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Thanatology > Exam 3 (Grief Counseling And Grief Therapy Ch.4-5 > Flashcards

Exam 3 (Grief Counseling And Grief Therapy Ch.4-5 Flashcards

1
Q

According to William Worden, grief therapy is

A

For those specialized techniques that are used to help people with abnormal or complicated grief reactions

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2
Q

Grieving has historically been facilitated through

A
  • the family
  • religious organizations
  • funeral rituals
  • other special customs
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3
Q

Goals of grief counseling

A

To help the survivor adapt to the loss of a loved one and adjust to a new reality without them

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4
Q

Specific goals that correspond to the four tasks of mourning

A
  • increasing the reality of the loss
  • helping the counselee deal with the emotional and behavioral pain
  • helping the counselee you overcome various impediments to readjustment
  • helping the counselee find a way to maintain a bond with the deceased well feeling comfortable reinvesting in life
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5
Q

Parked described three basic types of grief counseling…

A
  • performed by trained doctors, nurses, psychologists, or social workers
  • volunteers are selected and trained and supported by professionals
  • self-help groups
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6
Q

When to do grief counseling

A

In most instances grief counseling begins at the earliest a week or so following the funeral

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7
Q

According to William Worden, grief counseling involves

A

Helping people facilitate uncomplicated or normal grief to a healthy adaptation to the tasks of mourning within a reasonable timeframe

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8
Q

3 approaches-or philosophies to bereavement counseling

A
  • offered to all individuals who have experienced a death related loss
  • some people need help with bereavement but wait until they experience difficulty
  • if we can predict in advance who is likely to have difficulty, we can intervene early
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9
Q

The ratio of widows to widowers in the United States

A

5:1

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10
Q

Raphael discovered the following characteristics were significant predictors of the person who will not do well with death 1 and 2 years later

A
  • A high-level of perceived non supportiveness in the bereaved’s social network
  • moderate level of perceived non supportiveness in social network response
  • previously high ambivalent marital relationship with the deceased
  • presence of a concurrent life crisis
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11
Q

Toronto, Sheldon, Cochrane, Vachon, Lyall, Rogers and Freeman found 4 major groups of predictors were more important in explaining adjustment to bereavement in 80 widows

A
  • sociodemographic variables
  • personality factors
  • social support variables
  • meaning of the death event
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12
Q

If several of these dimensions are present in the 4week post death assessment, the person is identified as in need of intervention

A

1) more young children at home
2) lower social class
3) employment little, if any
4) anger high
5) pining high
6) self-reproach high
7) lacking current relationships
8) coping assessment by rater requiring help

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13
Q

Principles that will serve as guidelines for the counselor so that they can help the client work through and acute grief situation

A

1) help survivor actualize the loss
2) help survivor to identify and experience feelings (anger, guilt, anxiety, sadness)
3) assist living without the deceased
4) find meaning in the loss
5) facilitate emotional relocation of the deceased
6) provide time to grieve
7) interpret “normal” behavior
8) allow for individual differences
9) examine defenses and coping styles
10) identify pathology and refer

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14
Q

Worden suggests that anger probably comes from two sources…

A
  • frustration

- a sense of regressive helplessness

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15
Q

In extreme cases, retroflected anger may result in

A

Suicidal behavior either in thought or action

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16
Q

A small subset, _______ %of bereaved people will continue to struggle and develop some type of complicated mourning such as chronic or prolonged grief reactions

A

10-15

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17
Q

Platitudes

A

Not helpful, statements like “I know how you feel”, “you’ll be fine”, etc.

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18
Q

Useful techniques in grief counseling

A 
– Evocative language
– Use of symbols
– Writing
– Drawing
– Role-playing
– Cognitive restructuring
– Memory books
– Directed imagery
– Metaphors
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19
Q

Ways that drawing can help in grief therapy

A

– Helps facilitate feelings
– Identify conflicts that the mourner may be unaware of
– Heighten awareness of what the person lost
– Identify where the person is in the mourning process

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20
Q

The use of medication in management of acute normal grief

A

Medication ought to be used sparingly and focused on giving relief from anxiety or insomnia as opposed to relief from depressive symptoms

21
Q

Bereavement groups usually exist for one or more of the following..

