DREAM

Developing Resilience to Ease Anguish in Mourning

Mature adult hands set in second set of hands

The goal of our transdisciplinary program is to:

Determine psychosocial and neurobiological factors (or biological markers) that can complicate acute grief following the loss of a loved one
Advance our neurobiological understanding of prolonged grief disorder and bereavement-related depression
Identify interventions that may prevent the development of grief-related complications
Identify treatments that can improve health outcomes in those who experience prolonged grief disorder and bereavement-related depression
Share with the community resources and information regarding bereavement and its consequences
Build academic-community partnerships in Wisconsin and beyond to improve care for the bereaved
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 MCW 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

Associate Professor, Psychiatry and Behavioral Medicine
Associate Professor, Institute for Health and Equity
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

Take this survey and find out if you qualify

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.

Eligibility

Individuals with depression
Also, healthy non-depressed adults
You must be age 50 and older
You must be able to undergo an MRI

Interested in becoming a Participant?

Contact Stacy Claesges, Research Coordinator, to become a participant or with questions.
sclaesge@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.

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

Complete the survey and find out if you qualify

Grief Clinic

The Grief Clinic at the Froedtert & MCW 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:
Email cbischel@mcw.edu or call (414) 955-8952

In The News

Pandemic Takes Toll on Those Who Grieve
Terry D'arrigo
Psychiatric News, American Psychiatric Association | February 4, 2021

Mental Health: The Emotional Toll of the Pandemic, How Older Adults Are Grieving
Kathy Hardy
Today’s Geriatric Medicine (Vol. 14 No. 1 P. 26)

How COVID-19 Has Made The Grieving Process So Much Harder
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.

Medical College of Wisconsin to Study Brain Changes Following Loss of Loved One to Prevent Grief-Related Complications
Medical College of Wisconsin | August 7, 2020
Urban Milwaukee

Grief over covid-19 deaths may be unusually severe and long-lasting
Alice Klein
NewScientist | July 8, 2020

COVID-19 can trigger complicated grief among those who lost loved ones, experts warn
John Diente
International Business Times | July 10, 2020

COVID-19 May Lead to Uptick in Cases of Prolonged Grief Disorder
Psychiatric News Alert | July 1, 2020

Milwaukee study to focus on growing public health issue of late-life depression
Milwaukee Independent | November 12, 2017

Study finds that education, good health, and positive emotional wellbeing contribute to improved memory health in older women
Medical College of Wisconsin
Urban Milwaukee | February 29, 2016

Other Resources

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National

American Journal of Geriatric Psychiatry
(National) podcast on Grief by Dr. Goveas (October 2020 podcast)
Learn more

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)
Learn more

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

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
Learn more

Center for Disease Control and Prevention (CDC)
Resources on grief and loss
Learn more

Hospice Foundation of America
Grief resources
Learn more

National Funeral Director Association
Grief resources
Learn more

Local

Griefwords
Resources for mourners and caregivers at Froedtert & the Medical College of Wisconsin
Learn more

Children’s Wisconsin-Milwaukee Hospital
Grief and bereavement resources
Learn more

Horizon Home Care and Hospice
Grief Resource Center
Learn more

Compassionate Friends
Supporting family after a child dies
Learn more

Southeast Wisconsin Grief Network
Learn more

Archdiocese of Milwaukee Bereavement Ministry
Learn more

Archdiocese of Milwaukee Catholic Cemeteries
Learn more

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 Medical College of Wisconsin 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.
Learn more

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.
Learn more

Grief and the COVID-19 Pandemic in Older Adults.

(Goveas JS, Shear MK.) Am J Geriatr Psychiatry. 2020 10;28(10):1119-1125 PMID: 32709542 PMCID: PMC7320675 SCOPUS ID: 2-s2.0-85088212034 07/28/2020
Circulating endocannabinoid concentrations in grieving adults.

(Harfmann EJ, McAuliffe TL, Larson ER, Claesges SA, Sauber G, Hillard CJ, Goveas JS.) Psychoneuroendocrinology. 2020 10;120:104801 PMID: 32682172 PMCID: PMC7348598 SCOPUS ID: 2-s2.0-85087803094 07/19/2020
Amygdala Functional Connectivity Features in Grief: A Pilot Longitudinal Study.

(Chen G, Ward BD, Claesges SA, Li SJ, Goveas JS.) Am J Geriatr Psychiatry. 2020 10;28(10):1089-1101 PMID: 32253102 PMCID: PMC7483593 SCOPUS ID: 2-s2.0-85082764762 04/08/2020
Commentary on Disruption of Neural Homeostasis as a Model of Relapse and Recurrence in Late-Life Depression.

(Goveas JS.) Am J Geriatr Psychiatry. 2019 12;27(12):1331-1333 PMID: 31526546 PMCID: PMC7716776 SCOPUS ID: 2-s2.0-85072176914 09/19/2019
A candidate gene study of risk for dementia in older, postmenopausal women: Results from the Women's Health Initiative Memory Study.

(Driscoll I, Snively BM, Espeland MA, Shumaker SA, Rapp SR, Goveas JS, Casanova RL, Wactawski-Wende J, Manson JE, Rossom R, Brooks J, Hernandez DG, Singleton AB, Resnick SM.) Int J Geriatr Psychiatry. 2019 05;34(5):692-699 PMID: 30706571 PMCID: PMC6608707 SCOPUS ID: 2-s2.0-85062720937 02/02/2019
General and domain-specific cognitive reserve, mild cognitive impairment, and dementia risk in older women.

