Pyramid of Bereavement Support Levels
The Pyramid of Bereavement Support
This pyramid shows the three main levels of bereavement support: (1) General Support & Information, (2) Extra Support, and (3) Therapy Support. Most people coping with grief will only need level one support.
Level 1: General Support & Information
The first level of bereavement support represents general support and information. Most people who experience loss will only require first-level support, which involves providing people with information on the grieving process, practical help with tasks, and social support. Family, friends, and colleagues will provide much of this support.
Level 2: Extra Support
A small percentage of people may need extra support through their bereavement. This could be because of the nature of the loss – the death of a child, for example, or a sudden death – or because of other circumstances in the person’s life.
Extra bereavement support might be needed if:
The bereaved person feels unable to cope.
There are not many people available to the bereaved person.
Going through the details of the death or the relationship with someone who is not family might help.
Level 2 bereavement support provides a person who is bereaved with an opportunity to reflect in a focused way on their experience of loss. This support is generally provided by volunteers who themselves have been bereaved and have had specialised training in bereavement support.
Bereavement support at this level can be provided on a one-to-one basis or in groups and is used for both adults and children. Voluntary bereavement support services, self-help groups, faith groups, and community groups provide much of the support at this level. It may also be provided through a hospital or hospice.
Well-run bereavement support agencies ensure their volunteers are carefully selected, receive ongoing training, and are supervised by professionals. They are trained to provide a listening ear, to facilitate people in talking about their experience, and to support them in finding their way through their grief.
Level 2 Bereavement support organisations to contact:
If you have been bereaved through a hospice death, it is likely that a bereavement support service will be available in the hospice. Contact the hospice where the death occurred.
If you have been bereaved through an acute hospital, the hospital may provide bereavement support. Contact the hospital social work department or chaplaincy service.
The Bereavement Counselling Service (tel. 01-8391766) offers a volunteer-led bereavement support service that operates Monday-Friday, 9 a.m.-1 p.m.
Bereaved parents can contact Anam Cara (tel. 01-4045378). They provide peer support to bereaved parents and children and maintain online bereavement support forums.
If you have been bereaved through suicide, you can contact Pieta House (tel. 1800247247).
If you feel you need immediate support, contact The Samaritans‘ 24-hour call line at 116 123 (free call).
Level 3: Therapy Support
Level 3 bereavement support is specialised support provided by professionals (psychologists, psychotherapists, counselors, and doctors). Therapy support is appropriate for people who develop complications or become stuck in their grieving process (approximately 10-15% of bereaved people).
No experience of bereavement is easy, but the circumstances surrounding certain deaths can cause additional difficulties for those left behind. The death of a child, the experience of multiple losses over a short period of time, or a particularly traumatic death can all leave survivors needing support beyond that which family and friends may be able to offer. Other factors such as a history of difficulty in coping with loss or a difficult relationship with the person who has died can also suggest that professional intervention might be useful.
In Ireland there is no professional qualification in bereavement counselling. Professionally trained therapists, however, will be registered with a governing body like the ones listed below. These organisations will be able to furnish you with the names of qualified therapists who specialise in issues of loss and grief:
Turning Point in Dublin (01-2801603) offers training in bereavement counselling and bereavement counselling services.
Barnardos Children’s Bereavement Service (01-4732110) is a service for children and young people who have lost someone close to them – like a parent or sibling – through death.
Complicated Grief (Level 4)
For a small number of people, the reduction in their feeling of grief over time of does not happen. Their grief becomes stuck and they experience disabling and persistent symptoms that don’t improve. Strong feelings of yearning and distress continue to be experienced, often coupled with feelings of anger, guilt, bitterness, and an inability to reengage with their life.
Complicated Grief is now recognised as a diagnosable disorder with up to 10% of bereaved people at risk. Complicated grief can be diagnosed following a thorough clinical assessment as early as six months post-bereavement.
Do Bereaved People Always Need Counselling – Dr Susan Delaney gives some advice