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Bereavement

Treatments

Counseling or Grief Therapy

Treatment Summary: When clinicians began to establish a strategy on dealing with people going through bereavement and developing a treatment plan, it needs to take into consideration that they will be dealing with grief, depression, or both, so an ideal intervention would be to target both symptoms. Although people who are going through bereavement almost never require any formal treatment, for the ones who experience major depressive episodes, providing treatment can reduce anguish and further increase well being. In drawing an individual treatment plan, the most difficult phase is deciding who to treat because most bereaved individuals do not require treatment. Although the anguish that follows after the death of a loved one is painful, most people will recover and adjust to their life style. The diagnosis of major depressive disorder will not be provided by a clinician unless the symptoms last more than 2 months after the loss of the loved one. The management guideline for successful treatment is recognizing that bereavement-related MDE is similar to other non-bereavement-related MDE, and is linked to suicidal ideation and behaviors. An effective treatment also involves antidepressant medication.

  • Reference: Auster, T., Lanouette, N., Moutier, C., & Zisook, S. (2008). Bereavement and depression: Implications for diagnosis and treatment. Psychiatric Annuals 38(10) 655-661.
  • Submitter: N/A

Bereavement Intervention

Treatment Summary: Human beings experience the death of loved ones universally. The pain associated with the loss is intense. Cultural and social norms vary regarding appropriate grief responses and duration of grief process. However, grief reactions are as unique as the individual. Research indicates that the vast majority traverses the grieving process experiencing transitory pain and resumes normal functioning within a reasonable amount of time. Studies reveal that formal intervention, when conducted under these circumstances, is ineffective and is therefore unnecessary. Clinical ambiguity results when normal bereavement and complicated bereavement symptoms overlap. The most efficacious intervention occurs when individuals are assessed for maladaptive reactions to the loss and treatment is tailored to address the individual's symptoms. Several methods withstand scrutiny: complicated grief therapy (CGT), a dual-process model involving cognitive-behavioral procedures, a dual-track model utilizing biopsychosocial and relational tracks, and a constructivist model. Respectively, these are cognitive, attachment-oriented, and meaning-making processes that enable individuals to address and overcome symptoms.

  • Reference: Neimeyer, R. A., & Currier, J. M. (2009). Grief therapy: Evidence of efficacy and emerging directions. Current directions in psychological science, 18(6), 352-356.
  • Submitter: Sean Moore

Grief Mapping

Treatment Summary: Grief mapping is interactive, self-report tool used in individual or group settings for education, assessment and therapy for bereavement. The Grief Map is separated into thirds starting with the loss/unreality, through survival towards reorganization/ new life. Each section has triangles that represent some "mountain" (emotion, issue, event, or task) to overcome. The loss section's mountains relate to the loss itself, loss of support systems, and psychological issues. The survival's mountains deal with isolation, secondary losses, and daily role changes. Reorganizing's mountains direct attention to positives such as rebuilding self and creating purpose. Clients fill out their Grief Map: underlining the mountains that are relevant, crossing out mountains that they do not need, labeling blank mountains with individual needs, drawing the mountains to the height they see them in respect to the other mountains, and shading in the mountain with how much they feel they have dealt with that issue. This tool can help identify what needs to be addressed immediately, such as the suicidal thoughts mountain, identify client's goals, examine issues clients have already started working through, educate individuals, and normalize difficulties. It can be a self-help tool, show progress, create a sense of empowerment and control over progress and be used as a starting point to talk openly about feelings and situations. Grief mapping is left as a general tool to be individualized so it can be used with the most number of people. The map works well for individuals who cannot easily express emotion (i.e. persons with lower IQs and children).

  • Reference: Clark, S. (2001). Mapping grief: An active approach to grief resolution. Death Studies, 25,(6), 531-548. doi: 10.1080/07481180126861
  • Submitter: Jennifer Cherry

Music Therapy Songwriting

Treatment Summary: The study I have is a group study; however, I believe it can be modified for an individual client fairly easy. Participants are asked to create music and lyrics expressing their core emotions and concerns about their loss and how they are coping after their loss. The music therapist organizes the themes of the songs into five grief processes. These processes are listed in order (1) understanding, (2) feeling, (3) remembering, (4) integrating, and (5) growing. Although these are the actual themes, the music therapist may take license to develop more creative titles that relate specifically to their clients. The participant confers with other clients and the music therapist to ensure lyrics express the participant's thoughts and emotions accurately and in a manner understandable to others. Since not all humans are able to play music or write a musical score, the music therapist helps the participants develop chord progression and rhythmic styles using a variety of different musical styles to ensure the song expresses the emotional discord of the participant. After each process, the music therapist (or a talented participant) records the completed song on a CD for the group to listen to during the next session. During the last group session, after the participants have completed the five processes, the participants are asked to choose a special place (beach, mountains, park, etc.) to memorialize and celebrate the life of the loved one. The participants share thoughts of their loved one and how they experienced being a member of the group.

  • Reference: Dalton, T. A. & Krout, R. E. (2005). Development of the Grief Process Scale through music therapy songwriting with bereaved adolescents. The Arts in Psychotherapy, 32, 131-143. doi: 10.1016/j.aip.2005.022
  • Submitter: Sandra Frey

Grief Song-Writing Process (GSWP)

Treatment Summary: The GSWP Song-Writing Process is a seven sessions, small group intervention originally developed for bereaved adolescents. Students create verse lyrics and develop musical accompaniment to express themselves in the five progressive grief process areas of understanding, feeling, remembering, integrating, and growing. Session one is orientation, exploration of musical instruments and recording technologies, and to develop group cohesion. Sessions two to six are each focused on one of the five grief process area. Students are provided a pre-created chorus for each grief area, and then they individually write the verse using their experiences and concerns. Only one grief area per session is addressed. At the end, each student has created a song which reflects their own bereavement process and cognitive understanding. The songs are recorded by members, with the help of train professional, for group members to keep. Session seven focus is a memorial and celebration of the lost loved ones by sharing of member's songs, feelings, thoughts and other ways to remember. Also, group members share their thoughts and feeling about the group intervention experience. The program was developed by Thomas A. Dalton after an intensive literature grief counseling techniques.

  • Reference: Dalton, T. A. & Krout, R. E. (2006). The grief song-writing process with bereavedadolescents: An integrated grief model and music therapy protocol. MusicTherapy Perspectives, 24(2), 94-107. Retrieved on February 23, 2011 from
  • Submitter: Donna Lewis