A
  • Emotional support
  • education
  • social purposes
22
Q

Questions concerning group format for grief therapy

A
  • What is the group’s purpose?
  • How will the group be structured?
  • What will the logistics of the group be?
23
Q

there are two kinds of loss that may present particular problems in bereavement groups

A
  • multiple losses

- losses that are difficult to talk about

24
Q

examples of ground rules used in bereavement support groups

A
  • members are expected to attend and be on time
  • information shared in the group stays in the group
  • people are free to share as much or as little as they choose
  • everybody gets equal time
  • do not give advice unless it is asked for
25
Q

Key factors of grief counseling in group settings

A
  • choose group format
  • prescreen participants
  • define expectations
  • establish ground rules
  • determine leadership approach
  • understand interpersonal dynamics
  • handle disruptive behaviors effectively
26
Q

Three needs that at some level of awareness are on the minds of people when they participate in groups

A

1) inclusion
2) Control
3) affection

27
Q

Behaviors that are disruptive to group therapy

A
  • The attitude that “my loss is bigger than your loss”
  • The advice giver
  • The moralist
  • The nonparticipant
  • The person who brings up something important at the end of the group
  • The person who shares with the therapist after the group
  • The interrupter
  • The person who shows inappropriate affect
  • The person who makes the relevant comments
  • The person who shares too much
  • The group member who challenges or criticizes the leader
28
Q

One fact that dilutes the effect of funerals

A

They happen too soon

29
Q

Funerals have changed over the past 25 years to reflect

A
  • A more comprehensive understanding of ritual
  • The community as well as an individual focus
  • The importance of facing death
  • A better understanding of mourning
  • A more pluralistic society
30
Q

Why people fail to grieve

A
  • relational factors
  • circumstantial factors
  • historical factors
  • personality factors
  • social factors
31
Q

The type of relationship that most frequently hinders people from adequately grieving is the

A

Highly ambivalent one with unexpressed hostility

32
Q

Specific circumstances that may preclude a person from grieving or make it difficult for him or her to bring grief to a satisfactory conclusion

A
  • when the loss is uncertain

- when there are multiple losses

33
Q

Bereavement overload

A

When someone is so overwhelmed that they do not openly grieve, but experience grief as disabling anxiety

34
Q

Personality factors that may hinder ones grief

A

– Those unable to tolerate extremes of emotional distress

– One’s self concept (being the strong one in the family)

35
Q

Lazare outlines three social conditions that may give rise to complicated grief reactions

A
  • when the loss is socially unspeakable
  • when the loss is socially negated
  • The absence of a social support network
36
Q

Disenfranched grief (Doka 1989)

A

The mourners grief is not recognized or sanctioned by society

37
Q

Today we find that there is more of a continued relationship between normal and abnormal grief reactions, between the complicated and uncomplicated, and that pathology is more related to the________or________of a reaction then to the simple _________ or _________ of a specific symptom or behavior

A

intensity; duration

presence; absence

38
Q

data collected by Prigerson when she was at the University of Pittsburgh brought about two ideas; the first one being two factors at work in complicated grief..

A
  • traumatic distress

- separation distress

39
Q

the second idea that emerged from Prigerson’s studies at the University of Pittsburgh

A

The phenomenon of complicated grief was distinctly separate from anxiety and depression and there are three distinct entities: complicated grief, anxiety, and depression with minimal overlap

40
Q

The name now used for complicated grief

A

Prolonged grief disorder

41
Q

Horowitz has suggested that assessments for complicated grief should not be made until

A

The first anniversary of the death

42
Q

Worden’s paradigm that describes complicated mourning under 4 headings

A

1) chronic grief reactions
2) delayed grief reactions
3) exaggerated grief reactions
4) masked grief reactions

43
Q

Examples of exaggerate grief reactions

A
  • clinical depression
  • anxiety
  • phobias
  • serious alcoholism and other substance abuse
  • Posttraumatic stress disorder
44
Q

more than ___% of bereaved participants in their study of bereaved spouses reported an episode of anxiety disorder at sometime during the first year bereavement

A

40

45
Q

Masked or repressed grief generally turns up in one of two ways:

A

1) physical symptoms

2) maladaptive behavior

46
Q

facsimile illnesses

A

The physical symptoms experienced by the survivor were similar to those suffered by the deceased during his or her last illness

47
Q

The difference between exaggerated grief and masked grief

A

In exaggerated grief the patient knows that the symptoms began around the time of the death and are the result of the experience of the loss. However, Those with masked grief do not associate their symptoms with the death

48
Q

Lazare’s clues to unresolved grief reactions

A

1) intense and fresh grief
2) relatively minor event triggers an intense grief reaction
3) themes of loss come up in a clinical interview
4) unwilling to move material possessions belonging to the deceased
5) physical symptoms that occur annually around death anniversary or holiday seasons
6) radical lifestyle changes following the death
7) Long history of subclinical depression
8) A compulsion to imitate the dead person
9) self-destructive impulses
10) unaccountable sadness occurring at a certain time each year
11) A phobia about illness or death
12) avoiding visiting gravesite or participating in death related rituals or activities

Thanatology (17 decks)

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