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Neimeyer, R. (Ed.). (2016). Techniques of Grief Therapy:

Assessment and Intervention NeimeyerR. (Ed.). (2016).
Techniques of Grief Therapy....

Article  in  OMEGA--Journal of Death and Dying · September 2016

DOI: 10.1177/0030222816663410

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Neimeyer, R. (Ed.). (2016). Techniques of Grief Therapy: Assessment and Intervention.

New York, NY: Routledge. 352 pp. ISBN: 978-1-138-90593-1. $44.95 (paperback).

Reviewed by: Phyllis Kosminsky, New York, NY, USA.

This substantive book follows Neimeyer’s first Techniques of Grief Therapy

(2012) which was subtitled Creative Practices for Counseling the Bereaved and
focused on the range of innovative practices in grief counseling and therapy.
This new volume, subtitled Assessment and Intervention, offers the reader a rich
array of approaches to the assessment of varied bereavement responses and the
evaluation of interventions designed to help people who are bereaved. It includes
an entirely new selection of therapeutic techniques to complement the earlier
book. In the spirit of full disclosure, I contributed to the previous volume and
believe wholeheartedly in the principle that guided its development, namely that
grief therapy is as much an art as a science. Like that book, this one honors the
art of psychotherapy, highlighting the work of professionals of diverse orienta-
tions and expertise.

Organization and Focus

The book is organized into 12 parts with a total of 66 chapters authored by over
70 individual contributors. Part I, Framing the Work, offers a theoretical foun-
dation for the book and includes chapters on grief and grief therapy through
multiple lenses, including adult development, attachment, and trauma theories.
Also included in Part I is an introduction to a specialized website, CareSearch,
which is designed to help practitioners access the scientific literature on death,
dying, and bereavement. Part II, Assessing Bereavement, presents a variety of
models and tools for evaluating grief and bereavement. In Part III, Coping with
Grief, the focus shifts to self-assessment; the approaches here are meant to be
used in collaboration with the client and are designed to generate information
about client progress as well as to identify issues that might merit closer atten-
tion in therapy. Parts IV through XII present clinical procedures that address
specific therapeutic objectives, including, respectively, Attending to the Body;
2 OMEGA—Journal of Death and Dying 0(0)

Working with Emotion; Reconstructing the Self; Re-Storying Narratives of Loss;

Reorganizing the Continuing Bond; Re-Envisioning the Loss; Mobilizing Systems;
Facilitating Group Work; and Recruiting Ritual.
In Chapter 1, ‘‘Toward a Developmental Theory of Grief,’’ Neimeyer and
Cacciatore invite us to consider the idea that grief is essentially a process of
transition. Like other developmental processes, grief requires an individual to
navigate passage through a series of challenges or crises. With this starting point,
the authors delineate the specific kinds of interventions or therapeutic responses
that seem best suited to helping the bereaved through different parts of the grief
process. Bereavement, like maturation from childhood to adulthood, involves a
discernable set of challenges, what Erikson terms developmental crises. The
authors proceed to identify the questions, priorities, and needs of the bereaved
person as she faces each of three crises: Reacting, Reconstructing, and
Reorienting and provide examples of the types of therapeutic methods
that can offer optimal support at each stage. In closing, the authors note that
while their model is ‘‘consistent with current evidence, (it) invites trenchant
empirical validation and modification’’ (p. 11).
In Chapter 3, ‘‘The Dual Process Model in Grief,’’ Zech summarizes evidence
concerning the role of attachment style in how people respond to loss. She also
notes that attachment plays a role in how clients respond to treatment. For
example, people with an insecure, preoccupied attachment style are likely to
need help loosening their ties to the deceased and rebuilding their lives.
Dismissively attached people are more likely to benefit from interventions that
guide them toward confrontation with the loss (Kosminsky & Jordan, 2016).
Expressing a theme that runs throughout the book, Zech observes that while
classifications and models can be helpful in formulating treatment goals, in
practice her approach to working with the bereaved reflects a belief in the central
role of the therapeutic relationship and the improvisational nature of therapy.
Bereaved people, she concludes, most benefit from a ‘‘person centered and
experiential approach (that) adapts to the dynamic, evolving grief processes,
moment by moment in the ‘here and now’’’ (p. 21).
Parts II and III of this volume deal with a variety of assessment tools and
issues. As a clinician who has not ventured into the realm of formal research,
I found the chapters here particularly thought provoking, which is to say, they
made me think about measurement in a new way, less as an academic exercise
and more as an adjunct tool in treatment. Part II includes 10 chapters focused on
well-established instruments such as the Hogan Grief Reaction Checklist and
newer ones such as Holland’s Integration of Stressful Life Experiences Scale.
Each chapter includes a description of the development of the instrument, brief
instructions for how to administer and interpret it, and the instrument itself,
along with references for further reading. As far as I know, the chapters of Parts
II and III constitute the most comprehensive and accessible resource for
researchers in the field that has ever been assembled.
Book Review 3

