Date of Award


Degree Type


Degree Name


Degree Program

Counselor Education


Counselor Education

Major Professor

Belser, Christopher; Watson, Zarus E. P.

Second Advisor

Jeffers, Elizabeth

Third Advisor

Williams, June


Perinatal loss (i.e., miscarriage, stillbirth, termination, and infant death) is commonly referred to in the literature as an invisible loss, non-loss, and even medical event. It is an ambiguous loss exhibiting the dialectical contradiction between the physical absence and psychological presence of the baby accompanied by disenfranchised grief, a reaction to a loss that is unacknowledged by society. Despite the likelihood of mental health clinicians working with clients who have experienced perinatal loss, there has yet to be a therapeutic model designed specifically for the unique grief and trauma reactions presented in this population. Existing grief models do not address the traumatic nature of the loss, and oppositely, trauma models do not address the life-long grief symptoms experienced subsequent to perinatal loss. Lack of clinical trainings and cultural norming processes that do not acknowledge the significance of the loss leave clinicians without resources, tools, and interventions to effectively work with this population. Thus, the purpose of the study is to co-construct a therapeutic model to utilize when working with perinatal loss clients. Exploring therapeutic approaches employed by mental health clinicians, the proposed grounded theory study will collect three forms of data: (a) intensive interviews, (b) elicited documents (i.e., case studies), and (c) extant documents (i.e., perinatal loss specialty training agendas). The qualitative study will include 8-12 participants certified in perinatal mental health (PMH-C) to ensure participants’ clinical experience in working with the perinatal loss population for at least two years. Additionally, the proposed study will investigate the following three elements informing therapeutic approaches applied to this population: (a) cultural perceptions of perinatal loss; (b) how the cultural perceptions impact the therapeutic relationship regarding establishing goals, measuring client change, and determining effectiveness; and (c) identification of barriers within the therapeutic process. The findings of the study will be significant to not only mental health clinicians working with perinatal loss clients and the existing perinatal loss research, but they will also illuminate the nature of the therapeutic process for this population to decrease ambiguity surrounding the loss and enfranchise the griever.


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