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Grief Counseling: Therapy Techniques for Children and Hospice Care

Grief Counseling: Therapy Techniques for Children and Hospice Care

Unfortunately, Grief is an inevitable, inescapable part of life.

We will all lose someone we love at some point in our life—most of us at many points—and the loss can often hit us harder than we expect.

If we feel really knocked off our feet or are struggling for a prolonged period of time, that may be a sign that need some professional help to move on.

In this piece, we’ll cover the basics of grief counseling/grief therapy and provide suggestions, tips, techniques, and exercises you can implement as a person in grieving, part of the support system for a person who is grieving, or as a mental health professional.

Read on to learn more about grief counseling.

This article contains:

  • What is Grief Counseling? A Definition of the Basics
  • Grief Counseling and Grief Therapy: What’s the Difference?
  • The Benefits of Grief Counseling
  • Grief Counseling for Adults
  • Grief Counseling in the Workplace
  • Grief Counseling for Children and Elementary Students
  • How to Provide Grief Counseling in Hospice Care
  • Coping with Miscarriage
  • Grief Counseling and Therapy for Pet Loss
  • Group Grief Counseling and Retreats
  • Grief Counseling Resources: Books, Activities, and Worksheets (+ PDF)
  • A Take Home Message
  • References
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What is Grief Counseling? A Definition of the Basics

Before we get into defining grief counseling, let’s start with a definition of grief.

Grief is…

“… a reaction to any form of loss… [that] encompass a range of feelings from deep sadness to anger, and the process of adapting to a significant loss can vary dramatically from one person to another, depending on his or her background, beliefs, relationship to what was lost, and other factors.” (Mastrangelo & Wood, 2016)

Although you may be most familiar with the idea of grief as a response to the death of a loved one, the definition given here is more broad: “… a reaction to any form of loss” (emphasis mine). Thus, grief is something that can be experienced in a wide range of situations, including the death of a loved one or a pet, the dissolution of a marriage, estrangement with a family member, or any other kind of significant loss.

Grief counseling is intended to help the client grieve in a healthy manner, to understand and cope with the emotions they experience, and to ultimately find a way to move on (Therapy Tribe, n.d.). This can be accomplished through individual therapy, group therapy, and/or family therapy (Mastrangelo & Wood, 2016).

You are probably already familiar with one model of grief: Elisabeth Kübler-Ross’ popular “Five Stages of Grief” model. Although not much evidence has been found to support this model, it has stuck around in popular culture. The five stages are:

  1. Denial
  2. Anger
  3. Bargaining
  4. Depression
  5. Acceptance

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.

Grief Counseling: Therapy Techniques for Children and Hospice Care

 

Grief Counseling and Grief Therapy: What’s the Difference?

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.

 

The Benefits of Grief Counseling

While grief counseling is not necessary for most people dealing with the loss of a loved one, there are some big potential benefits for those who are struggling more than usual (Mehta, 2013). If an individual was experiencing distress before the loss they suffered, or if their grief is chronic and interferes with normal functioning, grief counseling can help him or her to address their intense emotions and move on with the healing process. Additionally, as with most forms of therapy, it is most effective if the individual voluntarily seeks it out.

 

Grief Counseling for Adults

If an individual does seek out grief counseling, this section describes what they can expect from their sessions.

The main goal of most grief counseling is to help the client integrate the reality of their loss into their life going forward, and helping them to maintain a healthy bond to the loved one they lost (Neimeyer, 2013). According to Dr. Robert A. Neimeyer, an active clinical psychologist and expert in grief therapy, there are two important first steps for working with a new client reeling from their loss:

  1. Processing the Event Story of the Death
    Clinicians working with a bereaved client will first encourage the client to engage in a healing re-telling of the loss. The clinician must create a safe space for the client to open up and build trust, so when the time comes to help the client rewrite the story of their loss, they are able to communicate effectively with the clinician.
  2. Accessing the Back Story of the Relationship

In addition to hearing about the loss event itself, the clinician will also learn about the client’s relationship with the loved one they lost. As Neimeyer says, “Death may end a life, but not necessarily a relationship.” The clinician will guide the client through learning how to reconstruct their bond with their loved one rather than relinquishing it (Neimeyer, 2013).

Once you’ve got the basics covered, you can move on to some grief-specific techniques.

