We’ve educated our members, and some have participated, in research efforts in the area of traumatic death and grief including: etiology, epidemiology, cultural variance and culturally appropriate interventions, perinatal and pediatric death, homicide, suicide, evidence based psychosocial interventions and mental healthcare, provider vicarious and secondary traumatic stress, means of coping, critical psychiatry and bereavement-related psychopharmacology, neuroscience, social support and family systems, carefarming and deep ecology, meditation, and mindfulness-based approaches to traumatic grief.
Research Studies
This section identifies significant research studies by Dr. Joanne Cacciatore and colleagues in the area of trauma and loss.
(Gorman, Cacciatore, 2017) How carefarming as an intervention for other populations experiencing psychological distress demonstrates the potential for carefarming as a means to therapeutically engage with individuals experiencing traumatic grief.
(Cacciatore J, Thieleman K, Fretts R, Jackson LB 2021). This study assessed bereaved individuals’ satisfaction of social support in traumatic grief. Findings suggest inadequate satisfaction from professional, familial, and community support. Pets emerged with the most satisfactory ratings. Emotional support is the most desired type of support following traumatic loss.
(Gorman, Cacciatore, 2020). This study explores the impacts of a carefarm intervention for traumatically bereaved individuals, a population at high-risk of poor physical and psychological outcomes. It examines how a carefarming model can enable and encourage participants to cultivate healthy and sustainable lifestyles.
(Gorman R, Cacciatore J. 2022). The effects of human–animal relationships on carefarms, with specific attention to the context of trauma histories. Findings suggest that animals with loss and trauma biographies may provide unique and unexpected psychological benefits to humans facing grief and trauma.
(Thieleman K, Cacciatore J, Gorman R 2021). An overview of how bereaved adults experienced a grief-specific carefarm. The spaces and species of the carefarm provided a supportive context for integrating grief, processing emotions, and receiving compassionate support.
(Thieleman K, Cacciatore J, Thomas S 2022). Opioid Naltrexone to treat prolonged grief intends to disrupt the griever’s capacity to engage in social bonding to eliminate craving for the person who died. This contradicts the belief that social connection is at the core of healing. Interfering with this capacity could have widespread detrimental effects on grievers.
(Cacciatore J, Frances A 2022). Prolonged grief disorder, now included in the DSM, has a remarkably easy symptom threshold to meet. There is no uniform expiration date on normal grief. This is particularly true when the relationship with the person who died was very close or the death was catastrophic, such as deaths by suicide, homicide, or accident, or the death of child.
(Cacciatore J, Flint M 2011). A mindfulness-based bereavement care model – the ATTEND (attunement, trust, touch, egalitarianism, nuance, and death education) model is an interdisciplinary paradigm for providers, including physicians, social workers, therapists, nursing staff, and others. Focuses on attunement as a means to moderate the negative effects of traumatic bereavement.
(Cacciatore, J, Lacass J, McPherson J 2014). This study examined health/mental health status, family functioning, and resiliency among a sample of bereaved parents. Results indicate significant clinical distress in this sample, with many reporting enduring psychological, familial, and health consequences following the death of a child.
(Wonch Hill P, Cacciatore J, Shreffler K and Pritchard K 2016). A child’s death augments how grieving parents view the world, the family, and the self. The study assessed whether miscarriage, stillbirth, and child death impact self-esteem and whether this loss is moderated by maternal identity. Findings showed that stillbirth and child death, but not miscarriage, negatively impacted self-esteem.
(Fox M, Cacciatore J, Lacasse J, 2014). This article examines the economic consequences associated with the death of a child. Findings suggest that productivity losses associated with child death comprise most of the costs and that the economic effects are substantial. Costs associated with on-the-job productivity losses (“presenteeism”) outweigh the costs associated with absenteeism.
(Cacciatore J, Thieleman K, Goldman R 2017). Findings from interviews with family members about their experiences with health-care providers during a child’s terminal illness, from diagnosis to death. Compassion emerged as a salient theme, and connected to participants’ perception of caregiver presence. Families were likewise negatively affected by behaviors that represented individual or institutional abandonment or nonpresence, and thus compounded the experience of loss.
(Thieleman K, Cacciatore J 2014). This study used a survey to investigate the relationship between mindfulness and compassion fatigue and compassion satisfaction among 41 volunteers and professionals at an agency serving the traumatically bereaved.
