grief counseling certification

Challenging and Encouraging Clients in Counseling

Posted on by Dominick Flarey

To help transform a person to change, attending, listening and responding are key, but the skilled counselor needs to be able to help instigate change or water the seeds of the healing process within a client.  Whether loss and grief, or merely more daily stressors or emotional issues that are holding the client back from living life productively, the counselor needs to know how to coach the client and help the client find that preferred outcome.  This involves not only identifying the goals and actively pushing towards them but also motivating and challenging them.  Like a coach who is able to abstract the best out of their players on the field, a counselor needs to be able to encourage and challenge his/her clients to produce meaningful change.  Some clients respond better, others may be still facing inner turmoil and self esteem issues.  Some clients may be more resilient naturally, while others may need more prodding and gentle and empathetic guidance.  Each client is unique and different but the general ideas within this short blog complement the previous blogs on attending the client and responding to the client.

Challenging and encouraging a client to change is much like a coach trying to get the best of a player on the field

 

Some clients may have zero motivation to be challenged.  They may possess some world view or bias that prevents this change.  Some may be forced to attend counseling and feel no need to change.  This can occur with state mandated counseling or clients forced to attend because of family or spouses.  Some clients may feel motivated simply because of guilt and look to foster a positive change.  Some may simply have an interest in the counseling process and wish to see what happens.  In the best case, one will find a client who understands the critical importance of counseling and the changes that need made.  Regardless of the clients motivation level, it is the purpose of the counselor to help bring the best out of the client. This can be easier said then done.

 

 

 

The Counselor as Coach?

Life coaching in itself is a newer field within the Human Service Field.  It is not clinical or requiring of various licensing but it does promote the idea of healthy change and life styles.  It involves a professional who is trained to motivate, direct and help clients meet end goals.  This involves both encouraging and challenging the client.  Whether it is a weight goal, training goal, dieting goal, or health and life style change, life coaches are inherently trained to help produce change through motivation, encouragement and challenging of their clients.  Counselors, whether pastoral or clinical, working in grief counseling or other mental counseling disciplines, through empathetic listening and responding, should have a vested interest in helping their clients meet change, but some may lack the skills to help motivate the client to change.  As counselors, the client is directed and given options, but is never commanded or forced to change, instead, the client is invited to change through an array of options.  Many times, clients need motivated and encouraged and even challenged to push forward through these options. Many times they may fall and need help getting up.  Again, like a coach in sports, it is the counselor’s profession to not only direct, but also to help the client emotionally and mentally push towards that direction.

Challenging for New Behaviors

According to Egan, it is important to challenge clients to change.  He states,

“Help clients, challenge themselves to change ways of thinking, expressing emotions, and acting them mired in problem situations and prevent them from identifying and developing opportunities…become partners with your clients in helping them challenge themselves to find opportunities in their problems, to discover unused strengths and resources, both internal and external, and to commit themselves to the actions needed to make opportunity development happen (2019, p. 190).

In challenging, Egan emphasizes the importance of the counselor and client relationship which is based on trust and partnership.  A counselor, in the eyes of the client, needs to earn the right to challenge.  Once this is established, the counselor needs to ensure that challenges are presented tentatively but not apologetically, with a balance between not being too harsh but not also too passive.  In addition, counselors need to ensure the challenges are clear and specific.  Challenges also should not make demands or be forceful in nature but provide a structural system of choices.  As the term challenge indicates, it is never easy, so help clients utilize unused strengths to help meet the challenges and the ability to build on successful challenges to meet new ones (2019, p. 220-225).  As Egan points out, the counselor should be a “catalyst for a better future (2019, p. 190)”.

Many times, a counselor has to identify what is preventing the person from being able to face a challenge in life

In challenging clients, many times, they have many inherent issues that are already hampering them with the problem and maybe life in general.  To help clients become more resilient and able to create new behaviors, counselors sometimes need to identify blocks and issues within the client.  Egan lists a variety of target areas that negatively affect a client’s ability to respond to challenges and delay productive and healthy change.  Through attending, listening and responding, a counselor is able to identify certain issues that may restrict the ability of a client to respond effectively to challenges.

The first issue Egan lists are what he refers to as self defeating mindsets that include “assumptions, attitudes, beliefs, values, bias, convictions, inclinations, norms, points of view, perceptions of self and the world, preconceptions and prejudices (2019, p. 190-191)”.   Albert Ellis looked at facing irrational beliefs head on with interventions that would challenge irrational mindsets.  According to Ellis, many individuals have flawed misconceptions on life.  Egan lists a few of these ideals.

