Research

Together with colleagues Jane Mowll (University of New South Wales, Australia) and Nancy Hogan (emeritus, Loyola University of Chicago), Louis co-authors a definitive chapter on the sad but relevant topic of sudden non-volitional losses, such as accidents, fatal medical events, pregnancy losses, unintentional overdoses, and calamities of nature. The chapter is intended for grief professionals tasked with helping survivors after such tragic events.

It has been said that “Art imitates life,” but in the sad case of familial homicide, life seems to imitate the products of a horrific imagination as found in superhero story arcs. In this chapter, Selin Santos joins Louis in studying how fathers react, constructively or destructively, in response to the murder of their family members. Suggestions are made for healthy grieving even in the face of such awful tragedies.

The concepts of intuitive grieving (e.g., expressing or talking out one’s feelings and reactions) and instrumental grieving (e.g., learning how to cope with one’s grief or performing some compensatory activity) receive validation in this empirical study of typologies.

The Postdoctoral Fellowship program at Baylor Scott & White in Temple, Texas is featured in this article, including a specialty training track focused on clinical problems linked to end-of-life, grief, and bereavement. Doctoral level psychologists seeking additional training to qualify for Texas licensure may have special interest in this opportunity.

This article is based on a keynote address Louis delivered in 2016 at the annual conference of the Association for Death Education and Counseling (ADEC) on the occasion of its 40^th anniversary as a professional society. All non-profit organizations go through developmental steps and continuing to thrive depends on how well the association can adapt to growth and formalization.

Many counseling textbooks give little, if any, guidance on how to address individuals approaching the end of life. In today’s aging population in developed countries, most elderly people die slowly from complications of chronic diseases, so it is more important than ever that counselors and health care professionals know how to open a sensitive dialogue with patients and their families around issues that arise as death nears. Constructive engagement can reduce fears and create opportunities for realizing meaning, fulfillment, and peace of mind and heart.

Gamino, L. A., & Bevins, M. B. (2013). Ethical challenges when counseling clients nearing the end of life. In J. Werth (Ed.), Counseling clients near the end of life: Practical perspectives on fundamental issues (pp. 3-24). New York: Springer Publishing Company.

Teaming with palliative care physician Mike Bevins, Louis addresses some of the ethical challenges faced by doctors and other health professionals who care for patients nearing death. Challenges identified include assessing the patient’s capacity for decision-making at the end of life to ensure the patient’s right to personal autonomy, honoring a patient’s advance directives, respecting cultural diversity among patients and their families, preserving the patient’s privacy while including families in the scope of care, and grappling with the limits of what medical treatment can accomplish in the face of inevitable death.

Gamino, L. A. (2012). Opening the family photo album. In R. A. Neimeyer (Ed.), Techniques of grief therapy: Creative practices for counseling the bereaved (pp. 231-233). New York: Routledge.

In this brief cameo piece, Louis describes a very helpful clinical maneuver when working with bereaved individuals—inviting them to bring some family or personal photos to the counseling session. Viewing the photographs together facilitates the therapeutic process of “joining” with the patient, generates unique insights into the patient’s family structure and personal history, and offers the therapist a true glimpse of the deceased person whom the patient is mourning.

Gamino, L. A. (2012). Ethical considerations when conducting grief counseling online. In C. J. Sofka, K. R. Gilbert, & Cupit, I. N. (Eds.), Dying, Death, and Grief in an Online Universe (pp. 217-234). New York: Springer Publishing Company.

In the proliferating enterprise of online counseling, many ethical considerations need to be addressed before a clinician undertakes the practice of counseling via email or over the internet using voice or image technology. In this article, Louis addresses issues such as establishing jurisdictional license to practice, authenticating the patient’s identity, protecting confidentiality, setting the boundaries of availability, handling emergencies, and collecting payment.

Gamino, L. A., & Ritter, R. H., Jr. (2012). Death competence: An ethical imperative. Death Studies, 36, 23-40.

