Role of Counselling and Helping In Bereavement

Bereavement is acknowledged as a significant stressor in people of all sexes and developmental stages (Cutcliffe and Stevenson 2010, p. 125). It is characterized by a range of feelings, such as desperation and loneliness, as well as anger, worry, despair, and frustration. It's important to handle the season of mourning the loss of a loved one carefully to avoid serious societal and physical issues (Howarth and Jupp 2016, p. 56). The bereaved frequently lose all sense of reality and struggle to accept their circumstances. This may lead to self-denial which can progress to poor mental health and eventual depression. The bereavement has been associated with increased health risks and high mortality rates.

In addition to the effects on the mental health of the bereaved, the physical health is also affected (Copson and Grayling 2015, p. 283). It is common for them to respond to the loss by actions that may harm their physical health. Research carried out by Stroebe and Abakoumkin (2005, p. 62) on effects of the trauma associated with the death of a loved one has shown tremendous adverse psychological and health effects. They found out that the bereaved are exposed to a state of loneliness that increases their chance of contemplating suicide. The effects progress to affect the core family unit (Floyd et al. 2017, p. 114). A study carried out on the social consequences of bereavement of a child to a couple revealed that the rate of divorce cases was eight times higher in bereaved parents than it is in non-bereaved parents. Although it has been shown that different people respond differently to cases of bereavement, all the affected individuals significantly change their healthy lifestyle (Chiong 2016, p. 68). Some respond by failure to eat, overeating and reduced physical exercise which may eventually affect their physical health. It is imperative that a healthy diet is maintained and a regular exercise schedule adhered to. This will not only help them to stay physically fit, but also take away the stress and encourage self-realization (Burnard and Campling 2013, p. 321).

According to Kathe Kollwitz, the children react differently to the loss of a person they closely relate to; such as the parents or any other close sibling ( 2016, p. 38). The children's response is evident through a sudden change in their behavior since they cannot express themselves in words. They may become irritable, change their sleeping patterns, increase bed wetting frequencies, change their eating patterns and record a significant shift in their social lives (Winokuer and Harris 2012, p. 232). They develop a tendency to avoid social gatherings and prefer to live secluded lives. Young children's immediate reaction when they are separated from one of their parents is anger, and a tearful behavior as they forcefully demand a reunion with their parent(s). This behavior is progressive, and it changes into other form of actions as the children struggle to accept the reality (Dryden and Mytton 2005, p. 189).

Theories of Grief and Mourning

Grief manifests differently in different people. It goes beyond the distressed emotional reaction to affect the cognitive and physiological status of an individual (Wood 2014, p. 23). The magnitude of the adverse effects of the loss is determined by a myriad of factors which include how the death occurred, the level of attachment to the deceased, the gender of the bereaved as well as the relationship to the deceased.

Bowlby made critical observations regarding attachment and separation after which he related it to bereavement (Humphrey and Zimpfer 2007, p. 98). He observed that attachment is a natural phenomenon adopted by human beings as a survival tactic. As the relationship become stronger, the attachment equally becomes stable and any separation in latter days lead to mourning and grief (Schneider and Krug 2017, p. 432). The pain is believed to be a standard method of adapting to the separation and finding ways to cope with the loss. The natural adaptive theory is classified into four phases;

Shock and Numbness

This phase is marked by denial, failure to accept the loss and physical distress which may lead to somatic symptoms (McLeod 2013, p. 45). The bereaved struggles to believe that the death of the loved one is real. This phase needs to be overcome to allow progression to other phases and ultimate healing from the loss (Burnard and Campling 2013, p. 143).

Yearning and Searching

The bereaved start to come around and realize that the loved one is dead. As a result, the need to fill the void left by the deceased increases leading to a preoccupation of their minds with the memories of the deceased (Weinstein 2008, p. 212). The phase should equally be overcome to allow the affected individual to progress to the next phase.

