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Developing Resilience to Ease Anguish in Mourning (DREAM)

Mature adult hands set in second set of hands

The goal of our transdisciplinary program is to:

  1. Determine psychosocial and neurobiological factors (or biological markers) that can complicate acute grief following the loss of a loved one
  2. Advance our neurobiological understanding of prolonged grief disorder and bereavement-related depression
  3. Identify interventions that may prevent the development of grief-related complications
  4. Identify treatments that can improve health outcomes in those who experience prolonged grief disorder and bereavement-related depression
  5. Share with the community resources and information regarding bereavement and its consequences
  6. Build academic-community partnerships in Wisconsin and beyond to improve care for the bereaved
  7. Educate and train both health professionals and lay public on (a) acute and integrated grief; (b) diagnosing and treating prolonged grief disorder and other grief-related complications; and (c) strategies to prevent grief-related complications.

Program Director's Message | Joseph S. Goveas, MD

Welcome to the 91ɫƵ DREAM Program

Experiencing the death of a loved one is inevitable, and grief is a natural response. Most acutely grieving adults are resilient and recover their pre-loss functioning within a year. However, a significant minority develop complications such as prolonged grief disorder (or complicated grief) and bereavement-related depression. The development of these complications is especially high following the death of a life partner or a child. The public health consequences of prolonged grief disorder and bereavement-related depression are enormous, and include declines in physical health and cognition, poor quality of life, functional impairment, premature mortality, and an increased risk of suicide.

Despite the magnitude of this problem, we cannot distinguish those grieving individuals who are resilient and will successfully transition to integrated grief from those who are prone to develop prolonged grief disorder or bereavement-related depression. Thus, it is not known who among the grieving individuals warrants early intervention, what treatments are most effective, and when to initiate treatment.

DREAM is a transdisciplinary program that examines factors that can complicate acute grief following the loss of a loved one, with the goal of identifying interventions that prevent grief-related complications. We also aim to identify treatments that can improve long-term health outcomes in those experiencing prolonged grief disorder and bereavement-related depression.

View Joseph S. Goveas Bio

Meet our team

Joseph S. Goveas, MD

Professor, Psychiatry and Behavioral Medicine
Professor, Institute for Health and Equity
Vice-Chair and Director, Geriatric Psychiatry
jgoveas@mcw.edu | (414) 955-8970

Current Research Studies

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Emotion Regulation in Complicated Grief

Sponsor: The National Institute of Mental Health
Principal Investigator: Joseph S. Goveas, MD

This novel study is expected to provide evidence that specific abnormalities in the emotion regulation brain circuitry that are associated with complicated grief symptom trajectories in individuals with acute grief. These brain circuit abnormalities could, in the future, serve as neurobiological indicators (or markers) of prolonged grief disorder (or complicated grief). Such biological markers could also be used to test the efficacies of treatment or prevention strategies that aim to prevent the development of prolonged grief disorder in acutely grieving individuals.

Learn more about this research study (PDF)

Eligibility

  • Individuals within 12 months following the death of a loved one
  • Also, healthy nonbereaved adults
  • You must be age 50 and older
  • You must be able to undergo an MRI

What will happen if I take part in the study?

  • You will be in this research project for about 18 months.
  • You will complete multiple visits during the course of your study participation.
  • You will receive clinical evaluations, physical/neurological examinations, cognitive (memory) testing, MRI brain scans, optional blood draws, and will complete questionnaires.

Benefits of participating

  • You will be contributing to our knowledge of how changes in the brain in grieving individuals may lead to the development of prolonged grief disorder.
  • The brain imaging measurements (biomarkers) may in the future help us identify treatment strategies that prevent the development of prolonged grief disorder in grieving individuals.

Interested in becoming a Participant?

Contact Stacy Claesges, Research Coordinator, to become a participant or with questions.
sclaesge@mcw.edu | (414) 955-8970

Iyengar Yoga as a Probe of Prolonged Grief Disorder Neurobiology
Sponsor: Advancing a Healthier Wisconsin Endowment (AHW)

Principal Investigator: Joseph S. Goveas, MD

The purpose of this project is to understand features in the brain and measurements in the blood that are associated with prolonged grief disorder with the use of Iyengar Yoga versus health education group. The study will also explore if this style of Iyengar Yoga and/or health education group sessions improves grief symptoms by modifying brain and blood measurements in individuals with prolonged grief disorder (PGD).

