Running Head: Counseling for Grieving families of Violence. Counseling for Grieving Families of Violence. Andrea Simmons. Tulane School of Social Work

Transcription

1 Grief 1 Running Head: Counseling for Grieving families of Violence Counseling for Grieving Families of Violence Andrea Simmons Tulane School of Social Work SOWK 745 Professor Jamey Boudreaux April 23, 2010

2 Grief 2 Counseling for Grieving Families of Violence Grief is a normal family ordeal that occurs within the family unit after the loss of a close love one. According to research, individuals use coping mechanisms that are either internal or external as a means to deal with their loss. In some instances, the sudden death of a love one or close friend can have a profound impact on the mental, emotional, and psychological capacity of the person who is left to deal with the loss. Researcher Theresa Rando explained that there are six stages of the grieving process that include, recognition, reaction, relinquish, readjust, reinvent and recollection of the loss. In grief recognition allows the individual to understand their loss, react to the loss, relinquish the loss allows the individual to put the loss behind them, and recollection allows the individual to review memories of the loss. Psychiatrist Elisabeth Kubler- Ross introduced the five stages of grief which include: Any diagnosis of a major illness could put the individual in a state of denial. The individual starts asking questions like, "Why me?" as the result of frustration stemming from the experience of loss. The bargaining stage involves negotiations with a higher power or justifying the need for more time, to fulfill a desire or witness an event. Depression sets in when there is the first sign of belief that death might be

3 Grief 3 inevitable. The individual may start grieving and may begin to alienate himself from loved ones. Acceptance - The individual experiences some peace at this stage, and understanding that he has done everything possible and it might be in his best interest to prepare for the inevitable. Grief can be a painful emotional adjustment which necessarily takes time and cannot be timed. Although each person s grief experience will be unique and each person grieves in different ways, there are common behavioral emotional and physical signs and symptoms that people who are grieving typically experience. Physically, a person that is grieving may experience fatigue and exhaustion, temporary loss of hearing and vision impairment, difficulty sleeping, change in appetite and muscle tremors and other physical malfunctions. Mentally people affected by grief sometimes become confused, intrusion unwanted thoughts, nightmares and dissociation feelings of detachment. Emotionally grief can cause one to experience shock, fear, anxiety, anger, loneliness, guilt fatigue, sadness and depression. There are different types of treatments that can help someone that is dealing with grief. Assessments are done by a physician, and referrals are made in some cases. The grief process can be considered to be a mild form of traumatic stress injury. Acute stress disorder and Post-Traumatic Stress

4 Grief 4 Disorder are two serious psychiatric disorders that occur in the wake of Traumatic stress experience. These disorders may occur after exposure to serious abuse, violent death and other lifethreatening experiences, and can be disabling. Some grief experiences can be more traumatic and can become difficult to resolve. The term pathological Grief is the normal grief process that is considered to be a mild form of traumatic injury. Pathological Grief sometimes applies to people who are unable to work through their grief, despite the passage of time. This type of grief reaction may be diagnosed after a longtime after time has passed and the grieving person is not improving. By labeling someone s grief as pathological, a doctor is indicating that the grieving process resolution is delayed for some reason and that professional help is needed (Dombeck, M. Ph,D. 2006) There are many types of treatments for stress related problems and PTSD treatment. Prolonged Exposure (PE) Therapy for Posttraumatic Stress Disorders, after a traumatic event, many individuals experience distress and symptoms of posttraumatic stress disorder (PTSD). Treatment for PTSD and distress may be highest when dealing with memories, thoughts, feelings, and situations that are related to the trauma. Exposure therapy is a type of therapy that helps you decrease distress about your trauma. This therapy works by helping you approach trauma-related thoughts, feelings, and situations that

5 Grief 5 you have been avoiding due to the distress they cause. Repeated exposure to these thoughts, feelings, and situations helps reduce the power they have to cause distress. Prolonged Exposure (PE) is one exposure therapy that works for many people who have experienced trauma (Department of Veterans Affairs 2010). Cognitive-Processing Therapy (CPT) was developed by Resick and Schnicke to specifically treat PTSD among people who have experienced a sexual assault. CPT lasts 12 sessions. CPT can be viewed as a combination of cognitive therapy and exposure therapy. CPT is like cognitive therapy in that it is based in the idea that PTSD symptoms stem from a conflict between pretrauma beliefs about the self and world and post-trauma information (Schulz, P. LCSW, 1999 et al). The many therapeutic approaches offered to PTSD patients are presented in Foa, Keane, and Friedman's comprehensive book on treatment. The most successful interventions are cognitivebehavioral therapy (CBT) and medication. Excellent results have been obtained with some CBT combinations of exposure therapy and cognitive restructuring, especially with female victims of childhood or adult sexual trauma. Sertraline (Zoloft) and paroxetine (Paxil) are selective serotonin reuptake inhibitors (SSRI) that are the first medications to have received FDA approval as indicated treatments for PTSD (Foa,E.B,Keane et al ).

