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Grief and Loss A Social Work Perspective

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Journal of Loss and Trauma

International Perspectives on Stress & Coping

ISSN: 1532-5024 (Print) 1532-5032 (Online) Journal homepage: http://www.tandfonline.com/loi/upil20

Grief and Loss: A Social Work Perspective

Jennifer E. Simpson

To cite this article: Jennifer E. Simpson (2013) Grief and Loss: A Social Work Perspective, Journal
of Loss and Trauma, 18:1, 81-90, DOI: 10.1080/15325024.2012.684569

To link to this article: https://doi.org/10.1080/15325024.2012.684569

Accepted author version posted online: 20


Apr 2012.
Published online: 20 Apr 2012.

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Journal of Loss and Trauma, 18:81–90, 2013
Copyright # Taylor & Francis Group, LLC
ISSN: 1532-5024 print=1532-5032 online
DOI: 10.1080/15325024.2012.684569

Grief and Loss: A Social Work Perspective

JENNIFER E. SIMPSON
Faculty of Health and Social Care, Open University in the South, Oxford, England

Despite the wealth of research that exists in the area of death, grief,
and loss, the scarcity of literature examining the impact upon
social work practitioners is troubling. This article initially draws
upon a case study to explore this impact through the theoretical
framework of disenfranchised grief. Further comment is made
regarding the possible factors that have led to the profession as a
whole experiencing disenfranchised grief. The article concludes
by arguing that practitioners are best served through the use of
‘‘super-vision,’’ which enables them to not only examine their
practice but also their response to death, grief, and loss.

KEYWORDS bureaucracy, disenfranchised grief, Monro, social


work, supervision

The death of an individual has a profound impact on those left behind. All
are touched in one way or another by grief and loss. In terms of social work,
there has been a considerable body of work produced that has focused on an
explanation of, and response to, the grieving process. Other work that has
been produced includes factors affecting grief in children, as well as the
theoretical context and framework in which social workers should practice
when faced with death and dying (Granot, 2005; Hope & Hodge, 2006; Price,
2010; Weinstein, 2008; Willis, 2002). Of the body of work that exists, little of it
mentions the impact grief and loss has on the social work practitioner and
how this should be effectively managed by the employing organization
and more immediately by the practitioner’s supervisor=manager.
Beginning with a brief practice vignette, which provides an exemplar,
the topic of grief and loss is first explored through the theoretical framework
of disenfranchised grief. This theoretical phenomenon describes a societal
and individual response to grief and loss that inherently denies recognition,

Received 26 October 2011; accepted 6 January 2012.


Address correspondence to Jennifer E. Simpson, Open University-South, Foxcombe Hall,
Boars Hill, Oxford OX1 5HR, England. E-mail: j.simpson@open.ac.uk

81
82 J. E. Simpson

legitimization, or support of the loss or grief being experienced by an


individual (Corr, 2002, p. 40). The focus then moves to the role social work
organizations have in terms of enabling disenfranchised grief to thrive,
because of the way in which they are structured and the culture they foster.
Lastly, attention will be centered upon supervision and reflective practice
as the means and method by which the effects of grief and loss can be
effectively mitigated by social work practitioners.

PRACTICE VIGNETTE

Robert and his wife Pat (for the purposes of this article, identifying infor-
mation has been changed in order to protect the identity of the persons
involved) were a couple in their mid-40 s who had risen to the challenges
of fostering children and young people with enthusiasm and commitment.
Initial contact with Robert and Pat had come about 5 years earlier as a result
of my being the assessing social worker for their application to foster. I had
been a student social worker at the time, and Robert and Pat represented my
first full-length social work assessment. My contact with Robert and Pat came
to an end when they were formally approved as foster carers by the agency
with which I was undertaking my practice learning opportunity. My relation-
ship with Robert and Pat was rekindled some 3 years later, when I became
their supervising social worker. During the 3-year period they had had a
number of placements and were now currently caring for two children.
However, the fostering environment was thrown into chaos when Pat
was diagnosed with cancer. She underwent life-threatening surgery, yet they
were able to maintain both placements through the support of their wider
family and back-up carers. It was at this point that I reentered their lives with
the job of reassessing their suitability for fostering as a couple.
Just before the reassessment exercise was to begin in earnest, Robert
shared the fact that Pat’s condition had become terminal and that she only
had a couple of months to live. Less than 6 weeks later, Pat passed away
and I was left feeling inept, after being so involved in discussions, planning,
and regular contact with Robert. I realized that I needed to shift to another
gear of formally recognizing Pat’s departure by standing on the sidelines as
a mark of dignity and privacy for Robert, which meant that my own sense
of grief and loss was indiscernible to those around me.