Eligibility

  • Individuals 12 months after the death of a loved one.
  • Also, healthy nonbereaved adults.
  • You must be age 50 and older.
  • You must be able to undergo an MRI.
  • You must not have had a serious back, joint or neck injury within the past 3 months.
  • You must not be currently practicing yoga.

What will happen if I take part in the study?

  • You will be in the study for about 18 weeks.
  • You will complete multiple visits during the course of your study participation.
  • You will receive clinical evaluations, physical/neurological examinations, cognitive (memory) testing, MRI brain scans, optional blood draws and will complete questionnaires.
  • If it is determined at the initial visit that you have prolonged grief disorder or a grief-related mental health complication, such as bereavement related depression, etc., you will be “randomized” to either one of two groups: Iyengar Yoga or health education group.

Benefits of participating

  • You will be contributing to improving our knowledge on brain and blood measure abnormalities that underlie grief related complications.
  • You will contribute in assessing the feasibility and effectiveness of Iyengar Yoga and/or health education in improving symptoms of grief.

Interested in becoming a Participant?

Contact Abigail Webber, Research Coordinator, to become a participant or with questions.
awebber@mcw.edu | (414) 955-8970

Neurobiological Markers of Major Depression in Individuals with Grief

Experiencing the death of a loved one is inevitable. Most grieving individuals are resilient and return to normal functioning but about 20% develop bereavement-related major depression, a condition associated with reduced quality of life, poorer medical outcomes, premature mortality and increased suicides. Early diagnosis to target treatment is essential to prevent these adverse health consequences, but currently we cannot identify who will progress from acute grief to bereavement-related major depression. Our goal in this project is to evaluate those with acute grief to identify brain changes that distinguish those who are resilient from those who will develop clinical depression.

Funding provided by the Costigan Family Foundation.

Past Research Studies

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Endocannabinoid System and Brain Network Function in Late-Life Depression

Sponsor: The National Institute of Mental Health
Principal Investigators: Joseph S. Goveas, MD; Cecilia J. Hillard, PhD

The major goals of this project are to determine components of the endocannabinoid signaling system (ECS) and brain network features associated with Late-life Depression (LLD) occurrence, and with persistent low mood and anhedonia, two core symptom dimensions of LLD. This NIH-funded study will set the stage for future seminal research that uses ECS and brain network function measures as biomarkers to aid diagnosis, predict and monitor outcomes to specific treatment interventions, and guide selection of optimal treatment for individual patients before initiation.

Tablet collaboration office setting

Research Study Participation

Are you interested in participating in the Emotion Regulation in Complicated Grief Study?

Complete the survey or contact Stacy Claesges, Research Coordinator, with questions.

sclaesge@mcw.edu | (414) 955-8970

Pebbles stacked on shore

Froedtert & the 91ɫƵ Grief Clinic

The Grief Clinic at the Froedtert & 91ɫƵ Tosa Behavioral Health Center serves adults who have experienced the death of a loved one. This clinic focuses on improving the health of bereaved individuals.

The clinic has:

  • Therapists who can assist individuals during their acute grieving process.
  • Therapists specifically trained in complicated grief therapy (CGT), and
  • Psychiatrists who treat grief-related complications, including but not limited to prolonged grief disorder; bereavement-related depression and anxiety; and post-traumatic stress disorder.

To schedule an appointment:
Call (414) 955-8952

In The News


Zosia Bielski
The Globe and Mail | October 6, 2023


Charlotte Huff
Cancer Today | June 22, 2022


Terry D'arrigo
Psychiatric News, American Psychiatric Association | February 4, 2021


Kathy Hardy
Today’s Geriatric Medicine (Vol. 14 No. 1 P. 26)


WUWM 89.7
Milwaukee’s NPR Lake Effect's Joy Powers talks with Dr. Joseph Goveas about how COVID-19 has made coping with the loss of a loved one more difficult.

