CBP CBP Complicated Grief and Prolonged Grief Disorder 2 — Questions and Answers
Question 1: Disenfranchised grief, as described by Kenneth Doka, occurs when:
- A grieving person receives too much social support
- A loss is not openly acknowledged, publicly mourned, or socially supported (Correct answer)
- Grief follows a predictable, linear pattern
- The bereaved person chooses not to grieve
Correct answer: A loss is not openly acknowledged, publicly mourned, or socially supported
Doka defined disenfranchised grief as grief that results from a loss not openly acknowledged or socially supported, leaving the bereaved person without recognized grieving rights.
Question 2: A client who lost her partner 18 months ago refuses to enter their shared bedroom, maintains all possessions unchanged, and cannot function at work. This pattern is MOST consistent with:
- Uncomplicated acute grief
- Prolonged Grief Disorder with avoidance and functional impairment (Correct answer)
- Major Depressive Disorder only
- Post-Traumatic Stress Disorder only
Correct answer: Prolonged Grief Disorder with avoidance and functional impairment
Situational avoidance, preservation of the deceased's environment, and functional impairment beyond 12 months are hallmark presentations of Prolonged Grief Disorder.
Question 3: When differentiating Prolonged Grief Disorder from Major Depressive Disorder, which feature is MORE specific to PGD?
- Persistent sadness
- Intense yearning and preoccupation specifically focused on the deceased (Correct answer)
- Sleep disturbance
- Loss of appetite
Correct answer: Intense yearning and preoccupation specifically focused on the deceased
While sadness and functional impairment overlap between PGD and MDD, intense yearning and a grief-specific preoccupation with the deceased are distinguishing markers of PGD.
Question 4: In complicated grief, imaginal revisiting exercises in Complicated Grief Treatment (CGT) are intended to:
- Eliminate all memories of the deceased
- Help the client process and integrate the memory of the death rather than avoid it (Correct answer)
- Induce cathartic breakdown
- Replace grief with acceptance through repetition alone
Correct answer: Help the client process and integrate the memory of the death rather than avoid it
Imaginal revisiting in CGT uses guided imagery of the death to help the client process avoided aspects of the loss and reduce the avoidance maintaining complicated grief.
Question 5: Which of the following is an example of a 'secondary loss' that may complicate grief?
- The death of a spouse from cancer
- Loss of financial security, social identity, and daily routines following the spouse's death (Correct answer)
- Feeling sad at the anniversary of the death
- Dreaming of the deceased
Correct answer: Loss of financial security, social identity, and daily routines following the spouse's death
Secondary losses—such as financial, social, and identity losses that cascade from the primary death—can compound grief and contribute to its complexity.
Question 6: A CBP practitioner is treating a widower with PGD who habitually avoids all social contact and activities he previously shared with his wife. The MOST indicated next therapeutic step is:
- Prescribing antidepressants
- Introducing graduated situational exposure to avoided activities within the therapeutic frame (Correct answer)
- Encouraging complete withdrawal from reminders to reduce distress
- Immediately referring out to a higher level of care
Correct answer: Introducing graduated situational exposure to avoided activities within the therapeutic frame
Graduated situational exposure—gradually re-engaging with avoided activities and places—is a core component of CGT and evidence-based practice for PGD.
CBP CBP Complicated Grief and Prolonged Grief Disorder 2
Disenfranchised grief, as described by Kenneth Doka, occurs when: