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The study examines the perceptions of interfaith spiritual care, received through a volunteer hospice organization, by 10 individuals facing death and dying. Qualitative methodology based on the Interpretive Phenomenological Analysis was used to collect and analyze the data. Four superordinate themes reflected meanings ascribed to spirituality and spiritual care in facing end of life: Vital Role of Spirituality in the End-of-Life Care, Definitions and Parameters of Spirituality and Interfaith Spiritual Care, Distinct Aspects of Interfaith Spiritual Care, and Unmet Spiritual Needs. The results expand an understanding of the role of spirituality and spiritual care as part of the hospice and palliative care through attention to individual perceptions and experiences, as well as to ways to expand attention to spirituality within the hospice care.

Continuing bond manifesting as unexplainable experiences reflects bereaved´s attempts to restore connection with the deceased. As an experience unaligned with a person's overall schemas of meaning unexplainable experiences are a source of anxiety that individuals aim to alleviate by attribution thinking. This study describes how bereaved aim to explain unexplainable experiences related to the death of their loved ones. The study analysed 408 narratives of 181 bereaved individuals. Bereaved individuals (1) described the meaning of their experience to be receaving information, emotions or support by the experience and communicating about crossing the boundary between life and death. As (2) reflections on the cause of their experiences bereaved individuals described certain and uncertain explanations of the phenomenon, ruling out explanations and the compatibility or incompatibility of the experience with their prior worldviews. The process of attribution thinking must be perceived as meaningful regardless of the outcome of the bereaved person's reflection., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

During the COVID-19 pandemic, stringent measures were imposed in numerous countries, including France. These measures significantly disrupted societal practices, particularly mourning and funeral rituals. This study, conducted between June and September 2021 as part of the COVIDEUIL-France research, involved 242 participants, predominantly female (84%) with an average age of 49.64 years. The research aimed to investigate the consequences of the absence of funeral rituals and the adoption of personalized, domestic, and digital alternatives. Using online surveys and psychological tools, including the Traumatic Grief Inventory Self Report Version (TGI-SR), General Health Questionnaire-28 (GHQ-28), and Post-traumatic Growth Inventory (PTGI), the study found a significant correlation between the lack of traditional practices and grief complications. Despite 21.81% of participants compensating with personal commemorations, digital commemorations were underutilized, raising questions about their effectiveness. The study provides crucial insights, emphasizing the need to address the psychological effects of disrupted mourning practices in France., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This study aimed to provide a systematic overview of existing quantitative research on the effects of psychotherapy interventions given to women with stillbirth on the grief process and depression in the postpartum period and to analyze the results. Four databases (PubMed (MEDLINE), Cochrane, Google Scholar, Web of Science) were searched between January-March 2024. Risk of bias and precision of evidence were assessed with the Cochrane risk of bias tool ROB-2 and ROBIN-1. Ten studies were included. Meta-analysis results showed that psychotherapeutic interventions significantly reduced the grief adaptations of mothers in the mourning process and there was a significant difference in the assessment of grief adaptation. Sub-group analyzes revealed mothers' depression values and stress levels compared to the control groups and there was a significant difference between the groups. Psychotherapeutic interventions given to women positively affect their grief adaptation and reduce stress, anxiety, and depression. PROSPERO ID: CRD42024516195., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This systematic review explores factors influencing resilience and post-traumatic growth in parents who have lost a child under 25 to cancer. While such parents are vulnerable to complicated grief, not all experience it. Eight qualitative and mixed studies from ProQuest, Science Direct, PubMed, and Cochrane databases were included. They highlight the importance of support and communication with palliative care teams and other grieving families. Understanding the ambivalence experienced during the process is crucial. The review underscores the limited research in this area and offers direction for future studies. Psychological interventions could aid these parents in adapting to their new reality., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The integration of assisted dying into end-of-life care is raising reflections on bereavement. Patients and families may be faced with a choice between this option and natural death assisted by palliative care; a choice that may affect grief. Therefore, this study describes and compares grief experiences of individuals who have lost a loved one by medical assistance in dying or natural death with palliative care. A mixed design was used. Sixty bereaved individuals completed two grief questionnaires. The qualitative component consisted of 16 individual semi-structured interviews. We found no statistically significant differences between medically assisted and natural deaths, and scores did not suggest grief complications. Qualitative results are nuanced: positive and negative imprints may influence grief in both contexts. Hastened and natural deaths are death circumstances that seem to generally help ease mourning. However, they can still, in interaction with other risk factors, produce difficult experiences for some family caregivers., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