  • I must only be liked and loved in life
  • I must always be in control in life
  • I must always have my things done my way or no way
  • I should never have any problems
  • I am a victim and not responsible for any of my issues
  • I will avoid things that are difficult
  • I believe my past dictates what I do in the future
  • I do not need happiness in anything or anyone else

(Egan, 2019, p.191)

Ellis considered these mindsets as impediments to change because when something did happen that was bad, the person would tend to “catastrophize” it and become unable to adjust to the problem or even be remotely open to challenges to face it.  In addition to these mindsets, Egan points out that some individuals embrace in four fallacies that hamper change, as according to Sternberg.  Among those listed by Sternberg were egocentrism and taking into account only one’s own interests, omniscience and thinking one knows everything about the issue, omnipotence and feeling one can do whatever one desires and invulnerability and one will never face true consequences (2019, p.192).  Obviously these four fallacies are undesirable characteristics and whether naive or part of a greater personality disorder, they are issues that can prevent true change in the client.

In addition to mindsets, some individuals may have self defeating emotions and feelings that prevent them from achieving goals.  They may possess low self esteem or poor self image.  They may have fears that prevent them doing greater things.  Others may possess various dysfunctional behaviors that are external in nature.  In essence, the person cannot get out of their own way in life.  Their behavior, unknown to them sometimes, continues to create the issues they are trying to escape. Others may possess discrepancies in what they feel and think in regards to what they say and do and how they view themselves versus how they are truly viewed by others. Other times, individuals can be hampered in making true change or answering challenges because of unused strengths or resources (Egan, 2019, p. 194-197).

Other “Blind Spots” within the client preventing and hampering change can include various levels of unawareness.  This can include being blind to one’s own talents and strengths seen by others but not perceived by the self.   Some individuals may be unaware due to self deception itself, or choosing ignorance.  Some individuals will avoid issues and problems because they simply would rather not know because the truth may be too terrifying.  In helping clients challenge themselves to new behaviors, counselors can open clients to new areas of awareness with simple self questions.

  • What problem am I avoiding?
  • What opportunities am I ignoring?
  • What am I overlooking?
  • What do I refuse to see?
  • How am I being dishonest with myself?

(Egan, 2019, p. 204)

As the counselor, but also a coach, it is important to help clients identify these issues and understand why they are unable to move forward.

Helping Clients Identify These Issues and Healthy Challenging

Carl Rogers promoted a empathetic approach. In helping others face hard realities, a fact based empathetic approach is key.  Showing patience and empathy and carefully presenting the issue with assertiveness but compassion is key in helping the client awaken to certain issues.  Of course, timing, tone, and words all play a key role in helping the client become acceptive.  The counselor cannot come across as afraid to address issues but not confrontational.  Sometimes, certain words, may offset a client or labels, and the counselor will need to navigate why and how to discuss the issue.  Also within this process, the counselor cannot simply give a set of directions but present options.  Finally, again, the counselor needs to present the new awareness and challenge to the client without judgment but in a way that creates self awareness and pushes forward change.

Counselors help motivate clients to change through empathy and supplying the client with appropriate level challenges and options to meet

When discovering hindering blind spots and issues, the counselor needs to become a detective in some respects before he/she can truly become a coach.  What is the client truly trying to say, or hinting at, or half saying (Egan, 2019, p.206)?  Counselors need to help clients understand their implicit thoughts and words and make them become more explicit.  In doing so, counselors can help clients understand themes in their stories, make connections with what may be missing and share educated hunches in feedback (Egan, 2019, p. 207-210).  Counselors can through their hunches, help clients see the bigger picture, dig deeper in the story, draw conclusions, open up more, see overlooked aspects, or even own their own story (Egan, 2019, p. 210-211).

 

 

Of course how these opinions and disclosures are presented to the client are critical.  They are part of the art of counseling and also the product of good coaching. A good coach is able to present a deficiency in a player’s form or approach and help turn into change and better performance.  This however involves not tearing down the player, but building the player up and giving the player the tools necessary to improve.  As an teacher and encourager, a coach is able to transform the problem and help the player have success on the field.  Likewise, an counselor needs to be able to coach his/her client through approaching a weakness and being able to challenge the person to overcome it and make it a strength in the field of life.  Strength Based Therapies as proposed by Pattoni, (2012) help clients label their strengths and identify them and utilize them in variety of goal setting environments. The process looks to expand hope but also create autonomy in facing issues.

