grief counseling: an investigation of counselors' training, experience, and competencies

Journal of Counseling & Development ■ April 2012 ■ Volume 90150

Research

© 2012 by the American Counseling Association. All rights reserved.

Received 09/25/09Revised 04/04/10

Accepted 04/05/11

Helping clients adjust to grief and loss is a critical skill for counselors that will be in more demand in the coming decades. Grief is the “emotion, generated by an experience of loss and characterized by sorrow and/or distress and the personal and interpersonal experience of loss” (Humphrey, 2009, p. 5). Researchers (Maples & Abney, 2006; Robb, Haley, Becker, Polivka, & Chwa, 2003) anticipate aging baby boomers’ requests for grief counseling to rise as they experience successive losses. Pending legislation to allow Medicare reimbursement for counselors would significantly increase the number of older adults served by the counseling profession (American Counseling Association [ACA], 2009). Many returning veterans are seeking services to help manage the losses and trauma of war (Papa, Neria, & Litz, 2008). As a result, counselors can expect to face more clients seeking assistance in surviving their losses.

Despite this increasing demand, there is evidence to suggest that not all counselors are adequately trained or completely comfortable providing grief counseling. Grief counseling is not required in accredited core counseling cur-ricula (Council for Accreditation of Counseling and Related Educational Programs, 2009), and surveys of counseling programs have found that the majority do not expect students to complete any training on grief (Humphrey, 1993; Hunt & Rosenthal, 1997). Many programs do not offer a course on grief or death and dying (Freeman & Ward, 1998). The scarcity of training is discouraging because studies have found that training in grief counseling can improve problem recognition and treatment planning skills in addition to in-

Anne M. Ober, Department of Counseling and Human Development, Walsh University; Darcy Haag granello, Department of Counselor Education, and Joe E. Wheaton, Department of Special Education, Ohio State University. Correspondence concerning this article should be addressed to Anne M. Ober, Department of Counseling and Human Development, Walsh University, 2020 East Maple Street, North Canton, OH 44720 (e-mail: [email protected]).

Grief Counseling: An Investigation of Counselors’ Training, Experience, and Competencies Anne M. Ober, Darcy Haag Granello, and Joe E. Wheaton

Grief is prevalent in counseling, but little is known about the current status of counselors’ preparation and competen-cies to provide effective care. This exploratory study surveyed counselors (N = 369) on grief training, personal and professional experiences with grief, and grief counseling competence. Multiple regression analyses found training and experience were statistically significant predictors of competence. The strong relationship between variables suggests these concepts may be understood as synonymous. Implications for training, practice, and research are discussed.

Keywords: grief, grief counseling, competencies, training

creasing counselors’ comfort level and coping skills when working with grieving clients (Kees, 1988; Mastrogianis, 1999).

Charkow (2002) found more than 50% of 147 members of the American Association of Marriage and Family Ther-apy and International Association of Marriage and Family Counselors organizations surveyed had no training on grief in their graduate programs. The majority of respondents reported less than 10 hours of professional development training postdegree and viewed their overall preparation in the area of grief as less than adequate. Almost all participants (98%) reported that they worked with at least one client on concerns related to grief. A survey of 627 rehabilitation counselors revealed 54% had no formal training on grief. Most (98%) stated they needed more training because 40% reported that they were working with terminal clients at the time of the survey and 61% had experienced the death of a client within the previous year (Allen & Miller, 1988). Col-lectively, these studies suggest that most of the counselors received minimal or no training on grief in their graduate programs and, furthermore, identified grief as an area in which they required additional training.

One study’s findings suggested mental health professionals did not require specific training to feel competent in providing grief counseling. Stephenson (1981) found that 90% of the 71 American Association of Marriage and Family Therapy counselors who reported feeling competent to provide grief counseling indicated they received little to no emphasis on grief in their training. This incongruity between a lack of

Journal of Counseling & Development ■ April 2012 ■ Volume 90 151

Grief Counseling

training and perceived competency was not investigated fur-ther. Nevertheless, the findings raise concerns about whether all counselors recognize the need for specialized training in grief counseling or understand that there are specific grief competencies that have been developed for counselors.

