Understanding, Assessing and Treating Grief

Overview of grief

Grief is a normal and expected response to a loss, such as the death of a loved one or the loss of something significant, such as a pet, job, or financial loss. It can also result from other life changes, such as a medical diagnosis, the end of a significant relationship, or the loss of independence.Grief can take many forms and can impact people in different ways, including emotional, physical, psychological, and spiritual reactions. Common emotional responses to loss include sadness, anger, guilt, and loneliness, while physical responses can include fatigue, difficulty sleeping, and changes in appetite. Psychological responses may involve a sense of numbness or disbelief, and can be accompanied by intrusive thoughts, memories, and images of the person or thing that has been lost. Spiritually, people may question their beliefs, feel abandoned by a higher power, or find comfort in their spiritual or religious practices.

What is grief?

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition Text Revision (DSM-5-TR), persistent grief can now be classified as prolonged grief disorder (formerly called persistent complex bereavement disorder). The DSM-5 recognised that grief is a normal response to the loss of a loved one or significant object, and acknowledged that individuals may experience a range of emotions, such as sadness, anger, guilt, and disbelief. The latest iteration of the DSM, the DSM-5-TR, does not argue with those statements, but posits that when symptoms persist for longer than 12 months after the loss and significantly interfere with an individual’s daily functioning, the grief reaction is maladaptive.

Note that these criteria should only be applied after the bereaved individual has had sufficient time to adjust to the loss; thus, the criteria should not be applied to an individual who has experienced a loss less than one year ago.

The DSM-5-TR section for prolonged grief disorder (found in the chapter on trauma- and stressor-related disorders) includes six diagnostic criteria:

Criterion A

The death occurred at least 12 months ago (six months for children and adolescents).

Criterion B

Since the death or loss, there has been the development of a persistent grief response characterised by one or both of the following symptoms, which have been present most days to a clinically significant degree. In addition, the symptom(s) has occurred nearly every day for at least the last month:<ol><li>Intense and persistent yearning or longing for the deceased person or object</li><li>Preoccupation with thoughts or memories of the deceased person</li></ol>

Criterion C

Since the death, at least three of the following symptoms have been present most days to a clinically significant degree. In addition, the symptoms have occurred nearly every day for at least the last month:<ol><li>Identity disruption (feeling like part of oneself has died since the death)</li><li>Difficulty accepting the reality of the loss, including persistent disbelief or denial</li><li>Avoidance of reminders that the person is dead</li><li>Persistent intense emotions: feelings of anger or bitterness related to the loss, or feelings of guilt or self-blame for circumstances surrounding the loss</li><li>Difficulty reintegrating into one’s relationships and activities after the death</li><li>Emotional numbness as a result of the death</li><li>A profound sense of loneliness, emptiness, or meaninglessness of life since the loss</li><li>Intense loneliness as a result of the death</li></ol>

Criterion D

The disturbance causes clinically significant distress or impairment, including difficulty sleeping, changes in appetite, or difficulty participating in previously enjoyed activities, including socially.

Criterion E

The duration and severity of the bereavement reaction clearly exceed expected social, cultural, or religious norms for the individual’s culture and context.

Criterion F

The symptoms are not better accounted for by another mental disorder, such as major depressive disorder, adjustment disorder with depressed mood, or substance-related and addictive disorders.

What are the symptoms of grief?

Grief can result in a range of emotional, physical, psychological, and behavioural symptoms. The specific symptoms an individual experiences will depend on a variety of factors, including the nature of the loss, their previous experiences with loss, and their individual coping styles.Common emotional symptoms of grief include:<ul><li>Sadness</li><li>Anger</li><li>Guilt</li><li>Anxiety</li><li>Despair</li><li>Loneliness</li><li>Numbness</li></ul>Physical symptoms can include:<ul><li>Fatigue</li><li>Insomnia</li><li>Changes in appetite</li><li>Aches and pains</li><li>Nausea</li><li>Heart palpitations</li></ul>Psychological symptoms may include:<ul><li>Difficulty concentrating</li><li>Intrusive thoughts or memories</li><li>Hallucinations or illusions</li><li>Difficulty accepting the reality of the loss</li><li>A sense of disbelief or denial</li></ul>Behavioural symptoms can include:<ul><li>Withdrawal from others</li><li>Difficulty participating in previously enjoyed activities</li><li>Substance abuse</li><li>Changes in eating or sleeping patterns</li><li>Increased absenteeism from work or school</li></ul>

Remember: grief is a highly personal experience and individuals may experience a range of symptoms, or none at all. Additionally, symptoms may wax and wane over time, and the course of grief can be unpredictable. Some people may experience relief from symptoms quickly, while others may experience symptoms for years after the loss.

