Grief Therapy Counseling Approach For All Losses
Grief Therapy Counseling Approach For All Losses
Grief Therapy Counseling Approach For All Losses
Although Kübler-Ross initially proposed that everyone moves through each of the five
stages once and only once, she later acknowledged that some people may only
experience two stages and that some people may revisit stages later in life
(Mastrangelo & Wood, 2016).
Another popular model comes from J. W. Worden, who proposed that humans must
undergo the “Four Tasks of Mourning” to heal:
1. To accept the reality of the loss
2. To work through the pain of grief
3. To adjust to life without the deceased
4. To maintain a connection to the deceased while moving on with life (Mastrangelo &
Wood, 2016)
Although there are many unique theories and models of grieving with different stages
and processes, generally all models agree that the following symptoms are common,
whichever order they appear in:
• Shock and disbelief, feeling numb, even denial that the loss occurred
• Sadness, despair, loneliness, feeling empty
• Guilt, regret, shame
• Anger, feeling resentful
• Anxiety, helplessness, insecurity, fear
• Physical symptoms like fatigue, nausea, sickness, weight loss or gain, aches and pains,
night sweats, heart palpitations, feeling faint or lightheaded, insomnia (Therapy Tribe,
n.d.)
It’s normal to experience these symptoms, but if you are experiencing them very
intensely or for a long period of time after suffering the loss, you may want to look
into grief counseling or grief therapy.
In general, the difference between counseling and therapy is merely one of semantics.
Both counseling and therapy use discussion between the client and the mental health
professional to help the client address emotional, mental, or behavioral issues and
solve problems.
However, the terms “counseling” and “therapy” are sometimes used in slightly
different ways; counseling is more often used to refer to sessions focused on assisting
clients who are dealing with everyday stressors and looking for ways to cope with
normal issues and problems, while therapy is more frequently used to describe
sessions in which clients are battling more difficult, more pervasive, and/or more
chronic problems, like depression, anxiety, or addiction.
Thus, although grief counseling and grief therapy are basically the same thing, “grief
counseling” may refer to the counseling that any individual might receive after losing
a loved one, while “grief therapy” is more likely to refer to sessions that a client
engages in when they are experiencing issues outside of the normal range of responses
due to their grief.
For example, if a widow is simply struggling to cope with the loss of her husband, she
may seek grief counseling; however, if she has lost her appetite and has had trouble
sleeping for weeks, it may be a more serious problem that she seeks grief therapy for.
Three of the biggest things a good grief counselor can do for their client are to:
1. Let them talk about the deceased; ask them about the person, and allow them to speak
about their lost loved one in a safe space.
2. Distinguish grief from trauma; if the client is struggling to get an image out of their head
or experiencing flashbacks to the moment they learned of their loved one’s death, they
are experiencing trauma, which can keep them from working through their grief.
3. Deal with any guilt they are feeling and help them organize the grief; the client may feel
guilty about what they did or didn’t do while their loved one was alive, or they may feel
guilty about not feeling “sad enough” or moving on while their loved one is dead.
Encourage them to let go of the guilt and commit to living a life that will honor the
deceased, even if that means forgetting about them for a little while (Tyrrell, n.d.).
Aside from the three important techniques listed above, there are many other more
specific interventions and modified strategies that can be used to support a client in
grief therapy.
For example, Dr. Alan D. Wolfelt developed the Companioning Model of
Bereavement caregiving, in which the counselor or therapist acts as a companion and
helper for the client. He is present for his client and observes their experience;
however, “observe” in this context doesn’t mean just watching, but bearing witness to
their experience and to watch out for them.
Companioning is about…
• Honoring the spirit, not focusing on the intellect.
• Curiosity, not expertise.
• Learning from others, not teaching them.
• Walking alongside, not leading.
• Being still, not frantic movement forward.
• Discovering the gifts of sacred silence, not about filling every painful moment with
words.
• Listening with the heart, not analyzing with the head.
• Bearing witness to the struggles of others, not directing them.
• Being present to another person’s pain, not taking away the pain.
• Respecting disorder and confusion, not imposing order and logic.
• Going to the wilderness of the soul with another human being, not thinking you are
responsible for finding the way out (Wheeler-Roy & Amyot, 2004).
Dr. Kenneth Doka recommends encouraging clients to use rituals to connect with their
loved one and carry on despite their grief. These four types of rituals can help:
1. Rituals of Continuity – These rituals establish that the lost loved one is still a part of the
client’s life, that the bond is still there.
2. Rituals of Transition – This type of ritual marks a significant change that has occurred in
the grief response, such as cleaning out the room of the deceased or donating their
belongings.
3. Rituals of Affirmation – In this ritual, the client can discharge any built-up regret
by writing a letter or a poem to the deceased thanking them for their love and support.
