Grief Therapy: How It Works, What It Costs, & What to Expect

What Is Grief Therapy?

Grief therapy involves talking with a qualified therapist to address someone’s struggles with emotions felt after the grief and loss they have experienced.² Sometimes, people can become stuck or overwhelmed by their grief which negatively impacts their ability to function in daily tasks. If someone is experiencing a prolonged grief disorder and finds it difficult to cope with their feelings on their own, grief therapy could be beneficial.

Who Can Provide Grief Therapy?

Although terminology for someone working with people experiencing bereavement in a psychotherapeutic way can vary by state, province, or country, they should always have regulation or credentialing by a governing body or college in the state or province in which they reside. These professionals should, at minimum, have a master’s degree in a discipline related to psychology and have licensure with the appropriate governing bodies or colleges in their region.

Grief Counseling Vs. Grief Therapy

Although people often use the terms grief therapy and grief counseling interchangeably, there are still differences between the two. Grief counseling is primarily used for bereaved individuals who are not experiencing intense symptom complications.³ It is a shorter-term timeline for treatment, focusing on reframing daily events and identifying an individual’s strengths.² Grief counseling is considered more directive and focuses more on surface-level issues.⁴

Conversely, grief therapy is a long-term treatment used to help those struggling with complicated forms of grief, focusing more on deeper issues and struggles, and is less directive to address multiple goals.^2,3,4

Who Can Benefit from Grief Therapy?

Experiencing grief is normal after loss and is a personally unique and adaptive process where most people do not require professional support.² That said, about 10-15% of bereaved people could benefit from grief therapy to help prevent significant suffering or address prolonged grief or persistent complex bereavement disorder.⁵

Those who have experienced a sudden or traumatic death could also benefit from grief therapy to help them process their traumatic grief and mourn the death of their loved one.⁶ Those who may be more isolated and lack the social support of family or friends in their grief could also benefit from the direction of a grief therapist. For anyone who desires professional help, it could benefit them to attend grief therapy and explore how they can better manage their grief response.

What Does Grief Therapy Help With?

Grief therapy has the potential to help you better recognize, explore, and manage the emotions that come with your loss.

Grief therapy has many benefits, including:³

• Helping you accept and process your loss
• Creating a safe space to grieve
• Identifying new healthy ways to cope with your grief
• Readjusting to life without your loved one
• Finding new meaning in your life
• Developing the bond with your loved one
• Address complicated grief reactions that may accompany prolonged grief disorder

Common Types of Grief Therapy

As the experience of grief is as unique as the person experiencing it, different treatment approaches and interventions are available.² It is vital to find a therapist with whom you feel seen, heard, and connected, as the therapeutic relationship is one of the most critical factors in therapeutic success.⁴

Here are some of the typical therapy techniques someone can expect to experience when participating in grief therapy:

Cognitive Behavioral Therapy (CBT) for Grief

CBT is a therapy technique that addresses and challenges a person’s maladaptive or unhelpful thoughts and behaviors that may present with prolonged grief disorder. CBT is used to help bereaved individuals identify and change the thoughts and behaviors that have added to their suffering. Therapists can also use CBT to help address complex thoughts and feelings around death. Research supports CBT’s use in treating prolonged grief disorder with an ability to foster long-term benefits.^7,8

Common CBT for grief techniques include:

• Exposure: Therapists have the client revisit memories of the death of the loved one to support the processing of the death event, using elements of exposure therapy.
• Cognitive Restructuring: Clients learn how to challenge negative automatic thoughts around their grief or the death of a loved one.
• Relaxation Strategies: Clients learn how to manage their feelings better when overwhelmed, using techniques like progressive muscle relaxation.
• Developing New Goals: Supporting clients to help identify and set healthy goals, using motivational enhancement techniques to help move forward and achieve them.

Acceptance and Commitment Therapy (ACT)

ACT is a type of therapy that promotes behavior change strategies and mindfulness to help individuals be more flexible and accepting of one’s thoughts, feelings, and experiences.⁹ ACT allows people to process their loss by accepting the reality of their loss, addressing the painful emotions that often come with loss, and assisting people to be flexible in handling difficult emotions.^3,10 Research has shown some support for ACT in alleviating distress related to one’s grief.^9,11,12

Some ACT for grief techniques include:¹⁰

• Mindfulness: Clients learn non-judgment and to be more present in the here and now.
• Defusion: Helps clients create distance between their thoughts and themselves and to be an observer of their thoughts versus viewing them as hard “truths” or “facts.”
• Reflection & Commitment of Values: Helps clients identify what goals and values they have and how they might be able to act to achieve their goals.
• Creating Epitaphs: Clients talk about an epitaph (i.e., a phrase to represent someone who has died that is typically found on a tombstone) that they would create for their loved ones. This helps to support a reflection of their values and move through emotional barriers around death.

Traumatic Grief Therapy

Traumatic grief can occur when a death occurs suddenly without warning or at random; if the event involves violence; they view the death as preventable; if it is believed the person who died suffered; or if the loss is seen as unjust.

