Grief is a natural response to loss, but for some people, the emotions can become overwhelming and persist for an extended period. When an individual is unable to transition from acute grief to a more integrated form of mourning following the death of a loved one, they may develop prolonged grief disorder. A therapist can offer vital support during these challenging times, helping people process their emotions and adapt to life after loss.
Recent research shows that a coherent syndrome of prolonged grief disorder has a typical onset of 6 to 12 months after the death of a close person and is associated with various poor outcomes, including negative health outcomes (e.g., high blood pressure), increased rates of suicidality, low life satisfaction, and increased service use. Understanding when and how to seek help can make a significant difference in the healing journey.
Table of Contents
- Therapy for Grief and Bereavement
- Different Types of Grief Therapy
- Helping Children Grieve
- Self-Care for Grief
- When to Seek Professional Help
- How Therapy Can Help
- Frequently Asked Questions
- Find a Therapist
Therapy for Grief and Bereavement
Each experience of grief is unique, complex, and personal. Grief may concern the death of a loved one, or it could involve a life change such as divorce or job loss. Your culture, personality, and experience can all affect the grieving process. Prolonged Grief Disorder Therapy (PGDT), the most rigorously validated among them in three NIMH-funded clinical trials involving a combined 641 PGD participants aged 20–93, demonstrated over 70% effectiveness in resolving PGD symptoms compared to 44% for depression-specific interventions.
For example, therapy may help you maintain healthy connections with your lost loved one. Many people find catharsis while talking about their loved ones. Reflection on positive memories can strengthen your bond with the lost person. As you reaffirm your bond, you may feel less sting from your loss.
That said, some people may become overly attached to the deceased. In complicated grief, a person may feel hopeless and desire to join the lost loved one in death. A therapist can help you adjust to life without your loved one. They may also help you strengthen bonds with surviving friends and family.
Different Types of Grief Therapy
Individual Therapy
Cognitive behavior therapy (CBT) for grief demonstrated a large effect for anxiety and medium effect for depression, with findings indicating that CBT for grief is an effective intervention for reducing symptoms of anxiety and depression in young people experiencing grief. Individual therapy provides a private, one-on-one setting where you can explore your feelings at your own pace.
Group Therapy
Structured group approaches—especially cognitive-behavioral, dual-process, and compassion-focused—showed reductions in prolonged grief and distress like depression and anxiety, with group therapy supporting emotional expression and social bonds, aiding adjustment after loss. In group therapy, you may find solace in sharing thoughts and feelings with other mourners. Recovery results are often rapid in this setting. Group therapy offers:
- Shared experiences with others who understand your loss
- Normalization of grief reactions
- Social support for dealing with difficult emotions
- Development of hope and coping strategies
Family Therapy
Family therapy may be suitable for a family who is struggling to adapt to the loss of a member. Family-based interventions have been effective in enhancing parental warmth and family communication, which are critical factors in helping children adapt to the loss of a parent, with studies reporting medium to large effects on reducing traumatic grief symptoms in children and improving the mental health of caregivers.
Online and Digital Interventions
Web-based grief interventions have emerged as a promising solution for providing accessible, flexible, and anonymous support to bereaved individuals, with studies evaluating the effects of web-based grief interventions on grief, anxiety, depression, and posttraumatic stress disorder in bereaved adults, both post-intervention and after three months of follow-up. These interventions offer:
- Flexibility in scheduling
- Privacy and anonymity
- Access from home
- Cost-effective treatment options
Helping Children Grieve
Children may not understand their loss at first. Young kids may believe the deceased will come back. They may also believe they are in danger of dying. However, children are capable of understanding death, so long as adults explain it to them in simple and direct terms.
Evidence-Based Approaches for Children
Currently, two treatment models have scientific evidence of helping children recover from Childhood Traumatic Grief: Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for children ages 3-18 years and their parents or primary caregivers, provided in 12-15 individual or group sessions. Treatments like trauma-focused cognitive behavioral therapy are proven effective, and there are many promising approaches to address child trauma, with the best treatment depending on the type, timing, and severity of the trauma.
