II. Diagnosis: Complicated Grief Reaction
-
General
- Symptoms present for 6 months
- Results in functional Impairment
- Based on expert opinion (Not defined in DSM IV)
- Major Criteria (3 of the following, daily or severe)
- Intrusive thoughts about deceased
- Yearning for deceased
- Searching for deceased
- Excessive loneliness
- Minor Criteria (4 of the following, daily or severe)
- Lacks sense of purpose
- Decreased emotional responsiveness
- Disbelief about the death
- Life feels meaningless
- Sense that part of self has died
- Lost sense of trust of control
- Performs harmful behaviors associated with deceased
- Excessive irritability or anger about death
III. Clinical communication strategies
- Effective strategies
- Use the deceased name in place of they or them below
- Acknowledge their death
- "I am sorry that they are gone"
- Talk about the deceased and memories
- "What are you remembering about them today"
- Bring closure on their death
- "...questions about final illness or treatment?"
- Talk about grief feelings
- "How has their death affected you"
- Harmful strategies to avoid
- Avoid being too casual or aloof
- Quick "Call me" or "How are you"
- Avoid pat answers
- "They are happy now" or "It is God's will"
- Avoid disallowing patient's feelings
- "You should be getting over this by now"
- Avoid being too casual or aloof
IV. Management: Complicated Grief Reaction
- Cognitive behavior therapy (Traumatic grief therapy)
- Selective Serotonin Reuptake Inhibitor (SSRI)