How to diagnose grief

In the past, grief was not typically diagnosed as a mental disorder because it is a normal response to the loss of a loved one or significant object. However, clinicians began to recognise that when grief persists over a much longer period than is normal for an individual’s culture or context and interferes with normal functioning, it is prohibiting the person from leading a fulfilling life. If there were to be a diagnosis, health provider funds in some jurisdictions could flow more easily to help the person. Thus, in the DSM-5-TR, grief persisting for more than a year may be diagnosed as prolonged grief disorder, as described above.Diagnosis of prolonged grief disorder typically involves a comprehensive evaluation by a mental health professional, including a clinical interview, a review of symptoms and medical history, and a consideration of any other factors that may be contributing to the individual's symptoms.In order to be diagnosed with prolonged grief disorder, an individual must meet the criteria outlined in the DSM-5-TR, which we listed above. Note particularly that these criteria should only be applied after the bereaved individual has had sufficient time to adjust to the loss and the symptoms must not be better accounted for by other mental disorders, such as depressive, adjustment, or substance misuse disorders.Additionally, it is important to consider cultural and religious factors that may influence an individual's grieving process, as well as any comorbid medical or psychological conditions that may be contributing to their symptoms. A mental health professional can provide a thorough assessment and make a diagnosis based on the individual's unique presentation.

Common treatment approaches for grief

The treatment of grief will vary depending on the individual and the nature of their loss. However, there are several common treatment options that can be effective in helping individuals manage their grief and move toward healing.Some common treatments for grief include:

Because grief is such a highly individual experience, different individuals may respond differently to the various treatments. A mental health professional can help individuals determine the best treatment plan for their individual needs and goals.

1
Psychotherapy

Psychotherapy, also known as talk therapy, can be a valuable tool for individuals who are struggling with grief. Therapies that may be useful include cognitive-behavioural therapy (CBT), exposure therapy, and grief-focused therapy. Psychotherapy can help individuals process their emotions, develop coping skills, and work through any complicated feelings or thoughts related to their loss.
2
Medication:

In some cases, medication may be prescribed to manage symptoms such as anxiety or depression that can accompany grief. Antidepressants, antianxiety medications, or sleep aids may be used to manage symptoms, but should only be prescribed by a qualified healthcare provider.
3
Support groups:

Support groups can be a valuable resource for individuals who are grieving, as they provide a safe and supportive environment for individuals to share their feelings and experiences with others who are going through a similar process. Support groups can help individuals feel less isolated and can provide a sense of community and belonging.
4
Creative expression:

Creative activities such as writing, drawing, or painting can be a helpful way for individuals to express their emotions and process their grief. Creative expression can be especially helpful for individuals who may have difficulty verbalising their feelings.
5
Mind-body techniques:

Mind-body techniques such as yoga, meditation, or deep breathing can help individuals manage symptoms of stress and anxiety that can accompany grief. These techniques can help individuals develop a sense of calm and inner peace, and can be especially helpful for individuals who are having difficulty sleeping or concentrating.
6
Physical activity:

Regular physical activity can help individuals manage symptoms of stress and anxiety and improve overall physical and mental wellbeing. Exercise can help release endorphins, which can improve mood and provide a sense of accomplishment.

Best practice treatment guides for grief

It is important to note that these guidelines are not meant to be prescriptive, but rather to inform the treatment planning process. A mental health professional can use these guidelines in conjunction with their clinical expertise and an individual's unique needs and circumstances to develop a treatment plan that is tailored to the individual's needs.

There are several best practice treatment guides for grief that can be used by mental health professionals to inform their treatment planning and decision-making. These guides typically provide evidence-based recommendations and are informed by research and clinical experience. Some of the most well-known best practice treatment guides for grief include:

The National Institute for Health and Care Excellence (NICE) guidelines

The NICE guidelines provide evidence-based recommendations for the treatment of grief in the United Kingdom. The guidelines provide recommendations for the assessment and management of individuals experiencing grief, including the use of psychotherapy, support groups, and medication, as appropriate.

The American Psychiatric Association (APA) Practice Guidelines

The APA Practice Guidelines provide evidence-based recommendations for the treatment of mental disorders, including grief. The guidelines provide recommendations for the use of psychotherapy, medication, and other treatments for individuals experiencing complicated grief, as well as for individuals who may have comorbid medical or psychological conditions.

