Modern Grief Therapy Beyond Kübler-Ross: New Models and Cultural Sensitivity in Bereavement Care 

Grief is an emotion that has been observed and interpreted in so many ways. It is a powerful emotion that is both personal and yet still universal whenever one loses someone they care about. According to research by Gustafson (1989), grief is highlighted as a unique emotion due to its close association with death and grieving usually feels so painful in a way as though a loss in oneself is experienced. The study also made a distinction between grief and similar emotions such as sorrow, Where it is intense and usually not caused by everyday sadness, it is a particular response to death. Additionally, although the terms grief and bereavement are used interchangeably, they are distinct. Bereavement is explained as a mourning period after the death of a living being, and grief is the emotional feeling that accompanies the bereavement (Gouveia, 2024). 

Elisabeth Kübler-Ross’ Five Stages of Grief 

While several individuals have studied grief, one of the leading researchers in this field is Elisabeth Kübler-Ross, who introduced the five stages of grief in her book ‘On Death and Dying’. The five stages of grief were denial, anger, bargaining, depression and acceptance. The first stage, denial, is when people refuse to accept the reality of the deceased. According to Kübler-Ross & Kessler (2009), this phase is a survival phase and acts as a shield to protect from being too overwhelmed and unable to cope. The second stage is anger, which is a common response to create a sense of control in the chaos of loss.

This anger can be towards others or oneself. Bargaining comes next, and involves thoughts like “What if I had done this differently? Will it have changed this outcome?” This stage is also influenced by guilt of not properly caring for the person before, and imagining other alternatives. Stage four is depression, which is different from depressive disorder. It reflects the reality of the person being truly gone. It is important to acknowledge this sadness as it’s essential towards the healing process. Lastly, acceptance, which is not simply being okay with the loss but rather learning to live with the memories and adapt. 

Criticisms and arguments regarding Kübler-Ross’s grief model

However, there have been criticisms and arguments regarding Kübler-Ross’s grief model, which are as follows: 

1. There’s no solid scientific evidence to prove that people go through grief in five clear, separate stages (Kastenbaum, 2012, as cited in Corr, 2018). These stages of grief are more descriptive rather than focusing on experience (Avis et al., 2021).
2. All people don’t experience it the same way, using only these five emotions or even in the same specific sequence, and furthermore, few studies found that the staged model is unsupportive in many grieving experiences (Kastenbaum, 2012, as cited in Corr, 2018). 
3. Critics view that many rush through their grief. Instead of taking time, individuals were more pressurized to achieve the end goal of grief, which was acceptance. Such attained acceptance masks the actual pain and may lead to weaker mental health. However, Kastenbaum noted that this issue wasn’t Kübler’s fault as she warns individuals against rushing through the stages (Kastenbaum, 2012, as cited in Corr, 2018). 
4. The model overlooks individual differences, and it reduces the grief to just five clinical stages. Some studies have also shown that misinterpreting the model and not using proper coping mechanisms to work through grief could be harmful to individuals (Avis et al., 2021).

These limitations made it necessary to have a better, more comprehensive, and personal understanding of grief. Other models of grief emerged and provided new explanations and aspects of grieving and coping. 

Bowlby and Parkes’ Four Phases of Grief 

The first phase, numbing, protects the mind from being overwhelmed by triggering a physiological and psychological shock. Second is yearning and searching, where the individual tries to maintain the emotional bond and attachment to the deceased. Third is disorganisation and despair, where pain and confusion are experienced. The final phase is reorganisation, where the individual gradually adjusts to life. These phases are rooted in Bowlby’s attachment theory, which emphasises retaining the emotional bond between the individual and the deceased (Fahey-McCarthy, 2003; Welfel et al., 2002). Unlike a fixed stage, this model is non-linear and its concept of reorganisation offers a more optimistic outlook than Kübler’s last stage of acceptance (Tyrrell et al., 2023). 

