JAMAICA THEOLOGICAL SEMINARY

“That I may know Him…that I might make Him known”

DEPARTMENT OF BEHAVIOURAL AND SOCIAL SCIENCES

FINAL EXAMINATION
GRIEF MANAGEMENT
DATE: Monday, December 17, 2018
DURATION: 6:00 p.m. – 9:00 p.m. (3 hours)

Student’s I.D. No.______________________ Lecturer: _______________________________________

GENERAL INSTRUCTIONS
Please tick (√) the appropriate box.

Kingston □ Mandeville □ St. Lucia □ Montego Bay Comm. College (Mo-Bay)

□ Montego Bay Comm. College (Frome) □ Portmore Community College □

The Moneague College □ Port Maria Campus □ Linstead Campus □

Candidates are reminded that the examiners shall take into account the proper use of the English
Language in determining the mark for each response.

1. THIS PAPER COMPRISES FOUR (4) SECTIONS - A, B, C & D

2. CANDIDATES ARE REQUIRED TO ANSWER:

a. Compulsory question in section A
b. One question in section B
c. One question in section C
d. One question in section D

3. ALL ANSWERS MUST BE DONE ON YOUR ANSWER BOOKLET

4. THIS PAPER HAS A TOTAL VALUE OF 100 POINTS

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 SECTION A

COMPULSORY QUESTION
THIS SECTION IS WORTH 25 MARKS

1. Case of Community Violence (25 marks)

Some years ago there was a spate of gang feud in one of Jamaica’s ‘inner city’ communities where a
significant number of persons were either killed or injured. Students attending the high school in the
area experienced the death of close family members; however, no significant counselling intervention
was done with them. As such, many of them are now displaying signs of unresolved grief. As the
social worker attached to the school it was brought to your attention and you were thereby
requested to do grief intervention/counselling with the group.

a) Identify five possible signs that would indicate that these students are displaying unresolved
grief. (10 marks)

b) Outline five different activities that can assist the group of adolescents in dealing with the
loss. (10 marks)

c) Explain how you would incorporate your faith (principles of scripture, knowledge of God) in
helping the adolescents cope with the loss and attach meaning to it. (5 marks)

SECTION B
CASE ASSESSMENT
ANSWER ONE OF THE FOLLOWING CASES (20 marks)
Case of Heather

1. Heather was 24-years old. She was just beginning her second year as a 7th grade math teacher
and was to be married to her high school sweetheart in two months. Heather was driving to
school when she was hit by a truck that ran a red light. She sustained multiple fractures, head
injury, and extensive internal injuries. Her parents and older brother were informed on arrival
at the E.R. that her chances for survival were extremely low. She was taken to the operating
room but after 3 hours of surgery with uncontrollable bleeding and several resuscitation
attempts, she died in the O.R. A clinical nurse specialist, who is on the rapid response team at
the hospital, was called to be with the family when they arrived at the hospital. She stayed
with them after they received the news of Heather’s death.

a. How is grief from this sudden death likely to differ from death resulting from chronic
illness? (5 marks)

b. What communication strategies would be helpful for the clinical nurse specialist to use
with Heather’s parents on their arrival to the ER? While she is in surgery? At the time
of her death? (5 marks)

c. What kind of grief would the fiancée likely experience? What types of interventions
would be helpful? How might his grief differ from Heather’s parents and siblings?
(10 marks)
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 Case of Mr. Milton

2. Mr. Milton a 75-year-old man with a history of metastatic prostate cancer was admitted to an
inpatient hospice unit because of progressive debilitation. His pain was well controlled, but he
had a poor appetite, was losing weight and had crying spells. When asked about possible
depression, he replied that he was not sure if he was depressed. One of his daughters who
lived near him and help care for him felt that his crying indicated that he was finally coming to
terms with his terminal diagnosis; another daughter felt that he was depressed. He made
statements like “If you give me more time I will dedicate it to serving others more”. His
daughters were always quarrelling about his progress. One of them hardly visits him while the
other went frequently but always cries on her visits.

