Oftentimes when we think about grief and loss, we think about death. While this may be our most intense example of loss, I would suggest that every time a person uses healthcare services, they experience loss. It arrives in many forms — a loss of independence, an unexpected evening in the ER, losing hair due to chemotherapy, loss of innocence, loss of childhood, or even a lost season of soccer. For a caretaker of a family member who is sick, there is a sacrifice of time, an altered lifestyle and sometimes a loss of self in the care journey. Loss is diverse and experienced by all.

Healthcare clinicians do everything in their power to provide comfort and to minimize pain. They focus on fixing what they can, but no one can fix loss. Loss is like a river, and grief is the boat one uses to navigate. In the river, there is no prescription to aid, no bandage to protect, and no sutures to be sewn. There’s no telling how the river winds, how long the river runs, or how wide the river gets. The resultant grief can be complicated by many factors, from thunderstorms to simple shifts in the wind.

Social workers have unique training and ability to pause, to contemplate and to empathize in times of loss. Their role in facilitating the journey of loss involves seeing the river, getting in the grief boat and providing the tools needed to row.

Seeing the River

Truly seeing the river involves identifying nonverbal cues which indicate the client is struggling and completing a comprehensive assessment to learn about the client’s situation. A client may be in a river of loss without recognizing it. A social worker understands how the river can be life-threatening. Responses to loss may be flooded with guilt and shame, and lead to danger, such as substance abuse and suicidal ideation. By identifying the loss early, the social worker and client can get to work early at managing the grief response.

Getting in the Boat

A social worker gets in the boat and sits with the client in their grief. They allow the client to fully feel and name their emotions. The social worker becomes familiar with the grief boat and its characteristics, understanding how each person’s boat is individualized to who they are, what they’ve been through and where they want to go. A vessel of grief is honored as the social worker provides presence, validation, and active listening. As the client and social worker explore the emotions involved in grief, the social worker can explain how grief varies along a nonlinear path, through stages known as denial, anger, bargaining, depression and acceptance.

During this phase, a social worker reviews the loss a client has already traversed. The client and social worker look back at what worked and hasn’t worked on the journey before turning back downstream.

Sitting in grief with a client emphasizes the power of companionship in the social worker to client relationship. Additional weight can stabilize the boat and prevent a capsize.

Social workers have unique training and ability to pause, to contemplate, and to empathize in times of loss.

Providing the Tools to Row

The goal of providing tools is to assist the client in accepting and adjusting to their loss.

The client is asked to reminisce on times and experiences prior to loss. By reminiscing, the client and social worker seek the meaning of the loss. They find symbols among sentimental items, places and photographs. Meaning may also be sought through various rituals to venerate what was lost and provide some closure.

The client’s personal strengths are important tools in processing grief. These strengths can be harnessed to empower the client and reinforce their sense of self. Counseling a client in grief involves shifting routines, creating healthy behavioral patterns and encouraging engagement in preferred activities to reestablish their identity and avoid unhealthy coping. Acts of self-care and restoration are emphasized as the client adapts to their new life after a loss.

Together, the social worker and client explore triggers and obstacles that rock the boat. Anticipating times of trouble helps the client to prepare for strong waves of emotions and equip themselves with coping techniques.

During the journey, the social worker emphasizes the need for social connectedness. They bridge the client to community resources, such as support groups. They support healthy relationships with family and friends who cheer along the river’s edge or get into the boat.

These various tools come together to prevent the client from drowning in a loss and progress toward integrated grief. Some will be in the boat forever, some will arrive on shore, and some will exit the boat and come back again. With the correct tools, the client can understand the reality and meaning of their circumstances, maintain the skills needed to row and continue to live their life.

In a time when so many of us have been inundated with loss, it’s important to recognize what helps us row. Loss can cause grief that lasts a lifetime, but grief can be a beautiful, strengthening, resilient journey when approached with the proper support. As social workers, we take the responsibility to help our clients stay afloat. We do not fear the water and our oars are at the ready.

If you are looking for evidence-based tools to help your social workers and other mental health care professionals support clients navigating grief and loss, Dynamic Health™ can help. Dynamic Health is an evidence-based tool designed to help nurses and allied health professionals master skills and foster a culture of evidence-based practice and critical thinking, leading to improved patient outcomes.