Bereavement And Spiritual Care - ACGB Home
for Clinicians and Service ProvidersAutumn 2013IN THIS ISSUE:Feature Article 1 Letter from the Editor 3 Abstracts 3 Interview 4 Book Review 5ACGB Workshop: Techniques of Grief Therapy 5 Our Services 6“ The way we understandourselves and the world welive in and the philosophicalor meaning systemswe draw upon, can bedisrupted by loss. ”Bereavement and Spiritual Careby Christopher HallHistorically grief has beenseen primarily as a process ofconfronting and working throughthe emotional impacts of a loss.Other dimensions of grief, such asits social and cognitive impacts havetended to receive less attention, butperhaps the most overlooked are thespiritual and religious dimensions of theloss, which are often neglected in boththe research literature and in clinicalpractice. More recently, the importanceof finding or reconstructing meaning inthe wake of a loss has been identified asbeing of critical importance. The way weunderstand ourselves and the world welive in and the philosophical or meaningsystems we draw upon, can be disruptedby loss. Bereavement may prompt anexamination of our belief systems inorder to answer the questions promptedby this event. This scaffold of meaningmay be able to accommodate and holdthis event. At other times this scaffoldof meaning may be found wanting anddemands an effortful engagement andreconstruction. These efforts may result inthis scaffold of meaning being reshapedand strengthened, or the frameworksof previously held spiritual beliefs andmeaning may collapse under the weightof the loss.higher power or life-force (Kaldor, Hughes& Black, 2010), how can we providespiritual support to the bereaved client?The International Workgroup on Death,Dying and Bereavement states that“spirituality is concerned with thetranscendental, inspirational andexistential way to live one’s life” (1990,p. 75). While spirituality is very personal,religion is more communal. The word“religion” means “that binds together”and “that which ties things into apackage”. Religion says “Here is a set ofbeliefs that forms a coherent whole, takeit as your own” (Doka, 2011). Miller (1994),writes that religion is a set of beliefs andpractices shared within a group of people,whereas spirituality is inherently individual,personal and eclectic.Bereavement researchers considerreligious faith as ‘‘one of the mostfrequently used and effective meansof coping with death’’ (Shuchter &Zisook, 1993, p. 32). A recent reviewof the role of religion and spirituality inadjustment following bereavement foundthey generally had a positive impact onadjustment to bereavement (Wortmann &Park, 2008). However many bereavementpractitioners have little specialist trainingin spirituality. Practitioners may bereluctant to enter into conversationsinvolving religion or spirituality, with sometaking the view that these conversationsare best left to clergy, pastoral carers orother members of faith communities. Thereality is that clients will determine thetiming, location and the person with whomthey will share their spiritual concerns.If we ignore spiritual concerns, clientsmay feel that this is an area outside thescope of bereavement care. True holisticcare requires that spiritual concerns areacknowledged, validated and addressed.With two-thirds of Australians claimingthat a spiritual life is important to themand 33% praying or meditating at leastweekly, how do we respond to andaddress the yearning that many clientshave to reconcile their experience of losswithin their spiritual and religious framesof reference? With nearly one quarter ofAustralians believing in God or a spirit,
fear of been judged as ‘crazy’. Actively inquiring into theseextraordinary experiences can be a source of comfort andmeaning. The bereaved will frequently draw upon existential,spiritual, and religious frameworks in order to make sense ofthese all too common experiences (Benore & Park, 2004).Ten Strategies For EnhancingSpiritual CareWe can start by engaging the client in an exploration of theirspiritual history through the use of a tool such as the FICA(Puchalski, 2006). This acronym represents:Faith orBeliefsWhat is your faith tradition?Importanceand InfluenceHow important is your faith to you?CommunityWhat is your church or community of faith?Apply andAddressHow do your religious and spiritual beliefsapply to your health? How might weaddress your spiritual needs?Does the bereaved person identify with a particular faithtradition? Do they belong to a faith community? Do they activelypractice that faith by engaging in public and private ritualsand