To get through life's problematic challenges, it helps to have the tools to cope. The 3-A Coping Framework: Acknowledge, Assess, Assist® is such a tool. To apply this framework in addressing adversity and loss, a major assumption is:
Wherever There is Adversity, There is Loss.
The following comprehensive definition precisely defines the situational losses people experience that can involve a variety of challenging circumstances:
Situational Loss is loss of a person, thing or quality resulting from an alteration of a
life situation involving changes related to illness, body image, environment and death.
Mosby’s Medical Dictionary, 8th ed., 2009
Another assumption of the 3-A Framework is that grief is a reaction to situational loss. To provide an example, situational loss is involved in the caring for a family member with any progressive neurological or chronic condition. Betsy Peterson acknowledged the situational loss and the grief that accompanies it. She relayed in her 2006 article “One Caregiver’s Search for Help” her experience as a family caregiver for her spouse, Pete, who lived over 10 years with Alzheimer's disease. In her writings, she expressed that it took her years to recognize that while caregiving, she was grieving the loss of her husband in similar ways that individuals grieve a death. She stated there was no guidance for family members in dealing with the grief. Consequently, she felt there was something wrong with her, but continued to believe that what she was experiencing was not unusual or unhealthy. She questioned why the grief had not been addressed.
Her own experience inspired the writing of her book “Voices of Alzheimer’s: Courage, Hope and Love in the Face of Dementia”. She wrote:
Some family members recognize on their own the grief which accompanies dementia....
a substantial number of caregivers only recognize they are grieving after they are told
this is what is happening to them.
Often people will not acknowledge on their own they are experiencing situational loss and grief. They need to be told so their reaction to the situational losses can be processed. Strengthened resiliency and personal growth are potential benefits from grief processing, which is another assumption in applying the 3-A Coping Framework.
Although “Acknowledge” is the first in sequence of the 3-A's Acknowledge, Assess, Assist, it is not necessarily the first step/phase or stage in applying the 3-A Framework. Rather, the components each feed into one another as they can be applied simultaneously. In the case of family caregiving or assisting any patients/clients experiencing adversity, a healthcare provider is assisting by assessing and acknowledging the losses being experienced, assessing if the family member is acknowledging the situational loss and how the reaction to the situational loss is manifesting. For self care, family caregivers or anyone experiencing loss can assist themselves through acknowledging their situational loss and assessing for themselves how the reaction to loss is manifesting. So this framework serves professionals as an intervention tool providing guidance and by sharing with your patients/clients, it also serves those experiencing situational loss so they can use the framework themselves with awareness as a self monitoring tool.