(Thieleman K, Cacciatore J, Wonch Hill P 2014). The intervention consists of the ATTEND model, which is comprised of the following elements practiced by the clinician: attunement, trust, therapeutic touch, egalitarianism, nuance, and death education. Results provide preliminary support for the use of this mindfulness-based approach for difficulties associated with traumatic bereavement.
(Duncan C, Cacciatore J, 2015). This is the first systematic review of the evidence on the prevalence of self-blame, guilt, and shame, commonly experienced in bereaved parents. Awareness of these affective states may assist clinicians in the identification of bereaved parents who are at a higher risk of developing adverse psychological outcomes.
Melanie Fox, Joanne Cacciatore, Jeffrey R. Lacasse. This article examines the economic consequences associated with the death of a child. The economic costs (funeral and medical expenses and productivity losses) of child death 6 months following the death were estimated based on 213 parents who had experienced the death of a child (usually unexpectedly and predominantly mothers).
Laura R. Umphrey and Joanne Cacciatore. Recognized as one of the most painful human experiences, the purpose of this study was to uncover the relational and metaphorical themes embodied in bereaved parent narratives following the death of a child.
Kara Thieleman and Joanne Cacciatore. The fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders has incited vociferous debate among academics, clinicians, and the general public. Two contested changes are eliminating the bereavement exclusion from the major depressive disorder diagnosis and creating a new category for intense and prolonged grief called persistent complex bereavement-related disorder. This article critically analyzes research and debate regarding these two changes and considers the likely implications for bereaved parents and other traumatically bereaved groups, who may be especially vulnerable to consequences of the two proposed changes.
Kara Thieleman and Joanne Cacciatore. This study used a survey to investigate the relationship between mindfulness and compas- sion fatigue and compassion satisfaction among 41 volunteers and professionals at an agency serving the traumatically bereaved. Compassion fatigue comprises two aspects: secondary traumatic stress and burnout. Because prior research suggests that compassion satisfaction may protect against compassion fatigue, the authors hypothesized that (a) mindfulness would be positively correlated with compassion satisfaction, (b) mindfulness would be inversely correlated with compassion fatigue, and (c) there would be differences between respondents with a personal history of traumatic bereavement and those with no such history.
Jeffrey R. Lacasse and Joanne Cacciatore. To examine psychiatric prescribing in response to perinatal/neonatal death, we analyzed data from a cross-sectional survey of 235 bereaved parents participating in an on-line support community.
J Frederik Frøen, Joanne Cacciatore, Elizabeth M McClure, Oluwafemi Kuti, Abdul Hakeem Jokhio, Monir Islam, Jeremy Shiffman, for The Lancet’s Stillbirths Series steering committee. In this first paper of The Lancet’s Stillbirths Series we explore the present status of stillbirths in the world—from global health policy to a survey of community perceptions in 135 countries. Our findings highlight the need for a strong call for action. In times of global focus on motherhood, the mother’s own aspiration of a liveborn baby is not recognised on the world’s health agenda. Millions of deaths are not counted; stillbirths are not in the Global Burden of Disease, nor in disability-adjusted life-years lost, and they are not part of the UN Millennium Development Goals. The grief of mothers might be aggravated by social stigma, blame, and marginalisation in regions where most deaths occur.
Joanne Cacciatore and Suzanne Bushfield. This article explores recent policy changes promoted by grassroots organizations relating to how stillbirths are recorded.
Ewa Nordlund, Astrid Börjesson, Joanne Cacciatore, Carissa Pappas, Ingrid Randers, Ingela Rådestad. The process of giving birth to a baby who has died is a significantly traumatic experience for the mother and her family and also for health professionals. support, or even the perceived lack of support, from professionals often influences whether or not the parents choose to see and hold their baby. Psychosocial clinical care may also affect long-term psychiatric sequelae. The purpose of this study is to explore the lived experiences of mothers following the death of a baby and their interaction with healthcare professionals.
Karina M. Shreffler, Patricia Wonch Hill, Joanne Cacciatore. We build on recent studies on the consequences of miscarriage and stillbirth for women to assess the (a) odds of divorce among women who experienced a loss compared to those who did not; and (b) fer- tility-specific characteristics that increase odds of divorce. Utilizing a nationally representative sample of 3,461 women who have ever been pregnant and married, we find that women who experienced miscarriage or stillbirth have greater odds of divorce than women who did not experience a loss, and we highlight the importance of characteristics associated with the pregnancy and loss experi- ences: gestation length, whether the pregnancy had been planned, and experiencing multiple losses.