(Petkus AJ, Resnick SM, Rapp SR, Espeland MA, Gatz M, Widaman KF, Wang X, Younan D, Casanova R, Chui H, Barnard RT, Gaussoin S, Goveas JS, Hayden KM, Henderson VW, Sachs BC, Saldana S, Shadyab AH, Shumaker SA, Chen JC.) Alzheimers Dement (N Y). 2019;5:118-128 PMID: 31011622 PMCID: PMC6461572 04/24/2019
Negative Affect Is Associated With Higher Risk of Incident Cognitive Impairment in Nondepressed Postmenopausal Women.

(Korthauer LE, Goveas J, Espeland MA, Shumaker SA, Garcia KR, Tindle H, Salmoirago-Blotcher E, Sink KM, Vaughan L, Rapp SR, Resnick SM, Driscoll I.) J Gerontol A Biol Sci Med Sci. 2018 03 14;73(4):506-512 PMID: 29028908 PMCID: PMC5861908 SCOPUS ID: 2-s2.0-85044222983 10/14/2017
Are Optimism and Cynical Hostility Associated with Smoking Cessation in Older Women?

(Progovac AM, Chang YF, Chang CH, Matthews KA, Donohue JM, Scheier MF, Habermann EB, Kuller LH, Goveas JS, Chapman BP, Duberstein PR, Messina CR, Weaver KE, Saquib N, Wallace RB, Kaplan RC, Calhoun D, Smith JC, Tindle HA.) Ann Behav Med. 2017 Aug;51(4):500-510 PMID: 28194642 PMCID: PMC5554747 SCOPUS ID: 2-s2.0-85012250789 02/15/2017
Long-term Effects on Cognitive Trajectories of Postmenopausal Hormone Therapy in Two Age Groups.

(Espeland MA, Rapp SR, Manson JE, Goveas JS, Shumaker SA, Hayden KM, Weitlauf JC, Gaussoin SA, Baker LD, Padula CB, Hou L, Resnick SM, WHIMSY and WHIMS-ECHO Study Groups.) J Gerontol A Biol Sci Med Sci. 2017 Jun 01;72(6):838-845 PMID: 27506836 PMCID: PMC6075542 SCOPUS ID: 2-s2.0-85027490316 08/11/2016
Intrinsic inter-network brain dysfunction correlates with symptom dimensions in late-life depression.

(Li W, Wang Y, Ward BD, Antuono PG, Li SJ, Goveas JS.) J Psychiatr Res. 2017 04;87:71-80 PMID: 28017917 PMCID: PMC5336398 SCOPUS ID: 2-s2.0-85007203312 12/27/2016
GENOME-WIDE ASSOCIATION STUDY (GWAS) AND GENOME-WIDE BY ENVIRONMENT INTERACTION STUDY (GWEIS) OF DEPRESSIVE SYMPTOMS IN AFRICAN AMERICAN AND HISPANIC/LATINA WOMEN.

(Dunn EC, Wiste A, Radmanesh F, Almli LM, Gogarten SM, Sofer T, Faul JD, Kardia SL, Smith JA, Weir DR, Zhao W, Soare TW, Mirza SS, Hek K, Tiemeier H, Goveas JS, Sarto GE, Snively BM, Cornelis M, Koenen KC, Kraft P, Purcell S, Ressler KJ, Rosand J, Wassertheil-Smoller S, Smoller JW.) Depress Anxiety. 2016 Apr;33(4):265-80 PMID: 27038408 PMCID: PMC4826276 SCOPUS ID: 2-s2.0-85016837684 04/03/2016
Global Quality of Life Among WHI Women Aged 80 Years and Older.

(Naughton MJ, Brunner RL, Hogan PE, Danhauer SC, Brenes GA, Bowen DJ, Snively BM, Goveas JS, Saquib N, Zaslavsky O, Shumaker SA.) J Gerontol A Biol Sci Med Sci. 2016 Mar;71 Suppl 1:S72-8 PMID: 26858327 PMCID: PMC5865532 SCOPUS ID: 2-s2.0-84973862281 02/10/2016
Predictors of Optimal Cognitive Aging in 80+ Women: The Women's Health Initiative Memory Study.

(Goveas JS, Rapp SR, Hogan PE, Driscoll I, Tindle HA, Smith JC, Kesler SR, Zaslavsky O, Rossom RC, Ockene JK, Yaffe K, Manson JE, Resnick SM, Espeland MA.) J Gerontol A Biol Sci Med Sci. 2016 Mar;71 Suppl 1:S62-71 PMID: 26858326 PMCID: PMC4759985 SCOPUS ID: 2-s2.0-85015598616 02/10/2016
A Voxel-Based Morphometry Study Reveals Local Brain Structural Alterations Associated with Ambient Fine Particles in Older Women.

(Casanova R, Wang X, Reyes J, Akita Y, Serre ML, Vizuete W, Chui HC, Driscoll I, Resnick SM, Espeland MA, Chen JC.) Front Hum Neurosci. 2016;10:495 PMID: 27790103 PMCID: PMC5061768 10/30/2016
Depression and frailty in later life: a systematic review.

(Vaughan L, Corbin AL, Goveas JS.) Clin Interv Aging. 2015;10:1947-58 PMID: 26719681 PMCID: PMC4687619 SCOPUS ID: 2-s2.0-84949990899 01/01/2016

Acknowledgements

Contact Us

Psychiatry and Behavioral Medicine
Tosa Health Center
1155 N. Mayfair Rd, 3rd Floor
Milwaukee, WI 53226

(414) 955-8970

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