Two published studies have investigated the self-perceived grief counseling competencies of practicing counselors and members of different professional organizations. Smith (2003) investigated the impact of grief training, personal experience with grief, and counseling self-efficacy on practicing counselors’ ability to cope with death, both per-sonally and professionally. This study found that general counseling skills and specific training on grief explained 35% of the variance in counselors’ self-perceived grief counseling skills. Additionally, those counselors who had confidence in their counseling abilities and an awareness of their own values and attitudes toward death believed they were more effective in expressing personal feelings on the topic of loss. Charkow (2002) surveyed family therapists and found that participants who had personal experiences with grief and higher levels of Personal Competencies (a subscale described next) in grief reported higher overall grief counseling competence.

To help counselors work more effectively with clients facing grief issues, Charkow (2000) developed a set of Grief Counseling Competencies. The competencies, based on a factor analysis of a survey of practicing family therapists, are divided into five major subscales: Personal Competen-cies, Conceptual Skills and Knowledge, Assessment Skills, Treatment Skills, and Professional Skills. The Personal Com-petencies subscale measures an individual’s overall wellness and ability to articulate thoughts and feelings about grief and includes topics such as self-care, sense of humor, spirituality, personal philosophy, and attitude toward loss. The Concep-tual Skills and Knowledge subscale assesses the counselor’s ability to define normal and complicated grief and describe effective and ineffective coping skills, knowledge of theories of grief, and developmental understanding of death. The Assessment Skills subscale evaluates the counselor’s ability to assess clients for unresolved losses, complete suicide as-sessments, assess spirituality, recognize cultural influences on grief, and assess making appropriate referrals to medi-cal treatment. The Treatment Skills subscale measures the ability to provide psychoeducation on grief and loss issues; facilitate individual, group, and family counseling sessions focused on grief; establish rapport with clients; use active listening skills; reframe loss experience; use creative arts in counseling; and cocreate and participate in mourning rituals. Finally, the Professional Skills subscale assesses the skills of providing grief-related community and school activities, providing crisis intervention, working on an interdisciplinary team, maintaining current literature on grief, and participating in professional support groups.

Although these two studies (Charkow, 2002; Smith, 2003) initiated research on the Grief Counseling Com-petencies, further research is required. Both studies used small samples, and one study was composed solely of professional organization members, making it difficult to generalize results to the overall population of licensed practicing counselors. Additionally, neither study inves-tigated prior training and professional experience with grief counseling. Thus, the current study investigated the following research questions:

Research Question 1: What is the current status of train-ing and experience in grief counseling in a sample of licensed practicing counselors?

Research Question 2: What are the self-perceived per-sonal and professional grief counseling competencies among licensed professional counselors?

Research Question 3: What counselor variables (age, gender, years of experience as a professional coun-selor, personal experience with grief as measured by both past behaviors and present feelings, and training and experience in grief counseling) best predict grief counseling competence?

MethodThis study used descriptive and regression methods to analyze data gathered from a representative sample randomly selected and a mail survey design (Fink & Kosecoff, 1998; Heppner, Kivlighan, & Wampold, 1992). A simple random sample of 1,000 participants was selected from a state board listing of 6,919 licensed professional counselors in one midwestern state, using SPSS software (Version 15). The required sample size (N = 134) was determined for an alpha level of .01 and a power of .80, with a medium effect size (Cohen, 1988). Each participant received a survey packet containing a letter of explanation and informed consent, a demographic question-naire, survey instruments and answer sheets, a self-addressed stamped return envelope, and a self-addressed stamped post-card with the participant’s name and an indication of survey completion, which was to be returned separately. After 3 weeks, a second mailing was sent to all participants from whom a postcard had not yet been received. All returned postcards were entered into a drawing for a gift certificate from a national retail chain to encourage participation. All procedures of the university’s institutional review board were followed. The first mailing produced 318 completed surveys, and the second mailing produced 56 surveys, resulting in a total of 374 surveys or a 37.4% response rate. Surveys that had significant missing responses were removed, resulting in 369 usable surveys. Responses from the first and second wave were compared, and, because no significant differences were found between the groups, the surveys were compiled and analyzed together.