When providing factful information and options to a client, a counselor needs to remain empathetic and tactful in delivering the news.  Some news can be shocking to a client and the client may need time or understanding in the process (Egan, 2019, p. 213).  Hence Egan recommends sometimes sharing one’s disclosures and challenges, but he recommends it to be used with caution.  He recommends being sure to use it sparingly, appropriately and culturally aware.  Timing can be key.  One does not wish to have one’s own disclosure to become a distraction (2019, p.215).

As a counselor and coach, how one gives suggestions and recommendations for better improvements are critical.  Inspired first with empathy and secondly aware of internal issues of the client, a counselor needs to approach and challenge the client without confronting but at the same time presenting clear and factual options to promote change.  These challenges are not easy, so like a good coach, a counselor needs to find ways to provide encouragement during the change process.  Counselors should invite clients to challenge themselves and help them identify specific challenges that will make the best changes.  Like a sports coach, while identifying any issue, the counselor needs to encourage and identify strengths to overcome a particular challenge.  Furthermore, the challenge needs to be evaluated as not to be too intense to be self-demeaning to the client.  Sometimes, success is built upon.  So when identifying challenges, the counselor needs to present them in a fashion that leads to success (Egan, 2019, p. 220).

As a counselor-coach, a counselor identifies changes that are essential and helps the client identify change.  Some clients are more resistant to change.  In another blog, we discuss the Client Change Scale which lists the levels of difficulty for a client to accept change or implement it based on their stage.  It is the counselor’s job to help the client see the necessity of change and help the client find it through encouragement and help.  Some changes will be first order, or deal with the current situation, or others may be second order and more long term or permanent.  This depends on the nature of the issue and the needs of the client.  The counselor like a coach, helps the client implement goals, strategies and plans to implement the change.   The counselor helps the client see his/her possible self, delve into creativity,  and think differently (Egan, 2019, p. 315-318).  In essence, the counselor helps the client see a better future, set goals to attain it and help them put it into action (Egan, 2019, p. 314).

 

Conclusion

Counselors are like coaches.  They need to challenge their clients by identifying weaknesses and help clients overcome them with appropriate challenges.  This involves active attending and responding to the client and understanding the inner challenges the client faces.  The counselor then is able to better become a catalyst of change in the clients life with setting appropriate challenges to make the client a better person in the field of life.

Please also review AIHCP’s multiple counseling certifications in Grief Counseling, Christian Counseling, Life Coaching, Anger Management, Stress Management and Crisis Intervention Counseling

Please also review AIHCP’s Grief Counseling Certification, as well as its Christian Counseling Certification.  Other mental health certifications for both pastoral and clinical counselors, or those engaged in the Human Service Fields, include Stress Management, Life Coaching, Anger Management, and Crisis Intervention. The programs are online and self study and open to qualified professionals seeking a four year certification in any of these fields.

 

 

 

 

 

 

 

Reference

Egan, G. & Reese. R. (2019).”The Skilled Helper: A Problem Management and Opportunity-Development Approach to Helping” (11th Ed). Cengage

Additional Resources

Sutton, J. (2022). “Motivation in Counseling: 9 Steps to Engage Your Clients”. Positive Psychology.  Access here

Sutton, J. (2022). “How to Perform Strengths-Based Therapy and Counseling”. Positive Psychology. Access here

“The Skill of Challenge in Counselling”(2019). Counseling Tutor. Access here

Voitilainen, L. et, al. (2018). “Empathy, Challenge, and Psychophysiological Activation in Therapist–Client Interaction”. Front Psychol. 2018; 9: 530. National Library of Medicine. Access here

 

Responding Skills in Counseling

Posted on by Dominick Flarey

In the previous blog, we discussed listening skills and observing skills of the client.  Good listening and observation set the stage for proper responses.  In this blog, we will shortly review core concepts in turning listening into positive and productive  counselor responses that help the client through the counseling process.  Attending skills are essential in any type of counseling, especially grief counseling.  When these basic skills are absent, the client can feel neglected or misunderstood.  Good grief counselors, whether licensed clinical counselors or non-clinical counselors, are able to incorporate these skills to enhance the therapeutic nature of counseling and keep the client as an active and on going participant in his/her mental health.  Bear in mind, good responses are not necessarily saying the most profound or theory correct statement, but the particular response that is best for the particular stage of counseling and needed comment.  Sometimes the responses may be short or longer, statements or questions, informative or probing, but they all have a particular reason and are the tools of the trade in discovering issues and helping clients find better outcomes.

