John R. Jordan

Stigmatization and suicide bereavement.

With survey data collected primarily from peer support group participants, the authors compared stigmatization responses of 462 parents losing children to suicide with 54 other traumatic death survivors and 24 child natural death survivors. Parents who encountered harmful responses and strained relations with family members and non-kin reported heightened grief difficulties. After controlling for time since the death and whether a childs death was traumatic or not, stigmatization continued to be associated with grief difficulties, depression, and suicidal thinking. Suicide survivors reported little differences in stigmatization from other-traumatic-death survivors, a result consistent with other recent studies, suggesting more convergence between these two populations than divergence.

How they died, time since loss, and bereavement outcomes

This analysis explores associations between differing death circumstances and the course of bereavement among a sample of 540 bereaved parents. Comparisons were made between parents whose children died by suicide (n = 462), those losing children from other traumatic death circumstances (n = 54), and others whose children died from natural causes (n = 24). Results were mixed, showing suicide survivors with more grief difficulties and other mental health problems on some criteria, though most findings showed no substantive differences between these subgroups. Results also showed, in the first years after loss, repeated suicide attempts and prior negative relationships with the decedent were associated with greater grief difficulties. However, as more time passed, all death circumstance differences were overshadowed by the importance of the time span since loss. This data also suggested that between 3 and 5 years usually marks the turning point, when acute grief difficulties accompanying a suicide loss begin to subside.

Personal Growth after a Suicide Loss: Cross-Sectional Findings Suggest Growth after Loss May Be Associated with Better Mental Health among Survivors

With a diverse sample of 462 parent survivors of their childs suicide we explored the association of the personal growth subscale of the Hogan Grief Reaction Checklist (HGRC) with mental health problems among longer-term survivors. In this article we offer additional validation for this scales association with longer-term survivorship and reduced grief difficulties. We also demonstrate its negative relationship with mental health problems. In addition, we explore the demographic correlates of personal growth, which are likely to enable some survivors to experience personal growth sooner than others. Overall, the findings suggest that personal growth represents an important part in the process of healing after suicide loss.

THE GRIEF EVALUATION MEASURE (GEM): AN INITIAL VALIDATION STUDY

ABSTRACT This article describes the development of the Grief Evaluation Measure (GEM), a new instrument designed to screen for the development of a complicated mourning response in a bereaved adult. The GEM provides a quantitative and qualitative assessment of risk factors, including the mourners loss and medical history, coping resources before and after the death, and circumstances surrounding the death. It is designed to provide an in-depth evaluation of the bereaved adults subjective grief experience and associated symptoms. Reliability and validity studies were conducted with two samples of bereaved adults (n =  23 and n =  92, respectively) from various clinical and support settings. Data on the two central sections of the GEM that assess the mourners grief response and the level of symptomatology are described. Results indicate that the GEMs internal consistency and test–retest reliability are high. The GEM demonstrates good concurrent validity for established measures of bereavement, trauma, and physical and psychiatric symptoms, and good predictive validity for mourner adjustment one year after initial assessment. Plans for future development and an invitation for other researchers to collaborate with research on the GEM are also discussed.

The Perceived Experience of Children Bereaved by Parental Suicide

Children whose parent died by suicide are a vulnerable and underserved population. This phenomenon will be described, as well as implications for practice and research. “Double Whammy,” a conceptualization of the overall experience of this marginalized group, emerged through two in-depth interviews from a phenomenological qualitative study with professionals who facilitate support groups for children bereaved by parental suicide. It was corroborated with current literature and practice experiences of the authors and their colleagues. Stigma was the largest contributor to the “Double Whammy,” and the following themes emerged as well: feeling isolated, feeling abandoned, and feeling responsible. The self-volition of suicide challenges how bereaved children make meaning and internalize feelings about the deceased parent, one’s self, and others. Developmentally appropriate education about suicide grief, depression, and normalizing the grief process is pivotal in helping children to effectively cope and manage their feelings.

Postvention is prevention—The case for suicide postvention

ABSTRACT There is now convincing empirical evidence that exposure to suicide increases the risk of subsequent suicide, as well as other negative mental health sequelae, in those who have been exposed. This article provides a review of this empirical evidence. It also concludes that this substantial evidence base makes the compelling case that all suicide prevention programs need to include postvention services as a direct form of suicide prevention with a population of people known to be at heightened risk for suicide themselves: suicide loss survivors.

The Aftermath of a Suicide

Nancy Rappaport is an Assistant Professor of Psychiatry at Harvard Medical School and the Director of School Based Programs in Child Psychiatry at the Cambridge Health Alliance. With J. A. Frazier,...

Feeling like a Motherless Child: A Support Group Model for Adults Grieving the Death of a Parent

This article presents a rationale and model for a time-limited bereavement support group for adults who are grieving the death of their parent(s) as an adult. The model is based on assumptions about the particular needs and issues of this population, and about the grieving process in general. The screening process and structure of group sessions are described, and the sequence of seven group themes are presented. Finally, some of the clinical impressions of the authors are offered, so that other professionals can use the model as a starting point for designing similar groups for the same population.

Surviving families of military suicide loss: Exploring postvention peer support

ABSTRACT The United States military began to experience a steady increase in suicide rates across all service branches at the inception of the wars in Afghanistan (2001) and Iraq (2003). As the number of suicide deaths increased, so did the number of affected survivors who seek postvention support. Unique issues that accompany suicide death may expose survivors to a more distressing and complicated grief process. Peer support has clinically been observed to be widely utilized by suicide loss survivors. This article explores unique issues accompanying military suicide loss, potential benefits of postvention peer-based support, clinical considerations, and future directions.

Clinical work with suicide loss survivors: Implications of the U.S. postvention guidelines

ABSTRACT The loss of a loved one to suicide can present difficult challenges for suicide loss survivors (people bereaved by suicide) as well as for clinicians who would seek to help them. Building on the recommendations in the new document Responding to Grief, Trauma, and Distress after a Suicide: U.S. National Guidelines, this article provides an overview of clinical work with suicide loss survivors. It includes discussions of the common themes of suicide bereavement, the psychological tasks for integration of a suicide loss, and the options for providing grief therapy after a suicide. The article will be of value to caregivers who work with suicide loss survivors in counseling or therapeutic context.