THE CURRENT SOCIAL WORK PERSPECTIVE ON GRIEF AND LOSS

The practice vignette above represents an exemplar of the grief and loss that
is regularly experienced by social work practitioners. As a profession, social
workers regularly come into contact with service users who are faced with
grief and loss as a result of a partner or close relative’s death, a life-limiting
Grief and Loss 83

condition, the loss of a child, or the impact of a mental health condition


(Weinstein, 2008, p. 2). This is a view that is substantiated by Farber et al.
(2004), who state that social work practitioners need to be consultants, col-
laborators, and guides to those individuals newly caught up in the uncertain-
ties of significant loss (Farber et al., 2004, p. 115, cited in Weinstein, 2008).
Taking into account the fact that social work practitioners are in essence
the tool by which a range of social work interventions happen (Rezenbrink,
2004, p. 862), this means that they are inevitably impacted by the losses and grief
of their service users. However, this known fact has yet to result in the
production of literature that acknowledges the emotional impact of grief and
loss upon the social work practitioner. An example of this is Goldsworthy’s
article (2005), which makes a plea for the development of grief and loss theories
to incorporate social work values and ethics. Goldsworthy (2005) argues that the
traditional theories such as Bowlby’s attachment theory (1980), Worden’s task
theory of grief and loss (1991, as cited in Goldsworthy, 2005), and Kubler-Ross’s
work identifying the phases in dying (1970, as cited in Goldsworthy, 2005) have
seemingly ignored the basic tenets of social work practice. She adds that the
‘‘prescriptive’’ nature of the theories pathologizes both the meaning and context
of the individual’s experience (Goldsworthy, 2005, p. 174). This has meant that
there is little or no acknowledgment of a strengths approach or recognition of
the various coping strategies individuals might employ when dealing with grief
and loss. Although the work of Goldsworthy (2005) is laudable, what seems to
have been completely missed are her own reactions to her service users despite
her stating explicitly that losses affect everyone throughout their lives and are
commonly encountered by social work practitioners (Goldsworthy, 2005,
p. 168). Disquieting though this example might be, there are a few examples
where social work practitioners do highlight grief and loss and its impact.
However, these mainly relate to practitioners who are involved in end-of-life
and adult care services (Rezenbrink, 2004; Weinstein, 2008).

THE SOCIAL WORK PROFESSION AND DISENFRANCHISED GRIEF

An explanation for this dearth might lie in Doka’s (1989) theoretical frame-
work of disenfranchised grief (Doka, 1989, cited in Corr, 2002). His seminal
work provides an explanation as to why grief and loss, as experienced by
some people, is not readily acknowledged or recognized on an individual
or societal basis. Doka (1989) defined disenfranchised grief as ‘‘the grief that
persons experience when they incur a loss that is not or cannot be openly
acknowledged, publicly mourned or socially supported. A key aspect of
the theory is that at all times grief and loss occur within a particular social
or cultural context’’ (Doka, 1989, cited in Corr, 2002, p. 39).
Since Doka’s (1989) initial theoretical proposition, researchers and clin-
icians in the area of thanatology have been able to expand upon and further
84 J. E. Simpson