Ober, Granello, & Wheaton

Participants

The majority of the participants were female (77%) and Eu-ropean American (92.7%) with an average age of 48 years (age range: 25–78) and had been working as counselors for an average of 11 years, post-initial-licensure (range from 6 to 39 years practicing postlicensure). Specifically, in terms of experience, 21.1% (n = 76) reported up to 3 years as licensed professional counselors, 29.1% (n = 105) indicated 4 to 9 years, 26.0% (n = 94) reported 10 to 20 years, and 23.8% (n = 86) identified as having more than 20 years of experience. A small percentage self-identified as African American (3.8%), and few identified as multiracial (1.6%), Latino (0.8%), Asian American (0.3%), and Native American (0.3%). (Percentages regarding race/ethnicity do not total 100 because of round-ing.) A majority of the participants held the supervisory credential offered by the state (61.8%), and most indicated their highest completed degree was a master’s degree (87.3%). Although the state board does not provide information on the demographic breakdown of licensees, the gender and race distribution of the sample is in line with previous research conducted with licensed counselors in the state. For example, Granello’s (2010) sample of the state’s licensed counselors also was primarily female (72%), was European American (85%), and held master’s degrees (84%). This breakdown is also roughly consistent with the membership statistics of ACA. Among those who report their gender and race, 75% are female and 83% self-report as Caucasian (ACA, 2010).

Instruments

Participants completed three instruments to measure Grief Counseling Competencies, personal experience with grief, and professional training and experience on grief.

Death Counseling Survey (DCS; Charkow, 2000). The DCS is a 58-item Likert scale created from surveying 34 experts in grief counseling to determine the necessary skills, knowledge, and self-awareness competencies. The DCS includes subscales based on the five Grief Counseling Competencies subscales: Personal Competencies, Concep-tual Skills and Knowledge, Assessment Skills, Treatment Skills, and Professional Skills. Each item is ranked on a 5-point scale ranging from 1 (this does not describe me) to 3 (this somewhat describes me) to 5 (this describes me very well). Mean scores for each subscale range from 1 to 5, with higher scores indicating greater levels of grief counseling competence (Charkow, 2000). Evidence of validity is dem-onstrated by correlational studies of the relationship between the DCS and the Bugen Coping With Death Scale (Bugen, 1980–1981; r = .73). Reliability is evidenced by Cronbach alpha values ranging from .79 to .94 for the five subscales (Charkow, 2002). In the current study, Cronbach alphas were .80 (Personal Competencies), .84 (Professional Skills), .86 (Assessment Skills), .91 (Conceptual Skills and Knowledge), and .94 (Treatment Skills).

Texas Revised Inventory of Grief (TRIG; Faschingbauer, DeVaul, & Zisook, 1987). The TRIG assesses the intensity of response to the loss of a loved one with two subscales: Past Behaviors (at time of death) and Present Feelings. The subscales contain a total of 21 items, and participants indicate responses to statements within a range of 1 (completely true) to 3 (both true and false) to 5 (completely false) about their experiences with loss. Mean scores for each subscale range from 1 to 5, with higher scores indicating less intense responses to loss.

The TRIG was previously used to investigate the rela-tionship between counselors’ grief and clients’ perceptions of grief counseling. The results indicated that counselors with higher scores on the TRIG (less intense responses to loss) were perceived to be less empathetic by their clients and those who had lower scores (more intense responses to loss) were perceived to be more empathetic (Hayes, Yeh, & Eisenberg, 2007). Boyer and Hoffman (1993) administered the TRIG to counselors and determined personal experi-ence with loss was a significant predictor of counselors’ emotional response, such as depression and anxiety, during their termination with clients.

Previous research explored the validity and reliability of the TRIG. Cronbach’s alpha values for the Past Behaviors subscale range from .77 to 82 and for the Present Feelings subscale from .82 to .91 (Boyer & Hoffman, 1993; Fasch-ingbauer et al., 1987; Hayes et al., 2007; Ringdal, Jordhoy, Ringdal, & Kaasa, 2001; Seecharan, Andresen, Norris, & Toce, 2004). Split-half reliability was found to be .74 for the Past Behaviors subscale and .88 for the Present Feelings subscale (Faschingbauer et al., 1987). Evidence of validity was reported by the authors for both subscales by testing hypotheses about different groups’ responses to the death of a loved one. Those respondents who stated their loved one was an active and important part of their day-to-day life reported more intense responses to the loss than did those whose loved ones were less a part of their day-to-day life (Faschingbauer et al., 1987). In the current study, the Cronbach’s alpha for Past Behaviors was .85 and for Present Feelings was .86.