Several of the instruments in Part II would lend themselves to assessing

therapeutic progress and guiding treatment. One example is Milman,
Neimeyer, and Gillies in Chapter 8, ‘‘Meaning of Loss Codebook’’ describing
their observer-rated tool for identifying what meaning an individual has made
following death-related loss. The MLC comprises 30 meaning-making categories
of potential meaning reconstruction. In a therapeutic setting, it can be used to
assess those areas where the client has been able to make meaning of his or her
loss (‘‘I value life more now’’) and those areas where he or she have not, or where
the meaning attached to the loss is negative (e.g., ‘‘I have lost my identity’’).
Client responses can thus serve as a guide to areas that warrant further clinical
attention. A complement to the MLC is the Grief and Meaning Reconstruction
Inventory (GMRI) described by Neimeyer, Gillies, and Milman in Chapter 9.
The GMRI consists of 29 items (e.g., ‘‘I value and appreciate life more now’’)
that are rated on a 5-point Likert scale, ranging from Strongly disagree to
Strongly agree. The items factor into five subscales, which include Continuing
bonds, Personal growth, and Valuing life. The GMRI offers a relatively straight-
forward way for clinicians and researchers to assess the degree and type of
meaning made in the wake of loss. It, like a number of other instruments in
these chapters, can be used both for research and for documenting therapeutic
progress over time.
The instruments provided in Part III are more collaborative in nature and are
essentially a blend of evaluation and therapeutic technique. These chapters offer
tools that clinicians can use with their clients to cooperatively assess client pro-
gress. Part III is thus a bridge between the focus on theory and research in the
first part of the book and the following chapters that detail therapeutic tech-
niques in much the same manner as in Neimeyer’s initial Techniques book. An
example of the tools presented in Part III is Jeffreys’ Chapter 17, ‘‘Self-
Assessment Tasks of Mourning,’’ which draws on Worden’s Four Tasks of
Mourning (Worden, 2009). Jeffreys describes his technique as a ‘‘conversation
stimulator’’ rather than a clinical diagnostic instrument. The clinician asks the
client to think about his or her grief in terms of four task categories of behavior
(these include expressing emotion and establishing a continuing bond with the
deceased). The exercise opens a discussion with the client about the nature of
grief and the identification of goals for therapeutic work.
A similar tool for stimulating discussion with a client is Meichenbaum and
Myers’ Chapter 19, ‘‘Strategies for Coping with Grief,’’ which offers a compre-
hensive list of coping strategies that survivors may use in the wake of loss,
particularly traumatic loss. The client is given the list and instructed to indicate
which of the coping strategies he or she has employed. Together, the therapist
and the client can identify other coping strategies the client might wish to try, as
well as what barriers might get in the way doing so.
Parts IV through XII of the book present techniques for grief therapy in a
format that will be familiar to readers of the first Techniques book. Each of the
4 OMEGA—Journal of Death and Dying 0(0)

chapters in these nine sections includes recommendations concerning clients for

whom the technique is, or may not be, appropriate, along with a case example.
The brevity of these chapters does not restrict their usefulness, but readers who
want more detailed information, including supportive research where available,
will be able to consult the references provided.
Given the now well-established value of integrating techniques that involve
the body into the practice of psychotherapy (Ogden & Fischer, 2015; Van der
Kolk, 2014), the chapters in Part IV are a welcome contribution to the literature
on grief therapy. Several of these techniques will be familiar to some readers, but
they may not have thought to use them with their bereaved clients. Readers
acquainted with focus-oriented therapy (Gendlin, 1996) will appreciate
Farber’s example of using this technique with a bereaved client. Also included
in this section, and yet more directly involved with the body, are instructions for
the use of tapping, yoga, and relaxation training. Clinicians who are new to
body-oriented techniques may find something in the methods presented here
to inspire them to dip their toes into this kind of work.
Part V, Working with Emotion, is dedicated to techniques for processing emo-
tions. A case could certainly be made that all of grief therapy involves working
with emotion, and there is an element of arbitrariness about some of what is
included here. This would appear, however, to be an unavoidable consequence
of editing a volume such as this one. Included here are strategies for working
with guilt, using a ‘‘grief drawer’’ to find respite from painful feelings, and
cultivating self-compassion to promote healing from loss.
Part VI, Reconstructing the Self, offers creative ways of helping clients exam-
ine the impact of the loss on their identity (e.g., Chapter 32, ‘‘Who Am I,’’ by
Lichtenthal and Breitbart), as well as tools for supporting the reconstruction of a
sense of personal meaning and purpose (Chapter 34, ‘‘Letters to Self,’’ by Rollo-
Carlson). Given my own view of the need to help many of our clients strengthen
their capacity for self-regulation, I was particularly pleased to see Pearlman’s
Chapter 31, ‘‘Building Self Capacities.’’ In emphasizing the importance of iden-
tifying those clients who need help with tolerating and managing emotion,
Pearlman, like many of her cocontributors, helps us appreciate the multiplicity
of factors that affect people’s response to loss, and the value of a person-
centered, heterogeneous approach to treatment.
In sum, the techniques included in this volume are not simply an expansion of
what was included in the first volume, but an update as well. They represent the
most current thinking about how to assess grief responses and how to help the
bereaved.

