HJNO May/Jun 2022

HEALTHCARE JOURNAL OF NEW ORLEANS I  MAY / JUN 2022 11 For many of us, a “tough day at work” could mean a series of long meetings or a difficult exchange with a coworker. But, for healthcare professionals who special- ize in helping patients successfully navigate grief, bereavement, and trauma, the stakes are much higher and the tough days much tougher. Five healthcare professionals — from the Trauma and Grief (TAG) Center at Children’s Hospital New Orleans, University Medical Center, Touro, and LCMC Health — shared their personal experiences utilizing a variety of approaches to treat grief and bereave- ment. While the terms “grief”and “bereave- ment” are often conflated, they refer to two distinct conditions. Whereas grief can be associated with a loss of any kind (includ- ing the loss of a job or the end of a personal relationship), bereavement refers specifi- cally to the death of a loved one. Julie Kaplow, PhD, executive director of the TAG Center, has dedicated her entire career to helping children overcome trauma and grief. At the TAG Center, which opened October 2021, Kaplow oversees an evi- dence-based process designed specially to aid grieving children ages seven and older. “The most important thing when we’re trying to help children who are grieving is that we’re using evidence-based inter- ventions that have been proven to work,” Kaplow said. “At the TAG Center, we only use interventions that have been rigorously tested to ensure that they produce decreases in psychological stress.” One of those evidence-based interven- tions is an approach called multidimen- sional grief therapy. This approach treats trauma as stemming from three primary causes: separation-related distress, exis- tential- or identity-related distress, and circumstance-related distress. While she is a leading practitioner and researcher of multidimensional grief therapy, Kaplow emphasizes the importance of an attentive, accurate assessment of each patient’s needs prior to determining a treatment path. “For grieving children, in particular, it can’t be a one-size-fits-all approach,” Kaplow said. “That’s where the assessment piece comes in. Not all grieving children require the same intervention. Peer support may be enough for some, whereas multi- dimensional grief therapy may be needed for others.” As challenging as Kaplow’s work is, it can be equally rewarding. Asked for an exam- ple of a patient whose recovery inspired her, she shared the story of a young man whose bereavement following the sudden death of his father was so profound that “he couldn’t physically tolerate hearing his deceased dad’s name.” By the end of treat- ment, he was able to discuss his father and how much he wanted to honor his father’s life with his own. “We never want to say that kids heal com- pletely from grief, but they’re able to tran- sition from being in intense pain to making meaning of the loss,” Kaplow said. Sonia Malhotra, MD, founder and direc- tor of the palliative medicine and supportive care program at University Medical Cen- ter, agrees that not only is there no “one- size-fits-all”approach to grief and bereave- ment, there’s also no “normal” timeline for recovery. Malhotra and her team, includ- ing licensed clinical social worker Mandy Swalm, interact with individuals who are struggling with grief and bereavement on a daily basis. They practice an approach called trauma-informed care, which Mal- hotra described as “the type of care that takes into account that all of our lived trau- mas add up.” Practicing trauma-informed care means responding to certain emotions “knowing that there may be trauma behind that emotion,”Malhotra said. She cautions the loved ones of grieving or bereaved individuals not to pressure the individual to rush the process and “get over it.” “Textbooks will tell you that ‘normal’ grieving can be expected to last for six months to a year, after which it’s consid- ered ‘complicated grief,’”Malhotra said. “But we’re taking care of people, not patients. Every loss is different, and we have to be attentive to the individualistic nature of loss.” “People will say: ‘It’s been a year. You have to let it go, you have to move on,’” Swalm added. “I’ve experienced that those kinds While the terms “grief” and “bereavement” are often conflated, they refer to two distinct conditions. Whereas grief can be associated with a loss of any kind (including the loss of a job or the end of a personal relationship), bereavement refers specifically to the death of a loved one.