Grief counselling: what to expect and how it helps

Grief is not a problem to be solved. It is a response to loss, and a deeply human one. But sometimes the weight of it gets too heavy to carry alone, and many people quietly wonder whether talking to someone might help, without ever quite knowing what "talking to someone" actually involves.

This is a guide to what grief counselling actually looks like in Australia, when it tends to help, and what to expect if you decide to reach out.

The quick answer

Grief counselling involves working with a psychologist or counsellor to make sense of, sit with, and slowly integrate a significant loss. Sessions are typically 50 to 60 minutes, weekly or fortnightly. How many sessions you need depends on the loss and what you're carrying, and we'll review this with you as you go. Grief counselling is not about "getting over" the loss or moving on quickly. It is about helping you carry the loss in a way that allows life to keep going. Medicare rebates are available for individual grief therapy with a GP Mental Health Treatment Plan. You do not need to be in crisis to benefit. You also do not need to be grieving a recent death; old, unprocessed losses respond to therapy too.

What is grief counselling, really?

Grief counselling is a structured space, usually with a psychologist or trained counsellor, where the focus of the work is the loss you are carrying. That loss might be:

• The death of a parent, partner, child, sibling, or close friend
• The death of a pet
• A pregnancy loss or stillbirth
• A traumatic or sudden death
• An anticipated death (the slow loss of a parent to dementia, for example)
• The end of a marriage or significant relationship
• A health diagnosis that changes the future you imagined
• The loss of a job, identity, role, or community

Grief is not exclusive to bereavement, although bereavement is what most people associate with the word. Any major change that requires you to let go of an imagined or actual life can produce a grief response.

What happens in a grief counselling session?

The first session is usually about understanding the loss and where you are with it now. The therapist will not push you to dive into details before you are ready. Expect them to ask:

• Who or what you have lost
• What the relationship was like
• How the loss has affected your day-to-day
• What support you currently have around you
• What has been hardest

Subsequent sessions tend to flow with where you are that week. Sometimes you will tell stories about the person. Sometimes you will sit in long silences. Sometimes you will cry. Sometimes you will laugh. Sometimes you will be angry, including at the person who has died. Sometimes you will not feel anything at all and will wonder what is wrong with you. All of this is grief.

Over time, grief therapy tends to involve some combination of:

• Telling and re-telling the story of the loss until it loses some of its sharpest edges
• Making sense of the relationship, including the complicated parts
• Working through specific stuck points (regrets, things unsaid, guilt about how you reacted at the time)
• Building a new relationship with the person who has died (continuing bonds, not severing them)
• Slowly rebuilding a sense of meaning and routine in the life that is left

Good grief therapy is not about closure in the Hollywood sense. It is about integration. The loss does not disappear. It becomes something you carry differently.

How long does grief counselling take?

There is no universal timeline. How many sessions you need depends on the loss and what you're carrying. Some people need only a few sessions; many need more, particularly when the loss has been traumatic, sudden, or layered with other complicating factors.

The reality is that grief itself does not finish in 12 weeks. Grief reorganises itself across years, sometimes a lifetime. Therapy supports the integration but does not determine the timeline of grief itself.

Normal grief vs complicated grief

Most grief, even when it is intense and long-lasting, is part of a normal human response and does not need clinical intervention beyond support and time. But for some people, grief becomes "complicated" or "prolonged." In representative community studies, about 1 in 20 bereaved adults develop prolonged grief disorder (Comtesse et al., 2024), and an Australian survey found about 6 in 100 (Aoun et al., 2015). Complicated or prolonged grief is when:

• Twelve months or more after the loss, the intensity has not eased at all
• Daily functioning is significantly impaired
• You feel persistently disconnected from yourself or others
• Avoidance of reminders has become so strong it shapes your whole life
• Intrusive thoughts about the loss are constant
• There is persistent guilt, self-blame, or a wish to have died with or instead of the person

There are specific therapies for complicated grief, and it typically does not resolve on its own with just time. If this sounds like where you are, professional support is particularly important.

