Personal Guidebook to Grief Recovery

Back To Life! A Personal Grief Guidebook

Back to Life is a comprehensive, quality bereavement handbook. It consists of 73 pages that explore many aspects of grief in detail. There are 19 chapters or lessons, each addressing a different aspect of grief, a coping skill or a strategy for emotional survival. Here you will learn: Good, solid information on how the grief process really works. Which symptoms of grief are normal, and which are dangerous warning signs. Valuable and practical coping skills to help you get through each day. Secrets to getting a good night's restorative sleep without prescription drugs. How to endure the holidays and thoughtless visitors. How to identify and defuse anger, guilt, and regret. Family changes to look for and how to keep your family intact through this. Just the right activities and comforting rituals to help ease you through your darkest days. Tried and true psychological exercises and strategies to help lessen the raw pain. Satisfying and therapeutic creative expressions of grief. Effective memorializing techniques to honor and remember your lost loved one. How to cling to hope and move surely towards brighter days. Read more here...

Back To Life A Personal Grief Guidebook Summary


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Grief Relief Audio Program

The Grief Relief Audio Program is a thoughtfully organized grief management program. 7 downloaded audio files unfold a step by step journey through enjoyable and highly effective guided techniques based on sound clinical practices. The user-friendly recordings are easy to download and access. Also included is a written pdf Guide & Instructions, as well as 3 bonuses well worth the cost of the entire program. The Management of Grief Grief Relief Teaches You How To: Put an end to Grief Paralysis Defuse consuming anger or guilt you may feel about your loss. Decrease isolation and find the support you need and deserve. Practice proven techniques that reduce stress and anxiety. Cope and make it through each day intact. Find hope that your dark despair will one day ease up. Reach for joy and happiness despite your loss. How to confront and acknowledge your grief so you pave the way for true healing to begin. An effective technique for admitting guilt and regret, and how to release it. The secret key that leads to understanding so you can get your life back. Read more here...

Grief Relief Audio Program Summary

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Author: Jennie Wright
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Price: $27.00

Dysfunctional Grieving

Related to Loss of child as result of (specify accident, SIDS, absence of anticipatory grieving). and unexpected death of infant shock grief denial social isolation.) Goal Parents will resolve dysfunctional grieving. Outcome Criteria V Parents acknowledge that their grief is unresolved and seek assistance. NOC Psychosocial Adjustment Life Change Provides support without adding to grief and feelings of guilt. Promotes positive grief resolution if parents hold see the infant and spend time saying good-bye on their own terms. Presence of other family members and significant others often serves as support for grieving family. Promotes positive grief resolution. Inform of stages and importance of grieving and of behavior that is expected in resolving grief. Use therapeutic communication techniques, especially active listening. Encourage parents to verbalize their understanding of the cause of death, their feelings of grief, and any concerns about seeking assistance with grieving. Refer...

Anticipatory Grieving

Related to (Specify perceived potential loss of child by parents perceived potential loss of physiopsychosocial well-being by child.) Defining Characteristics (Specify expression of distress of potential loss, inevitable kidney failure, kidney dialysis, premature death of child.) Goal Parents and child will begin to work through the grief process by (date and time to evaluate). Outcome Criteria V Parents will verbalize stages of grief.

NIC Grief Work Facilitation

Promotes movement through grieving process by utilizing defense mechanisms that have worked in the past. environment, for the initial shock and disbelief that are expected behaviors of grief. Therapeutic communication assists the parents to express their feelings and identify dysfunctional aspects of their grief. Provides support and assistance during bereavement or chronic grief which may affect family relationships, presence of infertility or other problems. Assists with resolution of guilt and grieving.