Grief Counseling Experience and Training Survey (GCETS; Ober, 2007). This instrument was modified from the Sexual Orientation Counselor Competency Scale (SOCC; Bidell, 2005), with permission from the author, to assess experience and training related to grief counseling. Because no other instrument exists to assess this construct, the SOCC was slightly modified, replacing the terms gay, lesbian, and bisexual clients with clients who present with grief. The GCETS is a 12-item Likert scale with a possible range from 1 (not at all true) to 3 (somewhat true) to 5 (totally true). A mean score (range = 1 to 5) assesses respondents’ clinical training, supervision, experience, and formal education on grief counseling. Prior to administering the GCETS as part of this study, we test piloted the assessment with 21 practicing mental health providers in a college counseling clinic. The


Grief Counseling

GCETS was shown to have an acceptable reliability coeffi-cient (α = .86). Evidence of validity was suggested through pilot participant interviews after completing the GCETS. In the current study, Cronbach’s alpha for the GCETS was .97. Because this study was the first administration of this instru-ment, further evidence is required for validity and reliability.

ResultsA demographic questionnaire provided data to answer the first research question: What is the current status of training and experience in grief counseling in a sample of licensed practicing counselors? A slight majority of respondents (54.8%, n = 190) stated they had not completed any specific courses on grief, although many respondents (73.2%, n = 254) reported they had completed at least one course that infused grief in a significant way. A large percentage (69.4%, n = 247) indicated that they had completed at least some professional development hours on grief. A significant majority (91%, n = 334) indicated training in grief counseling is necessary or should be required.

Counselors were asked to indicate familiarity with various theories of grief counseling as part of the demographic ques-tionnaire. The results demonstrated Stage Theory (Kubler-Ross, 1969) as the most recognized with 42.8% (n = 158) and 49.6% (n = 183) reporting some and a lot of familiarity, respectively. Task (Worden, 2009) and meaning making (Nei-meyer, 2001) theories were each known by about one quarter of the sample (28.2%, n = 104, and 25.5%, n = 94, respec-tively) had at least some familiarity; however, about 40% (n = 148 and n = 159, respectively) of the respondents reported no familiarity with either of these theories. Respondents were least familiar with the dual-process (Stroebe & Schut, 1999) and continuing bonds (Klass, 2001) theories (15.4%, n = 57, and 14.9%, n = 55, respectively), with approximately half of

the sample (48.0%, n = 177, and 52.8%, n = 195, respectively) indicating no familiarity with either theory.

The means and standard deviations were calculated for the Grief Counseling Competencies (DCS), training and experi-ence in grief counseling (GCETS), and personal experiences with grief (TRIG) to answer the second research question: What are the self-perceived personal and professional grief counseling competencies among licensed professional coun-selors? The results of the calculations are presented in Table 1. In general, counselors in the sample rated themselves slightly below the midpoint on the GCETS (M = 2.71, SD = 0.93) and slightly above the midpoint on all five Grief Counseling Competencies. On average, respondents scored highest on Personal Competencies (M = 4.41, SD = 0.43) and lowest on Conceptual Skills and Knowledge (M = 3.07, SD = 0.91). Finally, the average scores for both subscales measuring personal experience with grief, Past Behavior (M = 3.84, SD = 0.82) and Present Feelings (M = 3.71, SD = 0.74), were slightly above average, indicating, on average, a less intense response to loss both at the time of death and currently.

To answer the third research question—What counselor variables best predict grief counseling competence?—we created five separate regression equations, one for each of the Grief Counseling Competencies subscales of the DCS (Personal Competencies, Conceptual Skills and Knowledge, Assessment Skills, Treatment Skills, and Professional Skills). The Grief Counseling Competencies subscales were investi-gated separately because they could provide specific data on relative strength and weakness of abilities and, in turn, training in these areas. Because five separate regression equations were analyzed, the risk of a Type I error was reduced by completing each analysis at an alpha level of .01 for a total (familywise) alpha error rate of .05. All assumptions of normality, linearity, homoscedasticity, and multicollinearity were verified prior to completing the regression analyses (McClendon, 1994).

