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Bereavement and grief: Levels of bereavement support

Resources and information on bereavement and grief for the public and healthcare professionals.

The Bereavement Support Pyramid

The Bereavement Support Pyramid is a visualisation of the support people will need when they are bereaved.

The pyramid shows the three main levels of bereavement support: General Support and Information, Extra Support, and Therapy Support.

Most people coping with grief will only need level one support, but in some cases, extra support may be required to help the bereaved person manage the grieving process

The resources listed below cover the needs of bereaved people at each level of bereavement support.  

Level 1: General Support & Information


The first level of bereavement support represents general support and information. Most people experience loss will only require first-level support, which involves providing people with information on the grieving process, practical help with tasks, and social support. Family, friends, and colleagues will provide much of this support.

Level 2: Extra Support

A small percentage of people may need extra support through their bereavement. This could be because of the nature of the loss – the death of a child, for example, or a sudden death – or because of other circumstances in the person’s life.

Extra bereavement support might be needed if:

  • The bereaved person feels unable to cope.
  • There are not many people available to the bereaved person.
  • Going through the details of the death or the relationship with someone who is not family might help.

Level 2 bereavement support provides a person who is bereaved with an opportunity to reflect in a focussed way on their experience of loss. This support is generally provided by volunteers who themselves have been bereaved and have had specialised training in bereavement support.

Bereavement support at this level can be provided on a one-to-one basis or in groups and is used for both adults and children. Voluntary bereavement support services, self-help groups, faith groups, and community groups provide much of the support at this level. It may also be provided through a hospital or hospice.

Well-run bereavement support agencies ensure their volunteers are carefully selected, receive ongoing training, and are supervised by professionals. They are trained to provide a listening ear, to facilitate people in talking about their experience, and to support them in finding their way through their grief.

For those who have been bereaved through a hospice death or through an acute hospital death, a bereavement support service might be available in the hospice or hospital.

Level 3: Therapy Support


Level 3 bereavement support is specialised support provided by professionals (psychologists, psychotherapists, counselors, and doctors). Therapy support is appropriate for people who develop complications or become stuck in their grieving process (approximately 10-15% of bereaved people).

No experience of bereavement is easy, but the circumstances surrounding certain deaths can cause additional difficulties for those left behind. The death of a child, the experience of multiple losses over a short period of time, or a particularly traumatic death can all leave survivors needing support beyond that which family and friends may be able to offer. Other factors such as a history of difficulty in coping with loss or a difficult relationship with the person who has died can also suggest that professional intervention might be useful.

In Ireland there is no professional qualification in bereavement counselling. Professionally trained therapists, however, will be registered with a governing body like the ones listed below. These organisations will be able to furnish people with the names of qualified therapists who specialise in issues of loss and grief.

National Health Library & Knowledge Service. Health Service Executive. Dr. Steevens' Hospital, Dublin 8. Tel: 01-6352555/8. Email: