The client is also given another

copy of the CGT handout to provide to a supportive person who will attend the third session. Session 3 Usually session 3 includes a supportive person such as a family member or close friend, either in person or, if necessary, by telephone. The rationales for including a supportive person are that individuals experiencing complicated grief often lose a sense of connection with others, which the treatment aims to help restore; an outside perspective on the client and the way that grief is affecting his or her life can be helpful for the therapist; and a friend or family member can facilitate the treatment by understanding what the client is doing and why, and Inhibitors,research,lifescience,medical providing support throughout the process, which

is often difficult and painful. During the session, Inhibitors,research,lifescience,medical this individual is asked to describe the client since the death, his or her reactions to grief, and any avoided situations or activities. The therapist then provides an overview of the CG model and treatment to the support person. The client and support person discuss ways in which the latter can Inhibitors,research,lifescience,medical be helpful as the client progresses through the treatment. During the last 15 minutes or so, the client is seen alone to review the grief monitoring diary and provide an update on goal work. Session 4 The heart of CGT begins in this session, with the introduction of imaginal revisiting. Imaginal revisiting is a core element of CGT that in some ways resembles prolonged exposure, an empirically supported Inhibitors,research,lifescience,medical therapy for trauma and post-traumatic stress disorder (PTSD).57,58 In this technique, the client briefly (for approximately 5 minutes) visualizes and tells the story of when he or she became aware of the loved one’s death into a tape recorder and then debriefs with the therapist. The goal of the exercise is to help the client come to Inhibitors,research,lifescience,medical terms with the loss by processing it at an emotional level and integrating that emotional processing with the rational knowledge that the loved one has died. In the Nutlin 3 debriefing portion of the exercise, the client describes what he or she observed

while telling the story; the function of this discussion is to encourage the client to reflect on the story from the vantage point of the present. The client then participates in another visualization exercise in which the story Megestrol Acetate is put away. Finally, clients identify a reward they can give themselves for doing the hard, painful work of revisiting, both in session and during the assignment of listening to the tape every day between sessions. Other elements that continue throughout the treatment include the grief monitoring diary and restoration-oriented work to help the client move toward a personal goal that is unrelated to grief, in order to begin to visualize life with the capacity for joy and satisfaction without the loved one who died.