Rehab Kids

Shattered Assumptions:
Treat Grieving Clients Whose
World Has Been Turned Upside
Down
Joy R. Samuels, D.MIN., LPC-MHSP, NCC

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Shattered Assumptions:
Treat Grieving Clients Whose
World Has Been Turned Upside
Down
Joy R. Samuels, D.MIN., LPC-MHSP, NCC

Rehab Kids

ZNM057985
4/21
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Rehab Kids
 Materials Provided By

Joy R. Samuels, D.MIN., LPC-MHSP, NCC, has over 25 years’

experience as a licensed professional counselor, Fellow in
Thanatology, chaplain, and ordained minister. She teaches in
the graduate clinical mental health psychology department at
Lipscomb University and at Candler School of Theology at Emory
University in the United Methodist Church Course of Studies.
She maintains a private counseling practice and supervises
those seeking licensure as a LPC-MHSP.

Dr. Samuels holds D. MIN. and MDIV. degrees from Wesley

Theological Seminary, Washington, DC. Additionally, she holds
an M.S. degree in counseling psychology from California State
University, Northridge, CA, and a counseling certificate in
substance abuse from the Northern Virginia Community College,
Annadale, VA. Among her areas of expertise are individual,
couples and family counseling, trauma and bereavement, and
post-masters supervision.

Speaker Disclosures:
Financial: Joy Samuels is in private practice. She is an adjunct faculty at Lipscomb University.
Dr. Samuels receives a speaking honorarium from PESI, Inc.
Non-financial: Joy Samuels is a Fellow in Thanatology.

Materials that are included in this course may include interventions and modalities that are beyond the
authorized practice of mental health professionals. As a licensed professional, you are responsible for
reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of
practice in accordance with and in compliance with your professions standards.
 joy r samuels, D.Min., LPC-MHSP, NCC
Fellow in Thanatology

 I declare that I (or my family) do not

have any financial relationship in any
amount, occurring in the last 12 months,
with a commercial interest whose
products or services are discussed in my
presentation. Additionally, all planners
Declarations involved do not have any such financial
relationship
 I declare that I do not have any relevant
non-financial relationships

1
  Materials that are included in this course
may include interventions and modalities
that are beyond the authorized practice
of mental health professionals.
 As a licensed professional, you are
responsible for reviewing the scope of
Declarations practice, including activities that are
defined in law as beyond the boundaries
of practice in accordance with and in
compliance with your profession’s
standards.

 ‘Mind the gap’ - differences between expectations and

experiences 
 Exploring how expectations are created and maintained
 How to identify expectations and value language in clients
 Interventions to explore family of origin events
 Assessments to explore values and strengths
 Creating opportunities to recreate your assumptive world

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 Give sorrow words; the grief that
does not speak
Whispers the o'er fraught heart
and bids it break.

Shakespeare, Macbeth IV, iii, 209

While there are several research studies supporting these approaches there
are limitations to the existing studies such as:
 number of subjects (power),
 lack of randomization,
 generalizability (for example to diverse populations)

As with any psychotherapy there are some potential risks that you should
discuss with your clients, we think these include:
 protentional increase of client distress,
 protentional disruption to client’s mental health well being.

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 https://youtu.be/UOPyGKDQuRk
Mind the gap

 Experience- here and now,

felt sense, mindfulness

 Expectation- assumptive
world, core beliefs

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  Irvin Yalom

“Here & Now”  Fritz Perls

Theorists  Eugene Gendlin
 Mindfulness

’Mind the gap’

 75, white, cis-gender female, upper SES, single
following her spouse’s death, adult estranged
step-children, strong religious identification, and
faith community support.