The American Psychological Association (APA) Division of Trauma Psychology

The APA Division of Trauma Psychology provides guidelines and resources for the treatment of individuals who have experienced trauma, including loss and the resultant grief. The guidelines provide recommendations for evidence-based psychotherapies, as well as tips for building resilience and managing symptoms of trauma.

The International Society for Traumatic Stress Studies (ISTSS)

The ISTSS provides guidelines and resources for the treatment of individuals who have experienced trauma, including loss and grief. The guidelines provide recommendations for evidence-based psychotherapies, as well as tips for building resilience and managing symptoms of trauma.

Common comorbidities with grief

Loss and the resultant grief can often be accompanied by a number of comorbidities, or co-occurring conditions. These comorbidities can include:

Importantly, note that these comorbidities can be managed with appropriate treatment, such as psychotherapy, medication, and self-care strategies. A mental health professional can help individuals identify and manage any comorbidities they may be experiencing, and can provide guidance and support to help them move towards healing and recovery.

1
Depression

Depression is a common comorbidity in individuals who are grieving. Symptoms of depression include feelings of sadness, hopelessness, and a loss of interest in activities that were once enjoyable.
2
Anxiety

Anxiety can be a common comorbidity in grieving individuals, and can manifest as symptoms such as excessive worry, difficulty sleeping, and restlessness.
3
Post-traumatic stress disorder (PTSD)

In some cases, the grief from loss can result in trauma, which can lead to symptoms of PTSD such as flashbacks, nightmares, and feelings of avoidance or numbing.
4
Substance abuse

Substance abuse can be a common comorbidity in individuals suffering from grief, as some individuals may use drugs or alcohol as a way of coping with their emotions.
5
Sleep disturbances

Sleep disturbances such as insomnia or excessive fatigue can be a common comorbidity in grieving individuals, as they may have difficulty sleeping or have disrupted sleep patterns.
6
Physical health problems

Physical health problems such as headaches, stomach problems, or cardiovascular disease can be common in individuals who are grieving, as grief can take a toll on an individual's overall physical and emotional well-being.

MHA courses on grief

<ul><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/narrative-therapy-in-the-face-of-grief'>Narrative Therapy in the Face of Grief</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/the-abc-model-of-crisis-intervention-working-with-grief-and-loss'>The ABC Model of Crisis Intervention: Working with Grief and Loss</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/persistent-complex-bereavement-disorder'>Persistent Complex Bereavement Disorder</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/creating-sustaining-counselling-conversations-in-the-face-of-grief'>Creating Sustaining Counselling Conversations in the Face of Grief</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/working-with-trauma'>Working with Trauma</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/the-tsunami-after-suicide-finding-our-way-through-grief-and-trauma'>The Tsunami After Suicide: Finding Our Way Through Grief and Trauma</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/suicide-collateral-damages'>Suicide: Collateral Damages</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/supporting-the-suicide-bereaved'>Supporting the Suicide-Bereaved</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/clinicians-as-suicide-loss-survivors-postvention-for-caregivers'>Clinicians as Suicide Loss Survivors: Postvention for Caregivers</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/the-traumatic-effects-of-disasters'>The Traumatic Effects of Disasters</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/loss-and-grief-from-chronic-and-terminal-illness'>Loss and Grief from Chronic and Terminal Illness</a></li></ul>

Frequently asked questions about grief

What strategies can a patient use to manage their grief in daily life?

There are several strategies that individuals can use to manage their grief in daily life. These strategies can help individuals cope with their emotions and reduce the impact that a given loss and the resulting grief have on their daily functioning. Some strategies include:<ol><li>Individuals must allow themselves to feel their emotions: Grief can evoke a range of intense emotions, such as sadness, anger, guilt, and fear. It is important to allow these emotions and to express them in a healthy way. This may include writing in a journal, talking with a trusted friend or family member, or seeking support from a mental health professional.</li><li>Practice self-care: Engaging in self-care activities can help individuals manage their stress and improve their overall wellbeing. Exercise, meditation, spending time in nature, and engaging in hobbies and interests can all help the person care for themselves.</li><li>Connect with others: Building and maintaining social connections can help individuals cope with the grief from their loss. This may involve reaching out to friends and family, joining a support group, or seeking support from a mental health professional.</li><li>Create a routine: Maintaining a structured routine can help individuals feel a sense of stability and control during a time of upheaval. This can be achieved through regular exercise, meal times, and bedtimes.</li><li>Celebrate and honour the person who has been lost: This may include creating a memorial, sharing stories and memories with others, or participating in activities that honour their memory.</li><li>Find meaning and purpose: Grief can often leave individuals feeling a sense of loss of purpose. Finding meaning and purpose can help individuals orient toward a new sense of direction and fulfillment in their lives. This may manifest as volunteering, pursuing a new hobby or interest, or finding new ways to help others.</li></ol>Remember that everyone's grief journey is unique and that it is okay for an individual to grieve in their own way and on their own timeline. Seeking support from a mental health professional can also be beneficial in helping individuals manage their grief.

