Description of Models
The Two-Track Model
The Two-Track Model of bereavement primarily focuses on providing assistance and guidance to people who have experienced the loss of a significant other. Thus, the model defines two multidimensional tracks of the bereaved individual’s life and examines the bereavement response within the framework. One of the tracks in the model presents the dimension of biopsychosocial functioning that focuses on an individual’s social, behavioral, emotional, cognitive, and physical functioning. The other track focuses on the relationships with the deceased and the emotional bonds that connect them with the bereaved. Thus, consideration of bereavement response in the Two Track model helps define the effects of loss on an individual’s life and transform the relationship bonds to ensure their continuity.
The Two-Track Model of bereavement is a relatively old model, and much of its theoretical development occurred in the 1980s (Neimeyer et al., 2021). According to Steffen et al. (2022), the author of the theory, Simon Shimshon Rubin, initially came across the problem of inconsistency of clinical data in one of his research studies with the existing bereavement response models. Thus, the Two-Track Model presented Rubin’s attempt to explain the clinical data where non-recently bereaved maintained a strong emotional connection with their deceased children (Steffen et al., 2022).
Including two tracks in the model allowed Rubin to explain the unique lasting connection between the bereaved and deceased that may arise after the loss. Thus, applying the model allows for defining bereavement as a process throughout life, bringing clarity to possible interventions. Considering the aspects of strengths and limitations, the Two-Track Model has significant strengths in application to cases of spousal mourning for partners with cognitive impairment, such as dementia.
Thus, the study conducted by Rubin et al. (2021) suggests that the insights from the Two-Track Model of bereavement can provide the foundation for examining grief in dementia patients. In such cases, integrating the Two Track Model requires slight alterations in the second track, where relationship bonds with other persons are replaced with the patient’s internal representation (Rubin et al., 2021). Therefore, the model’s focus on two dimensions provides a broad scope for possible alterations and applications.
However, the Two-Track Model does not address possible cultural nuances in responses to loss. For example, the article by McDuffie et al. (2021) suggests that the model can be modified for application in the African American population. Thus, the model’s strength in the possibility of alterations neutralizes the model’s neglect of cultural differences in grieving.
Meaning Reconstruction
Attempts to find meaning in life and its loss present one of the common effects of loss on the bereaved. The Meaning Reconstruction in Bereavement program helps mourning clients find meaning in life after loss. The program also guides clients’ attempts to make sense of the meaning behind loss. According to Neimeyer, searching for the meaning can be characterized as an individual’s effort “to anticipate and to some extent control the events that constitute their lives” (2019, p. 81). Thus, the reconstruction of meaning presents an approach to grief based on the psychological constructivism theory (Neimeyer, 2019).
The treatment in the reconstruction process focuses on developing the client’s self-narrative. The main goal of the treatment in meaning reconstruction focuses on addressing two prominent dimensions of the client’s concerns. Thus, the first dimension focuses on establishing the client’s understanding of loss and its effects on the client’s life. The treatment in this dimension prioritizes the client’s processing of the story of the death event. The possible treatment activities, in this case, recommend that the mourner share the story of the death event with close ones or retell the narrative in written form (Neimeyer, 2019).
On the other hand, treatment focused on the alternative dimension of accessing the back story prioritizes restoring the client’s attachment to the deceased. The possible recommended treatment measures include the creation of imaginary conversations with the deceased in verbal or written form (Neimeyer, 2019). The meaning reconstruction model presents a relatively new approach to grief and loss counseling, with most contributions to the development of the concept made by Robert Neimeyer. The meaning reconstruction model is often applied in a family setting where bereaved caregivers face risks of high grief levels.
For example, the study conducted by Romero (2021) assessed the effects of meaning reconstruction applied to caregivers of patients with Alzheimer’s disease. The study defined that in most cases, applying the meaning reconstruction model positively reduces grief and supports caregivers’ positive thinking. However, some experts suggest that the positive effects of the application of the meaning reconstruction model in a family setting can face limitations in the form of family members’ attempts to “coregulate” each other’s grief experiences (Barboza et al., 2022, p. 6). Therefore, the model’s strength in application to a family setting depends on the family members’ relationships.
Worden’s Task Model
Worden’s Task Model perceives grief and bereavement as both mental reactions and cognitive processes, which involve restructuring thoughts about the deceased and defining the changes in the world after loss. Thus, the model outlines four specific tasks the bereaved can use to adapt to the loss. The model was introduced as an alternative to Kubler-Ross’s theory of the five stages of grief.