 Expectation- to continue her favorite way of self

identification, i.e., a married self

 Experience- without her spouse, she is no longer a

‘married’ self

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 The feeling that good things
are going to happen in the
future.
Oxford Dictionary

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 The world is benevolent

 The world is meaningful
Core
assumptions  The self is worthy

Janoff-Bulman (1992)

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  Benevolence of the world involves
the extent to which an individual
views the world in general and
The world is other people in positive or
negative terms.
benevolent
 Survivors may view the world as a
place in which bad things happen
and its people uncaring.
Ferrajão (2019)

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 Beliefs about the distribution of

outcomes, including expectations
of fairness and justice, perceived
control over events, and the
degree to which randomness is
explainable in the course of
events.
 Survivors may view the world as
an unjust and uncontrollable
place in which events happen by
chance—that is, bad things may
happen to good people.
Ferrajão (2019)

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  Worthiness of self involves self-
perceptions of goodness, morality,
or decency; the ability to engage
in appropriate behaviors and
decision making; and a sense of
being lucky or fortunate in one’s
life.
 They may develop a negative self-
image, viewing themselves as bad,
immoral, and subject to and
deserving of ill-fortune.
Ferrajão (2019)

15

Examples of worldviews include the

implicit or explicit belief:
 that life or society is fair,
 that in general, people are
trustworthy,
 and that one’s culture has value.
Poulin, Silver (2019)

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 Our assumptive world may be
composed of:
 How we tend to view others and
Working their intentions
definition of
 How we believe the world should
assumptive
work
world theory
 How we tend to view ourselves.

Harris, 2020

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 Each of us has formed a way of seeing things and interpreting events

that makes sense to us. This is our assumptive world.
 Our assumptive world helps us to feel a sense of predictability,
consistency, and safety as we go through our daily activities.
 The way that we view the world, others, and ourselves is formed
when we were very young and becomes the base from where we make
choices, form relationships, and establish our beliefs about how life
should work.
Harris (2020)

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  Significant life-changing events can cause us to feel deeply vulnerable
and unsafe.
 The world that we once knew, the people that we relied upon, and
the beliefs and perceptions that we once held may no longer be
relevant in light of what we have now experienced (or are currently
experiencing).
 The grief response is elicited in response to the loss of our assumptive
world; we may lose small parts, or our whole assumptive world can be
shattered.
 The appraisal of loss is subjective and entirely dependent upon an
individuals experience and interpretation of the loss.
Harris (2020)

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Assumptions or beliefs that ground, secure, stabilize, and orient

people. In the face of death and trauma, these beliefs are shattered
and disorientation and even panic can enter the lives of those affected.
Losing one’s assumptions about the world means the loss of safety,
logic, clarity, power, and control.

In essence, the security of their beliefs had been aborted.

Beder (2005)

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  It is important to note that the assumptive world is more than a
cognitive construct; these assumptions exist at the very core of what
in life provides us with a sense of meaning, purpose, and security.
 Each category of assumption will have cognitive aspects, but will also
incorporate:
social,
spiritual,
emotional,
psychological components.
Harris (2020)

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Presenting Loss Diagnosis of dementia in loved one.

 Ambiguous Loss Loved one physically present but psychologically

emotionally absent due to disease process.
 Nonfinite Loss Diagnosis of dementia typically ongoing, usually
progressive in nature.
 Chronic Sorrow Loss of loved one’s ability to engage and
participate in family life are ongoing with no
foreseeable end.

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  Tangible Loss Outward signs that loved one is compromised;
incidents of not remembering names, confusion,
inability to function outwardly noticeable.

 Intangible Loss Grief over lost relationship while loved one alive;
changes in family dynamics, affinities, and
interactions.

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 Disenfranchised If loved one is physically present, grief is not

acknowledged socially; however, loved ones may be
acutely grieving before death of the loved one with
dementia.

Compromises made by family members who

provide care of loved one are often
unrecognized but may have significant impact upon
family system (i.e., financial, emotional).
Harris (2020)

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 “Shaken, and not stirred.”
James Bond, Dr. No (1958)

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13
 Over the past three decades, multiple
theorists have proposed that the
psychological effects of NLE, including
both negative and positive outcomes such
as:
Negative  depression,

Life Events  anxiety,

 PTSD,
(NLF)  posttraumatic growth,
stem in part from their unique capacity to
challenge and alter individuals’
worldviews.
Poulin (2019)

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 Different types of negative life events

Do different predicted change in different worldview
beliefs:
types of NLE  Certain illnesses (threaten

predict meaningfulness beliefs),

 Certain events (violence- threatens
different benevolence beliefs)

types of  Recent violence predicted a decline in

benevolence beliefs, as did recent
worldview relationship events.
 In contrast, community disasters
change? predicted increased benevolence
beliefs.
Poulin (2019)

