Grief and loss theory in social work practice: All changes involve loss,just as all losses require change

Working with and recognising grief and loss issues have long been identified as one of the core skills of social work practice. Despite its centrality, the exploration and application of grief and loss theory from a perspective other than death and dying has received sporadic attention in social work literature. This paper begins with a personal reflection from practice, which provided the catalyst writing in the first place. The concepts of grief and loss are then discussed in relation to losses other than death and dying. An analysis of historical and contemporary theories of grief and loss will then be explored, with the author advancing a theoretically expansive approach to grief and loss. This theoretical approach is one that is consistent with social work practice and is committed to diversity of experience and clients' strengths, as it adopts a framework for practice, which is constantly mindful of the context and meaning systems of social work clients.     

“She was more than a friend”: Clinical intervention strategies for effectively addressing disenfranchised grief issues for same-sex couples

This article focuses on grief experienced by same-sex couples with attention to the distinct factors that influence same-sex grieving partners within all social work system levels. An actual case narrative—the first author's lived experience—guides the reader through a powerful, personal journey to gain a greater perspective and connection on the impact of grief and loss. The concept of disenfranchised grief is applied to same-sex couples focusing on the grieving process. The authors delineate effective strategies for practitioner intervention for those working with individuals experiencing grief due to the loss of their same-sex partner. Particular emphasis is placed on cultural competence and cultural humility for enhanced effectiveness while working with same-sex-partner grief issues.     

Drawing from experience.

The journey through grief after exposure to a sudden traumatic death is a painful and personal experience for children. This requires therapeutic interventions that explore and facilitate the healing potential within each child. Drawings are an expressive method that can provide a conduit for identifying and understanding issues requiring therapeutic intervention and follow up.     

The medicalization of women's sexual pain

The medicalization of women's sexual problems under the overall rubric of female sexual dysfunction (FSD) has been thoroughly critiqued by feminist scholars, health practitioners, and sex therapists. However, there has been much less commentary on the medicalization of women's sexual pain-currently, a subset of an official FSD diagnosis. This article critically examines interdisciplinary understandings and ways of addressing sexual pain. It analyzes these frameworks in relation to feminist theories on medicalization, heteronormativity, and the reciprocal relationship between these two processes. We argue that many women who experience sexual pain have been eager for medicalization as a path to minimizing pain during sexual activity and reinstating normative heterosexual practices and identities. These goals have been lobbied for by patient advocacy groups and noted by professionals in the field. Although there are some clear benefits to this case for medicalization, there are also theoretical, personal, and political costs. Guided by a growing body of feminist theoretical and qualitative, empirical research on this topic, as well as the first author's personal experience of sexual pain, this article highlights some alternatives to medicalization and makes suggestions for change.     

Parental Grief and Serious Mental Illness: A Narrative

Serious mental illness is associated with substantial personal and interpersonal distress and life disruption for the sufferer and for his/her family. A common response to having and caring for a family member with a serious mental illness is feeling loss and grief. This paper presents a representative narrative that attempts to capture the essence of the experience as conveyed by 22 parents of adult children with a serious mental illness. The implication of the narrative is examined.     

The Social Shaping of Emotion: The Case of Grief*

This article addresses the issue of how deeply social arrangements may penetrate into private emotion, in this instance, grief. It argues that the data necessary to address the issue satisfactorily are not available and thus current assumptions in the literature about the universality of the grief experience are at least suspect. However, there are theoretical reasons, derived from interactionist thought, to suspect that if certain components of the grief experience vary, so will the experience. Four of these components are examined (level of significance of the other who dies; definition of the situation surrounding the death; character of the self experiencing a loss through death; and the interactional situation/setting in which the prior three components occur). Evidence is also presented which is suggestive of space-time variation in these components. It is concluded that an assumption of the deep social shaping and thus the variability of grief is fruitful for further empirical inquiries.     

Gay Men and HIV

SUMMARY

This paper reports on the results of qualitative studies examining the personal experiences of sex and sexual negotiation for British gay men who are diagnosed HIV positive and those who know or presume themselves to be uninfected. These are contrasted with the results of a study of representations of HIV and AIDS within an international review of community health promotion literature aimed at gay men. The paper highlights the disparity between specific community responses to the epidemic as engendered in the cultural production of health promotion materials and the individual experience of HIV, suggesting a! paradigm for a community response to the epidemic which reflects the personal experience of gay men both infected and uninfected.     

