A CONTENT ANALYSIS OF THE TREATMENT NARRATIVES OF PATIENTS WITH COMPLICATED GRIEF
Stephanie A. Wilsey, Ph.D.
University of Pittsburgh, 2006
This dissertation explores the verbal content of revisiting exercises told by patients diagnosed with Complicated Grief during a therapy session. A revisiting exercise is a complete narrative account of a primary loss, from the time that the patient discovered or heard of the loss until the funeral and aftermath. Twenty-two patients receiving treatment for Complicated Grief each provided his or her last revisiting exercise from treatment. Narratives were analyzed via qualitative content analysis. Pearson Product Moment Correlations and Spearmans Correlation Coefficient for Ranked Data were also used to examine the relationship between narrative content and patients grief, depression, and trauma symptoms.
Results revealed four major thematic categories within the narratives: Emotions, Cognitions, Social Support, and Focus on Death. Overall emotional content tended to be negative, with an emphasis on angry and sad feelings. While patients spoke longer about unsupportive social networks, most patients reported a mix of supportive and unsupportive friends and family. Important cognitive categories included self-evaluations, blame, and asking why the loss occurred. Finally, for most patients, the appearance of the corpse became fixated in their minds and they had trouble getting past their dual aversion and fascination with this image.
Correlations between themes and symptoms scores did not occur in the expected direction and were not consistently significant. Correlations were useful, however, in generating hypotheses for further qualitative analyses. For example, the present study indicated that the integration of narrative themes should be explored in future research.
The study indicated that patients wove positive and negative themes together but primarily focused on themes that troubled them, such as unsupportive family and the corpses appearance. Although patients were told to tell the story of the death, for most, additional themes such as the support or lack of support from others were integral to the stories. Exploring a subsample of patients revealed how and where in the narratives patients described particular themes. In addition, the subsample exploration revealed that anger was the unifying theme in the narratives, particularly in narratives from early treatment sessions.
Implications for Complicated Grief research and treatment are presented, as well as implications for grief narrative research.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-04122006-184120 |
| Date | 18 April 2006 |
| Creators | Wilsey, Stephanie A. |
| Contributors | Nancy Elman, M. Katherine Shear, Maureen Porter, Louis Pingel |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-04122006-184120/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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