Techniques used in Grief Counseling

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.).

Interventions and Strategies in Grief Therapy

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).

Following this model, the counselor or therapist will:

  • Listen in a supportive manner to the client’s concerns.
  • Help disaster survivors recognize that, in most cases, their emotional reactions are natural, normal, and to be expected.
  • Assist survivors to reduce additional stress by organizing and prioritizing day-to-day and recovery-related tasks.
  • Help individuals to understand and recognize the wide range of reactions to trauma, such as numbness, frustration, confusion, anger, anxiety, sadness, and feelings of helplessness.
  • Assist individuals to draw on their own strengths and develop healthy coping mechanisms that permit them to gradually resume their pre-disaster (or pre-loss) level of functioning.
  • Sensitively and caringly help individuals to grieve their losses in their own unique ways.
  • Systematically draw upon an array of recovery resources for appropriate referrals (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).

Grief Counseling: Therapy Techniques for Children and Hospice Care

Tips for Coping with Grief

In addition to the techniques and strategies listed above, counselors will likely also offer the following three tips for those who are grieving.

1. Do not grieve alone

It’s vital that you stay connected with others during this time. Your support system may include your family, friends, leaders in your faith, a bereavement support group, and/or a licensed mental health professional to help you cope.

Your support system can help you:

  • Make the funeral arrangements or help you with new responsibilities.
  • Find peace and comfort through your faith’s mourning rituals.
  • Share your grief with others who can relate.
  • Work through your difficult emotions in a safe setting.

2. Take good care of yourself

It can be easy to forget about our own needs when we are reeling from loss, but neglecting yourself won’t help you effectively deal with your grief.

Remember to:

  • Do something creative to express your feelings (e.g., write something, paint, put together a scrapbook, or play a musical instrument).
  • Eat, sleep, and exercise to avoid adding physical fatigue to your emotional fatigue.
  • Be patient with yourself and allow yourself to feel whatever you feel.
  • Understand what triggers your grief and prepare for those triggers (e.g., plan to take a day or two off of work, let your friends and family know you’ll need extra support, etc.).

3. Seek professional grief counseling

Not everyone will need the services of a counselor or therapist during their grieving period, but it can be very helpful for those who are really struggling. A qualified professional can help you understand the grief process and give you the tools you need to cope with your emotions (Therapy Tribe, n.d.).

While everyone grieves differently, these three tips are essential for anyone who must cope with a profound loss.

 

Grief Counseling in the Workplace

Whether the loss takes place at work or outside of the office, losing someone you work with can be tough to process. It’s vital that the workplace leaders address grief in an appropriate way, or they risk loss of morale, extended loss of productivity, and a general negative attitude toward leadership.

Dr. Jerry Rothman offers the following suggestions to address grief in the workplace:

Before You Do Anything Else: Stop the Action

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 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.

Use Differing Formats

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.

Provide Many Opportunities

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.

Utilize Diverse Helpers

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 coworkers 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).

Grief Counseling: Therapy Techniques for Children and Hospice Care

 

Grief Counseling for Children and Elementary Students

As difficult as grief counseling can be in the workplace, it can be even more difficult for children and their families. Special care must be taken when working with children to help them grieve in a healthy manner.

The Dougy Center (aka The National Center for Grieving Children & Families) offers these tips to help you guide a child through the grieving process:

  1. Answer any questions they ask, even the hard ones about death. Give them honest answers that are appropriate for their age and development. Use concrete words like “died” or “killed” instead of “lost” or “passed away.”
  2. Give the child choices whenever possible. Let them decide how they want to say goodbye to the person, allow them to join in the funeral preparations and the service, and encourage them to work through their grief in whatever way works best for them.
  3. Talk about and remember the person who died. Don’t avoid talking about the deceased; bringing up the person they lost may help them to open up about their feelings. Remembering their loved one will help them see grief as a normal part of life and encourage them to focus on the good memories they have of the deceased.
  4. Respect differences in grieving styles; children within the same family may have wildly different methods of coping, and that’s okay. Let them work through it however is best for them.
  5. Listen without judgement. Reflect what they say back to them, and ask them about their experience. Avoid telling them how they should or shouldn’t think, feel, or behave in their grieving process.
  6. Hold a memorial service and allow them to say goodbye. It will help them see how valued and important the deceased was to others and to know that it is okay to grieve. If they don’t want to participate in the service, help them engage in their own service or ritual to say goodbye.
  7. Take a break from grieving, and allow the child to take a break from grieving. Children may need more time than adults to smile, laugh, and have fun, and may even require it to heal (The Dougy Center, n.d.).