Supporting Children Through Grief
In some cases, a death may change a child's daily routine. For instance, a widowed parent may need to hire a babysitter while they are at work. Adults can help children feel less anxious by letting them know what to expect. Children often feel more secure in a predictable environment.
Children often look to their guardians for how to grieve. If an adult hides their sadness, a child will likely try to do the same. When adults talk about their emotions, children can learn to recognize and accept the feelings in themselves. Adults can teach healthy ways to cope with strong feelings, as opposed to withdrawing or lashing out.
Activities That Help Children Process Grief
Legacy interventions are intended to promote adaptive grief processes, facilitate supportive conversations, foster emotional expression, and cultivate continuing bonds between the living and the deceased, with the value coming not from the product it creates but rather the process, which promotes connection, collaboration, and control. Children may have trouble verbalizing their thoughts at first. Certain activities can help:
- Storytelling and narrative therapy
- Art therapy and drawing
- Play therapy
- Memory books and scrapbooks
- Legacy-building activities
A child counselor can help children grieve in a healthy manner. Children who have lost a caregiver or sibling may benefit from family therapy.
Self-Care for Grief
Bereavement can involve a lot of vulnerability and pain. Like a physical injury, the emotional wounds of loss often take time to recover. If you are grieving, it is vital that you take care of yourself. Self-care can take different forms. During the grieving process, there are five aspects of yourself that may need healing.
1. The Physical Aspect
Stress from grief can cause changes in your body. Among the most common physical responses to loss are troubles with sleeping and low energy, with your body needing more rest than usual during your grief journey, and physical symptoms including muscle aches, shortness of breath, digestive problems, heart palpitations, headaches, and changes in appetite. Fatigue is especially common. Don't be surprised if you need more rest than usual.
During this time, routine can provide a sense of stability. A nutritious diet can reduce stress, so try to eat three meals a day, even if you are not hungry. A set sleep schedule can help stabilize energy levels as well. That said, be gentle with yourself. A nap or a snack can go a long way to providing comfort.
2. The Cognitive Aspect
Your mental state may be compromised during bereavement. You may have trouble focusing or making decisions. Like the rest of your body, your brain may need a bit of a break.
It's common and understandable for people to try to regain control by blaming themselves, or to focus on anger at others rather than feelings of helplessness or sadness, but these patterns can prolong the grieving process, with more helpful thoughts like "I did the best I could under the circumstances, with what I knew at the time" or "Others may be to blame, but at the moment, I need to focus on healing for myself and my family."
You may wish to restrict or avoid alcohol use during this time. Although alcohol may make you feel temporarily better, it is not a long-term solution to grief.
3. The Emotional Aspect
You may be overwhelmed with emotion, or you may feel completely numb. There are no "bad" feelings during grief. Remember to be patient and have self-compassion.
Music can be very healing to mourners because it helps us access our feelings, both happy and sad, with music soothing the spirit and nurturing the heart. During this time, you may need to be proactive about pursuing happiness. Activities to consider:
- Listening to music that comforts or uplifts you
- Spending time in nature
- Gentle exercise like walking or yoga
- Creative activities like art or writing
- Connecting with supportive friends
4. The Spiritual Aspect
When a loved one dies, it often sparks questions about death and life. People who have strong spiritual beliefs may find comfort in talking to their religious leaders. Rituals of mourning can provide validation.
Some people have no defined belief system, yet they may still seek to clarify their relationship with death and find meaning in life. Some may join a support group for people with existential questions. Others may find their own answers through meditation. The dual-process model includes three components: loss-oriented coping (LO), restoration-oriented coping (RO), and oscillation, with LO referring to strategies coping with stressors associated with the loss experience.
5. The Social Aspect
Recovery involves healing the body with physical compassion, healing the mind by exploring difficult emotions, and healing the spirit by recognizing and reclaiming one's purpose and meaning. Grief is a difficult process to go through alone. Social support can make recovery easier. Friends and family can help you with daily responsibilities as you recover. They can also offer emotional support.
When a person dies, the dynamics between their loved ones may change. You may find yourself growing closer to some people and further from others. Different people can fill distinct needs. Being honest about your needs can help prevent misunderstandings.
