Family Focused Grief Therapy: A Model of Family-Centered Care during Palliative Care and Bereavement

By David W. Kissane; Sidney Bloch | Go to book overview

Foreword

COLIN MURRAY PARKES

To those of us who have been aware of the innovative service to families facing death and bereavement that has been developed by David W. Kissane and Sidney Bloch this book has been eagerly awaited. Their work is a logical development in the field of palliative care in which it has long been recognized that, when life is threatened, it is the family (which includes the patient) which is, or ought to be, the unit of care.

The work also has great relevance for the wider field of bereavement care in which there is general acceptance that grief, the reaction to loss, is a consequence of the attachments that are severed. Since it is to our families that we are most strongly attached it follows that grief is a family event and that it is likely to be influenced by the particular attachments that exist within the family. Thus Raphael (1977) has shown that bereaved people who perceive their family as unsupportive often have difficulties after bereavement but they are also more likely than others to benefit from counselling. This suggests that one of the functions of the counsellor is to provide the kind of support which can be, but is not always, given by our friends and family.

Given this evidence the reader may be surprised that family focused grief therapy was not discovered long ago, that most of the support given to families before bereavement (even in the best hospices) is unsophisticated, and that most bereavement care is provided on a one-to-one basis at a variable time after bereavement. The reasons for this are partly historical and partly scientific. Psychological interest in bereavements and other stresses arose from the recognition that wars and disasters can cause serious psychiatric disorders. Thus, Freud's influential speculations about the relationship between 'mourning and melancholia' (1917) and Lindemann's observations of 'the symptomatology and management of acute grief (1944) both identified pathological grief as a mental disorder requiring treatment. This

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