New Orleans is no stranger to trauma. The Crescent City has a vast history of environmental calamities and oppression. Yet, New Orleans is renowned for its "joie de vivre"-or "love of life." Specifically, this community is known for its unique practice of second-line parades. Researchers have noted the healing power of second-line processions, but none have analyzed the practice and psychology of this ritual through a trauma-informed lens. The aim of this conceptual paper is to begin the conversation, rather than deliver hard fast conclusions, on the potential therapeutic function of second-line parades in response to grief. Relevant literature is presented to illustrate second-line parades, trauma theory, and to provide evidence that the therapeutic effects of second-lining may, in part, be explained by trauma theory. This paper concludes with remarks on conceptualizing the second-line funeral as a sophisticated trauma-informed approach to grief and a note for future research., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This study examined the relationship between having an opportunity to say goodbye to a dying family member or friend in person or virtually, as well as attending their funeral services in person or virtually, and the bereaved individuals' psychological distress and complicated grief during the COVID-19 pandemic. Five hundred and nineteen US adults who had lost a family member or a friend between January 2020 and June 2021 completed an online survey for this study. Only a small proportion of participants were able to say goodbye to their dying family member or friend in person, and saying goodbye virtually was associated with higher levels of complicated grief and psychological distress. Those who physically attended a formal, in-person funeral or memorial service reported lower levels of psychological distress. The findings suggest a complicated process of saying goodbye in different formats during the pandemic., Competing Interests: Declaration of Conflicting InterestsThe author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Recent studies investigate grief among soldiers who experienced combat loss, but little research exists on the qualitative lived experience of such an event. In this study, semi-structured interviews were conducted with soldiers (n = 19) who lost a comrade (3-21 years ago) to delve into their bereavement process. The reflexive thematic analysis of soldiers' accounts identified six main themes: (1) an unexpected and shattering experience; (2) emotional dissociation; (3) detachment from the outside world; (4) group formation; (5) accommodating the bereaved family; and (6) life-long impact. These themes were positioned on four distinct circles relating to the self and the surrounding social systems, indicating how soldiers' grief unfolds and remains encapsulated and disenfranchised. The findings emphasize the value of peer support groups that should be facilitated and encouraged by official bodies-even years after-as part of providing social recognition., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The study explores resilience and posttraumatic growth in adults in Kosovo who have experienced grief, using the Resilience Portfolio Model as a guiding framework. Twelve participants shared their experiences through semi-structured interviews, aiming to capture detailed personal narratives and insights into coping with loss. Thematic analysis of the data revealed three main themes: "Reaction to Loss," "Navigating through Loss and Embracing Adaptations," and "Resilience and Posttraumatic Growth." The findings highlight the transformative experiences contributing to personal development and resilience, emphasizing the significant role of cultural dimensions in shaping resilience and posttraumatic growth. The study underscores the importance of considering cultural context in therapeutic approaches to better support individuals in their recovery and growth from experiences of loss., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This article explores some of the implications of the often-heard saying that, "There are no right or wrong ways to grieve." In order to do so, this article offers some reflections on the key phrases that are involved implicitly or explicitly in this advice: loss, bereavement, grief, grieving, and mourning. On that basis, this article examines a series of claims: Are there actually no right ways to grieve?; Is there no single right way to grieve?; Are there no wrong ways to grieve? These analyses are enriched by incorporating some of the new understandings of loss, grief, and mourning that have emerged in the professional literature in recent years from research and scholarship. The conclusion offers lessons that should be learned and that should not be learned from the advice that, "There are no right or wrong ways to grieve"., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Physicians-in-training feel uncomfortable coping with the grief they experience while delivering end-of-life care, and medical schools offer minimal formal curricular offerings on end of life care. Few studies have identified what experiences medical students have with death while training or what lessons they are being taught by more senior physicians at bedside. This qualitative study conducted semi-structured interviews prior to and six months into the medical school clinical year. Our goal was to identify when students were encountering seriously ill/dying patients and what informal education students received about caring for dying patients. Descriptive statistics showed the majority of the encounters the students had with seriously ill or dying patients were in the hospital-based medicine setting. A minority of students participated in debriefs about end-of-life care with their care teams after the events. Thematic analysis showed significant heterogeneity in students' exposure and responses to patient deaths., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Children of incarcerated parents may grieve this loss, yet perceptions of their grief are understudied. Using vignettes varying by age (adult/child) and grief response (prolonged/resilient), we examined differences between perceptions of adults and children grieving parental incarceration. Participants rated grief response appropriateness, comfort providing support, and grief therapy recommendations for the grieving person in the vignette. Participants perceived resilience as more appropriate than prolonged grief [ F (1, 224) = 9.02, p = .003, η 2 = .04]. Age did not predict outcomes. Recommending grief therapy was higher for prolonged grief, yet 53% of participants with resilient vignettes