The long-term bereavement adjustment process for older widow(er)s can impact every aspect of their lives. This study will test a new, promising intervention approach based on the Dual Process Model (DPM) of coping with bereavement that includes the traditional grief support group focus but adds educational, daily life skill-building, and competency elements needed in the multidimensional adjustment process. This model emphasizes the need for adaptation to two types of bereavement-related stressors, each having its own unique process: loss orientation (LO), which addresses psycho-emotional stressors associated with the loss itself, and restoration (R), which focuses on coping with secondary stressors related to one's new widowhood status. Oscillation between the two processes is a key element because effective adaptation requires one aspect to emerge with greater importance, relevance, or urgency over the other at different times.
The aims of this study are to (1) compare the effectiveness of the DPM intervention versus a traditional support group in enhancing bereavement adaptation, and (2) determine the extent to which oscillation between loss orientation and restoration can be facilitated by the DPM intervention. The sample includes 330 widow(er)s, aged 50+ who are bereaved 2-4 months at baseline. A randomized pre/post experimental design will be employed with follow-up (3 & 9 months after post-test) in which participants will be assigned to either the DPM treatment condition (14 weekly sessions focusing on loss orientation, restoration, and oscillation) or the LO comparison group. LO outcomes include depression, grief, coping self-efficacy, and loneliness with R outcomes measured by competencies, mastery, and personal growth. Oscillation will be assessed by an inventory of daily life. Self-administered questionnaires also include measures of health status, social support, self-esteem, use of community resources, and religious/spiritual resources. It is hypothesized that subjects in the DPM intervention condition will demonstrate greater improvements on all adaptation and oscillation measures over time than those in the LO comparison group. Analytical strategy consists of repeated measures analysis of variance (ANOVA) with """"""""time"""""""" the within-subject factor and """"""""group assignment"""""""" the primary between-subjects factor. Findings from this study may stimulate the beginning of a paradigm shift in the content and delivery of bereavement interventions for adults by broadening the focus beyond the traditional psycho-emotional approach.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
5R01AG023090-05
Application #
7459877
Study Section
Behavioral Medicine, Interventions and Outcomes Study Section (BMIO)
Program Officer
Nielsen, Lisbeth
Project Start
2004-09-01
Project End
2010-06-30
Budget Start
2008-07-01
Budget End
2010-06-30
Support Year
5
Fiscal Year
2008
Total Cost
$415,485
Indirect Cost
Name
University of Utah
Department
Type
Schools of Nursing
DUNS #
009095365
City
Salt Lake City
State
UT
Country
United States
Zip Code
84112
Caserta, Michael S; Lund, Dale A; Utz, Rebecca L et al. (2016) ""One Size Doesn't Fit All"" - Partners in Hospice Care, an Individualized Approach to Bereavement Intervention. Omega (Westport) 73:107-125
de Vries, Brian; Utz, Rebecca; Caserta, Michael et al. (2014) Friend and family contact and support in early widowhood. J Gerontol B Psychol Sci Soc Sci 69:75-84
Caserta, Michael; Utz, Rebecca; Lund, Dale et al. (2014) Coping processes among bereaved spouses. Death Stud 38:145-55
Utz, Rebecca L; Swenson, Kristin L; Caserta, Michael et al. (2014) Feeling lonely versus being alone: loneliness and social support among recently bereaved persons. J Gerontol B Psychol Sci Soc Sci 69:85-94
Utz, Rebecca L; Lund, Dale; Caserta, Michael (2013) An Evaluation of the Living After Loss Intervention - Part 2: Do Bereavement-Related Outcomes Vary by the Dynamics of Support Groups? Grief Matters 16:36-40
Utz, Rebecca L; Caserta, Michael; Lund, Dale (2013) An Evaluation of the Living After Loss Intervention - Part 1: Do Bereavement-Related Outcomes Vary by the Content of Support Groups? Grief Matters 16:32-35
Caserta, Michael S; Utz, Rebecca L; Lund, Dale A (2013) Spousal Bereavement Following Cancer Death. Illn Crises Loss 21:185-202
Utz, Rebecca L; Caserta, Michael; Lund, Dale (2012) Grief, depressive symptoms, and physical health among recently bereaved spouses. Gerontologist 52:460-71
Utz, Rebecca L; Lund, Dale A; Caserta, Michael S et al. (2011) Perceived self-competency among the recently bereaved. J Soc Work End Life Palliat Care 7:173-94
Caserta, Michael; Utz, Rebecca; Lund, Dale et al. (2010) Sampling, recruitment, and retention in a bereavement intervention study: experiences from the Living After Loss Project. Omega (Westport) 61:181-203

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