Don’t spend money on grief counseling right away — first check whether your grief is truly stuck (see the symptoms listed in item 8).

9. Don’t spend money on grief counseling right away — first check whether your grief is truly stuck (see the symptoms listed in item 8).

Cost: No cost at all; in fact, this approach saves you the expense of counseling.

In plain terms: Offering psychological counseling to every bereaved person right after their loss yields little benefit at first, and over time those benefits disappear entirely. The reason is that most people without any intervention would have recovered on their own anyway. However, for those who clearly struggle to adapt, such counseling works just as well as treatment for other mental health issues. So the proper sequence is: first check whether your grief fits the criteria in item 8 (meaning it’s stuck and warrants a visit to a psychiatrist); only if it does should you spend the money on counseling.

Benefit: Data from 61 comparative studies confirm this pattern. General psychological intervention for all bereaved individuals shows minimal benefits right after treatment, which fade further over time. When counseling is limited to those who clearly cannot adapt, its effectiveness matches that of treatment for other mental health conditions. Poor results from studies without prior screening stem from the fact that the control group would have recovered on its own over time. Another 14 randomized controlled trials also show consistent results: treatment for people already experiencing difficulties brings significantly better outcomes than controls both immediately after treatment and during follow-ups, with benefits growing over time. Preventive intervention for people without any issues, however, proves ineffective. One study tracked 205 individuals from before and after the loss of a spouse at 6 and 18 months, identifying five possible trajectories: normal grief, prolonged grief, chronic depression, improvement following the loss, and resilience. The most common path is resilience, while normal grief is relatively rare.

Evidence grade: A

Sources: Currier JM, et al. (2008). The effectiveness of psychotherapeutic interventions for bereaved persons: a comprehensive quantitative review. Psychological Bulletin. <https://doi.org/10.1037/0033-2909.134.5.648>; Wittouck C, et al. (2011). <https://doi.org/10.1016/j.cpr.2010.09.005>; Bonanno GA, et al. (2002). Resilience to loss and chronic grief: a prospective study from preloss to 18-months postloss. Journal of Personality and Social Psychology. <https://doi.org/10.1037/0022-3514.83.5.1150>; Stroebe M et al. (2007). Health outcomes of bereavement. Lancet. <https://doi.org/10.1016/S0140-6736(07)61816-9> (review in the notes)

Notes: This recommendation means “not everyone needs it” rather than “no one should get it.” Those in high-risk groups per item 4 (bereaved after suicide, accidents or violent deaths) and those meeting the criteria in item 8 (grief that has become stuck and warrants psychiatric evaluation) are precisely the individuals for whom such counseling is supported by evidence. This same conclusion appears in a review published in The Lancet. Grief itself is not a disease, and most people do not require professional intervention. Resources should instead be directed toward high-risk individuals and those already suffering from complicated grief, post-loss depression or post-traumatic stress disorder.