Identifying Emotions in Counseling

Grief Counselors need to identify emotions when preparing a response or prompt to help the client’s story proceed smoothly

In the last blog, we spoke about the vital importance of observation and how a grief counselor needs to identify verbal but as well as non-verbal cues in a client that can illustrate a particular issue or feeling.  In formulating therapeutic responses, grief counselors and other counselors need to identify the particular emotion of an attending client.  This involves identifying the words associated with the emotion, implicit and unspoken emotions, and any non-verbal cues of the emotion expressed (Ivey, 2018, p., 170).   Based from the core universal feelings across cultures, a counselor should watch for sad, mad, glad and scared (Ivey, 2018. p., 171).   These are root words for all emotions and a grief counselor can build from these words to more complex emotions.

It is crucial to employ empathetic responses.  Like the previous blog, which emphasized empathetic listening, again, the word empathy appears in counseling.  The grave importance of empathy allows the counselor to become involved in the client’s state of being in a true and understanding way that helps the counselor produce productive and positive change.  Empathetic responses help the client feel understood and not judged, or admonished.  Hence, responses to emotions need to be empathetic and caring in nature.   Egan reports three important types of empathy in responding from the work of Arthur Clark.  He first lists subjective empathy, which puts the counselor literally in the client’s life and helps the counselor understand the emotional state of the client.  Second, he lists the term objective empathy which ties to the studies of the counselor and the counselor’s own personal experience in counseling.  Tying these together is a third type of empathy referred to as interpersonal empathy, which ties together the client’s feelings and the way the counselor is able to communicate it as well as any needed information (Egan, 2019, p. 132-133).

Interpersonal empathy involves the ability to perceive the issues, the know how to state it and the assertiveness when to input it (Egan, 2019, p. 134-137).  Grief Counselors need to perceive the emotion on display, the ability to articulate it and the assertiveness to sometimes address it when uncomfortable.  It is important to report what is said back with empathetic accuracy (Egan, 2019., p. 137).  Ivey also emphasizes the importance of accuracy in naming particular emotions.  He points out that counselors should use the words to describe the emotion by the client and also attempt to articulate the emotion with name and when only seen non-verbally as close as possible to what the client is experiencing (2018, p. 171).  Egan continues that is important when naming emotions to remain sensitive when naming them, as well as to not over-emphasize or under emphasize them.  He also encourages counselors to be aware of cultural sensitivities as well when naming particular emotions (2019, p. 139-142).

 

Prompts in Counseling

Some clients may speak openly about issues of loss, trauma or everyday issues.  They are a flood of information.  Other clients may be more shy, untrusting, or quiet in how they detail their issues.  Obviously, building trust is key within the therapeutic relationship and plays a large role in receiving vital information during the listening phases. However, sometimes it takes various prompts, nudges, or encouragements to help a client discuss difficult issues.  The art of counseling involves keeping a steady dialogue and flow between client and counselor and this falls upon the counselor’s shoulders to ensure this productive process.  According to Egan, probes are extremely beneficial in helping clients engage more fully, especially with more reluctant clients, in identifying experiences, feelings and behaviors.  They further help clients open to other areas of discussion and engage in conversation with more clarity and specifics.  They can also help clients remain on target and on important issues (2019, p. 177).

There are a variety of ways to help a client continue the story through prompts such as paraphrasing, summarizing, or open ended questioning

Some encouragers can be as simple as “uh huh” or a simple phrase of understanding which serves as a bridge for the client to continue speaking (Ivey, 2018, p. 148).  Sometimes, as simple, as saying “I see” or “okay” or “please continue” are strong enough phrases to encourage the client to continue the story. Sometimes the counselor can merely restate the emotion in a particular tone expressed by a client which further facilitates further discussion.  These simple prods can break silence and encourage the client to continue with the story.  Others can be simple non verbal movements, as a nod of the head, a particular look or leaning forward (Egan, 2019, p.161).  Prompts, probes or nudges can also take the form in longer responses.  Counselors can make statements, requests, or ask particular types of questions to better understand the story and also to properly push it forward.

Questions in particular have high value in counseling.  They help the counselor not only understand and clarify points, but they also show the client a sincere interest on the part of the counselor and sometimes can push the client to delve deeper into an issue and find more self discovery.  Questioning, however, for the pure purpose of questioning can be counter-productive and make the client feel they are being interrogated, so questions need to be utilized sparingly and effectively (Egan, 2019, p. 163).   Ivey points out that there are types of questions that are open and closed (2018, p. 124).  Both have their purpose and time but need to be utilized properly in order for the question to be effective.   Open ended questions, as a rule, should be utilized most.  These types of questions do not end with a simple response of “yes” or “no” by the client but look to abstract more information and input from the client.  According to Ivey, most open questions begin with the words “how”, “what”, “where”, “when” or “could” (2018, p. 124). Close ended questions look for a particular concise answer and have value but usually are used when the counselor is looking for a particular answer while the counselor is primarily talking during the session.   Another great question is the “what else question”.  This question looks for any additive elements to the story or if the counselor is missing anything (Ivey, 2018, p. 125).  Remember, if the counselor does not understand something, then questions or statement looking for greater clarity are better than pretending to understand.

