Trial of Family Focused Grief Therapy in Palliative Care and Bereavement

Inclusion Criteria: Subject/Patient Inclusion Criteria * Individuals with advanced disease/Stage 4-IV cancer who may be involved in palliative care treatment program. * Individuals with a poor prognosis Patient and Family Member Inclusion Criteria. * Per investigator's judgment participants must have satisfactory cognitive functioning to provide valid informed consent and participate in family therapy. * In the event that the index family member is declining or too frail to take part in family meetings, the family is able to participate without the index patient being involved in the study. * For every enrolled family there must be at least 2 family members willing/able to take part at the time of recruitment. * The presence of FRI screening scores of ≤ 9 or cohesiveness subscale score \< 4 based on the perception of any single family member, including the patient. Exclusion Criteria: * Inability through language to complete the study questionnaires - inability to speak English with an English-speaking therapist. * Age less than 12 years old for a child. * Patient and family member determined geographical inaccessibility to attend family sessions. * Significant psychiatric disturbance sufficient, in the investigator's judgment, to preclude participation in a psychotherapeutic intervention.