Discussion
This is not a book to be read cover to cover, or at least, not one that can be fully
absorbed on a single reading. I suspect that most readers will, as I did, peruse all
Book Review 5

of the sections, insert a lot of sticky notes on pages that catch their attention,
and come back to the book when they are looking for a way through a particular
therapeutic impasse. And this, to my mind, is what makes a book like this, along
with the initial Techniques of Grief Therapy book, particularly useful and worth
having on the shelf. In the everyday work of grief therapy, clinicians face an
impossible task: Everyone who comes to see us is bringing us a problem that we
can’t solve. To sustain ourselves in this work, we need to find something that we
can do to help our clients. Much of what we discover is through experience, trial
and error, and the session-by-session, week by week interaction we have with
our clients. If grief is a process, then it is also true that the identification of what
a person needs to heal and what we as clinicians can do to support that healing is
likewise a process: It is not something that can be prescribed at the outset of
treatment. On the other hand, the contributions of researchers, clinicians, scho-
lars, and all those who make up the collective enterprise of thanatology have
produced a rich storehouse of knowledge, and we owe it to ourselves, to each
other, and most of all, to our clients, to acquaint ourselves with it.
Although it is often erroneously attributed to Einstein, we have the sociolo-
gist William Cameron to thank for the observation that ‘‘Not everything that
can be counted counts, and not everything that counts can be counted’’
(Cameron, 1963, p. 13). I do not know if Cameron had love and loss in mind
when he made this pronouncement. But I think that his appreciation of the
limits to what we can measure, and in particular, the undeniable difficulty of
assigning scores and making calculations about realities like love, grief, and
healing, is the at heart of what leads many clinicians to be skeptical about
research.
Of course, it is also true that much of the research that is conducted in the
field of thanatology, like much of research overall, is incomprehensible to non-
researchers, even those who are knowledgeable about the subject being studied.
I am happy to report that the contributors to this volume have avoided this
second pitfall. There is little here that cannot be understood and appreciated by
people who are not versed in the intricacies of statistical analysis. But more
importantly, many of the methodologies presented here can be utilized by
grief therapists who, whether for their own information or in order to satisfy
the requirements of employers, oversight agencies, or funders, have an interest in
client assessment and treatment evaluation. In this sense, the volume bridges
theory, research, and practice.
In short, this is a book for clinicians who are looking for new ideas for
treatment and for ways to measure the progress of their clients. It is a book
for researchers who are interested in the scope of evaluative efforts and for
researcher or clinician or scholars who may be inspired by what is presented
here to consider collaborations that bring the best of their skills to the work of
assessment and treatment. It will also serve as a highly practical sourcebook for
classes on grief and grief therapy. When we consider all that has been said about
6 OMEGA—Journal of Death and Dying 0(0)

the unfortunate gap in our field between theory and practice, it seems especially
important that we find ways to initiate the next generation of grief therapists and
researchers into a professional environment that is more inclusive, integrated,
and less divided along the lines of professional orientation and identity. This
volume is an essential resource for all involved in advancing this project.
You may say I’m a dreamer. But I’m not the only one. (Lennon, 1971)

References
Cameron, W. B. (1963). Informal sociology. New York, NY: Random House.
Gendlin, E. T. (1996). Focusing-oriented psychotherapy. New York, NY: Guilford Press.
Kosminsky, P., & Jordan, J. (2016). Attachment informed grief therapy: The clinician’s
guide to foundations and applications. New York, NY: Routledge.
Lennon, J. (1971). Imagine. New York, NY: Capitol/Apple.
Neimeyer, R. (2012). Techniques of grief therapy. Creative practices for counseling the
bereaved. New York, NY: Routledge.
Ogden, P., & Fischer, J. (2015). Sensorimotor psychotherapy: Interventions in trauma and
attachment. New York, NY: W.W. Norton.
Van der Kolk, B. (2014). The body keeps the score. New York, NY: Penguin Books.
Worden, W. (2009). Grief counseling and grief therapy. New York, NY: Springer.

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