How we approach grief work at Unbound Minds

People often arrive in grief therapy thinking they should already be "better." One of the first things we do is take that pressure off.

Our approach is to follow your lead on pace. Some weeks you will want to dig in. Some weeks you will need to talk about the school run and your job and the leak in the bathroom, and that is also part of grief therapy. The work is not about manufacturing intensity.

Where appropriate, we draw on evidence-supported approaches including Continuing Bonds frameworks, Acceptance and Commitment Therapy, Cognitive Behavioural Therapy adapted for grief, and trauma-focused approaches when the loss involved trauma. For complicated grief specifically, we use frameworks developed for that purpose.

We see clients at our Kingswood (Nepean Health Hub) and Gledswood Hills clinics, and by telehealth across NSW, including people from Glenmore Park, St Marys, Emu Plains and Jordan Springs. We work with bereavement, pregnancy loss, anticipatory grief, and grief from non-death losses including separation, illness, and identity loss.

When to seek help

You do not need to wait for grief to become "complicated" to benefit from professional support. Reasonable signs it is worth reaching out:

• You feel like you are not coping with day-to-day life
• You are isolating from people who love you
• You are using alcohol, food, work, or other coping behaviours to numb out
• Sleep, appetite, or concentration are significantly disrupted weeks after the loss
• You feel guilty for not grieving "enough," or for grieving "too much"
• You have nobody in your life with whom you can be fully honest about how you are feeling
• The loss is layered (multiple losses close together, or a current loss reactivating an older one)
• The person you lost was complicated, and your grief is also complicated

If you are not sure whether you need a referral or how Medicare rebates work for grief therapy, our guides to whether you need a referral and how Medicare rebates work may help. Our piece on what to expect at your first psychology session covers the practical side of starting therapy.

Frequently asked questions

How long does grief counselling take?

The number of sessions varies depending on the nature of the loss and what is being processed, and we'll review this with you as you go. Therapy supports integration but does not artificially shorten grief itself, which often reorganises across years.

What happens in grief counselling sessions?

Sessions involve telling and re-telling the story of the loss, making sense of the relationship including the complicated parts, working through stuck points like guilt or regret, and slowly rebuilding meaning and routine. The therapist follows your lead on pace.

When should you see a psychologist for grief?

It is reasonable to seek help when daily functioning is impaired, when you are isolating, when sleep or appetite are significantly disrupted, when you are using numbing behaviours to cope, or when you simply do not have anyone you can be fully honest with. You do not need to wait for things to become severe.

Is grief counselling covered by Medicare?

Yes, individual grief therapy can be covered under a GP Mental Health Treatment Plan, which is a referral pathway through your GP. This typically provides a rebate for up to 10 sessions per calendar year. Some private health funds also cover counselling under extras.

What is the difference between normal grief and complicated grief?

Normal grief can be intense and long-lasting but gradually integrates over time. Complicated or prolonged grief is when, 12 months or more after the loss, the intensity has not eased, functioning is significantly impaired, and there are persistent stuck points. In representative community studies, about 1 in 20 bereaved adults develop prolonged grief disorder (Comtesse et al., 2024), and an Australian survey found about 6 in 100 (Aoun et al., 2015). There are specific therapeutic approaches designed for it.

Do you need a referral for grief counselling?

You do not need a referral to see a psychologist privately. You do need a GP Mental Health Treatment Plan if you want Medicare rebates. Counsellors can be seen without referral but are not Medicare-rebated.

If you would like support

Unbound Minds offers grief counselling for adults across Western Sydney. There is no right or wrong time to reach out. Some people come within days of a loss. Others come decades later because something has reactivated grief they thought they had handled. Both are reasonable.

You do not need to know what to say. You just need to call 1300 151 110, and we'll take it from there.