Counseling Pitfalls Video

Counselors can fall into pitfalls with clients and encounter ethical dilemmas often without knowing it.  They can sometimes be placed between two conflicting sources as well.  It is important to identify potential pitfalls and understand proper responses to avoid later ethical issues or possible termination by employer or suspension of licensure.

Counselors need to be aware of various pitfalls that can endanger their position and career. Please also review AIHCP’s various mental health certifications

 

 

 

 

 

 

 

 

 

The video below highlights and illustrates different types of scenarios and certain preventive measures to protect one’s career.  Please also review AIHCP’s various Mental Health Certifications for Human Service Professionals.  The certifications can serve both licensed and unlicensed professionals in advancing their careers.

Please review the video below

Counseling Ethics and Ethical Standards Video

Ethics in counseling has standards that counselors in the human service field must adhere to in regards to conduct with clients, other counselors, employers, students and other peers.  They are essential to ensure quality and standards within the field of counseling.  Various organizations such as the American Counseling Association offer lists of standards that the profession adheres to in regards to conduct.

Like all professions, Counselors also adhere to ethical standards. Please review AIHCP’s certifications for counselors

This video below reviews in more depth counseling standards and ethics.  Please also review AIHCP’s Certifications for counselors including Grief Counseling, Christian Counseling, Crisis Intervention, Anger Management and Stress Management.

 

Please review the video below

Grief Counseling: Assessment and Perception Problems for Grievers and Grief Helpers

Whether operating as a pastoral counselor, licensed counselor or a close friend and confidant in the grief process for a bereaved person, certain biases and perceptions from both the griever and grief helper can hamper the healing process or cloud assessment entirely.  In past blogs, we have talked about grief myths, grief bullies and both the griever and the grief helper’s own biases.  In this blog, we will put all together as one core unit in how these issues can culminate in preventing healing and also hamper one’s ability to help the grieving.

Helping others through grief is naturally composed of both healthy and unhealthy perceptions, biases and sometimes myths about loss itself.

 

Grief Myths

Grief myths exist in society and can attach to a particular griever, grief helper, or grief bully.  They prevent true healing because they mislead about the true nature of normal grieving itself.  They help form bias within the individuals toward a particular grieving process.  In Junietta McCall’s text, “Bereavement Counseling: Pastoral Care for Complicated Grieving” there are various problematic implications that occur due to bad perceptions.  Among them, McCall lists the denial of the necessity of grief work, the fact grief should always be simple, that any type of extended grief is due to immaturity or pathology, that grieving is feeling sorry for oneself or seeking attention and finally that grieving and any outward manifestation displays weakness in character or lack of faith (2012. p. 182-184).  When individuals believe grieving is not normal, or that is an attention seeking process, then these myths become problems that infect the person’s bias in both helper and griever.

Personal Bias

Grief bullies are particular guilty of personal bias.  They set timelines for grief and assert rules for expression of grief.  Most are harboring their own interior issues and cannot grieve properly themselves.  These individuals will assert that individuals are seeking attention, or weak in character.  Some may grow with a bias that “real men do not cry” or that it is simply time to “get over it”,  Others who are less bullies but more observers may dismiss other’s grief due to their own bias and simply state “the person never talks about it, so I leave it be” or “I avoid this person because it will turn into a sad and uncomfortable conversation every time” or “I would rather say nothing instead of bringing up the pain” or “She needs to simply have more faith” (McCall, 2012, p. 179-182).

From this comes a series of problems grievers face in their own perception of their loss.  They may question the amount or lack emotion displayed.  They may question if they have grieved or felt bad long enough or not enough.  Common exclamations such as “I should be over this by now” or “It is time to move on” or “I feel obligated to cry more” are all nagging pains within the person as the person encounters the grieving process over time.  Some may feel a religious obligation to feel happy that the person is in a better place and any crying is selfish or may question other emotions of anger or guilt. Others may feel ashamed they are angry with God or have not shown enough faith that the person is in a better place.

Others may feel conflicted based upon relationships with deceased or the nature of the loss itself.  They may feel guilty for not maybe noticing an illness soon enough, or not paying enough attention to someone who passed away and feel it is partly their own fault. The person may feel guilt for not visiting enough or appreciating the person enough.  This perception as well other perceptions can create future issues in the grief trajectory and how a person heals.  The only way these issues and emotions can be properly diagnosed is through talking and identifying them.

The Pastoral Counselor, Licensed Counselor or Grief Helpers Bias

Many times, even those who work as primary help of the bereaved enter into conversations with their own bias. While grief and loss are objective realities, everyone has  particular unique and subjective experience in their reactions to grief.  This incorporates a history of grieving that has good and bad things.  Some things may also be neutral and worked for oneself while one grieved but may not work for others.  This is not to say sharing experience and coping ideas are bad but it has to be done when invited.  Comparing grief and offering solutions that may have worked for one’s personal self may not work for others.  One should not be upset if one’s particular advice does not lead one to healing but understand that a grief helper is there to listen and sojourn with the bereaved and the griever’s own particular loss in the griever’s own particular way.  Biases of past experience hence can be helpful or detrimental based on a case by case basis.

Yet, biases inherently are part of the care and healing process and when used correctly can supply large doses of wisdom and knowledge to healing. The care process, according to McCall, involves both the griever’s bias and the helper’s bias.  This leads to two sets of perceptions, thoughts, feelings and beliefs (2012, p. 175).   In healthy outcomes, this feedback loop meets the needs of the given grieving situation and promotes healthy healing.

Grief helpers can play key roles in helping identify issues that relate to griever’s bias, beliefs or perceptions due to grief myths or personal complications within the grieving process.  McCall lists numerous ways pastors, counselors or friends can help the bereaved through difficult times.  McCall lists the critical importance of making careful observations, building healthy relationships, furthering necessary treatment and promoting professional and healthy behaviors (2012, p. 186).

