This document is an invite to join me on a journey that follows the path of bereaved children, adolescents and their families who attended seven bereavement groups within a mental health setting. This thesis sets out to illustrate how families hold and maintain grief within the family system and how effective a bereavement group is as a form of therapeutic intervention. The bereavement group is a platform where families bring their private stories into a public domain and talk about the concerns that they have seen in their families since the bereavement. As an insider/outsider researcher I am of the opinion that by talking, listening and sharing their stories with other families with similar experiences within the groups, families can begin to think about what could be done differently if they want something to change within their family system. By sharing, families learn how to go with their grief without their loved ones and begin to create new narratives about the next part of their journey. The group can provide an opportunity for families to hear the ‘Untold’ stories and begin to create new narratives within their family system. The bereavement group also acts as a lens that allows me to look into my practice as a family therapist within a social constructionist framework and make new meaning of the stories that families bring within the bereavement groups. A tapestry is created from the complex diverse stories of grief that are interwoven with each family that attends the bereavement group. Each family brings their own pattern of bereavement and creates new patterns as their experience is shared with other families. Data is taken from the conversations at the assessment, treatment and follow up stages to highlight what difficulties the families have when there is bereavement. This is to ascertain what factors may be contributing to holding and maintaining the grief in the family and whether a bereavement group is effective in bringing the issues out for all family members to discuss. Different methods are used to deconstruct the different themes and unpick the ‘Told’ stories. At the end of this journey my hope is that there is more awareness about the effect of bereavement and how it shows itself in children’s mental health and how the family system can be affected.

<p>For most parents there is no imaginable event more devastating than the death of their child. Nevertheless, while bereaved parents grieve they are also expected to carry on with their life. The day-to-day activities that were once routine for these parents may now be challenging due to the emotional turmoil they are experiencing. To date parental bereavement has been described as complex, intense, individualized, and life-long and their grief responses are interwoven with their daily activities, but the nature of their daily life challenges are not known. </p><p>This dissertation highlights the significance of how parents respond to their bereavement challenges because bereaved parents have higher morbidity and mortality rates than non-bereaved parents or adults who have lost their spouse or parents. Many bereaved parents in their daily routines include activities that allow them to maintain a relationship with their deceased child. These behaviors have been described as “continuing bonds”, but with this dissertation the continuing bonds concept is analyzed to provide a clear conceptual definition, which can be used for future research.</p><p>Using the Adaptive Leadership Framework as the theoretical lens and a mixed method, multiple case study design, the primary study in this dissertation aims to provides knowledge about the challenges parents face in the first six months following the death of their child, the work they use to meet these challenges, and the co-occurrence of the challenges, and work with their health status. Bereaved parents challenges are unique to their individual circumstances, complex, interrelated and adaptive, as they have no easy fix. Their challenges were pertaining to their everyday life without their child and classified as challenges related to: a) grief, b) continuing bonds, c) life demands, d) health concerns, f) interactions, and g) gaps in the health care system. Parents intuitively responded to the challenges and attempted to care for themselves. However, the role of the healthcare system to assist bereaved parents during this stressful time so that their health is not negatively impacted was also recognized. This study provides a foundation about parental bereavement challenges and related work that can lead to the development and testing of interventions that are tailored to address the challenges with a goal of improving bereaved parents health outcomes.</p> / Dissertation

Tsang Yik Wo. / "Architecture Department, Chinese University of Hong Kong, Master of Architecture Programme 2010-2011, design report." / Preface --- p.01 / Table of Content --- p.03 / Introduction / Chapter - --- Context and Scope --- p.05 / Chapter - --- Thesis Statement --- p.09 / Chapter - --- Interdisciplinary View --- p.11 / Chapter - --- Theoretical Framework --- p.15 / Value on the Place of Death / Chapter - --- Universal value --- p.17 / Chapter - --- Cultural value --- p.21 / Chapter - --- Local value --- p.23 / Chapter - --- Function of Cemetery --- p.38 / Architectural Research / Chapter - --- general understanding --- p.39 / Chapter - --- living and deceased connection --- p.43 / Chapter - --- living and deceased connection --- p.49 / Chapter - --- living and deceased connection --- p.55 / Chapter - --- land and spatial strategy --- p.59 / Site Selection / Chapter - --- a macro studies --- p.61 / Chapter - --- a micro studies --- p.63 / Spatial Requirement Analysis / Chapter - --- study on the space requirement and expected provision --- p.65 / Chapter - --- decay & regeneration --- p.67 / Design strategy / Chapter - --- urban strategy --- p.71 / Chapter - --- program strategy --- p.73 / Chapter - --- Final Design --- p.77 / Chapter - --- Special Studies --- p.87 / Conclusion --- p.91 / Design Process --- p.93 / Bibliography --- p.101