a. Is Mr. Milton at a place of acceptance? Elaborate in relation to the case: (6 marks)

b. Are both daughters grieving? What type(s) of grief is each daughter experiencing?
Elaborate in relation to the case. (6 marks)

c. Provide four (4) counselling strategies to help Mr. Milton (8 marks)

SECTION C
ANSWER ONE OF THE FOLLOWING

ARTICLE REVIEW

(Responses must be written on ONE PAGE ONLY meaning one side of the rule sheet)

1. Among the terms that have been used in the bereavement literature to describe atypical grief
are complicated grief (CG); traumatic bereavement; childhood traumatic grief; and prolonged
grief disorder (PGD). In this article, for consistency we use the term complicated grief.
Although the specific definitions for these conditions may differ, the common defining
characteristic is that the bereavement process is interrupted and there is no resolution.
Although mental health experts continue to analyze how CG symptoms differ from normal
grief reactions, signs and symptoms identified as characterizing CG include extreme focus on
the loss and reminders of the loved one; intense longing for the deceased; problems accepting
the death; numbness or detachment; preoccupation with feelings of sorrow; bitterness about
the loss; an inability to enjoy life; depression or deep sadness; difficulty carrying out normal
routines; withdrawing from social activities; irritability or agitation; and a lack of trust in
others (Mayo Clinic, 2007). Article: Concepts and Controversies in Grief and Loss – Robyn A
Howarth, 2011

a. Based on the information from the article write a detail case reflecting complicated
grief. Discuss what stage of grief is experience during complicated grief according to
Kubler-Ross (1969) (15 marks)

2. Preparatory grief, as introduced by KublerRoss in “On Death and Dying,” is “that [grief that]
the terminally ill patient has to undergo in order to prepare himself for his final separation
from this world.” Article: Identifying and Managing Preparatory Grief and Depression at the
End of Life; Hallenbeck N., Vyjeyanthi, S. and Periyakoil, M. (2002).

a. You are asked to do a presentation on how the dying person grieves. Describe in detail
the grief process and the difference between grief and depression (15 marks)

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3. “It would seem obvious that surviving the death of a loved one from suicide is a difficult
experience, one that has the potential to produce a markedly different type of mourning
process from other types of losses. Certainly, mourning after the suicide of a loved one is
often perceived by the survivor to be a very different experience from the losses of other
mourners” (Alexander, 1991; Bolton, 1983; Wertheimer, 1991). Article: Is Suicide
Bereavement Different? A Reassessment of the Literature 2001.

a. Describe the impact of suicide on family systems. (10 marks)

b. Explain the grief process including the main type of grief experienced and the stages of
grief that the family goes through as given by Kubler-Ross (5 marks)

SECTION D
ESSAYS
ANSWER ONE OF THE FOLLOWING (30 marks)

Please note that an essay has an Introduction and a Conclusion

1) Abortion is a common practice in the Jamaican society and can have severe impact on the
perpetrator.
a. Define the term abortion and discuss three reasons why individuals commit the act.
(15 marks)

b. What type(s) of grief is experienced during an abortion? Discuss the stages of grief;
Elaborate. (10 marks)

c. What is the role of the church in ministering to persons who commit this act (5 marks)

2. "Participating in the funeral ritual-standing at a wake and repeatedly looking at the deceased
in the casket, attending a funeral service, accepting the condolences of others, witnessing the
casket at the grave-graphically illustrates to the bereaved that the death has indeed occurred”
(Therese Rando, …). Funeral ceremonies/rituals play a vital role in the bereavement process.
a. Discuss five important reasons for creating and using rituals. (20 marks)

b. How can the church community address the issue of death among its members and
prepare the entire congregation for their own inevitable times of grief. (10 marks)

END OF EXAMINATION