recommended the person should seek grief therapy, which is concerning given possible iatrogenic effects. Thus, laypeople may have stigma toward individuals grieving parental incarceration, regardless of age., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This review examines Post-Traumatic Growth (PTG) in the aftermath of Drug-Related Deaths (DRDs) amid a public health crisis underscored by an increase in overdose fatalities. It examines grief and unique challenges confronting those bereaved by DRDs, such as stigmatization, and synthesizes existing literature to elucidate pathways toward resilience and growth. Fundamental mechanisms facilitating PTG, including reframing loss, engaging in open dialogues with support, and cultivating self-compassion and hope, are highlighted, demonstrating the transformative potential of navigating bereavement with supportive communication and personal development. The review also addresses limitations within current research, such as focusing on specific bereaved populations, which may impact the generalizability of findings. Recommendations for future research include longitudinal studies and broader demographic inclusion to understand and support individuals grieving a DRD. Advocating for holistic, growth-oriented bereavement care models, this review underscores the necessity of comprehensive approaches to facilitate healing and growth in the wake of DRDs., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: There is a lack of research that investigates the influence of physical activity on grief outcomes. This research aimed to examine the influence of cycling on grief outcomes in individuals who have experienced a bereavement., Method: Semi-structured interviews with 14 participants ( n = 8 males; age M = 47.5 years) who engaged in cycling behaviour and had experienced a bereavement. Reflexive thematic analysis was used to guide analysis., Results: Four key themes were generated, providing: an (1) Embodied experience of cycling, within the 2) Cycling community, helping to provide support, alongside the (3) Nature connectedness, which led to 4) Post traumatic growth, following bereavement., Conclusion: Evidence suggests that cycling can provide an opportunity for a physical challenge, an immense connection to nature and a community of support from likeminded individuals. These therapeutic qualities of cycling should be considered for future interventions and add novel findings to the area of cycling, bereavement and grief., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The "Trauer Netzwerk Niedersachsen" ("Bereavement Network Lower Saxony" (BNLS)) aims at supporting families after the loss of a child or teenager due to various causes. This study aims to describe the experiences of bereaved family members with the BNLS counsellors. 12 semi-structured interviews were conducted with parents who had received or were currently receiving BNLS counselling. The interviews revealed the vital role counselling played aiding individuals cope with their grief. Participants valued the bereavement support, which was often lacking in their personal support networks. Counselling assisted parents in returning to daily life and caring for loved ones. Discussing "death" and "dying" helped participants find peace with their loss. Our findings suggest that bereavement counselling should be considered an essential component of healthcare for family members dealing with the loss of a child. Additionally, there is need for awareness and publicity for both the BNLS and its bereavement counselling services., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This study seeks to locate and evaluate 'poetry therapy' as a form of therapeutic method for use by practitioners of humanistic psychotherapy especially when used in responding to the traumas associated with grief and loss. Following an initial survey of the literature, the study will explore some examples of the use of poetry therapy for grief, with an especial qualitative focus upon the insights to be gained from first-hand autoethnographic accounts. The study undertakes a literature review which also includes some consideration of peer-reviewed autoethnographic explorations authored by theorists and practitioners of psychotherapy in order to identify what additional insights, if any, may be gained from accessing these personal accounts of process. In particular, the humanist perspective upon grief should be tempered with pragmatism so as to avoid regarding poetry as a reductive sentimentalising of trauma: encountering loss may be seen as experiencing subjection to a 'lawless' world. The study confirms the use of poetry therapy and autoethnographic writing has significant utility and potential, whilst recognising the challenges for empirical confirmation, the need for practitioners to be sensitive to the nuances of the source materials and the subtlety of appropriate application for different client perspectives and groups., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Research has predominantly focused on the post-traumatic consequences of grief. Less is known about the factors associated with the capacity for recovery and growth. Objective: The main goal of this study is to analyse the mediating role of coping strategies in the relationship between the impact of the event and posttraumatic growth, considering the degree of kinship and the cause of death. Methods: This exploratory and correlational study, which used a cross-sectional design, involved a community sample of 889 adults who had lost a loved one. Results: Emotion and problem-focused coping strategies mediate the relationship between the impact of loss and posttraumatic growth, specifically when a spouse or a child dies. Conclusions: Individuals who experience greater suffering also undergo higher levels of post-traumatic growth. Coping strategies are crucial in post-trauma reconstruction and growth. Furthermore, the degree of kinship and the cause of death are decisive factors., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Prolonged Grief (PG-13) Children Form was adapted, then went through basic validation to be applicable on Indonesian adolescents. The form was adapted based on the guidelines by Beaton et al. (2000). Pre-testing was done on 40 adolescents by online interviewing. PG-13 Indonesian Version and the Depression, Anxiety and Stress Scales (DASS) were then reconstructed into an online questionnaire for basic validation purposes. It was completed by 131 adolescents. Results prove a high internal consistency reliability and acceptable construct validity of the PG-13., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

