Here is why I believe this to be a photoshopped photo: First, the little girls right eye is very different from her left and it's focused in a different direction. The eyebrow and every other part of her right side is unnaturally asymmetrical with her left. The lighting is off balance. Really, it just isn't convincing as a genuine ghost photo.
Btw, I am a portrait photographer and have a sharp eye for distortions in processing and lighting.

This is a fake. The little girl's hair which covers the grandmothers face is too high to be attached to the little girl's head.

incredible. maybe it's just a photo of a little girl with a woman standing behind her****I have an idea. Let's send this photo in and say that nobody was standing behind the little girl when we took the photo! we can say it's a ghost!! lol lol****just a thought

Dianne, let's look at the elements of this picture. The girl and the "ghost." If it's shopped, what would the girls eyes have to do with the arrangement? Obviously the woman would have been placed in the shot, the girls face nor her eyes would have been disrupted in any fashion.

Vromtramchick, how do you figure her hair is too high? It could be in a tie or just a tuft of fuzzy hair. Your observation is as irrelevant as Diannes. Why would the "faker" add a tuft of hair? It makes no sense. I'm not suggesting the photo is real, I don't know but the conclusions that you and Dianne make are really baseless.

It looks like the image is in a mirror behind the girl and the hair on her head that stands up more than it should is a reflection of her hair with the ghost in it****I heard the show and it does look like a future her or maybe a grandparent. Everyone does not have a perfectly asymmetrical face.

If I am right and it is shopped, then the logic of pulling together a convincing shot is in not choosing an obvious area to seam together any additions, and in this case it would be above the shoulder of the little girl. Plus the lighting is a great way of masking any seams. So I remain very skeptical of the validity of the ghost claim.
And, oh yeah, the "ghost grandma" looks too cartoony to be a ghost or human.

I've seen this photo floating around the internet for at least the last 5 years. I agree with Dianne, it is probably a photoshopped hoax.