Complicated Grief and the Reconstruction of Meaning: Conceptual and Empirical Contributions to a Cognitive-Constructivist Model.

A cognitive-behavioral model of complicated grief (CG) that emphasizes the struggle to integrate the loss into autobiographical memory receives both conceptual and empirical support from recent constructivist work on the role of sense making as a crucial process in bereavement adaptation. However, globally negative appraisals and anxious and depressive avoidance strategies, factors also posited by the cognitive-behavioral formulation, may play a more circumscribed role, inhibiting adjustment to loss in some, but not all, cases of CG. Converging research programs lend credence to a cognitive-constructivist approach to grief and suggest the relevance of meaning-oriented and narrative strategies for assisting clients whose lives have been devastated by loss.