Wolfelt’s Companioning Model 

Wolfelt (2009) developed a model that compares the treatment model with the companioning model. The treatment model aims at healing grief using clinical methods and medications, whereas the companioning model suggests that individuals should embrace it as a phenomenon in life. It also enables a grieving person to grow and move on from grief at their own pace. According to Wolfelt, the 11 principles of the companioning model focus on being empathetic, present, and showing respect for the mourner throughout the bereavement. His model prioritises building relationships over offering clinical solutions, helping people feel accepted rather than cured of grief (Kron, 2024).

Worden’s Four Tasks of Mourning 

Worden proposed that grief involves completing tasks rather than progressing through fixed stages. The first task is to accept the reality of the deceased. Next, the mourner who is experiencing the pain and facing emotions like guilt and sadness gradually processes it and starts healing. The third task is to adjust to a world without the deceased. Lastly, task four involves finding methods to connect and bond with the deceased while living life meaningfully. Worden’s model promotes flexibility and is widely used in clinical and social work settings to aid grieving individuals (Yousuf-Abramson, 2021). 

Neimeyer’s Social Constructivist Model 

This model highlights the significance of making meaning out of the chaos surrounding grief. The model shows that rather than passing through stages of grief, individuals tend to make sense of grief by constructing stories and narrating memories that help them cope with the loss. It emphasises sharing grief by participating in community and family activities such as rituals, funerals, etc. The model merges with many traditions of grief and bereavement in non-Western countries (Neimeyer et al., 2014). 

Dual Process Model 

Stroebe and Schut’s (1999) model explains that people cope with grief using two mechanisms: loss-oriented and restoration-oriented coping. Loss-oriented coping involves facing pain and related emotions. Restoration-oriented coping focuses on adjusting to the changes and engaging in new skills and gradually distracting oneself from the grief. The model allows oscillating between the two coping strategies to create a balanced method to manage stress and pain. 

Influence of Culture on Grief 

Grief is shaped not only by biology and psychology but also by society and culture. Cultural beliefs influence the ways of expressing sorrow and loss, including rituals and the mourning period, etc. Many researchers have emphasised the need to understand culture to learn more about grief (Rosenblatt, 2008). 

Western societies

Studies show that in many Western societies, grief is treated as a private and isolated emotion. The individual facing the loss often goes through the bereavement unsupported. There also exists a certain pressure to move on, and not being able to do so can be considered weak. This may even lead to feeling alienated and shameful, which could prolong the grief (Baars, 2025). 

Asian cultures

In many Asian cultures, grief is understood within a religious and cultural framework, such as in Confucianism and Buddhism. Confucianism emphasises the maintenance of familial harmony. In Chinese society, individuals follow the rituals set by ancestors to honour and strengthen the bond between people and the deceased. Their traditions and customs have also evolved over the years. Buddhist culture lays emphasis on karma and the reincarnation of an individual, depending on the good and bad actions that they have done while living. Many Asian cultures discourage overt emotional expression, leading individuals to bottle up their feelings to maintain emotional balance.

Indigenous and Latin American cultures

In contrast to these, grief in Indigenous and Latin American cultures is a shared and even a pleasant experience. For instance, people in Mexican culture celebrate Día de los Muertos—a joyful remembrance of loved ones—with music and food (Baars, 2025). They actively recognise grief as a shared experience, not an isolated one. Some cultures enforce social norms that regulate how sorrow and mourning are expressed. For example, the Navajo tradition limits mourning to a brief period. Similarly, in Mediterranean cultures, widows have strict social norms on clothing and public behaviour (Gouveia, 2024). 

These practices prove that there is no single way of experiencing grief. The cultural context is significant in influencing mourning, coping and making meaning after a loss. 

Therapeutic Approaches 

Grief therapies are driven by theoretical grief models like the dual process model, the constructivist model and others. They help individuals by providing a supportive environment and coping strategies to grow emotionally around grief and aid them in giving hope to live life meaningfully (Silverman et al., 2020). 

