Complicated grief in the South African context : a therapeutic intervention programme
Drenth, Cornelia Maria
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Complicated Grief is a relatively new concept that is globally debated by psychiatrists and psychologists. The time has come for social workers to join this debate and to develop and implement programmes to address the consequences following complicated grief, specifically which results in impaired social functioning. Complicated Grief, prolonged grief and traumatic grief are all synonyms. The term 'complicated grief is the preferred concept used in this research. Article 1 is a literature overview on factors leading to complicated grief and at the same time attempts to link these factors to the South African circumstances. South African citizens are not exempted from experiencing complicated grief. Cultural beliefs on death and dying, AIDS and cancer-related deaths, crime and sociopolitical deaths are but some of the risk factors. She furthermore highlights complicated grief as a matter to be assessed by social workers. The normality of grief is questioned when the grief experience prohibits the individual to regain a state of social functioning as close as possible to the pre-loss state. Complicated grief is regarded by many researchers as a specific condition in need of specific intervention. The efficacy of bereavement intervention in the case of normal grief is questioned, and it seems that individuals who experience complicated grief benefit more from bereavement intervention. Article 2 attempts to clarify the necessity to screen clients prior to including them in a complicated grief intervention programme by discussing the Inventory of Traumatic Grief as developed by Prigerson and colleagues. The researcher furthermore introduces the Grief Assessment Guide (GASsG) as an assessment tool during the screening process. In article 3 the researchers tabulate some of the most important models/approaches to bereavement and discuss its applicability to Complicated Grief. Specific attention is given to the Dual Process Model (Stroebe & Schut, 1999) and the task-centred approach (a social work approach to therapy) in an attempt to develop a model for Complicated Grief Intervention. This article furthermore proposes the Complicated Grief Intervention Model (CGIM) through the integration of the dual process model and the task-centred approach, while drawing on intervention techniques from other therapeutic approaches. Article 4 explains the implementation of the Complicated Grief Intervention Programme (CGIP) with the CGIM as framework for intervention. The researchers briefly discuss some of the intervention techniques, such as desensitization, visualization, client-log, miracle question, metaphors, rituals and humour. These techniques assist the social worker and the client towards achieving the goal. The CGIP is a time-limited interventions programme. It consists of, and is based on, the three steps of the CGIM: assessment, implementation and evaluation/termination. Although the CGIP has not been scientifically tested, it holds the potential to serve as a guided programme for social workers in the field of grief and bereavement. Article 5 is a discussion of the empirical findings of the research. This article describes the implementation of the proposed CGIP in the South African context. This article furthermore aims at evaluating the feasibility of implementing the CGIP rather than testing the effectiveness of the programme. Section C summarizes and evaluates the research and makes recommendations regarding its value and the value of possible future research on complicated grief in the South African context.
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