Show Elizabeth Kübler-Ross’ work on change is a bit different, because her model isn’t one of driving organizations through change but rather how humans adapt to loss. Despite the tangential nature to change, it’s an important foundation for anyone who is trying to accomplish change in their organization and serves as the foundation of William Bridges’ Transition Model. The Ultimate LossKübler-Ross’ work was focused on those facing their imminent mortality, whether that was their own death or the death of a loved one. These profound losses were very disruptive to a person’s psyche and caused them, she believed, to go through a set of stages in their grief. These stages of grief are her model. While the kinds of changes that we’re speaking of in most change projects don’t involve death (though they sometimes involve the prevention of death or injury), people experience loss with any change, whether that loss is simply a loss of routine or something more profound. The loss they experience causes the same kinds of ripples to the psyche as those associated with death. ShockThe first stage of grief is shock. In this stage, there’s a complete disbelief, confusion, or disorientation. In change projects, this is the point where the organization hears that a change is necessary and why. Previously, the change has often not been a subject of thought. DenialIn grief, denial is the denial of the diagnosis leading to death. In change, it may be that the change will never get off the ground, or that it’s the latest fad and will never be implemented in the person’s part of the organization. Denial can be particularly persistent and sometimes becomes the genesis of resistance to the change. If the change isn’t happening or the reasons for the change aren’t real, then the individual doesn’t need to change their behavior. AngerIn the anger stage of grief, the individual is angry at the diagnosis or event. Typically, this is seen as a person being angry at their spouse for dying. This is, obviously, not rational when they had no hand in their own death, but anger is a frequent emotion nonetheless. In change, anger is often focused at the need for change or the sponsor of the change. BargainingIn a diagnosis that will lead to death, this is often pleading with God, or whatever deity they believe in, to spare their loved one or themselves. In change, this is often an attempt to negotiate a smaller change than is being asked of the person. DepressionThough depression officially requires a negative view for more than two weeks, depression here is just a period of negative view of the world that emanates from the loss. In change, this is often seen as disengagement not just with the change but with the job more broadly. AcceptanceIn acceptance, the person slowly reorganizes their view of the world to include the new truth. In change, we see this as folks trying the change and adapting to the new behaviors. Acceptance is a long road with a gradient from not at all accepting to very accepting of the changes. CompletionThe completion is the final full acceptance of the loss or change. Completion, like the Termination stage in stages of change may be less of a real stage and more of a desire to reach full completion. Timing and CriticismsThere are criticisms for Kübler-Ross’ model, which fall into two basic categories. The first category is that the model isn’t research based. This criticism is largely leveled at the model by people who would appreciate the rigor of a clinical study but doing so is incredibly difficult. The second criticism for the model is that not everyone goes through these stages or they’re not linear. It’s helpful here to think that this model may need to cycle, and some of the stages may happen in a millisecond and be done. For some, they move past shock quickly. Others may not seem to stop in denial at all. However, considering that Kübler-Ross didn’t define a time limit for how much time a person must spend in each phase, it becomes possible to realize that they may be going through the stage, just very quickly. Resources
The five stages of grief model (or the Kübler-Ross model) is popularly known as a model that describes a series of emotions experienced by people who are grieving: denial, anger, bargaining, depression and acceptance. In actuality, the Kübler-Ross model was based on people who are dying rather than grieving. Although commonly referenced in popular culture, studies have not empirically demonstrated the existence of these stages, and the model has been considered by some to be outdated[1] and unhelpful in explaining the grieving process.[2][3] The model was introduced by Swiss-American psychiatrist Elisabeth Kübler-Ross in her 1969 book On Death and Dying,[4] and was inspired by her work with terminally ill patients.[5] Motivated by the lack of instruction in medical schools on the subject of death and dying, Kübler-Ross examined death and those faced with it at the University of Chicago's medical school. Kübler-Ross's project evolved into a series of seminars which, along with patient interviews and previous research, became the foundation for her book.[6] Although Kübler-Ross is commonly credited with creating stage models, earlier bereavement theorists and clinicians such as Erich Lindemann, Collin Murray Parkes, and John Bowlby used similar models of stages of phases as early as the 1940s.[7] In her book, Kübler-Ross states that the medical advancements of the time were the mark of change for the way people perceive and experience death. [4] Due to this, pediatricians have been seeing fewer life-threatening ailments for their patients compared to one-hundred years ago.[4] Kübler-Ross later noted that the stages are not a linear and predictable progression and that she regretted writing them in a way that was misunderstood.[8] "Kübler-Ross originally saw these stages as reflecting how people cope with illness and dying," observed grief researcher Kenneth J. Doka, "not as reflections of how people grieve."[9] As of 2019, On Death and Dying has been translated into forty-one languages with the 50th anniversary edition being published by Simon & Schuster. Stages of grief[edit]A diagram developed by Bertrand Grondin from a presentation of Kübler-Ross' ideas produced by France Telecom Diagram showing two possible outcomes of grief or a life-changing event Kübler-Ross originally developed stages to describe the process patients with terminal illness go through as they come to terms with their own deaths; it was later applied to grieving friends and family as well, who seemed to undergo a similar process.[10] The stages, popularly known by the acronym DABDA, include:[11]
In a book co-authored with David Kessler and published posthumously, Kübler-Ross expanded her model to include any form of personal loss, such as the death of a loved one, the loss of a job or income, major rejection, the end of a relationship or divorce, drug addiction, incarceration, the onset of a disease or an infertility diagnosis, and even minor losses, such as a loss of insurance coverage.[8] Kessler has also proposed "Meaning" as a sixth stage of grief.[13] In Questions and Answers on Death and Dying, Kübler-Ross answered questions after the publication of her first book, On Death and Dying. She emphasized that no patient should be directly told that they are dying and that practitioners should try to wait until the patient asks about death to discuss it. [12] A few other tenets that she believes in include those practitioners should listen to the patient first and foremost, patient's right to self-determination should still be practiced, and practitioners should avoid trying to force anything family members and the dying are not in the same stage.[12] In 2020, during the COVID-19 pandemic, Kessler applied the five stages to responses to the virus, saying: "It's not a map but it provides some scaffolding for this unknown world."
