Understanding and Processing Grief and Trauma Class

The Understanding and Processing Grief and Trauma Class was initiated and developed by me during my advanced MSW field placement and implemented through the Compassion House Counseling Program in Dalton, Georgia. Compassion House provides outpatient counseling and coordinated supportive services for individuals and families involved with community systems, including clients impacted by substance use recovery needs and family service involvement. Agency services include sobriety recovery-related supports and supervised visitation. Participants in this group included individuals currently receiving or previously served through Compassion House services, as well as those who self-referred or were referred by community partners based on clinical need.

I created this project in response to the high prevalence of trauma histories and unresolved grief among Compassion House clients. I facilitated an 8-week in-person psychoeducational group for adults ages 18 to 60, with nine participants meeting weekly for two hours. In addition to delivering the class, I developed a structured curriculum and created implementation materials to support consistent delivery and skill generalization. The project included three components: (1) the 8-week class, (2) facilitator lesson plans and scripted session guides, and (3) a participant workbook and supplemental practice materials. Following implementation, the curriculum and materials were retained by the agency and became a permanent part of Compassion House’s psychoeducational program offerings, with additional facilitators continuing delivery.

Social Problem

Unprocessed grief and trauma were addressed because they contribute to emotional dysregulation, impaired functioning, and increased risk for long-term mental health concerns, especially when individuals have limited access to care. National data indicate that approximately three in four U.S. adolescents have experienced at least one adverse childhood experience, and one in eight have experienced four or more, which is associated with increased risk for depression, substance use, suicidality, and chronic health concerns (CDC, 2023; Anda et al., 2006). In addition, childhood bereavement is common, with an estimated one in 12 youth losing a parent or sibling before age 18, demonstrating the widespread need for grief support and education (CBEM, 2023).

When grief and trauma are not processed, individuals may experience persistent anxiety, somatic symptoms, sleep disturbance, irritability, concentration difficulties, relational conflict, and reduced work and daily functioning (Kaplow et al., 2020; NCTSN, 2023). Chronic traumatic stress is also associated with changes in stress reactivity and emotion regulation that can increase vulnerability to ongoing dysregulation and maladaptive coping patterns over time (Anda et al., 2006). Without trauma-informed intervention, these impacts can intensify and contribute to long-term mental health disparities.

This need is reflected locally as well. Child welfare data show 70 removals to foster care in Whitfield County during October 2024 through September 2025 and 5,010 removals statewide in Georgia during the same period, underscoring the prevalence of family disruption, separation, and trauma exposure that can compound grief responses. Federal AFCARS-based outcomes further indicate that in 2023, Georgia had 1,054 children waiting for adoption whose parents’ rights had been terminated, reflecting the scale of permanent legal separation that can intensify grief and trauma for children and families.

At Compassion House, many clients are uninsured or underinsured, creating barriers to consistent therapy and trauma-informed services (SAMHSA, 2014). Providing a free psychoeducational group increased access to coping tools and supportive resources for individuals who may not otherwise receive care.

Intervention Goals and Tools

Mission

To create a trauma-informed, culturally responsive program where participants can understand the effects of grief and trauma and build skills for emotional regulation and resilience.

Goals

    • I aimed to increase participants’ understanding of grief and trauma responses and help them recognize how these responses can affect thoughts, emotions, relationships, and physical well-being.

    • I aimed to strengthen participants’ emotion regulation skills by teaching and practicing grounding, relaxation, and mindfulness strategies they could use during distress or activation.

    • I aimed to help participants identify and reframe unhelpful grief- and trauma-related thoughts by using CBT-informed coping skills such as thought-challenging prompts, coping statements, and cognitive reframing.

    • I aimed to reduce isolation and increase healthy connection by using group support, normalization, and structured peer discussion to help participants feel less alone in their experiences.

    • I aimed to increase participants’ confidence using coping skills outside of sessions so they could apply grounding, mindfulness, and cognitive coping strategies during triggers, grief reactions, and real-life stressors between meetings.