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14
 Do factors  Age significantly moderated the
association between total number of
facilitating recent events and levels of benevolence
beliefs.
positive
 Spirituality was not a significant
reappraisals moderator of the association between
recent negative events and benevolence
moderate beliefs.
the effects of  None of the proposed moderators
tested—age, social support, and
NLE on religiosity/spirituality—moderated the
association between NLE and
worldviews? meaningfulness beliefs.
Poulin (2019)

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Do NLE
predict  Recent events did not significantly
predict instability of either
changes in belief (benevolence beliefs and
meaningfulness beliefs)
chronic  Worldviews changed the most in the
absence of factors that may help
stability of individuals reinterpret those events, such
as older age and social support.
worldview
beliefs? Poulin (2019)

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  Individuals who experienced more
negative events had less stable
worldviews over time.
Shaken vs.
shattered
 In general, worldview change was
small, highlighting the apparent
stability of these beliefs.

Poulin (2019)

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 His research has identified resilience

as the core experience of most
people who experience trauma.
 By resilience is meant the ability of
individuals exposed to a potentially
highly disruptive event to maintain
both healthy psychological and
physical functioning and the capacity
for positive emotions.
 Individual characteristics and
environmental stressors before and
after an event appear to have more
of an impact on the response to
traumatic events than the nature of
the event itself.
 https://www.tc.columbia.edu/ltelab/

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 What are
your Our assumptions are guides for our
day-to-day thoughts and behaviors.
assumptions
for today? Janoff-Bulman (1992)

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Expectations created and maintained

“I wanted to be married”

 Faith community highlighted connections

through family and strongly held gender roles,
e.g., engagement, wedding, pregnancy, birth,
baptism, confirmation.

 Social and professional roles

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 How do clients talk about:
 Access
 Knowledge
 Belief
 Social Support

 Use of generalizations, and

globalizations.

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 Traffic was so horrible today.

 I got lost a couple of times trying to find this
place.

Access
 I really don’t understand why she does that.
Knowledge  I’ve never heard of that before.

Belief  No one has been able to help me before.

Social support  This is just so hard for me to do.

 I have to hurry home before my partner comes

home.
 I can’t get anyone to help with my kids.

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 “Until the lions have their
own historians, the history of
Whose the hunt will always glorify the
story? hunter.”
quoted by Chinua Achebe (2019)

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Tell me a Who are you in your story?

story  Coffee in bed

 Naval Academy rings

Roger  Just next steps

Schank  Recital Invitation

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  Expectation language

 ‘I guess I’ll have to go to the old women’s

bible study’

There were several groups that had

Identified themselves by interest, not gender
(her confirmation bias that single people
could not have interests outside of marriage)

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 ‘Thin slice moments’

 How did these moments shape
me?
 Genogram
 Generational themes
 In my family we…
 Spoken and unspoken
expectations
 Holidays, Celebrations
 Who did what when with whom
and how?

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 “Many of the most intense emotions arise during the
formation, the maintenance, the disruption and the renewal
of attachment relationships."
Bowlby 1977

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 How did the big moments shape

your life?

 What messages did you receive

from family and friends?

 What messages would you give

yourself?

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43

https://pin.it/43txWyG

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  Who
 When

Holidays  Where
&  What
Celebrations  How

 Why (meaning making)

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‘Thin Slice Moments’

 Not being able to pursue Math as a profession

 First clear memory of adaptation which
helped her reframe her difficulties to:
‘I have done difficult things before’

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  https://www.authentichappiness.sas
.upenn.edu
VIA
GRIT
Brief Strengths Survey
 https://www.viacharacter.org
 https://positivepsychology.com/stre
ngth-finding-tests/

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 Core Bereavement Items (Burnett et al., 1997)

 World Assumptions Scale (Janoff-Bulman, 1989)
 Grief and Meaning Reconstruction Inventory (Gillies et al., 2015)
 Persistent Complex Bereavement Inventory )Lee, 2015)

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  https://www.authentichappiness.
sas.upenn.edu/learn

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‘What do you well?’