Despair and Disorganization

The phase is characterized by hopelessness, despair, and anger after a full realization that the loved one will never come back (Short and Thomas 2014, p. 93). They have bitter questions and may sometimes feel angry with themselves due to their inability to prevent the death of their loved ones (Winokuer and Harris 2012, p. 12). The attitude towards life may change and withdrawal experienced. If the situation is not arrested, there is a possibility of slipping into depression, negativity, and even suicidal thoughts (Jones 2010, p. 154).



Reorganization and Recovery

This is a vital stage of mourning since it offers the platform for the restoration of faith in life (Lendrum and Tolan 2008, p. 129). It is characterized by positivism and self-actualization which results in reorganization of their lives as well as the establishment of new goals and patterns of the daily activities.

Role of Counselling and Helping

When a person is bereaved, there is a significant shift from their typical behaviors which pose a primary challenge on restoring the normal physical and mental health. In as much as the grieving is considered a normal human being reaction to the death of a loved one, it is expected to fade away with time (Bryant 2010, p. 76). In some individuals, however, the healing process takes more time than expected which may call for an intervention to speed up the healing process. Such people need psychological help and counseling to help them bridge the gap between the real self and the actual event of the death of their loved one (Humphrey and Zimpfer 2006, p. 254). The ideal method for counseling should endeavor to provide the individualized understanding of the mourning process, identify the areas that prevent the bereaved from healing, offer person-specific solutions to those areas, and help the bereaved to adapt to the new life as well as to prevent suicidal thoughts (Valentine 2011, p. 76). The process should be result-oriented and not be time-barred; the counseling should only end after the life of the bereaved gets back to the normal. The counseling should always be focused on finding solutions with the ideation of the problem being the real issue and not the individual (Morrisey 2015, p. 32). Additionally, the helper should always see the problem through the eyes of the bereaved and try to find solutions to the problems from within.

The natural method of handling the problem ensures that the bereaved individual acknowledges the problem and become part of the solution (Cutcliffe and Stevenson 2010, p. 54). This makes it easy for the solutions to be implemented and easy to abide with for any given individual. The two primary tasks that are vital for any counseling and helping in a bereavement session include;

Loss-oriented Activities

These activities directly affect the bereaved and are associated with the loss of the loved one (Burnard and Campling 2013, p. 87). It is important to acknowledge the activities that have led to the current problems. It may not be necessary for the counselor to get into the depths of the activities, but they should cleverly bring out the issue in an open-ended question format to ensure that the client tells the story (Barkway 2014, p. 110). This has been shown to have great relief in many of the bereaved clients. The ability to tell a story to somebody willing to listen opens up the healing process.

Restoration-oriented Activities

These activities aim at restoring the normal thinking as well as the normal behavior of the affected individual. The success of this stage is dependent on how well the counselor or the helper conducted the initial stage (Aoun et al. 2016, p. 88). It becomes easier if, by this time, the client has agreed that there exist a problem and that it is vital to seek solutions. The restoration activities will be generated in a discussion setting, and it is always advisable that the counselor let the solutions originate from the client.





The Humanistic Approach to Bereavement

This approach to grief counseling concentrates on the uniqueness of every individual (Carl 2012, p. 45). It is cognizant of the fact that different people react differently to different situations thus making it vital to treat each bereaved person separately. This counseling approach assumes that every person has an ability within them to grow both emotionally and psychologically towards achieving self-actualization and personal fulfillment (Carr 2011, p. 436). Counseling a bereaved person using the humanistic approach is intended to achieve the client's ability to accept the loss of their loved ones and move on with the typical daily programs. This is accomplished by convincing the client that the loss is not the problem but the problem is how they experience the loss. The loss is indeed painful, but it is also necessary to allow the client understand that the event of the loss is irreversible and that it is only them that have an inner ability to ability to accept the loss with positivity and achieve psychological comfort (Bryant 2010, p. 234). An American Psychologist, Carl Rogers (2012) explained that it is important for the bereaved to concentrate on the present happenings in their lives since it helps in self-actualization and the rediscovering of one's life direction (p. 102). He developed a theory to explain how the humanistic approach can be applied to encourage the bereaved as well as to repair their damaged self-esteem. The method is called the client-centred counseling.