What Is Complicated Grief

Bereavement and grief are universal experiences. Many features of acute grief resemble symptoms of major depression. Consequently, there is a long history of linking grief and depression in psychiatric thinking. Bereavement triggers an episode of major depression in about 20 of individuals who lose a loved one. However, not all grief-related problems meet criteria for major depressive disorder. There is a rich clinical literature describing pathological grief reactions, under various designations, including abnormal grief, unresolved grief, and complicated grief (CG). However, the absence of a reliable method of identifying the condition and or for evaluating its severity has obstructed the development and testing of treatments. This problem was addressed when Prigerson et al. developed a simple 19-item questionnaire that reliably identifies bereaved individuals who have persistent, intense grief and poor long-term outcomes (Prigerson et al., 1995a, 1995b). The condition so described,...

Tools For Traumarelated Problems

Those who have been exposed to traumatic events are at risk for developing many kinds of problems, and if cognitive-behavioral methods are to be widely adopted by a broad range of practitioners, they need to assist clinicians in comprehensively addressing the needs of their clients. This book illustrates the fact that those who are developing cognitive-behavioral treatment have been showing increased attention to significant problems trauma survivors face that are beyond the traditionally identified diagnosis of PTSD. In this text, this attention is reflected in the work of Najavits in extending cognitive-behavioral methods to the treatment of substance abuse concurrent with PTSD, Cloitre and Rosenberg in conceptualizing interventions to reduce risk of revictimization among sexual assault survivors, and by Shear and Frank in Chapter Twelve in their work on complicated grief. It is also shown in Chapter Nine, in Bryant's adaptation and extension of the procedures found effective in...

Responding To The Needs Of Clinicians

Dealt with well by the principal orientation. In the present volume, many of the authors speak to the capacity for integration of their approaches with other treatments. Walser and Hayes state that if research indicates that a client's problems would be better treated by a different approach, that latter treatment should be implemented first or integrated into the course of ACT. DBT and Seeking Safety are designed to be frontline stages of treatment for individuals with PTSD, so as to get the client stabilized prior to introducing exposure treatment. Najavits has explored how to integrate trauma processing therapy with Seeking Safety. Kubany and Ralston introduce a variety of ways to understand and challenge trauma-related guilt. Awareness of the role of guilt, and Kubany and Ralston's interventions, would be combined with other treatments not designed to systematically address guilt. An element that Monson and Friedman touch on is that psychopharmacological treatments can either help...

Gender Ethnicracial And Life Span Consideration

Overuse and abuse of alcohol are seen in all age groups and in females and males. More and more teens are identified as alcohol-dependent and should have their drug or alcohol usage assessed on admission to the hospital or clinic. Binge drinking (more than five drinks at one time for males and four for females) is a growing problem among college students. Approximately 70 of people who are alcohol dependent are males, but women are more likely to hide their problem. Of growing concern is the number of elderly who are abusing alcohol as a way to deal with their grief, loneliness, and depression. Ethnicity and race have no known effects on alcohol withdrawal.

Dying Child Introduction

Care of the dying child includes the physical and emotional interventions necessary to support the totally dependent child and grieving family. Nursing considerations involve the dissemination of information to the child, whose perceptions of death and responses to death and dying are age-related, and family with sensitivity, caring, and honesty. The nurse also helps the child move through the stages of awareness and acceptance, and helps the family move through the stages of grieving. An additional role of the pediatric nurse, when caring for dying children, is to direct the child and family to appropriate age-related information about death and dying.

Stress Management And Psychiatric Interventions

Another 10-week, group-based intervention designed to provide emotional support and coping skills after bereavement was tested in a cohort of 97 HIVpositive asymptomatic MSM dealing with loss. Results of this trial indicated that the bereavement intervention decreased grief and buffered CD4+ decline, and reduced plasma cortisol as well as the number of health care visits over a 6-month period, compared to a no-treatment control condition (Goodkin et al., 1998). In a subset of 36 men, the bereavement intervention also buffered against increases in HIV viral load (Goodkin et al., 2001). Therefore, group-based psychosocial interventions may be adaptable and successful in helping HIV-positive persons deal with different emotional challenges during the early asymptomatic stage of the infection.