Preparing Social Workers for the Inevitable

Despite the centrality of grief as a universal response to loss, and its prevalence in the social work domain, little empirical attention has been given to the impact of grief instruction in social work courses. This article presents results of a study examining the impact of a multimethod grief course on graduate social work students' level of death acceptance and sense of preparedness to respond to personal and professional losses. A quasi-experimental, nonequivalent control group design was used. Findings suggest that the grief course assisted students to perceive greater competence in their knowledge, skills, and sense of preparation for working with grieving clients, and that the course increased cognitive and affective dimensions of death acceptance in students. Implications for future research and for social work education are discussed in light of the study limitations.     

The State of Sex Research in MFT and Family Studies Literature: A Seventeen‐Year Content Analysis

The ability to conceptualize and treat sexual problems has been widely accepted as a crucial skill to master the MFT training. However, clients’ sexual relationships are often ignored by clinicians because of a lack of experience or training, or personal discomfort. In this content analysis, we review sex and sex therapy research within MFT and family studies journals since the turn of the century. Of the 13,919 articles published within the 15 journals, 137 focused on sexuality or sex therapy. The articles were divided into five themes: sexual and relational health, sexual diversity, treatment and contributors of sexual dysfunction, sex therapy practices, and sexual education and development. Implications for clinical practices, sex therapy integration, and future research are discussed.     

Grief and loss of a caregiver in children: a developmental perspective

Grief is one's response to loss. Each person's expression of grief is unique and influenced by factors such as age, culture, and previous exposure to loss. Whether or not children grieve has been debated, with some proponents stating that children do not grieve at all until they are adolescents, and others asserting that infants are capable of grief. The most common conclusion is that children of all ages do grieve, although their grief is different from that of adults. Children's grief is also closely related to developmental stage, so children of varying ages also grieve differently. Therefore, supporting a grieving child is relative to his or her stage of development. For this reason, it is important for practitioners working with grieving children to understand the manifestations of grief at various developmental stages, to provide competent support to children of all ages who experience loss.     

Now the Orgy Is Over

Based on six months of ethnographic fieldwork, this study explores the intersections between embodied flesh and digital (re)presentations by examining how participants experience virtual sex on Second Life. We explore how and to what extent Second Life avatars mediate personal desires and fantasies with others who, collaboratively, construct sexual adventures in forms of playful deviance that allow for the emergence of secret sexual selves, as well as how those sexual adventures are ultimately fashioned and experienced in a “diffused life” that is neither of Second Life nor of first but a tightly bound combination of the two. Despite the enormous freedom of Second Life residents for seemingly boundless creative self‐expression, we conclude that these experiences are more bound to and confined within disciplined practices than they first appear.     

The Impact of Sexual Abuse Treatment on the Social Work Clinician

A growing body of literature exists on the prevalence and psychological sequelae of sexual abuse and its treatment. However, less attention has been focused on the experience of clinicians who treat these clients. This article uses the concept of vicarious traumatization (McCann and Pearlman, 1990a) to describe the impact this work may have on the social work clinician. The issues addressed include the impact of the work on the clinician's world-view and the possibility that there is a grief process as clinicians come to terms with their exposure to traumatic material. Implications of this reaction and suggestions to alleviate the detrimental effects arc addressed.     

Social work intervention with bereaved children

Abstract

Bereavement in childhood can seriously affect a child's development. There is a tendency to diminish the child's experience of loss because bereaved parents are often less sensitive to their children and because children express their grief in a more discreet manner than is typical of adult grief. This tendency leads to the child's needs being underestimated and under-reported. A model of social work intervention which advocates short-term involvement has been shown to have a significant effect upon the well-being of the child and his family. The paper begins with a brief review of the literature on mourning, which highlights various perspectives on the role and nature of the process. A model of mourning which embraces the differences between adult and child mourning will be proposed which is informed by the principles of attachment theory and defined as a continuing process of adjustment rather than a resolvable experience of loss. This model of mourning has implications for social work intervention and is the foundation of the practice model. The practice model involves six bereavement counselling sessions with the parent, six play sessions with the child and formal and informal involvement with the child's teacher. It has four aims: (I) to enhance sensitivity in the parent to the child's experience of loss and mode of mourning, (2) to develop an improved pattern of communication within the child-parent relationship, (3) to develop resources for the child in his personal environment and (4) to enhance the child's resourcefulness within his mourning thus enabling him to feel more competent in the longer term. The model is founded upon an awareness of the need for short-term intervention within the context of a long-term issue and seeks to address both perspectives simultaneously. Some of children's commoner responses to bereavement will be outlined within the context of the play sessions and methods for resolving the problems associated with them will be discussed. Finally the nature of reasonable outcomes for the work will be considered.     

