Grief Psychology Exam 4

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Grief Psychology Exam 4
2013-04-28 17:27:54
complicated children death

Grief Psychology Exam 4
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  1. Define Chronic Grief
    is a grief reaction that is prolonged, excessive in duration, and never comes to a satisfactory conclusion
  2. Define Delayed Grief
    • (a.k.a. inhibited, suppressed or postponed grief)
    • a reaction that does not occur in a normal timeframe but occurs at a later time.
  3. Define Masked Grief
    occurs when a person experiences symptoms and behavior which causes them difficulty but they do not recognize the fact that these are related to the loss
  4. Define Exaggerated Grief
    occurs when the reactions to the loss are excessive and disabling.
  5. Define Disenfranchised Grief
    (Kenneth Doka)
    a loss that society believes does not deserve mourning. The loss is not openly acknowledge, socially sanctioned, or publicly shared.
  6. what are the types of death that lead to disenfranchised grief?
    • a)  Socially unrecognized relationships
    •   i)   Homosexual relationships
    •   ii)  Extramarital affairs
    •   iii)  Cohabitation

    • b)Not a genuine loss
    •   i)   Abortion / miscarriage
    •   ii)  Pets
    •   iii) Former Spouse

    • c)Grievers are unrecognized
    •   i)  Friends, schoolmate, co-  worker
    •   ii)  Those mentally disabled

    • d)  Death is socially unacceptable
    •   i)  Suicide
    •   ii) AIDS
    •   iii) Erotic asphyxia
    •   iv) Legal execution
  7. what type are deaths are considered "socially unacceptable"?
    • i)  Suicide
    • ii) AIDS
    • iii) Erotic asphyxia
    • iv) Legal execution
  8. Be able to identify symptoms of complicated grief'
    • a.  Main Symptoms (Provided by the American Cancer Society)
    • 1)  Difficulty speaking of the deceased without experiencing renewed and intense grief.
    • 2)  They constantly bring up themes of death and loss in even the most casual conversations.
    • 3) Ongoing sleep issues (too much or too little) that last for more than 6 weeks
    • 4)  Sudden and radical lifestyle changes
    • 5)  Exhibit self-destructive behavior (promiscuity, excessive drinking, or substance abuse)
    • 6) Develop some of the same symptoms of the deceased (psychosomatic issues).
    • 7)  Continued disbelief in the death of the loved one.
    • 8)Inability to accept the death
    • 9)Persistent flashbacks, nightmares, intrusive memories.
    • 10)  Magnified and prolonged grief symptoms; anger, sadness or depression
    • 11)Maintenance of a fantasy relationship with the deceased with feelings that he/she is always present and watching
    • 12)  Continuous yearning and searching for the deceased
    • 13)  Unusual symptoms that seem unrelated to the death (physical, or strange and abnormal behavior).
    • 14)  Breaking off all ties to social contacts

    • b. Other Symptoms:
    • 1)  Avoid anyone or anything associated with the deceased including friends, family, and previously shared activities.
    • 2)  Minor events trigger an intense grief reaction.
    • 3)  They exhibit consistent symptoms of depression, guilt, hopelessness and lowered self-esteem.
    • 4)  Ability to manage everyday responsibilities are significantly impaired.
  9. Know how children behave to death
        Birth – 2 Years of Age
           0-6 Months
    infants show only a non-specific distress reaction to the absence of their mother.
  10. Know how children behave to death
        Birth – 2 Years of Age
           6 Months to 2 Years
    1)  6 months to 2 years infants begin to experience normal grief reactions in response to the absence of their mother.

