IAHPC BOOK REVIEW FAMILY FOCUSED GRIEF THERAPY
David Kissane and Sidney Bloch
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Open University Press, 2000
ISBN 0.335-20349-3
254pp
RRP $US34.95 £22.50 $AUD39.9 
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This book describes an innovative family-focused therapy for grief and bereavement developed in Melbourne by Kissane and Bloch for families identified before
bereavement as being at increased risk of psychosocial morbidity. It carries a step further the concept that in palliative care the family, including the patient, is or should be the unit of
care.
Family focused grief therapy is for selected families who are identified as being at increased risk of morbid grief, and the point is made that the majority
of bereaved people cope satisfactorily and don’t need help. Families at risk are identified by problems related to cohesiveness, conflict, and communication or expressiveness. The therapeutic
model is clearly described and illustrated. Given that the families in question are the more difficult ones to deal with, treatment is therapist-intensive and highly structured and goal-oriented.
The authors claim the treatment to be cost-effective, but this may need to be validated in the future. A randomised controlled trial of this treatment is being conducted and the results should
be known in the next year or two.
Family focused grief therapy, which starts before bereavement and focuses on the family unit rather than individuals, has a lot of appeal. But is it applicable
to routine palliative care practice? Community-based palliative care services who manage patients for an average of a month, or in-patient hospices where the patient may only be known for a week
or two, do not have sufficient time to implement this treatment properly. Perhaps when our societies develop a more open acceptance of mortality and a wider use of advanced care planning, this
therapy may be more widely applicable. At the moment, this treatment is only applicable to a proportion of the families at increased risk, where the patient’s death is foreseen and acknowledged
several months in advance.
This book is well written and carefully documented and referenced, although the omission of the references (and perhaps more) from the Foreword by Colin Murray
Parks is unfortunate. Family focused grief therapy has a lot to recommend it and is very much in keeping with the principles of palliative care to support the family as a unit. It also emphasises
that it is the work done before the death that can be so important in the outcome of bereavement. Whether or nor family focused grief therapy will be more widely applied in the future depends
on more open acceptance of mortality and advanced care planning in our societies.
Roger Woodruff
Director of Palliative Care, Austin & Repatriation Medical Centre, Melbourne
(September 2002)
Author Information
David Kissane is Professor/Director of Palliative Medicine and Professor of Psychiatry at the University of Melbourne
Sidney Bloch has a personal Chair in Psychiatry at the University of Melbourne
Table of Contents
Introduction 1
1. Family care and family grief 7
2. A typology of family functioning 30
3. Conducting family focused grief therapy 47
4. Common themes that arise during FFGT 75
5. A typical encounter of therapy 99
6. Challenges and problems in the delivery of FFGT 129
7. The impact of specific life events on families 152
8. The ethical dimension 177
9. Clinical application of the FFGT model 194
Bibliography 229
Index 247
 
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