In this landmark article, Louis and co-author Hal Ritter explore and extend the concept of “death competence” first introduced in their textbook Ethical Practice in Grief Counseling. Using a case study in which a well-intended but unprepared counselor failed to provide adequate empathy to create a safe therapeutic setting for a grieving widow, Louis explains how clinicians can establish rapport with bereaved patients and facilitate a therapeutic dialogue that sets the stage for healing and recovery.

Gamino, L. A., Sewell, K. W., Hogan, N. S., & Mason, S. L. (2009-2010). Who needs grief counseling? A report from the Scott & White Grief Study. Omega, 60, 199-223.

Based on an empirical study of 69 bereaved individuals, Louis and his research team found that not all bereaved people require grief counseling. In fact, many bereaved individuals find ways to cope without professional intervention. Among those seeking help, reasons for consulting a counselor may vary. Some patients want relief from distressing emotions and personal suffering, others seek guidance on how to grow and adapt to loss of a treasured loved one.

Gamino, L. A. (2009). Mark Rothko: A case study in suicide. In B. Panter (Ed.). Creativity and madness: Psychological studies of art and artists, Vol. 2. Burbank, CA: AIMED.

Mark Rothko was a famous American abstract artist who enjoyed the height of his career in the 1950s and 60s. Despite his notoriety, Rothko suffered from depression and alcoholism. In this biographical review, Louis traces the evolution of Rothko’s art and how it paralleled his battle with personal demons that eventually led to his suicide in 1970.

Gamino, L. A., & Sewell, K. W. (2004). Meaning constructs as predictors of bereavement adjustment: A report from the Scott & White Grief Study. Death Studies, 28, 397-421.

Louis and his research partner Kenneth Sewell used data from the Scott & White Grief Study to predict how bereaved individuals will cope with the loss of a loved one. Specifically, grievers whose essay-based reflections on their experiences included themes of hope and recovery—such as deepening their personal relationships in the wake of loss or anticipating an afterlife—showed better adaptation following the death of a loved one.

Gamino, L. A., Easterling, L. W., & Sewell, K. W. (2003). The role of spiritual experience in adapting to bereavement. In G. R. Cox, R. A. Bendiksen, & R. G. Stevenson (Eds.). Making sense of death: Spiritual, pastoral, and personal aspects of death, dying and bereavement (pp. 13-27). Amityville, NY: Baywood.

In this book chapter, Louis and his colleagues focused on how spirituality emerges at the end of life. For some individuals, faith beliefs are central to how they approach death or handle bereavement. For others, spirituality may be a dormant or latent dimension that can be accessed in a “reachable moment” prompted by serious illness or impending death. Louis explains how clinicians can ask sensitively about spirituality without forcing the issue or imposing an unwelcome theology.

Gamino, L. A., Sewell, K. W., & Easterling, L. W. (2000). Scott & White Grief Study–Phase II: Toward an adaptive model of grief. Death Studies, 24, 633-660.

Louis and colleagues with the Scott & White Grief Study pursued a dual focus in their research investigation of 85 bereaved individuals—verification of factors that pose a risk for complications in grieving and identification of specific behaviors that enhance coping with loss. Elements such as seeing some (unintended) good resulting from a death and taking the opportunity to say goodbye to the dying or deceased loved one led to better adjustment following the death. Louis demonstrated how therapists can implement these findings in their everyday work with patients who are bereaved.

Gamino, L. A., Sewell, K. W., Easterling, L. W., & Stirman, L. (2000). Grief adjustment as influenced by funeral participation and occurrence of adverse funeral events. Omega, 41(2), 79-92.

One of the surprising findings in Phase 1 of the Scott & White Grief Study was the high likelihood of troublesome events occurring during funeral or burial services for a deceased loved one. Louis found that the most frequent source of trouble was conflict among surviving family members, especially tension that interfered with finding comfort during funeral rituals. Nonetheless, grievers who helped plan services and/or participated actively in funeral rites showed better future adjustment to the loss.