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Grief and Loss Treatment
1. Journey to Recovery Series
Grief and Loss Activities
Presented by: Dr. Dawn-Elise Snipes
Executive Director, AllCEUs
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2. Objectives
Define grief
Conceptualize grief in terms of any loss
Identify how failure to deal with grief can impact
a person
Explore the stages of grief
Review activities and interventions to help people
grieve
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3. Question
What types of things have people lost that need
to be grieved?
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4. What is Grief
Grief is a label assigned to all of the emotions
associated with dealing with any kind of loss
Physical (Things, abilities, freedoms)
Self-concept (Roles, values, labels)
Worldview (Innocence, safety)
Dreams (How things should be)
Social (Loss of relationships…)
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5. What is Grief
Primary losses also produce secondary losses
which also need to be acknowledged and grieved.
Loss of a part of ourselves
Loss of identity
Loss of self confidence
Loss of a chosen lifestyle
Loss of security or a sense of safety
Loss of dreams
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6. What is Grief
What secondary losses might occur for these events?
Death of a parent
Separation or divorce
Miscarriages
Disability
Chronic pain (fibro, rheumatoid arthritis)
Diabetes/Chron’s
Loss of a job
Moving to a new place
A child leaving home
House fire/tornado
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Loss of a part of
ourselves
Loss of identity
Loss of self confidence
Loss of a chosen lifestyle
Loss of security or a
sense of safety
Loss of dreams
7. Types of Grief
Anticipatory Grief: Experiencing anticipatory grief may provide time
for the preparation of loss, acceptance of loss, the ability to finish
unfinished business, life review and resolve conflicts
Normal Grief: Normal feelings, reactions and behaviors to a loss; grief
reactions can be physical, psychological, cognitive, behavioral
Complicated Grief:
Chronic Grief: Normal grief reactions that do not subside and continue over
very long periods of time
Delayed Grief: Normal grief reactions that are suppressed or postponed. The
survivor consciously of unconsciously avoids the pain of the loss.
Masked Grief: Survivor is not aware that behaviors that interfere with normal
functioning are a result of the loss.
Disenfranchised Grief: The grief encountered when a loss is experienced and
cannot be openly acknowledged, socially sanctioned or publicly shared.
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8. Stages of Grief
Denial: Numbness, dream, alternate explanations)
Anger: The unknown, loss of control, death,
isolation, failure—(shouldas and couldas)
Bargaining: If I … then I will wake up and realize
this was only a really bad dream
Depression: Helpless, hopeless
Acceptance: Radical acceptance that the loss
occurred and determining how to proceed from
there
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9. Exacerbating & Mitigating factors
How people react in a crisis depends upon 6
factors
How close the situation was to them (physical and
emotional proximity)
How many other stressors them experienced in the last
year
Mental health issues/Effective coping skills
Social supports
Understanding of the loss (meaning and cognitively)
How much control/responsibility they feel like they
had in the situation
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10. Impact of Unresolved Grief
Most people get stuck in either anger or
depression
Anger (shoulda, couldas and if onlys)
At self
At others
At higher power
Depression (Hopelessness, Helplessness—I don’t
now how to go on)
At self
At others
At higher power
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11. Denial
Denial, numbing is the mind’s way of protecting
people from what lies ahead.
Facing the loss
Understand the events of their lives and reconcile the
losses they have experienced (clarification)
What happened to me?
Anger is the power play
Break down the walls (Bricks or legos with the losses and
threats represented)
Bargaining, Pining
Mindfulness
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12. Depression
Depression, Disorganization and Despair
Address hopelessness and helplessness by focusing on
what can be changed
Death Disappearance
Loss Nothing will ever be okay again
Failure Failure at everything
Bad thing happens It has to happen again
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13. Acceptance
Acceptance/Reorganization
Redefine worldview integrating new experiences and
strengths
Visualize a positive future
Who am I? (identity)
Where am I going? (attachment)
How will I get there? (relationships)
When will I know I belong? (claiming and safety)
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14. Not a Linear Process
Most people experience grief surrounding a loss
for at least a year. (Timeline)
Holidays
Anniversaries
Reminders (people, places, things, media)
Many people will vacillate between depression
and anger. (Mindfulness, Emergency plan)
Normalize people’s experiences
Encourage them to reach out to supports
Address happiness and survivor guilt
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15. Self Care for Grief
Emotionally
Express feelings
Ask for and accept help
Don’t let anyone tell you how to feel—and don’t tell yourself
how you “should” feel
Be patient
Be kind to yourself
Add happiness triggers
Be aware of your grief triggers
Embrace the dialectic
It is gone but I have the memories/what I learned
I cannot change it but I can impact how it continues to impact
me
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16. Self Care for Grief
Physically
Get plenty of quality rest
How to handle being alone with your thoughts….
Exercise
Eat a healthy diet
Avoid alcohol
Pay attention to persistent changes in eating, sleeping,
mood or energy levels
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17. Self Care for Grief
Psychologically
Write things down
Simplify
Set short term goals
Distract/engage in pleasurable activities
Start writing the next chapter in your story
Plan ahead for grief triggers
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18. Self-Care for Grief
Interpersonally
Rebuild relationships (even understand they can be
members of more than one family)
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19. Bill of Rights for Grief
To know the truth about the loss
To have questions answered honestly
To need people and be heard with dignity and respect
To be silent and not talk about grief emotions and thoughts.
To talk about the loss as much as needed
To not agree with your perceptions and conclusions
To see the person who died and the place of the death.
To grieve any way she/he wants without hurting self or others.
To feel all the feelings and to think all the thoughts of his/her own unique grief.
To not have to follow the “stages of grief” as outlined in a book.
To grieve in one’s own unique, individual way without censorship.
To be angry at death, at the person who died, at god, at self, and at others.
To have “griefbursts”
To be involved in the decisions about the rituals related to the loss
To not be taken advantage of
To have guilt about what he/she could have done or shouldn’t have done
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20. Activities
Create safety
Invisible string (Windchime (heart, shells, keys, pipes,
terra cotta pots )
Book of memories
Heart-Break Pot (break into large pieces)
Using paint pens and markers, have each family member or
child write on the inside of the broken pieces.
Instruct them to identify their feelings about being alone in
their grief.
On the outside of the pieces write about or draw their
sources of support.
Glue back together
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21. Activities
Goodbye letter
Letter to God
Memory garden
Jar of memories / regrets
Memory mural
Timeline of Change
2 Box Organization – Keep it or Trash it
Create a family flag
Alphabet of gratitude
Raise and release butterflies
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22. Activities
Jenga (write discussion prompts on cards)
What is your favorite memory
What is the hardest part of the loss
What is something you learned
What is something you did to make yourself laugh this week
Who is your support
What are 2 things that help you most right now
The hardest time of day is…
When I am alone, I can…
Some things I enjoy
Changes in my family because of the loss
I am feeling…
3 ways to release feelings of sadness
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23. Summary
Losses encompass more than death or a person or
loss of property
Failure to acknowledge losses can cause unhelpful
reactions in similar future situations
It is important to explore feelings and reactions in
terms of their functionality---how are they
benefitting the person
It takes at least a year to deal with significant
losses
Many times there are multiple ancillary losses
that need to be addressed
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24. Summary
How people deal with grief and loss varies widely.
Grieving is a form of crisis
The body is on high alert which likely impacts
sleep, eating and energy to work or socialize
Minimizing vulnerabilities is important to reduce
unnecessary frustration and avoid confirming
helplessness
Ultimately it is hoped that the person can identify
how they are stronger or better off from the
experience
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