grief counseling program

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

 

Grief Counseling Certification Video on Sport’s Grief

Posted on by Dominick Flarey

In sports there are expectations by players and fans alike.  When those expectations are not met there is a sense of loss.  Grief is common in sports.  Noone likes to lose a game and while it builds character there can be some sadness.  Too much sadness or extreme emotional distress are signs of deeper issues

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

Grief Counseling Program Blog on Problems within a Bereavement Support Group

Posted on by Dominick Flarey

Problems occur within any plans.  It is part of life.  Support groups are not immune.  Despite the best plan, the best curriculum,  and best training, one still will encounter various issues within a support group.  If flexible and organized, most issues will not be objectively with the set up or the schedule, but will instead come from within.   With so many personalities and the issue of grief itself, there will be bumps in the road.  Individuals will have certain needs or react different ways. Please also review AIHCP’s Grief Counseling Program

Pre-screening the group can help.  Discovering individuals who do not want to be there or who are not ready to be there is important, but they still can slip through and issues can arise.  Within even the perfect set up, various red flags can emerge.  There may be an unwillingness for most to speak, or long winded individuals.  Some members may be more focused on themselves, or others may feel the group is not helping.  As the leader of the group, it is important to know when to stop and discuss to others privately and how to deal with conflict during the meeting itself.  Please review AIHCP’s Grief Counseling Support Group Program

Numerous red flags can emerge within a support group. Please also review AIHCP’s Grief Counseling Program and see if it meets your goals

 

If preparation for meetings is present, there is still the chance expectations may not meet the desires of group members.  If this is not rectified, then the group is doomed to failure.  It is important for everyone to be on the same page and have a clear understanding of objectives.  This is why is it so important to lay out the schedule and plan, identify the grieving process and help others along the process.

Alan Wolfert describes a variety of problem personalities that can cause issues in a group if it is not met with strong leadership.

One type of personality is an absent one.  This individual misses the majority of meetings or does not do homework.  Some are just to numb from the loss to share. One way to to prevent this is to make the effort to include everyone in the meeting and their importance.  Creating safe ways to introduce this individual to the meeting is key.  Sometimes helping this individual privately is also important.  As long as they are present, sometimes, their passive nature can be permitted as long as the leader understand the member is understanding the process.

An individual who was forced to join the group can be a big problem.  This type of individual will not be receptive and remain standoffish.  Many times, they are only entering the group to please others.  It is important to pre-screen this type of individual but if not, one needs to try to make the person feel as welcome as possible.  If things do not improve, a private meeting with an option to leave the group may be the only alternative.

Other individuals can the opposite problem.  Many of these personalities may push their own agenda.  Some may consider themselves experts on grief.  Initially, this may be a self defense mechanism.  However, a know it all can be detrimental to the group.  Sometimes it is best to thank this type of individual for their knowledge, but to push it to how the individual feels.  Try to pull out the feeling, not their intellect.  Others love to give advice.  Advice obviously as a ground rule is something only given upon request, but many feel the need to advice others.  It is important to correct unsolicited advice in a kind and gentle manner.

Some individuals like to preach.  Their preaching may be long winded as well as unwanted.  Many ways this prevents anyone from every knowing what he or she feels.  It important to keep the question on this individual in how he or she feels, not how others should feel.  Closely related to this or highly spiritual and judgmental individuals who believe everyone should believe the way they do.  It is important to maintain a spiritual atmosphere but also a conclusive one.  An individual who looks to push his or her own religious agenda as a way to cope can be detrimental to the group.

In addition, there are personalities who blame, challenge and interrupt.  Obviously these types of attitudes cause chaos.  One pushes blame away from the source of grief, while the other challenges the competency of the leader, as well as prevents others from sharing.  It is important to not tolerate any type of interruptions and abide by rules of the group.  In regards to challengers, it is important to hear it, but to not allow it to force a debate with you as a leader with a group member.   It is important to not be defensive and allow the group to see through the charade of the challenger.

Understanding the various needs of the support group can help guide everyone through the grief process. Please also review AIHCP’s Grief Counseling Program

 

Other individuals will try to avoid the grief work through other ways.  They will ramble about things not related to the grief work or look to socialize.  Many of these attitudes are shields to avoid their own pain, so again, it needs to be stopped but in a gentle and caring way.  It is important to keep the group on track and ready.

As a group leader, there will be plenty of challenges in merely planning and organizing the meeting but there are always issues that can arise within the group itself.   Be easy on oneself if it is first time conducting a group.  Evaluate oneself truthfully and see how one managed the problems.  As time continues and one gathers more group experience, one will be better equipped and ready to identify these group distractions and better handle them.

Please also review AIHCP’s Grief Counseling Program 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.

