This dissertation offers my personal exploration of the loss of my father through the eyes of multiple selves. Utilizing an arts-inspired autoethnographic narrative case study approach, I detail my journey of meaning making as I explore my personal transitions and self-discovery in the face of my bereavement, while also uncovering the potential for growth and development within my relationship with my dad. Throughout this dissertation, I incorporate a variety of mediums to capture the essence of the experience of my filial bereavement. Through this synthesis of form, it is my goal to invite witnesses to enter my experience, to have the opportunity to explore a different way of knowing by being able to look through the eyes of my multiple experiencing selves and their presentation of emotion, thought, and behaviour. Through blending of genre, this study provides a unique way of exploring a lived experience. It is meant to provide a specific view of a broad topic from multiple angles. Though it is situated within my personal bereavement, a daughter’s loss of her father, and inevitably my story will demonstrate the cultural influence of my Canadian background, it also aims to touch on aspects of the universality of loss, of bereavement, and what it means to be alive.

published_or_final_version / Social Work / Master / Master of Social Work

The rising population of older people in the UK (Office for National Statistics 2010) and pressure on healthcare services to reduce costs indicate the necessity of developing strategies that enable coping and independence. Loss through death of close family members, partners and friends is a key factor that inhibits physical, emotional and social well being of older people. The research carried out for this thesis explored bereavement in healthcare settings where contacts with bereaved older people commonly occur, and used data collected to develop guidelines for practice. The guidelines provide research informed enhancement to bereavement care and develop opportunities for meaningful interactions. They complement current policy development work on bereavement in healthcare settings (The Scottish Government 2011). A qualitative design drawing on phenomenological methodology was used to explore healthcare staffs’ experiences of caring for bereaved older people, and older people’s experiences of being bereaved and bereavement care. Theoretical sampling took place to recruit staff from a range of roles in general practice and community nursing, hospital wards and care homes, as well as a small sample of bereaved older people. Thirty nine participants took part in in-depth interviews that yielded four key themes: bereavement care depends on a relationship between healthcare staff and relatives; preparation for a relative’s death may not equate to preparedness for bereavement; the ‘Open Door’ to bereavement care is only slightly ajar, and bereavement care supports progression of the ‘Rolling Ball’ of life. The themes informed development of the guidelines in terms of structure and content. Recommendation statements consider bereavement care before the death; at the time of the death; and follow up in the weeks and months afterwards. Criteria in the recommendations provide suggestions for enhancements to practice that facilitate appropriate response to bereavement in older people. Consultation on the guidelines provided positive feedback that identified the potential to promote consistent interactions with bereaved older people, respond to needs and support coping.

Phase One: Effects of loss on the emotional health and well-being of children are wide-ranging and increase the risk of longer term impact on educational success and mental health (McLanahan 1999; Abdelnoor & Hollins 2004a). As frontline workers, school staff hold a role in identifying and supporting pupils at a universal level. How staff view the issue of loss and their role in supporting this is therefore pivotal. A survey design using two devised online questionnaires and semi-structured interviews identifies the experiences and perceptions of school based staff on the issue of loss for schools in one local authority. Using interactive analysis, qualitative and quantitative data from senior leaders in 20 schools, 25 additional school staff members and 9 multi-agency professionals is triangulated to determine perceptions. A range of effects across social, emotional, behaviour and learning are well recognised by staff although behaviour is used as the most frequent indicator of those at longer term ‘risk’. A more structured and rigorous school response exists for loss through death compared to family breakdown despite some specific staff concerns for pupils experiencing loss through multiple changes in the family. Whilst staff members indicate a high expectation to support pupils with loss, they report lower confidence in doing so. A series of influencing factors on staff perceptions are identified at a contextual, situational and individual level. Factors that could be targeted by Educational Psychology Service to help schools build capacity are highlighted, with future considerations for support with identification, training and supervision. Abstract: Phase Two: This second phase of a two part research design investigates how an Educational Psychology Service can increase the capacity of schools to support pupils who have experienced loss. Following a survey design identifying staff attitudes on the issue of loss for schools, a multi-method case study approach is used to research the implementation of a 6-week ‘Loss and Change’ intervention programme. Seven secondary age students participated in the group intervention for pupils who have experienced loss, facilitated by two Educational Psychologists working alongside a member of school staff. A grounded theory approach analysed data from observation, semi-structured interviews and self-report measures. Eight key processes that impact on the effectiveness of the programme are identified and the positive effects spanning social, emotional and behavioural mechanisms are reported for six of the participants. Potential implications of this model of practice for Educational Psychology Services seeking to develop the capacity of schools to support loss are discussed.

