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Understanding Grief: Assessment and Treatment Planning

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Dreams of the deceased. Absent-minded behavior. Common Grief ... William Worden: Four tasks of grieving. Robert Neimeyer: Rebuilding life and search for meaning ... – PowerPoint PPT presentation

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Title: Understanding Grief: Assessment and Treatment Planning


1
Understanding Grief Assessment and Treatment
Planning
  • Karen Horinek, L.C.P.C.
  • Bereavement Coordinator/Counselor
  • And
  • Terra Solove, M.S.W.
  • Bereavement Counselor

2
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)

3
Common Grief Responses Feelings
  • Numbness
  • Shock
  • Anger
  • Anxiety
  • Loneliness
  • Fatigue
  • Yearning
  • Relief

4
Common Grief Responses Physical Sensations
  • Tightness in the chest
  • Shortness of Breath
  • Lack of Energy
  • Panic Attack-like symptoms

5
Common Grief Responses Cognitions
  • Disbelief
  • Confusion
  • Sense of Presence
  • Lack of Concentration

6
Common Grief Responses Behaviors
  • Sleep disturbances
  • Appetite disturbances
  • Social withdrawal
  • Dreams of the deceased
  • Absent-minded behavior

7
Common Grief Responses
  • Cultural Differences
  • Gender Differences

8
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)

9
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

10
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

11
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

12
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.

13
Theories on Bereavement
  • Elizabeth Kubler-Ross Stages
  • William Worden Four tasks of grieving
  • Robert Neimeyer Rebuilding life and search for
    meaning

14
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

15
Taking Care of Myself
  • Know your own limits
  • Set boundaries
  • Nurture yourself
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