Source: ” The Understanding Your Grief Support Group Guide: Starting and Leading a Bereavement Support Group” by Alan Wolfert, PhD

 

 

Grief Counseling Program Blog on Trauma and Restoring Intimacy

Posted on by Dominick Flarey

Sexuality and intimacy are crucial aspects of human life.  It allows two to bond and share the deepest feelings with a wholesome sexual experience.  An experience that is pure and filled with love as opposed as corrupt and full of hate.  During trauma, individuals can lose intimacy and a healthy understanding of love and sex.  This can create obstacles to fully reacclimating into society because one is not able to form a new bond or attachment with another human being.  The act of intimacy and the act of sex in themselves can also become triggers and reminders of past abuse and push the person away from these normal and healthy bonds.  Please also review AIHCP’s Grief Counseling Program

One who has experienced trauma must eventually face intimacy, trust and friendship and if desired, a more deeper friendship in the contract of a sexual relationship.  Unfortunately, trauma makes this difficult and can prevent the person from an important fountain of healing that can bring the person closer to becoming one again.  In this article, we will look at a few issues of intimacy and sexuality that someone who has faced trauma will deal with and how that someone can learn to trust and love again.  Please also review AIHCP’s Grief Counseling Courses

In intimacy, one opens oneself to another.  This can mean many things to a survivor of sexual trauma or betrayal.  One feels the loss of a control.  In isolation, one feels one has the power to control what occurs and the fear of opening oneself, puts oneself partly at the power of another.  It is exactly this power that a trauma survivor fears.  In addition, trauma survivors fear abandonment.  If one opens up, then one risks the chance of being hurt and betrayed again.  Hence many experience abandonment issues.   Intimacy also opens up the chance of rejection.  Trauma survivors fear the thought of being rejected for who they are and may very well reject someone before they can be rejected.

It is important with intimacy to accept fears.  This is the hardest part, but only until one dismisses the fears, can one again learn to have a trusting relationship.   The fear may be in the other person, or in one’s own tendencies but one cannot have the healing powers of intimacy without trust and letting fears go.  One also needs to reject ideas and notions that can block intimacy with others.  Many who have been traumatized universally label everyone.  All men/women are bad is a common over generalization.  The perpetrator was not good but not all people are bad.  This central concept can take time to finally become a reality again. Other false narratives include assuming no one has every experienced what one has experienced, or that one cannot ever burden another with one’s issues.  In addition, others feel unloved and if anyone ever knew what occurred, then that person would no longer be lovable.  Flaws are seen as more prominent and as a sign of weakness, when in reality everyone has flaws.

It can be difficult after trauma to again show intimacy and open oneself up. Please also review AIHCP’s Grief Counseling Program

 

Learning how to discuss the past and discuss the future are critical communication skills.  Individuals who fear intimacy need to be better able to express to another and share how to handle issues and conflicts.  Without releasing the fear, false notions and opening up communication, then a person suffering from trauma will not be able to open again and find the value and healing within a friendship or a deeper relationship.

One of the biggest blocks to a deeper relationship is again seeing sexuality as wholesome and natural.  Sex in its very nature promotes union, trust, and love but the trauma has distorted the true value of intimacy and sexuality.  Following an assault, sex itself can become a trigger to a PSTD response.  A certain touch can remind one of the trauma and turn something of love into something of abuse.  The person has a hard time viewing sex as holy and the person as sacred.  The rape or assault has stripped sexuality and intimacy of its dignity and the person has difficult times again experiencing these feelings and senses in a positive way.

Sex can also be seen as a way to control others, or it may be a device to fix what went wrong before.  Unhealthy expressions and sexual behavior can result in different directions from fear of sex to promiscuity later in life.  It is hence important to remove these past negative images.  One image that is especially unhealthy is seeing all sexual behavior and correlating it with a sense of disgust.  It is important to learn skills to neutralize this feeling of disgust and help re-evaluate these past negative experiences with positive experiences.

In rebuilding oneself for intimacy and sexual relations, the traumatized need to overcome many hurdles of trust and intimacy but certain steps can help to start the healing process.  Disgust and association with trauma can be overcame with patience and time and understanding from one’s new partner.

It is hence important to again see certain parts of the body as holy and good.  They cannot be seen or associated as evil in themselves.  The action must be separated from the part of the body itself.  Second, one needs to learn neutralize disgust.  Ideas that the body is an object to be used must be dismissed and replaced with ideals that the body is a temple and a gift.  This not only deals with the other person, but also how one views oneself.  One can further separate the feeling of disgust with sex itself and shame.   The shame with trauma needs to be separated from the act itself.  By learning to separate negative feelings and events from the body and act itself, one can better open up to others.  One can then create a new narrative where the event with a different person is not hateful or abusive but instead filled with love and respect.

Unfortunately, while rebuilding each other, partners should be conscious of others past.  Certain boundaries may initially needed and a slow crawl until mutual comfort is met.  Flashbacks can occur and it is important to recreate intimacy and the sexual experience together to form new wholesome memories.  This requires patience, counseling as well as awareness.

