Grief counseling is not automatically necessary for everyone; match paid help to your needs
Offering psychological treatment indiscriminately to everyone after bereavement produces small average immediate benefits that may not persist, partly because many people recover without formal therapy. For people already struggling substantially, treatment can be as effective as psychotherapy for other mental health problems. Use the signs in entry 8 to consider an assessment, without treating them as a barrier to support you want or need.
What it takes
Avoiding an unnecessary course of counseling can save money.
What you may gain
A quantitative review of 61 controlled studies found small immediate benefits from general bereavement interventions and no detectable overall benefit at follow-up. Interventions selecting people with clear adjustment difficulties achieved effects comparable to psychotherapy for other problems. Unselected studies were less favorable partly because control participants improved over time without intervention. A meta-analysis of 14 randomized trials found treatments for established complicated grief superior to controls immediately and at follow-up, with effects increasing over time, while universal preventive interventions were ineffective. A prospective study of 205 people followed from before spousal death to six and 18 months afterward identified five trajectories: common grief, chronic grief, chronic depression, improvement during bereavement, and resilience. Resilience was the most common, while the conventional common-grief pattern was relatively uncommon.
Context & considerations
The conclusion is that not everyone requires formal therapy, not that nobody should seek it. The high-risk losses in entry 4 and persistent impairment in entry 8 deserve particular attention. The Lancet review likewise treats ordinary grief as a human response rather than a disease and supports concentrating professional resources on high-risk people and those with complicated grief, depression, or stress disorders after bereavement.
Research & references
Currier JM et al. (2008). The effectiveness of psychotherapeutic interventions for bereaved persons: a comprehensive quantitative review. Psychological Bulletin. https://doi.org/10.1037/0033-2909.134.5.648; Wittouck C et al. (2011). The prevention and treatment of complicated grief: a meta-analysis. Clinical Psychology Review. https://doi.org/10.1016/j.cpr.2010.09.005; Bonanno GA et al. (2002). Resilience to loss and chronic grief: a prospective study from preloss to 18-months postloss. Journal of Personality and Social Psychology. https://doi.org/10.1037/0022-3514.83.5.1150; Stroebe M et al. (2007). Health outcomes of bereavement. Lancet. https://doi.org/10.1016/S0140-6736(07)61816-9