Grief: the shifts in approaches

In this post I would like to summarise the main shifts in approaches to working with the bereaved, as influenced by the progression of theories in relation to grief.

The main shifts

• There had been a move from viewing the bereaved as passively reacting to grief, to seeing  them as being active in facing death's challenges.
• Old theories were not backed by research, whereas more recent ones are.
• A shift has occurred from being prescriptive and pathologising, to a focus on valuing individual meanings.
• Former approaches talked about lineal stages and phases, whereas now individual reality is the focus and a universal sequence of stages or tasks is no longer recognised.
• In the past the bereaved were discouraged to disengage from the deceased, but now the concept of forming continuing bonds with the deceased is recognised.
• Grief used to be treated as a private individual experience, but now social and relationship contexts are seen as having a great impact.
• Another move had been from a focus on emotional responses to also recognising the importance of cognitive (meaning) and behavioural impacts.
• Former theories encouraged "recovery" and return to pre-loss patterns, whereas now people are seen as being transformed by grief (and grieving is seen as something that continues, in various forms, for the remainder of people's lives).

Grief is a very individual experience

No two people will experience the same grief in response to the same loss and, although there may be some commonalities in their reactions, we need to ensure that we tap into their unique responses whilst listening to their individual stories.  

A Social Work approach to grief

Social Work intervention strategies will be based on a model that takes account of the interactions between social systems and human behaviour, and the influence of our ethical/ value base.

In human behaviour each individual is seen as a complex system of personalities, coping capacities, beliefs, values, choices, life journeys etc., and each of these parts might respond to loss in different ways. The individual will respond to loss in multiple ways, and some of these may be conflicting or ambivalent.

In social systems in relation to the family, the expression of grief will be regulated by norms of family interactions, family roles, hierarchies of power, support, conflicts and by family structures and processes. And in social systems in relation to the broader community grieving will be influenced by cultural interpretations of death and loss, imposed expectations and norms regulating grieving processes. These may be subtle or overt and may be contradictory.

As Goldsworthy says, our approaches in working with the bereaved need to be consistent with Social Work ethics of self-determination, inherent dignity and worth, empowerment and a commitment to the diversity of client experiences and meanings. We need to not pathologise the client (grief is not an illness, but a response to change).

Reference: Goldsworthy K (2005) Grief and loss theory in social work: all changes involve loss, just as all losses require change. Australian Social Work June 2005 Vol 58 No 2

Remember: Grieving is as natural as crying when you are hurt, sleeping when you are tired, eating when you are hungry, or sneezing when your nose itches. It is nature's way of healing a broken heart. (Source unknown)