Community-Based Interventions in New York City After 9/11

Abstract

The horrors of 9/11 have created tremendous psychosocial needs in the population of New York. For all major providers in this field, this has meant taking up the challenge of learning within the new situation, creating new frameworks for intervention, and implementing programs that previously had not been a part of the traditional social services environment. In this article, we will describe the process of transforming this challenge into an opportunity for organizational, professional and conceptual growth.     

Sensing the presence of the deceased: A narrative review

Researchers have reported that bereaved people often continue to sense the presence of the deceased. A particular collection of such experiences can be identified as instilling a perception that the deceased person is in some manner present in the company of the bereaved person. The aim of the current review was to synthesise the results on this topic to provide a comprehensive over-view for practitioners working with bereaved people who report these experiences. The studies were reviewed in terms of the nature of the experiences described, the provision of explanatory models to understand the significance of these experiences, describing any culturally specific aspects of these experiences, discussion of the personal impact of having the experiences, and for recommendations of how people who have these experiences can be supported.     

Doubly bereaved

This paper considers the initial phases of work with a family who suffered the death of one parent and the threatened loss of another parent, both from cancer. In this case, the children were ‘double bereaved’, not only by the actual and anticipated losses, but by the impact of these circumstances on their internal worlds, as manifested by their somatic symptoms and suicidal ideation. The need for a co-ordinated and supportive approach to families in these circumstances is emphasized, as is the importance of addressing individual concerns while maintaining a family perspective.     

Using Genograms Creatively to Promote Healthy Lifestyles

ABSTRACT

Family therapists have used Genograms as an assessment tool for years to examine the interactions and relationships of family members across generations. This article discusses how a therapist can use a genogram creatively to help clients examine the impact of family relationships on healthy and unhealthy lifestyle patterns and how those relationships may be influencing the manner in which clients are currently managing their lives. The integration of a creative genogram can assist clients in recognizing inherited health-disease risks, learned lifestyle patterns, and parental behavior modeling. This technique can assist clients in developing a healthier lifestyle.     

The distinctive moral personality of care exemplars

Positive emotion following bereavement was examined in a prospective longitudinal study. Participants lost a spouse (n?=?250) and were interviewed prior to the death, 6 months after the death, and in some cases 18 and 48 months after the death. Early theorists suggested that positive emotion during times of distress may indicate pathology. In contrast, more recent theorists suggest that positive emotion is desirable even during times of distress. In this analysis, positive emotion was associated with desirable outcomes (less depressed mood, more social support received, more social provision to others) and this effect was not diminished among people reporting elevated levels of distress. Also, the simultaneous occurrence of positive emotion and distress was not associated with pre-existing emotional instability. Those experiencing positive emotion reported lower levels of grief, but not qualitatively different grief. The findings suggest that positive emotion tends to be associated with desirable outcomes even among people reporting elevated distress.     

Complicated Grief in Canada: Exploring the Client and Professional Landscape

Complicated grief (CG) is one of the central themes in bereavement research and advanced clinical practice today. Using a mixed-methods approach, we wanted to learn (a) what tools Canadian practitioners used to identify or diagnose CG and (b) what interventions or strategies they used to address CG. Sixty-three professionals responded to our survey. There were no straightforward answers to these questions: the state-of-the art of CG in Canada is, in fact, complicated. Practitioners used a wide assortment of tools and strategies with no consensus on any one approach or tool. Building a Canadian CG community of practice was recommended.     

The Traumatic Grief Inventory Self-Report Version (TGI-SR): Introduction and Preliminary Psychometric Evaluation

Persistent Complex Bereavement Disorder (PCBD) is a disorder of grief newly included in the “Emerging Measures and Models” section of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013 American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. [Google Scholar]). Prolonged Grief Disorder (PGD) is a disorder with similar symptoms, likely to be included in the forthcoming 11th edition of the International Classification of Diseases (ICD-11; World Health Organization, 1992 World Health Organization. (1992). International classification of diseases and related health problems (10th revision). Geneva, Switzerland: World Health Organization. [Google Scholar]). We developed the Traumatic Grief Inventory Self-Report version (TGI-SR), an 18-item measure, for the assessment of symptoms of PCBD and PGD in clinical and research settings. This study was an initial attempt to evaluate psychometric properties of the TGI-SR. To this end, the measure was administered to 327 patients of a mental health institute specialized in the treatment of psychopathology associated with loss and trauma. We found evidence that items of the TGI-SR (all 18 items, as well as the selection of 17 items representing PCBD criteria, and 11 items representing PGD criteria) loaded on one dimension. The TGI-SR demonstrated strong internal consistency. Elevated scores on the TGI-SR were significantly correlated with elevated scores on indices of psychopathology and lower quality of life, attesting to the concurrent validity. Receiver operation characteristic (ROC) analyses of the TGI-SR total score against provisional diagnoses of PCBD and PGD yielded a high area under the curve index suggesting that the TGI-SR total score can be used as an indicator for probable diagnoses of both PCBD and PGD. Results of this study provide initial evidence that PCBD and PGD symptoms may be readily and reliably measured using the TGI-SR.     

Parent Grief 1–13 Months After Death in Neonatal and Pediatric Intensive Care Units

Objective. Describe changes in mothers’ and fathers’ grief from 1 to 13 months after infant or child neonatal or pediatric intensive care unit death and identify factors related to their grief.

Methods. Mothers (n = 130) and fathers (n = 52) of 140 children (newborn–18 years) completed the Hogan Grief Reaction Checklist at 1, 3, 6, and 13 months postdeath.

Results. Grief decreased from 3 to 13 months for mothers and from 3 to 6 months for fathers. Grief was more intense for mothers of deceased adolescents and mothers whose children were declared brain dead.

Conclusion. Mothers’ and fathers’ grief intensity may not coincide, resulting in different needs during the 13 months after infant or child death.