practices? How important is their faith system in makingdecisions?Moving beyond religious affiliation we need to explore whenand where does the bereaved person feel most spirituallyconnected. What practices do they utilise when they’re anxious,lonely or distressed? Where do they find meaning and hope?What frames of reference inform their spirituality such as karma,fate or punishment? What are the actions, prayers, words ormusic that provide spiritual comfort? Rituals, which can providea sense of comfort, meaning and connection, can also beexplored. For clients who do not have particular rituals we canwork with them to create “meaning-full” ritual (Hall, 2003).The frequently reported experience of sensing the presenceof the deceased should also be explored. Many clients maybe anxious about sharing these experiences because of a1Each person has a spiritual dimension thatmust be considered along with the emotional,cognitive and physical components of grief.2Cultivate curiosity in the bereaved personsspiritual and religious worlds, giving spiritualquestions both time and attention.3Spiritual needs can only be determinedthrough a thoughtful review of spiritual beliefs,practices, experiences and needs.45Listen, acknowledge, support and affirmthe clients spiritual concerns.6Assist the bereaved in making sense of the loss throughthe exploration of questions such as - How have youmade sense of the death? How do you interpret the lossnow? What philosophical or spiritual beliefs contributedto your adjustment to this loss? How has thisexperience affected your view of yourself or your world?7Explore extraordinary experiences that thebereaved may have had, including sensing thepresence of the deceased and dreams.8Develop knowledge of the spiritual resourcesand caregivers available in the widercommunity. This should include knowledgeof faith traditions and cultural practices.9Ensure that spiritual care is reflected in the workplacethrough a written statement of philosophy andthat appropriate training and time is available forstaff to develop expertise in spiritual care.10Consider your own spirituality as a bereavementpractitioner. What opportunities do you have forexpressing and enhancing your own spirituality?Spirituality has many elements and forms of expression.It may be religious or secular; private or public; andseek expression through symbols, rituals, practices,art, prayer or meditation. Consider: which ofthese forms of expression is the best fit for thebereaved person?ReferencesBenore, E. R., & Park, C. L. (2004). Death-specific religiousbeliefs and bereavement: Belief in an afterlife and continuedattachment. The International Journal for the Psychology ofReligion, 14, 1–22.Doka, K. J. (2011): Religion and Spirituality: Assessment andIntervention, Journal of Social Work in End-Of-Life & PalliativeCare, 7(1), 99-109.Kaldor, P., Hughes, P. J. & Black, A. W. (2010). Spirit Matters:How Making Sense of Life Affects Wellbeing. Ontario,Canada: Mosaic Press.Puchalski , C. (March, 2006). Spiritual Assessment in ClinicalPractice, Psychiatric Annals, 36(3), 150.Hall, C. W. (2003). Reconstructing meaning in the wakeof loss: Creating ‘meaning full’ ritual. Grief Matters: TheAustralian Journal of Grief and Bereavement, 4(3), 51–53.Shuchter, S. R. & Zisook, S. (1993). The course of normalgrief. In M. S. Stroebe, W. Stroebe, & R. O. Hansson(Eds.), Handbook of Bereavement: Theory, Research, andIntervention (pp. 23–43). Cambridge, England: CambridgeUniversity Press.International Work Group on Death, Dying, and Bereavement(Spiritual Care Work Group). (1990). Assumptions andprinciples of spiritual care. Death Studies, 14, 75–81.Wortmann, J. H. & Park, C. L. (2008). Religion and Spiritualityin Adjustment Following Bereavement: An Integrative Review,Death Studies, 32(8), 703-736.2
Letter from the EditorWelcome to the Autumn 2013 edition of Bereavement Practice for Clinicians and Service Providers.I hope this finds you well and the rewards of your work are unfolding for the year. My hope is that thisedition will offer you tools to enhance your work and renew your curiosity for learning.This edition takes as its theme spirituality, and bereavement, a subject not often explored.Christopher Hall, Director of the Australian Centre for Grief and Bereavement looks at the relationshipbetween meaning making and spirituality, and the significance of communal connection in religiousbeliefs. Various strategies for enhancing spiritual care have been outlined in this context.The book review, Techniques of Grief Therapy: Creative Practices for Counselling the