Careful observations push the intuitive abilities of a helper to notate issues that may be arising during the grieving process.  This involves not only note taking but also looking for non verbal clues as well as understanding the person’s past history to better identify issues that may be affecting the current grief process.    Three key consultation questions arise.  First, what is the counselor paying attention to and what could he/she be missing or taking for granted? Second, is something unsettling oneself or making oneself uncomfortable about a particular griever and what is it about? And finally, is the counselor helping the person or getting in the way? (McCall, 2012, p,. 196).

Beyond observations emerges the importance of building a healthy and professional relationship with the bereaved.  One that is helpful and not leading to co-dependence but one that is promoting a healing process where the bereaved will be able to again move forward in life.  This involves identifying with the person and forming an understanding of their pain.  It involves empathy, listening, communication and helping the person form connections from past, present and future (McCall, 2012, p. 189-192).

The third key according to McCall is integrating treatment based upon perceptions.  These treatments are unique for each individual griever and may depend on the griever and the nature of the loss.  Treatments can range based on the person but it involves good note taking and documentation of challenges and issues that appear during the grief trajectory.  These notes and documents help the grief counselor make better assessments and plans of action.  Maybe a particular griever needs a particular therapy best performed by a specialist in it, or maybe the griever needs to be seen by a licensed counselor instead of merely a pastoral counselor.  Maybe CBT is a better resource than a Humanistic approach, or psychodynamic approach?  Maybe this individual would benefit from journaling, or instead of journaling, other forms of artistic expression?

Finally, a review of oneself is critical.  It illustrates how one is reacting to the griever and how effective one is being in terms of helping the individual in his/her progress in grieving.  In analyzing oneself, one is better able to see how one has been successful and not with this particular griever and what things may need adjusted or even if one needs to step back and allow another with more experience or expertise to resume the role in the care plan.

Conclusion

The grief process is about human beings.  The griever and helper are on a mutual journey upon the grief trajectory.  Perceptions, bias and process are all part of it.  Some individuals have unhealthy bias and myths about grief and their perceptions are detrimental while others have healthy perceptions which aid in healing.  The dyad process of two individuals and their past, perceptions and ideas all constitute part of the care model and ultimate healthy grieving outcomes.

The care model of helping others through grief is between the bereaved and helper. Please also review AIHCP’s Grief Counseling Certification

 

Please also review AIHCP’s Grief Counseling Certification and see if it meets your academic and professional goals.  The program is online and independent study and open to qualified professionals seeking a four year certification in Grief Counseling.

Reference

McCall, J. (2012). “Bereavement Counseling: Pastoral Care for Complicated Grieving”. Routledge.

Additional Resources

“6 Myths About Grief”. PsychCentral.  Access here

Williams, L. (2015). “64 Myths About Grief That Just Need To STOP”. What’s Your Grief.  Access here

Feldman, D. (2019). “Five Myths About Grief You May Believe”. Access here

Haley, E. (2017). ” “I should have known…”: Understanding Hindsight Bias in Grief”. What’s Your Grief. Access here

 

 

Humanistic Approach in Counseling and Grief

There are many schools of thought in treatment of individuals facing emotional and mental distress.  Psycho-analysis, behavioral and cognitive schools look at each different human lens of existence to help individuals find balance and happiness.  Psycho-analysis delves deep into the past to find answers to trauma, pain, pathology or issues plaguing a person.  In this venue, we see the seed of Sigmund Freud’s thoughts.   Behavioral strategies look how one’s behavior can be modified to alter mental and emotional issues.  Ivan Pavlov demonstrated the role of classical conditioning on the a person’s behavior.  Cognitive schools emphasized the rethinking aspect to helping others overcome mental and emotional issues. Aaron Beck in the 1960s would combine behavior and cognition as a way to help others via Cognitive Behavioral Therapy.

Another type of way to address human distress is Humanist Therapy.  This type of behavior which has success for many is holistic in nature and looks at the now instead of the past to find healthy balance within a person.  It is far more patient based and subjective in nature.  Due to its greater emphasis on self-happiness and subjective view of self, it focuses more on the person’s emotion in the present and its interaction with others.  It looks to restore and find balance within the person.  It finds its conclusion through authenticity with self and room for self growth in the present and relationships with others (Sherrell, Z,, 2023)

This has many implications within grief.  Grief can shatter a person’s self image and world view.  Humanistic approaches can help restore confidence and hope. It is very sensitive to the needs of the person.  While it may not alone suffice for all cases, it can definitely contribute to specific needs of the grieving person.  In this blog, we will shortly review the nature of the Humanistic Approach for grief, its strengths, its weaknesses, and how it can be incorporated.

Humanistic Approach

Humanistic Therapy is a more holistic and emotional direct therapy that focuses on emotion in the present and how to deal with those emotions in relationship to self and self worth

 

The idea of meeting human needs to find balance has many strengths in psychological thought.  Abraham Maslow’s famous hierarchy of needs sketched a thorough outline of how when human needs are not met, pathology and dysfunction can occur.    Carl Rogers, however, established the Humanistic school of thought.  Rogers wished to treat the entirety of the human person and felt the imbalance or lack of fulfillment in life constituted the biggest problem to individuals.  He labeled the term congruence to distinguish between healthy balance in life that reflected interior perceptions with the outside world.  When balance occurred, Rogers believed human beings display healthy mental and emotional behaviors.  When incongruence emerged or imbalance between self and the world, then person’s mental and emotional health suffered (Mcleod, S., 2024).

Rogers Humanistic Approach centered upon the needs and desires of the person.  It revolved around the now and the relationships within the person’s realm.  The first key elements were regarding self image and self worth.  A person’s self image correlated with how the person viewed oneself in life, his/her existence and relationship with others and how the person fits (Mcleod. S. 2024).  Self image focuses on a person’s perceived value (Mcleod, S., 2024).   In contrast, the existence of the real self, the actual depiction of the person’s existence can cause distress and imbalance.  Identifying the real self is essential in understanding oneself in all the good and bad that exists within.  It is the starting point to reaching the ideal self.  The ideal self is what one hopes and strive to become.  When the ideal self and self image are imbalanced, congruence is not achieved and a state of incongruence exists that causes unhappiness and discontent as well as unhealthy psychological conditions (Mcleod, S., 2024).

