What is Prolonged Grief Disorder?
Grief is a natural response to loss, and for most people, its intensity eases over time even if the loss is never forgotten. For some, though, grief stays intense and disabling long after the death. Prolonged Grief Disorder (PGD) was added to the DSM-5-TR in 2022 to describe this pattern, and recognizing it helps Social Workers, Counselors, and Therapists connect clients with effective treatment.
This guide covers the diagnostic criteria for PGD, how it differs from typical grief, risk factors, how to help, early intervention, and continuing education.
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Quick answer: Prolonged Grief Disorder
- What it is: intense, persistent grief that causes significant distress or impairment well beyond what’s expected in the person’s culture.
- Timeline: in the DSM-5-TR, at least 12 months after a death for adults (6 months for children and adolescents). The ICD-11 uses 6 months.
- Core symptom: intense yearning for or preoccupation with the deceased, plus symptoms like identity disruption, disbelief, and feeling life is meaningless.
- Treatment: grief-focused therapies, such as Prolonged Grief Disorder Therapy, have the strongest evidence.
Jump to: What Is PGD? · PGD vs. Normal Grief · Risk Factors · How Social Workers Can Help · Early Intervention · Grief CEUs · FAQs
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1) What Is Prolonged Grief Disorder?
In the DSM-5-TR, PGD involves the death of someone close at least 12 months earlier (6 months for children and adolescents), with intense yearning for or preoccupation with the deceased most days, for at least the past month. The person also has at least three of these symptoms:
| Symptom | Example |
|---|---|
| Identity disruption | Feeling as though part of oneself has died |
| Marked disbelief | Struggling to accept that the death happened |
| Avoidance | Avoiding reminders that the person is gone |
| Intense emotional pain | Ongoing anger, bitterness, or sorrow related to the death |
| Difficulty moving forward | Trouble reengaging with relationships, activities, or plans |
| Emotional numbness | Feeling little or no emotion |
| Meaninglessness | Feeling that life is meaningless without the person |
| Intense loneliness | Feeling alone or detached from others |
The grief must cause clinically significant distress or impairment, last longer than expected based on the person’s cultural and religious norms, and not be better explained by another condition. The ICD-11 includes a similar diagnosis with a 6-month threshold.
2) PGD vs. Typical Grief
| Typical Grief | Prolonged Grief Disorder | |
|---|---|---|
| Course | Intensity gradually eases, with waves of grief over time | Grief stays intense and disabling |
| Functioning | The person gradually returns to daily life | Significant ongoing impairment in work, relationships, or self-care |
| Focus | Sadness is mixed with positive memories and moments of joy | Persistent yearning and preoccupation dominate |
| Culture | Expressions vary widely across cultures | Grief exceeds the person’s cultural and religious norms |
PGD can also occur alongside depression or PTSD, so a careful assessment matters.
3) Risk Factors
- Sudden, violent, or traumatic deaths, such as suicide, homicide, or accidents
- The death of a child or partner, or a very close or dependent relationship
- A history of depression, anxiety, or PTSD
- Limited social support
- Multiple losses or major stressors around the same time
- Grief that isn’t socially recognized (disenfranchised grief)
4) How Social Workers Can Help
| Strategy | What It Looks Like |
|---|---|
| Assess carefully | Explore the loss, symptoms, functioning, cultural context, and co-occurring depression, PTSD, or substance use. |
| Screen for suicide risk | People with PGD have a higher risk of suicidal thoughts, so ask directly and plan for safety when needed. |
| Validate and educate | Acknowledge the client’s pain and explain that grief can become stuck, and that effective treatment exists. |
| Use evidence-based treatment | Prolonged Grief Disorder Therapy (developed by Katherine Shear and formerly called complicated grief treatment) and grief-focused CBT have the strongest evidence. Refer when it’s outside your training. |
| Support meaning and connection | Help clients rebuild relationships, routines, and goals while keeping a continuing bond with the person who died. |
| Involve support systems | With consent, include family and connect clients with grief support groups. |
5) Early Intervention
Most bereaved people don’t need professional treatment, and research suggests routine grief counseling for everyone isn’t necessary. Support is most helpful when it’s targeted:
- Watch for warning signs, like grief that intensifies over time or significant problems functioning
- Offer extra support after sudden or traumatic losses
- Encourage social connection and healthy routines, like sleep and physical activity
- Support workplaces and schools in providing bereavement leave and grief resources
6) Continuing Education for Grief and Loss
Agents of Change Continuing Education offers self-paced courses and live CE events with ASWB and NBCC approval and certificates of completion for your license renewal. Related courses include:
| Topic | Course |
|---|---|
| Grief and loss | Grief Therapy |
| End-of-life care | Social Workers and Palliative Care |
| Risk assessment | Conducting Risk and Safety Assessments |
Explore more in the course library or start with 7.5 free CEUs.
7) FAQs: Prolonged Grief Disorder
How is Prolonged Grief Disorder different from normal grief?
Typical grief eases over time, even if the loss is always felt. PGD involves intense yearning or preoccupation and other symptoms that last at least 12 months for adults (6 months for children) and significantly interfere with daily life.
What are the risk factors?
Sudden or violent deaths, the loss of a child or partner, a history of mental health conditions, limited support, and multiple stressors can all increase risk.
How can I support someone who may have PGD?
Listen without judgment, offer practical help, stay in touch over time, and gently encourage them to see a professional experienced in grief treatment. If they mention thoughts of suicide, help them get support right away, such as by calling or texting 988.
8) Conclusion
Prolonged Grief Disorder is a recognized condition with effective treatments. By knowing the criteria, screening for risk, and offering or referring to grief-focused therapy, Social Workers, Counselors, and Therapists can help clients move from grief that feels stuck toward healing.
Learn more about Agents of Change Continuing Education. We’ve helped more than 100,000 Social Workers, Counselors, and Mental Health Professionals with exam prep and Continuing Education and want to help you next!
► Learn more about Agents of Change Continuing Education here: https://agentsofchangeprep.com/continuing-education/
About the Lead Instructor, Dr. Meagan Mitchell: Meagan is a Licensed Clinical Social Worker and has been providing Continuing Education for Social Workers, Counselors, and Mental Health Professionals for more than 10 years. From all of this experience helping others, she created Agents of Change Continuing Education to help Social Workers, Counselors, and Mental Health Professionals stay up-to-date on the latest trends, research, and techniques.
Disclaimer: This content has been made available for informational and educational purposes only. This content is not intended to be a substitute for professional medical or clinical advice, diagnosis, or treatment.
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