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Background: Psychotherapy for Prolonged Grief Disorder (PGD), a condition characterized by an intense and persistent grief response, has received increased attention over the past decades. Evidence-based approaches to prevent PGD are currently scarce, and not always effective. This paper introduces a protocol for a clinical trial exploring the effectiveness of a Meaning Reconstruction psychotherapy approach (MR) assisted with ayahuasca, a traditional indigenous medicine. Method: The outlined protocol is a three-arm, non-randomized controlled trial focused on reducing normal and pathological grief symptoms, comparing the effectiveness of Ayahuasca-assisted MR therapy (A-MR), MR therapy alone (MR) and No Treatment (NT). At least 69 people who lost a first-degree relative during the prior year, and with a Texas Revised Inventory of Grief score up 39 (TRIG ≥ 40), will participate in the trial. Participants will be allocated to an A-MR (n ≥ 23), MR (n ≥ 23) or NT (n ≥ 23) group. Those from the A-MR and MR therapy groups will undergo a therapeutic process involving 9 sessions of online psychotherapy. In addition, the A-MR condition involves 2 group sessions of ayahuasca. The primary outcomes will be normal and pathological grief severity as measured by the TRIG and Traumatic Grief Inventory Self-Report (TGI-SR), administered at baseline, post-treatment, and 3-month follow up. Measures of quality of life, post-traumatic growth, meaning-made, psychological flexibility, and self-belief consistency will be also included. In addition, subjective effects of ayahuasca and acceptance-avoidance promoting effects will be assessed following ayahuasca administration. Finally, we will analyze the potential mediating effect of meaning-made, psychological flexibility and self-belief consistency in grief symptoms (as measured by the TRIG and TGI). Discussion: This trial is the first to empirically examinate the potential of psychedelic-assisted psychotherapy for grief, as well as the potential processes of change that may account for it. Clinical trial registration: https://clinicaltrials.gov , identifier NCT06150859. [ABSTRACT FROM AUTHOR]

Bereavement counseling is often offered as a referral following an adverse event or after identification of lingering grief. This article proposes the value of prospective bereavement counseling when a person can reasonably anticipate loss to support anticipatory grief and facilitate supportive continuous care planning for patients experiencing loss. This article positions bereavement counseling as care aimed at finding peace by offering a framework of dimensions of peace, opportunities to foster peace in clinically important moments, and guiding questions to facilitate this clinical outcome in health care settings. [ABSTRACT FROM AUTHOR]

Background: The transition of family caregivers of patients with end-of-Life cancer receiving palliative care from hospital to home is a complex and challenging process. This phase of care involves not only the physical and psychological health of the patient but also the role adaptation and emotional support of the family caregivers. To gain a deeper understanding of the various experiences and feelings during this process, we conducted a qualitative study. Methods: This study employed a descriptive phenomenological research method. The interviews focused on the specific experiences, challenges faced, support received, and coping strategies of family caregivers of patients with end-of-life cancer during the transition from hospital to home palliative care. All data were treated with strict confidentiality, and recordings and transcriptions were made with the participants' consent. Results: A total of 15 family caregivers participated. Four main themes and nine sub-themes were identified: complex transition process (anxiety about uncertainty, resistance to transition), discontinuity in care (insufficient discharge guidance, lack of continuous communication mechanisms), post-discharge continuous care needs (need for home care knowledge and skills, social and emotional support, grief counselling and death education), and personal growth and gains (enhanced coping ability, increased psychological resilience). Conclusion: Family caregivers face numerous emotional, cognitive, practical, and social support challenges during the transition from hospital to home care. To improve the caregiving experience and quality of life, appropriate training and support should be provided to better meet the caregivers' needs. [ABSTRACT FROM AUTHOR]

Suicide is one of the leading causes of death worldwide, affecting numerous individuals close to the person who died by suicide, including family members, friends, and colleagues. Those affected by the suicide of someone are referred to as "suicide survivors", and the psychological consequences they face are particularly severe. One of these consequences is grief, which is more complicated in survivors of suicide compared with those grieving deaths from other causes, mainly because of the stigma that continues to surround them. Therefore, psychotherapeutic intervention for suicide loss survivors is crucial. This study examines the efficacy of cognitive-behavioral programs for addressing grief and other related variables in suicide loss survivors. The search was conducted in databases including Psycinfo, Academic Search Premier, Medline, APA PsycArticles, E-Journals, Scopus, and PubMed. Five randomized controlled trials were selected, one of which focused exclusively on minors. The results reveal that cognitive-behavioral therapy is effective, although the methodological quality of these studies is not adequate, and the representativeness of the samples is very low. More RCTs are needed on the application of cognitive-behavioral programs to treat grief in suicide loss survivors. [ABSTRACT FROM AUTHOR]