Primary Nursing Diagnosis

Teach the patient and family measures to prevent the condition from worsening. Patients and their families may be fearful and anxious, whether this is a new diagnosis or a progression of a chronic condition. The patient and family are required to make many lifestyle changes. Fear, anxiety, and grief can all stimulate the sympathetic nervous system, leading to catecholamine release and additional stress on an already compromised heart. Helping the patient to work through these feelings may improve psychological well-being and cardiac output.

Of Familial Breast Cancer Genetic Consultations

This analysis evidenced that the average genetic counselling session was 61 min comparable to that of European clinics (Hopwood et al. 2003a) , that patients spoke on average one-third of the session and consultants demonstrated consistently good practice in providing detailed information on essential aspects related to familial breast cancer. The authors noted that, although the woman's agenda was frequently elicited, other subjects were tackled less frequently, namely the women's decision to discuss the results with other family members or emotional concerns such as those relating to prior experiences of loss and grief. Considering the predominant role played by information processing in cancer genetic counselling, it has to be stressed that passive listening reduces understanding and interactivity should therefore be stimulated. Moreover, training in or self-monitoring of behaviours known to facilitate understanding (checking women's medical knowledge, checking understanding,...

Dealing with Endof Life Decisions

Over the course of a lifetime, men face a variety of inevitable stresses that create emotional responses. Dealing with death and dying presents some of life's greatest emotional stress. There are two ways in which a man finds himself confronting the issues surrounding death and dying as someone caring for a dying person, most often a parent, and as someone who is facing his own death. In both roles he must find ways to deal with his grief. Grief affects each person differently but typically involves four stages shock, denial, depression and withdrawal, and acceptance. If you are grieving, it is important for your emotional health to talk about your feelings to a family member or a close friend, to others in a support group, or to a counselor. Bottled up emotions can lead to depression, withdrawal from friends and society, sudden irrational outbursts, feelings of anger and resentment, insomnia, and even physical illness. Here are some positive steps you can take to deal with grief Take...

Discharge And Home Healthcare Guidelines

If the patient is having difficulty dealing with the perinatal loss, referring her to a support group is appropriate. Often, follow-up by the hospital perinatal grief counselor is done. Referral to a fertility specialist is indicated if she is having difficulty conceiving for 6 months after tubal surgery.

Short Term Effects of Circumscribed Trauma and Resilience

FAP also can help clarify why a single episode of trauma does not escalate into the clinical syndrome of PTSD for most people. We know that there is evidence that PTSD is predicted by the level of severity of the experienced grief and distress around a traumatic event (Bonanno & Field, 2001), and that those individuals who are exposed to trauma and show minimal distress are also unlikely to develop PTSD (Bonanno, 2004). Bonanno (2004) further identifies specific factors that appear to buffer the effects of extreme stress, such as hardiness, self-enhancement, repressive coping, and positive emotion and laughter. All of these factors operate, in part, by reducing initial levels of distress related to the traumatic material, generally through social affiliation. Thus Mower's (1960) two-factor theory is also consistent with current theories of resilience to trauma.

Sleep Wake Cycle and Hypnotics

Pharmacotherapeutic measures are indicated only when causal therapy has failed. Causes of insomnia include emotional problems (grief, anxiety, stress ), physical complaints (cough, pain), or the ingestion of stimulant substances (caffeine-containing beverages, sympa-thomimetics, theophylline, or certain antidepressants). As illustrated for emotional stress (B2), these factors cause an imbalance in favor of excitatory influences. As a result, the interval between going to bed and falling asleep becomes longer, total sleep duration decreases, and sleep may be interrupted by several waking periods.

NOC Family Coping

Assess stage of grief process, problems encountered, feelings regarding long-term illness and potential loss of child. Provides information about stage of grieving as time to work through the process varies with individuals the longer the illness, the better able the parents and family will be able to move towards acceptance. Teach parents of stages of grieving and behaviors that are common in resolving grief.