Compared with the other two models discussed earlier in the paper, Worden’s Task Model also allows the bereaved to evaluate the impact of loss on their life and process the grief. However, the four-task model provides a more extensive plan of action. Sometimes, the four-task model is also known as the TEAR model. Thus, the title presents a combination of abbreviations for each task.
The first stage of the model requires the bereaved to accept the loss and its irreversibility. According to Khosravi (2021), searching behavior, such as spiritualism, presents a common outcome of failing to accept the loss. Thus, the therapist’s primary goal in this task is to provide assistance to survivors and convey the message about the irreversibility of death (Khosravi, 2021). The following task requires the bereaved to experience and process the pain of grief.
The second task addresses that sometimes bereaved avoid processing grief by rejecting their feelings or resorting to escapism. For example, Khosravi (2021) explains that the use of alcohol or drugs can interfere with the processing of grief. Furthermore, the study conducted by Doku et al. (2020) explains that bereavement can cause alcohol-related mortality and increase the risks of all-cause mortality in bereaved persons. Thus, the second task is essential in protecting the bereaved from the potential adverse effects of grieving avoidance.
Next, the third task in the model focuses on the bereaved person’s adaptation to loss and adjusting to the world without the deceased. Lastly, the fourth task defines possible measures for the bereaved to integrate the loss into their future. The task reminds the treatment by accessing the back story in the meaning reconstruction model.
Thus, the main strength of Worden’s model of four tasks lies in a clear explanation of cognitive processes in bereavement that eases the model’s application. However, like Kubler-Ross’s theory of the five stages of grief, Worden’s model faces limitations in generalizing grief experiences. Therefore, applying the model in diverse populations can be complex due to cultural differences.
Model Application to the Case
Case Conceptualization
Brief demographic (for individual): Young adult, immigrated from China with his family at an early age.
Client Name: Bo-Chang.
Age: 28.
Employment status: unemployed.
Relationship status: single.
Reason for referral: referred by GP due to complaints about feeling lethargic and nauseated.
Presenting Problems
Isolation and loneliness due to the inability to accept the loss in the form of dismissal from work. The client expressed having no motivation to find a new job, which can be linked to a lack of support from friends and family. The client engages in unhealthy behavior and spends most of his time in video games to escape the reality of the world after the loss.
Predisposing Factors
A substantial part of the client’s social interactions was sourced from his work connections. Cultural differences may also present predisposing factors to Bo-Chang’s decision to pretend that the loss did not occur. Thus, Chinese cultural values contribute to developing high expectations from children since early childhood in Chinese parents (Zhang et al., 2021).
The trend of high parental expectations also extends to high expectations of career achievements in children, with more than 70% of parents expecting children to have successful careers (Shek et al., 2019). Therefore, pressure from high family expectations can also be considered a predisposing factor. Lastly, it is possible that immigration to Australia at a young age negatively affected the client’s socialization processes.
Precipitating Factors
The client complained about feeling lethargic and nauseated; he also expressed that he had trouble sleeping after the loss event.
Perpetuating Factors
The client’s extensive presence on social media suggests he experiences attention-seeking problems. The client’s inclination to social smoking indicates high susceptibility to peer pressure.
Protective Factors
The client’s friends and family have no opportunity to show support in changes because they are unaware of the financial collapse of the client’s employer. However, having a large circle of friends and family increases the client’s chances of receiving support in processing the loss. Furthermore, video games effectively shift the client’s attention from grieving due to his genuine interest in the hobby. It is possible that searching for a job in the video game industry will motivate the client more than searching for a position similar to the old one.
Model Application
Non-death losses are characterized as an individual’s deprivation of something meaningful. While non-death loss experiences are more common in human life, the overall grieving experience and response to loss can be similar. Moreover, the nature of non-death loss can also influence the overall grief experience (Smith & Delgado, 2020). Involuntary job loss presents a typical example of non-death loss, resulting in symptoms of job loss-related complicated grief (Van Eersel et al., 2022).
According to Van Eersel et al. (2022), involuntary job loss can present a source of severe emotional distress that causes disruption of an individual’s identity and affects their social relationships and status. Common JLCG symptoms include an individual’s difficulties in accepting reality after loss, disruption of everyday functioning, anger issues, and problems with finding a purpose or meaning (Van Eersel et al., 2022). Furthermore, avoidance behavior is often present in individuals experiencing job loss and can focus either on avoiding things associated with work or avoiding the reality of loss.