Her ‘Love of learning’ moved to her to explore

her grief process through a lens of ‘what am I
learning today?’

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 Relearning the world or coming to
terms with the loss of our
assumptive world is primarily about
learning new ways of acting and
being in the world.

It is a matter of coming to know

how to go on in the world where so
much of what we have taken for
granted in the emotional,
psychological, social, soulful, and
spiritual dimensions of our lives is
no longer supportable or
practicable. Attig (2002)

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“Trauma is a chronic disruption of connectedness.”

Stephen Porges, 2019

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 Our assumptive world may be composed
of:
Reframing
 How we tend to view others and their
our intentions
shattered  How we believe the world should work

assumptions  How we tend to view ourselves.

Harris (2020)

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 Create safety
In order to:  Focus on what is important

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 The Dual Process Model of Grief

FIGURE 3.1 The dual process model of bereavement.

Source: From Stroebe, M., Schut, H., & Stroebe, W. (2005). Attachment in coping with bereavement: A theoretical integration.
Review of General Psychology, 9(1), 48–66.

© 2021 Springer Publishing Company,

LLC. 3.55

55

56

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 “It is the meaning of the traumatic event, for the survivor,
that determines which assumptions are affected and how the
event is understood.”

Beder (2005)

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Meaning-Making:
 A social constructivist model that utilizes
a “master narrative,” which can be
Meaning described as a coherent overarching
making after story and understanding of one’s life and
experiences, along with the meanings
loss that are attached to these experiences.
experiences  This narrative construction is facilitated
by the grieving process.

Harris (2020)

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 Grieving is a process of reconstructing a
Meaning world of meaning that has been
challenged by loss
reconstruction  Redefining the self
 Redefining how one engages with the
world
Neimeyer  http://www.robertneimeyerphd.com/

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 Meaning-making is one of the primary

processes in which individuals engage
when there is dissonance between their
life experiences and their existing
assumptive world.
 Pre-existing assumptions that are no
longer viable in describing the world,
and one’s inner working models or
Neimeyer schemata, must somehow be re-worked
in order for the person to feel safe in the
world again.
 It can be said that meaning-making is the
primary task involved in rebuilding the
assumptive world after it has been
shattered by significant loss experiences;
the process of meaning-making and the
grief response are intricately entwined.

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 The storied nature of human life:
•Research in neuropsychology, child
development and social psychology
converges to suggest that human beings
are “wired” to process experience in
narrative terms
Neimeyer •We organize life events, imposing a plot
structure on them with a beginning,
middle and end
•Self-narrative: “an overarching
cognitive-affective-behavioral structure
that organizes the ‘micro-narratives’ of
everyday life into a ‘macro-narrative’ that
consolidates our self-understanding

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•The death of an attachment figure, especially when untimely, sudden

or violent, disrupts our sense of narrative continuity, and initiates
attempts to reaffirm or reconstruct a self-narrative that has been
challenged by loss
•When these attempts are unsuccessful, the bereaved may struggle
with a crisis of meaning in the wake of loss, and a disorganized
narrative through disruption of the coherence of their understanding
of who they are
•Identity reconstruction in the wake of loss can be regressive or
progressive, leading to constriction or expansion of one’s involvement
with life, typically leading the bereaved to appreciate life more keenly

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 Reactive/Dysregulated
Therapeutic Reflective

process Reintegrated/Reregulated

Kosminsky, Phyllis S.; Jordan, John R.

(2016)

63

1. DISTANGELING MULTIPLE LOSSES

 Distinguish between the relational implications, grief-related
feelings, and needs associated with each loss

2. THE GRIEF RIVER http://www.griefriver.com/

 Headwaters, rapids, runs, delta

3. WHO AM I? Write 4 answers to each question:

 Who was I?
 Who was I while these events took place?
 Who am I now?
 Who do I want to be?

