丧失亲人是我们每个人的一生都会经历的重大事件。而丧亲后的一系列生理与心理变化也被称为“哀伤反应”。丧亲者可能会产生对逝者产生强烈的渴望，感觉到抑郁、愤怒、内疚等情绪，甚至难以参加社会活动，进而在生活功能上受到损害。虽然绝大多数丧亲者的哀伤反应能够在一定时间内自发缓解，但仍然有部分丧亲者的哀伤适应过程受阻，并发展为延长哀伤障碍。其中，因所爱之人自杀而丧亲者（自杀遗族），往往会存在更高的患病风险。不同于其他类别的丧亲群体，自杀遗族面临的最大挑战就是处理因为逝者选择主动结束生命而产生的愤怒和遗憾，理解挚爱死亡的原因以及重新寻找生命的意义。本研究关注到了这一群体，并基于Neimeyer（2010）提出的意义重建疗法干预框架与Sands（2011）的自杀遗族三方模型，设计干预方案，对一例自杀遗族个体进行了哀伤咨询。

本研究通过电子海报在网络平台招募个案，并借助简明国际神经精神障碍访谈检查（M.I.N.I.）在初评时进行筛查。经过评估访谈，最终选定了一名延长哀伤问卷（PG-13）得分为22，满足入组要求的个案T作为研究对象。本研究为个案提供了1次哀伤初评、12次正式咨询以及1次回访会谈。其中，正式咨询包含5个阶段：开始阶段、重新理解丧失阶段、重新建立关系阶段、重新定位关系阶段和结束阶段，期间间隔采用ICG-R评估个案哀伤反应水平。

本研究综合复杂哀伤问卷修订版（ICG-R）压力生活经验整合量表（ISLES）、哀伤意义重构量表（GMRI）的得分变化情况，咨询目标的完成情况，咨询师的观察与评估，以及哀伤意义半结构化质性访谈结果四个方面，对咨询效果进行了评估。测量结果显示，T的哀伤反应水平随着咨询进行，整体呈现下降趋势（ICG-R由初评时的75分，到回访时39分）；其意义重建水平也明显上升（ISLES由初评时的39分，到回访时61分；GMRI由初评时的84分，到回访时104分）。除此之外，T的咨询目标也基本完成。T也报告自己的哀伤反应有所减少，在自我觉知、人际关系、对未来的期待和对世界的看法方面都完成了不同程度的意义重建，其对死亡的哲学态度也有着积极的变化。总体而言，本研究的意义重建疗法对来访者的延长哀伤症状，具备良好的干预效果。

本研究初步验证了意义重建疗法结合自杀遗族的三方模型，对自杀遗族进行哀伤干预的有效性，为后续研究与实践领域中的干预方案提供了初步参考。

Losing a loved one is a significant event that everyone will experience in their lifetime. The series of physiological and psychological changes that occur after bereavement are commonly referred to as "grief reactions." Bereaved individuals may experience strong yearning for the deceased, feelings of depression, anger, guilt, and even difficulty participating in social activities, resulting in impaired functioning. Although the vast majority of bereaved individuals' grief reactions spontaneously resolve within a certain period, some may experience obstructed grief adaptation, leading to prolonged grief disorder. Among them, those who have lost a loved one to suicide (suicide survivors) often face a higher risk of illness. Unlike other types of bereaved individuals, the greatest challenge facing suicide survivors is dealing with the anger and regret that arise from the deceased's decision to end their own life, understanding the reason for the loved one's death, and seeking meaning in life again. This study focuses on this group of individuals and designs an intervention plan based on the meaning reconstruction therapy intervention framework proposed by Neimeyer (2010) and Sands' (2011) three-dimensional model for suicide survivors, providing grief counseling for a suicide survivor..

This study recruited a case through an electronic poster on an online platform and used the Mini International Neuropsychiatric Interview (MINI) during the initial assessment to screen for eligibility. After evaluation, a case was selected as the study subject who had a Prolonged Grief-13 questionnaire (PG-13) score of 22, which met the inclusion criteria. This study provided the case with one grief initial assessment, 12 formal counseling sessions, and one follow-up interview. The formal counseling sessions consisted of five stages: the beginning stage, the stage of re-understanding loss, the stage of re-establishing the relationship, the stage of repositioning the relationship, and the ending stage, with ICG-R being used to assess the case's grief response level at intervals during the sessions.

This study evaluated the counseling effect from four aspects: the changes in the score of the Integrated Complex Grief-Revised (ICG-R) questionnaire, the Integration of Stressful Life Experiences Scale (ISLES), and the Grief and Meaning Reconstruction Inventory (GMRI), the completion of counseling goals, the observations and evaluations of the counselor, and the results of the semi-structured qualitative interview on the meaning of grief. The measurement results showed that T's grief response level decreased overall as the counseling progressed (ICG-R score decreased from 75 points at the initial assessment to 39 points at the follow-up interview). T's level of meaning reconstruction also significantly increased (ISLES score increased from 39 points at the initial assessment to 61 points at the follow-up interview; GMRI score increased from 84 points at the initial assessment to 104 points at the follow-up interview). In addition, T's counseling goals were mostly achieved, and T reported a reduction in their grief response and varying degrees of meaning reconstruction in self-awareness, interpersonal relationships, future expectations, and worldview. T's philosophical attitude towards death also changed positively. Overall, this study's meaning reconstruction therapy had a good intervention effect on T's prolonged grief symptoms.

This study preliminarily validated the effectiveness of meaning reconstruction therapy combined with the three-part model for suicide survivors in providing grief interventions for suicide survivors, providing a preliminary reference for intervention plans in subsequent research and practice.