Background: COVID-19 disrupted access to bereavement support. The objective of this study was to identify the bereavement supports used by Australians during the COVID-19 pandemic, perceived helpfulness of supports used, prevalence and areas of unmet support need, and characteristics of those with unmet support needs. Methods: A convenience sample of bereaved adults completed an online questionnaire (April 2021-April 2022) about their bereavement experiences including support use and perceived helpfulness, unmet support needs and mental health. Multiple logistic regression was conducted to determine sociodemographic correlates of unmet needs. Open-ended responses were examined using content analysis to determine key themes. Results: 1,878 bereaved Australians completed the questionnaire. Participants were mostly women (94.9%) living in major cities (68%) and reported the death of a parent (45%), with an average age of 55.1 years (SD = 12.2). The five most used supports were family and friends, self-help resources, general practitioners, psychologists, and internet/online community groups. Notably, each was nominated as most helpful and most unhelpful by participants. Two-thirds (66%) reported specific unmet support needs. Those with unmet needs scored lower on mental health measures. Correlates of unmet needs included being of younger age, being a spouse or parent to the deceased; reporting more impacts from public health measures, and not reporting family and friends as supports. The most frequent unmet need was for social support after the death and during lockdown. Conclusions: This study demonstrates the complexity of bereavement support needs during a pandemic. Specialised grief therapy needs to be more readily available to the minority of grievers who would benefit from it. A clear recommendation for a bereavement support action plan is to bolster the ability of social networks to provide support in times of loss. The fostering of social support in the wake of bereavement is a major gap that needs to be addressed in practice, policy, and research. [ABSTRACT FROM AUTHOR]

Background: An important first step in enhancing professional palliative care training is to investigate the educational needs of pediatric clinicians in this field. The aims of this research were to analyze the extent of end-of-life care experience of Chinese pediatric clinicians and identify the differing educational needs of physicians and nurses as well as associated impact factors. Methods: A cross-sectional descriptive survey via a structural questionnaire was used in this research. Results: In total, 187 clinicians, comprising 52 physicians and 135 nurses, participated in this study. The topics "pain management", "symptom management", and "discussing the prognosis with family members" were the most expressed educational needs among both physicians and nurses. Compared to nurses, physicians placed greater emphasis on the importance of "communication" and "pain and symptom management" (p < 0.05). Clinicians with more extensive end-of-life care experience more strongly felt the importance of learning about pain management and communication regarding end-of-life care (p < 0.05). Conclusions: Research showed that the education currently provided to pediatric clinicians does not meet their distinctive needs. Future palliative care education must be a continuing multi-level, interdisciplinary program and different education should be provided to physicians and nurses based on their respective needs. [ABSTRACT FROM AUTHOR]

Objective: To describe the implementation of a test-negative design case-control study in California during the Coronavirus Disease 2019 (COVID-19) pandemic. Study design: Test-negative case-control study Methods: Between February 24, 2021 ‐ February 24, 2022, a team of 34 interviewers called 38,470 Californians, enrolling 1,885 that tested positive for SARS-CoV-2 (cases) and 1,871 testing negative for SARS-CoV-2 (controls) for 20-minute telephone survey. We estimated adjusted odds ratios for answering the phone and consenting to participate using mixed effects logistic regression. We used a web-based anonymous survey to compile interviewer experiences. Results: Cases had 1.29-fold (95% CI: 1.24–1.35) higher adjusted odds of answering the phone and 1.69-fold (1.56–1.83) higher adjusted odds of consenting to participate compared to controls. Calls placed from 4pm to 6pm had the highest adjusted odds of being answered. Some interviewers experienced mental wellness challenges interacting with participants with physical (e.g., food, shelter, etc.) and emotional (e.g., grief counseling) needs, and enduring verbal harassment from individuals called. Conclusions: Calls placed during afternoon hours may optimize response rate when enrolling controls to a case-control study during a public health emergency response. Proactive check-ins and continual collection of interviewer experience(s) and may help maintain mental wellbeing of investigation workforce. Remaining adaptive to the dynamic needs of the investigation team is critical to a successful study, especially in emergent public health crises, like that represented by the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Prolonged Grief Disorder occurs within 7-10% of the bereaved population and is a more complicated and persistent form of grief which has been associated with suicidality, mental health disorders, sleep disturbance, poor health behaviors, and work and social impairment. EMDR is a fitting treatment option for those with Prolonged Grief, focusing on processing past memories, blocks, current triggers, future fears, and preparing the person for living life beyond the loss in line with the Adaptive Information Processing Model and grief frameworks. This paper discusses the theory, research regarding the application of EMDR with prolonged grief, and gives insight and guidance to clinicians working in this area including a case example. [ABSTRACT FROM AUTHOR]