According to Rogers, it is hence important to have a high positive regard with self worth.  Individuals with a high self worth can grow and handle stressors and difficulties, while those with a lower self worth encounter difficulties in life and have a hard time growing from negative events (Mcleod, S., 2024).   Rogers believed that a full functioning person reaches a state of actualization when congruence occurs ands is able to better live a fulfilled life.  He identified five primary characteristics to congruent individual.  He pointed out that one is open to new experiences, living existentially in the moment, trusting one’s feeling, displaying creativity  and living a fulfilled life (Mcleod, S., 2024).

The Humanist Therapist hence needs to help the person cultivate a higher self worth and find congruence.

Humanistic Techniques

In cultivating higher self and congruence, unconditional positive regard is employed that accepts the person for who he/she is and offers little criticism.  Rogers felt that conditional positive regard later put conditions on love or behavior that could negatively shape an individual’s development.  This less structured technique embraces the authenticity of the person and looks at the subjective needs of the person.  It places the Humanist Therapist into a place more of guide and equal than true authority figure in counseling.  The counselor utilizes deep empathy and rephrasing skills to help the person find congruence and balance.

One critical technique employed by the Humanist Therapist is Gestalt Therapy.  Gestalt Therapy focuses on the present and its emotions and how to better understand and grow from them (Dexter. G., 2022).  It helps one be more mindful of current situation and emotions and how emotions interact with current relationships in life.   It helps an individual better identify emotions, utilize them and communicate them with others (Dexter, G., 2022).   Some common themes found within Gestalt Therapy includes the “Empty Chair” where one pretends to speak to someone and role playing with the therapist to communicate emotion (Dexter, G. , 2022).

In addition to Gestalt Therapy, Humanist Therapists utilize a very Patient-Centered approach that acknowledges the needs of the patient and places a great importance on equality between client and counselor.  The counselor plays a key role in building the person’s self worth and avoiding judgement.  The therapy again is focused on the present and is more broad spectrum holistic instead of focusing on one particular issue.

Other techniques include Narrative Therapy which identifies values, Existential Therapy which identifies place in the world, and Logotherapy which focuses on helping individuals cope with difficulties and trials in life (Cherry, K., 2023).

Benefits and Disadvantages

When Humanistic Therapy is utilized there are benefits and disadvantages.  Obviously, helping one’s self esteem can empower someone to retake one’s life and move forward in life.  Self image and how one perceives oneself is essential to mental and emotional well being.  This holistic approach treats the entirety of the human person, helps one find empowerment, self acceptance and confidence, and grants the client an empathetic and non-judgmental guide (Sherrell, Z., 2023). However, there are limitations and possible weaknesses to the therapy.  It has the potential side effect of creating a dependency on the therapist, as well as not addressing acute issues in one’s mental health.  The lack of structure can also be counterproductive to certain personalities, as well as being very intensive emotionally and time consuming than other therapies (Sherrell, Z., 2023). It is also very subjective in nature.  The ontolology towards happiness is not a particular code but instead revolves around what one needs and wants.  This can sometimes create a disordered approach to what is right and wrong versus what makes someone happy.

Humanistic Approach in Grief

I think the approach has many benefits for grieving, albeit, I do not think it should be the only way one works with the grieving.  Obviously, different people need different strategies.  Some grieving individuals may need more cognitive and behavioral guidance with structure, while others may greatly benefit from a unstructured and holistic approach on emotion.  Some may greatly benefit from a mixture and blending of strategies.

Obviously when dealing with depression and emotion, the self image, self worth and the ideal self is key for happiness. Many depressed individuals have major self esteem issues and the techniques and practices in the Humanistic Approach can play a key benefit in helping a grieving individual find congruence and balance.  It can help the person understand the emotions, their connections with others, and how one can grow from loss and find connection again in life.

Conclusion

The Humanistic Approach has many advantages but its ultimate success depends on the needs of the griever and what therapy is best. Please also review AIHCP’s Grief Counseling Certification

I feel the Humanistic Approach is  best utilized in an integrative approach with cognitive and behavioral practices to better help the person not only emotionally but also grant the person ways to cognitively reframe issues.  The grave importance of self image, happiness and balance cannot be overlooked and are essential aspects of finding long term emotional and mental health.  Different individuals have different needs.  Some benefit better from a singular approach, while others from an integrated approach. Ultimately, when helping the grieving, the best therapy for the individual is the one that best meets the needs of the person.  If a licensed counselor is not comfortable or acquainted enough with one therapy, then referrals should be encouraged, but for those with comfort in a particular therapy or multiple disciplines, then one can truly begin to help others from a multi-faceted angle.  The Humanistic Approach is definitely one that all licensed counselors or those in grief theory should be familiar with.

Please also review AIHCP’s Grief Counseling Certification. The program is online and independent study and open to qualified professionals seeking a four year certification in Grief Counseling.

 

 

Additional Resources

Mcleod, S. (2024).  “Carl Rogers Humanistic Theory And Contribution To Psychology”SimplyPsychology. Access here

“Different approaches to psychotherapy”. APA. Access here

Sherrell, Z. (2023). “What is Humanist Therapy”. MedicalNewsToday.  Access here

Dexter, G. (2022). “What Is Gestalt Therapy?”. VeryWellHealth.  Access here

“Humanistic Therapy”. Psychology Today.  Access here

Cherry, K. (2023). “What Is Humanistic Therapy?”. VeryWellHealth. Access here

 

 

 

Purposeful Grief?

Grief - human hands holding black silhouette wordWritten by Paul J. Moon

Is grief purposeful? Perhaps one’s stance is that grief is merely a notion – a label and description – referring to humans’ reaction and response to perceived loss. Perhaps one’s view is that grief is something that is just ‘laid upon’ a person or something the person just needs to ‘get over’ or ‘get through’ in time. If this is the extent to which the phenomenon of grief is made out to be, then it is understandable not to think of it as having any purposeful trait or utility.