How does grief typically affect an individual's mood, energy levels, and motivation?

Grief can have a significant impact on an individual's mood, energy levels, and motivation. Some common effects include:<ul><li>Mood: Individuals who are grieving may experience a wide range of emotions, including sadness, anger, guilt, and anxiety. These emotions can be intense and may interfere with an individual's daily life.</li><li>Energy levels: Grief can often result in a decrease in energy levels, as the individual may feel physically and emotionally exhausted. They may have difficulty sleeping or have disrupted sleep patterns, which can further impact their energy levels.</li><li>Motivation: Individuals who are grieving may experience a loss of motivation and interest in activities they once enjoyed. This can result in feelings of hopelessness and a lack of direction.</li></ul>These effects can vary in intensity and duration, and each individual's experience of grief is unique. Some individuals may experience these effects more acutely, while others may experience them more subtly. With the right support and treatment, however, many individuals are able to manage these effects and find ways to move forward in their healing process.

What are the common physical and cognitive symptoms of grief?

In addition to the effects on mood, energy levels, and motivation, grief can also result in a number of physical and cognitive symptoms. Some of these include:<ul><li>Physical symptoms: Individuals who are grieving may experience physical symptoms such as headaches, stomach problems, muscle tension, and fatigue. They may also experience changes in appetite, weight, and sleep patterns.</li><li>Cognitive symptoms: Those in grief may experience cognitive symptoms such as difficulty concentrating, forgetfulness, and confusion. They may also experience intrusive thoughts or memories related to their loss.</li><li>Behavioural symptoms: Grieving individuals may experience behavioural symptoms such as irritability, mood swings, and changes in social behaviour. They may also experience feelings of avoidance or numbing, as well as feelings of hopelessness or despair.</li></ul>Fortunately, these symptoms can be managed with appropriate treatment, such as psychotherapy, medication, and self-care strategies. A mental health professional can help, providing guidance and support to move clients towards healing and recovery.

How does grief typically impact sleep, appetite, and sexual functioning?

Grief can have a significant impact on an individual's sleep, appetite, and sexual functioning. Some common effects include:<ul><li>Sleep: Individuals who are grieving may experience sleep disturbances such as insomnia or excessive fatigue. They may have difficulty falling or staying asleep, or they may experience nightmares related to their loss.</li><li>Appetite: Grieving individuals may experience changes in their appetite, such as a decrease in food intake or a loss of interest in eating. They may also experience changes in their weight.</li><li>Sexual functioning: Individuals in the throes of grief may experience changes in their sexual functioning, such as a loss of interest in sexual activity or difficulty with sexual performance. This can be related to the physical and emotional exhaustion associated with grief, as well as to the impact that the loss may have had on the individual's relationships and sense of self.</li></ul>As noted above, these effects can vary in intensity and duration, and each individual's grief journey is unique. Some individuals may experience these effects more acutely, while others may experience them more subtly. With the right support and treatment, however, many individuals are able to manage these effects and find ways to move forward in their healing process.

What are the potential complications of grief?

While grief is a normal and natural response to a significant loss, it can also have potential complications if not effectively managed. Some of its potential complications include:<ul><li>Prolonged grief disorder (PGD): As we have been discussing in this article, grief comes to be classified as a disorder – PGD – when it persists beyond a typical timeline and interferes with an individual's ability to function in daily life. PGD, formerly called persistent complex bereavement disorder and – before that – complicated grief, can result in symptoms such as depression, anxiety, and sleep disturbances through such disabling symptoms as persistent yearning, anger, and avoidance behaviours.</li><li>Substance abuse: Individuals who are grieving may turn to substance abuse as a way to cope with their feelings of pain and distress. Substance abuse can exacerbate the individual's symptoms and further interfere with their ability to function.</li><li>Suicidal thoughts: Grief can increase an individual's risk of suicidal thoughts, especially if they are struggling with depression or a history of trauma. It is important to seek professional help if an individual is experiencing suicidal thoughts.</li><li>Physical health problems: Grief can also result in physical health problems, such as headaches, stomach problems, and heart disease. These physical health problems can be related to the stress and emotional distress associated with grief.</li></ul>An individual needs to seek professional help if, in struggling with grief, they experience any of these potential complications. A mental health professional can provide support and treatment to help individuals manage their symptoms and find ways to move forward in their healing process.