    2)  Continued separation will cause the child to manifest despair, sadness and detachment unless a constant caring person takes over.
  11. Know how children behave to death
        Birth – 2 Years of Age
           Ages 2-5 (Pre-Schoolers)
    • a.  Do not understand the permanence of death
    • (since they have little understanding of time.)
    • b.  The child is aware that someone is missing due to the change of routine.
    • c.  May worry about the well-being of the deceased (food, clothing, toys)
    • d.  Unable to comprehend things outside their own experience.
    • e.  Normal responses
    •   1)  Continually asking if the deceased will be at school, church or other activity (The reassurance of the same answer over and over is comforting to the child)
    •   2) Discussing the death with strangers (supermarket, playground).
    •   3) Guilt, feeling responsible for the death
    •   4)  Withdrawal or aggression
  12. Know how children behave to death
        Birth – 2 Years of Age
           Ages 6-9 (Latency-Age Children)
    • a.  More complex understanding of death and dying.
    • b.  Realize that death is irreversible and universal (except to them).
    • c.  Reactions
    •   1) Death personified as monsters, ghost, creatures which they can hide from or run away.
    •   2)  “Magical Thinking” stage in which a child may “wish” someone dead, and upon death, there will be guilt.
    •   3)  Lack of vocabulary will cause a child to express how he feels. Crying, withdrawal, frightening dreams, aggressiveness, and misbehavior are not uncommon.
    •   (Boys will often exhibit aggressive responses in play).
    •   4)  These children need “permission” to grieve.
  13. Know how children behave to death
        Birth – 2 Years of Age
           Ages 9-12 Pre-Adolescence
    • a.  This age group has the cognitive understanding to comprehend death as a final event.
    •   b.  Excepting of a mature, realistic explanation of death as final and inevitable.
    •   c.  Reactions
    •      1)  Due to their short attention spans it is not unusual for a child to cry and then resume play as though nothing has happened.
    • (Adults need to be aware that this “switch” in behavior does not mean the child is not upset)
    •      2) If not discussed, there may be behavioral problems
    •      3) School disturbances, lack of concentration and a drop in grades is their cry for help.
    •          a)  ”Children at this age must be encouraged over and over again to talk about the loss and express their deep inner feelings in order to allow mourning to result in a positive outcome.”
    •          b)  There is also an interest and curiosity about the physical and metaphysical aspects of death.
    •      4) This age group may identify with the deceased and imitate his mannerisms. (Boys will be more aggressive in how they act out their feelings).
  14. Know how children behave to death
        Birth – 2 Years of Age
           Ages 13-18 (Adolescence)
    • a.  Have an adult meaning of understanding and realize that death happens to everyone.
    • b.  “Losses such as death affect the total life of the high school student involved, their work at school, their part-time jobs, their leisure activities, their relationship with friends and family and their concepts about themselves.”
    • c.  The “death experience” adds to the anxieties and confusion of normal puberty and intensifies their grief.  Adds to feelings of unattractiveness, insecurity, not belonging, not being in control of self and surroundings.
  15. Know how children behave to death
        Birth – 2 Years of Age
