Esteem HealthCHW Certification Training
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Module 2: Core CHW CompetenciesLesson 2.10 · 7 sections · ~30 min

Grief and Resiliency

Learning Objectives
  • Recognize the causes, signs, stages, and types of grief.
  • Explain the CHW's role in grief processing and outline specific supportive strategies.
  • Define resilience and detail its significance for both CHWs and their clients.
  • Name some factors that influence a person's resilience and identify techniques to build it.

Introduction

CHWs often work with patients facing difficulties and barriers that negatively impact health outcomes and quality of life. One big challenge is grief. CHWs can't eliminate grief, but they can recognize it and provide strategies for supporting patients through their grieving process.

This lesson also focuses on resilience — the driving force that keeps people pushing forward in the face of grief and other difficulties.

Grief is the natural response to loss

When we experience grief, we might feel disconnected from "normal life" and struggle to carry out daily activities. Everyone feels grief — but older adults often experience it more frequently as losses accumulate over a lifetime.

Each person experiences grief differently. The intense pain usually lessens over time as the person learns to cope. It can take months or even years — and that's normal.

The Kübler-Ross 5 Stages of Grief

Psychiatrist Elisabeth Kübler-Ross created the most well-known model of grief. Five stages — but remember: they aren't linear.

The Kübler-Ross 5 Stages of Grief

Stage 1 of 5

Denial

Key Points
  • Avoidance, confusion, shock, and fear when grief first hits.
  • Holding on to a false sense of hope.
These stages are not linear
People go back and forth between stages or feel parts of different stages at the same time. Grief isn't something that starts, finishes, and ends — it's an ongoing process. In some cases, grief can become "complicated" or "chronic", meaning the person is experiencing grief symptoms much longer than usual.

Many kinds of loss, many shapes of grief

Loss can come in many forms:

  • Loss of identity
  • Loss of safety
  • Loss of control over parts of life
  • Loss of expectations

Types of grief

Normal (common) grief
What the Kübler-Ross cycle describes, or something like it. Looks different in everyone — not always a straight line.
Complicated (chronic) grief
When symptoms persist much longer than usual. Can look similar to depression, anxiety, or post-traumatic stress. In the first few months after a loss it's hard to distinguish from normal grief — both produce similar symptoms. With normal grief, symptoms fade over time; with complicated grief, they persist or worsen.
Anticipated grief
Feeling sad before a significant loss happens — for example, feeling sad about the upcoming death of a family member who has cancer.
Ambiguous loss
When someone or something important is missing, but it's not clear what happened, making closure hard. Happens when someone is physically gone (natural disaster, military deployment) or still present but not the same (brain injury, serious illness, memory problems, addiction).

The CHW's role with grieving clients

CHWs can't solve grief or address its causes. But you can support, listen, and connect people with strategies and resources.

CDC-recommended strategies

CDC strategies for coping with grief

Crisis support
If grief becomes overwhelming — thoughts of self-harm, inability to function, prolonged hopelessness — get help right away. Dial or text 988 from any phone for the Suicide and Crisis Lifeline.
Call or text 988 — Suicide & Crisis Lifeline
Knowledge Check

A client lost her spouse eight months ago. She still rarely leaves the house, has stopped activities she used to enjoy, and tells you the sadness feels just as intense as it did at first — if not worse. Which type of grief best describes what she may be experiencing?

AAnticipated grief
BComplicated (chronic) grief
CAmbiguous loss
DNormal grief
Knowledge Check — Matching

Match each Kübler-Ross stage to the description that fits it best.

Terms
Denial
Anger
Bargaining
Depression
Acceptance
Definitions
Avoidance, confusion, shock, and holding on to a false sense of hope.
The end of fighting against the loss and adjusting to a "new normal."
Frustration when the loss can no longer be ignored — wanting someone or something to blame.
Deep sadness and hopelessness, wanting to be alone and withdrawing from others.
Hoping to avoid the pain, often asking a higher power for help.

Resilience

Resilience is the ability to deal with difficult situations. It means handling things well even when bad things happen — serious illness, family or work problems, stressful times. Resilience helps us "bounce back" and keep going.

Resilience doesn't mean you won't feel upset. In fact, to become more resilient, we often must feel emotional pain and work through it. If we didn't have hard times, we wouldn't need resilience.

Note
Resilience isn't a fixed trait. It's a set of skills and ways of thinking that anyone can learn and improve. Like any skill — practice makes you better.

What contributes to resilience

Studies find one factor above all: being surrounded by people who care about you — family and friends who love and trust you, and make you feel better about yourself.

Other contributors:

  • Making realistic plans and following through with them
  • Believing in yourself and your abilities
  • Being good at solving problems and communicating with others
  • Controlling emotions and avoiding impulsive actions

Ways to build resilience

Share these with clients — and apply them to yourself.

Tips for building resilience

Click a card to flip · ← → to navigate

Connect with Others
Tap to flip
Don't try to solve everything alone. Share and collaborate.
1 of 6

Take care of yourself first

The most important thing: take care of yourself. If you're not managing your own stress and problems, you won't be able to help the people you're working with.

In the event of lost cabin pressure, oxygen masks will drop from the panel above your seat. If traveling with small children, place your own oxygen mask on first and then assist your child.
Airplane safety briefing
Put your own oxygen mask on first
You can't help others if you can't breathe. Same principle here — your resilience makes you more useful to the people who depend on you.
Knowledge Check — Select all that apply

Which of the following are factors that influence a person's resilience? Select all that apply.

Being surrounded by people who care about you
Making realistic plans and following through with them
Believing in yourself and your abilities
Never feeling emotional pain or upset
Controlling emotions and avoiding impulsive actions

Taking a strengths-based approach

As a CHW, you'll encounter clients struggling to navigate a healthcare system that has many problems — including prejudice and injustice. By taking the time to learn about your clients and helping them be resilient in difficult situations, you can empower them to take charge of their own healthcare and make positive changes.

Reflection Prompts

Think of a time you bounced back from a difficult situation. Which of the resilience factors helped you most — and which could you strengthen?

How might you gently introduce one CDC grief-coping strategy to a client without minimizing their loss?

Lesson Takeaways

🌟 Lesson Takeaways

Grief is the natural response to loss — and it shows up in many forms (anticipated, complicated, ambiguous). The Kübler-Ross stages (denial, anger, bargaining, depression, acceptance) describe one path, but grief isn't linear. CHWs can't solve grief, but you can support it with presence, routine, honoring rituals, and connections to professional help. Resilience is the other side of the same coin: a learnable set of skills — built on caring relationships, realistic goals, self-confidence, problem-solving, and emotional control — that helps people handle the difficult stuff and keep going. Build it in your clients, and remember to build it in yourself.

🎉Great work!
📅
Coming up

Great work! At the end of this module, you'll join a live discussion with your cohort and an instructor to talk through grief, resilience, and how these show up in your own work. We'll see you there.