Laura Koopmans, Trish Wilson, Joanne Cacciatore, Vicki Flenady. Provision of an empathetic, sensitive, caring environment and strategies to support mothers, fathers and their families experiencing perinatal death are now an accepted part of maternity services in many countries. Interventions such as psychological support or counselling, or both, have been suggested to improve outcomes for parents and families after perinatal death. Objectives: To assess the effect of any form of intervention (i.e. medical, nursing, midwifery, social work, psychology, counselling or community- based) on parents and families who experience perinatal death.
Joanne Cacciatore & Kara Thieleman. There is little evidence to guide the use of psychotropic medications immediately following bereavement. This article presents a review of the relevant literature, followed by a case series on the use of psychotropic medication in traumatically bereaved individuals.
Joanne Cacciatore, PhD, MSW, FT, Ingela Ra ̊destad, PhD, and J. Frederik Frøen, MD, PhD. Some guidelines encourage mothers to see and hold their babies after stillbirth, which might be traumatizing. The study objective was to investigate the effects of women seeing and holding their stillborn baby on the risk of anxiety and depression in a subsequent pregnancy and in the long term.
Joanne Cacciatore PhD MSW FT, Stephen Schnebly PhD and J. Frederik Froen PhD. While most births result in a live baby, stillbirth (the birth of a dead baby) occurs in nearly 1 in 110 pregnancies. This study examined whether levels of maternal anxiety and depression are lower amongst mothers who received social support after stillbirth.
Cybele Blood and Joanne Cacciatore. Postmortem memento photography has emerged in Western hospitals as part of compassionate bereavement care for parents facing perinatal death. Many parents endorse this psychosocial intervention, yet implementation varies greatly and little research on parents’ specific needs guides health care professionals. Parents are in crisis and vulnerable after the death of their child, thus best practice is crucial. This study contributes 104 parents’ experiences and opinions toward the understanding of best practice in perinatal bereavement photography.
Kara Thieleman, Joanne Cacciatore & Patricia Wonch Hill. This article presents a quasi-experimental study of a mindfulness-based intervention for traumatically bereaved individuals using a single group with pre-test and post-test design. The intervention consists of the ATTEND model, which is comprised of the following elements practiced by the clinician: attunement, trust, therapeutic touch, egalitarianism, nuance, and death education.
Cybele Blood & Joanne Cacciatore. Postmortem photography is a widespread practice in perinatal bereavement care, yet few studies have explored how it affects bereaved parents, or how it might be received by parents of older children. This study is an examination of the meaning, utility, and social context of postmortem photography in a sample of 181 bereaved parents.
Joanne Cacciatore. This research study explores the effects of support groups on traumatic stress responses of women experiencing stillbirth.
Jennifer Huberty, Jenn A Leiferman, Katherine J Gold, Lacey Rowedder, Joanne Cacciatore, and Darya Bonds McClain. In the US, approximately one in 110 pregnancies end in stillbirth affecting more than 26,000 women annually. Women experiencing stillbirth have a threefold greater risk of developing depressive symptoms compared to women experiencing live birth. Depression contributes negatively to health outcomes for both mothers and babies subsequent to stillbirth. Physical activity may improve depression in these women, however, little is known about acceptable physical activity interventions for women after stillbirth. This is the purpose of this descriptive exploratory study.
This is an ethnographic study that utilized extended observations of the group and both individual and group interviewing in order to create a cultural portrait specifically focusing on Hutterites experiencing traumatic child death.
J. Cacciatore, Kerstin Erlandsson, Ingela Radestad. This study was designed to evaluate fathers’ experiences of stillbirth and psychosocial care.
Joanne Cacciatore and Zulma Raffo. Research on parental bereavement has focused on single or cross-gendered (heterosexual) bereaved parents. No previous studies have examined the unique experiences of same-gendered bereaved parents. This multi-cased study focused on child death in same-gendered -parent families.
OUR SERVICES AND WHO WE SERVE
For the grieving, we offer support through educational resources, mentors, forums, retreats, carefarm program, counseling, support groups, kindness walks, retreats and more. We provide key resources for community members, families, supporters and others helping someone experiencing traumatic grief. We offer researchers key insight into grief studies on trauma and loss, carefarming, green therapy, mindfulness and more. We offer providers specialized training and resources to improve their skills working compassionately with traumatized individuals. We provide grassroots advocacy support on important issues affecting our grieving families. We provide a sacred place for grieving individuals to connect with rescue animals who have also experienced the deepest suffering.