Client-Centred Counselling

Every individual has some internal resources that enable them to face whatever challenge that life brings their way (Chiong 2016, p. 345). It is imperative that the counselor or the helper realizes that the counseling session is about the bereaved and not themselves. The counselor is, therefore, not expected to ask intriguing questions or make conclusions on the course of action. As such, they are not expected to impose solutions to the client but instead to focus on the client. The client is always treated as the expert in the area (Cutcliffe and Stevenson 2010, p. 212) of their experiences, problems, thoughts as well the feelings. This, therefore, means that the client has the exclusive role of coming up with the most appropriate solutions to their problems (Hyot and Larson 2010, p. 38). The counselor should show the following active expressions while helping the bereaved;

Empathy

This is a quality that every trained counselor and helper should possess. It involves the ability to view the client's problems from their frame of reference. Carl Rogers (1987) explains the importance of any counselor to understand what the client is feeling, what they are thinking as well as the struggles they are going through in the life (p. 78). He suggests this approach as the best way to allow the client open up to the counselor and pour out all their anger, frustrations and difficulties without the fear of being judged harshly. As a result, the client's process of self-acceptance is accelerated as they don't hold back but instead finds an understanding person whom they can confide in without fear (Schein 2008, p. 118).

Genuineness/Congruence

This aspect helps the counselor to be honest and open up to the client. They should not appear superior to the client or become too professional to the point of scaring the client. The primary goal is to allow a conducive environment for the client to share their experiences and begin the healing journey (Lendrum and Tolan 2008, p. 118). When an individual loses a person they loved, it is likely that they become anxious and develop a problem with self-expression. This is because they feel secluded from the society which significantly reduces their worth (Cormier and Baker, 2011, p. 56). The counselor should always try to restore their worth by being friendly to them and showing them that the society values them. This will enable them to come around much faster and to resume their normal duties.

Warmth

The counselor/ helper should show unconditional positive regard to the bereaved; at no point should they be judgmental (Kisanne 2013, p. 123). Instead, it is their obligation to show the client love and value them. Several factors affect the ability of the client to recover including low self-esteem, inability to become self-reliant as well as the lack of exposure to new experiences. The client-centred theory recognizes that the primary thing that affects these factors is the environment and the personal relationships with the clients (Dunphy and Schniering 2017, p. 129). As a result, the counseling should be done in a calm environment where the client feels ease and open to counteract the past experiences. These experiences are linked to the self-disapproval and erasing them is, therefore, a significant step towards achieving self-actualization.

Importance of a Supportive and Emphatic Relationship

The relationship that between the client and the client plays a major role in the healing process (Gainey and Degges 2011, p. 332). The therapy needs maximum support from the society for it to achieve the intended purpose. The environment must be safe, supportive and an empathic relationship between the helper and the client must exist (Hancock 2016, p. 156). In most cases, the bereaved feels disrupted from the society and the support is necessary to solve the following possible scenarios;





The Loss Involved Their Primary Source of Support

It is tough for the bereaved to accept the loss of the only person whom they sought comfort and empathy in their times of difficulties. The fact that the loss involved their confidant proofs that they have suffered a major blow in their lives (Kerry 2012, p. 76). They knew nobody else to share and find solutions to their problems. As a result, these individuals goes through a lot of pain yet they have nobody to understand and listen to them. They seclude themselves from the society, and they easily suffer from depression. This kind of a person is in dire need of support and empathy (McNamara and Rumbold 2013, p. 108). The availability of somebody who can listen to them without jumping into conclusions will help them avoid the self-blame and the suicidal thoughts

Their Natural Support System Exhaust Itself

Research has shown that the possibility, of people surrounding the bereaved, to forget the feelings and suffering of the individual thus engaging in a process that makes it difficult for the healing process to occur (Neimeyer and Jordan 2015, p. 126). During the first few weeks, the society is primarily emphatic, but the gesture decreases as the time moves. This negligence results to loneliness which leaves the bereaved stressed and disconnected to the real world. The innate ability to contain the grief diminishes with time making it necessary to get help from trained counselors and helpers who will offer love and care for the achievement of the recovery (Pollak et al. 2011, p. 110).

