Grief, Loss & Bereavement

Loss and grief are universal processes and people ordinarily have the natural capacity to adjust to their new lives in the absence of loved ones. However, some losses are experienced more profoundly than others—they cause greater or more prolonged grieving and such reactions are sometimes described as ‘complicated’ or ‘complex.’ This can be associated with characteristics of the loss, or with the meaning of the loss for the individual concerned. Read more

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Assessment

Perinatal Grief Scale (Short Version) | Potvin, L., Lasker, J., & Toedter, L. | 1989
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- Paper
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Inventory of Complicated Grief | Prigerson, H. G., Maciejewski, P. K., Reynolds, C. F., Bierhals, A. J., Newsom, J. T., Fasiczka, A., … & Miller, M. | 1995
- Paper
  Primary Link Archived Link
- Reference Prigerson, H. G., Maciejewski, P. K., Reynolds, C. F., Bierhals, A. J., Newsom, J. T., Fasiczka, A., … & Miller, M. (1995). Inventory of Complicated Grief: a scale to measure maladaptive symptoms of loss.Psychiatry research,59(1), 65-79

Guides and workbooks

Remembering for good: wholehearted living after loss | Cath Duncan
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Coping with trauma and loss | Cruse bereavement care
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- Coping with trauma and loss (Original leaflet)
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- Coping with trauma and loss (Updated leaflet)
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Has Someone Died? Restoring hope | Cruse Bereavement Care
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Your grief: You’re not going crazy | MADD.org
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Bereavement – a self-help guide
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Information Handouts

Common reactions to grief and loss
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Information (Professional)

Solution-focused interventions for prolonged grief | Macdonald
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Helping children to cope with death | MADD.org
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Presentations

Supporting the bereaved: theory and practice | Dent | 2005
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Using Acceptance and Commitment Therapy to negotiate losses and life transitions | Speedlin, Milligan, Haberstroh, Duffey
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ACT and grief | Russ Harris link
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Complicated grief treatment: the theory, practice and outcomes | Dr M. Katherine Shear
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Bereavement and loss | Barbara McKay
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Grief and bereavement: a practical approach | Ian Anderson
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Attachment, loss, and complicated grief | Dr M. Katherine Shear
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Treatment Guide

Supporting children through grief | Cruse Bereavement Care
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When someone you know has died… – a guide for professionals offering bereavement support | Sue Read | 2014
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What Are Grief, Loss, And Bereavement?

Signs and Symptoms of Grief, Loss, and Bereavement

People respond to loss in an enormous variety of ways. Emotional and behavioral responses to loss might include: sadness, preoccupation, yearning, depression, anxiety, or numbness. A grieving patient might oscillate between strong feelings and no feelings. Diagnostic systems are beginning to draw distinctions between normal and ‘pathological’ grief. DSM-5 identified persistent complex bereavement disorder, previously referred to as complicated grief, as a diagnostic category for further research.

Signs and symptoms of persistent complex bereavement disorder are listed below. To meet diagnostic criteria for persistent complex bereavement disorder particular symptoms must have been present: to a clinically significant degree; on more days than not; in a manner which is out of proportion to or inconsistent with cultural, religious, or age-appropriate norms; and must have persisted for at least 12 months following the death:

persistent yearning or longing for the deceased
intense sorrow and emotion pain in response to the death
preoccupation with the deceased
preoccupation with the circumstances of the death
marked difficulty accepting the death
experiencing disbelief or emotional numbness over the loss
difficulty with positive reminiscing about the deceased
bitterness or anger related to the loss
maladaptive appraisals about oneself in relation to the deceased or death (e.g., self-blame)
excessive avoidance of reminders of the loss
a desire to die in order to be with the deceased
difficulty trusting other individuals since the death
feeling that life is meaningless or empty without the deceased, or the belief that one cannot function without the deceased
confusion about one’s role in life, or a diminished sense of one’s identity
difficulty or reluctance to pursue interests since the loss or to plan for the future

Psychological Models and Theory of Grief, Loss, and Bereavement

There are a wide range of models and metaphors to help clinicians and their patients to conceptualize the grief process. A number of models draw upon Bowlby’s attachment theory to understand grief as a rupture in the attachment relationship.

Elizabeth Kübler-Ross published a stage model of grief in her 1969 book On Death and Dying. Originally designed to understand emotional states experienced by terminally ill patients, it has been used more widely. It postulates that grieving individuals may go through stages of denial, anger, bargaining, depression, and acceptance.
Margaret Stroebe and Henk Schut published their dual-process model of coping with bereavement in 1999. They propose that effective ways of coping with bereavement include both loss-oriented and restoration-oriented process, and that bereaved individuals will oscillate between both processes.
Paul Boelen, Marcel van den Hout, and Jan van den Bout published a cognitive behavioral model of complicated grief in 2006. Bearing some similarities to the cognitive model of PTSD, this model identifies mechanisms that may serve to maintain and prolong the grieving process. These maintenance mechanisms include poor integration of the separation (loss) with existing autobiographical knowledge, negative global beliefs and misinterpretations of grief reactions, and anxious and depressive avoidance strategies.

Evidence-Based Approaches for Working with Grief, Loss, and Bereavement

Techniques that specialists in grief therapy have found helpful when working with grieving patients include:

encouraging the patient to narrate their story of the loss, the events leading up to it, and subsequent events;
exploring the meaning of the loss for that individual;
engaging in mourning tasks;
using imagery to ‘talk’ to the deceased.

Resources for Working with Grief, Loss, and Bereavement

Psychology Tools resources available for working therapeutically with grief, loss, and bereavement may include:

psychological models of grief, loss, and bereavement
information handouts for grief, loss, and bereavement
exercises for grief, loss, and bereavement including mourning tasks
grief and loss worksheets: CBT worksheets for grief, loss, and bereavement
self-help programs for grief, loss, and bereavement

References

Boelen, P. A., van den Hout, M. A., & van den Bout, J. (2006). A cognitive-behavioral conceptualization of complicated grief. Clinical Psychology: Science and Practice, 13(2), 109–128.
Kübler-Ross, E. (1969). On death and dying: What the dying have to teach doctors, nurses, clergy and their own families. New York: Scribner.
Stroebe, M., & Schut, H. (1999). The dual process model of coping with bereavement: Rationale and description. Death Studies, 23(3), 197–224.

Managing Bipolar Disorder

Grief, Loss & Bereavement

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Audio Collection: Psychology Tools For Developing Self-Compassion

Window Of Tolerance

Before I Blame Myself And Feel Guilty

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Self-Sacrifice

Self-Blame

Abandonment

Vulnerability To Harm

Cognitive Behavioral Model Of Post Traumatic Stress Disorder (PTSD: Ehlers & Clark, 2000)

What Keeps Death Anxiety Going?

Hindsight Bias

Understanding Death Anxiety

Exposures For Fear Of Death

Recognizing Prolonged Grief Disorder

Externalizing

Everyday 'Unusual' Experiences

Am I Experiencing Death Anxiety?

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What Are Grief, Loss, And Bereavement?

Signs and Symptoms of Grief, Loss, and Bereavement

Psychological Models and Theory of Grief, Loss, and Bereavement

Evidence-Based Approaches for Working with Grief, Loss, and Bereavement

Resources for Working with Grief, Loss, and Bereavement

References

Grief, Loss & Bereavement

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What Are Grief, Loss, And Bereavement?

Signs and Symptoms of Grief, Loss, and Bereavement

Psychological Models and Theory of Grief, Loss, and Bereavement

Evidence-Based Approaches for Working with Grief, Loss, and Bereavement

Resources for Working with Grief, Loss, and Bereavement

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