When to Seek Professional Help
Most people who experience an important death manage to successfully adapt to the loss over time, with grief progressing from an acute to a more integrated form; however, a minority of individuals (approximately 7%–10%) will evidence stable, high-grief trajectories requiring intervention if persistent symptoms are linked to distress or functional impairment.
Consider seeking professional help if you experience:
- Intense grief lasting more than 12 months
- Difficulty accepting the death
- Persistent yearning or longing for the deceased
- Identity disruption or feeling life is meaningless
- Difficulty trusting others
- Inability to move on with life
- Numbness or detachment
- Thoughts of joining the deceased
How Therapy Can Help
Evidence-Based Treatment Approaches
Compared with waiting list, behavioral therapy (SMD=-1.05), third-wave cognitive behavior therapy (SMD=-1.00), family therapy (SMD=-0.87), psychodynamic therapy (SMD=-0.88) and cognitive therapy (SMD=-0.84) were statistically effective in reducing grief symptoms, with only cognitive behavior therapy being more acceptable than waiting list.
Expected Outcomes
There are evidence-based treatments that can help you learn to correct unhelpful thoughts and beliefs, find positive coping strategies, and gain meaning from the loss, with treatment helping you find ways to honor and maintain positive memories of those you lost, work towards accepting the death, manage emotions like anger or avoidance, resume normal day-to-day life, and look forward to a better future.
Therapy can help you:
- Process complex emotions safely
- Develop healthy coping strategies
- Maintain connections with positive memories
- Build resilience for the future
- Address any co-occurring conditions like depression or anxiety
- Find meaning and purpose again
Frequently Asked Questions
How long does grief typically last?
The grief experience is not a state but a process, with most individuals recovering adequately within a year after the loss; however, some individuals experience an extension of the grieving process, a condition identified as prolonged grief disorder resulting from a failure to transition from acute to integrated grief.
What's the difference between normal grief and prolonged grief disorder?
Prolonged grief disorder is a diagnosable mental health condition with core symptoms of yearning, preoccupation, or both, which is associated with symptoms of emotional pain, identity disturbances, loss of meaning and purpose, and functional impairment. Unlike normal grief, which typically lessens over time, prolonged grief disorder involves persistent, intense symptoms that interfere with daily functioning for more than 12 months in adults.
Can children develop prolonged grief disorder?
Yes, children can develop prolonged grief symptoms, though the timeline is different. Prolonged grief disorder involves intense, painful emotions associated with a lack of adaptation to the loss of a loved one that persists for more than 1 year in adults and more than 6 months in adolescents or children.
Is online grief therapy effective?
Web-based grief interventions have emerged as a promising solution for providing accessible, flexible, and anonymous support to bereaved individuals, with recent studies evaluating the effects of web-based grief interventions on grief, anxiety, depression, and posttraumatic stress disorder in bereaved adults showing positive results.
Should I consider medication for grief?
While therapy is the primary treatment for grief, medication may be helpful in certain situations. In trials, augmenting therapy with an antidepressant (citalopram) resulted in superior resolution of co-occurring depressive symptoms, but with no discernible difference between citalopram and placebo in PGD symptom resolution. Talk to your healthcare provider about whether medication might be appropriate for your situation.
How can I help a grieving friend or family member?
The best way to help is to:
- Be present and available to listen
- Avoid trying to "fix" their grief
- Offer specific, practical help (groceries, childcare, etc.)
- Remember important dates (anniversaries, birthdays)
- Continue reaching out even months after the loss
- Encourage professional help if grief seems overwhelming
Find a Therapist
Therapy can be an important part of self-care during grief. If you're struggling with loss, a licensed therapist can offer assistance with any aspect of your grief journey. There is no shame in seeking help—grief is one of life's most challenging experiences, and professional support can make a significant difference in your healing process.
Search for a grief therapist in your area who specializes in:
- Prolonged grief disorder
- Trauma-focused therapy
- Cognitive-behavioral therapy for grief
- Family bereavement counseling
- Child and adolescent grief therapy
Remember, seeking help is a sign of strength, not weakness. With proper support, you can learn to carry your grief in a way that allows you to live a meaningful life while honoring your loss.
References:
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