2.1. Compare and contrast models of loss and grief

This guide will help you answer 2.1. Compare and contrast models of loss and grief.

Loss and grief are universal experiences. They are triggered by significant changes, such as the death of a loved one, relationship breakdowns, or other life-altering events. Different models of loss and grief exist to explain how people process these emotions. These models provide frameworks to understand behaviours and feelings that individuals might go through during grief. In this guide, we cover the most recognised models are explored and compared to highlight similarities and differences.

The Kübler-Ross Model

The Kübler-Ross model, also known as the five stages of grief, was introduced by psychiatrist Elisabeth Kübler-Ross in her book On Death and Dying (1969). Originally developed in response to terminal illness, it is now widely used to explain grief more broadly.

Stages of Grief:

1. Denial – People first struggle to accept the reality of their loss. They may feel numb or in shock, shielding themselves from overwhelming emotions. For example, someone experiencing the death of a loved one might avoid confronting the truth by pretending or thinking it hasn’t happened.
2. Anger – As denial fades, anger can surface. Individuals may express rage or frustration, questioning why the loss occurred. This anger can be directed at themselves, others, or even abstract forces like religion.
3. Bargaining – This stage involves attempts to regain control or reverse the loss. People often imagine “what if” or “if only” scenarios, trying to make sense of the situation. Religious individuals might plead with a higher power for intervention.
4. Depression – Grief tends to feel overwhelming at this stage. Sadness and despair dominate, leading to feelings of loneliness or hopelessness. People may retreat socially or struggle with normal routines.
5. Acceptance – This stage allows individuals to come to terms with the loss. It doesn’t mean forgetting the loss but learning to live with it. The grieving person builds a new sense of normality where the loss is acknowledged.

Strengths and Limitations:

Strengths:
The Kübler-Ross model is widely recognised and simple to understand. It normalises grief, making people feel less isolated.

Limitations:
Some critics argue that grief does not follow a strict linear progression. Stages can overlap or skip entirely. The model may also oversimplify complex emotions by reducing them to a fixed set of categories.

Worden’s Four Tasks of Mourning

Psychologist J. William Worden presented the four tasks of mourning in his book Grief Counselling and Grief Therapy. This model shifts the focus from passive stages to active tasks, recognising individual responsibility in managing grief.

Four Tasks of Mourning:

1. To Accept the Reality of the Loss – This means confronting the fact that the person or object lost won’t return. Avoidance or denial works against healing.
2. To Process the Pain of Grief – Experiencing emotional pain is part of mourning. People need to allow themselves to feel sadness, anger, and other emotions. Avoiding the pain can delay healing.
3. To Adjust to a World Without the Deceased – Loss creates change for the bereaved. This task involves adapting to new circumstances and taking on roles previously filled by the person lost.
4. To Find a Connection with the Deceased While Moving Forward – The final task suggests that people can maintain a bond with what they lost, but in a way that does not prevent continuing life. This could involve treasuring memories or keeping mementoes.

Strengths and Limitations:

Strengths:
This model promotes active involvement in grief, helping individuals regain control of their healing process. It recognises that grief includes practical challenges.

Limitations:
People may find it hard to move through these tasks when overwhelmed with emotion. Not everyone feels ready or equipped to confront pain or adjust to change in structured ways.

Dual Process Model of Grief

Psychologists Margaret Stroebe and Henk Schut created the Dual Process Model to highlight how grieving is a balancing act. It suggests people alternate between “loss-oriented” and “restoration-oriented” coping.

Loss-Oriented Coping:

This involves focusing on the loss itself, including mourning, reminiscing, and dealing with emotions tied directly to grief.

Restoration-Oriented Coping:

This focuses on rebuilding life amid the loss. People address practical challenges, such as managing finances, finding a new job, or creating a new normal.

The model notes that people oscillate between these two types of coping. They might spend one day grieving deeply and another handling responsibilities.

Strengths and Limitations:

Strengths:
This framework is realistic. It reflects how people naturally deal with grief in daily life rather than following rigid steps or tasks.

Limitations:
Its oscillating nature may be confusing for some individuals to interpret or consciously apply. Not everyone alternates between mourning and restoring in clear patterns.

Comparing These Models

The models of grief differ in their focus and approach. Comparing them can help care workers determine which may resonate most with the individuals they support.

Similarities:

• Grief evolves: All models agree that grief is not static but changes over time.
• Individuality matters: Each recognises that people experience grief differently. Not everyone follows the same path or timeline.
• Emotions are central: All models address the feeling of pain and the need to work through emotions.

Differences:

• Passive vs. Active Grieving: Worden’s tasks encourage active participation in the grieving process. Kübler-Ross, in contrast, presents grief as a series of stages that individuals progress through.
• Linear vs. Oscillating: The Kübler-Ross model takes a linear view of grief progression, whereas the Dual Process Model embraces alternating focus areas.
• Focus Areas: Worden’s tasks concentrate equally on internal emotions and external adjustments after loss. Kübler-Ross is more concerned with emotional stages, while Stroebe and Schut consider day-to-day coping.

Practical Applications in Health and Social Care

Understanding these models helps workers support individuals experiencing loss. However, applying them requires sensitivity, as grief is deeply personal. Below are some ways these models can be used effectively.

Tailoring Support to the Client:

• If someone expresses intense denial, workers might recognise this as part of Kübler-Ross’s stages and gently help them accept reality.
• A client overwhelmed by adapting to life changes might benefit from guidance inspired by Worden’s tasks. For instance, practical advice on adjusting roles could be offered.
• If oscillating grief behaviour is observed, the Dual Process Model can help explain why someone alternates between grieving deeply and carrying on as if life were normal.

Encouraging Emotional Expression:

All models encourage processing emotional pain. Care workers can support clients by providing safe spaces for sharing feelings or offering creative outlets, such as art therapy.

Avoiding Misapplication:

Refrain from forcing individuals into one model of grief. Instead, adapt the approach based on observations of their behaviour.

Limitations of Grief Models in Practice

While useful, no single model can capture grief entirely. Grief is complex and doesn’t fit neatly into theories. It may unfold differently for people based on cultural factors, mental health, or life circumstances. Care workers should remain flexible, offering support tailored to individual needs rather than strictly adhering to any one model.

Reflection Questions for Learners

To deepen your understanding of grief models as part of your Unit 2.1 answer, you might consider the following:

• How might cultural differences impact an individual’s progress through these models?
• Which model do you think is most useful for providing practical help in your role?
• Can you think of a time when you saw someone work through their grief in ways that reflect aspects of these models?

Final Thoughts

Understanding grief models is essential for supporting individuals experiencing loss. Comparing frameworks like the Kübler-Ross model, Worden’s tasks of mourning, and the Dual Process Model sheds light on various perspectives of grief. The key takeaway is that grief is personal, and these models serve as guidelines to inform practice rather than rigid rules.