Healthcare Training Institute - Quality Education since 1979
CE for Psychologist, Social Worker, Counselor, & MFT!!
Theories of Grief
The many descriptive stage/phase theories of grief that have emerged in the literature (e.g., Kavanaugh, 1972; Miles, 1984; Sanders, 1999), including those with up to 10 discrete elements (Westberg, 1971), are potential therapeutic tools in normalizing the experience of bereaved individuals. However, mental health counselors must be cautious when applying such theories to clinical work. The ease with which these theories can be consumed has often led to literalism in application (Payne, Jarrett, Wiles, & Field, 2002; Worden, 2002). Such literalism, rather than preventing complications in the experience of grief, can and often does produce such complications. When misapplied, these descriptive theories of grief responses can serve to foster a should or must (e.g., Ellis' 2000 REBT) mentality for bereaved individuals such that their concerns about grieving correctly actually become a Stressor in and of themselves. Both Kübler-Ross (1969) and Parkes (2001) stated that their identified patterns were descriptive and only rough guides. In general, (a) there is no reason to believe that there are a discreet number of responses to the state of bereavement, (b) even if there were, there is no evidence to suggest that these responses would proceed in a linear fashion, and (c) such descriptive approaches were / are not intended to serve as prescriptions for the right or correct manner in which to die or experience grief (Corr, 1993).
Although there is valuable information to be gleaned from the observed patterns in grief responses, these patterns should not obscure the remarkable uniqueness of the experience of grief (e.g., Aiken, 2001; DeSpelder & Strickland, 2002; Fleming & Robinson, 2001; Silverman, 2000). Factors contributing to the idiosyncratic reactions to bereavement include personality traits, cultural background, and developmental level of the bereaved as well as the nature of the relationship with the deceased, mode of death, availability of social support, and previous and concurrent Stressors (DeSpelder & Strickland; Corr et al., 2000; Worden, 2002). Because of its emphasis on the individual's phenomenological experience, a person-centered framework has often been suggested as appropriate with bereaved clients (Barbato & Irwin, 1992; McLaren, 1998). However, criticisms of Rogers' (1980) work have been similar to those offered in connection with a clinical emphasis solely on grief expression, without an accompanying focus on mourning and coping. More specifically, the person-centered approach has been criticized for the contention that the therapeutic conditions are both necessary and sufficient for encouraging awareness and, therefore, growth (Corey, 2001). In fact, Gilliland and James (1998) argued that the perception of the lack of technique to move clients beyond the expression and acceptance of negative emotions is a common criticism of Rogers' approach. In quite parallel fashion, Rando (1993) has suggested that the expression of grief (i.e., the involuntary and passive reaction to bereavement) is not sufficient "to come to successful accommodation of a loss" (p. 219). Encouraging a client to articulate his or her grief reactions might be beneficial, but is likely not enough to facilitate movement and coping. Rather, assisting the bereaved in their expressions of grief is just the beginning of the journey, and clinicians are charged with the more complex enterprise of guiding clients through the active process of mourning.
Grief and Mourning
Theories of Mourning - Connections with Counseling
Stage / Phase Approaches to Mourning
Stage / Phase approaches to mourning and person-centered counseling. As noted earlier, a person-centered approach to counseling can, through its focus on the uniqueness of the human experience, balance the dangers of literalism in stage / phase type theories. Rogers (1980) consistently emphasized the phenomenological perspective of each client (Hazier, 2003) and the formative actualizing tendency of each organism to move toward the realization of his or her full potential (Raskin & Rogers, 2000). Difficulties arise for individuals when obstacles, including conditions of worth (e.g., prescriptions for how one must mourn), are placed in the paths of developing individuals. Such conditions lead to an external locus of evaluation in which clients are overly concerned with how others view them; as a result, a disparity emerges between clients' perceived self-concept and their genuine experience. Bereaved individuals who are exposed to rigid, "almost dogmatic" (Hagman, 2001, p. 18), conditions of worth regarding how the mourning process must look may lose touch with their true individual experience. On the other hand, person-centered counseling can provide a critical opportunity for bereaved individuals to regain a subjective sense of their personal responses and actions related to death loss events. Although theories of grief and mourning can be used to inform the person-centered mental health counselor's work, his or her primary role is to provide the therapeutic conditions of empathy, unconditional positive regard, and congruence (Raskin & Rogers). Clients can then view the conditions of worth imposed by society (e.g., dictates of how to mourn) more realistically, accept their own responses, and follow their own subjective valuing process, which leads to positive growth. Therefore, the person-centered approach is particularly useful in increasing bereaved individuals' insight and awareness into their grief and mourning experience (Barbato & Irwin, 1992). Nonetheless, mental health counselors using a Rogerian approach should be encouraged to direct their therapeutic attention beyond a sole focus on grief expression to incorporate aspects of the mourning theories. Person-centered mental health practitioners serve their clients best, however, when they remain vigilant to the phenomenological core of their theoretical approach.
- Servaty-Seib, Heather, Connections Between Counseling Theories
and Current Theories of Grief and Mourning, Journal of Mental Health
Counseling, Apr. 2004, Vol. 26, Issue 2.
Reflection Exercise #4
Booklet for this course