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Models of Coping with Bereavement: A Review

22 important questions on Models of Coping with Bereavement: A Review

3 categories of coping processes

1) general stress and trauma theories
2) general theories of grief
3) models of coping specific to bereavement

Why is it difficult to assess adaptive coping strategies?

often not longitudinal
sometimes retrospective
often definitions include process and outcome variables

Stress and Trauma Theories

provide explanation for how people respond to stressful life events in general

Cognitive Stress Theory in Bereavement context

pinpoints the mediating role of cognitive appraisal in adjustment to loss
bereavement would be seen as stressor. Appraisal by the individual determines the extent to which bereavement is considered challenging or stressful.
Useful in bereavement context for few reasons :

- framework for the fine-grained definition of characteristics of the stressor, coping process and related strategies, and outcomes from which cause-effect relationships can be derived.
-bereavement is a global stressor

bereavement involves number of simultaneous ongoing stressors, the model acknowledges the possibility, however details appraisal and coping with one stressor at a time.

Predictions about strategies remain unclear.

Two general types of coping strategies

problem-focused vs. emotion-focused
confrontation-avoidance

Successful outcomes appears to require all coping strategies due to the complex and multi-dimensional nature of grief

Problem focused coping strategy

directed at managing and changing the problem causing the distress.
More appropriate in situations that are changeable

Emotion-focused coping strategy

managing resulting emotion
more appropriate for situations that are unchangeable

Trauma theory 3 independent bodies of research:

1) stress response syndromes
2) Emotional disclosure and social sharing
3) assumptive worldviews

Stress response syndrome

part of trauma theory
describes the normal manifestations of human reactions following traumatic events, which may sometimes increase the intensity and frequency to an extent that can be diagnosed as PTSD.
Horowitz identified the antithetical reaction of intrusion (compulsive re-experiencing of feelings and ideas surrounding the event)-avoidance (signifies a denial process) as distinctive features of traumatic reactions.

Why can a intrusion-avoidance pattern be helpful?

Description of intrusion-avoidance pattern helps to define the extremity of a person's reaction to a traumatic event.

Assumptive world views

fundamental assumptions people hold about themselves, the world and the relation between these two, which normally go unquestioned and unchallenged are shattered by traumatic event (in our case bereavement) Coping is said to involve rebuilding the inner world, to re-establish meaning, to adjust old assumptions or, at least partly, accept new ones. Effective coping from the perspective would be the search for meaning and to integrate the event into broader positively meaningful structures

3 assumptions of assumptive world view

- that we are worthy,
- world is benevolent
- what happens to us makes sense

Bereavement as a psychosocial transition (Parkes)

habits of thought which have been built up ober many year must be reviewed and modified, a person's view of the world must change which inevitably take time and effort.

gradual changes of assumptions is needed, deeply bound as these are with one's internal model of the world

Grief work:
-preoccupation of thoughts of lost person
painful repetitious recollection of the lost experience to accept irrevocability of loss

Rubin's Two-Track Model

1) Outcome Track (Biopsychosocial reactions to bereavement)
2) Attachment to the deceased, describing ways that this becomes transformed and a new still ongoing relationship to the deceased established.

Does not provide analysis of cognitive structures or processes however suggests a dynamic mechanism associated with attachment bond

2 research developments to understand adaptive coping

specification of cognitive tests and processes in the coping process
the extension of analysis beyond the interpersonal to interpersonal perspectives.

Intrapersonal coping models

distinction between task models (Worden) and process models

Model of Incremental Grief

One loss can trigger other loss, magnification of grief occurring with each added loss.
Places individual coping reactions within context of social environment --> outcome poor in cases of asymmetry and incongruence in grief.

Social construction models

Grieving as a process of meaning reconstruction. Meaning is negotiated between (grieving) family members, and the process of coming to terms with bereavement is an ongoing effort. Assumptions about the relationship to the deceased are actively explored and adjusted. Bereaved people develop narratives about the nature of the deceased life and death and these social constructions may affect grief outcomes.

- Walters new model of grief
- The meaning reconstruction model

Walter's new model of grief

process and purpose of grief so that hypothesis about adaptive coping can be drawn. Purpose of grief is to grasp the reality of death. This is accomplished through the construction of a durable biography that enables the living to integrate the memory of the dead into their ongoing lives.

Four component model (Bonnano and Kaltman)

Considered bereavement in terms of four components- context of loss
- continuum of subjective meaning associated with loss
- changing representations of loss relationship over time
- role of coping and emotion regulation processes

Dual Process Model of Coping with Bereavement

2 factors:
Loss-orientation (consistent with attachment theory and grief work)
Restoration-orientation (consistent with cognitive stress theory)

Both factors are involved in coping pocess and attended to varying degrees
bereaved person will alternate between the 2, but sometimes there will be a "time out"

Why do we need scientific model of coping with bereavement?

- basis for testing validity of assumptions
- theories to guide the planning of research
- development of assessment instruments
- to answer questions about effective coping to help those who suffer extremely

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Handbook of bereavement research: consequences, coping, and care | 9781557987365

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Models of Coping with Bereavement: A Review

22 important questions on Models of Coping with Bereavement: A Review

3 categories of coping processes

Why is it difficult to assess adaptive coping strategies?

Stress and Trauma Theories

Cognitive Stress Theory in Bereavement context

Two general types of coping strategies

Problem focused coping strategy

Emotion-focused coping strategy

Trauma theory 3 independent bodies of research:

Stress response syndrome

Why can a intrusion-avoidance pattern be helpful?

Assumptive world views

3 assumptions of assumptive world view

Bereavement as a psychosocial transition (Parkes)

Rubin's Two-Track Model

2 research developments to understand adaptive coping

Intrapersonal coping models

Model of Incremental Grief

Social construction models

Walter's new model of grief

Four component model (Bonnano and Kaltman)

Dual Process Model of Coping with Bereavement

Why do we need scientific model of coping with bereavement?

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