Encountering Grief in PT Practice Flashcards
Role of Health Care Providers
“Clinicians should recognize the boundaries of their own professional competency and personal tolerance for the care of bereaved individuals.
By helping to mobilize the bereaved person’s support network of family, friends, and community and by being knowledgeable about mental health resources available to assist those whose grief is extreme, health professionals may responsibly limit their own involvement.”
Grief/Mourning
Suffering
Emotional, physiological, cognitive, behavioral, social response to loss
Inward reaction/Outward expression of loss
Multifaceted process, adaptation to loss
Four Primary Types of Loss
Loss of a significant loved/valued person
Loss of sense/perception/view of the self/body, loss of mental/physical health
Loss of money, treasures, home, homeland
Loss that occurs in the process of human growth, development, aging; for example, high-intensity sports such as gymnastics; loss of mobility independence
Grief-related emotions may be very intense and disorienting
§ Anger
§ Guilt
§ Regret
§ Sadness
§ Despair
§ Denial
§ Depression § Fear
§ Disappointment § Anxiety
Physical & Cognitive signs
§ Fatigue
§ Emptiness
§ Lump in the throat § Anorexia
§ Insomnia
§ Confusion
§ Physiological
Models of Grieving “Grief work”
Kubler-Ross
Integrative Theory of Bereavement
Tasks of Mourning
Kubler-Ross Model
5 stages: denial, anger, bargaining, depression, acceptance
Integrative Theory of Bereavement Model
5 phases: shock, awareness of loss, conservation and withdrawal, healing, renewal
Tasks of Mourning Model
A process that involves mastering 4 tasks:
> accept the reality of loss
experience associated pain of grief
adjustment to new circumstances
emotionally relocate the deceased/move on (forward) with life
complicated grief:
unusually severe and prolonged
symptoms:
> intense yearning, longing, emotional pain
> frequent preoccupying thoughts
> feeling of disbelief
> inability to accept the lostt
> difficulty imagining a meaningful future w/o deceased person
Potential Impact of CG on Health
Severe sleep disturbance
Substance abuse
May activate parts of the brain (e.g. nucleus accumbens) associated with reward, creating an addiction-like response
Heightened risk for CV disease [e.g. MI, Takotsubo (stress) cardiomyopathy]
Increased risk for cancer
Suicidal ideation
Constructive Coping Strategies
appraisal-focused
problem/solution-focused
emotion-focused
May employ more than one simultaneously or at various times; can be adaptive or maladaptive; subconscious defense mechanisms may manifest as a manner of self-protection
Appraisal-focused:
seeking out meaning in a difficult, negative, threatening situation; modify thought processes
Problem/solution-focused:
highlights practical aspects of the challenging situation to solve or alter aspects that appear controllable; fact-gathering; action oriented
Emotion-focused:
emotion-regulation to reduce distress and feelings of being overwhelmed; active processing and expression of emotions; use of humor; journaling, visualization, meditation