interrogate his work. Such an approach has been taken by Corr (2002), who
revisits the original concept with the aim of appreciating even more fully the
impact of grief and loss. Corr (2002, p. 40) builds on the definition crafted by
Doka (1989) by adding that disenfranchised grief involves ‘‘[recognizing] that,
in various spoken and unspoken ways, social and cultural communities may
deny recognition . . . or support of the grief people experience.’’
It should be noted that Corr’s (2002) definition does not confine itself to
an understanding that social and cultural communities have merely failed to
notice or have inadvertently overlooked the grief and loss experienced by
individuals. His interpretation is stark, in that he claims disenfranchised grief
is an active process of disavowal, renunciation, and rejection (Corr, 2002, p.
40). He goes on to state that this deliberate act or series of acts has a tendency
to take three primary forms. First, the relationship is not recognized; this
relies upon the presumption that the sense of loss can only be experienced
by a closeness or traditional relationship, normally with spouses, family, or
lifelong friends. Corr (2002, p. 43) points out that there are a series of
disenfranchised relationships such as work colleagues, ex-spouses, and
in-laws, which are deemed by society as insufficient or inappropriate to
foster a sense of grief.
The second primary form is where loss is not recognized. Examples
include perinatal deaths, loss of certain body parts, or the loss of a partner
through a debilitating illness or condition such as Parkinson’s disease. Corr
(2002) explains that this form of disenfranchised grief originates from a refusal
to recognize that a real loss has taken place. The final form in which disenfran-
chised grief can be demonstrated is where the griever is not recognized. Corr
(2002, p. 44) states that this is normally applied to those persons who are not
readily accepted as having the ‘‘status of persons who experience grief.’’
Examples of such persons include very young children and older persons
who have little contact with members of their extended family.
When one applies Doka’s (1989) original theory and its subsequent
expansion by Corr (2002) to the social work profession, a whole series of
implications become apparent. Beginning with the wider cultural context
of the social work profession, it is one where there are often complex and
ambiguous demands, involving the balancing of various tensions, the pro-
motion of rights, advocacy, empowerment, and loss. Lishman (2002, p. 101)
quotes Trowell (1995, p. 195) by saying that this complexity ‘‘stirs up power-
ful and primitive feelings in all professionals.’’ A further perspective is pro-
vided by Turner (1995, p. 125), who states that those working with service
users in ‘‘disturbed and emotionally charged situations’’ have an increased
likelihood of taking into themselves confusion and chaos. It can be con-
tended that what is missing from her description is grief and loss. However,
they are not ignored by Rezenbrink (2004), who provides a personal
example, and Weinstein (2008), who offers a series of examples from
social work with older people, community mental health services, and adult
Grief and Loss 85

services. The characteristics of the profession, as described above, are further


compounded by the fact that social work practitioners may be unwilling to
openly share any sense of the confusion, chaos, and sense of loss they
experience. Turner (1995, p. 126) confirms this by pointing out that ‘‘many
workers feel they must appear to be coping well with their work at all times.
What they see as their less acceptable thoughts, feelings and actions are sup-
pressed, denied and avoided, for fear of being seen as not a good-enough
worker.’’
Taking Turner’s (1995) observation into account, it can also be claimed
that within the profession there is a level of disenfranchised grief that is
self-imposed. This stance is based on Kauffman’s (2002) exploration of
self-disenfranchised grief. He explains the reaction on the part of the individ-
ual as follows: ‘‘[Self] delivers and receives on behalf of society a message
such as, ‘Do not allow this grief to be real for you. This is not a loss, it is
not grief.’ ’’ (Kauffman, 2002, p. 62).
He adds that self-disenfranchised grief is a psychological symptom that
is self-initiated. In the mind of the individual, the influences of societal or
organizational disenfranchisement are likely to be imagined. However, this
imagining is based on past experiences of disenfranchisement or, as
Kauffman (2002, p. 62) has put it, ‘‘a psychological tendency to disallow
and disavow one’s own grief.’’ It is shame, Kaufmann argues, that acts
as the impediment that prevents the experience of grief from occurring
(Kauffman, 2002, p. 63). The overwhelming expectation is that social work
practitioners are to carry on working, in spite of the emotional turmoil
within, in order to demonstrate their competence as self-assured profes-
sionals, which means that there is little or no room to admit the ‘‘shameful’’
truth that such a sense of self-assurance might not in actual fact exist. In
summary, it can be argued that the social work profession, by its very nature,
has a predilection for self-disenfranchised grief based upon a suppression of
negative thoughts and feelings by the individual practitioner.

THE ROLE PLAYED BY EMPLOYING ORGANIZATIONS IN


REINFORCING DISENFRANCHISED GRIEF

This predilection for self-disenfranchised grief and the disenfranchised grief


that social work practitioners are likely to experience cannot be said to solely
rest with individuals; one must contend that it is shored up by the employing
organization’s structure and daily management. In terms of the organizational
structure, Mullender and Perrott (2002, p. 75–76) comment that social work
in the statutory sector is a hybrid when compared to traditional organizations
of the Weberian kind in that it lacks autonomy and is governed by an exten-
sive range of legislation, regulation, and guidance. A recent example of this is
provided in the Munro Review of Child Protection (Great Britain Department
86 J. E. Simpson

