Table 57 presents strategies for managing these symptoms. While symptoms of grief and loss may resemble each other, clients may not recognise their response as grief if it is unrelated to death [389, 1589]. The main issue in grief management is to normalise the process for the client. That is, encourage and support the grieving process, and remind the client that this process is natural [389, 1585]. Clients in AOD settings may struggle resolving their grief, as this process usually requires the ability to tolerate and express intense emotion [1586]. Everyone deals with grief and loss differently and therefore not all approaches will work for everyone. It has been suggested that treatment for grief and loss in AOD settings should target coping skills that can help clients process the emotions triggered by loss by [1586, 1590]: i) accepting the reality of the loss; ii) processing the pain associated with the loss; iii) adjusting to a world without the loss, and; iv) finding an enduring connection with the loss while moving on [389, 1588]. An information sheet for clients on grief and loss reactions is provided in the Worksheets section of these Guidelines.
Table 57: Dos and don’ts of managing a client with symptoms of grief or loss
| Do: |
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Encourage the acceptance of the reality of the situation (e.g., discuss the loss, encourage client to attend gravesite), as well as the identification and experience of feelings (positive and negative) associated with loss.
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Normalise the client’s emotional, psychological, physical, and behavioural reactions to the loss.
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Help the client find a suitable way to remember, but also reinvest in life.
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Continually monitor levels of depression and suicidal thoughts and act accordingly; risk is increased during periods of grief (e.g., the first 12 months after a death, anniversaries, holidays).
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Be aware and understanding of feelings associated with grief, including anger.
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Give both practical and emotional support.
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Give the client your undivided attention and unconditional positive regard.
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Be aware that concentration may be affected, therefore repeat instructions, write down instructions and so on.
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Discuss emotions and behaviours related to the loss, including AOD use.
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Encourage healthy avenues for the expression of grief (e.g., physical activity, relaxation, artistic expression, talking, writing) rather than AOD use.
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Encourage the client to seek social support. This may include bereavement services.
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| Don't: |
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Avoid the reality of the situation or the feelings associated with it (e.g., use the name of deceased).
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Judge or be surprised at how the client reacts – every person is different.
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Time-limit the client when discussing grief, it can be a slow process and the story related to grief may be retold many times.
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Be afraid to seek assistance.
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Adapted from Marsh et al. [1585], Stone et al. [389] and Horton et al. [1591].