Following these tips will help you ensure that you are giving your child (or children) the love and support they need while coping with loss. If you are a mental health professional, remember to pass along this advice to the parents of grieving children, and apply the principles in your own practice.

 

How to Provide Grief Counseling in Hospice Care

Hospice care is one of the most emotionally exhausting fields to work in, as you are dealing with grief and loss every day. While there are some aspects of an expected loss that make it easier to cope with, that certainly doesn’t mean it’s easy.

VITAS Healthcare recommends the following techniques for providing support and assisting the bereaved with coping:

  • Create a helping environment by finding a quiet, private place to talk and projecting warmth, interest, and respect.
  • Use the past tense, use the deceased’s name, and use words such as “death,” “died,” and “dead.”
  • Begin the first encounter by asking the bereaved to tell you about the death.
  • Ask him or her about any funeral or memorial services.
  • Ask him or her about what has been happening since the death (e.g., how have things been with friends and family, is he/she able to talk openly about the deceased).
  • Ask the following questions to encourage them to reflect on their grief reaction:
    o Some people have trouble eating or sleeping after they have lost someone they love. Are you eating okay?
    o Are you getting out of the house and engaging in any former activities or hobbies?
    o Is there anything bothering you in particular these days?
  • Ask about other difficult times in his/her life. Were these recent or in the past? How someone has responded to past losses can tell a great deal about how they are likely to adjust to the current loss.
  • Ask what coping skills he/she utilized in past crises; encourage him/her to utilize those same resources at this time.
  • Help them acknowledge their past accomplishments as a way to reestablish self-esteem.
  • Affirm their ability to survive their current loss.
  • Ask them about their relationship with the deceased.
  • Help them examine their special qualities and talents that endeared them to the deceased.
  • Most grief experts warn against making a drastic change too soon after the death of a loved one (examples include moving to a new home, getting into a new relationship). These premature changes are often viewed as an attempt to “run away” from the pain of grief.
  • Remind the survivor that it is normal to feel overwhelmed by the intensity of his/her feelings.
  • Help him/her identify feelings of loss and feel pain. Acknowledge that pain is a part of the grief experience, but reassure him/her the pain will not always be so intense.
  • Give him/her permission to cry.
  • Give him/her permission to feel relieved if he/she does.
  • Acknowledge that setbacks do happen and not to panic. Explain that it may feel like an emotional roller coaster at times, but that these are merely remnants of grief and not a signal that he/she is starting over again.
  • Grief is an exhausting process physically and emotionally, so it is important to encourage the bereaved to take extra care of themselves by eating balanced meals, drinking plenty of water, getting enough sleep, exercising regularly and limiting alcohol and other mind-altering drugs, as they can hinder the grief process.
  • Suggest that they be patient not only with themselves, but with others who may not understand what they are feeling.
  • Remind them to have realistic expectations about how quickly they will heal from the pain of grief.
  • Encourage them to take one day at a time. At times, it might be easier to break the day into manageable increments.
  • Suggest that they start slowly to return to their normal routine by doing small customary chores such as shopping.
  • One grief therapist suggests that the bereaved set goals for themselves for six months at a time, picking two or three realistic goals and establishing a deadline to accomplish them. Setting goals provides security and a renewed control over one’s life.
  • Doing small things for other people can also be helpful to someone who is grieving in that it takes attention off the bereaved and their pain for a while.
  • Reassure them that it is also OK to set limits with people and to say no.
  • Validate the survivor as they develop new skills and take on new roles.
  • Affirm their right to feel joy and hope and to eventually have another relationship, without viewing these as being disloyal to the deceased (VITAS Healthcare, n.d.)