Miscarriage in the Workplace: an Authoethnography

This paper is an extension of the literature on pregnancy and work, and it introduces miscarriage as an important topic of study in management. Miscarriage starts with a pregnancy, so a woman who has miscarried deals with many of the same workplace issues as women who carry to term. The experience of miscarriage, however, often leads to physical and emotional trauma and/or grief that many women hide from their co‐workers. In this paper we also explore how secrecy is an integral part of the miscarriage experience. The combination of secrecy and grief that is layered on top of a difficult physical experience makes miscarriage a unique experience that, to date, has mostly been ignored in management literature and practice. It is well documented that contemporary corporate structures have little room for addressing procreation, health and grief, it is perhaps unsurprising then that despite miscarriage being seen as a relatively common event it remains silenced.     

What is Sexual Satisfaction? Thematic Analysis of Lay People's Definitions

Sexual satisfaction is an important indicator of sexual health and is strongly associated with relationship satisfaction. However, research exploring lay definitions of sexual satisfaction has been scarce. We present thematic analysis of written responses of 449 women and 311 men to the question “How would you define sexual satisfaction?” The participants were heterosexual individuals with a mean age of 36.05 years (SD = 8.34) involved in a committed exclusive relationship. In this exploratory study, two main themes were identified: personal sexual well-being and dyadic processes. The first theme focuses on the positive aspects of individual sexual experience, such as pleasure, positive feelings, arousal, sexual openness, and orgasm. The second theme emphasizes relational dimensions, such as mutuality, romance, expression of feelings, creativity, acting out desires, and frequency of sexual activity. Our results highlight that mutual pleasure is a crucial component of sexual satisfaction and that sexual satisfaction derives from positive sexual experiences and not from the absence of conflict or dysfunction. The findings support definitions and models of sexual satisfaction that focus on positive sexual outcomes and the use of measures that incorporate items linked to personal and dyadic sexual rewards for both men and women.     

Editorial: Adiós: A farewell address

This brief farewell address presents a personal point of view on the state of sex research and the organizations which support scientists and scholars who work in this field. This point of view has been shaped by my experience as Editor (1988–1992) of The Journal of Sex Research, as well as 20+ years of conducting research on human sexual behavior.     

"Course is team taught": dimensions of difference in classroom pedagogy

We report on students' response to kinds of difference in the classroom as we have assessed it in our personal experience as a same-sex, mixed race, leftist couple team teaching in two disciplines and at five separate schools over a number of years. We argue that students are more accepting of differences arising out of sexual preference and race and most resistant to differences arising out of class, especially poverty.     

Memory,Mourning and Meaning in a Psychotherapist’s Life

In this paper the author, a psychotherapist specializing in bereavement, recounts her personal experiences of loss and the ways in which they intersect and inform her professional life. One clinical vignette explores how unresolved grief in a patient and anticipated grief in a therapist emerge in transference-counter-transference issues. Another vignette illustrates a way in which supportive therapy can open the door to intra-psychic work with the ill or dying patient and how psychoanalytically informed psychotherapy with the aged can help them to re-imagine their lives and to form different relationships, in their minds, with significant others in their past.     

Sexual Identity Formation of Women Who Love Women: A Contextual View Point

Nonheterosexuals experience oppression and discrimination that affect personal development on all levels. An increased awareness of sexual identity development could create more inclusive sexual identity models, better understanding for counselor educators, and better training for counselors on issues of sexual identity. The purpose of this study was to identify the life experiences that influence sexual identity in women who love women. This study required that participants attach meaning to sexual identity formation. From the data collected, four themes emerged: I was just different, information seeking, view of self as a woman within the context of culture, and contextual relationships. Findings of this study did not support a stage model of sexual identity development. Instead, this study supported the view that sexual identity is fluid and strongly related to relationships with peer groups.