With 7.3% of children under the age of 18 experiencing the death of a parent and more who experience a loss of a loved one bereavement is a common experience in the lives of children and youth. The current study sought to evaluate the effectiveness of an 8-week, school-based grief group treatment program in reducing symptoms of grief, dysregulation, and improving social support. A total of 296 children and youth (age 11-18) participated in the grief programming provided by a local hospice agency. With a retention rate of 76% the researchers identified a significant reduction in grief symptomology, frequency of emotion dysregulation, and a significant increase in perceived social support from pre- to post-8-week school-based grief programming. A reduction in intensity of dysregulation was not significant. Implications for school personnel and parental support of children and youth experiencing loss are discussed., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The current study examined the role of interpersonal vulnerability, that is, self-perceived threats to one's interpersonal domain, in the mental health of bereaved parents. Israeli bereaved parents in older adulthood ( N = 105, aged 48-88, M = 64.06, SD = 9.93) were pair-matched with equivalent 105 non-bereaved parents. Participants completed questionnaires assessing interpersonal vulnerability, satisfaction with life, and depressive symptoms. The results showed higher levels of interpersonal vulnerability among bereaved parents compared to their non-bereaved counterparts. Additionally, parental bereavement and interpersonal vulnerability were associated with worse mental health. Finally, interpersonal vulnerability mediated the association of parental bereavement with worse mental health. This study reveals interpersonal vulnerability as an important vulnerability factor among a significant minority in older adulthood., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The death of a child in the intrauterine stage has legal, psychological, spiritual, and health-related connotations that condition the woman's experience. To understand better the processes set in motion around early pregnancy loss, this ethnographic study explores the experiences of miscarriage in a group of 15 women. The following themes are analyzed: Experience of losing the child, spirituality, health care, and the need to physically recognize the child. The study shows that the need women have to honor the child who did not live may be conditioned by the perception of an uncertain loss and by the absence of a place to honor him/her. Attitudes among professionals are revealed that could be perceived as gender-related abuse. The care of women places emphasis on physical aspects, underlining the lack of comprehensive care during the grieving process., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Disenfranchised grief can be defined as a loss that is not openly acknowledged or a mourning process not recognized socially after a loss. One can also self-disenfranchise as suppressing and not allowing oneself to grieve. The current study aims to examine perceived disenfranchisement, self-disenfranchisement and disenfranchisement of others. For this purpose, three hypothetical unacknowledged loss scenarios, which are pet loss, a romantic relationship break-up and having a psychological disorder, were used to compare self and other disenfranchisement as well as to reveal the relationships to attachment and social support. The findings indicate that the three loss scenarios differ in terms of the acknowledgement of loss, grief and social and professional support for self and others. Subsequently, attachment and social support are significantly related to the evaluations of the disenfranchised grief process. Finally, the implications of the findings are discussed., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

A Massive-Open-Online-Course (MOOC) on death and dying (Dying2Learn) was offered in 2020, designed to build conversations about death as a natural part of life. In week 1, the content focused on how today's society engages with death through the language we use, humour, public mourning and funerals. This study investigated 2020 MOOC participants' responses to an online activity reflecting on funerals and memorials during the time of COVID-19. From this activity, n = 204 responses were analysed qualitatively. Themes included the positives and negatives of virtual funeral attendance (e.g. opportunity to have a way to participate when travel barriers existed, versus a sense of impersonal voyeurism); and the challenges related to the inability to physically comfort the bereaved due to physical distancing requirements. Comments made as part of this MOOC activity provide a unique insight into the community's experience of funeral changes necessitated by COVID-19, with important implications for the grieving process., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

In 2020-2021, a qualitative study was undertaken using an interpretive description methodology to identify what triggers grief in the first 2 years following the death of a beloved family member, and to gain other helpful insights about grief triggers from bereaved Canadian adult volunteers. In that study, a purposive sampling method was used to select 10 bereaved Canadian adult volunteers for in-depth, semi-structured interviews. This paper reports on the humor findings, as revealed to be a particularly complex grief trigger for many participants, as well as a periodic way for most to manage or live with their grief. Participant quotes and an extended discussion are included to illustrate the importance of these humor findings in relation to grief, and to inform bereaved people, bereavement service providers, and the general public about both helpful aspects and some cautionary considerations about humor., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Wuhan was the first large city where the initial breakout of COVID-19 took numerous lives. A group of social workers and mental health specialists coordinated the "Be Together Program" (BTP), a psychosocial grief intervention program to help a group of Wuhan COVID-19 