Does grief increase a patient's likelihood of suicide, and if so, how can a clinician assess suicide ideation?

Grief can increase a patient's likelihood of suicide, especially if they are struggling with depression or a history of trauma. The intense feelings of pain and distress associated with grief can lead to feelings of hopelessness and despair, which can increase the risk of suicide.To assess suicide ideation in a patient who is experiencing grief from a loss, a clinician should ask direct and open-ended questions about the patient's thoughts and feelings. Some specific questions a clinician may ask include:<ol><li>Have you been feeling hopeless or helpless lately?</li><li>Have you been having thoughts of wanting to hurt yourself?</li><li>Have you made any plans to hurt yourself, or have you taken any steps to carry out such plans?</li><li>Have you had any thoughts of death or suicide?</li></ol>A clinician should also take into account the patient's overall mental state, as well as any previous history of suicidal thoughts or behaviours. If a patient is experiencing suicidal ideation, it is important for the clinician to take the situation seriously and provide appropriate referrals and treatment to help reduce the risk of suicide.In cases of severe or immediate suicide risk, the clinician should involve emergency services and provide the patient with appropriate resources to help them stay safe. Individuals experiencing thoughts of suicide must seek help from a mental health professional as soon as possible, as treatment can help reduce the risk of suicide and support the healing process.

Popular books on grief

<ul><li>On Grief and Grieving: Finding the Meaning of Grief Through the Five Stages of Loss (2005) by Elisabeth Kübler-Ross and David Kessler</li><li>The Grieving Brain: The Surprising Science of How We Learn From Love and Loss (2022) by Mary-Frances O’Connor</li><li>Healing From Great Loss: Facing Pain and Grief to Recover Your Authentic Self (2022) by Ann J. Clark</li><li>It’s OK That You’re Not Ok: Meeting Grief and Loss in a Culture That Doesn’t Understand (2017) by Megan Devine</li><li>Permission to Mourn: A New Way to Do Grief (2014) by Tom Zuba</li><li>Bearing the Unbearable: Love, Loss, and the Heartbreaking Path of Grief (2017) by Joanne Cacciatore</li><li>Finding Your Way Through Grief: A Guide for the First Year (2008) by Marty Tousley</li><li>How to Carry What Can’t Be Fixed: A Journal for Grief (2021) by Megan Devine</li><li>The Grief Recovery Handbook, 20th Anniversary Expanded Edition: The Action Program for Moving Beyond Death, Divorce and Other Losses Including Health, Career, and Faith (2009) by John W. James and Russell Friedman</li><li>The Creative Toolkit for Working with Grief and Bereavement: A Practitioner’s Guide with Activites and Worksheets (2020) by Claudia Coenen</li><li>A Parent’s Guide to Raising Grieving Children: Rebuilding Your Family After the Death of a Loved One (2009) by Phyllis R. Silverman and Madelyn Kelly</li><li>The Goodbye Book (2016) by Todd Parr</li><li>Modern Loss: Candid Conversation About Grief, Beginners Welcome (2018) by Rebecca Soffer</li><li>The Other Side of Complicated Grief: Hope in the Midst of Despair (2016) by Rhonda O’Neill</li><li>The Orphaned Adult: Understanding and Coping with Grief and Change After the Death of Our Parents (2000) by Alexander Levy</li><li>The Year of Magical Thinking (2007) by Joan Didion</li><li>I Wasn’t Ready to Say Goodbye: Surviving, Coping and Healing After the Sudden Death of a Loved One (2008) by Brook Noel and Pamela D. Blair</li><li>The Empty Room: Understanding Sibling Loss (2007) by Elizabeth DeVita-Raeburn</li><li>Neurodivergent Voices Series: Grief Vol. 1 (2023), edited by Kit Caelsto</li><li>Understanding Death and Illness and What They Teach About Life: An Interactive Guide for Individuals with ASD and Their Loved Ones (2008) by Catherine Faherty</li><li>Finding Your Own Way to Grieve: A Creative Activity Workbook for Kids and Teens on the Autism Spectrum (2012) by Karla Helbert</li></ul>

