Creating a Treatment Plan for Grief and Loss: What to Include + Example

Grief is a natural, and normative, emotional response to a loss. In most cases, our mind jumps to the loss of a loved one, but in reality, grief can stem from various losses, including that of a relationship, change in careers, and other major life changes. Grief is often messy, and unpredictable. We may find ourselves struggling with sadness, anger, guilt, and despair, or physical symptoms like fatigue, appetite changes, and sleep disturbances. Keep reading to learn how to create a treatment plan for grief and loss, with what to include and an example.

Though grief is a universal experience, it is unpredictable. Every loss we feel affects us differently. We may have an idea of what it will feel like when we lose someone, or when the change occurs, but the truth is that we cannot fully appreciate the gravity of our emotions until there is a finite end. Grief is painful, and often a necessary step in the healing process.

Complicated grief is characterized by prolonged and intense feelings of grief. These feelings are persistent, and continue longer than expected, often causing impairment in functioning. Individuals with complicated grief often find that their symptoms worsen or remain the same over time, rather than lessening as we would expect them to.

As clinicians, there are several therapeutic approaches you could use when working with clients who present with grief and bereavement concerns, including:

Setting Goals and Objectives With Clients in Your Treatment Plan for Grief and Loss

When you begin thinking about crafting your grief treatment plan, it is important to reflect on your client as a whole, rather than honing in on their grief. Like the majority of mental health concerns, grief is complex and can even feel unpredictable for some. It is important to keep in mind other factors of their life that could be exacerbating their symptoms so that they too can be addressed in your comprehensive treatment plan for grief and loss.

Research has indicated that in most situations, people can move through their grieving process without professional help, and often find that their symptoms lessen over time. Even so, bereavement can contribute to an assortment of mental health concerns that can spark a client’s interest in counseling and therapy.

Before you can begin developing your treatment plan, you’ll need some more information. This is usually obtained during an intake assessment. The Indicator of Bereavement Adaption (IBACS) is a validated assessment for individuals who present with grief and bereavement concerns. Other tools commonly used include:

  • The Texas Revised Inventory of Grief (TRIG)
  • The Inventory of Complicated Grief (ICG)
  • The Grief Experience Questionnaire (GEQ)
  • The Structured Clinical Interview for Complicated Grief (SCI-CG)
  • The Grief Evaluation Measure (GEM)

Your evaluation should assess for mental health conditions, and other life stressors that may be exacerbating your client’s experience. This can include mood disorders, PTSD, shifts in employment, and financial stress. Additionally, it is important to speak with your client about what they are hoping to gain from their counseling experience. Some clients may come in knowing that they would like to focus on processing their relationship with the person, or relationship lost, and how it has affected their lives. While others may just need a compassionate, and welcoming ear to listen to their thoughts and provide a safe space for them to be their true self.

What to Include in a Treatment Plan for Grief and Loss + Sample

Our sample treatment plan for grief and loss will follow a hypothetical case to demonstrate the different aspects of a treatment plan. Our treatment plan aligns with the  customizable treatment plan available at TherapyByPro  Continue reading for a brief description of a grief case for Jane:

Case Example:

Since her grandmother’s death 3 weeks ago, Jane has been experiencing a range of distressing symptoms. She reports feeling irritable and easily agitated, particularly in situations that remind her of her grandmother. Sarah has been struggling with sleep disturbances, finding it difficult to fall asleep and stay asleep throughout the night. As a result, she feels fatigued and lethargic during the day. Sarah has also noticed changes in her appetite and weight gain. She describes feeling preoccupied with thoughts of her grandmother’s decline and the early signs of dementia that she exhibited before her death. Sarah worries that she may also be at risk for developing dementia, and is hyper aware of any lapses in memory or cognitive function. She noted that she experienced her second miscarriage about 8 months ago and feels as though she has been “stuck” in grief for almost a year. Jane said that her interest in counseling was self-motivated and that her husband is supportive of her choice. She denied having any physical health concerns and is not working with other health professionals outside of her primary care physician for medical needs. 

Agencies Involved and Plans for Care Coordination

In this case example, Jane reported that she did not indicate working with other health professionals. At this time, there is no need for care coordination.

