Rethinking Grief

Grief

Grief, say researchers, deserves a second look.

While we commonly associate the condition with obvious losses, the course of grief does not always follow a pattern or predictable timeline, as we might think.

Sometimes grief is complicated, and sometimes it is prolonged. For this reason, the diagnosis of persistent complex bereavement disorder (PCBD), was recently added as a condition for further study in the Diagnostic Statistical Manual of Mental Disorders, fifth edition (DSM-5).

Also referred to as prolonged grief disorder or complicated grief, PCBD is associated with long-term intense distress and suffering. It affects about seven to 15 percent of those grieving the loss of a loved one, and is typically diagnosed when persistent and severe grief continues beyond twelve months after the death of a loved one, resulting in functional impairment.

In looking to assess these criteria, Dr. Stephen Cozza and his team examined responses of study participants from USU’s National Military Family Bereavement Study, which is examining the impact of military service member death on family members. Participants included surviving family members of military members who died, by any cause, since Sept. 11, 2001.

What the researchers found should have us all reconsidering grief: even with the proposed DSM-5 criteria for PCBD, the individual’s actual experiences of clinically impairing grief were not accurately captured (Cozza et al., 2016).

What Dr. Cozza suggests is that when assessing grief, and a diagnosis of PCBD, symptoms such as prolonged distress and disability associated with the death of a loved one, persistent yearning or sorrow, and preoccupation with the deceased should be considered.

However, where a diagnosis of PCBD requires that six of twelve additional symptom criteria be required as currently proposed by DSM-5, we should be requiring a much less stringent criteria – such as meeting only one criteria. Further, the researchers encourage clinicians to remain vigilant to suicidal thinking, which is prevalent in those with persistent and impairing grief.

“It is imperative for clinicians to have reliable criteria to accurately identify and diagnose those individuals suffering from prolonged and impairing grief,” notes Dr. Cozza.

Related Online Continuing Education (CE) Courses:

Grief: The Reaction to LossGrief: The Reaction to Loss is a 2-hour online continuing education (CE/CEU) course that teaches healthcare professionals how to recognize and respond to grief.

Grief is the reaction to loss, and any kind of loss can trigger grief. People grieve for the loss of someone they love, but they also grieve for the loss of independence, usefulness, cognitive functioning, and physical abilities. Grief is also a lifelong process: a journey rather than a disease that is cured. It changes over time to deal with different kinds of losses. It is an experience that is intellectual, physical, spiritual, and emotional. It is affected by the person’s culture, support system, religious beliefs, and a host of other factors.

Grief is often not recognized by healthcare professionals, in patients or themselves. This course will teach healthcare professionals to recognize grief, as well as how to respond appropriately to the grieving person. The progression of aging and dying will be discussed in order to normalize the process, one of the most important aspects of working with a grieving person. Screening guidelines for depression, suicide risk, and grief are included, as are treatment strategies for anticipatory and complicated grief. A final section on compassion fatigue, burnout, and secondary stress includes strategies for professional self-care. Course #21-25 | 2018 | 35 pages | 15 posttest questions

Caregiver Help: Depression and GriefCaregiver Help: Depression and Grief is a 2-hour online video-based continuing education (CE/CEU) course that addresses caregiver depression and grief and provides strategies to help the caregiver cope.

The emotional stress of caring for persons who are aging, chronically ill or disabled can be debilitating for family members as well as professional caregivers. This course addresses caregiver depression and grief and provides a three-step process that can help develop an attitude of creative indifference toward the people, situations and events that cause emotional stress. It offers suggestions for dealing with preparatory grief, an experience shared by families and professionals as they cope with the stress of caring for someone who will never get well. In the process, it also explains the differences between reactionary depression and clinical depression. By gaining insights into the process of losing someone over an extended period of time, the mental health professional will be in a better position to understand the caregiver’s experience with depression and grief and provide both empathy and strategies for implementing a self-care plan. This course includes downloadable worksheets that you can use (on a limited basis) in your clinical practice. The course video is split into 3 segments for your convenience. Closeout course #20-92 | 2014 | 20 posttest questions

The Grieving SelfThe Grieving Self is a 3-hour online continuing education (CE) course that looks at stories of the bereaved to determine the major issues to address to reconnect those who grieve to a stable sense of self.
The annual number of deaths reported in the United States in the early part of this century was 2.4 million, about four per minute. This course looks at the stories of a few of those who are recently bereaved to determine the major issues for those who grieve: aloneness, loss of self, social connections, anniversaries and holidays, self and others’ expectations, the need to continue living, ambivalence of recovery, grief dreams, medical problems. Studies are reviewed which indicate some researchers’ conclusions as to: 1) Gender differences between men and women who grieve; there are important questions regarding the recruitment of subjects and the data gathering process for gender differences research. 2) And, who among the grief survivors are best served by counseling and psychotherapy. This author, while agreeing with much of the research, challenges the belief that the emotional loneliness suffered by the bereaved is the single, major dynamic of the bereaved, and can only be alleviated through passage of time. It is felt that an effort to reconnect those who grieve to a stable sense of self can help the bereaved regain better function and reduce the length of the time they are consigned to painfully distressing lives. Course #30-49 | 2010 | 34 pages | 20 posttest questions

Course Directions

Our online courses provide instant access to the course materials (PDF download) and CE test. Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. Click here to learn more. Have a question? Contact us. We’re here to help!

Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

Target Audience: PsychologistsCounselorsSocial WorkersMarriage & Family Therapist (MFTs)Speech-Language Pathologists (SLPs)Occupational Therapists (OTs)Registered Dietitian Nutritionists (RDNs)School Psychologists, and Teachers

Earn CE Wherever YOU Love to Be!

Grief Work: What Do I Say?

Grief

If you have not been trained in grief work, it can be intimidating to have a client expressing grief by crying, being upset, or angrily responding to you. You may not have easy access to a social worker, psychologist, or other mental health professional. The primary ideas to remember are these:

It is not about you. Grief is not a problem to be solved. It is a process to live through.

Talking to someone who is grieving stirs up your own feelings. This can trigger inappropriate responses to the grieving person. Think about what you are about to say, and why. If you start to talk about yourself, stop. This is not about you. It is about the grieving person.

If you are a problem-solver, you may be tempted to find a solution for the person’s grief. It may be appropriate to refer the person to a mental health professional, but you will not solve the problem and make the person feel better today, tomorrow, or even a month from now. Grief must take its course, and the course will be different for everyone. Your best response is to listen supportively, without judgment and without giving advice (Devine, 2017).

Use these basic ideas to respond to a grieving person:

  • Say, “I can’t imagine how you are feeling.” Do not tell the person you know how they feel. Their grief is unique to them. You may have a similar experience, but it will not be the same.
  • Ask, “What can I do to help right now?” The person may not know what you can do to help, but asking provides the person a small amount of control in a situation that feels wildly out of control.
  • Say “It sounds as if you loved her/him very much. Would you like to tell me what made him/her so special?”
  • Be silent with the person and wait. Offer a tissue if needed.
  • Say, “I am not sure what to say to comfort you, but please know I care” (What’s Your Grief, 2014).

Course excerpt from:

Grief: The Reaction to LossGrief: The Reaction to Loss is a 2-hour online continuing education (CE/CEU) course that teaches healthcare professionals how to recognize and respond to grief.

Grief is the reaction to loss, and any kind of loss can trigger grief. People grieve for the loss of someone they love, but they also grieve for the loss of independence, usefulness, cognitive functioning, and physical abilities. Grief is also a lifelong process: a journey rather than a disease that is cured. It changes over time to deal with different kinds of losses. It is an experience that is intellectual, physical, spiritual, and emotional. It is affected by the person’s culture, support system, religious beliefs, and a host of other factors.

Grief is often not recognized by healthcare professionals, in patients or themselves. This course will teach healthcare professionals to recognize grief, as well as how to respond appropriately to the grieving person. The progression of aging and dying will be discussed in order to normalize the process, one of the most important aspects of working with a grieving person. Screening guidelines for depression, suicide risk, and grief are included, as are treatment strategies for anticipatory and complicated grief. A final section on compassion fatigue, burnout, and secondary stress includes strategies for professional self-care. Course #21-25 | 2018 | 35 pages | 15 posttest questions

Click here to learn more.

Related Online Continuing Education (CE) Courses:

