Family focused grief therapy: The therapy of choice in palliative care

Palijativno zbrinjavanje predstavlja pružanje fizičke, psihosocijalne i duhovne podrške pacijentima koji su oboleli od teških bolesti, s neizbežnim smrtnim ishodom,kao i pružanje psihološke podrške članovima porodice i drugim bliskim osobama tokom bolesti pacijenta (anticipatorno tugovanje) i u periodu tugovanja i ožalošćenosti nakon njegove smrti.Terapija izbora u pružanju psihološke podrške u procesu tugovanja i ožalošćenosti jeste, svakako, porodična terapija fokusirana na tugovanje. Porodična terapija fokusirana na tugovanje - FFGT3 jeste kratak, fokusiran i vremenski ograničen psihoterapijski model intervenisanja iz porodične terapije, koji je namenjen porodicama koje se suočavaju sa neizlečivom bolešću i izvesnim smrtnim ishodom člana porodice. Uz izvesne modifikacije FFGT može se primeniti i u radu s porodicama koje se suočavaju sa neizlečivom bolešću najmlađeg člana porodice - deteta ili adolescenta. FFGT koji se realizuje kroz sedam do devet seansi u trajanju od po 90 min., i to u periodu od 9 do 18 meseci, što zavisi od procene potreba svake porodice posebno. Cilj FFGT-a je prevencija komplikovanog tugovanja, uz ciljan uticaj na unapređenje porodičnog funkcionisanja kroz povećanje kohezije među članovima, unapređenje komunikacije i razmene misli i osećanja, kao i na uticaj na konstruktivno rešavanje konflikata.Priča o bolesti, opraštanju i tugovanju jeste deo procesa. Tvorac ovog modela rada jeste dr David Kissane, psihijatar, porodični psihoterapeut iz Melburna, Australija, koji je radio na klinici Memorial Sloan Kettering Cancer Center (MSKCC) u New Yorku. Osnovni ciljevi preglednog članka Porodična terapija fokusirana na tugovanje - terapija izbora u oblasti palijativnog zbrinjavanja su, upoznavanje stručne javnosti u Srbiji sa ovim veoma korisnim modelom rada iz porodične psihoterapije i predstavljanje konceptualnog i praktičnog okvira palijativnog zbrinjavanja.Palliative care refers to offering physical, psychosocial and spiritual care to patients who are suffering from life threatening diseases. It also includes providing psychological support for family members and other close relations during the period of illness (anticipatory grief) and in the period of bereavement and mourning after the patient's death. The choice of therapy during the process of bereavement and mourning is Family Focused Grief Therapy (FFGT). FFGT is a brief, focused and time-limited psychotherapeutic model of intervention belonging to family psychotherapy which is specified for the families that face a life threatening disease of a family member. FFGT, with some modifications, can be applied in work with the families who are facing a terminal illness of younger family members - a child or an adolescent. FFGT typically comprises of 7 to 9 sessions lasting for 90 minutes, which are arranged flexibly across 9 to 18 months, depending on the needs of each family individually. It is important to emphasize that the frequency and number of sessions in each phase depend on the specific features and needs of each particular family. The intervention aim of FFGT is to prevent the complications of bereavement by enhancing the functioning of the family, through exploration of its cohesion, communications (of thoughts and feelings), and handling of conflict. The story of illness and the related grief is shared in the process. The creator of this model is Dr David Kissane, a psychiatrist and a family psychotherapist from Melbourne, Australia, who also worked at the Memorial Sloan Kettering Cancer Centre in New York. The main aims of this article are, on the one hand, to introduce this very useful model of the family therapy to the professional community in Serbia and, on the other, to introduce a conceptual and practical frame of palliative care