Studies On The Mental Health Consequences Of The Earthquake

The rubble, or who were living in tent camps after the earthquake 9 . The study by Berkem and Bildik reported that the reaction of children to the disaster and the presenting symptoms differed according to their age 10 . The study by Laor et al. 11 emphasized that the screening of children in the post-disaster period requires the detection of symptoms of PTSD, dissociation and grief.

Impact Phase And Early Actions

Primary aims of these units were to provide pertinent information, relief from the traumatic experience and or crisis intervention to the victims upon their request. The goal of intervention was not simply the prevention of post-traumatic stress disorder (PTSD), but also the management of acute stress reactions, grief, depression, and a host of other maladaptive psychological and behavioral responses according to the individual needs of the victims. Psychological care included mainly listening to the victims while they were referring to their personal experiences and ventilating their emotional overcharge, in addition to prescription of anxiolytic and or antidepressant medication whenever needed. Also, particular emphasis was given to fostering resilience by providing coping skills training at an elementary level and education about the expected stress response, traumatic reminders and normal versus abnormal functioning. Anxiety

And Significant Others

In a study of 61 family members of people with terminal cancer, Chapman and Pepler (1998) found that those family members who lacked hope were more likely to experience somatic distress, loss of control, and social isolation. Based on their results they suggest that health professionals (they specify nurses in particular) should be more aware of family members' somatic concerns. They further suggest that a way of fostering hope, and ultimately health, is to address expressed feelings of anticipatory grief and facilitate coping. Once the grief responses are dealt with, the level of hope would be expected to increase, providing an incentive for constructive coping with loss.

Major Depressive Disorder

Similarly, interpersonal therapy (IPT) has demonstrated efficacy in treating major depressive illness in HIV disease (Markowitz et al., 1992, 1995), and IPT may offer advantages to patients who have been recently diagnosed with HIV AIDS or have recently progressed in their disease severity. IPT is notable for its brevity and can successfully focus on the common problems encountered in HIV disease, including grief, changes of life after disease diagnosis, role identity during times of illness progression, interpersonal disputes related to family strife surrounding diagnosis, issues of homosexuality or drug abuse, and support of existing coping strategies.

Pharmacologic Highlights

The patient may experience less anxiety if allowed as much control as possible over his or her daily schedule. Explaining procedures and keeping the patient informed about the treatment plan and condition may also decrease anxiety. If the patient enters the final phases of lung cancer, provide emotional support. Refer the patient and family to the hospice staff or the hospital chaplain. Encourage them to verbalize their feelings surrounding impending death. Allow for the time needed to adjust while you help the patient and family begin the grieving process. Assist in the identification of tasks to be completed before death, such as making a will seeing specific relatives and friends or attending an approaching wedding, birthday, or anniversary celebration. Urge the patient to verbalize specific funeral requests to family members.

Systemic Perspective of Family Life

It is generally accepted that a family needs flexibility in managing the demands of a family member having a life-threatening illness. Palliative care practitioners offer a range of supportive care to underpin the family's own coping patterns, but some families may have limited flexibility because of their structure, they may be isolated, living miles from their families of origin (e.g. asylum seekers or refugees) or they may have lost flexibility because they have been caring for a long time. These are families where a family therapy approach may be helpful. Family interventions aimed at helping families are usually brief, focused and, importantly, leave families feeling competent. One example of such an intervention has been recently pioneered in Australia and in the USA Family-focused grief therapy. Family-focused grief therapy is a new model of intervention that has been used successfully with families using palliative care facilities (Kissane and Bloch 2002). This therapy relies...

