Grief Therapy Assessment and Intervention Plan for Bereavement

Clinical Assessment of Bereavement

Grief therapy is typically applied in cases such as Kong's, following the loss of a loved one. The procedures outlined below form the foundation of a comprehensive clinical assessment.

The Semi-Structured Clinical Interview

The informal assessment of individuals facing the effects of losing a loved one — such as in Kong's case — is the semi-structured clinical interview. This approach allows the therapist to classify clients according to the symptoms they exhibit and to record changes in symptom profiles over time. The following information should be collected from a client:

• Biographical data
• The mental illness history of the family
• The client's medical history
• Any past visits or interactions with a psychiatrist
• The client's social history
• Varying aspects of specific information related to the loss of a loved one

There is a need to focus the interview on the primary and secondary characteristics surrounding the death. Additional questions should address:

• Symptoms linked to bereavement, such as intense yearning for contact with the deceased, self-blame, anger, and avoidance of anything that is reminiscent of the deceased
• A pre-morbid personality profile
• Features related to depression, substance abuse, aggression, or anxiety

The clinician should ask pointed questions directed at revealing details related to post-traumatic stress symptoms, including the frequency, nature, duration, intensity, and brief descriptions of those symptoms (Shear et al., 2012).

Examination of the State of Mind

A person's state of mind is professionally assessed during an interview using the Mental State Examination. The method applies a common language and format to capture information that patients who have experienced loss manifest during the interview. The main objective is to identify symptoms so that the most appropriate intervention can be sought while any risks are taken into consideration.

The aspects that must be considered when conducting a loss assessment include behavior, appearance, speech, content of thought, cognition, perception, mood, affect, and insight (Marks, Jun, & Song, 2007).

Important Questions to Ask While Screening for Bereavement

Elderly individuals who manifest severe symptoms of bereavement as a result of losing a loved one need to be assessed for symptoms of complex bereavement and grief. These are potential triggers for serious reactions, including possible suicidal tendencies. Kong may still succumb to the effects of bereavement and grief despite his cultural values. He feels that he will face many challenges following the death of his loved one, and believes that life has no meaning anymore. He may even be contemplating death as a means of reuniting with the deceased. Suicidal ideation is an important subject to explore with grieving individuals. Direct questions that avoid ambiguity are important in this regard, such as:

• Do you sometimes think of killing yourself, especially when things are bad?
• Have you ever thought about how you might kill yourself?
• Can you access [mention opportunity or means]?
• Have you ever tried to kill yourself?
• Do you drink, smoke, or use other intoxicating substances?

Other risk factors such as social isolation and substance abuse should also be taken into consideration. Additional critical questions include:

• Can you tell me more about the death?
• Tell me what happened that day.
• What are the most notable developments since that day?
• How have your relationships with friends and family unfolded since then?

Such questions explore the dimensions of bereavement and grief. They offer the bereaved person a chance to speak about their loss and shed light on the circumstances and nature of the death. Factors such as denial will begin to surface, and feelings of anger and guilt are likely to emerge if they are present. The typical emotional responses associated with bereavement will manifest, and congruence between affect and content, alongside the client's history, will serve as a reliable indicator of conflicted emotions and ambivalence.

The signs of bereavement and grief may also indicate where the client currently stands in the bereavement process. Furthermore, these questions provide an opportunity to explore social interaction patterns following the death. It is important to consider terms of inclusion to help assess the client's acceptance of the permanent loss (Grief Counselling Through Questioning, 2013).

Exploring Dreams

People in grief commonly experience significant dreams. It is a helpful clinical intervention to invite clients to talk about their dreams. While there is no need to attempt interpretation, the therapist should gently guide the client in discussing them when the client expresses a desire to do so.