What Happens In Bereavement Counseling?

Medically reviewed by Julie Dodson
Updated October 30, 2023by BetterHelp Editorial Team
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Experiencing Loss?

Are you experiencing the death of a loved one? This type of grief can be difficult to overcome, especially on your own. However, understanding the options available to you in this time of need can help you to experience a higher quality of life. 

In this article, we’re discussing what bereavement is, and the role that bereavement counseling can play in the grief process. We’ll also be exploring supportive strategies that may be helpful as you walk through the process of restoration. 

What Is Bereavement And Bereavement Counseling? 

Bereavement is defined as the process of losing a close friend or family through death. Bereavement counseling is designed specifically to help people who are experiencing grief after losing a loved one. 

Forms of supplemental bereavement support can vary and may include tools such as joining a bereavement group to help people navigate their loss. These tools can help those experiencing bereavement by teaching them about coping mechanisms and giving them a safe space with a knowledgeable professional to talk to. 

As grief can be associated with extreme sadness, feelings of regret, guilt, and even anger, bereavement support options can be helpful. Understanding the range of the grief process and the options available for your support can help you to navigate the next steps more confidently.

The Grief Process

Everyone grieves differently. Culture, family, and personal beliefs can all affect how one will experience grief. 

The average person takes between 6-12 months to grieve, and while they may continue to have moments of sadness after this, they may be able to find relief over time. 

There are many ways to spend bereavement time that can help you process your feelings. The challenge for most is that this is a new reality that may never have been experienced before, requiring some to forge a new sense of identity and imagine a different future without the presence of their loved ones.

Understanding the process of grief and the range of experiences can help to validate those who are currently experiencing bereavement. Although psychologists and behavioral scientists have outlined models of grief as shown below, we do want to highlight that it can be an intensely personal experience that may deviate from the projected steps or phases. 

In 1969, grief was divided into five stages under the research of Elisabeth Kubler-Ross. These include:

  • Denial
  • Anger
  • Bargaining
  • Depression
  • Acceptance

It was expounded upon by Dr. J. W. Worden in the Four Tasks of Mourning, which include:

  • Accepting the loss
  • Working through grief
  • Adjusting to the new reality
  • Maintaining remembrance while moving on.

For those who are looking into the benefits of grief counseling, it's very likely that they have become stuck in one of these four tasks, such as between the stages of working through their grief and adjusting to the new reality after their loved one died. Working with a grief therapist or specialist can help many to progress more effectively through and between these stages, making progress toward a more fulfilling experience. 

Grief And Prolonged Grief Disorder: What To Expect In Counseling

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Grief in the form of prolonged grief disorder has recently been added to the DSM-V as of March 2022 as a formal condition. However, it may not be present in all who are experiencing bereavement. Grief may also be connected to other mental disorders like PTSD, stress, and depression. 

When beginning grief counseling and treatment, a therapist may ask about things outside of the recent death to try and get a better picture of what may be causing you to remain in your grieving process. The first meeting may center around the loss and might involve the therapist asking questions. 

You may lean into the experience and refrain from censoring yourself, as it's important to be honest about your grief to truly heal. Crying, anger or yelling is natural for many during such a time, and your counselor can offer strategies and support that may elevate you to a higher quality of life.

Counseling Types: Grief Therapy Vs. Trauma Counseling

These terms may often be used interchangeably, but the approach can be very different. It can help to know the differences between modalities when you're deciding if you are going to seek formal support for the first time. We’ve summarized the differences below.

Bereavement counseling and treatment can be offered without clinical help and may be more appropriate for people who are not dealing with complex grief issues. This approach can benefit people who may only be struggling a little and just need a safe environment to vent their grief without judgment or learn about additional resources. They may not have medications prescribed or previous disorders which may affect their grief. 

Grief therapy is generally designated as clinical psychotherapy that is intended for the treatment of persistent or complex grief. The goal of treatment for some is to determine the sources of conflict, psychosomatic disturbances, behavioral or emotional changes, and anything else associated with mourning behaviors. It may be in individual or group environments (such as support groups or family therapy), or a combination of the two therapeutic types.