Criticism[edit]Criticisms of this five-stage model of grief center mainly on a lack of empirical research and empirical evidence supporting the stages as described by Kübler-Ross and, to the contrary, empirical support for other modes of the expression of grief. Moreover, Kübler-Ross' model is the product of a particular culture at a particular time and might not be applicable to people of other cultures. These points have been made by many experts,[3] including Robert J. Kastenbaum (1932–2013) who was a recognized expert in gerontology, aging, and death. In his writings, Kastenbaum raised the following points:[15][16]
A widely cited 2003 study of bereaved individuals conducted by Maciejewski and colleagues at Yale University obtained some findings consistent with a five-stage hypothesis but others inconsistent with it. Several letters were also published in the same journal criticizing this research and arguing against the stage idea.[17] It was pointed out, for example, that instead of "acceptance" being the final stage of grieving, the data actually showed it was the most frequently endorsed item at the first and every other time point measured;[18] that cultural and geographical bias within the sample population was not controlled for;[19] and that out of the total number of participants originally recruited for the study, nearly 40% were excluded from the analysis who did not fit the stage model.[20] In subsequent work, Prigerson & Maciejewski focused on acceptance (emotional and cognitive) and backed away from stages, writing that their earlier results "might more accurately be described as 'states' of grief."[21] George Bonanno, Professor of Clinical Psychology at Columbia University, in his book The Other Side of Sadness: What the New Science of Bereavement Tells Us About Life After a Loss,[2] summarizes peer-reviewed research based on thousands of subjects over two decades and concludes that a natural psychological resilience is a principal component of grief[22] and that there are no stages of grief to pass. Bonanno's work has also demonstrated that absence of grief or trauma symptoms is a healthy outcome.[23][24] Among social scientists, another criticism is a lack of theoretical underpinning.[3][25] Because the stages arose from anecdotes and not underlying theoretical principles it contains conceptual confusion. For example, some stages represent emotions while others represent cognitive processes. Also, there is no rationale for arbitrary dividing lines between states. On the other hand, there are other theoretically based, scientific perspectives that better represent the course of grief and bereavement such as: trajectories approach, cognitive stress theory, meaning-making approach, psychosocial transition model, two-track model, dual process model, and the task model.[26] Misapplication can be harmful if it leads bereaved persons to feel that they are not coping appropriately or it can result in ineffective support by members of their social network and/or health care professionals.[3][20] The stages were originally meant to be descriptive but over time became prescriptive. Some caregivers dealt with clients who were distressed that they did not experience the stages in "the right order" or failed to experience one or more of the stages of grief. Criticism and lack of support in peer-reviewed research or objective clinical observation by some practitioners in the field has led to the labels of myth and fallacy in the notion that there are stages of grief.[24][25][27][28] Nevertheless, the model's use has persisted in popular news and entertainment media. References[edit]
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What are the main criticisms of KüblerOne common critique of the theory is the fact that dying does not happen in a stage-like progression. The emotional responses identified by Kubler-Ross may or may not occur in the order outlined in her theory. Additionally, all dying patients are unique.
What are some weaknesses in KüblerDisadvantages of Kubler-Ross Change Curve
This model lacks empirical evidence to support its assumptions and it fails to fully explain complex forms of emotions people have to cope with during change process. These 5 stages of grief or loss are neither sequential nor work in parallel.
Is KüblerIn actuality, the Kübler-Ross model was based on people who are dying rather than grieving. Although commonly referenced in popular culture, studies have not empirically demonstrated the existence of these stages, and the model has been considered by some to be outdated and unhelpful in explaining the grieving process.
Which of the following best describes KüblerFigure 1. Elizabeth Kübler-Ross developed her theory of grief based on work with those facing their own death, but the theory has been broadly applied to anyone dealing with grief or loss. According to Kübler-Ross, the five stages of loss are denial, anger, bargaining, depression, and acceptance.
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