Importance of Assessment
Assessment tools and frameworks are valuable resources for professionals working with individuals who are struggling with bereavement and grief. By utilizing these tools, professionals can gain a better understanding of the bereaved persons and provide appropriate support to clients.
According to the three-tiered bereavement care model mentioned above, bereavement care is comprised of “universal care”, “selective care” and “indicated care” according to the different needs of bereaved people. We propose the use of “Bereavement risk screening tool” to identify high-risk bereaved persons who need additional supports from the selective care. Besides, “Bereavement outcome aassessment tool” is used to identify bereaved persons who have high distress or severe impairment in daily functioning. They would be referred to receive specific supports from helping professional at the indicated care. Therefore, the use of suitable and effective assessment tool is extremely crucial for identifying and locating needy individuals for corresponding care and supports.
Bereavement Risk Assessment: Different Models
To better understand and assess the risk factors associated with bereavement, several frameworks have been proposed. One such framework, proposed by Stroebe and colleagues (2006), bereavement-related factors (e.g. traumatic loss, multiple loss), interpersonal risk factors (e.g. social isolation, family dynamics), intrapersonal risk factors (e.g., personality, religious belief), and appraisal and coping (e.g. emotion regulation).
A systematic review of predictors of maladaptive grief identified multiple risk factors differentiated by the time frame: factors related to the death, such as violent death, the quality of the caregiving or dying experience; factors prior to the death, such as childhood attachment style, a previous psychiatric history, relationship to the deceased, and dependency; and risk factors after loss, such as cognitive behavioural conceptualizations, social support (Lobb et al., 2010).
There are also risk-assessment tools that were developed and used in Western culture. For example, the Bereavement Risk Assessment Tool (Rose et al., 2011) and the Bereavement Risk Inventory and Screening Questionnaire (BRISQ) (Robert et al., 2017).
Bereavement Outcome Assessment: Examples of assessment tools
Assessment tools have also been developed to help professionals assess bereavement outcomes. Below are some examples.
PG-13-revised (Prigerson et al., 2021). The revised version of PG-13 is based on the new criteria of PGD in DSM-5. It contains 13 items and can be used to assess grief intensity as well as to assist the diagnosis of PGD.
TGI-SR+ (Lengerink, 2022) . The Traumatic Grief Inventory-Self Report Plus (TGI-SR+) is a 22-item self-report measure that can be used to assess the criteria sets of PGD as defined in both ICD-11 and DSM-5-TR.
ICG (Prigerson et al., 1995). The Inventory of Complicated Grief (ICG) is a 19-item self-report inventory to assess grief intensity.
Lobb, E. A., Kristjanson, L. J., Aoun, S. M., Monterosso, L., Halkett, G. K. B., & Davies, A. (2010). Predictors of Complicated Grief: A Systematic Review of Empirical Studies. Death Studies, 34(8), 673-698. https://doi.org/10.1080/07481187.2010.496686
Lenferink, L. I. M., Eisma, M. C., Smid, G. E., de Keijser, J., & Boelen, P. A. (2022). Valid measurement of DSM-5 persistent complex bereavement disorder and DSM-5-TR and ICD-11 prolonged grief disorder: The Traumatic Grief Inventory-Self Report Plus (TGI-SR+). Comprehensive Psychiatry, 112, 152281.
https://doi.org/10.1016/j.comppsych.2021.152281
Prigerson, H. G., Maciejewski, P. K., Reynolds, C. F., Bierhals, A. J., Newsom, J. T., Fasiczka, A., Frank, E., Doman, J., & Miller, M. (1995). Inventory of complicated grief: A scale to measure maladaptive symptoms of loss. Psychiatry Research, 59(1), 65-79.
https://doi.org/10.1016/0165-1781(95)02757-2
Prigerson, H. G., Boelen, P. A., Xu, J., Smith, K. V., & Maciejewski, P. K. (2021). Validation of the new DSM-5-TR criteria for prolonged grief disorder and the PG-13-Revised (PG-13-R) scale. World Psychiatry, 20(1), 96-106. https://doi.org/10.1002/wps.20823
Stroebe, M. S., Folkman, S., Hansson, R. O., & Schut, H. (2006). The prediction of bereavement outcome: Development of an integrative risk factor framework. Social Science & Medicine, 63(9), 2440-2451. https://doi.org/10.1016/j.socscimed.2006.06.012