Healthy sexuality is the ultimate key.  While intimacy does not necessarily involve sexuality, nor the necessity of entering into a sexual relationship, one must still restore a sense of the sacred to the sexual act.  Sex is not about control, secretive, shameful, wrong, abusive, dis-connective, controlling, superficial, or selfish but instead is a spiritual, emotional and physical act that binds.  It builds self esteem and gives proper pleasures associated with that.  It is celebrated and gives deeper meaning to life.  It does not abuse, but promotes a feeling of unity and safety.  It honors and loves and builds two instead of breaking down another. Finally, it does not reject, but it also accepts the imperfect and celebrates the two.

For some, sex is more than naturally just beautiful but also sacred from a religious view.  Sex in this regard binds two as one before God and calls forward a vocation that goes beyond the symbolic act of sex, but carries itself in all matters of life itself.  Spiritually, the destruction of sex to anything less is not of God and is a misuse of this divine gift to not only bring forth new life but also unify two into one.

Restoring intimacy with a victim of abuse can take time and patience but it can again reveal the goodness of intimacy and love

 

One can restore intimacy, and if desired, a healthy sexuality after assault, but naturally, the traumatized must learn to reprogram one’s mind to not only not fear but to open up and let go past narratives that prevent the leap of love and faith.  The traumatized must also learn differentiate the corruption of the perpetrator from the holiness and goodness of the action itself and how it can be experienced with a good person.

It is a most disgusting sin to harm another through sex because it injures the person not only physically but also emotionally.  It affects one’s ability to feel intimacy again and feel trust.  It is more than a theft of virginity or physical freedom, but is a theft of self, but fortunately, through healing, counseling and prayer, one can again heal.

Please also review AIHCP’s Crisis Intervention Certification, Stress Management Consulting Program as well as AIHCP’s Grief Counseling Certification Program.  The programs are online and independent study and open to qualified professionals seeking a four year certification in these disciplines.

 

 

Source: “The Post Traumatic Stress Disorder Sourcebook: A Guide to Healing, Recovery and Growth” by Glenn R Schiraldi, PhD

PTSD from the Mayo Clinic

PTSD from the National Institute of Mental Health

When PTSD and Intimacy Collide: What Really Happens? By Tia Hollowood

Understanding Intimacy Avoidance in PTSD by Annie Tanasugarn Ph.D., CCTSA

Grief Counseling Program Video on Miscarriage and Loss

Posted on by Dominick Flarey

The loss of a child via miscarriage is something many women and couples suffer alone.  Since there is usually no body to bury, the miscarriage is seen as less than losing a child.  The woman or couple are left with less support and not seen as parents that loss a child.  This disenfranchisement can cause unresolved grief for the woman or couple.  It is important to recognize the loss of a child via miscarriage.

 

Please also review AIHCP’s Grief Counseling Program 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.

 

Please review the video below

Grief Counseling Program Video on War and Traumatic Grief

Posted on by Dominick Flarey

With war comes a type of traumatic loss than many experience.  Whether soldier or civilian, the pain and loss is very traumatic.  The losses can vary from loved ones to home to identity itself.  They can long term consequences of depression, prolonged grief and PTSD.  The losses are so severe that they can implant a death imprint on the very person.

Please also review AIHCP’s Grief Counseling Program 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.

Grief Counseling Training Video on Grief and Identity

Posted on by Dominick Flarey

Many individuals lose identity with grief.  A loss limb, or a loss of a loved one that they identify with.  A father or mother may no longer feel like a parent if they lost a child.  Grief can transform one’s identify of self.

Please also review AIHCP’s Grief Counseling Program and see if it meets your needs.  The Grief Counseling Training is online and independent study and open to qualified professionals.

Grief Counseling Program Video on Grieving Styles

Posted on by Dominick Flarey

Grief is unique.  It is universal but different people can have different reactions and can grieve in multiple different ways.  Grieving styles is how one expresses grief and there are multiple ways individuals express grief in a healthy way.

Please also review AIHCP’s Grief Counseling Program 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

 

 

Please review the video below

Grief Counseling Training Video on Loss of a Sibling

Posted on by Dominick Flarey

Loss of a sibling can occur at multiple times in a life.  One can be young or old.  This loss always stings but can vary in pain. It also can call into play the fragile nature of life and how quickly one can pass.

Please also review AIHCP’s Grief Counseling Training Program and see if it meets your academic and professional goals.  The program is online and independent study and open to qualified professionals who wish to become a certified grief counselor.

Grief Counseling Program Video on Grief Resiliency and Oscillation

Posted on by Dominick Flarey

With stress or grief, it is important to be able to bounce back.  Individuals who have trouble coping with grief or stress have a hard time in life.  Resiliency is the term referred to an individual’s ability to recover from stress and grief.  Oscillation refers to the ups and downs of early grief.  It also plays a role in how one recovers.  The less steep peaks and valleys, the better the stabilization from the loss but this can take time and cannot be rushed

Please also review AIHCP’s Grief Counseling Program 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 as a grief counselor.