Boss 's recommendations for most effective therapeutic approach to ambiguous loss are constructed by a primary family-systems framework, with strong psych education to help re-frame. She also coins a dialectical approach for ambiguous loss that will help the client learn to “tolerate the tension of the ambiguity and cognitive coping strategies” (2006).
Boss promoted, when beginning work with clients, that therapists establish the structure of the “psychological family”. In her conceptualization, the psychological family extends beyond the physical presence of a family member. “As those who practice clinical work recognizes, there are grandparents, aunts, uncles, siblings, and other extended family member in the room during a therapy session, as the client reveals the psychological presence of those who have impacted their life and their way of being in the world.” Boss (2006) theorized that there are key assumptions linking the concept of a psychological family to ambiguous loss. First is that in cases of physical presence, but emotional loss, as from brain injury or alcoholism, the stress on the family system can be greater due to the tendency to “deny the affliction and expect the person to think/act/behave as they did before.” Perversely, when there is loss of physical presence loved ones can be kept “psychologically present.” Boss asserted that maintaining psychological presence helps to facilitate coping, rather than signal a “hallucinatory disorder”. Boss, “reframed the time of waiting for closure as an opportunity to practice dialectical thinking, and hope that the loved one will return to them, which prepares them to mourn, if there is no return.” Boss explained that while dealing with the ambiguous loss, family members can become accustomed to feeling uncomfortable with ambiguity and the discomfort helps build coping skills. Finally, Boss highlighted the social nature of humanity and encourages therapists and counselors to be open to the varying degrees of absence or presence in the interpersonal relationships of their clients. She believes that interpersonal relationships are a key factor in overall resilience. One of the strongest statements Boss made is that, “a shift in perception on the part of the therapist is required.” The idea that a client will find closure is not always possible with ambiguous loss and the therapist has to be able to cope with that ambiguity. Countertransference here is particularly hard. A therapist, to someone experiencing ambiguous loss, must be able to tolerate their personal ambiguity to help normalize the experiences and model coping strategies in combination with the teachings and discussion of them. Current Research There has been research in the following years since Boss first published her work applying her concepts to many various situations and targeted groups that are experiencing ambiguous loss. Unfortunately, little has been done to quantitatively measure and research the therapeutic approaches and their efficacy, but the research does give indications toward that goal. Particularly, DiYoung and Buzzi (2003) in their article “Ultimate Coping Strategies: The Differences among Parents of Murdered or Abducted, Longterm Missing Children” measured the self-reported coping strategies and grieving mechanisms of families whose children are missing. The research showed that the parents had used similar coping strategies with two variations: “first, when the children were confirmed to have been murdered, the coping strategies shifted;” and second, “while the parents of the murdered children began a new grieving process, the parents dealing with long-term loss coped using varying techniques depending on the likelihood of return as perceived by the time elapsed since the child was missing.” The parents of the children who were missing long term were less likely to view support groups and professional support as helpful. The parents of children who were murdered were more likely to view their support group experience as positive. Emotional responses were …show more content…
The work of mental health counselors is to seek out the best, most effective means of helping our clients cope. In the current political, social, and economic climate we see increased mental illness, alcoholism, and issues of returning soldiers, all cases where there is a risk of ambiguous loss for the remaining family members. The topic of ambiguous loss is particularly timely and may become increasingly pervasive. Research into best practices now will potentially lay the groundwork for a more effective
Boss promoted, when beginning work with clients, that therapists establish the structure of the “psychological family”. In her conceptualization, the psychological family extends beyond the physical presence of a family member. “As those who practice clinical work recognizes, there are grandparents, aunts, uncles, siblings, and other extended family member in the room during a therapy session, as the client reveals the psychological presence of those who have impacted their life and their way of being in the world.” Boss (2006) theorized that there are key assumptions linking the concept of a psychological family to ambiguous loss. First is that in cases of physical presence, but emotional loss, as from brain injury or alcoholism, the stress on the family system can be greater due to the tendency to “deny the affliction and expect the person to think/act/behave as they did before.” Perversely, when there is loss of physical presence loved ones can be kept “psychologically present.” Boss asserted that maintaining psychological presence helps to facilitate coping, rather than signal a “hallucinatory disorder”. Boss, “reframed the time of waiting for closure as an opportunity to practice dialectical thinking, and hope that the loved one will return to them, which prepares them to mourn, if there is no return.” Boss explained that while dealing with the ambiguous loss, family members can become accustomed to feeling uncomfortable with ambiguity and the discomfort helps build coping skills. Finally, Boss highlighted the social nature of humanity and encourages therapists and counselors to be open to the varying degrees of absence or presence in the interpersonal relationships of their clients. She believes that interpersonal relationships are a key factor in overall resilience. One of the strongest statements Boss made is that, “a shift in perception on the part of the therapist is required.” The idea that a client will find closure is not always possible with ambiguous loss and the therapist has to be able to cope with that ambiguity. Countertransference here is particularly hard. A therapist, to someone experiencing ambiguous loss, must be able to tolerate their personal ambiguity to help normalize the experiences and model coping strategies in combination with the teachings and discussion of them. Current Research There has been research in the following years since Boss first published her work applying her concepts to many various situations and targeted groups that are experiencing ambiguous loss. Unfortunately, little has been done to quantitatively measure and research the therapeutic approaches and their efficacy, but the research does give indications toward that goal. Particularly, DiYoung and Buzzi (2003) in their article “Ultimate Coping Strategies: The Differences among Parents of Murdered or Abducted, Longterm Missing Children” measured the self-reported coping strategies and grieving mechanisms of families whose children are missing. The research showed that the parents had used similar coping strategies with two variations: “first, when the children were confirmed to have been murdered, the coping strategies shifted;” and second, “while the parents of the murdered children began a new grieving process, the parents dealing with long-term loss coped using varying techniques depending on the likelihood of return as perceived by the time elapsed since the child was missing.” The parents of the children who were missing long term were less likely to view support groups and professional support as helpful. The parents of children who were murdered were more likely to view their support group experience as positive. Emotional responses were …show more content…
The work of mental health counselors is to seek out the best, most effective means of helping our clients cope. In the current political, social, and economic climate we see increased mental illness, alcoholism, and issues of returning soldiers, all cases where there is a risk of ambiguous loss for the remaining family members. The topic of ambiguous loss is particularly timely and may become increasingly pervasive. Research into best practices now will potentially lay the groundwork for a more effective