Ipt The Matrix For

Our initial treatment approach was standard IPT, a proven efficacious treatment for depression that includes abnormal grief as a possible problem area. Complicated grief resembles major depression in symptoms of dysphoric affect, guilty ruminations, suicidality, and social withdrawal so it seemed reasonable that IPT would be an efficacious treatment. Surprisingly, though, we found that standard IPT did not appear to sufficiently reduce CG symptoms in many patients. Consistent with this observation, CG appears to be only minimally responsive to antidepressant medication. Lack of efficacy of standard treatments for depression fit with a growing body of data indicating that CG is a separate condition, distinct from major depression (Prentice & Brown, 1989 Prigerson, Frank, et al., 1995). One difference in CG is the presence of symptoms resembling PTSD (Jacobs, Mazure, & Prigerson, 2000). CGT thus includes techniques to target the separation and traumatic distress symptoms related...

During the Palliative Phase

Is not possible to define the terminal period very clearly. Often, the child with cancer is on a gliding scale with declining chances, by which the pendulum of hope and fear remains present for a long time. In these circumstances an important role is reserved for the physician. Giving open information by telling the child and the parents that the treatment is no longer aimed at curing the disease but at palliation of symptoms will commence the process of grief and mourning. Studies show that children wish to be informed about their illness and plans for treatment (Wolfe et al. 2002). For the parents, the message that the child can no longer cured is a shock. Disbelief and the notion that what was feared is becoming reality often go hand in hand at this stage. Thoughts about how the death of their child might come, about the funeral, but also about what fine moments with the child will be missed, evoke feelings of pain and grief. Sometimes parent do not communicate with each other...

Integrating Cbt And Ipt In

Because IPT already has a grief focus with goals that are consistent with treating CG, and our group has extensive experience using IPT effectively, we decided to base our targeted CGT in an IPT framework. Goals for treating CG were similar to IPT grief-focus goals, and we included the core three-phase IPT method as an organizing framework. We integrated CBT strategies for treatment of PTSD as well as cognitive strategies for dealing with separation distress into this framework. We found that these additional complicated grief-specific components could be easily blended in an IPT grief-focused treatment that is time-limited and present-oriented. This similarity in therapist behavior supports the feasibility of a merged intervention. We have successfully integrated behavioral and cognitive techniques in two other IPT projects, one targeting bipolar disorder (Frank, Swartz, & Kupfer, 2000) and one that addresses comorbid panic and depression (Cyranowski et al., 2004). Thus, in...

Specific Problems Related To The Handling Of Large Numbers Of Bodies In Disasters And Emergencies

The presence of a large number of dead bodies after a disaster creates uncertainty and fear in the population. This is sometimes exacerbated by inaccurate information about the danger of epidemics that these bodies represent. There is simultaneously stress and widespread grief the prevailing chaos and the emotional climate can also lead to behaviors that are difficult to control. This type of situation requires appropriate psychosocial interventions at both the individual and community levels. Any form of mass burial always has a very negative psychosocial impact at the individual and community levels it denies the very understandable universal desire to give a proper farewell to family members and friends. Another problem in mass burial is the failure to identify the bodies, which heightens the pain and uncertainty and complicates the grieving process for survivors.

Psychological Support Measures

Although frequently neglected, plans for and subsequent efficient implementation of psychological support for the involved personnel (first responders, EMS personnel, hospital staffs) are essential to the success of all disaster recovery operations. Both at the time of bioterrorist attack and during its aftermath, implementation of effective community counseling and psychological support measures must be considered. Grief caused by sickness and possible deaths of family members, possible economic losses, persistent personal anxiety, and a host of other factors may lead to the development of numerous cases of posttraumatic stress disorder that will negatively affect subsequent recovery of the community.

Common Treatment Obstacles And Possible Solutions

Children often present with complex problems, demonstrate a broad constellation of symptoms, and have histories that include multiple traumas. Although the treatment model outlined in this chapter focuses primarily on reducing PTSD symptoms resulting from child sexual abuse, it can be modified to treat PTSD symptoms resulting from other types of traumas, including exposure to domestic violence, physical abuse, traumatic bereavement, and community violence. A critical step in addressing each of these traumas is that of providing education to both children and parents about the identified trauma in terms of its prevalence, characteristics, psychosocial impact, etc. For example, it is important for mothers to be made aware of the dramatic behavioral impact that exposure to domestic violence can have on children, despite the fact that the children may have never been physically harmed by the batterer. Educational information can be shared and explored with children, using...

