Family dynamics and the grieving process: A systematic review and narrative synthesis.

Abstract

Grief is typically conceptualized as an individual process, yet it unfolds within families and is shaped by its dynamics. We conducted a systematic review to synthesize evidence examining how family dynamics influence grief responses. A pre-registered review (PROSPERO registration: CRD420251061451) was conducted in accordance with PRISMA guidelines. Four databases (CINAHL, Scopus, PsycINFO, Medline) and gray literature were searched to identify studies that reported original data, involved two or more members of multiple families, and focused on post-death grief, with the last search in June 2025, yielding 7,806 records. Twenty-nine studies met inclusion criteria and methodological quality was assessed. Findings were narratively synthesized into four themes: communication and cohesion, caregiver influence on child adjustment, roles and reorganization, and cultural and societal influence. Evidence was limited by self-report measures, retrospective data, and cross-sectional designs. Findings suggest that addressing family dynamics in clinical practice, community programs, and policy may promote healthier adaptation following bereavement.