for Education, 2011), which, quoting Parton (2010), identifies that the
procedure for child protection work is 55 times longer than it was in 1974.
This in turn has led to an organizational approach that includes special-
ization, the development of standardized services, and hierarchical lines of
management control, as well as stringent application of policies and proce-
dures (Mullender & Perrott, 2002, p. 76). These factors have in recent years,
under the drive of increased efficiency in local government and the audit of
performance through mechanisms like statistical returns and inspections, led
to an approach that is overtly reliant upon bureaucracy and control. This
approach along with the hybrid nature of social work organizations, it can
be argued, inevitably results in an organizational culture where there is little
opportunity to acknowledge the emotional challenges faced by social work
practitioners. Evidence from recent reviews of social work practice (Munro
Review of Child Protection, Social Work Task Force) points to the fact that
the current management style relies heavily on bureaucracy and the com-
pletion of associated tasks to the detriment of the necessary cognitive and
emotional requirements of social work practitioners. Where such detriment
exists, it can be said that disenfranchised grief will be present as the organiza-
tional practices and culture deliberately ignore the grief and loss being
experienced by social work practitioners in favor of the more immediate
pressing issues related to financial constraints and a lack of resources.
Having recognized that the organizational structure and culture of social
work services are likely to leave the grief and loss of social work practitioners
deliberately unrecognized, this will inevitably translate into the way in which
they are managed and supervised on a daily basis. Unfortunately, there are
many examples of the poor management and supervision of social work
practitioners (Great Britain Department for Education, 2011b; Rezenbrink,
2004; Weinstein, 2008; Turner, 1995; Social Work Task Force, 2009). When
the concept of disenfranchised grief is applied to the profession, it is appar-
ent that there are considerable risks to the mental and emotional welfare of
social work practitioners, as the feelings being experienced are at variance
with the presumed helping role and the realities of what can be achieved.
Rezenbrink (2004) identifies burnout, compassion fatigue, and vicarious trau-
matization, all of which can possibly have a devastating impact not only
upon the individual social work practitioner, but also on service provision.
More often than not, social work practitioners are likely to find coping
mechanisms that enable them to either avoid or manage the powerful emo-
tions associated with the loss and grief they come into contact with. Some
social work practitioners will seek solace informally from other colleagues;
others will draw on their own personal experiences from the past, and there
will be those practitioners who will lean on their religious faith (Weinstein,
2008).
From the literature that is available, sadly, one is left with the conclusion
that few social work practitioners will be able to use supervision as a tool to
Grief and Loss 87

find meaning in the midst of the loss and grief they experience. This is
because managers are more than likely to have been affected by the organi-
zational priorities and culture, thus leading to the subversion of the super-
vision process by making it a mechanism to control and=or instruct staff
(Turner, 1995).

‘‘SUPER-VISION’’: A PRACTICE-BASED SOLUTION TO


DISENFRANCHISED GRIEF

A case has been made for the fact that an integral aspect of the work carried
out and experienced by social work practitioners involves grief and loss. This
fact has not been acknowledged as widely as it should be by the profession
because of a widespread failure to actively acknowledge the emotions and
accompanying behaviors prompted by grief and loss. With the specter of dis-
enfranchised grief lingering over the profession, what can be done to repo-
sition it from a place of denial to acknowledgment and, subsequently, to grief
being seen as part of a self-care strategy (Rezenbrink, 2004, p. 858)? One
possible answer is supervision. Not the type that has already been decried,
but rather ‘‘super-vision,’’ which is described by Turner (1995) as managers
having a larger and freer view of the work social work practitioners describe
to them, simply because they are not embroiled in it (Turner, 1995, p. 125).
Rezenbrink (2004, p. 861) proposes an alternative definition: where a
good supervisor is able to create a safe place for sharing both personal
and professional struggles and will acknowledge strengths.
Whichever definition is preferred, there is clearly a need to ensure that
social work practitioners have the opportunity to name the losses they have
experienced and have them not only acknowledged, but also accepted. The
freedom of being able to bring a range of losses to supervision can have,
according to Rezenbrink (2004) and Doughty (2009), a powerful effect in
terms of conveying a sense of liberty and, as previously stated, providing
the space for practitioners to heal through formally grieving. However, in
order for this to be achieved, the way in which supervision is carried out
has to change. There must be a deliberate move away from the avoidance
of painful issues and the natural inclination to rush towards a series of solu-
tions or litany of instructions (Turner, 1995, p. 126). Moreover, managers, as
part of providing the necessary environment for the sharing of experiences of
loss and grief, must contain their own anxieties that are related to the
ultimate responsibilities they have regarding service provision. Yet it is sense-
less to think that it is only managers who need to change their approach to
supervision; social work practitioners also have their part to play.
Social work practitioners need to come to supervision with the idea of
the encounter with their supervisor being ‘‘super-vision,’’ where they are
able, through their manager, to have a larger and freer view of their work
88 J. E. Simpson