The paper discusses ecological grief as a particular affective phenomenon. First, it offers an overview of several philosophical accounts of grief, acknowledging the heterogeneity and complexity of the experience that responds to particular personal points of importance, concern and one's identity; the loss triggering grief represents a blow to these. I then argue that ecological grief is equally varied and personal: responding to what the grieving person understands as a loss severe enough to present intelligibly a degradation of her life and the world, to their meaningfulness or even sustainability. More specifically, both personal and ecological grief may manifest in an eroded sense of the future as a space in which one would invest oneself with plans, projects, ideas, desires, and endeavours. On the other hand, personal grief is, in some cases, conceptualised as having embedded the inherent possibility to come to closure or "move on" (e.g., by marrying again), while with ecological grief, the intelligibility of overcoming (replacing) the loss may be, depending on its scale, severely limited. I argue that this erosion of the future need not take the shape of paralysing sadness but rather of a disruption of taking some options of projecting oneself into the future seriously or as real. [ABSTRACT FROM AUTHOR]

The mystery of death, dying and funerals has been a universal phenomenon in the lives of almost all human beings, from humanity's fall from grace to today. Death visits every culture, clan and family, and yet it continues to be a terrifying, unexpected stranger and the most feared enemy of human beings. People from different cultures use different coping mechanisms to fight off the pain of death, but for some people in the Collins Chabane Municipality, a particular Christian religious belief has been shown to be the most reliable asset during the battle. It is questionable whether alternative traditions besides Christianity can compete with Christianity in bringing healing from the pain of death. Various methods of healing, like African grief therapy and psychological healing, are offered to bereaved family members after death and even after burial, but are they enough for Africans to return to their normal lives? This article discusses why (Christian) religious belief is essential during and after the burial of a loved one. This is carried out within the context of colonialism having eroded all African traditions, creating a space for Christianity alone to be a remedy in death and burying. [ABSTRACT FROM AUTHOR]

Background: Grieving is a life-long process, and children in the grieving process are faced with memories of a loved one, which act as a trigger for emotional reactions that may hinder the grieving process. Most children are able to cope with loss and complete the grieving process with the support of people close to them, however, some grieving children need the help of experts during the grieving process and adjustment to their loss, because they are at risk of developing long-term psychological difficulties. Aims: The aim of this paper is to provide information to experts in the field of mental health on effective counselling and psychotherapeutic methods and techniques, as well as practical guidelines in work with grieving children. Methods: Four databeses were searched on November 1, 2023 for peer-reviewed literature on therapeutic approaches for working with bereaved children. The key search terms were: “Child” OR “Children” OR “Adolescents” AND “Grief” OR “Grieving process” OR “Childhood bereavement” OR “Loss and trauma” OR “Traumatic grief” AND “Therapeutic techniques” OR “Psychotherapy” OR “Counselling” OR “Therapy” OR “Interventions”. The search was conducted in English. Twenty-eight articles/books published up until November 2023 that matched the inclusion requirements were found. Results: Two “category” of psychotherapy approach were identified, namely, evidence-based psychotherapy techniques and creative (expressive) techniques. The psychotherapy techniques are based on individual or group treatment, psycho-education and work with family members and peers. Alongside evidence-based psychotherapy treatments, it is useful to use creative or expressive techniques as a supplement. Conclusion and implications: The effectiveness of psychotherapy and counselling intervention has been proven beyond doubt through a great deal of research, and therefore counselling and psychotherapy should be seen as the first choice in treatment of children in the grieving process. The presented review results could guide clinicians in selectively implementing grief therapy in a way that will be the most helpful to bereaved children, adolescents, and their families. [ABSTRACT FROM AUTHOR]

This article centers around my work as a critical race feminista; an academic experiencing consistent attacks on the scholarship I produce while also being a tía (aunt), an active griever, and a godmother to my eldest nephew, Solano Garcia. This is the first time that my nephew and I will have shared our most private papelitos guardados (intimate guarded papers). In this article, we respond to the paucity of Black, Indigenous, and People of Color-centered death, grief, and well-being in academia. Using a critical race feminist epistolary methodology, we document our epistolary exchanges that contain dehumanizing attempts on our bodymindspirit matrices as active grievers of color confronting the premature death of my brother, who died at the age of 37 in the summer of 2021. Unlike the 'western' psychotherapeutic tradition of overcoming death and grief, we stake a claim, sit with it, and affirm it as an ongoing process. We argue that recognizing and affirming death and grief is a life-making process that creates spaces for healing through our epistolary offerings. This article aims to offer BIPOC faculty, staff, students, and their families life-affirming strategies towards radical self-care, love, and intergenerational collective healing within a sociopolitical context that operates as a surveillance mechanism. [ABSTRACT FROM AUTHOR]

