321 -Grief and Loss Individual and Group Interventions | Journey to Recovery Series
Counselor Toolbox

 
 
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This podcast episode is based on Journey to Recovery: A Comprehensive Guide to Recovery from Mental Health and Addiction Issues by Dr. Dawn-Elise Snipes  Read it for free on Amazon Kindle Unlimited.

Journey to Recovery Series
Grief and Loss Activities
Presented by: Dr. Dawn-Elise Snipes
Executive Director, AllCEUs

CEUs are available for this podcast at https://www.allceus.com/member/cart/index/product/id/924/c/

Objectives
~ Define grief
~ Conceptualize grief in terms of any loss
~ Identify how failure to deal with grief can impact a person
~ Explore the stages of grief
~ Review activities and interventions to help people grieve

What is Grief
~ Grief is a label assigned to all of the emotions associated with dealing with any kind of loss
~ Physical (Things, abilities, freedoms)
~ Self-concept (Roles, values, labels)
~ Worldview (Innocence, safety)
~ Dreams (How things should be)
~ Social (Loss of relationships…)
What is Grief
~ Primary losses also produce secondary losses which also need to be acknowledged and grieved.
~ Loss of a part of ourselves
~ Loss of identity
~ Loss of self confidence
~ Loss of a chosen lifestyle
~ Loss of security or a sense of safety
~ Loss of dreams

What is Grief
~ What secondary losses might occur for these events?
~ Death of a parent
~ Separation or divorce
~ Miscarriages
~ Injury or disability
~ Loss of a job
~ Moving to a new place
~ A child leaving home
~ House fire/tornado

Types of Grief
~ Anticipatory Grief: Experiencing anticipatory grief may provide time for the preparation of loss, acceptance of loss, the ability to finish unfinished businss, life review and resolve conflicts
~ Normal Grief: Normal feelings, reactions and behaviors to a loss; grief reactions can be physical, psychological, cognitive, behavioral
~ Complicated Grief:
~ Disenfranchised Grief: Chronic Grief: Normal grief reactions that do not subside and continue over very long periods of time
~ Delayed Grief: Normal grief reactions that are suppressed or postponed. The survivor consciously of unconsciously avoids the pain of the loss.
~ Masked Grief: Survivor is not aware that behaviors that interfere with normal functioning are a result of the loss.
~ The grief encountered when a loss is experienced and cannot be openly acknowledged, socially sanctioned or publicly shared.
Stages of Grief
~ Denial: Numbness, dream, alternate explanations)
~ Anger: The unknown, loss of control, death, isolation, failure—(shouldas and couldas)
~ Bargaining: If I … then I will wake up and realize this was only a really bad dream
~ Depression: Helpless, hopeless
~ Acceptance: Radical acceptance that the loss occurred and determining how to proceed from there
Exacerbating & Mitigating factors
~ How people react in a crisis depends upon 6 factors
~ How close the situation was to them (physical and emotional proximity)
~ How many other stressors them experienced in the last year
~ Mental health issues/Effective coping skills
~ Social supports
~ Understanding of the loss
~ How much control/responsibility they feel like they had in the situation

Impact of Unresolved Grief
~ Most people get stuck in either anger or depression
~ Anger (shoulda, couldas and if onlys)
~ At self
~ At others
~ At higher power
~ Depression (Hopelessness, Helplessness—I don’t now how to go on)
~ At self
~ At others
~ At higher power
Denial
~ Denial, numbing is the mind’s way of protecting people from what lies ahead.
~ Facing the loss
~ Understand the events of their lives and reconcile the losses they have experienced (clarification)
~ What happened to me?
~ Anger is the power play
~ Break down the walls (Bricks or legos with the losses and threats represented)
~ Bargaining, Pining
~ Mindfulness

Denial
~ Depression, Disorganization and Despair
~ Address hopelessness and helplessness by focusing on what can be changed
~ Death Disappearance
~ Loss Nothing will ever be okay again
~ Failure Failure at everything
~ Bad thing happens It has to happen again