As for known grief conceptualizations in culture, Kubler-Ross’ stagic model explains the purposefulness of grief is to eventually reach the point of loss ‘acceptance’ (Kessler & Kubler-Ross, 2005). Per Worden (tasks of mourning model; 2018), the purposiveness of grief is asserted as finding ways to remember the person who died while continuing on in the mourner’s remaining life. Or perhaps, as averred by Thomas Attig (1996), the purposefulness of grief is (or at least compels a mourner) to engage in relearning the world. As may be observed in subsequent sections, the picture of relearning the world may serve as a relevant entry into yet another (arguably more contemplative) landscape concerning the purposefulness of grief.

Now, the claim that grief is purposeful may be pointedly supported by considering what it can produce in some mourners. For instance, a survivor of the Sioux City, Iowa plane crash (on July 19, 1989) stated, “I decided to live with as few regrets as possible,” and that the frightening experience “was like being picked up by the scruff of the neck and shaken, and God says, ‘This is your only life. Just be grateful that you’ve got these days…these wonderful people in your life. Just be grateful for that.’” She concluded: “One of the things that has followed me…wrapped me…is that feeling of gratitude” (for more on this survivor’s account: https://www.npr.org/templates/story/story.php?storyId=18007783). No doubt that brushing up against one’s mortality via personal involvement in such a major devastation (where 111 of 296 passengers perished), and living through it, will stir a range of reactions, including grief (perhaps traumatic grief for others who died in the wreck, survivor guilt, etc.). Yet, the graphic and unforgettable experience also incited needful realizations in this particular survivor concerning the importance of minimizing regrets in life as well as embracing gratitude for what one does have (and, perhaps also, shunning envy and complaints about what one does not have). It is not difficult, then, to see how this sort of processing can hold immense instructional value, stemming from a grief-inducing incident, for future living. Thus, it is argued that grief is purposeful in potentially prompting existential instruction: that is to say, grief can hold instructive value for mourners willing to duly engage, explore, and mindfully wrestle with associated dynamics toward discerning the offered lessons.

Further evidence of grief’s existentially instructive value can be seen in the research concerning posttraumatic growth (PTG). Tedeschi and Calhoun are key scholars in this area, and they point to how bereaved adults who appear to have experienced PTG express the following kinds of development in themselves:

  • positive changes in relating to others (e.g., no longer taking others for granted; more deeply valuing kinship, friendship, etc.)
  • better understanding of self (e.g., realizing personal capabilities, strengths, etc.)
  • deeper appreciation of life (e.g., increased gratitude; shifting life priorities/goals due to altered values, etc.)
  • more focus on spirituality, religious beliefs (e.g., revisiting life philosophy one holds and how meaning is made of life circumstances, etc.) (Tedeschi et al., 2011)

What is of essence in PTG is how learned lessons seem to come through and due to encounters with significant losses. In other words, the very pathway of grieving purportedly uncovered in persons who evince PTG elements of particular discoveries and findings concerning themselves, relations with others, and various facets of reality that compelled them to look at life anew and with renewed (clarified) perspectives. Apart from, and in absence of, the traumatic hardships, it may be queried if the same sort of instructive lessons might have been learned.

Now, the idea of gaining existential discoveries and clarity can usher in a prized concept in the human experience: wisdom. In the long line of writings and musings about what wisdom is (and is not), one definition asserted in modern times is that wisdom is seeing through illusion (McKee & Barber, 1999). According to these authors, one way to think about the application of wisdom is to be able to decipher the central actuality of a given matter among a pool of mixed data. In other words, being wise is going beyond mere appearances in order to access the underpinning verities of an item of focus; wise persons can separate ‘wheat from chaff’ (as it were) and glean the core truth of a matter.

In context of the claim of purposeful grief, learning carefully from one’s grief journey may potentially help break through layers of illusions one had adopted previously concerning issues related to, for instance, own and others’ mortality (i.e., now better realizing the truth of how death cannot be avoided or averted, that it must be prepared for, that it can occur any time to anyone, etc.), trials and disappointments in life (i.e., now better realizing the truth of how such need not be merely perceived as pointless, useless, vacuous, but rather be so lived through towards growing in self-knowledge, knowledge of objective reality, etc.), and an assortment of other vital dynamics in this life. When rudimentary acknowledgements as these can be keenly ascertained and held – via grieving reflectively and with a deliberate eye towards learning from emergent ordeals – then it is not difficult to imagine how an enlightened mourner may be compelled to pursue life with an approach that is more intentional, perspicuous, and wise. Indeed, illusions abound in this life, and so anything that can assist in discarding as many of them as possible could be viewed as a help, even if it is one’s own grieving process and bereavement journey.

In sum, William Cowper’s thought may be fitting here: Grief is itself a medicine. Cowper (1731-1800) was an English Christian and noted hymn writer, and he grievously struggled with deep depression all his adult life, including multiple attempts to suicide. Amid his (lengthy) poem, Charity, the pithy phrase of insight (and wisdom) can be found…

Oh most degrading of all ills that wait
On man, a mourner in his best estate!
All other sorrows virtue may endure,
And find submission more than half a cure;
Grief is itself a medicine, and bestow’d
To improve the fortitude that bears the load;
To teach the wanderer, as his woes increase,
The path of wisdom, all whose paths are peace;

Though space here does not permit an analysis of what Cowper might have intended in this small portion from the poem, the overall tone of ideas asserted in preceding sections may be captured in these few verses.

If grief itself can be received as medicine, then how purposeful it is indeed.

 

References

Attig, T. (1996). How we grieve: Relearning the world. Oxford University Press.

Kessler, D., & Kubler-Ross, E. (2005). On grief and grieving. Scribner.

McKee, P., & Barber, C. (1999). On defining wisdom. The International Journal of Aging and Human Development49(2), 149-164.

Tedeschi, R. G., Calhoun, L. G., & Addington, E. (2011). Positive transformations in response to the struggle with grief. In K. J. Doka & A. S. Tucci (Eds.), Beyond Kübler-Ross: New perspectives on death, dying and grief (pp. 61-75). Hospice Foundation of America.