Among many forms of grief therapy, the Cognitive-Behavioural model of complicated grief suggests prolonged grieving individuals who find it difficult to adjust to the world after the loss struggle with integrating the loss of the individual into their real-life narrative. This is accompanied by self-blame and guilt (Neimeyer & Currier, 2009). The therapeutic intervention of the Cognitive Behavioural Model in such cases involves both Cognitive Restructuring (CR) and Exposure Therapy (ET) to help reorganise their thoughts, encouraging them to participate in activities that offer relaxed distraction along with confronting their painful memories. Both CR and ET are effective when applied together rather than applied alone or in a reverse manner (Boelen et al., 2007). 

The Two-Track Model of Bereavement, devised by Rubin et al. (2009), explains grief to be focused on two tracks at the same time. The first track focuses on the person’s physiological and psychological symptoms, such as signs of anxiety, sadness, or being reserved than usual. The second track focuses on the mourner’s current bond with the deceased, including how they remember the person and the ways they used to remain connected to them. This model helps therapists support both emotional healing, allowing people to move forward without feeling the need to quickly forget their loved one and replace them with memories. 

Conclusion 

Grief is emotional and complex, with no two people experiencing it the same way. Although universally associated with loss, grief processing and expression vary across individuals, cultures as well and their psychological contexts. The five stages developed by Elisabeth Kübler-Ross brought a system that organised emotions into stages, which helps in understanding what the grieving person is experiencing. Nevertheless, it has its strengths and weaknesses, because of which more comprehensive models have been proposed, which took a more diverse experience of grief into account. 

Bowlby and Parkes’ phases of grief based on attachment theory, grief task formulated by Worden, companioning model developed by Wolfelt, Dual Process model by Stroebe & Schut, and the constructivist model by Neimeyer are all based on reflection of emotions, the person’s pace of grieving, and assistance by others. These models don’t rely on fixed stages but put more emphasis on the necessity to develop emotionally and to guide oneself through the bereavement process with continued emotional attachment to the dead. 

Furthermore, the experience of grief is highly determined by cultural beliefs and traditions. It takes place on a social landscape, be it the silent mourning observed in most Asian societies or the mass festivals in Latin America. The understanding of all these emotional, cultural, and psychological layers allows for a greater knowledge of grief. Additionally, the essential need for grief therapies like the Cognitive-Behavioural Model, the Two-Track Model of Bereavement, and more helps individuals gain control amidst the chaos and allows them to heal and grow. 

Ultimately, grief is subjective, and the process of healing is gradual. If the grieving process is rushed, individuals may struggle to overcome the intense pain. This can lead to mental health conditions, addictions, and other physical health issues.

FAQs 

1. What are some common models of Grief?

Common models of grief are the five stages of grief (anger, bargaining, depression, acceptance) and the dual process model (loss-oriented and restoration-oriented coping), the social constructivist model, etc. Each understands grief differently with and each model has their strengths and weaknesses. Grief studies are a culmination of these models and theories. 

2. How does Culture influence the way people grieve? 

Cultural norms and traditions significantly shape how individuals express grief, the bereavement period and other rituals. For example, some cultures may encourage public displays of emotion, while others emphasise internal mourning. There is also a distinction between the Western and non-Western methods of grieving, where the former supports isolated mourning and the latter supports community grieving. Similarly, some cultures have small happy events to remember the deceased, whereas in other cultures 

3. How long does grieving last? 

Grief, being an intensely painful and complex emotion, does not have a particular timeline. Getting over grief and moving on varies from person to person. However, although there isn’t a set timeline, it is essential to note if the individual is not able to cope at all and is crossing a dangerous line in terms of mental and physical health. In this case, the individual needs to get help, either through family and friends or through therapy and medications if the condition worsens. 

4. How can I support someone grieving, especially if their cultural background is different from my own? 

Active listening, empathy and being respectful towards their cultural perspective of grief a key methods to support the individual. Additionally, encouraging them to take part in activities and hobbies and having conversations could gradually bring them back to their normality. It is imperative to note that it takes time, so do not rush the individual to move on.