Bereaved, edited byRobert A. Neimeyer, is a collaboration of interventions with the bereaved that draws from both researchand grounded practice techniques (Well worth reading, I have certainly taken away some pearls ofwisdom that have enhanced my insight).We are also excited to announce that Robert A. Neimeyer will be delivering a series of workshops for the Centre in Melbourne,Brisbane and Sydney in July this year. See page 5 for further information.I would like to take this opportunity to wish you all a safe Easter holiday period and some good chocolate for those who indulge.I am looking forward to continued connections with you throughout the year and very much welcome any feedback that assists us indelivering relevant information to you in this publication. Take good care of yourselves.Warm regards,Jenny Field, Senior Bereavement Counsellor and Volunteer CoordinatorAustralian Centre for Grief and Bereavementj.field@grief.org.auAbstractsSourced through PubMed.govA review of spiritual assessment in health care practice.Med J Aust. 2007 May 21;186(10 Suppl):S60-2. Rumbold, BD.“The recent surge of interest in links between spirituality and health has generated manyassessment approaches that seek to identify spiritual need and suggest strategic responses forhealth care practitioners. The interpretations of spirituality made within health frameworks donot do justice to the way spirituality is understood in society in general. Spiritual assessmentshould not impose a view or definition of spirituality, but should seek to elicit the thoughts,memories and experiences that give coherence to a person’s life. Spiritual assessment toolsshould not be used without adequate exploration of the assumptions made. Assessmentprocesses need to be adequately conceptualised and practically relevant.”Click here to access the full text articleFormal and Informal Spiritual AssessmentAsian Pac J Cancer Prev. 2010 Apr;11 Suppl 1:51-7Puchalski, CM.“Spirituality is increasingly recognized as an essential element of health. A novel model ofinterprofessional spiritual care was developed by a national consensus conference of expertsin spiritual care and palliative care. Integral to this model is a spiritual screening, history orassessment as part of the routine history of patients. Spiritual screening can be done by aclinician on an intake into a hospital setting. Clinicians who make diagnosis and assessmentsand plans, and make referrals to appropriate experts do spiritual histories. In spiritual care,board certified chaplains, spiritual directors and pastoral counselors are the typical spiritualcare referrals. Board certified chaplain do a spiritual assessment that is a more detailedassessment of religious and spiritual beliefs and how those impact care or patient’s healthcaredecision-making. There are several screening and history tools. One history tool named FICA,was developed by a group of primary care physicians and recently validated at study at theCity of Hope. This tool is widely used in a variety of clinical settings in the US and Canada.The spiritual history tools allow the clinician the opportunity to diagnose spiritual distress oridentify patients’ spiritual resources of strength and then integrate that information into theclinical treatment or care plan.”Click here to access the full text article3
Reflections of a Bereavement PractitionerKeren Ludski has been working in the field of bereavement since 1998, and establishedher private practice, Peace of Mind, in 2002. She is a qualified and experiencedprofessional educator, counsellor, counselling supervisor, VET assessor and trainer,facilitator and speaker.What has bought you to thisfield of work?In 1998 my third child died of SIDS.I found it very difficult at the time tofind the right kind of support for me.There seemed to be plenty ofcounsellors and psychologists around,but not many who really dealt with griefand loss (especially loss of children) andnot many that I connected with. Part ofmy road to recovery was realising thatthis was a field of work that I wanted tocontribute to.How do you bear the sadnessyou witness or people sharewith you?This has certainly been a real learningprocess for me. I have implementedmany strategies over the years to offermyself a degree of protection from otherpeople’s sadness with mixed results.When I sit with clients now, I know thatit’s ok for me to be sad, as I’m witnessingpeople at their most vulnerable. At theend of the day however, I remind myselfthat this is their story, their grief — it is notmine. Using a strategy to ground myselfenables me to