bereaved people. Under the Dual-process model framework, BTP used the internet and social media as the main tools, combined with group and individual intervention. Additionally, it employed a "Supermarket Mode" with abundant intervention themes and approaches for BTP participants to choose according to their special needs. Additionally, Chinese cultural elements are integrated into the program. At the end of the program, the grief scores of participants in the qualified sample reduced significantly, and the prevalence of the potential Prolonged Grief Disorder diagnosis reduced from 75% to 12%. The study also found that the BTP was especially effective for those who had high levels of grief reaction., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Continuing the bond (CB) to a deceased loved one plays a clinically significant role in grief. We validated the Continuing Bonds Scale (CBS) examining externalized CB (illusions and hallucinations) versus internalized CB (use of the deceased as a secure base) in relation to risk factors of complicated grief and bereavement-related adjustment. Data from 364 bereaved German participants on CBS, Inventory of Complicated Grief (ICG), and Posttraumatic Personal Growth Inventory (PPGI) entered an exploratory factor analysis. This yielded a two-factor-solution representing externalized and internalized CB ( KMO = .89, χ2 = 2100.5, df = 120). Both factors demonstrated high internal consistency (Cronbach's α = .87). ICG and PPGI highly correlated with externalized and internalized CB. Cause of death and feelings of responsibility were associated with externalized CB. In the future, the use of the CBS could help predict problems in grief processing and consequently implement early interventions., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This paper considers the way the outbreak of coronavirus and the subsequent lockdown has egregiously impeded the Hindu death ceremonies and mourning rituals in India. It makes a comparative analysis of how Hindu death rituals get renegotiated, modified and reinterpreted across two vastly different regions of India, both of which have their local customs. Whilst death rituals in India are contingent on the deceased's caste, community, class, gender and age, the impediment to the major death rituals creates a central conundrum for all mourners. It results from the substitution of 'sacred' ritual guidelines with new 'profane' ones for the 'disposal' of deceased COVID-19 patients. Departure from many significant pre-liminal rites, specific transition rites, and post-liminal rites has eschatological, ritual and cultural ramifications. The inability to grieve in unison during a Shraddh ceremony denies mourners any scope to quell distressing feelings about mortality which serves as a source of consolation., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This study examined the roles of resilience and willingness to seek psychological help in influencing Post-Traumatic Growth (PTG) among 173 emerging adults who experienced parental loss during their school years. A positive relationship was found between resilience, the willingness to seek psychological help, and PTG. Participants who endured loss over five years prior manifested increased PTG (New-Possibilities, Spiritual Change, and Appreciation of Life sub-scales) relative to those with more recent losses. The multiple regression model was notable, accounting for 33% of the variance in PTG. Both resilience and the willingness to seek psychological help assistance significantly predicted PTG, surpassing other predictors in the model. It is worth noting that the type of loss, whether sudden or anticipated, did not alter PTG levels. In essence, this study underscores the enduring positive psychological impact of parental loss on emerging adults, highlighting the critical need for comprehensive psychological resources and support for such individuals., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This study addresses the experiences of informal caregivers caring for elderly family members with Alzheimer's disease (AD) during the COVID-19 pandemic. The study includes a sample of eight informal caregivers who were evaluated through a semi-structured interview six months after the death of a loved one they cared for. A thematic content analysis was applied to the interviews and yielded two higher-order domains: (1) Experiencing the AD and the death of a family member and (2) The grieving process during the COVID-19 pandemic. The results provide valuable insights into family caregivers' experiences regarding the profound emotional impact of caregiving and grief during the COVID-19 pandemic. Caregivers maintain their identity even after loss, underscoring the enduring impact of caregiving. The identity as a caregiver impacted coping and grief responses, highlighting the need for tailored interventions., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Aim: To understand the experiences and perceived impact on the wellbeing of individuals attending a suicide bereavement social support group., Design: A qualitative study guided by a realist evaluation framework., Methods: Data were collected from May-July 2020 using online semistructured individual interviews with participants ( N = 6), from the North West of England recruited from a suicide bereavement support group's social media. Data were analysed using thematic analysis informed by the realist framework., Results: Effective social support includes the prioritisation of building meaningful connections with like-minded individuals, providing a safe space for authentic self-expression aiding personal relationship maintenance. Contextual factors included: Societal and cultural stigma of suicide, self-stigma and gender norms. Mechanisms influencing support seeking include: Not wanting to burden loved ones due to judgement, and a lack of understanding., Impact: Policymakers can reduce demand on healthcare systems by developing tailored support groups to suit individual needs., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Losing a significant other through death is a tragic experience worsened by the novel coronavirus disease 2019 (COVID-19). To curb this massive increase of deaths, the South African government introduced various rules to regulate the burial process. However, these COVID-19 regulations have caused major ruptures and disruptions on how bereaved families