           Ages 13-18 (Adolescence)
                12-14 Early Teen
    • a)  Searching for the answer to the question “Am I OK”
    • b)  In acting as though they are “being watched” and “judged” they may have a more difficult time expressing grief.
    • c)  They may also be confused if others do not grieve or act in the same manner as they do.
  16. Know how children behave to death
        Birth – 2 Years of Age
           Ages 13-18 (Adolescence)
                14-16 Middle Teen
    • a)  Belief that they are indestructible and cannot be harmed.
    • b)  Express grief by risk taking.
  17. Know how children behave to death
        Birth – 2 Years of Age
           Ages 13-18 (Adolescence)
                16-19 Late Teen Years
    • a)  Teens are searching for meaningful relationships. 
    • b)  Able to understand complex relationships and more interested in the other points of view.
    • c)  Grieve as adults do.
  18. Know what to say to children regarding death
    • a.  Find out what they already believe about death.
    •   1) Holding and touching is good during this talk.
    •   2) If you do not know the answer, do not make things up.
    • b.  It is acceptable for you to feel sad and cry
    • in front of children
    •   1) Everyone responds to death differently
    •   2)  Be honest with children (they are more resilient than we think)
    •   3)  Use simple, clear language that a child can understand
    • c.  Be aware of confusing stories or euphemisms.
    •   1)  “The deceased went on a long trip”, child will anticipate return. (Although children may still long for the return of the individual)
    •   2)  “The deceased is asleep”, child may develop fear regarding sleep
    •   3) “They died because they were sick”, child may equate illness and going to the hospital with dying. Illness and death are separate issues. Assist the child’s understanding.
    •   4)  Reassure them that they were not responsible for the death of the individual.
  19. when does Grollman suggest children should begin attending funerals?
    age of 7 go attend funerals
  20. How may children participate in the selection process?
    • a)  Attending or not attending the service
    • b)  Selecting the casket
    • c) Deciding on whether or not to view the body
    • d) Choosing special objects to put in the casket
    • e) Choosing which clothes the deceased will wear
    • f)  Choosing the grave marker and what will be written on it
    • g)  Picking out the urn for cremated remains
    • h)  Choosing the location to spread the ashes
    • i)  Selecting the burial site
    • j)  Selecting flowers, music, and readings for the service
    • k)  Participating in the service
    • l)  Closing the casket for the last time or being involved in this process
  21. What should be explained to a child who wishes to attend the visitation or funeral?
    • a) Explain what will occur at the visitation and funeral. (Unfamiliar situations or surprises can complicate the grieving process).
    • b) “Tell it like it is”
    •     1)  Who will be at the funeral or memorial service?
    •     2)  Where will the service take place?
    •     3)  When will the funeral happen?
    •     4)  What is going to happen?
    •     5)  Why are we doing this?
  22. Know Worden's 3 issues regarding death in the immediate family
    1.  Who the person (deceased) was.  “The functional position or role the deceased played in the family can affect grief in family members. To the extent that the deceased had a significant funeral position, his death is going to create a corresponding disturbance of functional equilibrium.”