Gender Ethnicracial And Life Span Considerations

If you suspect that an infant is at risk for SIDS, elicit a history of risk factors. Determine if the infant has a history of apparent life-threatening events (ALTEs). In this situation, the infant may cease to breathe, develop pallor, have a marked change in muscle tone, choke or gag, or become unresponsive, and yet the child is successfully resuscitated. This near miss is thought to be a warning sign for future SIDS. If parents have lost a child to SIDS, the history of the event needs to be elicited carefully and with compassion because of the loss and grief patients are experiencing.

Ensuring Utilization of Services

Identifying the reasons for reluctance to utilize available services requires more investigation, but we do know that many factors may contribute. Lack of help-seeking behavior may sometimes reflect an awareness that some stress symptoms are to be expected, an acceptance of posttrauma distress, and an intention to get on with life nonetheless. Some individuals who endorse high levels of PTSD symptoms may not label themselves as significantly distressed or disabled (Shalev, Tuval, Frenkiel, & Hadar, 2004). other reasons may be more problematic. Families experiencing grief following the Lockerbie bombing reported thinking that they could handle it on their own, with help from family, friends, and their religious faith that accessing mental health counseling would be a sign of weakness or stigma that they could not afford it financially or that they could not admit to hav

Ineffective Coping And Compromised Family Coping

Defining Characteristics (Specify for the child depression, anxiety, withdrawn, excessive outbursts of temper, insecurity, sleep and or eating disturbances, regressive behaviors, behavioral problems acting out , denial, difficulties in interpersonal relationships, nonadherence with treatment. For parents shock, disbelief, anger, guilt, numbness, denial, ambivalence, bargaining, overprotectiveness, grief for the loss of their healthy child, anticipatory grief for the potential loss of their child.)

NOC Family Normalization

Assess family ability to cope with child, stress on family relationships, developmental level of family, response of siblings, knowledge of health practices, family role behavior and attitude about long-term care, economic pressures, resources to care for long-term condition and grieving

Sleep Disturbance In

Grief and Bereavement Because HIV infection can affect multiple members of a family, a social network, or even a community, loss and bereavement are not uncommon. Acute grief can lead to insomnia, which may be relieved by short-term use of hypnotics. Lack of social support or pre

Investigation of the Death

Questioning of the parents should be done with a sensitive, sympathetic, and compassionate approach. The parents of a dead infant are subjected to severe psychological trauma with, not infrequently, feelings of guilt that they did something to cause the death. Many individuals are unaware of what a SIDS or crib death is. Attempts should be made to ease the grief and prevent a guilt-ridden reaction. Investigators, in addition to investigating the scene, should do their best to convince the parents that they are in no way at fault or to blame for the infant's death and that there was no way they could have prevented it. If, subsequently, the case turns out not to be SIDS-related, or there is something that the parents could have done to prevent the death, no harm has been done by this approach.

Cassia and Cinnamon

Sadam Hussain may have burned a year's supply of (U.S.) oil during the Gulf War. In his grief over the loss of his wife, fiddling Nero is said to have burned a year's supply of cinnamon. France was receiving cinnamon as early as 761, to be assigned to various monasteries. Ninth century Swiss chefs used cinnamon cloves and pepper to season fish. Cinnamon played a big bad role in Sri Lanka's history. As the most sought after spice in fifteenth and sixteenth century explorations, it, with the black pepper, played a role in the colonization of Ceylon and the discovery of America. Portuguese colonialists forced Ceylonese to pay tribute with cinnamon bark in 1505 when they seized it.