Another important prompt involves paraphrasing.  Paraphrasing is a useful tool utilized in responses by counselors to help keep the conversation going or to help the client hear reflectively what the client has stated.  Sometimes the mere power of hearing something back has immense value.  When a counselor paraphrases, the counselor usually states the emotion in a sentence and then concludes with a “because” phrase.  For instance, a counselor may paraphrase to a depressed client by stating, “you are depressed because you no longer feel any energy”.  This paraphrase can illicit additional information or continue the conversation, much in the same fashion as a simple nod, or phrase.  Ivey points out that paraphrasing is not repetition but also adding some of the counselor’s own words (2018,p. 148).  It is important to note that when paraphrasing, if something is worded incorrectly, the counselor should apologize and ask for deeper clarification.  Sometimes, hearing certain things back can trigger an individual, or if worded differently, and the client is not ready to hear the interpretation, the client may respond quickly, or begin to close up.  Cultural issues can sometimes play a key in this.

Finally, Summaries are a critical promoting tool in responding to a client. Summaries are more detailed paraphrases that adds more depth to the conversation.  They are usually utilized to begin an interview to help bridge the previous meeting, or to conclude a meeting, but they have other purposes as well during the session (Ivey, 2018, p. 148).  Egan points out that sometimes a more detailed summary can help during a session when the discussion is not going anywhere.  They can also be utilized to help the client see a new perspective (2019, p. 178-179).   A counselor utilizing a summary for purposes of illustrating a new perspective can state “I’d like to get the bigger picture… or “I’d like to put a few things together” (Egan, 2019, p. 179).   According to Egan, it is also important to help clients create summaries.  The counselor can ask the client to put together the major points or concerns of the issue and to articulate them Egan, 2019, p. 180).

Carl Rogers saw the importance of these ways to respond.  In this Basic Listening Sequence BLS, he saw the skills of the counselor in how he/she responds to be most crucial.  The utilization of open/closed questions, encouraging, reflecting feelings, paraphrasing and summarizing were all critical elements in the empathetic relationship and understanding the story (Ivey, 2019,p.194).

Pitfalls to Avoid When Responding

Responses while helpful can also be detrimental when not properly utilized by the counselor during a session.  A counselor needs to avoid certain responses that derail the process or make the client uncomfortable.  Not responding or asking too many questions are two extremes to avoid.  Not responding can remove merit from a statement or display disinterest to the conversation.  While sometimes silence can be powerful, not saying anything or responding is usually non productive to the counseling session (Egan, 2019.p. 155).  It is also a dis-service merely to respond for the sole purpose of it.  Counselors should avoid parroting or repeating without context  Parroting dismisses any empathetic response (Egan, 2019, P. 156)

Counselors need to avoid distracting questions when working with clients

In addition to not responding, some counselors misuse questioning.  They can either over utilize it and make the session appear as an interrogation, or ask distracting questions that inflame rather than heal.  For instance, instead of responding with empathy, some counselors can ask inflaming and distracting questions that upset the client.  Instead of focusing on the client’s feelings, the question looks at how the client may have responded. “Did you confront him” or ” Did you do anything at all” or “Are you positive you cannot resolve this” (Egan, 2019., p. 155).  These questions again distract from the story and the emotion and can cause irritation in the client as he/she focuses on a personal injustice or slight.

Cliches are another responses that should be avoided.  In grief counseling,  cliches are counter-productive.  In general counseling, they are also counter-productive.  Cliches can minimize the conversation and cheapen it.  They attempt to replace understanding and empathy with a more generic and impersonal response (Egan, 2019, p. 155).  Clients can hear cliches from the next door neighbor, they do not need to hear them from trained professionals that are their to help assist them in resolving issues.

Another pitfall is how counselors advise clients.  In the counselor-client model, most people expect advise from a counselor.  Other cultures may demand it.  However, in counseling, the counselor does not exist to advice a course of action, but presents a host of options for the client to choose. The client is in control and the counseling relationship is one of teamwork and collaboration.  When the client is told what to do, then the counseling relationship strips the client of self discovery and self healing.  The client is not looking for a family member to give un-wanted advice, but a set of options.  Instead of saying what to do, instead utilize “if I was in your situation, here are a few options that I might look into” (Egan, 2019, 156).

