Most Suitable Counseling Modality for Bereavement

Essay question

Post bereavement, friends and relatives suffer in various aspects of their lives. This paper not only underscores the significance of counseling during this trying time

also tries to come up with the most suitable of the available modalities.

Introduction

There are different modalities of psychotherapy, each with its benefits and working mechanisms. Note that loss of loved ones may force counselor to cherry pick on appropriate elements from different modalities or opt to work with completes and manageable sets of modalities. About 2 or 3 modalities (Breen et al., 2014). Therefore, we prefer the CGT approach which is an integration of favourable elements from IPT and CBT.

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Possible thesis statements

All bereavement counseling modalities have their advantages. However, some are more favourable for success than others. Comparison of appropriateness is based on effectiveness of treatment, duration and focuses of therapy on comfort of bereaved people. Also, the need to achieve the said comfort faster forms the basis for this paper.

Person-Centered Therapy is a fundamental aspect of bereavement training. The founder Carl Rogers premised this approach on a proposition that we are always progressing towards being the best form of ourselves. Everyone, at birth, has the potential of achieving this form but may veer off this path due to some experiences in life. This approach is very lengthy and demands an established client-therapist rapport. The therapist is charged with responsibility of enabling client’s growth (Breen et al., 2014). They should be frank, empathetic by assuming the perspective of client without being fully attached and be genuine. Assumption made in this approach is that clients are capable of finding their true selves by themselves provided they have pictured their potential. Also, there is no such thing as mental illness: just losing touch with ones self-potential. With time, counselors are introduced to integrated models which can be tweaked to fit different issues. Thus, we explore the use of CGT as an integrated model.

Complicated Grief Therapy (CGT) is a young model which is based on; the attachment theory, CBT and interpersonal therapy (IPT). The fact that it is an integration of the theory and the two models makes it an inclusive approach. The resultant techniques are generalized into methods in which the client is repeatedly guided into revisiting the bereavement. When compared with IPT, bereaved kin who enrolled for either one of these two tools in a trial showed a quicker response for CGT. It stood at 51% Vs 28 % (Diamond et al., 2012).

The "newness" of CGT is seen when unlike the others which focuses on distress and depression, it targets complicated grief (CG) symptoms. A series of clinical trials reported a "measure of magnitude of effect felt" of -0.53 in favour of approaches involving complicated grief over supportive counseling (those related with suppressing depression). Also, the said favourable approaches had a leaning towards CBT either in part or wholly. Subsequent follow-up showed growth in effects of CG approaches (Fox & Jones, 2013).

CG approach is designed such that the bereaved face hindrance while trying to progress from acute to integrated grief. This is characterized by intensified emotions which may be protracted, maladaptive behavior and blame of oneself. Intensity may force them to take note of grief triggers and run away from them. This disrupts their lifestyle and plunges it into chaos. Little is known about these workings. An assumption that full implications of loss of loved ones has not been understood is made (Wilson, 2011). Mental projection of attachment figure is interfered with so that while declarative memory takes note of loss, implication memory does not. CG adopts a robust approach of removing hindrances to success of CGT for bereavement counseling at all costs. Note however, that this specific technique does not affect bereaved kin's relationship with other entities as it does the actual loss itself.

After the primary analysis, a complementary analysis focused on naturalistic pharmacotherapy on subjects of the trial for comparison of effectiveness of CGT over IPT, reported that treatment response for CG therapies was greater among individuals under medication. This development was mitigated by a lowered attrition for these subjects. For IPT, 30% of subjects under medication Vs 23% not taking them left the trials. This is compared to 42% and 9% respectively for those in CGT groups. This may be used to show that CGT is more tasking; more so for subjects who were not under medication (Clute, 2010).

