counseling. Bibliotherapy, a creative counseling tool, is presented as an appropriate intervention when counseling grieving clients. Guidelines for using bibliotherapy with grieving clients are considered.     

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.     

Cognitive behavioral variables mediate the associations of neuroticism and attachment insecurity with Prolonged Grief Disorder severity

Prolonged Grief Disorder (PGD) is a debilitating syndrome of grief. A recent cognitive behavioral model asserts that three processes are critical to this condition: (1) insufficient integration of the loss with autobiographical knowledge about the self and the lost person; (2) negative cognitions; and (3) anxious and depressive avoidance behaviors. These processes are assumed to contribute to PGD symptoms and to mediate the influence of personality-related vulnerabilities on the development and maintenance of these symptoms. The present study examined the mediational role of these three processes in the linkage between neuroticism, attachment anxiety, and attachment avoidance on the one hand and PGD symptom severity on the other hand. Self-reported data from 348 bereaved people were used. The results showed that the three personality variables were significantly associated with PGD symptom severity. Moreover, the results provided support for the mediating effects of indices of insufficient integration, negative cognitions, as well as avoidance behaviors - even after controlling for the shared variance between mediators. Theoretical and clinical implications are discussed.     

Cognitive behavioral variables mediate the associations of neuroticism and attachment insecurity with Prolonged Grief Disorder severity

Abstract

Prolonged Grief Disorder (PGD) is a debilitating syndrome of grief. A recent cognitive behavioral model asserts that three processes are critical to this condition: (1) insufficient integration of the loss with autobiographical knowledge about the self and the lost person; (2) negative cognitions; and (3) anxious and depressive avoidance behaviors. These processes are assumed to contribute to PGD symptoms and to mediate the influence of personality-related vulnerabilities on the development and maintenance of these symptoms. The present study examined the mediational role of these three processes in the linkage between neuroticism, attachment anxiety, and attachment avoidance on the one hand and PGD symptom severity on the other hand. Self-reported data from 348 bereaved people were used. The results showed that the three personality variables were significantly associated with PGD symptom severity. Moreover, the results provided support for the mediating effects of indices of insufficient integration, negative cognitions, as well as avoidance behaviors – even after controlling for the shared variance between mediators. Theoretical and clinical implications are discussed.