Interpretations based on theories and models are also tempting responses that have a time and place but usually not in responses.  A counselor may have a wealth of knowledge to share, but when interpretations and labeling of an client’s state of mind overtake empathetic responses, then the process of counseling can become derailed.  Instead of giving a moralistic interpretation based on past study, respond to the client’s feelings (Egan, 2019. p. 155).

Counselors need to be also honest in their responses to a client.  Pretending to respond with ingenuine “Uh huh” or “Ok” can lead to later issues when the counselor is expected to remember or understand something previously stated by the client.  Hence if, one loses sight, or track of a story, it is far better not to pretend to understand but to ask for clarification.  This is not only polite and professional but it also shows genuine interest and also pushes the client to better explain the issue which alone may be beneficial (Egan, 2019, p. 157).

Finally, a counselor’s response should not be sympathetic and agreeing for the sake of being so.  Empathy is far different than sympathy.  Many times sympathy can drown logic and allow one to lose focus on the facts.  An empathetic counselor while caring remains grounded.  The counselor response is not overtly sympathetic or judgmental but one that addresses emotion and the issue in a caring way.  The client is looking for help beyond a shoulder to cry on (Egan, 2019, p. 157).

Conclusion

A grief counselor’s response to a client is key in helping the client tell the story.  The response is tied to good observation of the client’s emotions.   Good responses are helpful in transitioning the story, moving it forward, but also in in proper feedback about the story.  Empathy is the guiding force in responding.  Grief Counselors can utilize nudges or prompts with verbal and non-verbal responses. Some verbal responses can be one word or a phrase, while some may include paraphrasing or summaries.  Good counselors utilize responses like an artist and interweave them throughout the counseling process.

Please review AIHCP’s multiple mental health certifications including Grief Counseling and Christian Counseling

Please also review AIHCP’s numerous mental health certifications that involve counseling skills.  AIHCP offers a Grief Counseling Certification, as well as a Christian Counseling Certification.  Other topics include crisis counseling, stress management and anger management.  All of the programs are online and independent study and open to qualified professionals seeking a four year certification.

 

 

 

 

 

 

References

Egan, G & Reese. R. (2019). “The Skilled Helper: A Problem-Management and Opportunity-Development Approach to Helping” (11th Ed). Cengage

Ivey, A. et, al. (2019). “Intentional Interviewing and Counseling: Facilitating Client Development6 in a Multicultural Society” (9th Ed.) Cengage

 

Additional Resources

Bennett, T. “Empathic responding (or active listening) in counseling: A basic, yet essential response for counselors to master in their practice”. Thriveworks.  Access here

“ENCOURAGERS, PARAPHRASING AND SUMMARISING”. Counseling Connection.  Access here

“What Are The Benefits Of Paraphrasing In Counseling”. Processing Therapy.  Access here

 

 

 

Grief Counseling Video on Journaling

Posted on by Dominick Flarey

Writing about our feelings is an important way to express in a positive and healthy way.  Within CBT it has numerous effects in helping the person reframe and identify troublesome emotions and behaviors. It allows one to express but also cognitively review and respond to the self.

Instead of maladaptive coping, journaling helps the individual express without hurting oneself with damaging practices that lead to worst grief responses.  It grants the person privacy in expression but also grants the person control.  The person controls what is written as long within the confines of where the person writes, the person is able to safely release the pain in a positive way.

Please also review AIHCP’s Grief Counseling Certification and see if it matches 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.

 

Neurotransmitters and Mental Health Video

Posted on by Dominick Flarey

Neurotransmitters play a big role in our mental health from a physiological view.  They are important chemicals without our brain and body that balance various moods.  Serotonin for example when balanced regulated mood disorders such as depression.  Proper balance and understanding of these transmitters play a key role in mental health.  Sometimes it is diet, other times it may require medication to find balance, but most licensed mental health care professionals can help individuals find the mental help they need if an imbalance occurs.

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.  AIHCP also offers a variety of other mental health certifications for other professionals as well.

Strategies and Prompts in Helping Others Grieve

Posted on by Dominick Flarey

Grief is a life long process.  Individuals deal with grief or loss to some extent on a consistent basis throughout life. The more significant losses remain with individuals and the ability of the individual to process the loss, understand it, incorporate it and exist with it are key to normal grieving styles.  Those in the field of grief counseling on both the non clinical and clinical side need to sharpen their talents in helping individuals process the loss in a healthy way and be able to find continuing meaning in life.  This involves not only understanding the various therapies on the more broad spectrum of treatment but how to micro handle daily sessions with individuals with minor positive interventions.  Hence while one may employ CBT as the broad approach to help one heal, the daily encounters and how these encounters occur, allow the overall therapy to take root finds its productivity in certain skills and abilities.   Some of these skills deal with how the grief counselor reframes thoughts, repeats words, shows empathy, or other verbal strategies to help emphasize certain parts of treatment, but positive interventions during treatment involve notation of certain parts of the journey within the inner dynamics of whatever treatment.  As the person tells their grief story, finds self, relationship, memories and continuity within the grief story of one’s life, the counselor plays a key role in highlighting these points.