Worden, J. W. (2018). Grief counseling and grief therapy: A handbook for the mental health practitioner (5th ed.). Springer.

 

Grief Counseling and the Dual Process Model

The normal grieving process is one of ups and downs.  In the initial raw phases of grief, emotions oscillate from extremes.  One moment, one may be sad, or angry, another one may find some sort of peace, only to find oneself again in deep emotional turbulence.  As time progresses, the individual begins to attempt to reacclimate into life, find meaning to the loss, and form new stories and relationships in life.  When this is successful, adaptation occurs.  This does not mean acclimation means there is no scar, no memory, or occasional tears, but it does represent an ability to exist with the loss and live life at a functional and successful level.

Healthy grieving involves a dual process of loss orientated and restoration oriented stressors that help us balance the loss in life

Throughout the medium phase of grief, as one struggles with the pain and adjusting to the new reality, one begins to balance focus between the loss itself and reintegration into life.  Time to grieve, but time to move forward is both a painful process, but a necessary one.  According to Margaret Stroebe and Henk Schut, a griever experiences a dual process model in which one deal with loss-orientated stressors or the primary loss and restoration-orientated losses that are secondary. One within this process, will oscillate between grief orientated tasks as well as restoration orientated tasks.  This shows the non-linear reality of grief and how one navigates the tricky waters of adjustment to a loss.

Within the loss-orientated grief work, the individual naturally focuses on the loss.  A person may have a bad day and reflect on the past.  He/she may reflect on the broken bond and the pain it has caused.  This can be done through reflection, crying, yearning, pictures or regressive traits of denial or avoidance.  These are not essentially setbacks but crucial parts of normal grieving.    Those who deny these emotions, deflect or ignore them, ultimately become stuck in the emotional phases of grief and develop complications within the grieving process.  Hence, this part is an essential element in the natural process of grief itself.

Within the restoration-orientated work, one focuses on new roles since the loss.  Sometimes, these roles are a result of secondary losses.  Positions or tasks held by the deceased, may now fall upon the bereaved.  In this process, the bereaved must leave the pain of loss-orientation and gradually deal with the secondary losses and re-orientation into life.  Whether it is paying the bills, cleaning, cooking, going to work, self care or exercise, one is forced to distract oneself from the pain within.  This involves discovering new roles or positions in life and adjusting to these changes despite the occasional set back.  As one reclaims old hobbies and habits and explores new activities that accompany the new journey, the bereaved is able to adjust to the loss and the new narrative.  As time progresses, these two dual functions balance the person into a proper adjustment.  An adjustment that recognizes the past, feels the past, but does not allow it to destroy the present or future.

“What’s Your Grief” points out one important core concept in this process.  Lista Williams states,

“If there is only one thing you take from the Dual Process Model of Grief it is this: it’s okay to experience grief in doses. At times you will face your loss head-on, others you’ll focus on fulfilling practical needs and life tasks, and once in a while you will need to take a break or find respite. This is partially why we talk so often about self-care.”

Williams.L. (2014). “Grief Theory 101: The Dual Process Model of Grief”. What’s Your Grief. Access here

 

Hence, the dual process of Stoebe and Schut recognizes a key element in the stages of grief that illustrate the back and forth between certain stages and the oscillation of emotions.  Some days, one may grieve harder than others without explanation, while other days, one may feel stronger and more goal orientated.  This does not mean one is grieving pathologically or that something is wrong with the bereaved, but is a natural process of adjustment.  This represents a natural ebbing and flowing of human emotion in response to loss.  One should not feel terrible for being sad or that one is not progressing according to standards, but instead realize some days are worst than others and we grieve in periods that are more intense and less intense.  In addition, when one is adjusting and having a better day, one should not feel guilty for feeling motivated or happy as if one is betraying the deceased, but instead realize they are learning to adjust.

Conclusion

Ultimately grieving is stressful.  It represents a serious adjustment with numerous stressors and emotions that can sidetrack oneself.  Many feel rushed to recover or that they are experiencing pathology in their grieving.  They feel grieving too long is bad.  Others may feel extreme guilt when days seem better.  It is important to have a strong understanding of the grieving process itself, its stages, but also its natural biorhythms that flow and ebb with emotion.  The dual process model captures this essence of grief and reminds grievers that grief takes time but it also differs from day to day as one adjusts through this stressful situation.  It also reminds grievers that while one may adjust to the loss and understand its meaning, that it still always has the possibility to sting and hurt.

The dual process model is key to understanding grief.
Please also review AIHCP’s Grief Counseling Certification and see if it meets your academic and professional goals.

The American Academy of Grief Counseling offers a Grief Counseling Certification that trains those within the Human Service, pastoral, counseling, and education fields in grief counseling.  Within the training, one will learn many of the grief models, including the dual process model and how they all come together to tell a deeper and more concise story about grief itself.  Please review the Academy’s Grief Counseling Certification and see if it meets your academic and professional goals.  The program is online and independent study and open to qualified professionals seeking a four year certification.

Additional Resources

Dembllng, S. (2023). “The Dual-Process Model of Grief”. Psychology Today.  Access here

Stroebe, M. & Schut, H. (1999). “The dual process model of coping with bereavement: rationale and description”  Death Studies.1999 Apr-May;23(3):197-224. doi: 10.1080/074811899201046.  National Library of Medicine. Access here

“Dual Process Model of Grief”. Counseling Tutor.  Access here

“The Dual Process Model:  An outline of Stroebe and Schut’s dual process theory”. (2021). Funeral Guide.  Access here

Job Loss and Grief Video

Loss is many times only associated with death of a loved one by the public, but the reality is loss occurs all the time even in little things.  Job loss can be a little thing or a very big thing depending on one’s family and financial situation.  Furthermore, a career can be a very self defining element to oneself.  One’s life style may be defined by what money allows oneself to do.  So there are many subjective elements to job loss and how negative an event it can be for someone.

