Bereavement/Grief Interventions

Bereavement is a universal life cycle experience. It involves a process of transition accompanied by strong emotions. Intervention begins with the mourners' support system and their community. Sigmund Freud (1856-1939), Eric Lindemann (1900-74), John Bowlby (1907-90), and Elizabeth Kubler-Ross (1926-2004) were influential figures in the field. The continuing bonds paradigm underscores ongoing emotional connections to persons who have died. Loss initiates disruption in biopsychosocial functioning, but it is also intimately rooted in the relationship to the deceased. The thoughts and feelings, as well as the relationship to the deceased and the story of the death, are very important in the bereavement response and outcome. The two track model of bereavement and the dual process model of coping with loss reflect this perspective. Bereavement is also a catalyst for meaning making, personal growth, and life revision. Although most bereaved are resilient, maladaptive variants of the grief response are estimated at 15-20%. The diagnosis of grief-related difficulty is controversial. Clinical interventions are effective for complications of grief, but their value for unselected populations is unproven. Mutual and self-help programs are an important component of assistance for the bereaved.