Trauma counseling and treatment can support many who are grieving after a violent or sudden loss, which may create additional strain on the patient grieving.

After your initial visit with your counselor, in which you will likely discuss the actual event of the death, your subsequent sessions may vary depending on the methods of the therapist and the type of counseling you choose. The process will generally involve exploring the emotions that a patient is feeling to try and tap into the sadness, anger, guilt, regrets, or other buried emotions. The length of time spent in counseling may often be determined between the patient and therapist since there are no set time lengths. While therapy may not always feel enjoyable, treatment can help you develop healthy coping strategies that prevent you from turning to unhealthy behaviors such as extreme risk-taking or the choice to abuse drugs. 

Coping Strategy: The Dual Process Model Of Coping

One of the most common methods taught in bereavement counseling is the dual process model of coping. The model is a two-directional approach that generally involves accepting the grief (loss process) and confronting it through healthy emotional release and changing perspective (restoration process). It can work by giving the patient a way to cope with triggers or events in everyday life that may destabilize them during their grieving process.

Coping Strategy: Intentionality In The Loss Process

The loss process is generally about the loss itself and acceptance. This period can be used to allow patients to express the way they feel about the loss and the subsequent changes in their life. Demographic changes, location changes, economic changes, friendship, family, and routine changes can all be a part of this too. 

This specific process focuses on the pain that these losses have caused rather than allowing the patient to use denial (the first step in the grieving process) which can support them in moving on to their next healthy step. For example, when families experience the loss of a child, each may need to work through how this death impacted them in different types of ways. Children in the family may mourn the loss of a sibling while parents acknowledge how the death has changed their overall family dynamic. It may even be that one spouse handles the loss differently from the other. 

Coping Strategy: Embracing The Restoration Process

The process of restoration can begin for most after the loss process is complete and accepted, and once any excessive attachment has been let go of. A person may be ready to begin the restoration process when they have finished the stages of grief or at any point in their own individual healing process. 

The process generally focuses on the person creating a new role for themselves in the post-loss world and redefining their responsibilities there. The thought process is usually adjusted so that when faced with a situation which before would have led back into the grieving process the person can now confront it objectively, accept the feelings, and not be consumed by their feelings.

Coping Strategy: Sense Making

Some counselors like to use sense-making as part of their bereavement counseling treatment. This can include helping survivors to see the benefits that have come from the death, such as an ending of pain for terminal patients or the liberation of a career to pursue their own goals. 

Generally, the aim of sense-making is to help the patient feel a greater appreciation for life and to make it more meaningful without a specific push to move on until they feel completely resolved and ready to do so.

Bereavement Support For Those Living With Cognitive Impairment

There may need to be specialist support provided by trained counselors if a person looking for bereavement counseling is dealing with mental disorders or intellectual disabilities.

Non-verbal behaviors may require a different type of treatment to determine stress and express grief to continue functioning. Additionally, this type of bereavement counseling can include the family and those around the patient to potentially encourage them to see how others are handling the event and model behaviors based on them. 

How Can Online Therapy Help Those In Bereavement

Bereavement can be a complex emotional process that can have both emotional and physical effects. In-person therapeutic models may not feel feasible or available to those who may have difficulty leaving the bed or the home due to the weight of their sadness. Online therapy can provide support to someone from the comfort of their own home or safe space and can be used through in-app text messaging for a more direct or immediate response than many would find with traditional in-person models. 

Is Online Therapy Effective For Those Living In Bereavement

Current literature does suggest that virtual intervention models can support those experiencing grief or prolonged grief. Studies referenced in a recent meta-analysis found that individuals in the test group experienced heightened user satisfaction rates after virtual intervention was given, and had lessened symptomatic intensity after the intervention and support was received. 

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Experiencing Loss?

Takeaway

If you're struggling with grief, or if you notice it’s led toward the development of symptoms of depression, you may want to find a counselor who is able to connect and support you on your journey to healing. Because grief counseling is about trusting the therapist to express your grief honestly, it's helpful for many if there is a bond and connection present before therapy commences. Sites like BetterHelp can allow you to search therapists based on specialty, experience, availability, and other preferences such as gender, religious affiliation, therapeutic approach, and more.

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