Job loss can have many grief reactions. Please also review AIHCP’s Grief Counseling Certification

Job loss is something that can cause great distress and emotional turmoil.  It can challenge one’s identity and affect many lifestyle options.  It is important to understand that loss can occur in many facets of life and adjustment is needed.  Please also review AIHCP’s Grief Counseling Certification and see if it meets your academic and professional goals.  The program is online and independent study and open to qualified professionals.

 

 

 

 

 

 

Please review the video below

Utilization of CBT in Grief and/or Depression

Grief and loss strike an imbalance in life.  During the adjustment process, numerous complications can occur that can veer a person off course in adjustment.  Sometimes Grief Counseling and simple talk can help but other times more powerful forms of counseling are required via licensed counselors with an expertise in grief counseling.  In some cases, therapy involves looking solely at the past and the emotional aspect via Psychodynamic Approach, sometimes professionals utilize a more rational approach through Cognitive Behavioral Therapy, and in some cases, professionals utilize a combination.

CBT helps identify distorted thinking of an event and help the person reframe those thoughts and maladaptive behaviors

Cognitive Behavioral Therapy or CBT has a high success rate in helping complicated and dysfunctional grievers find understanding and meaning in life through examination of the loss and recognition of unhealthy feelings, irrational thoughts and imbalanced behaviors.  It involves intense reflection, grief work and homework, and application to help the person reframe distorted views due to complicated grief or even cases of depression.  Originally utilized by Aaron Beck (1967), it looked to challenge distorted feelings and help the person find healing through rational re-direction.  In essence, CBT recognizes the Cognitive Triangle of thought, behavior and emotion.   Each aspect of human existence affects the other.  Thoughts can positively or negatively affect behavior, behavior can affect emotion and emotion can affect thought.  If any of these are imbalanced, it can create a distortion itself.

Albert Ellis, (1957) was a core contributor to Beck’s thought.  Ellis was discouraged by the limitations of psychoanalysis and limitations of only becoming aware of an emotion but wanted tools to cognitively help the person move forward.   Ellis drafted the ABC Model which identified a triggering or Activating event with a belief that in turn caused a consequence.  An activating event could be labeled as any traumatic event or loss that in turn was interpreted by the person.  In complications of grieving, the interpretation or belief regarding the event many times caused negative consequences, instead of the event itself.  The purpose of the therapy was to revisit the event, understand it and correlate proper consequences from the objective nature of the event instead of subjective beliefs or faulty conclusions.  Hence irrational, unhealthy, and counter productive thinking and new distorted behaviors from an event are key elements within complications of grieving.  CBT looks to challenge those ways of thinking and behaviors with an indepth cognitive, intellectual and rational discussion to help correct the emotions and behaviors via better thinking or reframing.

Cognitive Distortions 

Individuals who suffer from depression or complications in grieving generally have a faulty cognitive view of reality.  Due to the event, loss, or trauma, there is a type of worldview that haunts them and adversely affects their emotional and behavioral response to life.  For those suffering from depression or complicated loss, many have a variety of distorted views which include:

  • All-or-nothing thinking: Viewing situations in binary terms, without considering nuance.
  • Catastrophizing: Anticipating the most adverse outcomes without empirical justification.
  • Mind Reading: Presuming to understand others’ thoughts without direct evidence.
  • Emotional reasoning: Basing conclusions on emotions rather than objective data.
  • Labeling: Characterizing oneself or others based on a singular trait or event.
  • Personalization: Attributing external events to oneself without a clear causal line

 

McCleod. S. (2023). Cognitive Behavioral Therapy (CBT): Types, Techniques, Uses. Simple Psychology.  Access here

As McCleod points out, many of these distortions are assumptions that usually are tied to lower self image or negative self schemas.  These negative self schemas play a key role in the illogical thinking and ideals of a depressed person

Cognitive Triad and Cognitive Distortions 

Beck used the example of the Cognitive Triad that illustrated three ideals of self, the world, and the future.  In all cases of depressed individuals, the self image of the person was negative, the ideal that the world hated them was present and that the future possessed no future blessings.  Beck theorized that this triad stemmed from a negative schema in life that originated from a negative life event that was never processed properly.  This in turn led to a complication in grieving or adjusting.  From these events, a series of even more cognitive distortions emerged within the depressed person in how they viewed life itself.

Among the many included magnification of bad events or minimization of good events, over personalization of others emotions as if they are correlated with oneself, and  improper correlation of negative causal events with oneself (select abstraction).  As one can imagine, a depressed person is trapped not only with emotional imbalance but is also haunted daily with these negative cognitive sequences

CBT Process

CBT challenges these thoughts.  It looks for one to reframe them and see things in different lights.  It looks to gain a better understanding of these thoughts and behaviors and incorporate better problem solving ways to deal with them.  This reframing involves first a serious discussion and revisiting of the activating event and understanding it more objectively.  Sometimes the therapist will utilize exposure therapy with the patient, asking them to discuss and think about the past incident.  For more traumatic or painful memories, this takes time and over sessions, longer exposure occurs.  Sometimes, this is through direct memory or pretending to be a bystander watching the past.  This challenges the person to face one’s past, fears and trauma and move forward.

Following analysis, one is asked to discuss thoughts and emotions associated with the event.  This is where illogical and damaging thoughts and behaviors can identified and weeded out.  The patient is given alternative ways of thinking and reframing thoughts about the event, as well as ways to better cope with daily issues.  This is key in helping the individual.  The therapist not only unroots the cognitive distortion but also gives the patient the psychological and mental tools necessary to alter negative thoughts and behaviors in association with the event.  Sometimes, the therapist and patient can role play a future event to help the patient better prepare for interaction.  Other tools include meditation and ways to calm oneself when a potential social trigger presents itself that can challenge the new reframing.

CBT gives the patient the opportunity to also be their own therapist.  To work through issues, apply skills and complete homework assignments.

