Types of Grief Therapy

Not All Grief Needs Therapy, and Not All Therapy Fits All Grief

Most grief does not require professional treatment. The Dual Process Model of bereavement, developed by researchers Margaret Stroebe and Henk Schut, describes healthy grief as a natural oscillation between confronting the loss and taking breaks from it. For the majority of bereaved people, this oscillation happens on its own — painfully, slowly, but without clinical intervention.

That said, somewhere between 4% and 15% of bereaved adults develop Prolonged Grief Disorder, a condition recognized in the DSM-5-TR since 2022. And many more people — well within the range of normal grief — find that professional support helps them process what they are going through, even if they don't meet the threshold for a clinical diagnosis.

The question is whether support would help, and which approach fits your situation.

When to Seek Grief Counseling

There is no calendar deadline for when grief should end, and anyone who tells you there is (six months, one year, two years) is repeating a myth. But there are signals that professional support would help:

• You are unable to function at work, in relationships, or in daily tasks for an extended period — not just on bad days, but most days
• You are experiencing intrusive thoughts about the death that you cannot control or redirect
• Physical symptoms (chest pain, nausea, insomnia, weight loss) persist without medical explanation
• You are using alcohol, drugs, or other substances to manage the pain
• You feel that life has no meaning or purpose without the person who died, and that feeling is steady, not just a passing wave
• You are having thoughts of wanting to die or to be with the person who died

If any of these resonate, talking to your doctor or a grief-trained therapist is a reasonable next step. The Brief Grief Questionnaire uses a clinical threshold of 8 to screen for Prolonged Grief Disorder. A screening tool is not a diagnosis, but it can help you decide whether to seek further evaluation.

Complicated Grief Treatment (CGT)

CGT is a structured approach designed for prolonged grief. It combines elements of cognitive behavioral therapy with grief-focused techniques.

How it works: CGT uses a dual-track approach that mirrors the Dual Process Model. One track focuses on processing the loss itself — including revisiting the story of the death, which a clinician can explain before treatment begins. The other track focuses on restoration: setting personal goals, rebuilding routines, and re-engaging with life.

Who it is for: People whose grief has lasted more than twelve months (six months for children), who experience daily symptoms, and whose functioning is significantly impaired. A qualified clinician can assess whether this approach fits the person's needs.

What it is not: A quick fix, or something you do instead of feeling grief. CGT does not try to eliminate grief. It tries to unblock grief that has become stuck.

Cognitive Behavioral Therapy (CBT) for Grief

Standard CBT, adapted for bereavement, focuses on identifying and challenging thought patterns that keep grief from progressing naturally.

How it works: A CBT therapist helps you identify specific thoughts that are maintaining your distress — "I should have done more," "I will never be happy again," "It's my fault" — and examine whether those thoughts are accurate, complete, or helpful. CBT also uses behavioral activation: gradually re-engaging with activities and people that you have been avoiding since the loss.

Who it may fit: People whose grief is complicated by intense guilt, self-blame, or avoidance behaviors. A grief-trained clinician can discuss whether CBT is appropriate if you have stopped doing things you used to enjoy, stopped seeing friends, or are avoiding reminders of the deceased.

Limitations: CBT is not specifically designed for grief — it is adapted from its use in depression and anxiety. Some bereaved people find it too structured or feel that the focus on challenging thoughts dismisses the validity of their pain. A skilled grief-trained CBT therapist adjusts for this, but the fit depends on the therapist as much as the method.

EMDR (Eye Movement Desensitization and Reprocessing)

EMDR was originally developed for trauma, and its application to grief is most relevant when the death was traumatic — sudden, violent, witnessed, or associated with helplessness.

How it works: EMDR uses bilateral stimulation (eye movements, tapping, or auditory tones) while you recall distressing memories. The theory is that this helps the brain reprocess traumatic memories so they lose their emotional charge without erasing the memory itself.

Who it may fit: People whose grief is complicated by traumatic imagery — replaying the moment of death, intrusive images of the person in pain, or flashbacks to the notification. A clinician can discuss whether EMDR is appropriate for trauma-related symptoms.

Support Groups

Grief support groups are not therapy, but they can offer a way to connect with other people who understand what you are going through.

In-person groups may be offered through hospice programs, hospitals, religious organizations, and community centers. Contact the group to confirm its cost and whether you need a referral.

Online groups (including forums and moderated communities) offer accessibility for people who cannot attend in person or who prefer anonymity.

Peer-led vs. professionally facilitated: Groups may be led by peers or facilitated by a professional. Ask what format a group uses and whether it fits what you are looking for.

Support groups can provide peer connection. If grief symptoms persist and impair daily functioning, a mental-health professional can assess whether additional care is needed.

Finding a Grief Therapist

Look for a therapist who has specific training or experience in bereavement, not just general counseling credentials. Grief therapy is a specialization, and a therapist who is excellent at treating anxiety may be mediocre at treating grief.

Questions to ask in a first session or screening call:

• What training have you had specifically in grief and bereavement?
• What therapeutic approach do you use with bereaved clients?
• Have you worked with people who experienced the same type of loss I experienced?

The Anniversary Grief & Milestone Dates toolkit includes a PGD screening tool that can help you assess whether your grief patterns warrant professional evaluation, along with a symptom tracker to monitor how your grief shifts around milestone dates.