PBC Perinatal Loss & Bereavement Theories 2 — Questions and Answers
Question 1: Which theorist introduced the concept of 'continuing bonds' as a healthy aspect of grief, replacing the goal of 'letting go'?
- Kübler-Ross
- Klass, Silverman & Nickman (Correct answer)
- Worden
- Bowlby
Correct answer: Klass, Silverman & Nickman
Klass, Silverman & Nickman's 1996 work challenged the detachment model, proposing that maintaining an ongoing relationship with the deceased is normal and healthy.
Question 2: In Rando's 'Six R Processes' of mourning, what does the second 'R' — 'React to the separation' — primarily involve?
- Reorganizing the assumptive world
- Experiencing the pain of the loss emotionally and physically (Correct answer)
- Relinquishing old attachments
- Relocating the deceased within one's life
Correct answer: Experiencing the pain of the loss emotionally and physically
The second R requires the mourner to fully experience and express the psychological, behavioral, social, and physical pain caused by the loss.
Question 3: A bereaved mother states she finds comfort talking to her stillborn daughter's photo each morning. According to the continuing bonds theory, this behavior is best described as:
- Pathological denial requiring clinical intervention
- A healthy internalization maintaining relational connection (Correct answer)
- Complicated grief needing immediate referral
- Regression to magical thinking
Correct answer: A healthy internalization maintaining relational connection
Continuing bonds theory supports that maintaining symbolic connection with the deceased through rituals like talking to a photo is a healthy grief adaptation.
Question 4: Therese Rando identified which factor as a 'high-risk' predictor for complicated mourning following perinatal loss?
- Having supportive family present at delivery
- A sudden, unexpected loss with little opportunity to prepare (Correct answer)
- Previous experience with grief
- Strong religious faith
Correct answer: A sudden, unexpected loss with little opportunity to prepare
Rando identified sudden, unexpected death — common in perinatal loss — as a significant risk factor for complicated mourning due to the absence of anticipatory grief.
Question 5: Which model specifically addresses the oscillation between loss-orientation and restoration-orientation in bereavement?
- Kübler-Ross Stage Model
- Dual Process Model by Stroebe & Schut (Correct answer)
- Worden's Tasks of Mourning
- Bowlby's Attachment Theory
Correct answer: Dual Process Model by Stroebe & Schut
Stroebe and Schut's Dual Process Model (1999) describes healthy grieving as a dynamic oscillation between confronting loss and attending to life changes and restoration.
Question 6: In the context of perinatal bereavement, 'disenfranchised grief' most commonly occurs when:
- Parents are given private time with their deceased infant
- Society does not recognize the depth of the loss, such as after early miscarriage (Correct answer)
- The grief is expressed loudly in public settings
- Parents choose not to see the baby
Correct answer: Society does not recognize the depth of the loss, such as after early miscarriage
Doka's disenfranchised grief describes losses that society fails to acknowledge as significant, such as early pregnancy loss, leaving parents without social support.
Question 7: According to Worden's Task II of mourning, 'Working through the pain of grief,' which clinical intervention best supports a bereaved parent?
- Discouraging discussion of the baby to avoid prolonging pain
- Encouraging the parent to suppress emotions until they feel ready
- Creating space for parents to express their pain without judgment (Correct answer)
- Focusing immediately on future pregnancy planning
Correct answer: Creating space for parents to express their pain without judgment
Task II requires the mourner to experience and process emotional pain; the counselor's role is to provide a safe, non-judgmental space to facilitate this work.
PBC Perinatal Loss & Bereavement Theories 2
Which theorist introduced the concept of 'continuing bonds' as a healthy aspect of grief, replacing the goal of 'letting go'?