Grief Counselors can help individuals find meaning in loss through various strategies and interventions throughout the process.

 

 

Junietta Baker McCall’s text “Bereavement Counseling: Pastoral Care for Complicated Grieving” lists a variety of positive strategies and helpful interventions in chapter 7.  She discusses how the therapists or grief counselors can help guide the person in the person’s grief story, sense of self and relationship, and the building of memories and continued continuity in healing through various prompts and interventions during sessions.  These insights go far deeper than a general discussion of a therapy, or utilization of counselor skills, but look at certain points in therapy at a much more micro level where the grief counselor can better help the person through a particular session and goal.  She states that specific strategies and interventions can be “used to respond to grief … and suggest possible ways to engage the grieving individual (McCall, J. 2012, p. 223).

 

 

Strategies in Narrative Therapy

Grief Narrative is a therapy within all overall models of CBT, Psycho Dynamic or Humanistic approaches.  It is the re-telling of the person’s loss and trauma.  It is where everything begins in the healing process.  It permits the person to vocalize the inner feelings and share the loss.  It permits communication and healing and allows for reframing and eventual change in understanding the place of the loss within the person’s life.  Obviously for it to be successful, depends not only the story being told but how the grief counselor is able to guide the individual.

Counselors should utilize the story as a way to develop a caring model relationship that enables them to understand their client.  The story needs to be encouraged to be told no matter the sadness and shared.  In doing so, the grief counselor should grant the person space and time to comfortably tell the story.  The grief counselor should repeat words that need repeated for the person to hear his/her own words echo, as well as show empathy and interest in the telling of the events.   In this way, the grief counselor shows engagement and can later model future healthy grieving models (McCall, J. 2012, P. 225).

Throughout the story, it is important for the grief counselor to accept the therapeutic nature of the grief story.  What matters most is the here and now of the story, not what others think.  At this moment, the important part of healing is the subjective truth of the story to the person.  How does the person feel at this moment in the here and now (McCall, J. 2012, p. 226).  Remain empathetic throughout the story and remain an advocate for the person as the story continues and upon completion of the story within the session, ask the person if the story has been told to the person’s satisfaction.  Upon completion of the story, share observations, address emotions and remain honest in assessments with possible referrals or information to help the person continue the story for next time (McCall, J. 2012, p. 228-229).

With guidance, the story’s initial subjective truths can correlate with objective reality.  The person may recognize various issues within the story, such as blame, or guilt, or anger that once existed that no longer should exist.  In addition, one can begin to reframe the loss within an objective truth as the person heals.

Regaining Self and Connection

Within the grieving process, many times, the person loses sense of self.  One may have had such dependence upon the other that one can no longer function.  Maybe one identified as a spouse, parent or position and when these things are taken, a person loses this important self image.  Again, obviously various CBT or Humanistic Approaches to help cognitively reframe or heal broken images can be utilized, but it is within the smaller bits of communication with the bereaved, where one moves from one point to the next.

It is critical to address and measure a person’s sense of self within sessions.  Asking questions that relate to a person’s self image and how a person may feel since the loss.  Maybe the person is withdrawing from hobbies or no longer finds interests.  These are important notations that can help one measure if one’s sense of self is damaged due to the loss.   McCall recommends utilizing the term loneliness not to just mean when one is alone but a feeling that can occur in any circumstance.  In addition, she uses the term isolation to refer to any inner experience to withdraw from others (2012, P., 237-238).  The grief counselor while helping the person’s self re-find itself, needs to also help the person find relationship with others.  The counselor can describe ways for the bereaved to reach out to others and in what ways

Reclaiming Memories and Meaning

Grief healing occurs when old memories are properly collected, understood, and properly recalled with the present and possible future.  One is able to find meaning of the loss, no matter what it was, and able to tie the loss together within the chapters of one’s life.  The loss has meaning but does not define completely the self or person.  The person continues with the loss, albeit in a healthy way.  The person is able to build new relationships and write new chapters, despite the existence of the loss.