6 Grief 6 According to Sandra L. Brown victims need various types of counseling services to help them through their recovery period. Some of these types of services may be sought out as outside referrals. Individual Counseling or Private counseling allows the client to personally deal with issues related to the trauma. This can be to process the events of the traumatic experience, for symptom reduction, to treat other comorbid condition that are affecting the victim, to work an aspect of the grief process, to strengthen cooping resources, to address relationships impacted by the victimization, to examine the victim s altered worldview of themselves, to address safety issues, or any other issue that the victim needs to work on related to the trauma or their functioning level. Family Therapy, the victim is often in need of support and assistance from their families. However, the victim s family may be having their own reactions to the victim s trauma. Helping families support one another through the recovery may be paramount in giving the victim the personal support they need from within the family structure. Group Therapy or Peer Support may be in tensely helpful to the victim when their ready. The support of other victims who have gone through the same situation has experience is exceptionally beneficial, as is the reduction in symptoms that usually results from the use of a support group. Spiritual

7 Grief 7 Counseling can help victims to understand how a benevolent God can allow their victimization. Faith and spiritual struggles are common even for those who attend regular spiritual services. Victims of faith can have dramatic setbacks as a result of insensitive statements made by untrained spiritual advisors. Expressive Arts is Auxiliary therapies that help victims express trapped feelings can be helpful to the victim. These arts can include art, music, dance, retreats, rope courses, and other types of body work, such as a massage. It is difficult for someone who is grieving to know when grieving will be completed. It has not set timeframe for finishing. There are several signs that indicate when a person is starting to complete the grieving process. Important signs that grief is winding down include the slow return of the ability to feel pleasure and joy again, the return of a present or future facing orientation for instance looking forward to things in the future again. Regaining the desire to of reaching out to others and re-engaging in life is very promising indication. The transition from grieving to re-engaged hope on the present and the future does not happen all at once. Grieving people may start to feel guilty when they realize that they are not grieving anymore. However, in time the guilty feelings will begin to subside as life continues. A final sign that grief is

8 Grief 8 ending occurs when the grieving person can think about their lost as a happy past memory and less as a painful present absent. Naturally, they may still feel pain but is acute as it once was. The National Organization for Victim Assistance (NOVA) offers early psychological Intervention (EPI). NOVA alone with other partners provides spiritual and psychological services to victims and survivors of crime and disaster. The emotional and spiritual care committee voluntary organization active in disaster facilitated the process of the four major groups who provide EPI, The American Red Cross, the International Critical Incident Stress Foundation and the Salvation Army provide these services. Family Service of Greater New Orleans provides individual, couple, family & group counselling in numerous areas. West Jefferson Medical Center- Behavior Medical Center offers a General Grief Group for those in need. East Jefferson General Hospital Perinatal Bereavement Services for patient and the public.

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10 Grief 10 References Brown, Sandra L. M.A. Counseling Victims of Violence 2 nd edition Hunter house Inc. Publishers PO Box 2914 Alameda CA pg.29 Dombeck, K. Ph.D. Understanding Pathological Grief.2006 pg. 4 updated Dec 15, 2006 Mentalhelp.net Foa,E.B., Keane, T.M., & Friedman, M.J. (2000). Effective treatments for PTSD: Practice guidelines from the International Society for Traumatic Stress Studies. New York: Guilford Publications. Myers, E. (1986) When Parents Die A guide for Adults, March 1st 1997 by Penguin (Non-Classics) (first published 1986) Schulz, Priscilla LCSW from an article of the same title by: Patricia A. Resick and Monica K. Schnicke, University of Missouri-St. Louis Published: Journal of Consulting and Clinical Psychology, V. 60 (5), , 1992 U.S. Department of Veterans Affairs Vermont Avenue, NW - Washington, DC 20420Reviewed/Updated Date: February 5, 2010

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