observe and practice cultural rites and customs following death within an African context. Consequently, many bereaved family members, particularly Black Africans, struggle with adhering to the regulations and funerals have been coined ' super spreaders ' of the virus. The concerns raised in this article are twofold, namely, the impact of the Covid-19 regulations on how Black Africans grieve and mourn, as well as the involvement of social workers in formulating regulations that ought to be adhered to. This article explores the fissures and bricolages brought about by COVID-19, ultimately suggesting possible ways of dealing the losses ascribed to the pandemic., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The benefits of expressive writing have been explored since at least the 1980s. The effect of expressive bereavement-related writing has been studied primarily in college students, yielding inconclusive results. Nonetheless, recent effective, integrated psychotherapy protocols, targeting complicated and prolonged grief, include writing assignments, typically in the form of letters. The present paper explores how and why letter writing might be effective and meaningful as a therapeutic tool in the context of grief psychotherapy. It describes how working with letters, addressed to the deceased, might help facilitate self-disclosure, promote exposure to what is avoided, confront unfinished business, encourage continuing bonds, and help achieve a coherent narrative around experiences with the loss. As a therapeutic tool, letter writing has the potential to be helpful to many bereaved people, as it is a simple, effective, and meaningful way to access and work with relevant clinical material in the context of psychotherapy., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Aim: This study was conducted to determine the experiences of women who encountered loss in the prenatal period., Method: This study was a qualitative study conducted using the phenomenological method and was conducted according to the guidelines of the COREQ checklist. A total of 11 women who were experienced loss in the early prenatal period were interviewed. The data were analyzed using the content analysis., Results: Three main themes and eight sub-themes emerged. The themes were light of life (bubble of happiness, journey), dark farewell (silent scream inside, unfinished tale: motherhood, loneliness, family approach) and obscurity (uncertainty about the future, need for support). Women expressed that the loss process had negative effects on their mental health and that they needed help., Conclusion: Pregnancy illuminates women's lives, while prenatal loss involves intense and various negative emotions, and women need support in many ways. These results show that women who experienced loss in the prenatal period should be allowed to express their feelings, thoughts and experiences, and the risks in terms of mental health should be reduced by supporting them during the loss and mourning process., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This study examined the effectiveness of an 18-session manualized integrative group psychotherapy intervention for parentally bereaved young adults with grief complications. Participants, 63 young adults aged 20-27 years, completed questionnaires assessing symptoms of prolonged grief, PTSD, depression and anxiety prior to and following treatment. Treatment effectiveness was assessed by comparing outcomes for the intervention group to a waitlist comparison group. Results revealed a statistically significant reduction in symptoms of grief (large effects size), PTSD (medium effect sizes), and depression (medium effect size). The treatment did not result in a significant reduction in anxiety symptoms. The study provided preliminary support for this intervention for parentally bereaved young adults., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The current study focused on the associations between the cause of a loved one's death, mourner's emotional distress, mourner's ongoing relationship with the deceased, and posttraumatic growth (PTG). The sample comprised 91 Israeli mourners following death due to traffic accident, military service, or prolonged illness. Participants completed questionnaires assessing psychological distress, ongoing relationship with the deceased, and PTG. Findings showed that in traffic-accident deaths, mourners reported higher psychological distress and preoccupation with the deceased compared to that reported by the other mourner groups. Moreover, psychological distress mediated the association between the cause of death and PTG. The findings emphasize the differences between the mourner groups., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

In China, older adults whose only child has died are known as shiduers ; these people are not only deeply impacted by their individual bereavement from losing their child but are also influenced by macro institutional factors. To further investigate this unintended consequence of the one-child policy and to illustrate the mechanism of influence of institutional factors on the sufferings and grief experiences of this population, this study conducted in-depth semi-structured interviews with 20 shiduers in Wuhan, China. In line with Ulrich Beck's theory of risk society, the findings argue that the crises inherent in institutional factors not only affect the post-loss experiences of shiduers in harmful ways but also pose a number of life difficulties that are difficult to control and mitigate. More importantly, most shiduers ' life difficulties are rationalized, gradually transforming into manufactured and widespread shidu risks that persist long-term throughout their aging process., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Given the nature of horse-human interactions in equine-assisted services (EAS), death of a horse may have significant impacts. In this study, an online survey was distributed to EAS practitioners. The goal of the study was to explore the experiences of practitioners and identify the socioemotional processes that occur upon the death of an equine within an EAS program. Open-ended responses ( N = 84) were analyzed qualitatively using a grounded theory and constant-comparative approach. Responses are situated into two themes (1) Processing the death of an equine and (2) Practical implications. Experiences processing the death of an equine