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Brief Grief Questionnaire {BGQ)

Initial: ____. Date: __/. __;__. -THE CENTER FOR - COMPLICATED Grief . Brief Grief Questionnaire {BGQ). Katherine Shear and Susan Essock DO NOT CIRCULATE WITHOUT WRITTEN PERMISSION BY AUTHOR. 1. How much are you having trouble accepting the death of _____? 0 1 2. Not at all Somewhat A lot 2. How much does your Grief still interfere with your life? 0 1 3. Not at all Somewhat A lot much are you having images or thoughts of _____ when he/she died or other thoughts about the death that really bother you? 0 1 3. Not at all Somewhat A lot 4. Are there things you used to do when _____ was alive that you don't feel comfortable doing anymore, that you avoid?}

COMPLICATED GRIEF Brief Grief Questionnaire {BGQ) Katherine Shear M.D. and Susan Essock Ph.D. DO NOT CIRCULATE WITHOUT WRITTEN PERMISSION BY AUTHOR 1.How much are you having trouble accepting the death of _____ ? 0 Not at all 1 Somewhat 2.How much does your grief still interfere with your life? 0 Not at all 1 Somewhat 2 A lot 3 A lot

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1 Initial: ____. Date: __/. __;__. -THE CENTER FOR - COMPLICATED Grief . Brief Grief Questionnaire {BGQ). Katherine Shear and Susan Essock DO NOT CIRCULATE WITHOUT WRITTEN PERMISSION BY AUTHOR. 1. How much are you having trouble accepting the death of _____? 0 1 2. Not at all Somewhat A lot 2. How much does your Grief still interfere with your life? 0 1 3. Not at all Somewhat A lot much are you having images or thoughts of _____ when he/she died or other thoughts about the death that really bother you? 0 1 3. Not at all Somewhat A lot 4. Are there things you used to do when _____ was alive that you don't feel comfortable doing anymore, that you avoid?}

2 Like going somewhere you went with him/her, or doing things you used to enjoy together? Or avoiding looking at pictures or talking about _____? How much are you avoiding these things? 0 1 3. Not at all Somewhat A lot 5. How much are you feeling cut off or distant from other people since _____ died, even people you used to be close to like family or friends? 0 1 3. Not at all Somewhat A lot Screen positive: total score 4. Pg 1.

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