Example for Jane:

Other Agency: None at this time

Plan to Coordinate Services: N/A

Clinical Diagnoses

Jane’s current symptoms appear to fall within the normative range of grief and bereavement. Because this is a normative reaction to death and loss, it is not sufficient for a mental health diagnosis on its own. However, it is important to be mindful of her symptoms as you continue working together to monitor for conditions such as major depressive disorder. With that being said, you can still utilize appropriate screeners and assessments commonly used for her presenting concern.

Example for Jane:

No diagnosis at this time

Supporting Assessments: Indicator of Bereavement Adaption, Score 27

Current Medications and Responses

Jane has indicated that she is not currently taking psychotropic medications.

Example for Jane:

None at this time

Presenting Problem and Related Symptoms

This section of your treatment plan will describe your client’s presenting concern in detail, being mindful of relevant symptoms. Your description should provide readers with a thorough understanding of your client’s symptoms, impairment, and overall emotional well-being.

Example for Jane:

Jane is a 33-year-old female who works as a teacher. Her symptoms are consistent with the normative process of grief.  Her irritability, sleep disturbances, appetite changes, and preoccupation with cognitive decline suggest a significant impact on her emotional and physical well-being. J.’s concerns about her cognitive functioning may be indicative of anticipatory grief or anxiety about her own mortality, exacerbated by her grandmother’s experience with dementia. J. reported having a miscarriage earlier in the year, which was difficult for her to cope with at the time, and she has been able to work through this grief. She denied the use of psychotropic medications and identified her husband as a healthy support person. 

Goals and Objectives

The goals and objectives of your grief and loss treatment plan should be specific to your client, realistic for their capabilities and resources, and attainable within the designated time frame. Goals on a treatment plan tend to be long-term goals your client is working towards, with objectives describing short-term goals that work towards their overarching goal. Your treatment plan can note the therapeutic approach and interventions you’ll be using.

Example for Jane:

Goal 1:

Reduce Symptoms of Grief and Improve Coping Skills

  • Objective 1: Increase awareness of maladaptive thought patterns and beliefs related to grief through cognitive restructuring exercises, such as identifying and challenging irrational beliefs about loss and mortality.
  • Objective 2: Develop and implement adaptive coping strategies, including relaxation techniques (e.g., deep breathing, progressive muscle relaxation) and mindfulness practices (e.g., mindful breathing, body scan) to manage distressing emotions and physical symptoms associated with grief.
  • Objective 3: Enhance problem-solving skills to address practical challenges and stressors related to the loss, such as organizing memorial events, managing legal matters, or maintaining social connections with supportive individuals.

Goal 2:

Improve Sleep Quality and Reduce Sleep Disturbances

  • Objective 1: Implement a structured sleep hygiene routine, including consistent bedtime and wake-up times, creating a comfortable sleep environment, and avoiding stimulating activities before bedtime.
  • Objective 2:  Incorporate mindfulness-based relaxation techniques into the bedtime routine to promote relaxation and reduce arousal before sleep, such as guided imagery or progressive muscle relaxation.
  • Objective 3: Develop and practice a mindfulness meditation routine, such as a body scan or loving-kindness meditation, to cultivate present-moment awareness and reduce rumination or worries that may interfere with sleep.

Goal 3:

Enhance Emotional Regulation and Reduce Anxiety Symptoms

  • Objective 1:  a. Learn cognitive-behavioral coping skills to identify and challenge anxiety-provoking thoughts and beliefs related to grief and anticipatory fears about cognitive decline, using techniques such as cognitive restructuring and thought records.
  • Objective 2: Engage in mindfulness-based stress reduction (MBSR) practices to cultivate acceptance and non-judgmental awareness of difficult emotions, allowing for a more compassionate and balanced response to grief-related distress.
  • Objective 3: Develop an individualized anxiety management plan, including relaxation techniques, mindfulness practices, and coping strategies to implement during times of heightened anxiety or distress, such as grounding exercises or self-soothing activities

Specific Interventions to Be Used

The therapeutic interventions mentioned within your treatment plan should align with your therapeutic approach, and what would best fit your client’s needs. Grief is an individualized experience, so it is important to reflect on the information you gathered during your evaluation and assessments as you formulate your treatment plan. This particular section of your treatment plan can be a helpful resource for specific interventions to use in session, and to identify who is responsible for carrying out actions that work towards identified goals and objectives. 

