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<article  article-type="case-report"        dtd-version="1.4">
            <front>

                <journal-meta>
                                                                <journal-id>dev exp health med</journal-id>
            <journal-title-group>
                                                                                    <journal-title>Developments and Experiments in Health and Medicine</journal-title>
            </journal-title-group>
                                        <issn pub-type="epub">3062-2948</issn>
                                                                                            <publisher>
                    <publisher-name>Dokuz Eylul University</publisher-name>
                </publisher>
                    </journal-meta>
                <article-meta>
                                        <article-id pub-id-type="doi">10.18614/dehm.1759486</article-id>
                                                                <article-categories>
                                            <subj-group  xml:lang="en">
                                                            <subject>Clinical Oncology</subject>
                                                            <subject>Psychiatry</subject>
                                                    </subj-group>
                                            <subj-group  xml:lang="tr">
                                                            <subject>Klinik Onkoloji</subject>
                                                            <subject>Psikiyatri</subject>
                                                    </subj-group>
                                    </article-categories>
                                                                                                                                                        <title-group>
                                                                                                                        <article-title>Dual-focused therapy for prolonged grief in breast cancer: A case study</article-title>
                                                                                                    </title-group>
            
                                                    <contrib-group content-type="authors">
                                                                        <contrib contrib-type="author">
                                                                    <contrib-id contrib-id-type="orcid">
                                        https://orcid.org/0000-0002-8178-6804</contrib-id>
                                                                <name>
                                    <surname>Savaş</surname>
                                    <given-names>Esra</given-names>
                                </name>
                                                                    <aff>İSTANBUL SAĞLIK VE TEKNOLOJİ ÜNİVERSİTESİ, REKTÖRLÜK</aff>
                                                            </contrib>
                                                                                </contrib-group>
                        
                                        <pub-date pub-type="pub" iso-8601-date="20260429">
                    <day>04</day>
                    <month>29</month>
                    <year>2026</year>
                </pub-date>
                                        <volume>40</volume>
                                        <issue>2</issue>
                                        <fpage>252</fpage>
                                        <lpage>258</lpage>
                        
                        <history>
                                    <date date-type="received" iso-8601-date="20250806">
                        <day>08</day>
                        <month>06</month>
                        <year>2025</year>
                    </date>
                                                    <date date-type="accepted" iso-8601-date="20250826">
                        <day>08</day>
                        <month>26</month>
                        <year>2025</year>
                    </date>
                            </history>
                                        <permissions>
                    <copyright-statement>Copyright © 2025, Developments and Experiments in Health and Medicine</copyright-statement>
                    <copyright-year>2025</copyright-year>
                    <copyright-holder>Developments and Experiments in Health and Medicine</copyright-holder>
                </permissions>
            
                                                                                                <abstract><p>Objective: This case report aims to illustrate the clinical trajectory of a woman diagnosed with early-stage breast cancer who developed prolonged grief following the loss of her sister to the same illness, and to explore the therapeutic effectiveness of a dual-focused intervention. Case: The patient presented with depressive symptoms, anxiety, avoidance behaviors, and diminished self-worth while navigating both cancer-related distress and bereavement. She received a sequential therapy plan consisting of individual cognitive-behavioral therapy (12 sessions) followed by a structured, group-based CBTgrief protocol (12 sessions). During the intervention, clinically significant reductions were observed in symptoms of depression and grief-related avoidance. In parallel, improvements were noted in self-compassion, meaning-making, and interpersonal functioning. Conclusion: This case underscores the therapeutic relevance of combining individual and group-based interventions in patients coping with concurrent cancer diagnosis and traumatic grief. It also highlights the role of sociocultural dynamics—including gender norms, identity disruption, and body image—in shaping the psychological experience and recovery process in Turkish female cancer patients. The report contributes to the psycho-oncology literature by demonstrating how dual-process grief interventions can be effectively tailored within a culturally sensitive framework.</p></abstract>
                                                            
            
                                                            <kwd-group>
                                                    <kwd>Prolonged grief</kwd>
                                                    <kwd>  breast cancer</kwd>
                                                    <kwd>  cognitive behavioral therapy</kwd>
                                                    <kwd>  group intervention</kwd>
                                                    <kwd>  dual trauma</kwd>
                                            </kwd-group>
                            
