Prolonged Grief Disorder (PGD): pathological grief, prolonged grief, and complicated grief, existed before. The first criteria set for PGD diagnosis in the DSM-5 was persistent complex bereavement disorder, with symptoms lasting more than one year. In this Part 2 Segment of Complicated Grief, we will clarify current issues and methods to help clients define and develop milestone markers for a healthy grieving process.
Upon completion of the training, participants will be able to:
- Clarify current issues with complicated and prolonged grief.
- Develop milestone markers of a healthy grieving process.
- Assist the client in identifying distorted cognitive thinking regarding grief.
- Incorporate counteractive measures to distorted beliefs.
- Create a plan for therapists to help clients lower grieving stress symptoms.
Syllabus:
Objective #1: Understanding Prolonged Grief Disorder (PGD)
- Defined as persistent complex bereavement with symptoms over one year
- Includes identity disruption, emotional numbness, and avoidance
- Impacts both mental and physical health—linked to cardiovascular events and stress-related disorders
- Requires differentiation from typical grieving processes and depression
Objective #2: Challenging Traditional Grief Models
- Questions the rigidity of the five stages of grief
- Encourages redefining self after loss rather than “moving on”
- Recognizes acute grief may lessen in months but resurfaces over time
- Acknowledges spiritual crises and loss of faith as part of the grief journey
Objective #3: Phases of Grieving
- Phase 1: Reaction – absorbing the emotional impact
- Phase 2: Rumination & Replay – obsessive review and meaning-seeking
- Phase 3: Return – re-engaging with life post-loss
- Emphasizes the non-linear nature of grief recovery
Objective #4: Cognitive Distortions in Grief
- Examples include “I should have done more,” “It’s not fair,” and “I can’t move on”
- Clients may resist support, feel guilt, or deny the future
- Hogan Grief Reaction Checklist used to assess distorted beliefs
- Distortions often rooted in self-blame, hopelessness, and avoidance
Objective #5: Milestone Markers of Healthy Grieving
- H.E.A.L.I.N.G.: Honor, Ease emotional pain, Accept grief, Learn to live with loss
- Integrate memories, Narrate stories, Gather support
- These milestones represent adaptive coping and emotional integration
Objective #6: Addressing Comorbid Conditions
- Grief often coexists with PTSD, substance use, sleep disorders, and social isolation
- Childhood trauma may exacerbate emotional dysregulation
- Prolonged grief can mimic or trigger anxiety, depression, or suicidal ideation
- Requires holistic assessment and integrated treatment planning
Objective #7: Reframing Distorted Beliefs
- Counter maladaptive thoughts with acceptance, compassion, and narrative therapy
- Promote “moving forward with grief” versus “moving on”
- Validate continued bonds and meaning reconstruction
- Address survivor guilt and rumination through grounding techniques
Objective #8: Anchoring Techniques and Continuing Bonds
- Therapeutic tools: letter writing, empty chair technique, linking objects
- Emphasize rituals and symbolic acts to maintain healthy emotional connection
- Continued bonds reduce anxiety and support purpose-finding after loss
- Encourage expression in safe, supported environments
Objective #9: Reducing Stress and Building Coping Plans
- Activities: breathe, move, write, talk, distract, create
- Address both physical and emotional symptoms of grief
- Self-care plans include trusted support, mood boosters, and healing places
- Encourage gradual re-engagement with life and identity exploration
Objective #10: Reconstruction and Meaning-Centered Grief Therapy
- Grieving is an active process of reconstructing identity and meaning
- Model includes validation, memory integration, restoration, and transcendence
- Emphasizes resilience and transformation through ongoing reflection
- Incorporates cognitive, emotional, and spiritual healing over time
Social workers completing this course receive 3 Clinical asynchronous continuing education credits.
For other board approvals, this course qualifies for 3 Clinical continuing education training.
Instructor: Dr. Paul Hardy, D.Min. NMAC, CSAC
Recording Date: 9/07/2024
CEUS On-Demand, LLC, provider #2274, is approved as an ACE provider to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Regulatory boards are the final authority on courses accepted for continuing education credit. ACE provider approval period: 08/7/2026 - 08/6/2027. Social workers completing this course receive 3hrs Clinical continuing education credits.
CEUs On-Demand, LLC has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 7091. Programs that do not qualify for NBCC credit are clearly identified. CEUs On-Demand, LLC is solely responsible for all aspects of the programs.
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