let go of their sadness.How do you support yourselfwhen client stories orcircumstances resonatewith you?I believe that it is imperative in thisfield of work to have both a personaland professional support network. Myprofessional support network allows methe forum to debrief on a regular basis.This, in conjunction with my regularsupervision, allows me opportunity todelve within myself and really spendsome time working with what’s goingon for me. My supervisor is also greatin helping me develop strategies todeal with transference and countertransference issues. My personal supportnetwork constantly ensures I separatework and personal time and thereforeestablishes boundaries that are sonecessary in this field. I’ve learnt howimportant self care is and I ensure thatI continuously make time for myself toexercise, do yoga and walk my dog.How do you help peopleunderstand the complexities ofgrief and bereavement?I always start by normalising their griefprocess. I find that by normalising theirgrief experience, I’m opening the doorfor them to share whatever is goingon in their minds. I find that there isalways a place for psycho-educationwithin the session and this allows meto gently educate my clients on thejourney that is loss and grief. By givingthem information (not too much that itbecomes overwhelming) clients are ableto gain some insight as to what may layahead for them. I also constantly remindthem that it is a highly personal journeyand people do it in their own way.What is the most challengingaspect to your work in grief andbereavement?I think the most challenging aspect ofthis job is that we cannot fix it. I do nothave a magic wand that I can wave andtake away their pain. I cannot bring thedead person back. I cannot put their lifeback together for them. The reality ofthe situation makes it a very humblingexperience for me.What do you find mostrewarding in your work?The most rewarding part of my workis being able to sit as one with a client,allowing them to share their deepestthoughts, no matter how strange theythink they are. The ability to normalisetheir experience, thereby removing theirbelief that they are ‘freaks’ or ‘abnormal’,is an aspect of the job that I actuallylove. Providing an environment wherethey are safe to share all aspects oftheir experiences with the deceased issomething that I’m incredibly passionateabout.What three pieces of advice/insight would you give to thoseworking in the field of grief andbereavement?1. Establish a solid support network.2. Ensure that you have worked throughyour own grief experiences.3. Leave the ‘fix it’ mentality at home.What are some ways you haveengaged in self care in thisintense field of work?I find journalling incredibly beneficial. Itgives me the opportunity to be honestand open in my thoughts around myinteractions with clients. I can then takethe insight I have received from myjournal and discuss it in supervision. Ihave also made myself a priority. If I amnot feeling strong, healthy and nourishedthen I will have nothing to give to myclients. I therefore book out times in mydiary for exercise and yoga. I also ensurethat I have some time for me at the endof the workday before I step back intomother mode.4
The Australian Centre for Grief and Bereavement is pleased to present:Robert A. Neimeyer, PhDUniversity of Memphis - USATechniques of Grief Therapy: Creative Practicesfor Counselling the BereavedMelbourne, Brisbane, Sydney July 2013As contemporary models of bereavement have become more nuancedand empirically informed, so too have the practices available to griefcounsellors and therapists. Dr Neimeyer’s workshops offer in-depthtraining in several of these techniques, nesting them both within thetherapy relationship and in the context of current theories and research that provide flexibleframeworks for intervention. Making extensive use of actual clinical videos as well as how-toinstruction in the use of numerous therapeutic tools, participants will discuss and practice severalmethods for helping clients integrate the reality of the loss into the ongoing story of their lives, whilealso reconstructing their continuing bond to their loved one.Robert A. Neimeyer, PhD, is Professor in the Department of Psychology, University of Memphis,where he also maintains an active clinical practice. Since completing his doctoral training at theUniversity of Nebraska in 1982, he has published 25 books, including Techniques of Grief Therapy:Creative Practices for Counseling the Bereaved and Grief and Bereavement in ContemporarySociety: Bridging Research and Practice (both with Routledge), and