Society's Myths

This is a serious issue that affects the recovering of the bereaved from the pain of losing their loved ones. Some societies consider disclosure of grief-related distress as a result of death as unacceptable (Roberts and Corcoran 2015, p. 289). This is worse when the deceased died from a condition that the society doesn't accept as natural. The dead were, in most cases, stigmatized when they were alive and the general belief is that the society should not mourn such individuals. Such cases include people who die of AIDS as well as those that commits suicide. The bereaved in such situations suffers a very traumatizing moment which requires support from the counselors and the helpers (Miller and Rollnick, 2012, p. 217). Jordan and Neimeyer argue that these cultural barriers, against natural healing after a loss, are the greatest challenge that every caregiver should embrace (2003, p. 780). The caregiver should offer them compassion to show them that they are still valued by the society.

Traumatic Loss

The loss of the loved ones through traumatizing experiences such as homicide and accidents can be extremely painful to the bereaved (Ross and Danchev 2008, p. 623). In most of these cases, the bereaved were on the site where their loved ones died. According to psychologists, these experiences can create hallucinations which need experts' attention to avoid a progression to depression.

Role of Motivational Interviewing in Bereavement

Motivational interviewing plays a crucial role in the counseling therapy sessions in a loss case. This theory not only complements the humanistic approach theory but also builds on it offering essential steps necessary in guiding the bereaved (Stoddard et al. 2014, p. 345). It helps the client to express themselves freely about their problems making it easy for the helper to achieve client-centred solutions. The interview is guided by its primary goal which is to alleviate the unhelpful behavior and try as much as possible to adopt useful behaviors. Miller and Rollnick (2001) argues that the motivational interview helps in the interaction and it is not just a way of obtaining information. It should allow the patient to experience care and love from the caregivers (p. 221). This approach uses various principles including;

Open-ended Questions

The counselor should always ask open-ended questions to help them understand the views of the client and elicit their opinion on the subject. These questions create an environment that is conducive for dialogue since they are open and cannot be answered using one word or phrase. This creates neutrality in obtaining the information from the client; the counselor gets as much information as they need without offending the client (Rippe 2014, p. 376). Additionally, asking open-ended questions helps the instructor not to make premature judgments about the mourning situation of the client.

Reflective Listening

This principle emphasizes the need to listen more and tell less. The counselor should allow the bereaved to communicate their feelings of anger and guilt as they listen carefully. They should then accept the feeling and encourage the non-judgmental and collaborative relationship (Copson and Grayling, 2015, p. 349). The counselor should then target providing the support until the bereaved fully recover from the trauma. A key thing with this approach is that it complements the information given rather than disputing it, therefore, naturally persuade the client to change their approach to the loss.

Develop Discrepancy

This is a way of letting the client realize that there is a gap between the current actions and their future plans. It is important to create a distinction between the client and their actions so that the client's confidence is built. This can be accomplished through a crafty application of other people’s examples to show how the client's action conflicts their values (Burnard and Campling, 2013, p. 49). This makes the client to voluntarily express the desire to change and articulate the methods that they would wish to use to reach the change.

Avoid Argument

The primary intention of the counseling is to ensure that the bereaved get backs to their healthy lives. An argument creates an uncomfortable environment for the client to express them. Most of the bereaved people have low self-esteem, and the counselor should always aim to restore the confidence but not to diminish it further (Morrisey 2015, p. 46). The counselor may be tempted to argue when the client become stubborn and unwilling to embrace positive change. However, the argument will only build resistance, and the client will strive to come up with opposing theories which make it unhealthy for the discussion (Harris and Winokuer 2012, p. 234). Miller and Rollnick argue that the most common area that generates arguments is forcing the client to accept a title such as "You are in denial." As such, the counselor should always refrain from pushing titles to the clients. The counselor should walk along the conversation but not drag the clients into conclusion.