The traumatic death can lead survivors to experience both trauma and grief, which they would then work on managing symptoms of both in therapy. If you have experienced a traumatic loss, it is crucial to seek the support of a professional with trauma and grief training, as it will present with more complications.

Some traumatic grief therapy techniques include:⁶

• Building Resources: Clients develop emotion management and coping skills, identify and develop social supports, and find adaptive ways to address subsequent temporary upsurges of grief.
• Processing Trauma: Clients process the traumatic grief through thought, emotion, and behavior-based interventions.
• EMDR: Eye movement desensitization and reprocessing therapy is an approach sometimes used to help reprocess trauma through bilateral brain stimulation and has shown to be helpful for those who have experienced a traumatic death or whose grief is complicated.^13,14
• Facilitating Mourning: Mourn the loss experienced, readjust to the new world without your loved one (without forgetting them), and reinvest energy in a new kind of relationship with the deceased, such as developing grief rituals.⁶

Complicated Grief Therapy (CGT)

Complicated grief, now known as prolonged grief disorder (PGD), is when distress significantly impairs life in various ways for at least 12 months or more after the death (or at least six months or more for children and adolescents). Suppose symptoms of grief go past the 12-month mark, and you are still experiencing an overwhelming sense of yearning/longing for your loved one or being preoccupied with memories or thoughts of them. In that case, it is crucial to connect with a grief therapist.¹

Complicated grief therapy, also called prolonged grief disorder therapy, is usually a 16-session manual-directed intervention from positive psychology and motivational interviewing, which includes psychoeducation and prolonged exposure and can effectively address PGD.¹⁵

Common complicated grief therapy techniques include:

• Psychoeducation: Learning about grief and complicated grief’s effect on the mind and body, so the individual knows what signs to look for and how to respond to them.
• Grief Monitoring Diary: Tracking your grief daily and describing what it looks like as part of homework assignments between therapy sessions.
• Imaginal Revisiting: Visualizing/mentally revisiting the moment the individual learned about the death and what occurred during that time.
• Discussing Memories: Bringing stories or pictures into the session and telling the therapist about your loved one to foster positive memories against traumatic ones.

Group Therapy

Group therapy is when a trained mental health professional facilitates a psychotherapeutic practice for a small group of clients around a specific subject. Grief group therapy can benefit some clients who may be more isolated as it can develop social and emotional support and relationships. It can also foster hope, normalize a person’s experience, and help them learn healthy coping skills.

Common grief interventions for group therapy include:¹⁶

• Sharing Grief Reactions: This can help to normalize grief-related thoughts, feelings, and behaviors after death against others’ views in the group.
• Exploring Expectations of Grief: This can help challenge myths or misguided expectations of what people think grief should look like vs. realistic expectations.
• Discussion & Practice of Coping Skills: Learning from/as a group what healthy coping skills are and what healthy skills others do and find beneficial.
• Sharing the Story of Death: This enables sharing feelings related to death while being supported by the group in a safe environment that encourages vulnerability.

Art Therapy

Art therapy can be a way to help people articulate how they are feeling in nonverbal ways.^17,18 Art therapists can help clients explore themselves and facilitate understanding of their grief response through color, shapes, and imagery.

Art therapy can be helpful for those who might have difficulty identifying and expressing what they are thinking and feeling. Expressive arts therapy can help grieving clients express intense emotions, which they can’t otherwise do with words, provide a safe space for them to do so, and be a way to remember the person who died.¹⁷

Some art therapy interventions for grief include:¹⁹

• Visual Arts: Sketching, drawing, and painting to help express feelings, regrets, memories, etc.
• Collage Work: Having multiple magazines or catalogs with images and words and then cutting or tearing out the pictures and words that represent how you might be feeling to make a collage. Collages help those struggling to find the words to explain their emotions.
• Music Therapy: Creating songs, singing, or playing instruments to express your feelings.
• Woodworking: Creating works from wood that represent the deceased or your grief.²⁰

Common Grief Therapy Techniques

There are many techniques that therapists incorporate when doing grief therapy with people. They all share the goal of helping people understand the emotions they are experiencing relating to their grief. Using these tools helps people cope with grief, understand its origins, and alleviate the severity of symptoms.

Here are several techniques that could be used during grief therapy:

• Companioning: This is about being totally present with the person who is mourning without any judgment. It involves listening and signaling your ongoing support and steadfast willingness to be by their side as they grieve.
• Bibliotherapy: Also called book therapy, it uses the art of selected reading and storytelling, prescribing specific books for those that are mourning. It helps people to clarify their thoughts through reading. Bibliotherapy can help with problem solving, empathy, and self awareness as mourners read about others who struggled with similar feelings.
• Naming emotions: Emotions related to grief can feel overwhelming and confusing. Some people try to suppress their emotions because they are afraid of the pain this will cause. There is much to learn when feelings are expressed and identified, offering critical insights for those mourning as they gain self understanding and learn how to cope.
• Helping restore routine: Grief overturns daily practices and engaging in self care is often overlooked while mourning. Creating a structured routine gives you other things to focus on and helps you know what to expect each day. This structure can provide comfort and healing.
• Facilitating the creation of grief rituals: Grief rituals can help people both process and express their grief in ways that are meaningful to them. It is a way of honoring the memory of the person that is lost.