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 4. LOVING KINDNESS MEDITATION
 May I be free from inner and outer harm and danger. May I be safe
and protected.
 May I be free of mental suffering or distress.
 May I be happy.
 May I be free of physical pain and suffering.
 May I be healthy and strong.
 May I be able to live in this world happily, peacefully, joyfully, with
ease.
Jack Kornfield

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5. WELCOMING WHAT IS http://www.focusing.org/index.htm

 Welcoming the resistance
 Inviting a felt sense
 Attending
 Articulating
 Resonating
 Sensing a stopping point

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  Writing your personal grief narrative

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7. LETTERS TO SELF
Writing from adult to child
 What do you want to tell your “child” so that you are prepared for
your future life?
Writing from child to teen
 What does your “child” want you to hold on to that could get lost in
adolescence?
Writing from present to future self
 What are you hoping to change for the future?

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 8. RELATIONSHIP REVIEW
 The clinician identifies narrative disruptions, disorganization,
dominant themes, and other obstacles that need to be restructured
to allow integration to occur. Neimeyer (2006)

9. Mapping the influence of the loss

10. Bridgework, Samuels (2000)

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Bridgework

Memory of the event Behavior I am engaging in today

Value or Belief that is being challenged Value or Belief that is being lived out

This intervention starts with the memory of the painful event. Rather than staying in the memory, identify
which value is being challenged; i.e., the memory of a spouse being unfaithful, the value or belief that is
being challenged is faithfulness. The arrow points to a current event or behavior that I am engaging in that
is reflective of the value or belief in faithfulness; i.e., I am choosing to limit the conversations at work to
professional topics vs. relationship concerns.
The idea is that memories surface as a reminder of what is important to us, not only of times our values
and behaviors were congruent, but those times when they were not. Focusing on the underlying value of
the painful event allows me to move out of the emotional content of the memory to self-efficacy. I can
engage in behavior today that is congruent with the values and beliefs I have. Samuels, 2000

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 ‘What is important?’

‘Tell him I’m coming.’

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We are beings who are

wired for attachment, but
Final we exist in a world that is
Thoughts defined by impermanence,
change, and loss.

(Robert Neimeyer in personal communication with Darcy

Harris, 10.19.2018)

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  https://podcasts.apple.com/gb/podcast
/griefcast/id1178572854
 https://podcasts.apple.com/gb/podcast
/terrible-thanks-for-asking/id1126119288
 https://help2makesense.org/podcast/

podcasts  https://www.cruse.org.uk/blog/podcasts
-for-grief
 https://player.fm/podcasts/Loss-And-
Grief
 https://podcasts.apple.com/us/podcast/
grief-out-loud/id963387015

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 https://www.grief.org.au/ACGB/Bereave
ment_Support/MyGrief/ACGB/Bereavem
ent_Support/MyGrief.aspx?hkey=aa58a00
4-82f0-408e-8ce5-7f0d0624df87
 https://www.headspace.com/science

apps  https://liliesgriefsupport.weebly.com
 https://bounce.works/apartofme/
 https://play.google.com/store/apps/det
ails?id=com.ima.fantastic.griefsupport&h
l=en&gl=US

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  www.adec.org
 https://complicatedgrief.columbia.edu
 http://www.tc.columbia.edu/LTElab/
 http://www.robertneimeyerphd.com/home.
html
websites  Http://deathcafe.com
 http://www.nationalhospicefoundation.org
 http://www.dougy.org/grief-resources/
 www.optionb.org
 https://appreciativeinquiry.champlain.edu

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 https://www.tandfonline.com/toc/upil20/curr
ent
 https://journals.sagepub.com/doi/full/10.117
7/0030222817691870
 https://journals.lww.com/jhpn/pages/default.
aspx
 https://journals.sagepub.com/home/pcc
professional  https://journals.sagepub.com/home/icl
journals  https://www.tandfonline.com/toc/rber20/curr
ent
 https://ct.counseling.org/2019/04/grieving-
everyday-losses/
 https://www.grief.org.au/ACGB/Publications/
Grief_Matters/ACGB/ACGB_Publications/GM/G
rief_Matters.aspx?hkey=99fd058a-31bb-4817-
a614-3e8f049cc319

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  Beder, J. (2005) Loss of the Assumptive World-How we deal with Death and Loss.
OMEGA, Vol. 50(4), 255-265.
 Chen, S., & Bonanno, G. A. (In press). Psychological adjustment during the global
outbreak of COVID-19: A resilience perspective. Psychological Trauma, 12 (S1), S51-
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NOTES
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