TAblE 1

Means and Standard Deviations for Training and Experience in grief Counseling (gCETS), grief Counseling Competencies (DCS), and Personal Experiences With grief (TRIg)

Variable

Grief Counseling Experience and Training Survey (GCETS)Death Counseling Survey (DCS)

Conceptual Skills and Knowledge Professional Skills Treatment Skills Assessment Skills Personal Competencies

Texas Revised Inventory of Grief (TRIG) Present Feelingsc Past Behaviorsc

Note. N = 369. CI = confidence interval. aPossible range of mean scores is 1–5, with higher scores indicating higher levels of training and experience. bPossible range of mean scores is 1–5, with higher scores indicating higher levels of self-perceived competence. cPersonal experiences. dPossible range of mean scores is 1–5, with higher scores indicating less intense response to loss.

M 95% CISD

2.71a

3.07b

3.19b

3.47b

3.56b

4.41b

3.71d

3.84d

0.93

0.91 0.83 0.71 0.73 0.43

0.74 0.82

[2.61, 2.81]

[2.97, 3.17][3.11, 3.27][3.39, 3.55][3.48, 3.64][4.37, 4.45]

[3.63, 3.79][3.76, 3.92]



The predictor variables were age, gender (dummy coded, with men as the reference group), years of professional experi-ence as a counselor, training and experience in grief counseling (GCETS), and personal experiences (past behavior and present feelings) with grief (TRIG). The criterion variables were the Grief Counseling Competencies subscales of the DCS.

Table 2 shows the Pearson product–moment correlations computed between predictor and criterion variables, and Table 3 presents the results from the five multiple regression analyses. Each analysis was run using the Enter method, forcing all predictor variables into the equation. Standardized beta weights (and the significance level of the corresponding t values) are reported to determine the unique contribution of each predictor variable to the equation. In addition, structure coefficients for each of the predictor variables are reported to allow for an understanding of the underlying relationship of each predictor variable to the predicted criterion vari-able, sometimes called YHAT (predicted value of criterion/dependent variable [y]), regardless of its redundancy to other predictors. For an exploratory investigation such as this, where the goal is to understand the relationships between the predictor and criterion variables rather than to find the most parsimonious prediction equation, the combination of standardized beta weights and structure coefficients provide the most comprehensive understanding of the relationships between the variables (Dunlap & Landis, 1998).

In all five regression equations, training and experience in grief counseling (as measured by the GCETS) was the strongest of all the predictor variables, accounting for the most variance in the criterion variable. Gender provided ad-ditional unique and significant contributions to the variance in Personal Competencies, Assessment Skills, and Treat-

ment Skills, with women scoring significantly higher than men. Age was the only other predictor variable that offered a significant unique contribution, with younger counsel-ors scoring significantly higher on Conceptual Skills and Knowledge. However, the size of the structure coefficient for age is extremely small (r

s = –.02), meaning that although

it adds to the model in a statistically significant way, the overall contribution of age to the variance in Conceptual Skills and Knowledge is very small (correlation between predictor and criterion variable r = .02, p = .36). Neither personal experience with grief (past or present) nor years of experience as a counselor was found to be a significant contributor to any of the regression models.

DiscussionThis study surveyed the largest sample to date of practicing coun-selors on training and experiences related to grief counseling and Grief Counseling Competencies. The results provide valuable data regarding the knowledge, skills, and awareness of practic-ing counselors, using the only instrument created specifically to assess Grief Counseling Competencies. As with previous studies on training (Allen & Miller, 1998; Charkow, 2002; Stephenson, 1981), slightly more than half of this sample reported no course preparation on grief, but it is surprising that approximately 45% had completed at least one specific grief course.

The content of grief counseling courses and professional development programs has not been thoroughly investigated, nor do guidelines exist for topics or objectives of grief counseling training. As a result of the lack of standards and competencies, training may focus on theories not validated by empirical research. The sample indicated little familiarity

TAblE 2

Correlations between Predictor and Criterion Variables

Variable

1. Age 2. Gender 3. Years of experience as a professional counselor 4. Grief Counseling Experience and Training Survey 5. Past Behaviors subscale of the Texas Revised Inventory

of Griefa 6. Present Feelings subscale of the Texas Revised

Inventory of Griefa 7. Personal Competencies subscale of the Death

Counseling Survey 8. Conceptual Skills and Knowledge subscale of the

Death Counseling Survey 9. Assessment Skills subscale of the Death

Counseling Survey 10. Treatment Skills subscale of the Death

Counseling Survey 11. Professional Skills subscale of the Death

Counseling Survey

Note. n = 361. aPersonal experiences.*p < .05. **p < .01.

