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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?.

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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 responses feelings
Common Grief ResponsesFeelings
  • Numbness
  • Shock
  • Anger
  • Anxiety
  • Loneliness
  • Fatigue
  • Yearning
  • Relief
common grief responses physical sensations
Common Grief ResponsesPhysical Sensations
  • Tightness in the chest
  • Shortness of Breath
  • Lack of Energy
  • Panic Attack-like symptoms
common grief responses cognitions
Common Grief ResponsesCognitions
  • Disbelief
  • Confusion
  • Sense of Presence
  • Lack of Concentration
common grief responses behaviors
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
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 depression1
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 depression2
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

Assessing between Grief and Depression
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