serves as Editor of the journalDeath Studies. The author of nearly 400 articles and book chapters, he is currently working toadvance a more adequate theory of grieving as a meaning-making process, both in his publishedwork and through his frequent professional workshops for national and international audiences.Event DetailsPROGRAM ONE:Processing the Event Storyof the DeathPROGRAM TWO:Accessing the Back Story ofthe RelationshipDates:Melbourne:8th & 9th July, 2013Brisbane:11th & 12th July, 2013Sydney:15th & 16th July, 2013These workshops can be doneconsecutively, as part of a twoday program, or separately asindividual workshops.Click here for furtherinformation and to registerto attend.Book ReviewTechniques of Grief Therapy:Creative Practices forCounselling the BereavedEdited by Robert A. Neimeyer (2012)408pp. Routledge, ISBN: 9780415807258AUD: 59.00 (RRP 67.00)This book, alongwith a range of otheruseful resources,can be purchasedfrom the AustralianCentre for Grief andBereavement.Robert Neimeyer’s latest text, Techniques ofGrief Therapy: Creative Practices for Counsellingthe Bereaved, comprises mindful collaborativeexplorations of grief work, which honour theconceptual and empirical work of fellow workersin the field.To order this text,please call the Centreon 1800 642 066or emailinfo@grief.org.au“It’s not about what grief therapydoes for someone but ratherwhat clients and therapists dowith techniques” (p3)As Neimeyer acknowledges in the prologue, becausegrief is so universal, grief therapy can be easilymistaken as a ‘simple’ journey. To the contraryhowever, this b
Spiritual Care 1 Each person has a spiritual dimension that must be considered along with the emotional, cognitive and physical components of grief. 2 Cultivate curiosity in the bereaved persons spiritual and religious worlds, giving spiritual questions both time and attention. 3 Spiritual needs can only be determined
Pre-requirement: Completion of RTS Bereavement Training: Perinatal Death or RTS Bereavement Training: Pediatric & Adult Death Advanced Skills in Perinatal Bereavement Care Those who provide perinatal bereavement care often ask about education that will take them beyond the basics. That's what this workshop is designed to do.
Examples of bereavement programs and evaluation of outcomes Site Bereavement Components Evaluation Cardiac ICU A bereavement packet mailed to families at 4 wk with a list of support groups in the area and 7 brochures with information on grief A sympathy card
Bereavement Training: Perinatal Death Acquire the skills needed to provide gold-standard bereavement care. Learn evidence-based bereavement best practices. Reduce healthcare disparities while supporting diverse grieving populations. Learn strategies to care for yourself and support your colleagues. In-Person Training La Crosse, WI
Vision for Spiritual Care Spiritual care is integral to patient-centered care. Resides at the center of care. Focuses on the needs of the whole patient. Identifies needs and concerns that impact patient outcomes. All Interdisciplinary Care Team members provide spiritual care. Chaplains are the spiritual care specialists who conduct spiritual
integration of spiritual care and health care, symposia, and grand rounds that are committed to providing best practices in research conference on integration of spiritual care and health care, symposia, and grand rounds Your Source for Spiritual Care Resources www.healthcarechaplaincy.org Coming soon! The Telehealth Module for Spiritual Care:
process was invaluable and to Cathy Quinn, Midwife Consultant Perinatal Bereavement Care. The parents, family members, health professionals and organisations who participated in the . education and training opportunities in the delivery of compassionate bereavement and end-of-life care in accordance with their roles and responsibilities.
bodies and minds, spiritual care practitioners care for our spirits. The increasing need for spiritual care makes these practitioners even more crucial. However, many of us have limited access to quality, professional spiritual care. At times of struggle, this lack of spiritual care can have a negative impact on our health and well-being.
accounting and bookkeeping principles, practices, concepts and methods featured in the unit and there was good evidence of preparation and practice with regard to structure, format and presentation of accounting data and information among the sound financial statements, double-entry bookkeeping and cash budgets submitted. That said, this is not a unit solely of numbers or arithmetic and there .
