These answers draw in part from “Being a Grief-Informed BCBA: Dying Death and Grief are Everyone's Business” by Patricia Lund, BCBA, Certified Sexuality Educator, Certified Trauma Professional (BehaviorLive), and extend it with peer-reviewed research from our library of 27,900+ ABA research articles. Clinical framing, BACB ethics code references, and cross-links below are synthesized by Behaviorist Book Club.
View the original presentation →The temporal relationship between a loss event and behavioral changes is the strongest initial indicator. Behavior that emerges or significantly intensifies within days to weeks of a loss should be evaluated for grief-related factors. However, grief and operant contingencies are not mutually exclusive. A behavior may have begun as a grief response but subsequently come under the control of environmental contingencies. Comprehensive assessment should consider both possibilities and develop interventions that address the grief context while also managing any operant contingencies that have developed.
Grief-relevant losses for individuals with disabilities include the departure of preferred staff members, peers transitioning out of programs, residential moves, changes in daily routines, loss of access to preferred environments or activities, parental separation or divorce, loss of physical abilities due to health changes, and even the loss of an anticipated future such as when a transition plan changes. Any significant disruption to an established relationship or routine can produce grief responses. The key is to take the individual's perspective and consider what relationships and routines are most important to them.
Supplement your standard FBA with grief-specific information gathering including a detailed loss history, timeline of behavioral changes relative to the loss, and information from caregivers about the individual's prior relationship with the person or situation that was lost. During direct assessment, pay attention to context variables that may trigger grief-related behavior such as reminders of the lost person, times of day associated with the lost relationship, or settings where the loss is most salient. Interpret assessment results cautiously, recognizing that standard functional analysis conditions may not adequately capture grief-related maintaining variables.
BCBAs can and should recognize grief, adapt their assessment and treatment approaches accordingly, teach communication and coping skills, and create supportive environments. However, providing grief counseling or psychotherapy is outside the scope of behavior-analytic practice unless you hold additional credentials. The distinction is between being grief-informed, meaning your clinical decisions account for grief as a context variable, and being a grief therapist. When a client needs specialized grief support, make appropriate referrals while continuing to provide behavior-analytic services that are adapted to the grief context.
Cultural backgrounds profoundly influence how grief is expressed, how long mourning periods last, what rituals are observed, and what support is considered appropriate. Some cultures encourage open emotional expression while others value stoicism. Some have extended communal mourning practices while others expect rapid return to normal activity. As a grief-informed practitioner, you must ask families about their cultural practices and beliefs around grief rather than making assumptions. Interventions should respect and accommodate cultural grief practices. Code 1.07 of the BACB Ethics Code requires cultural responsiveness, which in this context means ensuring your approach to grief is culturally sensitive and informed.
Disenfranchised grief occurs when a loss is not socially recognized or validated. For individuals with disabilities, this happens frequently. Staff changes, peer departures, routine disruptions, and program transitions may not be recognized as genuine losses by those around the individual, yet they can produce significant grief responses. Behavioral indicators may include withdrawal from social interaction, decreased engagement with previously preferred activities, increased stereotypy or self-stimulatory behavior, sleep and appetite changes, and increased challenging behavior. When these changes coincide with a loss that others have minimized, disenfranchised grief should be considered.
Anticipatory grief, the grief that occurs before an expected loss, is common and clinically significant. When you become aware that a client's family member has a terminal illness, proactively prepare by discussing the situation with the family to understand their wishes regarding communication with the client. Begin teaching or strengthening coping and emotional expression skills. Maintain predictable routines, as these provide stability during uncertain times. Plan for the period following the death by identifying additional supports that may be needed. Document your planning so that all team members are prepared. Being proactive rather than reactive significantly improves the client's experience.
This should be determined on a case-by-case basis in collaboration with the family and treatment team. Some clients benefit from the normalcy and structure of continuing familiar routines, including treatment goals. Others need a temporary reduction in demands while they process their loss. Observe the client's behavior and responsiveness during sessions. If they are significantly less engaged, more emotionally distressed, or showing regression, reducing demands temporarily is often appropriate. Communicate with the funding source about the clinical rationale for any modifications. The key principle is flexibility guided by the individual's current needs.
Behavior technicians often develop close relationships with clients and families, and their grief when a loss occurs is real and deserving of recognition. Provide space for technicians to express their feelings, offer information about grief responses, and normalize the experience of professional grief. Check in regularly in the weeks following a loss, as grief often intensifies after initial shock subsides. If your organization has an employee assistance program, remind staff of its availability. From a clinical standpoint, ensure that technicians' grief does not compromise their ability to serve other clients, and be prepared to temporarily reassign cases if needed.
Useful organizational resources include a loss history section in intake and reassessment documents, a grief response protocol that outlines steps for the team when a client experiences a loss, a list of local grief counselors who have experience with individuals with disabilities, training materials for behavior technicians on recognizing and responding to grief, and guidelines for modifying treatment plans during bereavement periods. Additionally, developing relationships with hospice organizations and bereavement support groups in your community provides referral options when specialized support is needed.
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Being a Grief-Informed BCBA: Dying Death and Grief are Everyone's Business — Patricia Lund · 2 BACB Ethics CEUs · $20
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All behavior-analytic intervention is individualized. The information on this page is for educational purposes and does not constitute clinical advice. Treatment decisions should be informed by the best available published research, individualized assessment, and obtained with the informed consent of the client or their legal guardian. Behavior analysts are responsible for practicing within the boundaries of their competence and adhering to the BACB Ethics Code for Behavior Analysts.