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MCAQE - Coggle Diagram

- - - - Symptoms of PGD include challenges to one’s sense of identity and feeling that life is empty or meaningless following the loss of an attachment figure (Lichtenthal, Currier, Neimeyer, & Keesee, 2010; Prigerson et al., 2009a; Rando, 1986).
        struggle with their sense of identity and purpose, the meaning of their child’s life, and making sense of the their untimely loss (Davies, 2004; Lichtenthal & Breitbart, 2015; Lichtenthal et al., 2010; Wheeler, 1993).
        
        addressing challenges to finding
        meaning, purpose, and identity
        that many grieving individuals face
        
        Central to this model is the principle that individuals have the freedom to choose their attitude toward their suffering, and that this attitude (i.e., the way they face the adversity before them) can be a source of meaning in and of itself (Breitbart & Poppito, 2014; 1959/1992).
        principles of meaning reconstruction (Neimeyer, 2001a; Neimeyer, in press)
        emphasis on helping mourners (a) find meaning in the loss and in their lives in its aftermath, and (b) reconstruct a sustaining bond to the deceased to reaffirm attachment security or address unfinished business.
        
        MCGT’s hypothesized mechanisms of change. The theoretical foundation is largely informed by the
        cognitive-behavioral model, which has demonstrated efficacy in improving prolonged grief, mood, and anxiety (Boelen, 2006; Bryant et al., 2017; Tolin, 2010).
        
        MCGT assists with reconstructing unhelpful thoughts that may have their origins in preexisting cognitive schemas (e.g., a belief that being emotional is a sign of weakness, or a belief that one is incompetent). These shifts can result in a reduction in negative affect.
        Engagement with sources of meaning (e.g., relationships, valued activities, experiences) has overlap with behavioral activation and is thus expected to similarly result in positive experiences, cognitions, and affect (Lejuez, Hopko, & Hopko, 2001).
  - - - Although the loss cannot be changed, rituals create an opportunity to express and enact painful emotions. 02
        Rituals have positive characteristics for dealing with prolonged grief as they are structured: the action is time limited (12) and the ritual symbolically and aesthetically translates the grief experience into ritual form (10, 24). Rituals take place within a symbolic reality, which gives some emotional distance to the actual experience, but at the same time creates space to feel and express emotions (24, 65, 66). By choosing objects or symbols that represent the deceased or conducting a memorial during therapy, grief emotions are channelized through the ritual form. The use of symbols and symbolic actions (e.g., having a moment of silence, lighting a candle or listening to a special music piece) helps to stay attentive and feel emotions. Emotions are intense, but not overwhelming as the time frame is limited and the actions are ritually structured. The symbolic expression and interaction help to feel emotions, but because of the aesthetic translation the emotional expression remains at
    - - group
        
        conducting ritual action togethe
        create a sense of cohesion and solidar
      - categorized three types of grief rituals in therapy:
        (1) honoring rituals,
        emphasize that the deceased is still remembered.
        (2) letting go rituals, and
        the ritual serves to leave the traumatic experience behind. The purpose is not to forget the experience, but to give it a place in the client’s personal life history” [
        (3) self-transformation rituals
        affirm that one has entered a new place in one’s journey through grief.
        
        acknowledge legacies or to say thanks
        eath rituals may serve important social, cultural, and psychological functions that foster adaptation to loss
        Other ritual elements focus on addressing painful emotions or sensations,
        such as re-enacting the dying scene,
        finding a metaphor for loss,
        writing an “angry” letter to the perpetrator.
        Rituals in grief therapy, thus, are helpful due to different processes, such as expressing various emotions (thankfulness, care for the deceased, but also feelings of guilt, and asking for forgiveness), as well as creating a bond with the deceased and other bereaved, which perhaps was before the treatment ambivalent or problematic.
        Rituals structure internal and external processes through ritualized action (21, 24).
- - - - A recommendation to abandon using SHE in primary care cannot be made with certainty.
        because SHE is easily accessible
        More work is needed to educate general practitioners on the health risks of insomnia and the availability of psycho-behavioural treatments.
        Cross-sectional studies have revealed that daytime napping, smoking, alcohol use and uncomfortable sleeping environment are more common in individuals with insomnia, compared to good sleepers; however, the frequencies of these behaviours are not high (43). The findings may explain why SHE may not be a sufficient treatment, while having poor sleep hygiene may be a prerequisite for using SHE
  - - - Reliability analyses suggested that sleep hygiene behaviors as measured by the Sleep Hygiene Index are relatively stable over time for a nonclinical population
        Results confirmed the finding by Brown et al. (2002) that sleep hygiene is strongly related to sleep quality
        這study sleep hygiene is modestly related to perceptions of daytime sleepiness
        
        this is a valid and reliable assessment
        BUT but may not be sufficient in under-standing and modifying sleep hygiene behavior
        an understanding of sleep hygiene in context may be important
        An incongruity between sleep hygiene knowledge and practices in clinical (Lacks and Rotert, 1986) and non-clinical populations (Brown et al., 2002) suggests that an understanding of sleep hygiene in context may be important.
        e.g., precipitation and/or maintenance of maladap-tive sleep hygiene behaviors may not be addressed by education alone). 11