In the second case, avoidance behavior manifests in attempts to preserve a connection with the lost job (Van Eersel et al., 2022). This means that creation and reconstruction are often recommended for application in cases of non-death losses (Smith & Delgado, 2020). Moreover, the job had significantly more meaning for the client than just a source of income.
The meaning reconstruction model targets two prominent dimensions: clients’ understanding of loss and its effect on their lives, and their connection to the subject of loss. In application to the client’s case, meaning reconstruction will allow the client to acknowledge the positive contribution the job has brought to his life. The application of the model will also develop the client’s understanding of the inability to return to the job after the financial collapse of the company and the absence of his guilt in the event. Therefore, applying the meaning reconstruction model presents the most suitable option in the client’s case.
Intervention Strategies
This means that grief therapy and counseling reconstruction predominantly focuses on narrative reconstruction. Thus, the interventions focus on exploring the client’s narrative, use of therapeutic writing, and visualization of the loss event (Matthews, 2019). In the client’s case, meaning reconstruction intervention strategies can provide him with assistance in accepting the reality of loss. Writing therapies promote self-healing and clients’ personal growth (Ruini & Mortara, 2022). Narrative reconstruction presents the primary intervention used in the treatment of post-traumatic stress disorder that can also be applied in treating prolonged grief disorder (Elinger et al., 2021).
The narrative approach to intervention is efficient in career matters; thus, constructing an autobiographical career narrative can benefit the client’s motivation to find a new job (Kaliris & Issari, 2022). The study by Patterson et al. (2019) defined listening to the narratives about deceased family members of other people as a meaningful activity for young people. Similarly, listening to other young people’s job loss stories can present a possible meaning reconstruction intervention for the client. However, the list of possible meaning reconstruction interventions is not limited to narrative writing.
For example, art therapy intervention presents a common technique to explore grief experiences (Nelson et al., 2022). Furthermore, the study conducted by Castiglioni and Gaj (2020) suggests that meaning reconstruction interventions can be executed using modern technologies, such as virtual or augmented reality. The potential application of VR intervention for grieving clients is featured in a study about treating post-traumatic stress disorder with augmented reality by Chang et al. (2020). Ethical issues can complicate the application of virtual reality intervention to treat mourning (Pizzoli et al., 2021).
However, the client’s case focuses on a non-death loss, meaning that the potential effect of the intervention is much less likely to be negative. According to Mason et al. (2020), the application of virtual reality interventions is not limited to young adults: the virtual reality support group proved effective in improving complicated grief symptoms in older adults. Thus, digital technology interventions can benefit a client who spends a lot of time playing online video games.
Critical Reflection
Completing the assessment allowed me to deepen my knowledge in grief counseling and explore how grief models can be applied to specific client cases. Thus, starting the assessment with an exploration of three different grief models provided the necessary theoretical foundation for the assessment. Moreover, the segment allowed me to define the core principles of different grief models and facilitated further navigation in applying the models to the case scenario. Furthermore, working on the assessment allowed me to define several essential insights about applying grief models and the possible intervention process.
Firstly, most grief counseling theories are based on Western perceptions of loss, and as a result, many overlook cultural differences in grieving. Therefore, paying special attention to cultural differences in modern grief counseling is essential for future developments in the field. Next, grief counseling in cases of non-death loss is essential because it allows learning about the mechanisms behind the human responses to loss. Furthermore, the client’s application of knowledge received through grief counseling for non-death loss can ease the process of loss acceptance in the future. Lastly, creating a case conceptualization is essential for the process of grief model selection because it allows not only defining the client’s prominent needs but also outlining the existing opportunities for change.
In conclusion, considering the study’s limitations, it is unfortunate that the section for possible intervention strategies was significantly shorter than other segments. Thus, completing this section was the most interesting part of the assignment because it allowed learning about available intervention strategies and fitting them into client presentations.
References
Barboza, J., Seedall, R., & Neimeyer, R. A. (2022). Meaning co-construction: Facilitating shared family meaning-making in bereavement. Family Process, 61(1), 7–24. Web.
Castiglioni, M., & Gaj, N. (2020). Fostering the reconstruction of meaning among the general population during the COVID-19 pandemic. Frontiers in Psychology, 11, 1-13. Web.