It is essential in CBT to identify and recognize the distorted thought or maladaptive coping in response to the event and give the person the tools necessary to properly understand the issue and reframe it for healing purposes.  CBT usually takes 20 sessions or so to finally uproot the issue and help reframe and correct distorted thinking.

Limits of CBT

While CBT is successfully, it can have limitations.  It is based primarily upon the cognitive thought process and looks to correct maladaptive coping and distorted thoughts to help the person find balance, but other therapies, such as the Psychodynamic Approach Looks at the emotional response stemming from the past event and how that event negatively affects present day emotions.  The Freudian Psychodynamic Approach finds the repressed feelings and how to cope with those feelings.  If utilized in combination with cognitive, I feel both approaches integrated can help the person have a more holistic and complete person healing process.  The other limitation of CBT is if solely utilized as talk, it does not address the chemical imbalance within the brain and neurotransmitters.  Sometimes, serotonin balance is necessary and depression medications are necessary to help a person find new balance and alter thought process.

Hence, a multi faceted approach is sometimes necessary in treating a person, not merely an intellectual approach.  This does not mean CBT is not highly effective. It is extremely useful tool in helping individuals reframe negative thoughts and behaviors due to an incident and helping them correct those issues.

Conclusion

Please also review AIHCP’s Grief Counseling Certification and see if it meets your academic and professional goals

CBT and other therapies combined are excellent ways to help correct complications in grieving stemming from distorted thinking and helping the individual from an intellectual standpoint reframe and understand the loss in a logical way void of false images.  It is a heavy talk based therapy that asks one to revisit the past, rethink and reframe it, and correct distorted thoughts and behaviors.  It sometimes requires additional therapies with it to help others overcome depression or complications in the grieving process but overall is very successful.  This type of therapy or any grief therapy is reserved for licensed therapists.  Pastoral grief counselors who are not licensed need to refer more serious cases of grief and loss to these types of licensed counselors.

Please also review AIHCP’s Grief Counseling Certification.  The program is open to both licensed and unlicensed Human Service professionals and offers an online and independent program that leads to a four year certification.

Additional Resources

“Cognitive Behavioral Therapy (CBT)”. Cleveland Clinic.  Access here

“What is Cognitive Behavioral Therapy?”. (2017).  Post Traumatic Stress Disorder. APA. Access here

Raypole, C. & Marcin, A. (2023). “Cognitive Behavioral Therapy: What Is It and How Does It Work?”. Healthline.  Access here

“Cognitive Behavioral Therapy” Psychology Today.  Access here

 

Parenting and Grieving Video

Parenting can be difficult but parenting while grieving can be even more difficult.  Trying to balance child care, career and home with emotional distress can sometimes seem impossible.  It is even harder for single parents with less support.  It is important to express grief and share it with your children and to find time for self care.  It is essential to allow oneself to grieve but not to keep it oneself and pass on bad grieving habits to children.

Parenting while grieving can be a difficult time to navigate. Please also review AIHCP’s Grief Counseling Program

Please also review AIHCP’s Grief Counseling Certification and see if it meets your academic and professional goals.  The program is online and independent study and open to qualified professionals.

 

Please review the video below

Assessing Complications in Grieving

Grief is a natural reaction to loss.  Grief is the price of love and as long as love survives, the bond will never be broken.  Even though one may never see the other, the bond remains.  How that bond exists is important.  If the bond remains and the person is again able to reintegrate into society, then it is a healthy bond, if however, the bond prevents one from living again, then the bond is existing at an unhealthy state.  Also bear in mind, whether the loss is death, or any type of loss, complications can occur where one does fully readjust and adapt to the new situation.  In all these cases, the grieving process, while natural, became unhealthy due to a variety of issues.  In Grief Counseling, we refer to unhealthy adjustment in loss as Complicated Grief.

Complications in grief prevent individuals from successfully navigating the grieving process. Grief Counseling can help

Complicated Grief can be seen as an extreme grief reaction beyond what is defined as normal, or as an absent grief reaction all together.  It can also be seen by its manifestations upon the mental, emotional, physical and social aspects of the person, as well as its duration.  It can occur at any point within the grieving process and keep a person at a particular stage of his/her grief.

Some cases of grief are more susceptible to complications in grieving, albeit not guarantees of complications. Such losses that are extremely traumatic as found in war, natural disaster, rape, grotesque displays of death, and acts of terrorism can have more serious imprints upon the brain and cause PTSD and grief complications that prevent the evil from being processed.  In addition, extremely painful losses such as the loss of a child or parent,  or suicide can have a more impactful sting to a person’s recovery.  Finally, sudden losses can also shock the system.  If a loved one is murdered, dies in a car crash, or one is suddenly faced with a personal loss or injury, then grief responses can be become complicated

Grief Counselors have a special role in monitoring grief trajectories to ensure they remain steady and on normal pace.  While everyone grieves uniquely, there are general human responses to loss that involve stages of denial, anger, bargaining, emotional distress, restructuring and re-adjusting to the loss itself.  Within this, individuals may bounce back and forth between stages, or oscillate in extremity of emotion from day to day, but there is a general measurement that is not equated as pathological.   Grief Counselors who are not licensed counselors need to spot complications in grief and refer patients to licensed counselors when depression or complicated grief appears.  Licensed Counselors with expertise in grief can then help the person unblock the impasse that permits the person to continue the grieving journey.

It is important to note that grief is not a pathology and individuals suffer from loss and the imbalance it causes for the rest of their lives, but what is pathological is inability to readjust to living life.  It is also important to note that the degree of the loss and attachment play a key correlation with the time to normally recover from a loss.  Time and duration are difficult assessments with deep emotional pain when grading it with a loss.   The attachment and how the person is progressing sometimes needs to be evaluated to see if the person is stuck in complication or merely still progressing at a natural rate.