can be situated within Worden's Four Tasks of Mourning, extending a grief model previously only considered in the context of human death to animal death. Practical implications found within responses highlight actions practitioners can take to prepare for and process through the death of an equine in their program., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This mixed-method research study delves into the repercussions of the COVID-19 pandemic on loss and mental health in Italy. The analysis uncovers a significant correlation between COVID-19 fear and heightened anxiety, depression, and stress, exacerbated by social isolation and misinformation. The loss of loved ones during the pandemic intensifies distress, with 28% showing signs of prolonged disorder and 22.8% displaying maladaptive grief symptoms. Distress persists across pandemic phases (59.3% critical, 54.9% intermediate, 48.4% less critical), attributed to grief, fear, uncertainty, and isolation. Qualitative analysis identifies two core themes: 'Death without Dying' and 'Online Grieving Practices and Coping Strategies,' elucidating disruptions to traditional grieving and the role of online coping strategies. Our findings underscore the pandemic's multifaceted impact on grief and mental health in Italy, highlighting the importance of addressing social and emotional needs during crises., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Experiencing the homicide of a loved one has a substantial impact on the mental health of family members and friends who must survive their loved one's tragic death. This systematic review aims to synthesize the current findings on post-homicide factors and identify the factors most frequently related to the mental health of homicidally bereaved individuals (HBI). Four databases were searched (PsycINFO, SCOPUS, Sociological Abstract, PubMed). The selection of studies was based on a peer review process conducted by two independent researchers to ensure interrater reliability. The articles were screened to ensure the presence of homicidally bereaved adults, resulting in a total of 35 eligible papers to be considered in the current review. Factors were organized into categories, with the criminal justice system-related factors ( n = 18), social factors ( n = 17), and coping factors ( n = 13) being the most prevalent. This review identifies clinical avenues for preventing distress and fostering the well-being of HBI., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Mandated measures to reduce the risk of spreading the coronavirus (e.g., social distancing and travel restrictions) led to isolation and reshaped the dying process as well as grief rituals for loved ones of deceased individuals due to COVID-19 and other causes of death. The purpose of this study was to investigate the difference between those who lost a loved one during and not during the global pandemic in terms of complicated grief and perceived social support. A cross-sectional quantitative approach was employed, surveying 580 individuals, all of whom had experienced the loss of a loved one. Our findings suggest that bereavement during the COVID-19 era uniquely intensified the Complicated Grief experience. However, the perceived social support did not vary based on the timing of the bereavement. The strengths, limitations, and future research directions are further explored., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Stillbirth commonly affects women in Nigeria, but their experiences of grief following stillbirth is under explored. This study aimed to describe Nigerian women's experiences of grief after stillbirth. Face-to-face, semi-structured interviews were conducted with 20 women in Nigeria who experienced stillbirth. The results from the thematic analysis suggest that mothers had an unmet need to see their stillborn baby, and they experienced communication challenges such as being blindsided/misled about the baby during their interactions with health personnel. The participants experienced emotional and psychological reactions to grief that manifested in the form of emotional pain, sadness, blame and shock, but having a sense of gratitude helped them cope. The findings of this study highlight gaps in bereavement care and suggest the need for basic bereavement training for health personnel., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Situated in the context of existing literature on wounded healers and the use of self in therapy, the aim of this qualitative study was to examine the experiences of psychological therapists who experienced the death of a parent in childhood. Seven psychological therapists from a range of professions and therapeutic modalities participated in semi-structured interviews exploring how this experience impacted them personally and professionally, in their therapeutic work. Using interpretative phenomenological analysis, three master themes emerged: 'A loss beyond words'; 'Navigating in a strange landscape'; and 'Something lost, something gained'. Areas of convergence and divergence between these findings and previous theory and research are discussed, particularly with respect to literature on grieving and the self of the therapist. Implications for therapeutic practice, supervision and training are highlighted, including the importance of self-reflection and supervision in facilitating the use of self, and the value of therapeutic training incorporating self-of-the-therapist work., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The current study was conducted to explore the bereavement (experienced loss of a loved one through death within time frame of 0-3 years span). Seven adolescents (10-19 years old) with intellectual disability were included in the study. Semi-structured interviews were conducted through interview guide which was prepared with the help of Piaget's theory of cognitive development concept related to death. Data was analyzed with content analysis and six major themes were derived, that is, meaning of death, death rituals, religious concepts related to death, reasons of death, grieving perception, and coping with grief. Mostly, concepts were explained under the light of religious preaching and their introjection in the lives of adolescents with intellectual disability. Current study helped in exploration of experiential phenomenon of loss in adolescents with intellectual disability., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The