Intervention Tools

The primary intervention was an 8-week psychoeducational group informed by trauma-informed care, CBT-based coping strategies, and polyvagal-informed regulation skills. Participants met in person once weekly for two hours in a classroom setting. To support consistent delivery and skill generalization, I created a structured implementation approach and facilitated weekly instruction and practice using the following tools:

  1. I developed facilitator lesson plans and scripted session guides that provided a session-by-session structure, including objectives, psychoeducation content, discussion prompts, and skills practice components. LINK: Grief Facilitator Guide

  2. I created trauma-focused psychoeducation slides that provided accessible teaching on trauma responses, grief reactions, triggers, and coping strategies, followed by guided discussion and weekly skills practice. LINK: Grief Slide show

  3. I provided participant practice materials, including printed handouts and between-session prompts that supported grounding, mindfulness, and cognitive coping skill use outside of sessions. LINK: Grief Class Handbook

  4. I developed a participant workbook aligned with weekly session objectives and pacing needs. The workbook included original written content and curated psychoeducational visuals to support learning, reflection, and skills practice. LINK: Grief Class Handbook

  5. I used an EMDR-informed grounding script that included brief stabilization strategies such as breathing, sensory grounding, and present-moment orientation, used as needed to support regulation during activation. LINK: EMDR Script

  6. I implemented weekly CBT-based journaling prompts and cognitive coping practice to help participants identify unhelpful grief- and trauma-related thoughts and practice cognitive reframing and coping skill application between sessions. LINK: Grief Class Handbook

  7. I facilitated a Grief Processing Timeline and Narrative Activity to help participants organize loss experiences, identify coping patterns and strengths, and support meaning-making with appropriate emotional pacing. LINK: Grief Processing Timeline and Narrative

 

Theoretical Foundations & Literature Support

Theoretical Perspectives

This intervention was designed using trauma-informed care, cognitive behavioral therapy, and Polyvagal Theory to support safety, learning, and skill generalization. Trauma-informed care emphasizes safety, choice, collaboration, empowerment, and cultural responsiveness, reducing the risk of traumatization and strengthening engagement (SAMHSA, 2014). Cognitive behavioral therapy supports skill-based coping by teaching participants how thoughts, emotions, and behaviors interact and how reframing unhelpful beliefs can reduce distress and improve functioning (Shapiro, 2018). Polyvagal Theory supports grounding and regulation strategies by explaining how the nervous system responds to perceived threat and how cues of safety can reduce reactivity and increase regulation (Porges, 2018). Together, these approaches support the expected effectiveness of a structured psychoeducational group that teaches grief and trauma responses while reinforcing coping practices across multiple sessions.

Review of the Literature

Evidence indicates that trauma-informed psychoeducation and skills-based coping interventions improve understanding of trauma responses and strengthen emotional regulation (SAMHSA, 2014; NCTSN, 2023). CBT-informed coping strategies are associated with reductions in trauma-related distress and improved functioning when participants consistently practice cognitive coping and behavioral skills (NCTSN, 2023; Shapiro, 2018). In addition, EMDR-informed stabilization and grounding strategies are commonly used to reduce acute distress and support regulation as part of phased trauma approaches that emphasize stabilization before deeper processing (Shapiro, 2018). These findings support the expected effectiveness of a trauma-informed grief and trauma psychoeducational group.

Results Achieved

People Served

Nine adults completed the 8-week grief and trauma class, ages 18 to 60. Participants reported a range of experiences, including bereavement, childhood adversity, relationship loss, and significant life transitions. Many participants reported longstanding emotional challenges related to unprocessed grief or trauma and limited access to coping tools or affordable mental health support.

Outcome Evaluation

Outcome evaluation was measured using a pre- and post-self-report survey assessing understanding of grief and trauma responses and confidence using coping skills taught in the group, along with participant reflections and facilitator observation to support interpretation of change. Results are organized by the group goals.

  1. Increase understanding of grief and trauma responses. Post-survey results indicated a 32 percent increase in self-reported understanding of grief and trauma responses and how those responses affect thoughts, emotions, relationships, and the body.

  2. Improve emotion regulation skills. Although a standardized emotion regulation instrument was not administered, participants’ weekly reflections and in-session participation suggested increased ability to use grounding, breathing, and mindfulness strategies to return to a regulated state when distressed. Facilitator observations noted improved engagement and reduced escalation during emotionally activating discussions as the group progressed.

  3. Strengthen ability to identify and reframe unhelpful thoughts using CBT-informed coping skills. Participants’ journaling reflections and skills practice indicated increased ability to identify unhelpful grief- and trauma-related thoughts and apply cognitive reframing strategies discussed in group. Participants frequently referenced using coping statements and thought-challenging prompts introduced during sessions.