    2.  Historical Antecedents – How did the survivor grieve previous losses?  “An emotionally well integrated family may show minimal grief reaction at the time of death, but members may respond later with various physical or emotional symptoms or some type of social misbehavior.”

    3.  Personality variables – “The value families place on emotions and the kinds of communication patterns that give a person permission to express feelings or not express feelings can affect mourning.  Families that conspire to feelings of suppression may ultimately keep the individual from an adequate resolution of grief”
  23. those appropriate and helpful acts of counseling that come after the funeral.
    Aftercare (post-funeral counseling)
  24. the state of estrangement an individual feels in social settings that are viewed as foreign, unpredictable or unacceptable.
  25. occurs when the individual is overly integrated into society, and has an exaggerated concern for it.
    Altruistic Suicide
  26. Results from a lack of regulation of the
    individual or during time of adverse conditions when traditional group standards no longer apply.
    Anomic suicide
  27. syndrome characterized by the presence of
    grief in anticipation of death or loss; the actual death comes as a confirmation of knowledge of a life-limiting condition.
    Anticipatory grief
  28. a death has occurred and the funeral director is advising the family from the time the death occurs until the final disposition including selection of the services and merchandise during the arrangements conference.
    At-need counseling
  29. grief extending over a long period of time without resolution.
    Complicated grief (abnormal, unresolved)
  30. the act or event of separation or loss that results in the experience of grief.
  31. a phrase coined by Carl Rogers to refer to that type of counseling where one comes actively and voluntarily to gain help on a problem, but without any notion of surrendering his own responsibility for the situation; a non-directive method of counseling which stresses the inherent worth of the client and the natural capacity for growth and health.
    Client centered (person centered) counseling
  32. advice, especially that given as a result of consultation.
    Counseling (Webster)
  33. any time someone helps someone else with a problem.
    Counseling (Jackson)
  34. good communication within and between men; or, good (free) communication within or between men is always therapeutic.
    Counseling (Rogers)
  35. a therapeutic experience for reasonable health persons. Do no confuse this with psychotherapy which is treatment for emotionally disturbed persons, who seek, or are referred for assistance with pathological problems. A counselor’s clients are encouraged to seek assistance before they develop serious neurotic, psychotic, or characterological disorders.
    Counseling (Ohlsen)
  36. a general term for the exchange of  information, feelings, thoughts and acts between two or more people, including both verbal and non-verbal aspects of this interchange.
  37. according to client-centered counseling, the necessary quality of a counselor being in touch with reality and other’s perception of oneself.
  38. inhibited, suppressed or postponed  response to a loss. A reaction that does not occur in a normal time frame but occurs at a later time.
    Delayed grief (Inhibited, Suppressed or Postponed) (Worden)
  39. the defense mechanism by which a person is unable or refuses to see things as they are because such facts are threatening to the self.
  40. counselor takes a live speaking role, asking questions, suggesting courses of action, etc.
    Directive counseling
  41. describes a loss that society believes does not deserve mourning. The loss is not openly acknowledged, socially sanctioned, or publicly shared.
    Disenfranchised Grief (Kenneth Doka)
  42. an occurrence of a severety and magnitude that normally results in death, injuries, property damage, and cannot be managed through the routine procedures and resources of the government.
  43. a factor in disasters linked to violent causes of death.
  44. A factor in disasters linked to exposure to victims of life threatening situations.
  45. Occurs when the individual fails to become totally integrated into society or family life.
    Egoistic Suicide
  46. latin word meaning "to move or stir up"
  47. an act or practice of allowing the death of persons suffering from a life-limiting condition.
    Euthanasia (right to die)
  48. persons are usually conscious of the relationship of the reaction to the death, but the reaction to the current experience is excessive and disabling.
    Exaggerated grief (Worden)
  49. to assist understanding of the circumstances or situations the individual is experiencing, and to assist that person in the selection of an alternative adjustment if necessary.
  50. One may receive too much control by society and feel oppressed under extremely strict rules.
    Fatal Suicide
  51. an emotion or set of emotions due to loss
  52. helping people facilitate uncomplicated grief to a healthy completion of the tasks of grieving within a reasonable time frame.
    Grief counseling
  53. a set of symptoms associated with loss.
    Grief syndrome (Lindermann)
  54. blame directed toward one’s self based on real or unreal conditions.
  55. historically an inn for travelers, especially one kept by a religious order; also used to indicate a concept designed to treat patients with a life-limiting condition.
  56. counseling in which a counselor shares a body of special information with a counselee.
    Informational counseling
  57. intervention intended to kill a person who is incapable of making a request to die; an infant or a young child, or a mentally incompetent patient. One unable to voice their opinion.
    Involuntary active euthanasia
  58. a document which governs the withholding
    or withdrawal of life-sustaining treatment from an individual in the event of an incurable or irreversible condition that will cause death with in a relatively short time, and which such person is no longer able to make decisions regarding his/her medical treatment.
    Living will
  59. occur when persons experience symptoms and behaviors which cause them difficulty but they do not see or recognize the fact that these are related to the loss.
    Masked grief (Worden)
  60. is the forgoing or withdrawal of medical treatment that offers no hope or benefit to the total well-being of the patient with the intent of causing death.
    Passive Euthanasia
  61. a deliberate attempt to change attitudes or beliefs with information and arguments.
  62. the scientific study of behavior and mental processes.
  63. when a physician provides medications or other means for a patient to use on himself to end life. The physician does not control the act, the patient does.
    Physician-assisted suicide
  64. a relation of harmony, conformity, accord or affinity established in any human interaction.
  65. returning to more familiar and often more primitive modes of coping.
  66. the assumption of blame directed toward one’s self by others.
  67. the sudden and unexpected death of an apparently healthy infant, which remains unexplained after a complete autopsy and a review of the circumstances around the death.
    Sudden infant death syndrome (S.I.D.S. or crib death)
  68. redirection of emotion to culturally or socially useful purposes.
  69. the study of death.
  70. The individual who make a fully voluntary and persistent request for aid in dying
    Voluntary active euthanasia – Mercy Killing