TREATMENT of INDIVIDUALS WITH PROLONGED and COMPLICATED GRIEF AND TRAUMATIC BEREAVEMENT Donald Meichenbaum, Ph.D. Distinguished Professor Emeritus, University of Waterloo Waterloo, Ontario, Canada and Research Director of The Melissa Institute for Violence Prevention, Miami, Florida www.melissainstitute.org www.roadmaptoresilience.org Contact Information Mailing Address
[email protected] 150 Belleview Blvd. Apt. 703 Belleair, FL 33756 Meichenbaum 2 TABLE OF CONTENTS PAGE 3 Complicated Grief versus Traumatic Bereavement 4 Incidence of Complicated Grief 6 The Nature of Prolonged and Complicated Grief Reactions: Use of a CLOCK Metaphor 11 Assessment Procedures 1. Guided Interview and “Art of Questioning” 2. Self-report Measures 3. Self-monitoring procedures 4. Risk Assessment: Past and Present (Suicidality) 5. Coping with Grief Checklist 23 Appendix XX.1 Strategies for Coping with Grief Checklist Need for Ecological Assessment: Other Losses 29 Evidence-based Principles and Practices for Clients with PCG and Traumatic Bereavement 31 Treatment Guidelines and Outcome Studies 34 Core Tasks and Processes of Grieving 35 Implications for Psychotherapy 37 Examples of the Core Tasks of Psychotherapy 1. Establish, Maintain and Monitoring the Psychotherapeutic Alliance 2. Conducting Psychoeducation: Examples 3. Restorative Retelling Procedures 4. Exposure-based and Supplemental Interventions 5. Addressing Bereavement Specific Issues 6. Self-attributional Training or Helping Clients “Take Credit” for Changes 50 References 59 Internet Websites Meichenbaum 3 COMPLICATED GRIEF versus TRAUMATIC BEREAVEMENT There is value in drawing a distinction between individuals who experience Prolonged and Complicated Grief versus Traumatic Bereavement in response to the loss of a loved one or for someone for whom an individual has a strong attachment relationship.