Helping individuals understand memories and how they connect to meaning and healing are important in grief work. Please also review AIHCP’s Grief Counseling Certification

 

In helping individuals, whether through CBT or Humanistic Approaches, grief counselors can pay close attention to particulars and emphasize and carefully monitor certain aspects of this transition during sessions.  It is important to see the gradual transformation of the bereaved throughout the process.  A good grief counselor will see when certain parts are not lining up and where to intervene and help the client proceed to the next important step of adapting to the loss.

The grief counselor should utilize all mind, body, soul connections tied with ritual and belief.  These ideals within the person can play key roles in anchoring the person with meaning in the loss. It is also at this point to ensure the bereaved understands the value of working through grief and that while the first step is to survive the loss, there is so much more beyond just surviving (McCall, J, 2012, p. 252-256).  McCall points out it is crucial for the person to understand that surviving the loss is vital to growth but it still not quality of life.  As the person recognizes this survival, the person will start to set aside other destructive maladaptive coping habits.  These habits need addressed in any counseling.

The grief counselor can help the person progress by asking the client to discuss how it was before the loss.  In addition, discuss current accomplishments, as well as offer encouragement.  Ask the client to fantasize what one hopes life to be like in the future (McCall, J. 2012,. p. 257).

In remembering, teach clients that memories can be unbearable and that is OK.  Ask the client what the memory means to him/her.  Let the client know some events make no sense in life and cannot be made into order.  Let the client know he/she cannot change the memory or event, but he/she can learn to grow with it.  Use other examples of similar stories of how others coped, or present ways to help put an intrusive thought to the back mind.  Helping individuals focus on issues when it is safe instead of intrusive and inopportune times helps the person handle emotion and bad memories (McCall, J. 2012, p. 260).  As time progresses, help the person reframe bad memories for more positive outcomes and valuable ways to see the past so one may move forward to the future.

Finding meaning in the present and future also means recognizing healing.  So many times, one only focuses on the trauma, but it is equally important to focus on healing and transformation. McCall recommends to help the person focus on the mystery of life.  Let clients know that they have control of their lives and can dictate what the future holds.  Help clients identify healing moments without guilt.  Let individuals know beyond being aware of healing moments to embrace them, pray for them , hope for them and practice gratitude when they occur (2012, p. 265).

It is interesting to note that Aaron Antonovksy famous for his theories on “salutogenesis” which emphasizes health as something more aligned with well being than focus on pathology speaks of the importance of coherence in health.  For well being and health to exist, he points out three key elements that I feel are important to reframing grief and finding meaning.  He first lists comprehensibility as the belief that things/stressors/loss happen in an orderly fashion.  Obviously, world views can be shattered with grief and any type of well being is destroyed initially after loss.  Secondly, Antonosky points out manageability as crucial to well being in the belief that one has the ability and skills to cope with stressors or loss.  In stress, when an organism is over-whelmed, then breakdown begins, so it is not surprising that Antonosky would point out that for well-being, one must be able to manage stressors or loss.  Finally, he lists meaningfulness as source of coherence and well being.  Meaningfulness is what defines a person’s existence and why one pushes forward.  In grief theory, when meaning in life is loss, then well being suffers.  It is the purpose of grief counseling to help the person adjust to loss by again finding meaning in life with the loss.

Conclusion

Helping individuals throughout the grieving process involves identifying issues and helping people one step at a time. Please also review AIHCP’s Grief Counseling Certification and see if it meets your academic and professional goals

Sense of meaning is critical to overall health.  Without a sense of meaning, health itself can suffer.  So when sense of meaning is restored and connected with past, present and future, then true adjustment can occur.  Grief Counselors play a key role in helping individuals regain this balance and sense of health.  It is sometimes in intense sessions where minor observations and interventions occur that grief healing occurs.  It does not occur immediately, but results in multiple months and sometimes years, helping the person adjust to the loss in a healthy way.

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.

Reference

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

Additional Resources

“Salutogenesis”. Wikipedia.  Access here

Sutton, J. 2018. “10 Grief Counseling Therapy Techniques & Interventions”. Positive Psychology.  Access here

“The psychology of grief – applying cognitive and behaviour therapy principles”. InPsych 2011 | Vol 33. APA. Access here

Kelly, L. (2021). “7 Grief Therapy Techniques for Coping”. TalkSpace.  Access here

 

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

Posted on by Dominick Flarey

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

Posted on by Dominick Flarey

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

“Humanistic Therapy”. Psychology Today.  Access here

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

 

 

 

Grief Counseling and the Dual Process Model

Posted on by Dominick Flarey

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

Posted on by Dominick Flarey

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 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.

Utilization of CBT in Grief and/or Depression

Posted on by Dominick Flarey

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