91ɫƵ to Study Brain Changes Following Loss of Loved One to Prevent Grief-Related Complications
91ɫƵ | August 7, 2020


Alice Klein
NewScientist | July 8, 2020


John Diente
International Business Times | July 10, 2020


Psychiatric News Alert | July 1, 2020


Milwaukee Independent | November 12, 2017


91ɫƵ
Urban Milwaukee | February 29, 2016

Other Resources

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National

The Center for Complicated Grief
A major resource for webinars, research updates, and scientific articles, podcasts, manuals and tools, handouts related to complicated grief (aka prolonged grief disorder)

The Center for Complicated Grief
Training workshops covering principles and practice of complicated grief therapy (CGT)

Association for Death Education and Counseling (ADEC): The Thanatology Association
Several educational resources and websites offering assistance and information on a variety of topics related to grief, trauma, dying and death are listed

Center for Disease Control and Prevention (CDC) - Taking Care of Your Mental Health
Resources on grief and loss

Hospice Foundation of America
Grief resources

National Funeral Director Association
Grief resources

Dougy Center for Grieving Children and Families

Sesame Street In Communities – Helping Kids Grieve

Local

Griefwords
Resources for mourners and caregivers at Froedtert & the 91ɫƵ

Children’s Wisconsin-Milwaukee Hospital
Grief and bereavement resources

Horizon Home Care and Hospice
Grief Resource Center

Compassionate Friends
Supporting family after a child dies

Southeast Wisconsin Grief Network

Archdiocese of Milwaukee Bereavement Ministry

Archdiocese of Milwaukee Catholic Cemeteries

Church and Chapel Funeral (under the grief support tab)

Kyles Korner
(414) 777-1585

Support Groups

Horizon Grief Resource Center
11400 W. Lake Park Dr.
Milwaukee WI 53224

This on-going support group is for people whose spouse/partner has died. This group is free of charge and does not require a commitment to attend a certain number of sessions. Please arrive 15-20 minutes early the first time you attend a support group to fill out the opening paperwork (this must be completed before attending group). Call (414) 586-8383 if you have questions.

Froedtert & the 91ɫƵ Grief Support Group
Angela Polcyn, MS Thanatology is a bereavement coordinator and grief support specialist with advanced training. She offers a grief support group for families or individuals who have experienced the death of an adult loved one.
Learn more (PDF)

GriefShare support groups and seminars
This is Christian based grief support in various local churches with trained facilitators.

Church and Chapel Funeral (under the grief support tab)

Kyles Korner
(414) 777-1585

Healing Hearts

Professional Grief Counseling

Grief Clinic
Froedtert Tosa Health Center
1155 N. Mayfair Rd.
Wauwatosa, WI 53226

(414) 955-8952
Please refer to the Grief Clinic description above

North Hills Health Center – Behavioral Health
W129 N7055 Northfield Dr.
Menomonee Falls, WI 53051

(262) 253-5400
Several therapists with experience providing counseling for grieving individuals are accepting patients

Horizon Grief Resource Center (GRC)
11400 W. Lake Park Dr.
Milwaukee, WI 53224

(414) 586-8383
Horizon GRC offers a wide range of grief and bereavement services, including short-term individual and family counseling (by appointment), professional referrals for long-term counseling, support groups for various types of loss, educational workshops, wellness activities, presentations, and educational programs, etc.

Recent Publications

  • (Petkus AJ, Wang X, Younan D, Salminen LE, Resnick SM, Rapp SR, Espeland MA, Gatz M, Widaman KF, Casanova R, Chui H, Barnard RT, Gaussoin SA, Goveas JS, Hayden KM, Henderson VW, Sachs BC, Saldana S, Shadyab AH, Shumaker SA, Chen JC.) Alzheimers Dement. 2024 May;20(5):3472-3484 PMID: 38591250 PMCID: PMC11095467 SCOPUS ID: 2-s2.0-85190406564 04/09/2024

  • (Goveas JS, O'Connor MF.) Am J Geriatr Psychiatry. 2024 May;32(5):535-538 PMID: 38176964 SCOPUS ID: 2-s2.0-85182365610 01/05/2024

  • (Hoffmann BM, Blair NP, McAuliffe TL, Hwang G, Larson E, Claesges SA, Webber A, Reynolds CF 3rd, Goveas JS.) Int Psychogeriatr. 2024 Mar 11:1-6 PMID: 38462965 PMCID: PMC11387951 SCOPUS ID: 2-s2.0-85187712212 03/11/2024

