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This information was taken from the article Grief Counseling and Therapy

How individuals and families cope with dying, death, grief, loss, and bereavement is as unique as a fingerprint. The response to the death of a family member, relative, or close friend places one in the category of "bereaved." Those who are bereaved experience grief, a person's response or reaction to loss, which encompasses physical, psychological, social, and spiritual components. How one copes with other life events and adapts to one's present and future is also part of the grieving process.

In the broadest context losses can be thought of as the loss of one's possessions, one's self, one's developmental losses, or one's significant others. Historically, many grief counselors and grief therapists have chosen to follow the popular "grief counseling theory of the time." However, in the twenty-first century there are constantly changing theories regarding grief and loss, and new challenges and questions raised by researchers, clinicians, and the bereaved themselves regarding what is or is not helpful during the bereavement process. In addition to counselors and therapists as defined in the more traditional sense, "grief and bereavement specialists" have emerged to help people deal with their grief, both before and after death.

What Is Grief Counseling and Grief Therapy?
In Grief Counseling and Grief Therapy (1991), the clinician and researcher William J. Worden, Ph.D., makes a distinction between grief counseling and grief therapy. He believes counseling involves helping people facilitate uncomplicated, or normal, grief to a healthy completion of the tasks of grieving within a reasonable time frame. Grief therapy, on the other hand, utilizes specialized techniques that help people with abnormal or complicated grief reactions and helps them resolve the conflicts of separation. He believes grief therapy is most appropriate in situations that fall into three categories: (1) The complicated grief reaction is manifested as prolonged grief; (2) the grief reaction manifests itself through some masked somatic or behavioral symptom; or (3) the reaction is manifested by an exaggerated grief response.

Does a person need "specialized" grief counseling or grief therapy when grief, as a normal reaction to loss, takes place? Are people not able to cope with loss as they have in the past or are individuals not being provided the same type of support they received in previous generations? Individual and family geographic living arrangements are different in the twenty-first century than in past years. People have moved from rural to urban centers, technology has altered the lifespan, and the health care decisions are becoming not only more prevalent but often more difficult. Cost and legal issues become factors in some cases.

Today, ethics committees in hospitals and long-term care facilities are available to help families and health care providers arrive at common ground. Traumatic and violent deaths have also changed the bereavement landscape. What had helped individuals and families in the past in many situations has eroded and the grief and bereavement specialist, or the persons, agencies, and organizations providing those services, is doing so in many cases out of default. Grief counseling is used not only by individuals and families, but in many situations by schools, agencies, and organizations, and in some cases by entire communities affected by death.

Goals of Grief Counseling and Therapy
Professionals believe that there are diverse frameworks and approaches to goals and outcomes of the grief counseling and therapy process. Robert Neimeyer believes, "The grief counselor acts as a fellow traveler [with the bereaved] rather than consultant, sharing the uncertainties of the journey, and walking alongside, rather than leading the grieving individual along the unpredictable road toward a new adaptation" (Neimeyer 1998, p. 200). Janice Winchester Nadeau clearly reminds grief counselors and grief therapists that it is not only individuals who are grieving, but entire family systems. A person is not only grieving independently within the family system, but the interdependence within the family also affects one's actions and reactions. According to Worden there are three types of changes that help one to evaluate the results of grief therapy. These are changes in: (1) subjective experience, (2) behavior, and (3) symptom relief.

Where Is Counseling Done and In What Format?
Grief counseling and grief therapy are both generally done in a private area (generally an office setting). These private areas may be within hospitals (for both inpatients and their families and for outpatients), mental health clinics, churches, synagogues, chemical dependency inpatient and out-patient programs, schools, universities, funeral home aftercare programs, employee assistance programs, and programs that serve chronically ill or terminally ill persons. Additional sites might include adult or juvenile service locations for criminal offenders. Private practice (when a counselor or therapist works for herself) is another opportunity to provide direct client services.

Treatment options include individual, couple, and family grief counseling or grief therapy, and/or group counseling. Sessions are approximately one hour in length, or longer for individual sessions. Groups are either closed (for a set period of time with the same small group of individuals attending each session) or open (offered once, twice, or several times a month and open to whoever attends without previous registration or intake). Grief support groups are generally not therapy groups, but supportive therapeutic environments for the bereaved. Group sessions are generally ninety minutes long. Treatment plans are used by grief counselors in most individual and family counseling situations and in all grief therapy situations.

In some cases a grief counselor may be meeting with a person one time to help "normalize" what the person is feeling, while grief therapy requires multiple sessions. In most cases a fee is paid by the person utilizing the grief counseling or grief therapy service and is either paid on a sliding scale or by self-pay, third-party insurance, victim assistance programs, community charitable care programs, or some other type of financial arrangement. Some hospice/palliative care programs offer grief counseling and grief therapy services at no charge for a limited number of sessions.

Crisis intervention hotlines emphasize assessment and referral, and residential settings for children, adolescents, and adults are also locations where grief counseling or grief therapy is utilized. A number of grief therapists do consulting work with other grief therapists or grief counselors, or with agencies or organizations.

Approaches Used
There is not one method or approach. Each counselor or therapist has his or her own techniques that he or she utilizes because they are effective, although counselors often defer to other techniques that suit a particular person much better based on the individual's circumstances. Counseling and therapy techniques include art and music therapy, meditation, creation of personalized rituals, bibliotherapy, journaling, communication with the deceased (through writing, conversations, etc.), bringing in photos or possessions that belonged to the person who has died, role playing, bearing witness to the story of the loved one, confiding in intimates, and participating in support groups.

The "empty chair" or Gestalt therapy technique is also an approach widely used by grief counselors and grief therapists. This technique involves having an individual talk to the deceased in an empty chair as if the deceased person were actually sitting there; afterward, the same individual sits in the deceased person's chair and speaks from that person's perspective. The dialogue is in first person, and a counselor or therapist is always present. The Internet also provides a number of sites that address the topic of grief and provide links to counseling services and organizations.

How Effective Is Counseling?
Various factors will determine the effectiveness of grief counseling or grief therapy. Some counselors and therapists utilize instruments to measure the effectiveness of the helping sessions. Others rely upon subjective comments from the client, his or her family, behavior observations, cognitive responses, symptom relief, and spiritual discussions. Because grief is a process and not an event, what takes place along the grief journey may alter how one continues to cope and adapt to loss. One loss or multiple losses do not make a person immune to future hardships.

Qualifications of Counselors and Therapists
Most grief counselors and grief therapists have advanced degrees in either social work, nursing, psychology, marriage and family therapy, medicine, theology, or a related field. Many have terminal degrees. In the United States and Canada, there is no state or provincial grief counseling or grief therapy certification requirements as of 2001. However, to practice in the United States in fields such as social work, psychology, or marriage and family therapy, a state license is required.

Georgia Family Crisis Solutions Counseling Center offers advanced Grief Counseling and we invite you to make your appointment today

Grief Counseling - Family Crisis Counseling Solutions