1 2 3 4 5 6 7 8 9 10 11

— –.18** .64** .15**

.11*

–.04

.08

–.03

–.05

.07

.03

— .14* .03

.12*

.05

.19**

.08

.15**

.10

.08

— .24

.13

.09

.08

.15

.18

.19

.19

—

.15

.09

.37**

.83**

.72**

.84**

.77**

—

.22**

.14*

.17

.18

.15

.11

—

.08

.07

.06

.12

.08

—

.35**

.38**

.45**

.33**

—

.86**

.89**

.84**

—

.84**

.74**

—

.88** —


Grief Counseling

with dual-process and meaning-making theories, two ap-proaches with some evidence of validity (Lindström, 2002; Richardson, 2007; Richardson & Balaswamy, 2001; Schut, Stroebe, van den Bout, & Terheggen, 2001). The theories that counselors report most familiarity with, stage and task, have both had their utility questioned. For example, stage theory (Kubler-Ross, 1969) has not been supported by any empirical evidence (Bonanno & Kaltman, 1999; Hansson & Stroebe, 2007; Lindström, 2002; Maciejewski, Zhang, Block, & Prigerson, 2007; Payne, Jarrett, Wiles, & Field, 2002; Stroebe & Schut, 1999; Wortman & Silver, 2001). Corr (1993) suggested that research on the effectiveness of grief counseling yields inconsistent results at least in part because counselors’ application of invalidated theories may conceptualize grief and its resolution inaccurately. Thus, even when training is acquired, it may not adequately pre-pare counselors if it does not include theories that have been validated through empirical research.

Results from this study parallel Charkow’s (2002) find-ings. Counselors rated themselves highest on Personal Com-

petencies (M = 4.41, SD = 0.43) and lowest on Conceptual Skills and Knowledge (M = 3.07, SD = 0.91). The Personal Competencies subscale, however, contains general questions not related specifically to grief training, such as self-care, sense of humor, spirituality, and the ability to articulate a personal philosophy of death and grief. Thus, counselors perceive themselves, on average, well-prepared in terms of self-awareness and self-care to work with clients on grief. However, when it comes to specific knowledge and skills about grief (e.g., theories of grief, definitions of types of be-reavement, identification of effective and ineffective coping skills, and applying a developmental understanding of grief in work with clients), counselors perceive themselves to be, on average, much less prepared.

These results underscore the importance of helping counselors recognize that personal familiarity with a topic, such as grief, is not the same as professional knowledge and understanding. For example, although counselors may be comfortable with their conceptualization of death, this knowl-edge is not necessarily sufficient when working with a client

TAblE 3

Regression Analyses for Variables Predicting grief Counseling Competence

Predictor Variable

Personal Competencies (n = 366) Training and experience in grief counseling Gender Age Years of experience as a professional counselor Personal experiences (TRIG Past Behaviors) Personal experiences (TRIG Present Feelings)

Conceptual Skills and Knowledge (n = 366) Training and experience in grief counseling Gender Age Years of experience as a professional counselor Personal experiences (TRIG Past Behaviors) Personal experiences (TRIG Present Feelings)

Assessment Skills (n = 358) Training and experience in grief counseling Gender Age Years of experience as a professional counselor Personal experiences (TRIG Past Behaviors) Personal experiences (TRIG Present Feelings)

Treatment Skills (n = 358) Training and experience in grief counseling Gender Age Years of experience as a professional counselor Personal experiences (TRIG Past Behaviors) Personal experiences (TRIG Present Feelings)

Professional Skills (n = 368) Training and experience in grief counseling Gender Age Years of experience as a professional counselor Personal experiences (TRIG Past Behaviors) Personal experiences (TRIG Present Feelings)

Note. For gender, men were the reference group. rS = structure coefficient for each predictor; TRIG = Texas Revised Inventory of Grief.

