Most bereavement caregivers accept as a truism that their interventions are helpful. However, an examination of the bereavement intervention literature suggests that the scientific basis for accepting the efficacy of grief counseling may be quite weak. This article summarizes the findings of four recent qualitative and quantitative reviews of the bereavement intervention literature. It then discusses three possible explanations for these surprising findings and concludes with recommendations for both researchers and clinicians in thanatology that could help to focus efforts to answer the questions of when and for whom grief counseling is helpful.

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Results reinforce a growing literature on the salutary effects of spirituality, and underscore its relevance as one possible form of constructive coping for professionals attending to the needs of the dying and bereaved. The study carries further implications for how the stresses of such work might be ameliorated by enhanced training efforts, as well as creative facilitation of diverse spiritual expressions (e.g., inclusive forms of ritual recognition of loss) in the workplace.

shaping people's responses to life events and regard human beings as capable of at least a bounded agency in determining the course of their lives (Kelly, 1955). On the other hand, constructivists construe the self more as a process than a product, stressing the dialectical dynamics of ongoing self-development in response both to sensed discrepancies within the self-system (Green.berg & Pascual-Leone, 1995) and to perturbations of personal structure arising in the (social) medium in which humans exist (Maturana & Varela, 1987). Likewise, the recognition that constructivists accord to abstract or tacit features of personal knowledge (Hayek, 1952;Polanyi, 1958) and their conception of identity as comprising many "possible selves" (Markus & Nurius, 1986) temper their assumption of the ultimate knowability of the self and, with it, their enthusiasm for rationalistic self-control procedures (Neimeyer, 1993a(Neimeyer, , 1995b. Viewed in sociohistorical terms, such theories can be seen as edging toward a postmodem conception of the self as inherently social, multiplistic, contingent, evolving, and, in principle, unspecifiable (Neimeyer & Stewart, 1998a). It follows that psychotherapeutic procedures for fostering change would need to tack between the self and social system, helping clients to articulate, elaborate, and negotiate those (inter)personal meanings by which they organize their experience and action (Neimeyer, 1 9 9 5 ~) .Although this reconstruction of the self as permeable, pluralistic, and process oriented represents a genuine departure from more traditional conceptions of' personality, some critics believe that it subtly reproduces the discourse of essential individuality in the attempt to transcend it. Thus, social constructionists argue that constructivists give insufficient attention to the extent to which the self is constituted in language, understood as a situated and shifting symbolic order that structures our relationship as people to "reality" and ourselves (Gergen, 1994). Because the very terms in which we construe ourselves are cultural artifacts, our selves are deeply penetrated by the vocabularies of our place and time, expressing dominant modes of discourse as much as any unique personality. Indeed, "like a foetus floating in an amnion of culturally available signs, symbols, practices and conversations, the 'self' symbiotically depends for its existence upon a living system that precedes and supports it" (Neimeyer, 199813, p. 140). In more radical forms, this view of the "saturated self" as populated by the contradictory discourses in which one is immersed threatens the very conception of the individual as a coherent entity with identifiable boundaries and properties (Gergen, 1991). The extreme postmodern vision of the "death of the self" (Lather, 1992) heralds the demise of personal subjectivity and its replacement by the cacophonous echoes of incoherent conversations, anonymous media images, and fragmented communication networks that colonize our mental life. Passing fully through this postm...

The COVID-19 pandemic, coupled with significant social changes due to legislative and public health requirements, has changed the way in which people experience grief. We examined whether dysfunctional grief symptoms, disrupted meaning, risk factors, and functional impairment differed between people bereaved from COVID-19 and from other natural or violent causes in this same period. A sample of 409 participants (67.73% male; M = 37.54 years) completed an online survey in June 2021. There were no statistically significant differences between the three groups on any of the outcome variables; all three groups manifested clinical levels of functional impairment equal to or greater than bereaved groups diagnosed with complicated or prolonged grief disorder prior to the pandemic.Disrupted meaning partially mediated the relationship between risk factors on the one hand and functional impairment and dysfunctional grief symptoms on the other. Findings indicate that deaths during COVID-19, rather than deaths from COVID-19, may precipitate symptoms of significant clinical concern.As of mid-August 2021, there have been over 207 million confirmed cases of COVID-19 and over 4.3 million deaths (World Health Organization, 2021). Each death is estimated to affect an average of 9 people (Verdery, Smith-Greenaway, Margolis, & Daw, 2020). Based on these projections, nearly 40 million people are mourning the loss of a close person from COVID-19. Early in the pandemic, commentators predicted an increased risk of deleterious grief outcomes due to sudden/unexpected death, multiple co-occurring stressors, inability to be by the bedside to comfort the dying and say goodbye, limited opportunities for mourning rituals, and increased social isolation (