Grief is a life changing and universal experience, expressed through individual sets of responses and behaviours. Society and health workers’ interpretation and beliefs regarding grief and bereavement have changed throughout the decades. This is a continually evolving process. As we move into a new century, so too does grief move into a new era where a new postmodern paradigm is arising. We are thus deviating away from stage theories that are time limited, linear and predictable. Emphasis in this new wave of thought is placed upon grief as an oscillating and highly unique experience, one that encourages a continuation of a bond and lifetime relationship with the deceased. This current qualitative study explores the new phenomenon in relation to both the grief process and bereavement support programs, by extensively reviewing the literature and analysing data from a number of interviews with the bereaved. Furthermore the supports offered by society, with particular focus on a Melbourne Community Bereavement Follow Up Program, are reviewed. By observing and discussing expressions of grief it was found, although unique and varying, some patterns or common behaviors emerged. Supports and comforts that assisted the bereaved are explored. Issues, including inappropriate comments and problems with bureaucratic departments, are also developed and discussed. There is an emphasis placed upon the need of health care staff and the community in general to increase their understanding of the grief process and bereavement support, so as to enhance care and practice when working with people who have suffered loss.

Background This thesis addresses the topic of parental bereavement, using a multi-method approach. It aims to add to knowledge about the phenomenon of parental bereavement, outcomes for bereaved parents following the loss of their child, and factors associated with these outcomes. Method An initial literature study and qualitative investigation were carried out. Findings from these informed the choice of quantitative variables to be tested in a group of parents in early and mid-bereavement. Census records were used to provide information on long term health and social outcomes. Results The literature related to the parent’s experience following the death of their child is limited. The qualitative study indicated a variety of factors for testing, related to the circumstances of the loss, continuing bonds with the deceased child, restoration-oriented stressors, for example, employment and relationship problems, and ruminative behaviours. In early bereavement, lower grief levels were found in people who had displayed cognitive restructuring behaviours. Grief and depression were prevalent, and were found to exist independently. Rumination was associated with grief and depression in mid-bereavement. Grief was predicted by depression and self-blame and depression was, in turn, predicted by rumination and education level. Rates of mothers returning to work following the loss of a child in the first year of life were lower than those whose child lived. Mortality rates were up to four times higher in bereaved parents than non-bereaved comparisons, up to 35 years post-loss. Conclusions The loss of a child has ongoing social, emotional and health consequences for parents. Social factors are a particularly important issue, and therapeutic interventions may benefit from reducing negative aspects of coping such as rumination rather than promoting specific coping strategies. Support for bereaved parents should come from a number of sources, in order to address their complex and potentially long-term needs.

published_or_final_version / Social Work / Master / Master of Social Sciences

Thesis--PlanB (M.S.)--University of Wisconsin--Stout, 1998. / Includes bibliographical references.

Thesis (M.S.W.)--Smith College School for Social Work, Northampton, Mass., 2008. / Typescript. Includes bibliographical references (leaves 92-96).

Thesis (M.A. in Christian Formation)--Associated Mennonite Biblical Seminary, 2004. / Abstract. Thesis supervisor: Daniel S. Schipani. Appendix 1: "A Questionnaire for People Who Are (or at One Time Were) Widowed." Includes bibliographical references (leaves 141-150, 191-194).

Thesis (M.A. in Christian Formation)--Associated Mennonite Biblical Seminary, 2004. / Abstract. Thesis supervisor: Daniel S. Schipani. Appendix 1: "A Questionnaire for People Who Are (or at One Time Were) Widowed." Includes bibliographical references (leaves 141-150, 191-194).