Denial
~ Acceptance/Reorganization
~ Redefine worldview integrating new experiences and strengths
~ Visualize a positive future
~ Who am I? (identity)
~ Where am I going? (attachment)
~ How will I get there? (relationships)
~ When will I know I belong? (claiming and safety)

Not a Linear Process
~ Most people experience grief surrounding a loss for at least a year.
~ Holidays
~ Anniversaries
~ Reminders (people, places, things, media)
~ Many people will vacillate between depression and anger.
~ Normalize people’s experiences
~ Encourage them to reach out to supports
~ Address happiness and survivor guilt

Self Care for Grief
~ Emotionally
~ Express feelings
~ Ask for and accept help
~ Don’t let anyone tell you how to feel—and don’t tell yourself how you “should” feel
~ Be patient
~ Be kind to yourself
~ Add happiness triggers
~ Be aware of your grief triggers
~ Embrace the dialectic
~ It is gone but I have the memories/what I learned
~ I cannot change it but I can impact how it continues to impact me
Self Care for Grief
~ Physically
~ Get plenty of quality rest
~ How to handle being alone with your thoughts….
~ Exercise
~ Eat a healthy diet
~ Avoid alcohol
~ Pay attention to persistent changes in eating, sleeping, mood or energy levels

Self Care for Grief
~ Psychologically
~ Write things down
~ Simplify
~ Set short term goals
~ Distract/engage in pleasurable activities
~ Start writing the next chapter in your story
~ Plan ahead for grief triggers

Self-Care for Grief
~ Interpersonally
~ Rebuild relationships (even understand they can be members of more than one family)

Bill of Rights for Grief
~ To know the truth about the loss
~ To have questions answered honestly
~ To need people and be heard with dignity and respect
~ To be silent and not talk about grief emotions and thoughts.
~ To talk about the loss as much as needed
~ To not agree with your perceptions and conclusions
~ To see the person who died and the place of the death.
~ To grieve any way she/he wants without hurting self or others.
~ To feel all the feelings and to think all the thoughts of his/her own unique grief.
~ To not have to follow the “stages of grief” as outlined in a book.
~ To grieve in one’s own unique, individual way without censorship.
~ To be angry at death, at the person who died, at god, at self, and at others.
~ To have “griefbursts”
~ To be involved in the decisions about the rituals related to the loss
~ To not be taken advantage of
~ To have guilt about what he/she could have done or shouldn’t have done
Activities
~ Create safety
~ Invisible string (Windchime (heart, shells, keys, pipes, terra cotta pots )
~ Book of memories
~ Heart-Break Pot (break into large pieces)
~ Using paint pens and markers, have each family member or child write on the inside of the broken pieces.
~ Instruct them to identify their feelings about being alone in their grief.
~ On the outside of the pieces write about or draw their sources of support.
~ Glue back together

Activities
~ Goodbye letter
~ Letter to God
~ Memory garden
~ Jar of memories / regrets
~ Memory mural
~ Timeline of Change
~ 2 Box Organization – Keep it or Trash it
~ Create a family flag
~ Alphabet of gratitude
~ Raise and release butterflies

Activities
~ Jenga (write discussion prompts on cards)
~ What is your favorite memory
~ What is the hardest part of the loss
~ What is something you learned
~ What is something you did to make yourself laugh this week
~ Who is your support
~ What are 2 things that help you most right now
~ The hardest time of day is…
~ When I am alone, I can…
~ Some things I enjoy
~ Changes in my family because of the loss
~ I am feeling…
~ 3 ways to release feelings of sadness
Summary
~ Losses encompass more than death or a person or loss of property
~ Failure to acknowledge losses can cause unhelpful reactions in similar future situations
~ It is important to explore feelings and reactions in terms of their functionality—how are they benefitting the person
~ It takes at least a year to deal with significant losses
~ Many times there are multiple ancillary losses that need to be addressed
Summary
~ How people deal with grief and loss varies widely.
~ Grieving is a form of crisis
~ The body is on high alert which likely impacts sleep, eating and energy to work or socialize
~ Minimizing vulnerabilities is important to reduce unnecessary frustration and avoid confirming helplessness
~ Ultimately it is hoped that the person can identify how they are stronger or better off from the experience

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