GRIEF MANAGEMENT IN COGNITIVE BEHAVIORAL THERAPY: CLINICAL CONCEPTUALIZATION, INTERVENTIONS, AND THERAPEUTIC CHALLENGES

Abstract

Grief is an expected human response to the loss of a significant person and may involve emotional, cognitive, behavioral, physical, and social manifestations. Although most people gradually integrate the loss into their life trajectory, some bereaved individuals experience persistent, intense, and disabling symptoms consistent with Prolonged Grief Disorder. This article aims to analyze, based on scientific literature, the contributions of Cognitive Behavioral Therapy to the understanding and clinical management of grief in adults, considering its intervention strategies and the challenges involved in therapeutic practice. A descriptive integrative review with a qualitative approach was conducted, comprising 13 articles published in Portuguese and English between 2005 and 2023. The studies were organized into categories related to the clinical delimitation of grief, cognitive-behavioral case formulation, maintenance factors, therapeutic interventions, and ethical care. The results indicate that cognitive-behavioral interventions directed at individuals with persistent distress may reduce symptoms of prolonged grief, depression, anxiety, and posttraumatic stress. The most frequent components include psychoeducation, grief monitoring, assessment of loss-related cognitions, cognitive restructuring, exposure to avoided memories and situations, behavioral activation, restoration of relationships, and goal planning. The literature also demonstrates that sadness alone does not constitute an indication for psychotherapy or evidence of dysfunctional thinking. Intervention should derive from an individualized formulation that considers distress, functional impairment, cultural context, social support, and clinical risks. Cognitive Behavioral Therapy therefore provides relevant resources for grief care, provided that its application respects the uniqueness of the bereaved person and does not transform a human experience into a standardized process of correcting or eliminating pain.