Chang, L., Cassinelli, A., & Sandor, C. (2020). Augmented reality narratives for post-traumatic stress disorder treatment. 2020 IEEE International Symposium on Mixed and Augmented Reality Adjunct (ISMAR-Adjunct), 306-309. Web.
Doku, D. T., Neupane, S., Dobewall, H., & Rimpelä, A. (2020). Alcohol-related mortality and all-cause mortality following bereavement in two successive generations. PloS One, 15(12), 1-8. Web.
Elinger, G., Hasson-Ohayon, I., Barkalifa, E., Boelen, P. A., & Peri, T. (2021). Narrative reconstruction therapy for prolonged grief disorder – A pilot study. European Journal of Psychotraumatology, 12(1), 1-7. Web.
Kaliris, A., & Issari, P. (2022). Exploring narrative ideas in career counseling. Open Journal of Social Sciences, 10(2), 365-380. Web.
Khosravi M. (2021). Worden’s task-based approach for supporting people bereaved by COVID-19. Current Psychology, 40(11), 5735–5736. Web.
Mason, T. M., Tofthagen, C. R., & Buck, H. G. (2020). Complicated grief: Risk factors, protective factors, and interventions. Journal of Social Work in End-of-Life & Palliative Care, 16(2), 151–174. Web.
Matthews, A. (2019). Writing through grief: Using autoethnography to help process grief after the death of a loved one. Methodological Innovations, 12(3), 1-10. Web.
McDuffie, D. L., Allen, R. S., Crowther, M. R., & Black, S. (2021). Investigating the applicability of the Two-Track Model of Bereavement to a Southern sample of African American adults. Death Studies, 46(9), 2056-2069. Web.
Neimeyer, Robert A. (2019). Meaning reconstruction in bereavement: Development of a research program. Death Studies, 43(2), 79–91. Web.
Neimeyer, R. A., Harris, D. L., Winokuer, H. R., & Thornton, G. (Eds.). (2021). Grief and bereavement in contemporary society. Routledge.
Nelson, K., Lukawiecki, J., Waitschies, K., Jackson, E., & Zivot, C. (2022). Exploring the impacts of an art and narrative therapy program on participants’ grief and bereavement experiences. OMEGA – Journal of Death and Dying, 1-20. Web.
Patterson, P., Noke, M., McDonald, F. E. J., Kelly-Dalgety, E., Sidis, A., & Jones, B. L. (2019). Life Imprint and meaning reconstruction for young people who have experienced the death of a family member from cancer. Psycho-Oncology, 28(9), 1938-1941. Web.
Pizzoli, S.F.M., Monzani, D., Vergani, L., Sanchichi, V., & Mazzocco, K. (2021). From virtual to real healing: A critical overview of the therapeutic use of virtual reality to cope with mourning. Current Psychology, 1-8. Web.
Romero, M. M. (2021). Meaning Reconstruction in bereaved family caregivers of person’s with Alzheimer’s disease: A mixed-methods study. Omega, 82(4), 548–569. Web.
Rubin, S. S., Manevich, A., & Doron, I. I. (2021). The Two-Track Model of Dementia Grief (TTM-DG): The theoretical and clinical significance of the continuing bond in sickness and in death. Death Studies, 45(10), 755–771. Web.
Ruini, C., & Mortara, C.C. (2022). Writing technique across psychotherapies – from traditional expressive writing to new positive psychology interventions: A narrative review. Journal of Contemporary Psychotherapy, 52, 23–34. Web.
Shek, D., Lam, C. M., & Zhu, X. (2019). Parental expectations amongst Chinese parents in Hong Kong: Profiles and demographic correlates. International Journal of Child and Adolescent Health, 12(4), 345-356. Web.
Smith, P. H., & Delgado, H. (2020). Working with non-death losses in counseling: An overview of grief needs and approaches. Adultspan Journal, 19(2), 118-127. Web.
Steffen, E. M., Milman, E., & Neimeyer, R. A. (2022). The handbook of grief therapies. Sage.
Van Eersel, J. H.W., Taris, T. W., & Boelen, P. A. (2022) Job loss-related complicated grief symptoms: A cognitive-behavioral framework. Frontiers in Psychiatry, 13, 1-11. Web.
Zhang, Y., Leung, S. K. Y., & Li, H. (2021). Parental play beliefs in the developing areas of China: A multiple case study. Education Sciences, 11, 1-15. Web.