and its impact (Turner, 1995, p. 125). Practitioners also need to enter into and
sustain throughout supervision a reflective approach. Payne (2002) explains
this approach as the ability of the practitioner to appreciate how his or her
thoughts affect actions, which then go on to shape the situation the prac-
titioner is operating in. This will require social work practitioners to honestly
acknowledge their emotions, as well as the motivating factors behind
their behaviors. Practitioners will also need to develop the disciplines of
‘‘reflecting-in-action’’ and ‘‘reflecting-on-action’’ (Schön, 1983, cited in Carter,
Jeffs, & Smith, 1995). Reflecting-in-action concerns itself with the issues=
dilemmas of a case as it is actually being worked. Reflecting-on-action relates
to the contemplation of practice. The development of these two disciplines, it
can be argued, will bring a richness to supervision, the outcome of which is
likely to be an autonomous, skilled, and emotionally stable practitioner.

THE ROLE THAT NEEDS TO BE PLAYED BY EMPLOYING


ORGANIZATIONS TO SUPPORT SUPER-VISION

Nonetheless, it is not entirely acceptable to make managers and social work


practitioners the only focal points of change. Change must also take place in
the macro environment of the organization. This change has already begun
as a result of the recommendations made by the Social Work Task Force,
where there is an emphasis on clear, universal, and binding standards for
employers, which have now been labeled ‘‘Standards for Employers and
Supervision Framework’’ (Social Work Task Force, 2009, p. 7). Social work
organizations are now being required to make a positive unambiguous
commitment to a strong supervision culture (Social Work Task Force, 2009,
p. 35). Yet it is interesting to note that the proposed standards will not just
be left to social work organizations to implement; there is a likelihood they
will be incorporated into both self-regulation and inspection frameworks,
which will further strengthen and reinforce the necessary cultural changes
required (Social Work Task Force, 2010, pp. 18–21). The fundamental
changes to social work as set out by the Social Work Task Force, if fully
employed, leave room for the implementation of super-vision as a tool,
which will allow the necessary time and space for social work practitioners
to examine their practice and, where loss has been experienced, be given
the permission to grieve accordingly and ultimately find meaning to integrate
such loss into their life and work (Rezenbrink, 2004, p. 88).

FUTURE CONSIDERATIONS FOR SOCIAL WORK PRACTICE

With the widespread acknowledgment that grief and loss are integral aspects
of social work, there needs to be greater attention paid by academics to
not only the expansion of grief and loss theory in social work practice
Grief and Loss 89

(Goldsworthy, 2005), but also the impact loss has on social work practitioners.
An initial step has been taken by the author to consider the effects using the
theoretical framework of disenfranchised grief; this is because an appreciation
of the concept serves to remind everyone of the often imperceptible ways in
which the acknowledgment and recognition of grief and loss are withheld
(Carr, 2002, p. 57). One can argue that additional work is required in this area
as part of discovering what adaptive grieving styles (Martin & Doka, 2000, as
cited in Doughty, 2009) can be employed by social work practitioners and
how these might be facilitated, if at all, by supervision.

CONCLUSION

This article has set out the rationale that within the profession of social work
there is a predilection towards disenfranchised grief based not only upon the
inability of social work practitioners to openly admit painful and difficult
feelings, but also on the organizational and managerial culture that fails to
recognize such emotions. Against this backdrop, the suggestion has been
made that an effective solution to this predilection is through the use of
‘‘super-vision,’’ which provides an opportunity for social work practitioners
to truly air their feelings and have them acknowledged. It has been argued
that the possibility of the solution becoming a reality can be found in the
major changes that are being made to the social work profession as a result
of the Social Work Reform Board. However, it would be all too easy for the
final sentence of this article to be written in such a way as to represent a clar-
ion call for social work practitioners to rise up and reclaim supervision.
Instead, the final sentence has been left to Rezenbrink (2004, p. 855), who
accurately states: ‘‘The cumulative effects of daily critical incidents are often
imperceptible, but have a way of catching up with us.’’

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Jennifer E. Simpson is a regional academic manager working for the Open


University on its undergraduate social work program in the south of England. As a social
work practitioner, she specialized in children and family social work, in particular foster
care. She has also worked extensively with educational establishments in the area of
child protection and building resilience.

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