WASHINGTON, D.C. -- Grief counseling may not always be effective and, in some cases, may be harmful, a report released today said.
The surprising conclusion from a panel convened by the Washington-based Center for the Advancement of Health, an independent nonprofit institute, recognizes that grief in response to the loss of loved ones is a universal condition and that little is known about its effects.
"We do know that between birth and death, grief is the one universal condition and that it is the quintessential mind-body interaction," said Jessie C. Gruman, PhD, president of the Center. "In many cases, prolonged grief leads to physical health problems, but normal grief typically does not lead to long-term problems, and, in some cases, the ways in which people come to terms with loss can be positive for emotional health."
The three-year project was funded by the Project on Death in America, a program of the Open Society Institute of the Soros Foundation, and examined all recent research on the relatively little-studied field of grief and bereavement loss of a spouse, a child, a parent, a friend or victims of terror. "Reviews of studies of bereavement interventions indicate that grief counseling may not be helpful for many people experiencing normal grief and may even have negative effects," the report said.
The academic literature does indicate, however, that counseling or other medical interventions may be helpful for people suffering "complicated" grief, in which the bereaved experience symptoms that may interfere with normal functioning. About 80 percent of people return to somewhat normal functioning with six months of a loss.
The report concludes: "For adults experiencing normal grief, interventions are likely to be unnecessary and largely unproductive; for adults at risk of developing complicated grief, interventions may provide some benefit, at least in the short term; and for adults experiencing complicated grief, the available evidence indicates that psychotherapeutic interventions are likely to provide some benefit."
The most effective support for people suffering from grief is likely to come from family, neighbors, friends and religious, social or business colleagues, the report says, with professional advice available to those peers and "natural helpers."
"The purpose of this project was to strengthen research on grief and bereavement with the ultimate goal of improving the care that grieving people receive," Gruman said.
Most deaths in the United States occur in healthcare settings. About 60 percent are estimated to occur in hospitals or medical centers, and an additional 16 percent occur in other health care institutions, such as nursing homes or hospices, the report said. Demographic trends are likely to place greater service and economic demands on the health care system, including increasing needs for care related to end-of-life issues.
Among findings of the project:
? The experience of loss may be universal, but responses are widely variable and there is no single clearly defined course or process of bereavement or grieving.
? The majority of the population appears to cope effectively with bereavement-related distress, and most people do not experience problematic grief or adverse health effects.
? Maintaining continuing psychological and emotional bonds with the deceased is not necessarily an indication of problematic grieving and can be associated with positive adaptation to bereavement.
? Grief is best defined not as an exclusively medical problem but as an individual and societal event with potential medical implications. Since death most frequently occurs in health care settings, health care providers may be the point of contact for grieving individuals and need training in how to provide the most appropriate care.
? Data collected from New Yorkers after Sept. 11, , indicate that the potential psychological effects of a major national trauma are not limited to individuals who directly experience the event or experience loss from the event.
The report is available at http://www.cfah.org/pdfs/griefreport.pdf
The Center for the Advancement of Health is an independent nonprofit organization that promotes greater recognition of how psychological, social, behavioral, economic and environmental factors influence health and illness. The Center receives funding from the John D. and Catherine T. MacArthur Foundation.