Background: Minimally invasive tissue sampling (MITS) has increasingly been used to improve the diagnosis of disease and identification of the cause of death, particularly in underserved areas. However, there are multiple barriers to accessing those who die within the community, our study aimed to explore the perceptions and insights of community members and healthcare providers regarding the feasibility of implementing MITS in community settings. Methods: A qualitative exploratory study was conducted. A total of twenty one in-depth interviews were conducted with deceased infants' parents, elders of the family, religious leaders, community leaders, and funeral workers. Focus group discussions were conducted with health care providers (n = 14) in two peri-urban slum areas of Karachi, Pakistan. The duration of this study was from August to October 2020. Data was analyzed using thematic analysis and was coded and merged into categories forming eight major themes. Results: In general, participants viewed minimally invasive tissue sampling (MITS) as beneficial for improving child health, though some had concerns about disrespecting the deceased during sample collection. Misinformation, fear of needles, and medical procedures were major barriers to MITS implementation. To enhance acceptance, community and religious leaders suggested using religious rulings, obtaining parental consent, ensuring confidentiality, and increasing efforts of community engagement. Community healthcare providers, along with funeral workers, recommended providing community members with grief counseling to increase study participation. Besides concerns about sampling interfering with respect for the decease, community members also raised concerns about misinformation. Further, participants provided feedback on the design and appearance of the mobile van used to collect MITS samples from children under the age of five. Conclusion: This study is critical for understanding the challenges associated with implementation of community-based MITS sampling in Pakistan. Integrating the use of a mobile van for sample collection, grief counseling along with community engagement sessions and advocacy will help address community-based misinformation and develop community trust. [ABSTRACT FROM AUTHOR]

Objective: To explore the grief experiences of family members of patients with advanced malignant tumors before and after death. Methods: This study used both quantitative and qualitative research methods. A total of 10 people with family members with terminal malignant tumors were chosen and assessed five times according to a specific non-invasive mortality index and the Distress Thermometer scale. Additionally, the participants attended an in-depth interview. Results: The grief experiences of the bereaved included their knowledge of and attitude towards death, the physical and mental conditions of the family members of patients in the terminal stage, the needs of family members, and the response to death and growth of those family members. Conclusions: The grief experience interviews of family members of patients with advanced malignant tumors are universal. It is suggested that the nursing staff should pay attention to the emotional experience of the bereaved after the death of the patient throughout the whole nursing process, including the continuous follow-up during the home period. It is hoped that the implementation of grief counseling methods in the later stage can help the bereaved to successfully go through the grieving period, prevent grief disorders, and help them return to society. [ABSTRACT FROM AUTHOR]

After-death communication (ADC) is the phenomenon of perceiving spontaneous and direct contact by a deceased loved one. Evidence suggests that ADC is a widespread human experience, particularly for bereaved individuals. Many people who have ADCs report them to be comforting, suggesting therapeutic potential. However, many individuals in Western cultures choose not to disclose their ADCs to mental health providers, citing fears of pathologization, disenfranchisement due to gender expectations, negative ADC encounters, or minimization by clinicians. For others, ADCs are deeply personal and people may keep the experiences to themselves for fear that providers might explain the ADCs away by framing them in purely psychological terms. As such, there is a paucity of literature on how therapists should best approach the topic of ADC with clients. The following narrative review offers clinical interview and assessment strategies from theoretical papers and empirical studies to guide this process. Clinicians are encouraged to self-reflect on their natural inclinations around ADC, assess general psychological functioning, normalize and validate the ADC experience, assess client feelings and explanations, and inquire about spiritual beliefs. Clinicians can also help clients to explore the meaning and personal significance of their ADCs as well as clients' perceived relationships with the deceased. [ABSTRACT FROM AUTHOR]

The article provides guidelines for supporting the dying patient and their families. These include establishing agreements, ground rules, and setting a tone of cooperation and civility, making time with lawyers, financial advisers, and clinicians to prepare for what is coming, and taking time to calm fears and anxieties about death and dying.

Background: Due to its high death toll and measures to curb the pandemic, COVID-19 has affected grieving experiences and may contribute to risk factors for Prolonged Grief Disorder (PGD). Persons at risk for PGD often seek support from grief counselling. Objective: To explore whether pandemic-associated risk factors have become more important topics in counselling in a mixed-method design. Method: German grief counsellors (n = 93) rated whether pre-defined risk factors had become more important in grief counselling and indicated additional important themes in an open format. Results: The counsellors indicated that all pre-defined risk factors had become more important, though differing significantly in their frequency. Most frequently endorsed risk factors were lack of social support, limited possibilities to accompany a dying loved one and absence of traditional grief rituals. Qualitative analysis identified three additional themes: the societal impact of the pandemic, its impact on bereavement support and health care, and a chance for personal growth. Conclusions: The pandemic has affected bereavement experiences and grief counselling. Counsellors should monitor grief processes and specific risk factors to provide the best possible care for bereaved people when needed. Pandemic-associated risk factors for PGD have become more important topics in grief counselling during COVID-19. Risk factors include especially a lack of social support, limited possibility to accompany a dying significant other and absence of traditional grief rituals. Future research is needed to investigate whether monitoring and addressing these risk factors can improve bereavement care. [ABSTRACT FROM AUTHOR]