The Grieving SelfThe Grieving Self is a 3-hour online continuing education (CE) course that looks at stories of the bereaved to determine the major issues to address to reconnect those who grieve to a stable sense of self. The annual number of deaths reported in the United States in the early part of this century was 2.4 million, about four per minute. This course looks at the stories of a few of those who are recently bereaved to determine the major issues for those who grieve: aloneness, loss of self, social connections, anniversaries and holidays, self and others’ expectations, the need to continue living, ambivalence of recovery, grief dreams, medical problems. Studies are reviewed which indicate some researchers’ conclusions as to: 1) Gender differences between men and women who grieve; there are important questions regarding the recruitment of subjects and the data gathering process for gender differences research. 2) And, who among the grief survivors are best served by counseling and psychotherapy. This author, while agreeing with much of the research, challenges the belief that the emotional loneliness suffered by the bereaved is the single, major dynamic of the bereaved, and can only be alleviated through passage of time. It is felt that an effort to reconnect those who grieve to a stable sense of self can help the bereaved regain better function and reduce the length of the time they are consigned to painfully distressing lives. Course #30-49 | 2010 | 34 pages | 20 posttest questions
Suicide PreventionSuicide Prevention: Evidence-Based Strategies is a 3-hour online continuing education (CE) course that reviews evidence-based research and offers strategies for screening, assessment, treatment, and prevention of suicide in both adolescents and adults. Suicide is one of the leading causes of death in the United States. In 2015, 44,193 people killed themselves. The Centers for Disease Control and Prevention (CDC) notes, “Suicide is a serious but preventable public health problem that can have lasting harmful effects on individuals, families, and communities.” People who attempt suicide but do not die face potentially serious injury or disability, depending on the method used in the attempt. Depression and other mental health issues follow the suicide attempt. Family, friends, and coworkers are negatively affected by suicide. Shock, anger, guilt, and depression arise in the wake of this violent event. Even the community as a whole is affected by the loss of a productive member of society, lost wages not spent at local businesses, and medical costs. The CDC estimates that suicides result in over 44 billion dollars in work loss and medical costs. Prevention is key: reducing risk factors and promoting resilience. This course will provide a review of evidence-based studies so that healthcare professionals are informed on this complex subject. Information from the suicide prevention technical package from the Centers for Disease Control and Prevention will be provided. Included also are strategies for screening and assessment, prevention considerations, methods of treatment, and resources for choosing evidence-based suicide prevention programs. Course #30-97 | 2017 | 60 pages | 20 posttest questions
Overcoming the Stigma of Mental IllnessOvercoming the Stigma of Mental Illness is a 2-hour online continuing education (CE/CEU) course that explores the stigmas around mental illness and provides effective strategies to overcome them. The Substance Abuse and Mental Health Services Administration (SAMHSA) defines mental illness stigma as “a range of negative attitudes, beliefs, and behaviors about mental and substance use disorders.” Mental health and substance use disorders are prevalent and among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. This course will explore the stigmas surrounding mental illness and provide effective strategies clinicians can use to create a therapeutic environment where clients can evaluate their attitudes, beliefs, and fears about mental illness, and ultimately find ways to overcome them. We will explore the ways in which mental illness stigmas shape our beliefs, decisions, and lives. We will then look at specific stigmas about mental illness, from the fear of being seen as crazy to the fear of losing cognitive function and the ways in which we seek to avoid these fears. We will then look at targeted strategies that, you, the clinician, can use to create a therapeutic alliance where change and healing can overcome the client’s fears. Lastly, we will look at the specific exercises you can use in session with your clients to help them address and overcome their biases and stigmas about mental illness. Course #21-24 | 2018 | 35 pages | 15 posttest questions
Course Directions
Our online courses provide instant access to the course materials (PDF download) and CE test. Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. Click here to learn more. Have a question? Contact us. We’re here to help!—

Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

Target Audience: PsychologistsCounselorsSocial WorkersMarriage & Family Therapist (MFTs)Speech-Language Pathologists (SLPs)Occupational Therapists (OTs)Registered Dietitian Nutritionists (RDNs)School Psychologists, and Teachers

Earn CE Wherever YOU Love to Be!

Grief: The Reaction to Loss

New Online Continuing Education (CE/CEU) Course @pdresources.org

Grief: The Reaction to LossGrief: The Reaction to Loss is a new 2-hour online continuing education (CE/CEU) course that teaches healthcare professionals how to recognize and respond to grief.

Grief is the reaction to loss, and any kind of loss can trigger grief. People grieve for the loss of someone they love, but they also grieve for the loss of independence, usefulness, cognitive functioning, and physical abilities. Grief is also a lifelong process: a journey rather than a disease that is cured. It changes over time to deal with different kinds of losses. It is an experience that is intellectual, physical, spiritual, and emotional. It is affected by the person’s culture, support system, religious beliefs, and a host of other factors.

Grief is often not recognized by healthcare professionals, in patients or themselves. This course will teach healthcare professionals to recognize grief, as well as how to respond appropriately to the grieving person. The progression of aging and dying will be discussed in order to normalize the process, one of the most important aspects of working with a grieving person. Screening guidelines for depression, suicide risk, and grief are included, as are treatment strategies for anticipatory and complicated grief. A final section on compassion fatigue, burnout, and secondary stress includes strategies for professional self-care. Course #21-25 | 2018 | 35 pages | 15 posttest questions

Course Directions

Our online courses provide instant access to the course materials (PDF download) and CE test. Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. Click here to learn more. Have a question? Contact us. We’re here to help!

Professional Development Resources is a nonprofit educational corporation 501(c)(3) organized in 1992. We are approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners; and are CE Broker compliant (all courses are reported within a few days of completion).

Target Audience: PsychologistsCounselorsSocial WorkersMarriage & Family Therapist (MFTs)Speech-Language Pathologists (SLPs)Occupational Therapists (OTs)Registered Dietitian Nutritionists (RDNs)School Psychologists, and Teachers

Earn CE Wherever YOU Love to Be!