Most current grief programs support the children and/or parents of bereaved families rather than the family as a whole. This exploratory study was a quantitative and qualitative investigation of the use of expressive arts therapy with bereaved families during a weekend camp experience and a series of followup sessions. The purpose of the study was to determine the effectiveness of using expressive arts activities in improving the functioning of the bereaved family as a whole as well as individual family members. Participants included eight families who lost a child to a chronic illness between 2 to 36 months months prior to the onset of the study. Children ranged in age from 3 to15, and parents ranged in age from 26 to 66, for a total of 27 participants. The Child Life Department at Children's Medical Center of Dallas, a division of The University of Texas Southwestern Medical Center in Dallas, Texas recruited the families. Participants received flyers and invitational letters and registered through the mail. Families attended a weekend camp where they experienced a wide variety of expressive arts activities in a combination of group formats: multi-family groups, parents' group, developmental age groups for children, total childrens' group, individual family group, mothers' group, and fathers' group. The research design was a pretest/posttest quasi-experimental control group design, but a control group could not be established. Therefore, one-tailed t-tests were used to compare participant functioning between the beginning and end of the study. Instruments used in this study included the Family Environment Scale, the Behavior Assessment System for Children the Beck Anxiety Inventory and the Beck Depression Inventory. In addition, the researcher used qualitative analysis to assess contents of family members' and counseling staff's journals, expressive arts products, and family members' evaluations. Results of this exploratory study indicated some improvements in children's, parents' and total family functioning. Expressive arts therapy shows promise in effecting constructive change in bereaved families and is deserving of further research.

his study compares ethnic, age, and gender differences concerning attitudes and behaviors toward death, dying, and bereavement among Caucasian, African, Hispanic, and Asian American adult participants in north Texas with the results of a 1976 study by Kalish and Reynolds on death attitudes and behaviors of Caucasian, African, Mexican, and Japanese American adult participants in Los Angeles, California. A modified version of Kalish and Reynolds' study questionnaire was administered to 526 respondents (164 Caucasian, 100 African, 205 Hispanic, and 57 Asian Americans) recruited from community and church groups. Findings of this study were compared with those of Kalish and Reynolds in specific areas, including experience with death, attitudes toward one's own death, dying, and afterlife, and attitudes toward the dying, death, or grief of someone else. Data was analyzed employing the same statistical tools as those used by Kalish and Reynolds, i.e., chi square calculations, frequencies, percentages, averages, and analyses of variance. As compared with the earlier study, results indicated that this study's participants were less likely to have known as many persons who had died recently or to state they would try very hard to control grief emotions in public. Present study participants were more likely to have visited dying persons, to want to be informed if they were dying and believe that others should be informed when dying, to prefer to die at home, to have made arrangements to donate their bodies or body parts to medicine, to have seriously talked with others about their future deaths, to consider the appropriateness of mourning practices and the comparative tragedy of age of death from a relative standpoint, and to want to spend the final six months of their lives showing concern for others. Between study differences were found in ethnic group, age group, and gender group comparisons. Within study differences in death and dying attitudes were also found in this study among ethnic, age, and gender groups.

