Providing effective and appropriate care to people facing significant life-changing events such as serious illness or bereavement demands that the individual way in which each person experiences and deals with loss, needs to be recognised and understood. This website sets out a model of grief and associated assessment measures, which provide practitioners in health and social care with an approach to working with people who seek support in coping with loss leading up to a death or following it.

A theoretical framework which has been developed by Linda Machin, the Range of Response to Loss model (RRL), emerged from her practice and research and while consistent with the concepts of other contemporary theoretical perspectives provides a particular focus on the application of theory to practice. It underpins the concepts which have shaped the creation and design of  the Adult Attitude to Grief and the associated assessment tools.

The Adult Attitude to Grief scale (AAG) was originally devised (Machin 2001; Machin 2014) to test the validity of the concepts within the Range of Response to Loss model  using a study sample of bereaved people. While confirming the categorical distinctions set out in the RRL model it also demonstrated the potential use of the scale as a way of profiling individual grief responses. Subsequent research has validated the AAG as a practice tool and its use to identify vulnerability. The AAG is widely used in bereavement care practice and has been modified for use across a range of client groups, including people facing significant changes in health, the Attitude the Health Change scale (AHC) and children, Children’s Attitude to Grief (CAG) 

The RRL as a theoretical framework and the AAG as an assessment tool provide ways of determining the level of support a grieving person may need. An approach to intervention (Machin 2014) is set out which addresses individual ways of reacting to and coping with loss, and varied levels of vulnerability.


Machin, L. (2001) ‘Exploring a Framework for Understanding the Range of Response to Loss: A Study of Clients Receiving Bereavement Counselling’. Unpublished PhD thesis: Keele University, UK.

Machin, L. (2014)  Working with Loss and Grief. London: Sage (2nd edition)