Aside from this (long!) list of questions and discussion items, there are also some more specific techniques and strategies you can use, including:

  • Some bereaved feel the need, especially right after the death, to find out everything they can about the illness and/or circumstance of their loved one’s death, and sometimes they want to review the medical records. This is normal and especially typical in a sudden death.
  • Encourage the use of symbols and “transitional objects” such as photos, audio or video tapes, articles of clothing or jewelry, or a collection that was special to the deceased.
  • Suggest writing a letter to the deceased or to God expressing his/her thoughts or feelings.
  • Suggest keeping a journal of the grief experience, or special thoughts, poems and remembrances.
  • Reading about grief often helps to normalize their grief experience. Bookstores, libraries, hospices and the Internet all have excellent grief resources.
  • Family members could put together a memory book that includes stories about family events, photos, poems, drawings, etc. They could also make a memory box, in which some special items are kept that can be shared with others or kept as a keepsake.
  • Suggest the use of artwork to express their grief feelings.
  • One grief therapist suggests that the bereaved person play out in his/her mind the “unfinished business” from the relationship with the deceased and try to come to a resolution. It is sometimes helpful to focus on what the survivor was able to do for the deceased instead of what they should have done.
  • The “empty chair” technique, where the bereaved person imagines the deceased and is encouraged to express whatever they need to say is another effective method for “unfinished business.”
  • Role-play can be helpful when the bereaved face situations that are feared or that they feel awkward about – like starting a new relationship. Role play can build stronger coping skills (VITAS Healthcare, n.d.)

Supporting those grieving the loss of a loved one in hospice care has its own challenges, but it is generally similar to any other kind of grief therapy or counseling, in which the most important thing is to provide them with support, encouragement, and caring.

Grief Counseling: Therapy Techniques for Children and Hospice Care

 

Coping with Miscarriage

As common as miscarriages are, they can still generate enormous feelings of loss and grief in expectant parents (and others heavily invested in the pregnancy, such as grandparents of the child lost). It is absolutely normal to experience grief after a miscarriage, whenever it occurs in the pregnancy; however, recent research shows that around 15% of women who experience miscarriages suffer from more serious grief-related symptoms that may require the assistance of a qualified mental health professional (Leis-Newman, 2012).

If you are suffering the symptoms below over a long period of time or to the point that you cannot function normally, you may want to look into counseling or therapy for your loss.

After a miscarriage, the sufferer may experience:

  • Depression
  • Numbness and disbelief
  • Anger
  • Guilt
  • Sadness
  • Difficulty concentrating
  • Fatigue
  • Trouble Sleeping
  • Loss of appetite
  • Frequent episodes of crying
  • Broken or suffering relationships with family or friends
  • Self-harm/suicidal attempts or actions (American Pregnancy Association, n.d.)

A common post-miscarriage grieving process may unfold in the following manner:

  1. Shock or denial that the miscarriage happened.
  2. Anger, guilt, and/or depression; feeling that it isn’t fair, or asking “Why me?”
  3. Acceptance of the reality of the miscarriage.

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!

 

Grief Counseling and Therapy for Pet Loss

The loss of a furry, four-legged loved one can also send us deep into grief. In our current society, pets are often treated as members of the family, and the loss of them can be almost as crippling as the loss of a human family member.

Counseling is available for coping with the loss of a pet, although you may find that your grief over losing a beloved pet is more suited to online support and support groups than to sessions with a mental health professional.

If you are struggling with the loss of a pet, check out the Rainbow Bridge website. It offers those grieving the death of a pet forums, chat rooms, suggestions and advice, an opportunity to memorialize the pet, and information on helping others, especially children, cope with the loss. You can find these resources here.

The Association for Pet Loss and Bereavement also offers many resources to help you deal with the loss of your pet, including access to professionals, information on training to become a pet bereavement counselor, chat rooms and forums, and memorials to lost pets. You can see these resources and more at their website.

Finally, the Best Friends organization has a page on pet loss and grief resources here that includes hotlines you can call to work through your grief, websites and webpages that can help, and recommended reading. Check out their page here.

However you choose to cope, remember that there is no shame in grieving the loss of a pet—they really can become members of the family, and it’s never easy to lose a family member! If you feel you are struggling more than normal, don’t be afraid to seek the help of a qualified mental health professional to guide you through the grieving process.