loss of the spouse causes several secondary losses, such as loss of family and individual identities, and for that, it is considered a risk factor for complicated grief. Our objective was to investigate the possible specific aspects of widowing. Data collection occurred via an online questionnaire, during the new Coronavirus pandemic and the mixed design (both qualitative and quantitative) research had the participation of 93 individuals. The loss of the spouse was considered the worst loss experienced by the participants. Loneliness, routine, bureaucracy, and rituals were the main difficulties, while spirituality, family, and work were mentioned as protective factors. Signs of complicated grief were associated with age and time since the death of the partner. There was no significant difference between gender nor between the type of death. The manifestations of widowing are similar to other forms of bereavement, but there are specifications that should be taken into consideration by professionals in order to promote quality of life., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

In a sequential mixed methods study, interview data showed that bereaved parents consistently reported "stupid" or "insensitive" things people said that were not helpful when their child died. Subsequently, a discourse analysis of 170 sympathy cards was conducted to assess societal messaging that may influence people's insensitive words. The findings reflected two distinct time periods in the bereavement process: a time of sadness followed by a time of peace. Possible links to insensitive things people said included: suggestions that the sad time should only last a few days, suggestions of "healing," religious statements such as the deceased being with God or advice to pray to God, and notions of celebration in some contexts. Very few excerpts were similar to the advice-giving quotes that interviewees considered to be insensitive. Many cards reflected the love and memories inherent in creating a continuing bond with the deceased and achieving peace.

In this multimethod study, we examine bereaved parents' capacity for mentalizing the temporal dimension of their grief. The theoretical assumptions of our study draw on the clinical and anthropological perspectives on the passage of time in grief. Parents' mentalization of their experience of grief was measured both in the attachment context, using the Adult Attachment Interview (AAI) and using the narrative Child Loss Interview (CLI). We used thematic analysis to code parents' mentalizing utterances in order to categorize time-related changes during the grieving process. Parents generally mentalize their grief-related experiences at a lower level of reflective functioning than their general attachment experiences. However, a higher general ability to mentalize contributes to a higher level of RF and greater coherence in mentalizing their grief. Parents experience time in grief through oscillation between the past with the deceased child and a restricted form of existence in the present reality., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This study was conducted to explore and understand the experiences of midwives who care for women experiencing stillbirth and the challenges they face in this process. A qualitative study was conducted with 11 midwives using the phenomenological method. Descriptive analysis of the data revealed four main themes: 1) Silent screams in the face of despair (women's reactions to stillbirth), 2) Being a partner in pain, "two sides of a zipper" (midwives' experience of stillbirth), 3) Efforts to cope with the pain, and 4) Just two words: "if only." The impact of stillbirths on midwives should not be disregarded. Emotions such as shock, horror, fear, guilt, and anger experienced by midwives following a stillbirth can adversely affect their mental health. The guilt experienced by midwives can also negatively impact their health and quality of life, as well as cause burnout and distancing from the profession., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: The "Bereavement Network Lower Saxony" (BNLS) provides professional bereavement support to families grieving for a child. The present study aimed at exploring the experiences of BNLS bereavement counsellors in providing bereavement support to affected families. Methods: 12 semi-structured qualitative interviews were conducted with bereavement counsellors of the BNLS between June and August 2022. Interviews were recorded, transcribed and analysed using qualitative content analysis, according to Mayring (2010). Results: Bereavement counsellors perceived that grief could be experienced very differently, and thus bereavement support must always be based on the individual needs and resources of bereaved family members. Bereavement counsellors appreciated exchange within the network and supervision to cope with emotional load that arises from compassion for those affected. Conclusions: Bereavement support within a network structure may improve the accessibility of individual support and enable exchange between counsellors, thus ensuring better bereavement support. Public outreach and strategic partnerships with clinics may amplify the positive impact of this support service., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Unexplained experiences are common among bereaved people and are a natural part of grieving, but their consequences may affect their coping with grief. However, professionals lack awareness of these unexplained experiences, which may lead to an unnecessary pathologising of the experiences and a lack of opportunity for the bereaved to process their experiences in a safe environment. The study involved an inductive content analysis of 408 narratives of the consequences of unexplained experiences shared by 181 bereaved individuals. The consequences of the unexplained experiences were: (1) Experiencing after-effects which may alleviate or aggravate wellbeing, as well as be life-affecting; (2) consequences related to sharing or concealing the experiences, and the reactions of others to recounting the experience; (3) documenting the experience through videography, photography and keeping mementos. In conclusion, these experiences have consequences to bereaved which needs to be taken account in support interventions aimed at bereaved individuals., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.