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The mourner's history of losses, personality style, and pre-morbid mental health adjustment also impact the grief process (Rando, 1993). The traumatic circumstances that surrounded the events of September 11th added an unprecedented degree of complexity to the grief of those who experienced losses that day. While it appears reasonable that issues related to the trauma itself must be resolved before there is sufficient intrapsychic energy to deal with the loss per se, parsing out the differences between the symptoms of post-traumatic stress and those of complicated grief can be challenging (Figley, Bride, & Mazza, 1997).
Depressive symptoms may also be confusing and interfere with the recognition of and response to the symptoms of complicated grief (Rando, 1993). Especially in the initial phases of recovery from a traumatic loss, individual interventions are an appropriate modality of treatment. The process of assessment for the variety of co-morbid risks that can accompany traumatic loss is facilitated in individual sessions. There is also the opportunity to provide support and problem-solving that specifically address the challenges that have been generated by both the loss itself, the circumstances surrounding it, and its intrapsychic concomitants.
But because of the sense of emotional isolation that commonly accompanies both trauma and the loss of a significant other, support groups are an excellent adjunct to individual treatment (Figley et al., 1997). Studies report the importance of the supplemental support system such groups provide, and the critical necessity for normalizing discussions about reactions and difficulties that take place in group sessions (Yule & Udwin, 1991; Fitzgerald, 1994; Rando, 1988; Underwood & Dunne-Maxim, 1992).
In later stages of recovery, group support can be essential to the process of going on with life. Immigrants and Cultural Minority Groups Given both the effect that culture has on grief and bereavement, and the disproportionate rates of infant death, particularly among Afro-Caribbean immigrants compared to European, Latin American, Mexico, and those born in the United States, we sampled providers serving this community. The importance of cultural competence cannot be overstated. Cultural competence should include: providers being aware of their cultural traditions and beliefs, learning about the cultural beliefs and customs of the community being served, having genuine appreciation and respect for cultural diversity, and being empathic, flexible, and prepared to tailor the care to meet individual and family needs of those that have suffered a loss (ACOG).
The Needs of People Experiencing Loss, Grief, and BereavementThere was broad agreement that the needs of individuals regarding loss, grief, and bereavement are highly individualized. There is a wide range of grieving styles and experiences. However, the fundamental needs of bereaved individuals are support and acceptance. This includes recognition and validation of their grief and grieving style, from family, friends, employers, and the general community.
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