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Conclusion

CGT is very effective and the fact that it draws from elements of IPT and CBT makes it a "hybrid" model which is better. It takes an approach of tackling complicated grief rather than distress and depression (Hudson et al., 2018). This gives it an edge by exhibiting more psychological growth and healing. The secondary analysis however shows that it is a very rigorous modality compared to IPT. It is even harder when the bereaved do not go through it with medication.

References

Servaty-Seib, H. L., & Taub, D. J. (2010). Bereavement and college students: The role of counseling psychology. The Counseling Psychologist, 38(7), 947-975.

Altmaier, E. (2011). Best practices in counseling grief and loss: Finding benefit from trauma. Journal of Mental Health Counseling, 33(1), 33-45.

Steffen, E., & Coyle, A. (2011). Sense of presence experiences and meaning-making in bereavement: A qualitative analysis. Death Studies, 35(7), 579-609.

Breen, L. J., Aoun, S. M., O'Connor, M., & Rumbold, B. (2014). Bridging the gaps in palliative care bereavement support: an international perspective. Death Studies, 38(1), 54-61.

Diamond, H., Llewelyn, S., Relf, M., & Bruce, C. (2012). Helpful aspects of bereavement support for adults following an expected death: Volunteers’ and bereaved people's perspectives. Death studies, 36(6), 541-564.

Hughes, M. (2013). Bereavement and support: Healing in a group environment. Taylor & Francis.

Allen, J. Y., Haley, W. E., Small, B. J., Schonwetter, R. S., & McMillan, S. C. (2013). Bereavement among hospice caregivers of cancer patients one year following loss: predictors of grief, complicated grief, and symptoms of depression. Journal of palliative medicine, 16

Fox, J., & Jones, K. D. (2013). DSM‐5 and Bereavement: The Loss of Normal Grief?.

Journal of Counseling & Development, 91(1), 113-119.

Wilson, J. (2011). The assimilation of problematic experiences sequence: An approach to evidence-based practice in bereavement counseling. Journal of social work in end-of-life & palliative care, 7(4), 350-362.

Nseir, S., & Larkey, L. K. (2013). Interventions for spousal bereavement in the older adult: an evidence review. Death Studies, 37(6), 495-512

Ellis, J. L. (2012). The power of place: The emotional effects of specific buildings on those seeking bereavement counseling. Northern Kentucky University.

McAteer, R., & Wellbery, C. (2013). Palliative care: benefits, barriers, and best practices. Am Fam Physician, 88(12), 807-13.

MacKinnon, C. J., Smith, N. G., Henry, M., Berish, M., Milman, E., K&rner, A., ... & Cohen, S. R. (2014). Meaning-based group counseling for bereavement:

Bridging theory with emerging trends in intervention research. Death Studies, 38(3), 137-144.

Clute, M. A. (2010). Bereavement interventions for adults with intellectual disabilities: What works?. OMEGA-Journal of Death and Dying, 61(2), 163-177.

Barlow, C. A., Waegemakers Schiff, J., Chugh, U., Rawlinson, D., Hides, E., & Leith, J. (2010). An evaluation of a suicide bereavement peer support program. Death Studies, 34(10), 915-930.

Thieleman, K., Cacciatore, J., & Hill, P. W. (2014). Traumatic bereavement and mindfulness: A preliminary study of mental health outcomes using the ATTEND model. Clinical Social Work Journal, 42(3), 260-268.

N&pp&, U., Lundgren, A. B., & Axelsson, B. (2016). The effect of bereavement groups on grief, anxiety, and depression-a controlled, prospective intervention study. BMC palliative care, 15(1), 58.

Aoun, S., Breen, L., O'Connor, M., Rumbold, B., & Nordstrom, C. (2012). A public health approach to bereavement support services in palliative care. Australian and New Zealand Journal of Public Health, 36(1), 14-16.

Hudson, P., Hall, C., Boughey, A., & Roulston, A. (2018). Bereavement support standards and bereavement care pathway for quality palliative care. Palliative & supportive care, 16(4), 375-387.

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