In initiating grief therapy, which is listed as the first step?

In initiating grief therapy, which is listed as the first step?

• A. Rule out physical disease
• B. Explore and defuse linking objects
• C. Revive memories of the deceased
• D. Deal with affect or lack of affect stimulated by memories

Answer: (A)

Rule out physical disease is the best choice because symptoms seen in grief—fatigue, sleep disturbance, pain, even mood changes—can mimic medical illnesses. Before doing grief processing, it’s essential to confirm there isn’t a medical condition that needs treatment or could complicate therapy. Once physical health is ruled out, therapy can safely focus on psychosocial work like examining attachments (linking objects), revisiting memories of the deceased, and managing affect. Those latter steps are important for processing the loss, but they depend on ensuring there isn’t an underlying medical issue driving the symptoms.

Rule out physical disease is the best choice because symptoms seen in grief—fatigue, sleep disturbance, pain, even mood changes—can mimic medical illnesses. Before doing grief processing, it’s essential to confirm there isn’t a medical condition that needs treatment or could complicate therapy. Once physical health is ruled out, therapy can safely focus on psychosocial work like examining attachments (linking objects), revisiting memories of the deceased, and managing affect. Those latter steps are important for processing the loss, but they depend on ensuring there isn’t an underlying medical issue driving the symptoms.