4. Rituals of Intensification – These rituals connect group members and reinforce their
common identity; a military unit may gather periodically to remember their fallen
comrades or the survivors of an act of violence may revisit the site and place flowers or
erect a memorial to those they lost (Wheeler-Roy & Amyot, 2004).
Smaller, everyday rituals can also be helpful for those grieving a loss; these are called
Rituals to Commemorate, and include things like lighting a candle and thinking of the
loved one, watching home videos or going through old pictures of the loved one,
traveling to a place the loved one always wanted to visit, or visiting the burial site and
leaving a tribute or symbolic item, like flowers or a balloon.
The mental health professional will not always encourage or apply the same
techniques equally; there are a million different ways to grieve, and every healthy
method of grieving is valid. However, there are two poles in grieving, with people
falling anywhere on the spectrum between. The poles are “Intuitive Griever” and
“Instrumental Griever.”
The Intuitive Griever experiences feelings associated with their grief intensely and is
open with expressions of their grief (e.g., crying, lamenting their loss). For them,
successful strategies to cope with their grief involve facilitating their experience and
expressing their feelings. They may experience prolonged periods of confusion,
inability to concentrate, disorganization, and disorientation, and they might also suffer
from physical exhaustion and/or anxiety.
On the other hand, the Instrumental Griever is more prone to thoughts of grief than
feelings of grief and is often reluctant to talk about their feelings. They prioritize
mastery of themselves and their environment and find success in problem-solving
strategies. They may experience brief periods of cognitive dysfunction, like confusion,
forgetfulness, and obsessiveness, and they may have increased energy levels
(Wheeler-Roy & Amyot, 2004).
The very first step, that should be taken immediately following a death, is to call a halt
to business as usual. Leaders should pause all nonessential activities and reschedule
them to allow employees to process what has happened.
This may involve closing the business for a day or gathering all employees for a few
hours to let them know what happened and address anything that needs addressing
(e.g., safety concerns). Leaders should ensure that all employees are aware of the
situation and leave with accurate information.
Focus on Feeling/Talking/Sharing
After the initial gathering to discuss what happened and make sure everyone is up to
date, make some time for employees to gather and share their feelings. It is imperative
to give employees a chance to work through their feelings and connect with their
coworkers after a loss.
You may want to invite an external facilitator to lead a group discussion.
In larger organizations, this may need to be broken into several smaller groups; the
important thing is that each employee gets a chance to share in a safe environment.
After every employee has had a chance to share, the organization can plan a larger
ceremony or remembrance that includes the entire organization.
Every individual grieves in their own way, and it’s important to avoid imposing a
specific type of grieving on anyone. Offer as many different formats of grief
counseling or support as possible. Some people may not be comfortable sharing in a
group and would benefit from speaking to someone one-on-one.
Others may find ceremonies and rituals comforting, while others may find them over-
the-top or overly solemn. Try to offer support for a wide range of coping styles and
strategies.
Create Ceremony/Rituals
Although some may not appreciate them, most people find some comfort in
ceremonies and rituals. The ceremony could be something as simple as having
everyone sign a card to the deceased’s family, or it can be as big as planning a
company-wide memorial service for the deceased.
If the loss is particularly significant to the workplace, periodic remembrances may be
helpful as well.
Some people take time to process their emotions before reaching out, and others may
be in shock or denial for a period of time. Make sure to offer multiple opportunities
across a longer time period instead of designating a single day or week as the time to
grieve.
Give employees every opportunity you can to work through their feelings.
Just as people grieve in many different ways, they always turn to a wide variety of
people for support. Some prefer to speak with loved ones, while others may want to
sit down with a mental health professional.
Many people benefit from speaking with those in a position of authority in their
organization or to a religious figure, like a pastor, priest, or rabbi. Still, others might
be comfortable talking to a volunteer that they do not know, but have no desire to
share their deepest thoughts and feelings with co-workers or managers.
Try to secure many different types of people as helpers for your employees as they
grieve (Rothman, 2010).
At least some of these helpers should be mental health professionals external to the
organization. They can provide objectivity and a promise of confidentiality for
employees, allowing them to be honest and open (Lotich, 2017).
Getting to step three doesn’t mean the grieving process is done, but it means you have
accepted your situation and you now understand what you’re dealing with; from here,
it can get much, much better.
To help you along your grieving process, remember to:
• Reach out to your loved ones for understanding, support, and comfort.
• Seek counseling if you need it, and encourage your partner to seek counseling if he or she
needs it; know that you are not alone.
• Give yourself the time, space, and permission to grieve and remember what you have
lost.
• Set realistic goals for yourself, and focus on one thing at a time.
• Allow yourself to feel both grief and joy; celebrating brief moments of joy does not
dishonor your loss (American Pregnancy Association, n.d.).
While you are grieving your loss, it can be all too easy to focus on your own grief and
ignore your partner’s experience. This is dangerous to the health of your relationship
and should be avoided at all costs. To help your relationship survive the grieving
process, be sure to:
• Be respectful and sensitive to your partner’s needs, as they should be to yours.
