Dual Process Model of Grief vs Prolonged Grief Disorder Treatment
A side-by-side comparison: mechanism, evidence, the conditions each treats, philosophical roots, and where they actually disagree clinically.
At a glance
Dual Process Model of Grief
- Tradition
- Integrative
- Founder
- Margaret Stroebe & Henk Schut (1999)
- Evidence
- RCT-supported
- Focus
- Grief + Adaptive
- Format
- Individual, group
- Duration
- Variable
Prolonged Grief Disorder Treatment
- Tradition
- Integrative
- Founder
- M. Katherine Shear (2005)
- Evidence
- Guideline-recommended
- Focus
- Processing + Restoration
- Format
- Individual
- Duration
- 16 sessions
How they work
Dual Process Model of Grief
Core mechanism: Healthy adaptation requires dynamic oscillation between loss-oriented coping (processing grief) and restoration-oriented coping (rebuilding life); rigid fixation in either mode produces complications
Ontology: Grief is not a state to move through but a dynamic oscillation between confronting loss and rebuilding life; pathology emerges from rigidity, not from the pain itself
Prolonged Grief Disorder Treatment
Core mechanism: Revisiting the death narrative integrates the reality of loss + imaginal conversations transform the continuing bond + restoration goals rebuild engagement with life
Ontology: Prolonged grief as a failure of natural adaptation — the attachment system cannot update to accommodate the permanence of loss, leaving the bereaved stuck between wanting the person back and knowing they are gone
Conditions treated
1 shared · 0 Dual Process Model of Grief-only · 0 Prolonged Grief Disorder Treatment-only
Both treat
What each assumes — and misses
Dual Process Model of Grief
Philosophical roots: Lazarus & Folkman (coping as process); Bowlby (attachment and loss); Worden (task model as precursor); regulatory flexibility research (Bonanno); gender role socialization and grief
Blind spots: Descriptive rather than prescriptive — tells clinicians what healthy grief looks like but less guidance on what to do when someone is stuck; cultural assumptions about individual coping may not map to collective grief practices
Therapeutic voice: Some days you need to sit with the grief. Other days you need to do your taxes and clean the kitchen. Both are grief work. The back and forth isn't a sign you're doing it wrong — it's exactly how this works.
Prolonged Grief Disorder Treatment
Philosophical roots: Bowlby (attachment); Shear (complicated grief as attachment disorder); Foa (emotional processing applied to grief); Klass & Silverman (continuing bonds); DSM-5-TR nosology
Blind spots: Revisiting exercises may feel coercive for clients whose culture doesn't value explicit grief narration; 16-session format may be insufficient for losses compounded by other traumas; PGD diagnosis itself is debated as potentially pathologizing normal grief
Therapeutic voice: I'd like you to close your eyes and tell me the story of when your husband died — start from where things felt most difficult. We'll go through it together, and I'll be right here.
Choosing between them
Dual Process Model of Grief and Prolonged Grief Disorder Treatment both sit within the Integrative tradition — they share a worldview about what suffering is and how change happens. Differences are more often about technique and emphasis than about underlying theory.
For deeper coverage: see the full Dual Process Model of Grief and Prolonged Grief Disorder Treatment pages, or use the interactive comparison tool to add more modalities to this comparison.