b p rS

Adjusted DR2DR2

.35 .19 .15 –.07 –.04 .07

.84 .05 –.11 .01 .00 –.01

.74 .13 –.10 –.04 –.03 .03

.84 .08 –.02 –.01 .00 –.02

.79 .06 –.09 .02 .01 .03

<.001 <.001 .02 .25 .45 .18

<.001 .11 <.001 .87 .97 .83

<.001 <.001 .04 .40 .53 .47

<.001 <.001 .64 .77 .95 .63

<.001 .10 .05 .73 .89 .45

.86 .44 .19 .19 .33 .33

.98 .09 –.02 .17 .20 .08

.97 .11 –.04 .24 .24 .18

.99 .12 .08 .22 .17 .14

.99 .10 .05 .24 .12 .10

.18

.70

.55

.71

.61

.17

.69

.54

.70

.60



who needs crisis intervention or developmentally appropriate activities related to his or her grief (Professional Skills). Ad-ditionally, Personal Competencies cannot replace necessary grief counseling skills, such as working on interdisciplinary teams related to grief (Professional Skills), assessment of clients’ unresolved losses or spiritual and cultural influences on grief (Assessment Skills), or developing an appropriate treatment plan to help resolve issues related to grief (Treat-ment Skills).

The lower scores on Professional Skills, Assessment Skills, Treatment Skills, and Conceptual Skills and Knowledge were not unexpected. Lower scores may reflect limitations in coun-selors’ access to appropriate grief counseling experiences in the work setting, limited access to training and education in grief, or a lack of desire or incentive to stay current with the current grief counseling literature and research.

In this study, personal experience, as measured by the TRIG, did not significantly predict Grief Counseling Com-petencies as suggested by the beta weights of these predictor variables ranging from 0.00 to 0.07, as reported in Table 3. However, prior research with counselors found significant relationships between counselors’ personal responses to loss and clients’ perceived empathy as well as reactions to termi-nation with clients (Boyer & Hoffman, 1993; Hayes et al., 2007). The finding that grief counseling competence is not related to personal grief experiences is important because it demonstrates that all counselors, regardless of their personal experiences, can become competent in this area.

The positive relationship between training and experience and self-perceived competence was to be expected, but the extent of the strength of the relationship was surprising. The variable of training and experience was responsible for the majority of the variance in each of the regression models, accounting for between 50% and 69% of the variance in four of the five Grief Counseling Competencies. There are several possible explanations. Perhaps the difference between training and experience (as measured by the GCETS) and counsel-ing competencies (as measured by the DCS) was a subtle distinction for the respondents. Although the majority of the questions on the GCETS ask about specific experiences and training, two of the 12 items did ask about general competence in grief counseling (“At this point in my professional develop-ment, I feel competent, skilled, and qualified to counsel clients who present with grief ” and “I feel competent to assess the mental health needs of a person who presents with grief in a therapeutic setting”). In contrast, the items on the DCS ask respondents to indicate specific competencies in knowledge, skills, and awareness, such as “I can define and articulate the nature and symptoms of complicated/unresolved grief situ-ations” and “I can assess for unresolved losses that may not be stated as a presenting problem.” Although the constructs of training and experience and competence are understood to be separate as part of the study’s design, the respondents

may not have interpreted the questions from each instrument as distinct from the other.

Another possibility may be that the respondents under-stood training and/or experience as equated to competence. Thus, if a counselor received training and/or experience in grief counseling, the counselor believed she or he gained competence. However, although experience is necessary and valuable, it is not the same as demonstrated effectiveness. The lack of acknowledged, well-defined competencies and training standards for grief counseling result in a vacuum in which counselors are left to define for themselves the knowledge and skills required to effectively work with clients.

The other variables that significantly related to grief counseling competence were gender and age. Women scored significantly higher than men did on three subscales (Personal Competencies, Assessment Skills, and Treatment Skills). This difference may reflect a distinction between genders in the response to grief that has been previously identified in the literature (e.g., Bennett, 2007; Cochran, 2006; Schut, Stroebe, & van den Bout, 1997; Williams, Baker, Allman, & Roseman, 2006). However, it is important to note that the addition of gender into these equations, although statistically significant, contributed very little to the variance accounted for by the models, with standardized beta coefficients ranging from .05 to .19. Furthermore, the differences in scores were of little practical significance (ranging from 0.15 to 0.26 on a 5-point scale).