                                                                                                                        </article-meta>
    </front>
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                            <ref-list>
                                    <ref id="ref1">
                        <label>1</label>
                        <mixed-citation publication-type="journal">1.	American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5-TR. 5th ed., text revision. Washington, DC: American Psychiatric Publishing; 2022.</mixed-citation>
                    </ref>
                                    <ref id="ref2">
                        <label>2</label>
                        <mixed-citation publication-type="journal">2.	World Health Organization. International classification of diseases for mortality and morbidity statistics (11th Revision) – ICD-11. Geneva: WHO; 2019. Available from: https://icd.who.int</mixed-citation>
                    </ref>
                                    <ref id="ref3">
                        <label>3</label>
                        <mixed-citation publication-type="journal">3.	Eser, E., Fidaner, H., Fidaner, C., Eser, S. Y., &amp; Elbi, H. (1999). Yaşam kalitesinin ölçülmesinde WHO-5 iyilik hali indeksinin Türkçe versiyonunun psikometrik özellikleri. 3P Dergisi. 7(1), 5–13.</mixed-citation>
                    </ref>
                                    <ref id="ref4">
                        <label>4</label>
                        <mixed-citation publication-type="journal">4.	Hisli, N. (1988). Beck Depresyon Envanteri&#039;nin geçerliği üzerine bir çalışma. Psikoloji Dergisi. 6(22), 118–122.</mixed-citation>
                    </ref>
                                    <ref id="ref5">
                        <label>5</label>
                        <mixed-citation publication-type="journal">5.	Neff KD. The development and validation of a scale to measure self-compassion. Self Identity. 2003;2(3):223–250. https://doi.org/10.1080/15298860309027</mixed-citation>
                    </ref>
                                    <ref id="ref6">
                        <label>6</label>
                        <mixed-citation publication-type="journal">6.	Savaş, E., O’Connor, M., &amp; Boelen, P. A. (2025). Aarhus Uzamış Yas Ölçeği Türkçe Formunun Psikometrik Özellikleri: Geçerlik ve Güvenirlik Çalışması. Yayınlanmamış veri.</mixed-citation>
                    </ref>
                                    <ref id="ref7">
                        <label>7</label>
                        <mixed-citation publication-type="journal">7.	Boelen PA, O’Connor M. CBTgrief: A treatment manual for prolonged grief disorder. Utrecht: Utrecht University; 2022.</mixed-citation>
                    </ref>
                                    <ref id="ref8">
                        <label>8</label>
                        <mixed-citation publication-type="journal">8.	Boelen PA, Lenferink LIM, Smid GE. Cognitive-behavioral variables mediate the associations between intolerance of uncertainty and prolonged grief disorder symptoms. Eur J Psychotraumatol. 2021;12(1):1951111. https://doi.org/10.1080/20008198.2021.1951111</mixed-citation>
                    </ref>
                                    <ref id="ref9">
                        <label>9</label>
                        <mixed-citation publication-type="journal">9.	Shear MK, Ghesquiere A, Glickman K. Bereavement and complicated grief. Curr Psychiatry Rep. 2013;15(11):406. https://doi.org/10.1007/s11920-013-0406-z</mixed-citation>
                    </ref>
                                    <ref id="ref10">
                        <label>10</label>
                        <mixed-citation publication-type="journal">10.	O’Connor M, Seeley J, Jones H. Prolonged grief disorder: evidence and controversies. Lancet Psychiatry.2023;10(2):124–134. https://doi.org/10.1016/S2215-0366(22)00346-7</mixed-citation>
                    </ref>
                                    <ref id="ref11">
                        <label>11</label>
                        <mixed-citation publication-type="journal">11.	Akyüz A, Şahiner G, Seven M. Depression, self-esteem, body image and quality of life in Turkish women with gynecological cancer. Asian Pac J Cancer Prev.2008;9(3):505–510. https://pubmed.ncbi.nlm.nih.gov/19256742</mixed-citation>
                    </ref>
                                    <ref id="ref12">
                        <label>12</label>
                        <mixed-citation publication-type="journal">12.	Öztürk S, Aksoy Derya Y. Jinekolojik kanserli kadınların beden imajı, benlik saygısı ve cinsel işlevleri arasındaki ilişki. J Educ Res Nurs. 2021;18(1):32–38. https://doi.org/10.5222/HEAD.2021.74858</mixed-citation>
                    </ref>
                                    <ref id="ref13">
                        <label>13</label>
                        <mixed-citation publication-type="journal">13.	Gök U, Güdücü Tüfekci F. Jinekolojik kanserli kadınların yaşadıkları psikososyal sorunlar: sistematik derleme. Turk J Oncol. 2018;33(3):128–137. https://doi.org/10.5505/tjo.2018.1762</mixed-citation>
                    </ref>
                                    <ref id="ref14">
                        <label>14</label>
                        <mixed-citation publication-type="journal">14.	Gürsoy E, Yılmaz D. Jinekolojik kanserli kadınların cinsel yaşam kalitesi ve etkileyen faktörler. J Anatolia Nurs Health Sci. 2019;22(3):326–333. https://doi.org/10.17049/ataunihem.522401</mixed-citation>
                    </ref>
                                    <ref id="ref15">
                        <label>15</label>
                        <mixed-citation publication-type="journal">15.	Neimeyer RA, Currier JM. Grief therapy: Evidence of efficacy and emerging directions. Curr Opin Psychiatry.2021;34(5):528–533. https://doi.org/10.1097/YCO.0000000000000733</mixed-citation>
                    </ref>
                                    <ref id="ref16">
                        <label>16</label>
                        <mixed-citation publication-type="journal">16.	Kissane DW, McKenzie M, Bloch S, Moskowitz C, McKenzie DP, O’Neill I. Family focused grief therapy: a randomized controlled trial in palliative care and bereavement. Am J Psychiatry. 2006;163(7):1208–1218. https://doi.org/10.1176/ajp.2006.163.7.1208</mixed-citation>
                    </ref>
                                    <ref id="ref17">
                        <label>17</label>
                        <mixed-citation publication-type="journal">17.	O’Connor M, Piet J, Hougaard E. The effects of mindfulness-based cognitive therapy on depression and anxiety: A meta-analysis. Psychol Med. 2019;49(6):1–10. https://doi.org/10.1017/S0033291718002296</mixed-citation>
                    </ref>
                                    <ref id="ref18">
                        <label>18</label>
                        <mixed-citation publication-type="journal">18.	Yıldız F, Demir Y. Jinekolojik kanserli kadınlarda beden imajı ve cinsel işlev bozukluğu: sistematik derleme. J Health Nurs. 2020;17(2):135–141. https://doi.org/10.31732/jhns.700832</mixed-citation>
                    </ref>
                                    <ref id="ref19">
                        <label>19</label>
                        <mixed-citation publication-type="journal">19.	Neff KD, Germer CK. A pilot study and randomized controlled trial of the mindful self-compassion program. J Clin Psychol. 2013;69(1):28–44. https://doi.org/10.1002/jclp.21923</mixed-citation>
                    </ref>
                            </ref-list>
                    </back>
    </article>