AIDS who is paraplegic due to HIV myelopathy may each be dealing with bereavement in a unique manner. Although far less frequent than before the potent antiretroviral therapies, opportunistic infections such as cytomegalovirus retinitis can lead to loss of vision, HIV-cardiomyopathy to congestive heart failure, and HIV-associated dementia to loss of cognitive function. These occur primarily in persons who lack access to care or are nonadherent to care, and who may also be at increased risk of mood disorders. Loss and grief with mourning and bereavement commonly follow these tragic losses. A study by Kemeny and Dean (1995) investigated the relationship between early AIDS-related bereavement and subsequent changes in CD4 T-cell levels and overall health over 3 to 4 years of follow-up. The results indicated that those subjects who had experienced an AIDS-related bereavement event showed a more rapid loss of CD4 T cells 2 years post-bereavement, possibly suggesting an ongoing effect from...

Family Scripts

When Janet's only daughter died suddenly, the problem for her was that she was plunged into echoes from her past. As the first Christmas after her daughter's death approached, her young son and husband desperately wanted to talk about what they were going to do. Janet was locked in her own grief. The family agreed to meet with a therapist. In the session Janet revealed for the first time that she had had an older sister who had died suddenly when Janet was 8 years old. Janet remembers her family being devastated and she called it growing up in the house of death. Her parents never talked about what had happened but took Janet to her sister's grave each week. Her adolescence was lonely and Janet retreated into her books. After university she never returned home to live but married after gaining her degree. Thereafter she did not visit her sister's grave anymore. Janet's husband and son were determined to talk about things and encouraged her to find together her sisters grave. The...


CGT is an IPT-based psychotherapy that targets the specific occurrence of a dysfunctional primary grief reaction. Underlying the CGT model is the idea that grief itself can go awry, and that this is different from the onset or worsening of a DSM-IV disorder that might be triggered by the stress of a loss. Grief is a problem primarily because of the strength of the lost attachment relationship and the perceived internal psychological ramifications of its loss. Thus, whereas IPT is a highly effective treatment for mood disorders, its model of grief does not fit our conception of CG, nor does it necessarily describe the process of natural grief as elucidated by empirical data. IPT strategies focus on the hypothesized therapeutic value of cathartic expres To construct CGT, we modified iPT and added CBT-based enhancements. These include (1) revisiting of the time of the death, (2) revisiting activities, people, and objects that the patient is avoiding, (3) directed work with memories, and...

Double Protection

Empathy, but also serve to protect oneself against confrontation with the other person's emotions. This is called the law of double protection. It is essential for the child to believe that his or her parents are strong if they can handle the situation, it constitutes the signal that the threat can be averted and boosts the confidence that the child will survive. All attempts by parents who conceal the true meaning of the situation from the child are attempts neither to burden nor to weaken the child. The parents' avoidance of discussing their worries and grief related to the illness prevents the child from thinking about it, but also protects the parents from being confronted with the child's emotions. Not only do parents achieve self-protection through the other person, the child achieves it as well. Not asking questions which might worry the parents, hiding grief, and being brave are attempts of preventing the parents from becoming distressed, and themselves from becoming...

Network Of Care

Medical care in Israel is free of charge. Additionally, the National Insurance Institute of Israel (NII), a government agency responsible for most types of disabilities, supports the medical, financial and rehabilitation costs related to trauma emanating from terror. The NII provides extensive coverage, including medical care, disability compensation, dependants benefits, vocational rehabilitation and other forms of assistance (e.g., loans and grants for housing). These benefits extend to psychiatric casualties indeed, the NII has been very active in reaching out for casualties following major acts of terror, and has provided psychological debriefing sessions to groups of survivors. The NII also follows widows and dependants, starting from the first days of grief and escorting some individuals for years. Despite individual complaints about red tape and the slow process of recognition, the NII provides a safety network for all physical and psychological casualties of terrorism, so that...