• Keep the communication lines open and share your thoughts and emotions with one
another.
• Accept the differences in coping styles and acknowledge the other’s coping process as
valid (American Pregnancy Association, n.d.).
Coping with a miscarriage is a heart-wrenching and difficult process, but know that
you are not alone and there are tons of people out there who have suffered the same
loss, and tons of support available.
If you or a client are dealing with prolonged grief, you might consider something a bit
more intensive and social than individual counseling. Group counseling and retreats
may be just what you need to deal with your grief.
Group counseling, or group therapy, for grief can facilitate rapid recovery and help
you find comfort in sharing with others, all under the guidance of a licensed mental
health professional (Mastrangelo & Wood, 2016).
Usually, these groups are closed and limited to a certain number of group members,
who stay in the group all the way to the end. They can take many different forms and
focus on different specific losses; for instance, the Grief, Loss, & Transition Center
offers the following group therapy options:
• “Art in Grief” Therapy
• Parent Loss
• Suicide Loss
• Spouse / Partner Loss
• Trauma Information Group
• Family Therapy
Grief support groups are groups that offer members support and understanding as they
cope with their loss. They can be found in most large cities and towns around the
world, and there are many different kinds of support groups with different areas of
focus. For example, some support groups qualify as group counseling and are led by a
mental health professional, while others may be more informal and led by a peer.
These are some of the other areas in which support groups can vary:
• Attitude and culture
• Structure
• Attendance (good vs. spotty)
• Consistent group vs. changing group
• Focused on specific loss vs. general loss
• Focused on advocacy and action vs. grief experience (Williams & Haley, 2017)
To reap any of the benefits of group counseling or support groups, you must be sure to
find one that is a good fit for you. If you do, you might experience any or all of the
following benefits:
• Instillation of hope by seeing those farther along in the grieving process who are
functioning and coping well.
• The universality of grief in a support group reminds you that you are not alone; there are
many others who experience grief as well.
• Information and insight sharing can help you get helpful suggestions, good advice, and
general understanding.
• The opportunity to practice and receive altruism, which is healing in and of itself.
• The group cohesiveness can help you feel that you belong, that you are accepted, and that
your experience is valid (Williams & Haley, 2017).
However, grief support groups are not for everyone, and there are some pitfalls and
disadvantages as well, including:
• It can be overwhelming, especially when you are feeling vulnerable.
• It can be discouraging to see others in the midst of their grief and leave you feeling
hopeless.
• They will likely not provide you with a therapy experience, especially if a peer is leading
the group.
• You might get bad information or bad advice from others in the group.
• You may experience judgment from others, along with negativity and insensitivity.
• There may be difficult people in the group who derail healing.
• The culture of the group may be unhealthy or you may feel pressure to adopt beliefs you
don’t necessarily agree with (Williams & Haley, 2017).
If group therapy and support groups aren’t intensive enough for you, you may want to
try a grief retreat. These retreats offer you the opportunity to work through your grief
over a long period of time, from a couple of days to a week or two. Some have
schedules all attendees are expected to follow, while others are more self-directed, but
they all give attendees a chance to connect with others who are grieving and talk with
an expert in loss and grief.
If you are interested in a grief retreat, these are some of the resources you can use to
find one that will suit you:
• Retreat Finder website
• STAR Foundation Upcoming Retreats
• Camp Carousel Weeklong Retreat for Children, Teens, and Adults
• Spark of Life Grief Recovery Retreats
There are also several activities, exercises, worksheets, and other resources you can
put to good use with your clients, like:
• Healing Activities for Grieving Children & Teens from Ryan’s Heart – This PDF offers
13 exercises and activities for young children (3 to 12) and five for teens (13 to 19).
• The Goodbye Letter – This worksheet is intended for children. Completing it will help
them say their goodbyes to the deceased in a constructive manner.
• Grief Sentence Completion – The Grief Sentence Completion worksheet allows children
and teens to reflect on—and hopefully share—their feelings related to loss.
• The Grieving Process Handout – This handout walks the reader through the normal
grieving process and touches on the more unhealthy grieving process as well.
• The Stages of Grief – This model is not the only model out there, but it is a popular one
and refers to many stages or emotions that the bereaved experience. This handout outlines
these stages.
• My Stages of Grief – Although Kübler-Ross’ five-stage model of grief is no longer
considered the definitive model of grief, some clients may find it helpful to complete this
worksheet on how they have progressed through the grieving process.
• Remembering for Good Grief Workbook – This PDF is a 35-page workbook packed with
information, suggestions, and exercises to help your client address his or her grief and
heal.
• Interventions for Prolonged Grief – This resource offers solution-focused techniques and
strategies for helping your client deal with their loss and learn how to continue
functioning.