Adjust to Client's Resistance

The bereaved is expected to resist and behave in a defiant manner which can make it relatively difficult for the counselor to offer help. However, it is paramount to realize that directly countering the resistance will only result into more defiance and the only solution would be to roll along with the client (Schneider and Krug 2017, p. 349). The counselor should seek to understand the client's perspective and take advantage of the situation to move the discussion towards a particular mutual way making it more solution oriented.

Support Self-Efficacy

Most bereaved individuals suffer so much pain that the self-belief in the recovery process diminishes entirely. Such individuals' lose hope of recovering from the loss and may start engaging in destructive behaviors. Consequently, it is important to restore hope, optimism and the possibility of achieving the desired change. This is well accomplished by identifying the strengths of the client and bringing them to the forefront to boost the self-image. The area is vital for the recovery of the bereaved, and the helper should have an unwavering conviction in the ability of the client to recover (Wood 2014, p. 38). As the process progresses, the client is expected to ultimately accept that they are responsible for the change they desire and agree to take steps towards achieving it.

Who needs Bereavement Counselling and Help?

Bereavement counseling is necessary for any person who fails to contain or regulate the pain of losing their loved ones alone (Humphrey and Zimpfer, 2007, p. 234). If this happens, the individual lives in denial, hallucinations and high level of depression. Additionally, palliative care for the relatives of patients with a terminal illness is vital before and after the loss (Floyd et al.2017, p. 222). This element of counseling ensures that the families are psychologically prepared for any eventuality.

Does the Grief Counselling Work?

Losing a loved one is, with no doubt, one of the most painful and traumatic experiences in the human life. Different people behave differently to the loss. Some will be distressed by the loss while others may already have had distress before the loss; the loss only serves to increase the suffering (Dryden and Mytton 2005, p. 333). Due to this fact, it is vital to have a person-centred approach so that the solutions are tailor-made to suit the specific individuals. The success of the counseling is dependent on various factors including how the entire process is conducted as well as the willingness of the bereaved to participate in the process(Valentine 2011, p. 45). Most cases of success occur when the bereaved acknowledges the problem and seek to find solutions from within themselves. Imposing solutions to the clients is counterproductive and will eventually backfire. The grief counseling should not involve groups of people but rather individuals (Winokuer and Harris 2012, p. 239). When it is done appropriately, the counseling has been shown to yield the desired results.

In the recent past, there have been theories countering the benefits of the grief counseling process. Hoyt and Larson (2012) have, however, disputed the claims that the counseling is irrelevant (p. 112). They argue that there is no empirical or statistical proof that the process does not work. This argument is supported by Worden (2013) who reaffirms the importance of the grief counseling. In as much as the results of the counseling may vary from one individual to another, the majority of the clients achieves the goal of self-actualization (p. 232). The case for the benefits offered by the person-centered therapy is active, and the empathic relationship has been shown to itself contribute significantly to the relief of the clients.

Conclusion

The success of the grief counseling is achieved when the client seeks to get help voluntarily. The customers, when they present themselves for help, are likely to acknowledge the existence of the problem and take full responsibility for the solutions. The counseling has been shown to be effective in many cases of traumatic events such as the tornado or the loss of lives in a devastating tsunami; this only occurs when the counseling is person-centred and not as a mass. Research on the impacts of the advice to a group of people shows great tendencies of resistance and the unwillingness to cooperate and thus leads to unsuccessful sessions.

The person-centred approach offers a stable foundation for the counseling process. The deeply empathic environment surrounding this approach creates a conducive environment for the client to start seeking solutions from within themselves. The warmth and non-judgmental approach that is rolled out in this method bring out a loving and caring feeling which is vital for the healing process. All these factors combined makes the person-centred approach the excellent way to achieve the best results in bereavement counseling and helping.





















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