Key Signs of Complications

Acute grief is extremely painful.  Someone in acute grief cannot function at first.  They are emotionally unable to rationalize, they cannot interact with others, and have no meaning for the loss.  One cannot find complications in acute grief because the grief is raw and new.  In fact, the extreme pain in acute grief is natural and important in the grieving process itself.   When someone is experiencing acute grief symptoms months or years later, depending on the loss, then one can better access if complications have occurred.  If a person is still extremely emotional over the loss as if it just occurred and is unable to process it and feels depression to the point it is crippling to life, then this is a sure sign of a complication.  These emotional intense pains will creep into every aspect of the person’s life.  One’s physical health, stress levels, sleeping patterns and immune response can all take hard hits.  In addition, one’s mental health can decline as a constant state of depression emerges over the person.  Life will no longer have any meaning to the person.  Happiness will be unattainable in any activity.  One’s social life will become isolated.  One may resign from past activities that gave oneself joy and completely disassociate from family and friends.  This will negatively affect profession and career and academics.  Finally, one will maladaptively cope with the issue through possible drug use.  As pointed out, the absence of grief can also be a sign. Maladaptive coping that prevents the person from recognizing the loss can occur.  Individuals may deny the grieving process by keeping oneself busy.  One may avoid cleaning out a deceased’s closet after a year.  These are also signs of not adjusting to the loss in a healthy way.

Complications within the Trajectory

When someone denies a terrible reality or loss, they are naturally protecting themselves.  This is normal in grief reaction, however, if denial persists, then the processing of the loss can never take place.  If a grief counselor discovers constant denial, avoidance of the subject, the person’s possessions, or areas where the person died, then there are chances of a complication in the grieving process that have prevented the person from moving forward in the denial phase.  It is no longer healthy but has become a toxic maladaptive coping mechanism.

If someone experiencing extreme adverse emotions beyond the initial acute phase of grief, then there are also signs of complications within the grieving process.  Individuals may be extremely angry, sad, or guilty even over a death.  Complicated relationships with the deceased, how the deceased passed, a person’s role in the passing of the deceased, unresolved issues with the deceased, and not expressing emotion earlier in the loss can lead to a mass of untamed emotions.  One needs to discuss these emotions and why they are exhibiting themselves later in the grieving process.  Through grief counseling, one can better understand the source of the emotions and help individuals come to grips with how they felt about the person, the person’s death and their emotions in relationship to it.

Becoming stuck in grief is a sign of complicated grief. An individual is trapped in the grieving process and unable to adjust to the loss in a healthy way

Someone who is suffering over depression, or suffering from pro-longed grief have exceeded any normal time frame.  Again time frames and duration of grief can vary, but a good grief counselor can calculate if someone is experiencing excessive duration and depression.  When the person has lost meaning to life and is unable to find happiness over an extended period of time after the loss, then the person needs professional aid in fighting off the depression which may be chemically based as well.

Other individuals suffer from an inability to reorganize their lives and find meaning the loss.  They are unable to live with the loss but still live from day to day.  Individuals may not be able to make new connections or tie the loss of the past to the present and future.  They remain stuck in the past and unable to proceed into new venues.  They feel obligated to the past.  They may utilize maladaptive practices such as drugs to cover feelings or ignore new events.  They may not be able to visit a grave, or discuss the loss.  The deceased’s past is only of pain, with no remembrance of happiness or smiles.  Healthy grieving permits one to have both sad and happy memories.  It allows one to make new connections with people without feeling a betrayal to the deceased.  It permits one to find meaning in the deceased’s life and push forward with that meaning into other venues or social agendas.

Resiliency

Most individuals who grieve losses face difficult acute phases but grieve naturally.  They are able to process the loss and move forward in life despite the pain.  For the percentage who does not grieve normally, one should not consider weak.  Resiliency to loss has many factors.  The nature of the loss itself has a large impact to the adjustment to it.  Again, objective natures of loss can play a key role into how one recovers.  Traumatic, stigmatic, sudden, or severe loss can play key role in preventing processing of a memory or loss.  Others who face complications may have family history of depression and a natural serotonin imbalance, hence reducing resilient behavior.  Still others without emotional support can face a difficult uphill battle in adjusting to the loss.  Individuals with family and social support have an easier time healing from loss than those alone or with unsupportive friends and family.  Others have proper guidance to avoid maladaptive coping mechanisms such as drinking and find guidance in support groups that offer other venues to cope with loss.  Prayer, mediation, exercise and hobbies are ways they adjust to the pain and loss itself.  Finally, individuals whether religious or not that hold to some world view to anchor them have a better chance of adjusting to loss over time.

Conclusion

Hence when grief is not processed properly, complications can occur within any point within the trajectory.  Complications manifest in extreme emotions or lack of emotions well beyond the acute phase of grief and duration of these emotions exceed normal process ranges.  They prevent the person from moving forward and adjusting to the loss in a healthy way.  Grief Counselors play a key role in helping individuals remain on a healthy trajectory, with special care to the unique grieving situation.  Licensed counselors who are also grief counselors can play a key role in helping those who fall off the healthy trajectory and help them again find the care they need to find adjustment to the loss.

Please also review AIHCP’s Grief Counseling Certification and see if it meets your academic and professional goals

Again it is important to note that grief is normal.  It is  natural and healthy process.  Grief is not an imbalance that needs corrected.  There is no true recovery but more so a process that leads to acceptance of the loss and finds meaning in the loss.

To better help others through the grieving process, the American Academy of Grief Counseling and AIHCP offers a four year Grief Counseling Certification for qualified professionals.  The program is online and independent study and open to those interested in helping others navigate the murky waters of grief. Please review AIHCP’s Grief Counseling Program and see if it meets your academic and professional goals.

Additional Resources

“Complicated Grief”.  The Mayo Clinic.  Access here

“Complicated Grief.” The Cleveland Clinic.  Access here

Sutton, J. (2022). “How to Treat Complicated Grief in Therapy: 12 Examples”. Positive Psychology.  Access here

Shear, K. et, al. (2013). “Bereavement and Complicated Grief”. Psychiatry Rep. 2013 Nov; 15(11): 10.1007/s11920-013-0406-z. National Library of Medicine.  Access here

Talbbl, R. (2017). “Six Signs of Incomplete Grief”. Psychology Today.  Access here