Grief Counseling: Therapy Techniques for Children and Hospice Care 

Group Grief Counseling and Retreats

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 judgement 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
  • Brookhaven Retreat: Comprehensive Recovery for Women
  • STAR Foundation Upcoming Retreats
  • Camp Carousel Weeklong Retreat for Children, Teens, and Adults (The linked flyer is for 2017, but check out their website for information on future retreats)
  • Spark of Life Grief Recovery Retreats

 

Grief Counseling Resources: Books, Activities, and Worksheets (+ PDF)

If you’re interested in learning more about grief counseling and techniques and resources you can use to guide your clients through the grieving process, this section is for you!

Some of the most popular books on grief counseling include:

  • Grief Counseling and Grief Therapy: A Handbook for the Mental Health Practitioner by J. William Worden
  • Techniques of Grief Therapy: Creative Practices for Counseling the Bereaved by Robert A. Neimeyer
  • The Grief Recovery Handbook: The Action Program for Moving Beyond Death, Divorce, and Other Losses including Health, Career, and Faith by John W. James and Russell Friedman
  • It’s OK That You’re Not OK: Meeting Grief and Loss in a Culture That Doesn’t Understand by Megan Devine
  • Processing Through Grief: Guided Exercises to Understand Your Emotions and Recover from Loss by Stephanie Jose

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.

 

A Take Home Message

This piece was a big darker than the usual entries on this blog, but it’s an important topic. We can get quite squeamish when the subject of death arises, but it is a natural part of life that we must all face at some point.

Likewise, grieving is a natural and virtually unavoidable part of life. You may never “get over” your grief, but you can learn to manage and cope with your grief and go on with your life.

I hope you found this piece helpful and informative. Please let us know your thoughts in the comments section below. Have you used grief counseling before? How did it go? Have you counseled anyone through grief therapy? Are there are important tips or exercises we missed?

Thanks for reading!

  • References

    • American Pregnancy Association. (n.d.). After a miscarriage: Surviving emotionally. American Pregnancy Association: Pregnancy Loss. Retrieved from http://americanpregnancy.org/pregnancy-loss/miscarriage-surviving-emotionally/
    • Leis-Newman, E. (2012). Miscarriage and loss. American Psychological Association Monitor on Psychology, 43. Retrieved from http://www.apa.org/monitor/2012/06/miscarriage.aspx
    • Lotich, P. (2017). 5 things employers can do to manage grief in the workplace. Thriving Small Business. Retrieved from https://thethrivingsmallbusiness.com/managing-grief-in-the-workplace/
    • Mastrangelo, L. H., & Wood, J. (2016). Grief, loss, and bereavement. GoodTherapy. Retrieved from https://www.goodtherapy.org/learn-about-therapy/issues/grief
    • Mehta, V. (2013). Does grief counseling cause more harm than good? Psychology Today. Retrieved from https://www.psychologytoday.com/us/blog/head-games/201305/does-grief-counseling-cause-more-harm-good
    • Neimeyer, R. A. (2013). Techniques of grief therapy: Creative practices for counseling the bereaved. Professional Development Training Institute. Retrieved from http://www.apa.org/ed/ce/resources/grief-therapy.pdf
    • Rothman, J. (2010). Grief in the workplace: An outline for helping. Center for Recovery & Therapeutic Services. Retrieved from http://www.griefcounselor.org/articles/grief-article-managing-grief-in-workplace.html
    • The Dougy Center. (n.d.). How to help a grieving child. The Dougy Center Grief Resources. Retrieved from https://www.dougy.org/grief-resources/how-to-help-a-grieving-child/
    • Tyrrell, M. (n.d.). 3 techniques for good grief counselling. Uncommon Knowledge. Retrieved from https://www.unk.com/blog/3-grief-counselling-techniques/
    • VITAS Healthcare. (n.d.). Technique used to assist the bereaved. VITAS Healthcare: Grief and Bereavement. Retrieved from https://www.vitas.com/resources/grief-and-bereavement/techniques-to-assist-the-bereaved
    • Wheeler-Roy, S., & Bernard, A. A. (2004). Grief counseling resource guide: A field manual. New York State Office of Mental Health. Retrieved from https://www.omh.ny.gov/omhweb/grief/
    • Williams, L., & Haley, E. (2017). Grief support groups: Positives and pitfalls. What’s Your Grief. Retrieved from https://whatsyourgrief.com/grief-support-groups-positives-and-pitfalls/

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