  • (Goveas JS.) Am J Geriatr Psychiatry. 2023 Dec;31(12):1058-1061 PMID: 37543462 PMCID: PMC10703544 SCOPUS ID: 2-s2.0-85166923505 08/06/2023

  • (Shadyab AH, Larson JC, Rapp SR, Shumaker SA, Kroenke CH, Meliker J, Saquib N, Ikramuddin F, Michael YL, Goveas JS, Garcia L, Wactawski-Wende J, Luo J, Hayden KM, Chen JC, Weitlauf J, Baker LD.) J Gerontol A Biol Sci Med Sci. 2022 Dec 06;77(Suppl 1):S42-S50 PMID: 35235646 PMCID: PMC8903468 SCOPUS ID: 2-s2.0-85133327333 03/03/2022

  • (Goveas JS, Ray RM, Woods NF, Manson JE, Kroenke CH, Michael YL, Shadyab AH, Meliker JR, Chen JC, Johnson L, Mouton C, Saquib N, Weitlauf J, Wactawski-Wende J, Naughton M, Shumaker S, Anderson GL.) J Gerontol A Biol Sci Med Sci. 2022 Dec 06;77(Suppl 1):S31-S41 PMID: 34915558 PMCID: PMC8754805 SCOPUS ID: 2-s2.0-85136612146 12/17/2021

  • (Blair NP, Cohen AD, Ward BD, Claesges SA, Agarwal M, Wang Y, Reynolds CF 3rd, Goveas JS.) J Psychiatr Res. 2022 Dec;156:252-260 PMID: 36272343 SCOPUS ID: 2-s2.0-85140273934 10/23/2022

  • (Korthauer LE, Goveas JS, Rapp SR, Espeland MA, Shumaker SA, Garcia KR, Rossom RC, Garcia L, Tindle HA, Salmoirago-Blotcher E, Wassertheil-Smoller S, Zaslavsky O, Cochrane B, Sink KM, Masaki K, Driscoll I.) Int J Geriatr Psychiatry. 2022 Nov;37(11) PMID: 36205005 PMCID: PMC9616073 SCOPUS ID: 2-s2.0-85139274577 10/08/2022

  • (Goveas JS.) Am J Geriatr Psychiatry. 2021 Dec;29(12):1264-1266 PMID: 33839012 PMCID: PMC8449786 SCOPUS ID: 2-s2.0-85103976184 04/12/2021

  • (Reiland H, Banerjee A, Claesges SA, Giuca AM, Hillard CJ, Reynolds CF 3rd, Goveas JS.) Psychiatry Res Commun. 2021 Oct;1(1) PMID: 35928209 PMCID: PMC9345326 08/06/2022

  • (Goveas JS, Shear MK.) Focus (Am Psychiatr Publ). 2021 Jul;19(3):374-378 PMID: 34690607 PMCID: PMC8475942 10/26/2021

  • (Kang M, Bohorquez-Montoya L, McAuliffe T, Claesges SA, Blair NO, Sauber G, Reynolds CF 3rd, Hillard CJ, Goveas JS.) Front Psychiatry. 2021;12:783187 PMID: 34955928 PMCID: PMC8692767 SCOPUS ID: 2-s2.0-85121649643 12/28/2021

  • (Goveas JS.) American Journal of Geriatric Psychiatry. December 2021;29(12):1264-1266 SCOPUS ID: 2-s2.0-85103976184 12/01/2021

  • (Harfmann EJ, McAuliffe TL, Larson ER, Claesges SA, Sauber G, Hillard CJ, Goveas JS.) Psychoneuroendocrinology. 2020 Oct;120:104801 PMID: 32682172 PMCID: PMC7348598 SCOPUS ID: 2-s2.0-85087803094 07/19/2020

Acknowledgements

Contact Us

Psychiatry and Behavioral Medicine
Research Park Center
10000 W. Innovation Dr., 3rd Floor
Milwaukee, WI 53226

 

(414) 955-8970

Program Director
Joseph S. Goveas, MD
Professor, Psychiatry and Behavioral Medicine
Professor, Institute for Health and Equity
Director, Geriatric Psychiatry

Tosa Health Center Google map location