Copyright of Psicologia em Estudo is the property of Universidade Estadual de Maringa and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Palliative care in the delivery room is an interprofessional and interdisciplinary challenge addressing the dying newborn and parents as well as the caregivers. It differs in some significant aspects from palliative care in the neonatal intensive care unit. Clinical experience suggests that many details regarding this unique specialized palliative care environment are not well known, which may result in some degree of insecurity and emotional distress for health care providers. This article presents basic background information regarding the provision of palliative care to newborns within the delivery room. It offers orientation along with a preliminary set of practical recommendations regarding the following central issues: (i) the basic elements of perinatal palliative care, (ii) the range of non-pharmacological and pharmacological interventions available for infant symptom control near the end of life, (iii) meeting the personal psychological, emotional, and spiritual needs of the parents, and (iv) care and self-care for medical personnel. [ABSTRACT FROM AUTHOR]

Background: During the COVID-19 pandemic, many people have experienced traumatic losses and therefore are at risk of developing complicated grief regarding the restrictions on the performance of routine mourning rituals. This study is a randomized controlled trial for assessing the efficacy of three versus five sessions of grief counseling on grief intensity, psychological distress, and quality of life of grief among bereaved people due to COVID-19. Methods: A total of 120 bereaved people, due to COVID-19, will be enrolled in this multi-center randomized controlled trial after assessment for inclusion and exclusion criteria. Following the informed consent procedure, participants will be allocated into two groups equally by the Stratified Balanced Block Randomization, one of them delivering a three-session grief counseling intervention and the other delivering a five-session grief counseling intervention. The intervention will be delivered by trained psychologists via in-person individual sessions. The primary outcome is grief intensity, and the secondary outcomes are psychological distress, quality of life, and satisfaction of the participants. These outcomes will be measured by the Grief Intensity Scale (GIS), the General Health Questionnaire-28 (GHQ28), the Short Form Health Survey-12 (SF-12), and the Client Satisfaction Questionnaire (CSQ-8), respectively. The assessments will be done at three time points, one before the intervention and the others 1 month and 3 months after the intervention. The data will be analyzed using the SPSS V.18 and Stata V.11 software. The analysis approach will be “intention to treat.” Discussion: Results of this study can be applied for selecting the most suitable intervention leading to the prevention of complicated grief and the maintenance and promotion of the mental health of bereaved people due to COVID-19. [ABSTRACT FROM AUTHOR]

Background and Objectives: Rituals have been reported to serve as a vital mechanism for expressing grief and fostering communal support worldwide. Despite these benefits, use of rituals in Indigenous communities is threatened by missionization, globalization, and westernization. This study sought to examine the relevance of traditional mourning rituals in community morality and well-being. Anchored in cultural evolutionary theory, the study employed an ethnographic research design., Methodology: Data were collected from 45 community elders, 30 bereaved adults, 30 bereaved adolescents, and 8 religious leaders through focus group discussions and interviews., Results: The study established five mourning rituals practiced by the Luhya people, each potentially serving an evolutionary function for community survival and well-being. Our findings show that Luhya traditional mourning rituals play an important role in community well-being, though not all members may benefit equally from these effects., Conclusions and Implications: The study established conflict over rituals with differing viewpoints from religious leaders, cultural leaders, and the western biomedical approach to mental well-being. Yet, the bereaved reported that both Luhya and religious rituals helped them process their grief. To address mental health issues fully, it is important to establish collaboration between western models, religious approaches, and cultural approaches., Competing Interests: None declared., (© The Author(s) 2025. Published by Oxford University Press on behalf of the Foundation for Evolution, Medicine, and Public Health.)

Background: Due to the COVID-19 pandemic, grief is currently a widely experienced psychological problem. Depression symptoms and suicidal ideation are associated with COVID-19 grief. Therefore, the present study was conducted to compare the effectiveness of grief counseling and God-oriented spiritual counseling on depression symptoms and suicidal ideation in people with COVID-19 grief. Methods: The present experimental study was conducted with a pretest-posttest design, a control group, and follow-up. The study population consisted of all residents of Shahr-e-Rey, Iran, who had lost a member of their family due to COVID-19. Through purposive sampling, 51 individuals who were willing to participate in the study and met the study inclusion criteria were selected and were randomly assigned to 2 experimental groups and 1 control group (17 in each group). In the 3 stages of pretest, posttest, and follow-up, data were collected using the Beck Depression Inventory (Becket al., 1996) and Beck Scale for Suicidal Ideation (Beck et al., 1988). The collected data were analyzed using repeated measures analysis of variance (ANOVA) in SPSS software. Results: The results showed that both methods of intervention were effective in reducing depressive symptoms and suicidal thoughts. However, the effect of God-oriented spiritual counseling was greater than the other intervention. The study findings showed that the interaction effect of group x time for symptoms of depression (r¡2 = 0.343; P < 0.001; F = 12.53) and suicidal thoughts (r¡2 = 0.148; P < 0.001; F = 4.16) were significant at the 0.01 level. Conclusion: In general, the present study showed that God-oriented spiritual counseling, compared to grief counseling, is more effective on the symptoms of depression and suicidal thoughts. [ABSTRACT FROM AUTHOR]

Copyright of Saúde e Sociedade is the property of Universidade de Sao Paulo, Faculdade de Saude Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Amputation is the surgical removal of all or part of a body part. It demands an adjustment in almost every sphere of a person's life in addition to physical disability. An amputee faces problems in almost every psychosocial sphere. 1 , 2 Along with physical pain in the stump, patients may experience phantom sensations. 3 – 5 Patients may also grieve, feel depressed, and anxious 3 , 6 , 4 , 7 or have posttraumatic stress disorder symptoms. 8 , 9 They may be apprehensive about their future plans and inconclusive regarding life challenges. Grief is one of the most common reactions to amputation, 10 , 1 , 7 but often gets neglected in intensive surgical units. 1 Many times, grief reactions are not resolved, turning into complicated grief or prolonged grief, leading to conditions like depression, anxiety, or even suicide. This article is about an attempt to help a patient initiate the grieving process for healthy outcomes. [ABSTRACT FROM AUTHOR]

This article presents a case study about a fictional client’s experience of complicated grief. This article differentiates between complicated grief and normal (adaptive) grief. It also distinguishes between bereavement, grief, and mourning. The counseling process is described using developmental theory and narrative reconstruction to illustrate how to implement creative techniques. [ABSTRACT FROM AUTHOR]

This study investigated how counselor educators ( n = 61) integrated grief content in accredited counselor education programs, characteristics of the course in which grief is taught, and professional background of faculty members. Most participants endorsed general content items (e.g., reactions to loss), grief theories (e.g., stages/phases of grief), and practice considerations (e.g., self-care). Additionally, results indicated grief-focused courses were mostly elective ( n = 23; 85.19%), facilitated face-to-face ( n = 18; 66.67%) and taught by counselor educators influenced by significant personal loss ( n = 18, 78.26%). Results demonstrated a lack of professional affiliation with grief-related organizations, professional development through certifications, or continuing education. Discussion of results, implications for the counseling profession, and areas for future research and practice are explored. [ABSTRACT FROM AUTHOR]

Introduction: Several factors can influence the journey of perinatal grief in mothers, including the quality of care during this experience. The objective of our study was to investigate the factors influencing the perception of grieving women during the perinatal period and identify the role of medical and paramedical healthcare professionals in psychological support. Objectives: To determine the factors influencing the perception of fetal loss in grieving mothers. Methods: This was a descriptive, longitudinal, retrospective study conducted between july 2021 and march 2022 at the Fetal Pathology Department of the Center for Maternity and Neonatology in Tunis, Tunisia. The study included women who experienced perinatal loss and underwent fetal pathology examination. The study was conducted in two stages: Initial consultation at the Fetal Pathology Department, five weeks after the date of expulsion, for perinatal grief counseling. Follow-up interview one year after the date of expulsion: The participants were contacted via telephone for an average duration of twenty minutes.The assessment of perinatal grief during both interviews was conducted using the shortened version of the Perinatal Grief Scale (PGS) Results: The mean age of the patients was 31.41 years (± 5.15). The average gravidity was 2.47 (± 1.43). More than half of the patients had no living children (n=41). The majority of patients had no notable pathological history. Six patients had been followed in psychiatry, and five had a history of subfertility. The majority of patients (n=61) reported having good marital relationships. Among the participants, 20% (n=14) had a high Perinatal Grief Scale (PGS) score (PGS >= 91) at five weeks post-loss and were subsequently referred for psychiatric consultation. At one year, all participants had a PGS score > 91, demonstrating the effectiveness of psychiatric management. Multivariate analysis identified four independent factors associated with a high PGS score at five weeks: absence of living children (OR=0.59; 95% CI [0.36-0.98]; p=0.04), quality of marital relationship (OR=1.2; 95% CI [1.1-3.9]; p=0.02), family support (OR=2.52; 95% CI [1.55-4.12]; p<0.001), and quality of loss disclosure (OR=2.52; 95% CI [1.32-3.77]; p=0.003). Conclusions: To identify patients at high risk of developing complicated grief and improve the quality of psychological care, it is necessary to implement appropriate protocols, provide training to healthcare personnel, and establish well-equipped healthcare facilities. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Background: Persons with serious mental illnesses (SMIs) are at increased risk for exposure to trauma and posttraumatic stress disorder (PTSD). Prolonged Grief Disorder (PGD) may also impact this population but has been seldom studied. Aims: The present study investigated the rate of both PTSD and PGD among clients receiving community mental health services, and the clinical correlates of co-occurring PTSD/PGD. Methods: Trauma history, PTSD and PGD were assessed among 536 individuals receiving community mental health services (Study 1). A subsample of 127 individuals from Study 1 who met DSM-5 criteria for PTSD based on diagnostic interview completed measures of psychiatric symptoms (Study 2). Results: In Study 1, 92.4% of participants receiving community mental health services had experienced a traumatic event, 49.6% met criteria for probable and provisional PTSD, 14.7% scored positive for probable PGD, and 11.9% met criteria for probable and provisional PTSD as well as probable PGD. In Study 2, participants meeting diagnostic DSM-5 criteria for PTSD and probable PGD had more self-reported PTSD symptoms, but did not differ on other outcomes. Conclusions: Findings highlight the need for trauma informed services including grief counseling for persons with SMI. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic caused considerable burden on mental health worldwide. To address this emergency in Peru, Socios en Salud (SES) implemented an innovative digital system for the diagnosis and psychological therapy in vulnerable populations. We describe the development, implementation, and participant outcomes of this intervention. Methods: We conducted an intervention in a general population of Lima, Peru using a digital tool, ChatBot-Juntos, incorporating the abbreviated Self-Reporting Questionnaire (SRQ) to screen psychological distress. Participants positive for psychological distress received remote Psychological First Aid (PFA) and grief therapy if needed. Participants with a mental health condition or safety concern were referred to mental health services. SRQ scores were collected 3 months after PFA sessions. Differences between screening and follow-up scores were compared using Wilcoxon sign-rank test. Results: In total, 2027 people were screened; 1581 (77.9%) screened positive for psychological distress. Nine hundred ninety-seven (63%) people with psychological distress received PFA, and 320 (32.1%) of those were also referred for mental health care. At 3 months after follow-up, SRQ scores were collected for 579 (58%) participants. Significant reduction in SRQ scores was observed 3 months after PFA [median SRQ score changed from 9 to 5 (p < 0.001)], and after PFA plus referral to mental health services [median SRQ score changed from 11 to 6 (p < 0.001)]. Conclusion: Digital technology can be used to screen for psychological distress and deliver mental health support for populations affected by the COVID-19 pandemic. More research is needed to determine whether technology contributes to improved mental health outcomes. [ABSTRACT FROM AUTHOR]

