Dual process model of grief counseling

Chapter 12 - Personal Loss

Question(s):

Compare the Adaptive grieving model (Martin & Doka, 2000) and the Dual Process model (Stroebe & Schut, 2001).

What are the similarities and differences?

Which seems to fit best to your style of counseling?

Why is that so?

Conceptual Approaches to Bereavement

There are a variety of models, ranging from psychodynamic to constructivist to cognitive- behavioral approaches, that seek to deal with loss (Bowlby, 1969, 1973, 1980; Cohen, Mannarino, & Deblinger, 2006; Gillies & Neimeyer, 2006; Neimeyer & Levitt, 2000; Osterweis, Solomon, & Green, 1984; Powers & Griffith, 1987; Raphael, 1983).

Historically, stage/phase models (Bowlby, 1969, 1973, 1980; Kübler-Ross, 1969; Kübler-Ross & Kessler, 2005) have achieved a great deal of fame and notoriety.

A Counterpoint to Traditional Models

Dutro (1994) has described how our concepts of grief and loss have become more dynamic, moving from the medical or pathology theories to more interactive models. Dutro’s comprehensive and dynamic model views grief and loss from the perspective that each individual experience loss according to psychophysiological, affective, and cognitive-behavioral factors, such as the mode of death, relationship of the deceased, prior losses experienced, and domiNant subcultural norms. These factors figure into a dynamic structural model of grief that, according to Dutro, is in sync with sociocultural life in the 21st century.

His and others’ dynamic, individualistic grief models (Dyregrov & Dyregrov, 2008; Humphrey, 2009; Konigsberg, 2011; Neimeyer, 2000; Worden, 2002) refute many ideas about grief that have been associated with older stage theories:

1. The common assumptions concerning “stages” of grief are not supported.

2. Placing time limitations on grief is inappropriate.

3. The withholding or suppression of sadness in response to bereavement is not necessarily pathological.

4. Insistence on severing ties or detaching oneself from lost objects denies lifelong bonding and use- fulness of positive memories.

5. One-size-fits-all models don’t work because each individual griever’s experience is unique. Grief is not a unitary phenomenon but rather a multidimensional, interactive, individual experience for every bereaved person, based on a complex set of interwoven variables.

6. There are no fixed beginning and ending points in grieving.

7. While grief does not end, it does change. From that standpoint two current models, the dual process model (Stroebe & Schut, 2001; Stroebe et al., 2008) and the adaptive grieving model (Martin & Doka, 2000), seem to best represent current thinking (Doughty, 2009; Humphrey, 2009) on the fluid, idiosyncratic nature of grief and grieving and how the crisis worker should consider approaching them.

The Dual Process Model.

The dual process model may be characterized as an approach-avoidance model that has two components: loss orientation and restoration orientation. Loss orientation stressors are associated with the loss itself, which may be experienced in ruminating about it and having behavioral, emotional, and cognitive reactions to it that oscillate between avoiding and confronting the disrupted bond with the object of the loss (Stroebe & Schut, 2001; Stroebe et al., 2008). Stroebe and Schut see this process as a normal and natural process of loss adaptation. For instance, a college athlete may feel sadness and anger over the loss of a girlfriend (confronting the stressors) but redouble workouts and increase his study time (avoiding the stressors) in efforts to put lost love out of his mind. As the loss recedes in time, and in line with how processing models are sup- posed to operate, a restoration orientation begins. So, both avoidance and confrontation are to be seen as a normal and natural process of loss adaptation (Humphrey, 2009, p. 47).