Psychiatric Bulletin (2003) 27: 318-319. doi: 10.1192/pb.27.8.318-a
© 2003 The Royal College of Psychiatrists
Psychiatric Bulletin (2003) 27: 318-319
© 2003 The Royal College of Psychiatrists
Family Focused Grief Therapy. A Model of Family-centred Care During Palliative Care and Bereavement
David A Alexander, Professor of Mental Health, Medical School, University of Aberdeen,
Director
Aberdeen Centre for Trauma Research
David W Kissane, Sidney Bloch (eds). Open University Press, 2002. 272 pp.
£22.50 pb, £65.00 hb. ISBN: 0-335-203493
Death is not new; carefully conducted and well-presented research is a much
less familiar achievement. You will not regret reading this book. The core of
the book is the use of family focused grief therapy in a randomised,
controlled trial extending over a 5-year period and involving 81 families.
That project, the Melbourne Family Grief Studies, represents a tour de
force. For those who have an appetite for figures and statistics, the
authors have provided an appendix that contain data from their project.
Over nine chapters, Kissane and Bloch introduce the reader to the systemic
family approach to the management of grief (in the setting of palliative
care), the rationale to family focused grief therapy, their research methods
(including The Family Relationships Index), and the possible applications of
the therapy, as well as the challenges that might face those who use their
model of intervention. They demonstrate persuasively that this time-limited
therapy identifies the family as the unit of care and that it can be used in
different socio-cultural and clinical settings. It is amenable to empirical
evaluation, and it is securely wedded to theoretical constructs, particularly
those associated with attachment theory. This is not a sterile text. The
authors reify their theoretical principles and concepts by presenting relevant
clinical cases, some of which are very complex. I particularly liked their
willingness to describe frankly how the cases had been managed, whatever the
outcome.
While the authors articulate how to use family focused grief therapy, they
show no sympathy for those who seek a ‘therapy by numbers’
approach. The family focused grief therapy requires training and supervision,
as well as an understanding of family dynamics and a willingness to deal with
families sensitively and flexibly.
Just when you think you have grasped the essentials to family focused grief
therapy, you are then challenged with the penultimate chapter, which is
dedicated to ethical issues. This is not a litany of pious prescriptions. It
is a thought-provoking chapter of value to any practitioner, whatever their
theoretical persuasion. The preeminent injunction is ‘First do no
harm’.
In conclusion, this book represents a genuine contribution to the
repertoire of methods for helping families prior to and subsequent to the
demise of a loved one. It is well written in an unpretentious and frank style.
The authors’ wealth of clinical experience is evident in their writing,
as is their ability to blend a scholarly and scientific approach with a
compassionate and flexible clinical one.
