The following checklist is designed to assess many of the attributes and issues frequently associated with Complicated Grief, including: Unresolved Grief, Hopelessness/Suicidal Ideation, and Affective/Behavior Manifestations. All items are phrased in the same direction and the selection of 10 or more items is an indication that the individual is experiencing symptoms associated with complicated grief.

We recommend that users of this instrument remove or white-out the sub-section headings before administering the checklist to clients, because the heading titles may be interpreted negatively by some clients, which could affect their responses.

[A] UNRESOLVED GRIEF [N=10 ITEMS]
A1. I miss my loved one(s) terribly.
A2. I have so much unfinished business with my loved one.
A3. I worry about whether my loved one suffered before dying.
A4. I am angry at my loved one for dying.
A5. I feel guilty because sometimes I am still mad at my loved one.
A6. I try not to think about the loved one I’ve lost.
A7. I find myself thinking about my loved one all of the time.
A8. Even when I try not to think about my loved one, my mind goes there anyway.
A9. Everyone tells me I need to get over my feelings of grief.
A10. People tell me that I need to move on, but I can’t.

[B] HOPELESSNESS/SUIDICAL IDEATION [N=20 ITEMS]
B1. I often think about killing myself.
B2. I often think about dying.
B3. I haven’t been happy in a very long time.
B4. I feel “out of control” around food.
B5. Life is so unfair.
B6. I am not looking forward to my future.
B7. I see no future for myself.
B8. I don’t believe that my life will get better any time soon.
B9. I have no hope for the future.
B10. I continually relive my loss/traumatic event(s) over and over again.
B11. I feel like my life is on hold.
B12. Sometimes, I think it would be better if I ended it all.
B13. I feel apart from God.
B14. I feel so alone.
B15. It is hard for me to get on with my life.
B16. I find it hard to talk about my loss with others.
B17. I have no patience for anything — everything just “sets me off.”
B18. Sometimes I think I’m over my loss, but later, I start feeling badly again.
B19. I feel miserable most of the time.
B20. Nothing is getting better in my life.

[C] AFFECTIVE/BEHAVIORAL MANIFESTATIONS [N=10 items]
C1. Sometimes, I cry for no apparent reason.
C2. There is nothing I can do to make my life better.
C3. I have given up on ever feeling joy again.
C4. Recently, I have been unable to sleep through the night.
C5. I sleep for hours on end and still wake up exhausted.
C6. I often wake up during the night.
C7. I often feel numb — just nothing at all.
C8. I have been smoking and/or drinking too much lately.
C9. I can’t remember the last time I laughed.
C10. I have done reckless things lately, because I really don’t care what happens to me.

Sylvia Kay Fisher is a program specialist at the Center for Program Planning and Results of the U.S. Department of Labor. She was formerly a therapist and psychological evaluator. Ronnie Fisher is a retired psychology teacher and a former social worker and counselor.

This assessment tool is published in Counselor,The Magazine for Addiction Professionals, August 2003, v.4, n.4, p. 67.

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