Empirical Research

Trauma is still very much in its infancy. To date, there are only a handful of studies examining the treatment efficacy of treating a range of childhood traumas, such as exposure to community violence, witnessing domestic violence, physical abuse, and traumatic grief. One study, conducted by March, Amaya-Jackson, Murray, and Schulte (1998), found that an intervention based on cognitive-behavioral therapy (CBT) significantly reduced PTSD symptoms in a small group of children exposed to community violence. In a review of treatment for childhood trauma, Cohen, Berliner, and Mannarino (2000a) reported that the available literature addressing domestic violence focused almost exclusively on the battered women or the offenders. Clinical descriptions and reports addressing children's reactions and possible treatment goals are available, but no empirical treatment outcome investigations have been published. A recent pilot study documents the successful use of CBT-based interventions for...

Outcome Criteria

V Clients verbalize the stages of the grieving process. V Clients identify support systems they may use for grief. Assess stage of grief process, problems encountered, feelings regarding long-term illness and potential loss. Teach parents about stage of grieving process and of behaviors that are common in resolving grief. NIC Grief-Work Facilitation of grieving time to work Promotes understanding of feelings and behaviors that are manifested by grief. (Did clients verbalize the stages of grieving Did clients identify support systems Use quotes.)

Clinical features

Cataplexy has been considered pathognomonic of narcolepsy despite the fact that it can be seen, exceptionally, as an independent problem. Its isolated presence may lead to question whether daytime sleepiness also occurs. Its presence does not distinguish between primary and secondary narcolepsy. As already mentioned by Daniels 42 , it consists of a sudden drop of muscle tone triggered by emotional factors, most often by positive emotions, more particularly laughter, and less commonly by negative emotions such as anger. In a review of 200 narcoleptics with cataplexy, all reported that laughter related to something that the person found hilarious, triggered an event surprise with an emotional component was the second most common trigger. Cataplexy occurs more frequently when trying to avoid taking a nap and feeling sleepy, when emotionally drained or with chronic stress. Elderly subjects with very rare incidence of cataplexy may see a great increase in frequency during a period of grief...


Freud and Abraham's original contributions on the dynamics of grief and depression shed some light on the meaningfulness of suicide. They observed that depression often follows either real or imagined loss. Ambivalent anger toward the lost loved one can be turned against the self in an act of aggression. Suicide can be understood as a cathartic expression ofrage and sadness that symbolically attempts to recapture what has been lost (Abraham, 1911, 1924 Freud, 1917).

What Is Cg Treatment

CGT treatment (CGT) is a 16-session psychotherapy model that is delivered in three phases consisting of a beginning, middle, and termination see Figure 12.1). In the beginning phase the therapist provides an introduction to the treatment model, in which grief is understood to be a natural inborn, biopsychosocial pathway to adjustment to a painful loss. Characteristic features of grief are reflections of separation distress and traumatic distress, manifested in various ways that can be influenced by cultural practice. The trajectory of natural grief is to move from an engrossing primary state in which grief exerts a psychological and emotional preeminence to an integrat- TABLE 12.1. Items Rated on the Inventory of Complicated Grief Introduction and rapport building History of relationship, loss, and grief Introduction to the treatment model and procedures Introduction to personal goals work LOSS FOCUS Grief monitoring Imaginal revisiting Cognitive work Situational revisiting Memories...

Lessons Learned

The chaos was not limited to the air and directly affected the medical care given to the survivors. Kenyan medical professionals at the Nairobi Hospital where the wounded Americans were receiving care claimed that US Air Force medical personnel were insensitive. This misunderstanding was to multiply against the background of allegations of looting at the embassy by Kenyans, who in turn accused the marines of protecting the Embassy grounds at the expense of the lives of Kenyans. Even as the digging in the rubble for survivors continued, sharp words were exchanged between frustrated well-meaning people united in their grief in the face of this tragedy.

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