Although age emerged as a significant unique contributor to the equation for the self-perceived grief competency of Conceptual Skills and Knowledge, the structure coefficient reveals that this finding is of little practical significance be-cause the overall relationship between these two variables is extremely small. What is important to take from this finding is that although older counselors may have more years of experience in the field (age and years of experience as a pro-fessional counselor were correlated, r = .64, p < .01), neither age nor experience are useful predictors of grief competency.

Implications and Directions for Future Research

Although exploratory in nature, this study has implications for counselor training, continuing education, and future research. It is important to note that counselors who received training rated themselves as more competent than those who did not, with more training related to higher levels of self-perceived competence. In addition, the relatively lower scores on the subscales of Conceptual Skills and Knowledge and Professional Skills provide insights into specific training needs. It appears that counselors would benefit from professional development in grief topics related to these subscales, including theories of grief counseling, terms and definitions, crisis intervention for grief, community-based psychoeducational grief programming,


Grief Counseling

methods for working on interdisciplinary teams to reduce grief, counselor peer support, and identification of clients’ effective and ineffective coping skills. Training did not, however, have the same impact on Personal Competencies, suggesting these were developed outside of specific grief training. Nevertheless, it may be important for grief counseling training to incorpo-rate reflection and understanding of personal experiences of grief and to reinforce practices of self-care to prevent burnout (O’Halloran & Linton, 2000). Finally, it is clear from the cur-rent study that both young professionals and their older col-leagues need training in grief counseling to meet the needs of their clients and to remain current with research findings that counter some of the traditional approaches to grief.

This study represents the first known attempt to measure the Grief Counseling Competencies of practicing counselors. As such, the results can be used to begin the process of deter-mining whether the Grief Counseling Competencies proposed by Charkow (2000) are appropriate and useful for the counsel-ing profession. Several different types of competencies have been accepted by our profession (i.e., multicultural counsel-ing, advocacy, and addressing spirituality in counseling) in response to clients’ needs. Grief counseling is an area for which standards, for both competencies and in turn training, need to be established to ensure effective care.

However, there are several limitations to the current study. First and most important, the instruments in the study measure self-perceived grief counseling competency. The development of instruments for supervisors or clients would be important to compare self-reports with rating by others. In addition, this study is exploratory and is the first of its kind to assess Grief Counseling Competencies of practicing counselors, specifically investigating professional experience, training, and personal experience with grief. As a first step in under-standing Grief Counseling Competencies, the results must be interpreted carefully as initial findings rather than definitive answers. A third limitation is the lack of demographic vari-ability within the sample. With 93% of the sample indicating European American (and 77% female), the sample reflects the lack of diversity among licensed professionals in many states, including the one from which the sample was drawn. Because of this limitation, the results cannot be generalized to counselors of color. Clearly, this is an important consid-eration for future researchers who may wish to oversample counselors from other races to obtain a more diverse sample. For the state in which this research was conducted, this was not possible because the state counseling board does not include information in its database regarding gender or race of licensed counselors.

Future research to continue to validate the instruments and their utility for practicing counselors is important. For example, in this study, participants’ scores on the TRIG, which measures intensity of grief reactions, were not re-lated to their self-perceived grief counseling competency.

However, this does not mean that the two concepts are not related, and it may be that understanding the impact of coun-selors’ personal experience with grief may be best served by a qualitative methodology. Furthermore, a comprehensive investigation into the content and quality of the current training on grief counseling needs to be completed across counselor education programs, because all such surveys of counselor education programs are more than a decade old. The information gleaned from these types of studies—and others—could provide valuable information to establish standards for training and competencies in grief counseling as part of the profession’s proactive response to increasing needs to effectively manage loss. In addition, the counseling profession could benefit from a comprehensive and diverse database of resources on grief counseling, including topics such as studies on effectiveness, interventions, and com-munity and professional resources.

The Grief Counseling Competencies (Charkow, 2000) pro-vide standards for training and assessment of skills, knowledge, and awareness of grief but have yet to be endorsed by ACA. This study represents the first step in applying these competen-cies to practicing counselors, but there is much more work to be done. Grief competencies that arise from research, that are validated through effectiveness studies, and that are appropriate for practicing counselors could do much to help the profession of counseling face the increasing demands for grief counseling in the coming years.

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grief counseling: an investigation of counselors' training, experience, and competencies

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