What You Need to Know

Therapy for grief, or grief counseling as it is often called, is designed to help you process and cope with a loss — whether that loss is a friend, family member, pet, or other life circumstance.

Grief affects everyone differently. It also affects people at different times. During the grieving process, you may experience sadness, anger, confusion, or even relief. It’s also common to feel regret, guilt, and show signs of depression.

A licensed therapist, psychologist, counselor, or psychiatrist can provide therapy for grief. Seeing a mental health expert for grief and loss can help you process the feelings you’re experiencing and learn new ways to cope — all in a safe space.

Grief generally follows stages or periods that involve different feelings and experiences. To help make sense of this process, some experts use the stages of grief.

The Kübler-Ross stages of grief model, created by Elisabeth Kübler-Ross, was originally written about people dying, not about people grieving, but later, she wrote on applying the principles to the grieving process after a loss.

There are five stages of grief under the Kübler-Ross model. These include:

• Denial. After the death of a loved one, it’s not uncommon to be in denial about what happened. This can help temporarily protect you from the overwhelming emotions that come with grieving.
• Anger. You may find that you are angrier than normal and direct your emotions at other people, including the person who died. It’s also possible to direct the anger toward yourself.
• Bargaining. When you move out of denial and anger, you may find a period where you create a lot of “if only” and “what if” statements.
• Depression. This is often called the “quiet” stage of the grieving process. You may experience overwhelming feelings of sadness or confusion. It’s common for your emotions to feel heavy during the depression stage, and you may want to isolate yourself from others.
• Acceptance. When you get to a point where you accept what happened and understand what it means in your life, you’ve reached the acceptance stage.

Over the years, some experts expanded this model to include seven stages:

1. shock and denial
2. pain and guilt
3. anger and bargaining
4. depression
5. the upward turn
6. reconstruction and working through
7. acceptance and hope

It’s important to note that the empirical evidence to support the stages of grief as a model is lacking, and, according to a 2017 review, some experts believe it may not be best when helping people going through bereavement.

Kübler-Ross’s model was, after all, written to explore the stages that people who are dying and their families go through, not for people to use after death.

One positive outcome of this model is that it emphasizes that grief has many dimensions, and it’s perfectly normal to experience grief through many feelings and emotions.

When grief is long lasting and interferes with daily life, it may be a condition known as prolonged grief disorder. According to the American Psychological Association, prolonged grief is marked by the following symptoms:

• pervasive yearning for the deceased
• difficulty accepting the death
• intense emotional pain
• emotional numbness
• feeling like you’ve lost a part of yourself
• persistent depression
• withdrawal from typical social activities

In general, this type of grief often involves the loss of a child or partner. It can also be the result of a sudden or violent death.

According to a 2017 meta-analysis, prolonged grief disorder may affect as many as 10 percent of people who have lost a loved one.

Finding help for grief

Most therapists provide grief counseling. If counseling is outside of your budget, many mental health professionals offer a sliding scale. Also, consider online and in-person support groups. Talk to a doctor about a referral to a mental health expert. You can also find a counselor online or nearby through one of the following websites:

Seeking therapy after a loss can help you overcome anxiety and depression by processing your experience at your own pace.

Each mental health expert may utilize a different approach to help patients tackle grief, and cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) are two methods often used for bereavement.

Cognitive behavioral therapy

CBT is a common treatment approach for mental health conditions like depression, anxiety, and post-traumatic stress disorder (PTSD).

During a CBT session, the therapist will help you identify negative thought patterns that can affect your behaviors.

They may ask you to explore thoughts related to grief and loss or other unhelpful thoughts to address how these thoughts affect your mood and behavior. They can help you lessen the impact with strategies such as reframing, reinterpreting, and targeting behaviors.

Acceptance and commitment therapy

ACT is another method that may help with grief and loss.

According to a 2016 research paper sponsored by the American Counseling Association, ACT may also be helpful with prolonged, complicated grief by encouraging clients to use mindfulness to accept their experience.

ACT uses the following six core processes for grief counseling:

1. Acceptance of negative emotions. This step involves a willingness to experience and accept negative emotions and thoughts.
2. Cognitive defusion. This process involves distancing from emotions so that it’s easier to examine and understand them.
3. Contact with the present moment. By teaching mindfulness, ACT encourages people to focus on the present as that is when change is possible and when you experience life.
4. Self as context. This step involves observing yourself having your experiences or becoming an observer of the experiences in your life.
5. Values. These are the principles you hold that help direct your life.
6. Committed action. The culmination of ACT, this step involves taking action and overcoming obstacles by working through the previous steps.

Grief counseling for children incorporates many of the same elements as counseling for adults, but the therapist works in ways that are appropriate for children.

According to the American Academy of Child and Adolescent Psychiatry, children, especially younger ones, react differently to death than adults.

In general, preschool-age children see death as temporary and reversible, but kids ages 5 through 9 think slightly more like adults. Some common ways grief counselors treat children include through:

• Play therapy. Play therapy uses a child’s most instinctive behavior of interacting with the world around them by playing. A therapist may use dolls, puppets, stuffed animals, a dollhouse, or other toys to encourage the child to communicate thoughts, feelings, questions, and concerns they may otherwise struggle to express in talk therapy.
• Art therapy. Art therapy allows a child to express themselves creatively and without words. A therapist may ask a child to draw or paint a picture of the person they are grieving and then use it as a way to explore their feelings.
• Narrative therapy. Several children’s books deal directly with death but in a child-centric way. A therapist may use books to help a child understand death and dying and what can happen moving forward.

Things you can do to feel better if you’re grieving

Self-care is a critical component of the grieving process. In addition to participating in therapy, consider things you can do to take care of yourself. Here are some ideas to get you started:

• Stick to a daily routine.
• Get physical activity daily.
• Eat a healthy diet.
• Restrict or avoid alcohol.
• Practice mindfulness meditation.
• Spend time with friends and family.
• Incorporate at least one thing in your day that brings you joy.

It can be difficult to quantify or predict the outlook for people dealing with grief, especially since each person manages it in their own way. It’s also challenging to predict if any one treatment may work the best.

Grief does not follow one particular path. Healing is unique to each individual, and the outlook for people dealing with grief looks different for each person.

A therapist can play a key role in supporting the healing process by facilitating counseling sessions based on your situation.