“I’m Going Through Another Phase… But I’m Taking Her With Me”: Exploring the Positive Impact of Continuing Bonds, Nostalgia, and Reminiscence on Coping with Bereavement

This thesis focuses on the continuing bonds model of grief, bringing together existing knowledge and new theory. Paper 1 is a review of the literature investigating continuing bonds from the perspective of those delivering therapeutic bereavement support. Fourteen peer-reviewed qualitative papers commenting on therapeutic activities were reviewed and critiqued to assess how the practice of bereavement counsellors and therapists aligned with continuing bonds. Included papers were generally good quality, and a narrative synthesis of their findings determined that relatively few therapeutic activities were aligned with the concept. In the absence of awareness or training on continuing bonds, counsellors relied on basic skills and older stage-based understandings of grief in their work. The review concludes that more work is needed to bring therapeutic practice in line with newer conceptualisations of grief such as continuing bonds. Paper 2 is an empirical study exploring continuing bonds from the perspective of those who are grieving, specifically looking at how maintaining a bond has helped them adapt to their loss. Eight bereaved adults were interviewed about their experiences, and grounded theory methodology was used to analyse responses. From this, a framework was developed which aimed to illustrate factors involved in the formation, expression and helpfulness of continuing bonds. Bonds were judged to be an important resource as a bereaved individual adapts to the death, and serve a variety of functions. Different continuing bonds expressions were associated with different benefits: some providing temporary comfort in times of emotional need, and others acting as a guiding presence as the individual navigates their grief. The empirical paper concludes with clinical implications of the framework and recommendations for further continuing bonds research. Paper 3 is an executive summary of the work. This was developed in collaboration with service users and provides an accessible overview of the empirical paper.