  4. Reduce isolation by increasing healthy connections through group support. Weekly journaling reflections indicated reduced isolation and increased connection through normalization and shared experiences. Participants described feeling less alone in their grief and reported increased willingness to seek support and participate in peer discussion.

  5. Increase confidence using coping skills outside of group sessions. Post-survey results showed a 27 percent increase in confidence using grounding, mindfulness, and cognitive reframing strategies outside of group during moments of stress, triggers, or grief reactions.

A limitation of the evaluation was that not all goals were assessed using standardized instruments or weekly quantitative tracking. For goals without direct quantitative measures, outcome conclusions are supported by participant reflections and facilitator observation.

Process Evaluation

Process evaluation data were collected through weekly journaling reflections and an end-of-group participant feedback form focused on participants’ experiences of the group process, including perceived helpfulness of the content, materials, pacing, and facilitation. Participant feedback described the group as safe and helpful and emphasized that psychoeducation, skills practice, and peer discussion were the most beneficial components. Participants also noted that the predictable structure supported engagement and requested an additional session and more printed take-home resources, which were added at the end of the cycle to strengthen participant support and skill practice.

De-identified clinical outcome summary. Clinical Outcome Feedback Summary

Recognition and Impact

The program received a positive review from the Compassion House clinical supervisor, and the curriculum was retained for continued implementation as part of the agency’s psychoeducational programming. To date, approximately four facilitators have used the curriculum to deliver the class. All program materials and documentation, including lesson plans, intervention scripts, slides, participant materials, and de-identified evaluation summaries, were retained by the agency for quality review and replication.

Conclusions

Limitations

The project timeline limited long-term follow-up and reduced the ability to measure whether skill gains were maintained after the group ended. Limited printing resources reduced the amount of take-home materials that could be provided consistently. As the sole facilitator, responsibilities related to engagement, safety monitoring, pacing, and session delivery reduced the time available to administer measures, track data consistently each week, and summarize results in greater detail. As a result, evaluation data were primarily collected at baseline and post-group, along with qualitative reflections.

What Could Have Been Done Better

The project could be strengthened by extending the duration and adding a co-facilitator. A longer format would allow additional time for skills rehearsal and guided application to real-life triggers. A co-facilitator would support more robust data collection by assisting with administering and collecting tools, tracking attendance, and summarizing feedback while the primary facilitator manages group flow and emotional safety. More robust data collection would include brief weekly check-in ratings, one or two validated baseline and post measures such as PHQ 9 or GAD 7 or a brief trauma symptom screener as appropriate, tracking skill use frequency between sessions using a simple one-page log, and a 30-day follow-up check-in to assess sustained impact and continued service needs.

Unexpected Outcomes

Participants expressed interest in continuing peer support connections outside of the group, and several pursued individual counseling following completion of the class. In addition, the agency requested adaptation of the curriculum for adolescent use, supporting future implementation and expanded community reach.

Competency 1 Ethical and Professional Behavior

Groundwork. I clarified the purpose and limits of the group, planned how confidentiality and mandated reporting reminders would be communicated, and aligned my facilitation approach with supervision expectations and agency policies.

Writing Development. I prepared de-identified documentation and developed written group norms, including confidentiality limits, respectful participation expectations, and crisis-response steps. I also created session guides and materials that supported consistent and ethical delivery.

Presentation Implementation. I maintained professional boundaries, used trauma-informed pacing, obtained consent before grounding interventions, and sought supervision when ethical or clinical questions arose during group delivery.

Competency 2 Diversity and Difference in Practice

Groundwork. I considered how grief and trauma are shaped by culture, faith traditions, gender roles, socioeconomic factors, and community norms within the service area. I also planned for varied grief presentations across participants, including later-life widowhood, child loss, relationship loss, and major life transitions.

Writing Development. I used inclusive, person-first language and developed flexible reflection prompts and examples that allowed participants to interpret loss, coping, and meaning-making through their own worldview and lived experience.

Presentation Implementation. I validated differences without correcting or minimizing participants’ experiences, invited multiple perspectives during discussion, and adjusted activities and pacing to remain respectful, accessible, and responsive to participant needs.

Competency 3 Human Rights and Social, Economic, and Environmental Justice

Groundwork. I identified barriers to access to mental health services and trauma-informed care locally, including uninsured or underinsured status, cost, limited provider availability, and practical constraints that reduce consistent participation in treatment.

Writing Development. I designed the group as a no-cost resource and framed psychoeducation to reduce stigma and normalize help-seeking. I emphasized coping support and emotional safety as part of equitable access to care.