Example for Jane:

  • Intervention/Action: Cognitive restructuring and coping skills training
  • Responsible Person: Counselor A
  • Intervention/Action: Mindfulness breathing and body scans
  • Responsible Person: Counselor A
  • Intervention/Action: Psychoeducation about sleep hygiene
  • Responsible Person: Counselor A
  • Intervention/Action: Introduction to self-soothing activities including deep breathing and gentle movement exercises
  • Responsible Person: Counselor A

Family Involvement

Family support for clients struggling with grief and loss can be impactful. Jane mentioned that her husband was supportive of her choice to engage in counseling, which indicates a positive support system. You can begin by asking Jane if she would like to have anyone join her in sessions, but this may not be necessary unless some conflicts or disagreements have resulted from the death. In this example, Jane did not mention conflict, so family involvement in therapy may not be necessary.

Example for Jane:

At this time, Jane does not wish to involve his family in her treatment

Additional Services and Interventions

Additional treatment services can be used to enhance Jane’s treatment experience and provide comprehensive care. You can begin by providing her with a few relevant referrals, and provide her additional ones as they become relevant or needed.

Examples for Jane:

  • Provide referral for grief and loss support group
  • Refer to primary care physician for evaluation of health needs

Estimation for Completion

The estimated time of completion for Jane will depend on the continuation of her symptoms and her overall well-being. Grief therapy is usually a short-term treatment option; however, it can last from a few weeks to a few months. Individuals who do not find that they are adjusting to the loss and are continuing to experience impairment should be monitored for complicated grief.

Example for Jane:

12 sessions over 3 months, to be adjusted as needed

Aftercare Plans

Aftercare plans should reflect the current needs of your client in the case of a sudden discharge or unexpected termination. You can adjust this section as needed, to reflect the current needs of your client. 

Example for Jane:

Aftercare plans:

  • Continued therapy and counseling
  • Support group for grief and loss
  • Continue with regular use of relaxation strategies and coping skills

Final Thoughts On Creating a Treatment Plan for Grief and Loss

Developing a treatment plan for grief and loss requires a comprehensive understanding of your client’s unique experiences, needs, and goals. Your therapeutic rapport can be built on a foundation of empathy, sensitivity, and respect for their grieving process. This can help you develop a safe space for them to express their feelings, memories, and struggles related to the loss.

In the end, the goal of grief and loss therapy is to help clients navigate their grief while trying to find meaning and healing in their loss, When working together, you can help empower your clients so that they healthily can cope with their grief, promoting resilience and growth in the face of loss.

TherapyByPro offers various worksheets and therapy aides that can support you in your work with clients experiencing grief and loss, including this Coping Skills Worksheet Bundle. Visit  TherapyByPro to view additional template options!

TherapyByPro is an online mental health directory that connects mental health pros with clients in need. If you’re a mental health professional, you can Join our community and add your practice listing here. We have assessments, practice forms, and worksheet templates mental health professionals can use to streamline their practice. View all of our mental health forms, worksheet, and assessments here.

Resources:

  • Newsom, Catherine et al. “Effectiveness of bereavement counselling through a community-based organization: A naturalistic, controlled trial.” Clinical psychology & psychotherapy vol. 24,6 (2017): O1512-O1523. doi:10.1002/cpp.2113
Kayla Loibl, MA, LMHC
Author: Kayla Loibl, MA, LMHC

Kayla is a Mental Health Counselor who earned her degree from Niagara University in Lewiston, New York. She has provided psychotherapy in a residential treatment program and an outpatient addiction treatment facility in New York as well as an inpatient addiction rehab in Ontario, Canada. She has experience working with individuals living with a variety of mental health concerns including depression, anxiety, bipolar disorder, borderline personality disorder, and trauma.

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