The present review descriptively introduced psychological interventions employed during divorce process to contribute to the development of effective mental health practices. As a life crisis, divorce might have negative impacts both on spouses and children. In recent years, the terms such as constructive and healthy divorce have also started to be underlined in the related literature. In fact, increasing divorce rates necessitate well-established post-divorce support programs. Hence, more information regarding psychological interventions during divorce process is needed to employ effective practices for affected families. Psychological post-divorce interventions usually aim to reduce the negative effects of the termination of the marriage and to support the family members in terms of functional coping skills. Such interventions might include the entire family, a subsystem (e.g., spouses, parents, siblings) or the affected individual alone. Psychological interventions during divorce process might also be delivered in the form of psychotherapy, mediation, or psychoeducational programs. In psychotherapy settings, cognitive-behavioral therapy, forgiveness therapy, and grief therapy can be employed depending on the nature and intensity of the problems. Accordingly, the principles, approaches, and stages of psychological interventions during divorce process were summarized in the current review. Particularly, lack of longitudinal and controlled studies in post-divorce interventions, inadequacy of training for conducting such programs, and contextual factors compromising the effectiveness were emphasized. The limitations of the current literature on psychological interventions during divorce process were also addressed and suggestions have been made for future research. [ABSTRACT FROM AUTHOR]

Bereavement is a deeply personal experience that is also shaped by one's socio-cultural context. This qualitative study explored the social support experiences and needs of spousally bereaved individuals in a South African township. The botho/ubuntu philosophical framework was used to interpret participants' experiences in this regard. Six ethnically diverse, bereaved spouses aged 55–67years, residing in a predominantly Setswana-speaking township in the North West Province of South Africa, were interviewed. Thematic analysis was used to analyze the data. An indigenous knowledge consultant was interviewed to situate participant experiences pertaining to mourning rites and traditions within the indigenous socio-historical and contemporary cultural context. The following themes were identified: (i) Sources of social support during bereavement; (ii) Inadequate social support after spousal death; (iii) The need for grief counseling; and (iv) Social restrictions and systematic isolation during the traditional mourning period: "It is as if you smell." Broadly, bereaved spouses drew on their support networks at various stages of their bereavement, which included family members, in-laws, friends, burial societies, their surrounding communities, and religious communities and figures. However, some experienced ostracization and stigmatization during the mourning period, which was invariably longer for the widows in this study, in line with conventions across Black South African cultures. Some participants reported withdrawal of support by their in-laws and harmful attitudes and assumptions rooted in patriarchal ideology by family members and in-laws. As pertaining to botho/ubuntu , the study also showed that communality or relationality entailed both positive and negative aspects, including support, co-operation, care, lack of support, stigmatization, and ostracization. Unlike conventional conceptualizations of botho/ubuntu , the study findings illustrate the human experience as comprising varying dimensions of relationality, ranging from harmony to disharmony. Findings regarding the negative aspects of communality are compatible with those relating to relational interdependence in African and East Asian settings. The findings also expand our understanding of the nature of disharmony alongside harmony in interdependent socio-cultural contexts. [ABSTRACT FROM AUTHOR]