Presentation Implementation. I delivered skills-based psychoeducation and facilitated supportive group discussion that increased access to coping tools and peer support for participants who may not otherwise receive trauma-informed services.

Competency 4 Practice-Informed Research and Research-Informed Practice

Groundwork. I selected evidence-informed approaches appropriate for a psychoeducational group, including trauma-informed care principles, CBT-informed coping strategies, polyvagal-informed regulation skills, and EMDR-informed stabilization concepts.

Writing Development. I translated the literature into session objectives, slide content, and practice activities. I also aligned skills practice with stabilization-focused best practices and structured the curriculum to build learning progressively across sessions.

Presentation Implementation. I used participant feedback and observed needs to refine pacing and emphasize the most relevant skills. I summarized outcome and process feedback to support continued implementation and quality improvement.

Competency 5 Policy Practice

Groundwork. I observed how insurance gaps, limited local providers, and agency resource constraints affect access to trauma care and increase reliance on low-barrier services for vulnerable clients.

Writing Development. I documented the program model, implementation approach, and outcomes in a format that supports continuation, replication, and internal decision-making about service delivery.

Presentation Implementation. I communicated needs and results to supervisors and contributed to agency-level decisions to retain the curriculum and continue offering the program as part of Compassion House’s psychoeducational services.

Competency 6 Engagement

Groundwork. I planned engagement strategies responsive to trauma histories, including predictable structure, participant choice, consent, emotional pacing, and clear expectations for participation and safety.

Writing Development. I built check-ins, normalization prompts, and strengths-based language into session guides to support trust, collaboration, and sustained participation.

Presentation Implementation. I used active listening, transparency, and collaborative pacing to foster safety. I adjusted facilitation in real time to reduce shutdown and overwhelm and to support engagement across varied participant needs.

Competency 7 Assessment

Groundwork. I identified common grief and trauma-related needs among the agency’s adult client population and selected feasible pre- and post-evaluation methods appropriate for a psychoeducational group format.

Presentation Implementation. I administered the pre- and post-surveys, reviewed weekly journaling reflections, and used in-session observation to assess regulation needs, guide pacing, and summarize change at group completion.

Competency 8 Intervention

Groundwork. I selected interventions appropriate for a group psychoeducation model and prioritized stabilization skills suitable for mixed grief and trauma histories, including grounding, mindfulness, and CBT-informed cognitive coping strategies.

Writing Development. I developed structured session plans, skills practice activities, and supplemental worksheets and handouts aligned with trauma-informed care principles and evidence-informed coping strategies.

Competency 9 Evaluation

Groundwork. I defined measurable outcomes focused on understanding of grief and trauma responses and confidence using coping skills, and I selected feasible evaluation methods appropriate for the setting and group format.

Writing Development. I created pre- and post-surveys and feedback forms and summarized results to guide program improvement and support continued implementation.

References

Anda, R. F., Felitti, V. J., Bremner, J. D., Walker, J. D., Whitfield, C., Perry, B. D., Dube, S. R., & Giles, W. H. (2006). The enduring effects of abuse and related adverse experiences in childhood: A convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neuroscience, 256(3), 174 to 186. https://doi.org/10.1007/s00406-005-0624-4

Centers for Disease Control and Prevention. (2023). Adverse childhood experiences ACEs.

Judi’s House and JAG Institute. (2023). Childhood bereavement 2023 national report.

Kaplow, J. B., Howell, K. H., & Layne, C. M. (2020). Developmental considerations for grief and trauma in children and adolescents. Journal of Traumatic Stress, 33(6), 1110 to 1119. https://doi.org/10.1002/jts.22586

National Child Traumatic Stress Network. (2023). Child trauma and exposure statistics.

Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the body: A sensorimotor approach to psychotherapy. W. W. Norton.

Porges, S. W. (2018). The pocket guide to the polyvagal theory: The transformative power of feeling safe. W. W. Norton.

Shapiro, F. (2018). Eye movement desensitization and reprocessing EMDR therapy: Basic principles, protocols, and procedures (3rd ed.). Guilford Press.

Substance Abuse and Mental Health Services Administration. (2014). SAMHSA’s concept of trauma and guidance for a trauma informed approach (HHS Publication No. SMA 14 4884). U.S. Department of Health and Human Services.

Sue, D. W., & Sue, D. (2016). Counseling the culturally diverse: Theory and practice (7th ed.). Wiley.