A literature study was undertaken to investigate the experience of loss and grief in the different developmental stages, as well as to identify characteristics of loss and grief in the young child. Guidelines have been compiled on how to handle loss and grief in young children. The empirical study comprised of workshop presentations. Through these presentations it was also determined as to whether parents and children would benefit from such workshops, as well as if the information regarding loss and grief addressed the parents’ needs. The empirical study found that parents are ignorant about loss and grief in the young child. However, all the parents had questions about loss and grief. After the workshops parents indicated that they became aware of positive changes in their own behaviour towards their children, and also in that of their children. One of the biggest problems in handling loss and grief in the young child seemed to be open and honest communication. / Educational Studies / M.Ed. (Guidance and Counseling)

Det mest dramatiska en tonåring kan uppleva är att en förälder dör.Det finns behov av kunskap om hur personer som upplevt detta anser vara ett gott stöd. Vetenskapliga studier, lagar och handlingsplaner om hur vårdpersonalen ska tillgodo se dessa behov finns redan. Dock vet man ytterst lite om vilka råd tonåringar som kommer att förlora en förälder i cancer skulle vilja ge vårdpersonalen.Beskriva tonåringars behov av stöd och delaktighet i samband med att en förälder blir sjuk och dör i cancer.Uppsatsen är en del av en nationell populationsbaserad studie med tonåringar (13-16 år) som förlorat en förälder i cancer 2000-2003. Data insamling gjordes via enkäter 6-9 år efter föräldraförlusten. Uppsatsen utgår ifrån enkätens sista fråga: Vilka råd skulle du vilja ge den personal som vårdar cancersjuka föräldrar till tonårsbarn? En induktiv innehållsanalys har använts som analysmetod. De unga vuxna beskriver tonåringens behov av att få veta allt om sin förälders sjukdom. De ger vårdpersonalen en mångfald beskrivningar av råd om hur och när information bör ges. Svaren berör även hur vårdpersonalens agerande påverkar mötet med tonåringen. Resultatet i uppsatsen diskuteras bl.a. genom den modell för delaktighet Andershed (1989) utvecklat. Både delaktighet i ljuset och delaktighet i mörkret beskrivs i modellen. Tonåringarna vill veta allt om sin sjuke förälder för att kunna känna delaktighet med sin förälder på ett meningsfullt sätt. Tonåringarnas känsla av delaktighet kan påverkas av hur vårdpersonalen bemöter dem.

Background: Cconsiderable proportion of the population experiences major life disruptions after losing a loved one to suicide. Social stigma attached to suicide survivors adds to complications occurring in the course of suicide bereavement. Despite its known risks, stigma related to suicide survivors has been sparsely investigated. Methods: We conducted a systematic literature search in PubMed, Web of Science, PsycInfo and PsyArticles, of studies indexed up through August 2015. Articles were eligible for inclusion if they addressed experiences of stigma in suicide survivors, compared them to other bereavement populations, or investigated stigmatizing attitudes within the public. The search was restricted to English-language studies. Results: 25 records matched inclusion criteria. Study designs were heterogeneous, making comparisons difficult. Results demonstrated that suicide survivors experience stigma in the form of shame, blame, and avoidance. Suicide survivors showed higher levels of stigma than natural death survivors. Stigma was linked to concealment of the death, social withdrawal, reduced psychological and somatic functioning, and grief difficulties. Only one study investigated stigmatizing attitudes towards suicide survivors among the general population. Limitations: Internal and external validity of the studies was restricted by a lack of valid measures and selection bias. Conclusions: More methodologically sound research is needed to understand the impact of stigma on suicide survivors\' grief trajectories and to separate it from other grief aspects. Clinicians and grief-counselors as well as the public should be educated about the persistent stigma experienced by suicide survivors.

Although funerals are seen as universal rituals to honor the death of a loved one, their value in facilitating the grief process is not known. The present study explored the relationships between cause of death, feelings and attitudes toward the funeral, and subsequent bereavement adjustment.