Social workers are often required to educate their clients about the grieving process, spot abnormal bereavement and provide sympathetic, nonjudgmental support. The job entails serving as de facto mental health professionals and listening actively to suggest coping techniques and help people accept deaths and other losses that cause them to grieve.
It’s important to understand key facts about the grieving process, or social workers could make things worse or fail to spot the warning signs of unnatural grief. The following five areas contain essential information for successful grief counseling:
1. Understand the Symptoms of Grief
The symptoms of grief vary with each person, so generalities provide only a basic outline for understanding. Common emotions include the five stages of grief:
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
At one time, these stages were almost universally accepted, but counselors have found that not everyone goes through all five stages, but knowledge of the theory often proves useful therapeutically. Other symptoms of grief include anger, shock, fear, sadness, guilt, behavioral changes, sexual promiscuity, recklessness, aggression, hyperactivity, disruptions in lifestyle patterns, drug and alcohol abuse and many other reactions. Therapists can’t fix the pain, but they can listen with sympathy, accept a client’s feelings without censoring them and explore therapeutic solutions like faith, spirituality, doing good deeds, staying busy, expressing emotions and others.
2. Knowing the Risk Factors for Dangerous Grief
Most people recover from grief relatively quickly, and routines like funeral services, wakes, counseling sessions and other structured events help people to deal with grief over deaths or great personal losses. However, some people become dangerously affected by grief and develop harmful symptoms like substance abuse, severe depression, loss of purpose in life, anger at God or authority figures, lack of energy, shortness of breath, weakened muscles and other physical effects. Medical research hasn’t identified all the physical or psychological issues that trigger severe grief, but the following situations often result in people experiencing prolonged, and potentially dangerous, grief:
- Multiple losses in a short period
- No support system at home, school or work
- A codependent relationship with the deceased
- History of abuse or neglect
- Suicide
- Unexpected or violent death or loss
- Physical problems like diabetes, high blood pressure, allergies, headaches and poor eating or sleeping habits
Various local, state and national organizations publish resource guides that can help counselors find programs and resources for clients overwhelmed by grief.
3. Active Listening While Maintaining an Appropriate Demeanor
Listening actively works more effectively than talking. Remember that you have the power and authority, but clients don’t want to know what you would do because they don’t have an equal relationship with you. However, if you listen actively and pay close attention to what a client says, he or she may open up and share more feelings. Maintain eye contact, but vary it so that you’re not staring. Show emotion about what’s being said, and don’t hide your face or reactions. The wrong body language can erase any benefits that active listening gains, so be aware of the following “body-language” signals:
- Sit on the same level as the client
- Orient your body toward the client
- Maintain an open posture by not crossing your arms and legs and keeping you body upright and centered
- Use positive gestures
- Maintain eye contact
- Avoid nervous gestures like fidgeting or looking at a watch
4. No Two Situations Are Exactly the Same
Every person is a unique individual, so never respond or diagnose by referring to other people’s experiences. Each individual, family and relationship has its own dynamic, so always remember that the person in front of you may not be like the person you saw yesterday. Repeat the mantra to yourself, “It’s not the same.” The case before you has its own characteristics, and it might require a very different approach regardless of how similar the two cases might appear on the surface. Listen actively until you get an accurate picture of the client and see him or her as a unique person with special needs, idiosyncrasies and personal qualities.
5. Drawing a Line Between Sympathy and Respect for the Counselor
Regardless of how devastated any client becomes, social workers must be firm at some point with each client. Parents correct children with love, and grief counselors bear responsibility for encouraging grieving people to resume normal lives despite their pain. Acting out, giving up and disrespecting counselors and others aren’t appropriate behaviors, and counselors should not encourage or empower these kinds of conduct. It’s especially tricky when dealing with children to balance the need to show sympathy while not allowing the child too much leeway for acting out, throwing a tantrum or withdrawing.
Dealing with grief can prove overwhelming for the victims of grief and their social workers if the grief counselors aren’t prepared for the issues that arise. Dealing with deaths, elderly patients, terminally ill people and those in long-term or hospice care can challenge social workers. One good resource for learning the best practices in palliative and end-of-life care is provided by the National Association of Social Workers or NASW.
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