Recent research on grief

<ul><li>Psychosomatic Medicine – <a target='_blank' href='https://journals.lww.com/psychosomaticmedicine/Abstract/2019/10000/Grief__A_Brief_History_of_Research_on_How_Body,.8.aspx'>Grief: A brief history of research on how body, mind and brain adapt</a></li><li>Frontiers in Psychology – <a target='_blank' href='https://www.frontiersin.org/articles/10.3389/fpsyg.2021.691464/full'>New perspectives in bereavement and loss: complicated and disenfranchised grief along the life cycle</a></li><li>European Journal of Psychotraumatology – <a target='_blank' href='https://doi.org/10.1080%2F20008198.2021.1957272'>Traumatic grief research and care in the aftermath of the COVID-19 pandemic</a></li><li>Australian Psychological Society – <a target='_blank' href='https://psychology.org.au/for-members/publications/inpsych/2011/dec/beyond-kubler-ross-recent-developments-in-our-und'>Beyond Kubler-Ross: Recent developments in our understanding of grief and bereavement</a></li><li>American Psychological Association – <a target='_blank' href='https://www.apa.org/news/podcasts/speaking-of-psychology/grieving-changes-brain'>Speaking of psychology: How grieving changes the brain, with Mary-Frances O’Connor</a></li><li>MDPI Behavioral Sciences – <a target='_blank' href='https://doi.org/10.3390/bs11080110'>A biopsychosocial approach to grief, depression, and the role of emotional regulation</a></li><li>The Arc, Autism Now – <a target='_blank' href='https://autismnow.org/blog/bereavement-and-autism-a-universal-experience-with-unique-challenges/'>Bereavement and autism: A universal experience with unique challenges</a></li><li>International Journal of Environmental Research and Public Health – <a target='_blank' href='https://doi.org/10.3390/ijerph20065117'>The Ambiguous Loss Inventory Plus (ALI+): Introduction of a measure of psychological reactions to the disappearance of a loved one</a></li><li>ADPI Behavioral Science - <a target='_blank' href='https://doi.org/10.3390/bs13040299'>The Restorative Integral Support (RIS) model: Community-based integration of trauma-informed approaches to advance equity and resilience for boys and men of color</a></li></ul>

References

<ul><li>American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders: Fifth edition, text revision. Washington, D.C.: American Psychiatric Association Publishing.</li><li>Australian Psychological Society. (2023). Grief. Australian Psychological Society. Retrieved on 5 April, 2023, from: <a target='_blank' href='https://psychology.org.au/for-the-public/psychology-topics/grief'>Grief | APS (psychology.org.au)</a></li><li>Clarke, J. (2023). How the five stages of grief can help process a loss. Very Well Mind. Retrieved on 5 April, 2023, from: <a target='_blank' href='https://www.verywellmind.com/five-stages-of-grief-4175361'>How the Five Stages of Grief Can Help Process a Loss (verywellmind.com)</a></li><li>Health Direct. (2022). Grief and loss. Health Direct. Retrieved on 5 April, 2023, from: <a target='_blank' href='https://www.healthdirect.gov.au/grief-loss'>Grief and loss - the effects of grief and how to deal with it | healthdirect</a></li><li>org. (2023). Coping with grief and loss. HelpGuide.org. Retrieved on 5 April, 2023, from: <a target='_blank' href='https://www.helpguide.org/articles/grief/coping-with-grief-and-loss.htm'>Coping with Grief and Loss - HelpGuide.org</a></li><li>Psychology Today. (n.d.). Grief. Psychology Today. Retrieved on 5 April, 2023, from: <a target='_blank' href='https://www.psychologytoday.com/au/basics/grief'>Grief | Psychology Today Australia</a></li></ul>

Understanding, Assessing and Treating Grief

Guidelines, tools and resources for mental health clinicians

Jump to section

Overview of grief

What is grief?

What are the symptoms of grief?

How to diagnose grief

Common treatment approaches for grief

Psychotherapy

Medication:

Support groups:

Creative expression:

Mind-body techniques:

Physical activity:

Best practice treatment guides for grief

Common comorbidities with grief

Depression

Anxiety

Post-traumatic stress disorder (PTSD)

Substance abuse

Sleep disturbances

Physical health problems

MHA courses on grief

Frequently asked questions about grief

Popular books on grief

Recent research on grief

References