From the Guidelines
Not everyone has to get therapy for grief; it can take its natural course if it's not affecting daily functioning. Grief is a normal, natural response to loss, and many people process it over time without professional intervention 1. However, therapy can be beneficial if grief becomes prolonged or complicated, interferes with daily activities, leads to persistent depression, or involves thoughts of self-harm.
Key Considerations
- Signs that professional help might be needed include inability to perform routine tasks, intense grief that doesn't improve with time, persistent feelings of guilt or hopelessness, or substance use to cope with emotions.
- The grieving process varies widely among individuals in both intensity and duration, and what's considered "normal" grief depends on cultural, personal, and situational factors.
- Most people develop natural coping mechanisms and find support through friends, family, or community resources, gradually adapting to their loss over time.
Recommendations for Support
- Family members should be offered acute grief support at the time of withdrawal of life-sustaining measures and death, and offered a referral to community bereavement support services 1.
- ICUs should compile a list of resources for grief and bereavement support, including support groups in their area.
- The interprofessional team should be educated on acute bereavement support for grieving family members and friends, and family members should be educated about the grieving process 1.
Prioritizing Morbidity, Mortality, and Quality of Life
- The primary focus should be on ensuring that the grieving individual's physical and mental health needs are met, and that they have access to support services if needed.
- Clinicians should assess the individual's symptoms and provide psychological and social support to prevent or alleviate suffering 1.
From the Research
Grief and Therapy
- Not everyone who experiences grief requires professional intervention or treatment, as most people can cope with their emotions on their own 2.
- However, a significant minority of bereaved individuals may experience intense, prolonged, and disabling grief symptoms, also known as "Complicated Grief," which can benefit from targeted support and formal interventions 2.
- For individuals struggling with acute grief, clinicians can provide recognition and acceptance of their emotions, elicit and compassionately listen to their narratives, and regularly check in on their grief experiences 2.
Complicated Grief Therapy
- Complicated Grief Therapy (CGT) is an evidence-based approach that involves helping individuals accept and cope with their loss while adapting to life without the deceased 2.
- CGT consists of seven core themes, including understanding and accepting grief, managing painful emotions, planning for a meaningful future, strengthening ongoing relationships, telling the story of the death, learning to live with reminders, and establishing an enduring connection with memories of the person who died 2.
Cognitive-Behavioral Therapy
- Cognitive-behavioral therapy (CBT) is a first-line, empirically supported intervention for anxiety disorders and can be effective in treating other mental health conditions, including depression and posttraumatic stress disorder (PTSD) 3, 4, 5.
- CBT can be used in conjunction with other treatments, such as selective serotonin reuptake inhibitors (SSRIs), to produce greater improvement in symptoms than either treatment alone 6.
Natural Course of Grief
- The natural course of grief can vary from person to person, and while some individuals may not require professional intervention, others may benefit from targeted support and therapy to cope with their emotions 2.
- There is no one-size-fits-all approach to grief, and the decision to seek therapy should be based on individual circumstances and needs 2.