When grief is a family affair

The mental health consequences of bereavement have long been recognised. However, the family context of grief has been relatively under-addressed and there is a limited research base to guide clinical interventions. The authors of this text have internationally recognised expertise in psychotherapy (including family interventions) and palliative care. They both have substantial clinical and academic backgrounds in psychiatry, and have a substantial body of innovative research in Australia into the psychological and psychiatric aspects of oncology and palliative care, including bereavement.

Family focused grief therapy provides a scholarly overview of the research and theoretical basis of our current understanding of the impact of bereavement on the family. This work is highly relevant to many areas of healthcare and is particularly innovative in applying preventive approaches involving careful clinical screening and assessment of a family’s functioning and coping. Kissane and Bloch’s work identifying high-risk patterns of family interaction is an important and an internationally recognised contribution to this field.

The authors successfully link a research framework and a strong theoretical base with practical clinical interventions to address a problem that frequently challenges clinicians. The provision of detailed clinical vignettes deepens the scope of the book and encompasses the complexities of family life and the realities of clinical practice. The examples are relevant to the broad range of cultural issues for families in the Australian community. The vignettes appropriately and sensitively recognise the multiple problems that many families contend with, but, at the same time, utilise an approach that recognises family resources. By doing so the authors walk an appropriately balanced path between acknowledgment of the significant adverse consequences of grief for families and individuals, and the resilience of many families. Underpinning this is the philosophy that family functioning and coping can be enhanced to protect the individuals who comprise the family, and that there are patterns of family functioning that can hinder recovery from bereavement.

As a whole, the book demonstrates the relevance and importance of mental health approaches to this very broad area of healthcare, and the contribution that can be made by bridging the fields of psychotherapy and palliative care. While the book would be of particular interest to professionals working in oncology and palliative care, the research methods, the nature of the intervention, and the understanding that this work brings to family work, are likely to be of interest to a very broad range of clinicians. By bringing research into clinical practice, the authors have made a major contribution to this field.

Brian J KellyPsychiatrist, St Vincent’s Hospital Darlinghurst, NSW