The loss of a significant person to suicide or overdose is more than a traumatic life event.  It also poses a profound challenge for survivors in establishing a sustainable continuing bond to the deceased, characteristically leaving many questions unanswered, much that is unsaid, and multiple longstanding concerns unresolved.  This module focuses on the burden of such unfinished business with the deceased for mourners, as they struggle to revisit, reevaluate and often repair the relationship with someone who they typically have loved, even if ambivalently, and lost to a tragic death.  In such cases, joining grieving clients in the quest for meaning in the loss nearly always requires that therapists accompany survivors in some form of relational reconstruction.

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We begin by reviewing the implications of the Tripartite Model of Meaning Reconstruction for survivors of suicide loss and relate these to the most relevant goals of grief therapy.  We then present two well-validated measures that help clarify the problematic history shared with the deceased in the first instance, and the extent and focus of unresolved relational issues in the second.  Both can be used as a form of clinical assessment to orient the work of therapy, start a necessary conversation with the client, or assess the greater resolution of residual anger, regret, guilt and other forms of relational distress as therapy progresses.  In addition to introducing these scales and discussing their practical application, we will review the emerging evidence base documenting the frequency and focus of unfinished business in suicide loss and violent death bereavement more generally, and its relationship to prolonged and anguished forms of grief and associated outcomes.  Clinical videos of clients who have lost loved ones to suicide illustrate both these challenges and their effort to reconstruct a continuing bond with their loved one that reaffirms attachment security and makes room for a simpler form of adaptive grieving.  Cultural differences in patterns of unfinished business in different samples will also be briefly noted.

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In the second half of our program, we will then turn to a creative technique that can help clients realign a troubled relationship with the deceased without necessarily relinquishing it, in essence seeking to conserve what had value in the shared bond in a curated form.  We will then provide clear guidelines and prompts for resuming a symbolic conversation with the dead that was traumatically ended by the suicide, accident, overdose or other form of sudden death, with an emphasis on constructing safety in pursuing and processing these imaginal exchanges.  Learners in the workshop will be given opportunities to practice each method, reflect on the experience, and share their learning with others in small group and plenary group formats.  As a result, they should leave the training with a more ample toolbox for clinical assessment and intervention into some of the most complicated dimensions of grief therapy.

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Note:  This 3-hour CE module focuses on application of psychological assessment and/or intervention methods that have overall consistent and credible empirical support in the contemporary peer reviewed scientific literature beyond those publications and other types of communications devoted primarily to the promotion of the approach.

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LEARNING OBJECTIVES

• Distinguish 3 narrative challenges to meaning reconstruction in suicide bereavement and their implications for the selection of therapeutic approaches;

• Describe the psychometric features of two validated instruments for evaluating relational complications with the deceased and their clinical application in grief therapy; 

• Summarize the evidence base regarding the incidence and impact of unfinished business with the deceased among mourners who have lost significant others to suicide and other forms of violent or sudden death;

• Outline the steps of one creative therapeutic procedure appropriate for both individual or group contexts that helps clients review and revise their relational narrative regarding a complex history with the deceased;

• Discuss guidelines for prompting clients to reopen conversations with significant figures that were closed by their premature or traumatic death, both affirming continuing bonds and addressing lingering issues; and 

• List procedures for safe entry into, enactment of, and exit from symbolic conversations with the deceased and note how these can be integrated powerfully into grief therapy.

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Note:  Completion of this program and return of the Responsive Journal satisfies 1 Technique Module required for Certification in Grief Therapy as Meaning Reconstruction, Certification in Family-Focused Grief Therapy, or Certification in Grief Therapy for Suicide Bereavement.

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PROGRAM CONTENT

This program contains the following video segments:

1. Continuing the Bond:  The Use of Extensional Objects (50 mins)

2. Shadows of Suicide:  Unfinished Business with the Deceased (50 mins)

3. Pruning the Branches:  Our Relationship Tree (48 mins)

4. Rewriting Attachment:  Correspondence with the Deceased (37 mins)

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COURSE PACK CONTAINS...

• A PDF copy of the presentation slides;

• Copies of both the Quality of Relationship Inventory—Bereaved Version (QRI-B) and the Unfinished Business in Bereavement Scale (UBBS) along with scoring instructions and permission to use them in clinical and research contexts;

• Instructions for using Our Relationship Tree technique in the wake of complicated loss, with further questions for processing the client’s experience; and 

• Detailed guidelines for Correspondence with the Deceased, with special reference to suicide and drug-related deaths; and

• The Responsive Journal that, upon completion and return, confers 1 Technique Module required for Certification in Grief Therapy as Meaning Reconstruction, Certification in Family-Focused Grief Therapy, or Certification in Grief Therapy for Suicide Bereavement.

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TARGET AUDIENCE

• Psychologists, social workers, counselors, art / music / expressive arts therapists, pastoral care personnel, healthcare professionals, bereavement volunteers

• To qualify for the 3 CE Credits, please kindly note that:

  • Completion of watching the entire recorded module is required to receive CE credits.  No partial credit is awarded.

  • You are required to complete a CE quiz after watching the recording.  An overall score of 75% or higher within three attempts is required to obtain CE credits.

  • The certificate of CE credits will be issued to you upon your submission of a participant evaluation form.

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INSTRUCTIONAL LEVEL

• Advanced

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Disclosure Statement

This recorded module is not supported financially by a manufacturer of any commercial product and there is no sale of any product or publication during the recorded session.  There is no known conflict of interest for this CE module or the presenting faculty.