Grief_bereavement

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Published on December 22, 2008

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Understanding Grief: Assessment and Treatment Planning : Understanding Grief: Assessment and Treatment Planning Karen Horinek, L.C.P.C. Bereavement Coordinator/Counselor And Terra Solove, M.S.W. Bereavement Counselor What is Grief? : What is Grief? Grief is the physical, emotional, somatic, cognitive and spiritual response to actual or threatened loss of a person, thing or place to which we are emotionally attached. We grieve because we are biologically willed to attach. (John Bowlby, Father of Attachment Theory) Common Grief ResponsesFeelings : Common Grief ResponsesFeelings Numbness Shock Anger Anxiety Loneliness Fatigue Yearning Relief Common Grief ResponsesPhysical Sensations : Common Grief ResponsesPhysical Sensations Tightness in the chest Shortness of Breath Lack of Energy Panic Attack-like symptoms Common Grief ResponsesCognitions : Common Grief ResponsesCognitions Disbelief Confusion Sense of Presence Lack of Concentration Common Grief ResponsesBehaviors : Common Grief ResponsesBehaviors Sleep disturbances Appetite disturbances Social withdrawal Dreams of the deceased Absent-minded behavior Common Grief Responses : Common Grief Responses Cultural Differences Gender Differences Differences between Grief and Depression : Differences between Grief and Depression Depression shares common features with grief. Misdiagnosis can result in overlooking depression when it is present and inappropriately treating grief. American Family Physician Article (www.aafp.org/afp/20020301/883.html) Assessing between Grief and Depression : Assessing between Grief and Depression Grief Experienced in waves Diminishes in intensity over time Healthy self-image * Excerpts from Therese A. Rando (1993).Treatment of Complicated Mourning. Research Press, Champaign, IL. Depression Moods and feelings are static Consistent sense of depletion Sense of worthlessness and disturbed self-image Assessing between Grief and Depression : Assessing between Grief and Depression Grief Anhedonia Hopelessness Response to support Overt expression of anger * Excerpts from Therese A. Rando (1993).Treatment of Complicated Mourning. Research Press, Champaign, IL. Depression Anhedonia Pervasive hopelessness Unresponsive to support Anger not as pronounced Assessing between Grief and Depression : Assessing between Grief and Depression Grief Guilt is focused on aspect of loss Not demoralizing or humiliating Preoccupation with deceased Suicidal gestures rare in uncomplicated grief Elicits sympathy, concern and desire to embrace * Excerpts from Therese A. Rando (1993).Treatment of Complicated Mourning. Research Press, Champaign, IL. Depression Guilt is preoccupied with a negative self-image Demoralizing and humiliating Preoccupation with self Suicidal gestures not unusual in depression Elicits irritation, frustration and a desire to avoid Grief Assessment : Grief Assessment What was the relationship Nature of the Attachment Mode of Death Historical Antecedents Personality Variables Social Variables * Adapted from William Worden. (1982). Grief Counseling and Grief Therapy. New York: Springer Publishing Company. Theories on Bereavement : Theories on Bereavement Elizabeth Kubler-Ross: Stages William Worden: Four tasks of grieving Robert Neimeyer: Rebuilding life and search for meaning Treatment Planning : Treatment Planning Establish a relationship with the bereaved Be comfortable with their expression of grief Listen Normalize grief reactions Companion them in rebuilding their life Taking Care of Myself : Taking Care of Myself Know your own limits Set boundaries Nurture yourself

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