Common Types of Grief Therapy for Children

Children may have difficulty expressing themselves using the same techniques as adults as they may not have the verbal knowledge or life experiences to process their emotions through traditional talk therapy effectively. Thus children will likely need an entirely new set of therapy techniques to help them identify and adjust their thoughts regarding grief and loss.

More specific grief therapy techniques that grief therapists might use for treating children include:

Play Therapy

In play therapy, certified therapists might use board games and cards, dolls, and puppets to revisit their versions of how their loved one died to help children “play out” their worries, confusion, thoughts, and feelings when dealing with their grief.²¹Children often have difficulty using words to express themselves, so engaging in play can help with this.²²

Some methods a therapist might use in play therapy for grief include:

• Sand Trays: Uses a tray filled with sand with different toy figures to allow a child to express themselves symbolically and create a story in the sand tray.²³
• “Medical Kit”: If the child came upon the body or witnessed the death, some certified play therapists may develop a toy “medical kit” for the child to re-enact the death, coming upon the body and exploring rescue fantasies.²⁴
• Dance: Children may benefit from engaging in dance to help revisit feelings and body sensations concerning their grief. It can provide them with an outlet to express themselves non-verbally.²⁵
• Toys: Having a wide selection of toys and figures in the therapy room for children to select from and play with can help them work out fears and concerns.²²

Art Therapy

Art therapy for children can be an excellent resource for those grieving because they can have difficulty identifying and articulating how they feel. It can be a beneficial process to use art to express what they might not understand, cannot yet verbalize, or don’t possess the language to explain. It can also help identify changes that come with loss and learn how to cope.²⁶

Some art therapy for grief interventions include:

• Memory Box: Children can decorate a container and place meaningful items that remind them of the deceased in and outside the box.²⁷
• Paper Plate Asks: These can help children identify the feelings they show to those around them on the outside of the mask and feelings on the inside that they might not show to others.²¹
• Sculpting: Creating figures, masks, models, or other items can be a way for children to express what is on the inside and have a physical representation reminder of
• Feelings Heart: Colors are assigned to feelings the child has experienced recently, and the child colors in an image of a heart with those assigned colors (e.g., blue = sad).²⁶

Narrative Therapy

Narrative therapy (and narrative exposure therapy) aims to help the bereaved “re-story” their experience by revisiting the death or trauma while considering new perspectives to better identify, articulate, and integrate their thoughts and feelings.²⁰

Some narrative techniques used for grief interventions include:

• Create a Storybook: A child can create a storybook with their therapist about the death, which children can revisit when they need a reminder of their new understanding of what has happened.²⁸
• Appreciating Their Art: A child can engage in different types of art therapy and then write or share about the experience to help foster the meaning behind the art piece.²⁰
• Storytelling: By recounting a story, a child can identify and voice how they see themselves in the ever-changing context of grief and engage in making sense of their loss.²⁹
• Writing: Writing activities (such as journaling) reflecting on their thoughts and feelings of loss can add new perspectives. Or providing advice they would give another child in their situation can help instill all they have learned.³⁰

How to Find a Professional Grief Therapist

Grief therapy can be done in person, individually through online therapy, or in an online group session. Asking your primary care physician for recommendations of therapists can be a way to find a therapist, as well as looking up therapists who specialize in grief therapy or grief counseling through online therapist directories. Be sure to look for specialization in grief and trauma-informed care to ensure that proper treatment is provided for your needs.

How Much Does Grief Therapy Cost?

The average cost of grief therapy can be anywhere from $70 to $150 per clinical hour, but can be $250 or more for some professionals.³¹ A psychologist or psychiatrist can be more expensive per hour due to the additional training, schooling, and expertise these professionals possess.

Grief therapy’s cost will vary by location, professional education level, years in practice, and training in specialized techniques and approaches a therapist has acquired. Depending on your mental health insurance plan, individuals can use private health insurance to help cover some or all of the cost of grief therapy. Be sure to look up your insurance plan to see what types of licensed professionals are covered and what percentage, or up to what amount, insurance will cover.

What’s the Outlook for People Who Are Grieving?

Grief is a unique experience for every person, and there is no specific time frame for grieving. It can take a year or more for people to grieve the death of a close loved one. Eventually, the symptoms related to grief should get less frequent and less intense with time. The goal is for the bereaved person to begin to accept their loss, heal, and move forward with their lives.

Some people may experience complicated grief. This occurs when symptoms remain for an extended period of time, over a year, and the grief-related symptoms become worse and yearning for the person that has died remains strong and constant. The bereaved person cannot move forward and remains seriously debilitated. In these circumstances it may be necessary to ask a mental health professional to get the help needed to overcome complicated grief.

Final Thoughts

Grief therapy can be helpful for anyone who is finding their grief is negatively impacting their ability to function in their day-to-day. It also provides a safe, non-judgmental place to explore, unpack, work through, better manage, and potentially find meaning in their grief. Everyone experiences grief differently, and there is no predetermined course of what grief should look like or how long it will last. If you need help dealing with your loss, a mental health professional is an excellent resource to connect with to recover and heal from your loss.