In this paper, we present the grief as a natural response to the losses that people experience. We regard grief as an adaptive mechanism to the new situation that occurs with a loss. In our success-oriented consumerist society, grief has become a taboo: fighting pain in losses became a sign of weakness and failure. This is valid also for Christians, who consider faith as the measure of successful dealing with distress. We present the positive perceptive structures that may help the grief -- based on Anil Seth's theories. Later on, we speak about the toxic positivism, which harms the grieving person and the adequate expression of condolence, which may express our participation in his/her tormented situation. Destructive attitude consists in shaming, abandoning, or betraying the grieving person, whereas constructive attitude means acceptance, condolence, and support. This paper tries to provide a practical guideline to an empathic grief counselling. [ABSTRACT FROM AUTHOR]

Present-centered therapy (PCT) was originally developed as a strong comparator for the non-specific effects of psychotherapy in the treatment of posttraumatic stress disorder. PCT qualifies as a not strictly supportive treatment as it is structured and homework is assigned between sessions. It does not focus on cognitive restructuring or exposure. A growing body of literature supports its beneficial effects. For example, it demonstrated only slightly inferior effect sizes and lower dropout rates compared to that of trauma-focused cognitive behavioral therapy in several trials with patients suffering from posttraumatic stress disorder. The current study is the first to evaluate the feasibility and the treatment effects of PCT in adults with prolonged grief disorder (PGD). Meta-analyses on psychotherapy for PGD have yielded moderate effect sizes. N = 20 individuals suffering from PGD were treated with PCT by novice therapists as part of a preparation phase for an upcoming RCT in an outpatient setting. Treatment consisted of 20–24 sessions á 50 min. All outcomes were assessed before treatment, at post-treatment, and at the 3-month follow-up. The primary outcome, PGD symptom severity, was assessed using the Interview for Prolonged Grief-13. Secondary outcomes were self-reported PGD severity, depression, general psychological distress, and somatic symptom severity. Furthermore, therapists evaluated their experiences with their first PCT patient and the treatment manual. In intent-to-treat analyses of all patients we found a significant decrease in interview-based PGD symptom severity at post-treatment (d = 1.26). Decreases were maintained up to the 3-month follow-up assessment (d = 1.25). There were also significant decreases in self-reported PGD symptoms, depression, and general psychological distress. No changes were observed for somatic symptoms. The completion rate was 85%. Therapists deemed PCT to be a learnable treatment program that can be adapted to the patient's individual needs. The preliminary results of PCT as a treatment for PGD demonstrate large effects and indicate good feasibility in outpatient settings. The treatment effects were larger than those reported in meta-analyses. Thus, PCT is a promising treatment for PGD. Possible future research directions are discussed. [ABSTRACT FROM AUTHOR]

The author has been a grief therapist in private practice for almost 40 years. The largest percentage of his clients have been suicide loss survivors, and in this article, the author reflects on the “lessons learned” about how grief therapy with survivors is both the same as, and very different from, work with clients bereaved after other types of losses. After briefly reviewing some of the empirical literature about differences between suicide bereavement and grief after other modes of death, the author argues that perhaps the most distinguishing and difficult aspect of a suicide loss is the “perceived intentionality” of the death, and the related “perceived responsibility” for the death. The author goes on to identify a number of tasks of psychological reintegration after a suicide loss that can serve as a template for treatment goals for clinicians and clients alike. These include the cultivation of a very specific type of secure and nurturing therapeutic alliance; extensive psychoeducation about suicide, trauma, and grief; the need to help the client repair the psychological continuing bond with the deceased; and providing gentle support for the survivor in rebuilding an assumptive world that has been shattered by the suicide of a loved one. Finally, the article concludes with a discussion of the clinical implications of these differences for work with suicide loss survivors.

The aim of this article of to analyze ritual in evidence-informed treatments for prolonged and traumatic grief. A scoping review is conducted in order to give an overview of existing literature on ritual and symbolic interventions in grief therapies for prolonged grief and the type of evidence supporting these interventions. The 22 studies reported in this review reveal a variety of ritual elements ranging from symbolic expression and interaction, writing assignments, dialogue with the deceased or an imaginary person, to farewell ceremonies at the end of the treatment. The interventions are studied within different populations (e.g., bereaved spouses, perinatal loss, grief after violent death, and genocide). Almost all studies show significant effects of the grief treatment, trauma and related symptoms. However, the effects are mostly measured for the entire treatment and not separately for the ritual intervention. In the discussion we focus on the role of ritual and culture in prolonged grief treatment. [ABSTRACT FROM AUTHOR]