Referral criteria for non-clinical grief support

The gap

The person your resource list misses

You know who they are. They decline the therapy referral, sometimes politely and sometimes not, because in their own view there is nothing wrong with them. They tried the group once and did not go back, or the group is bereavement-focused and their loss was a divorce, a diagnosis, a job, or an estrangement. They are managing. They are also carrying something with nowhere to put it.

Non-clinical grief support exists for exactly that person. It is structured, one-to-one, forward-looking work on adjustment and life after a loss, and it does not require anyone to be unwell in order to qualify for it. Grief coaching is one form of it.

There is a capacity argument as well. Federal regulation requires a Medicare-certified hospice to run an organized bereavement program under the supervision of a qualified professional with experience or education in grief or loss counseling, and to make bereavement services available to the family and others named in the bereavement plan of care for up to one year following the death. The same regulations state plainly that bereavement counseling is a required hospice service and is not reimbursable. Where bereavement staffing is limited, non-clinical support does not replace what your team provides. It can absorb individual work that a small bereavement staff cannot sustain across the full bereavement period.

Sources: 42 CFR 418.64(d)(1), counseling services and bereavement, and 42 CFR 418.204(c), special coverage requirements.

The evidence

Where non-clinical support fits, and what it offers

Need comes in levels

A population survey of 678 bereaved people tested a public health model of bereavement support, which predicted that 60 percent would be at low risk, 30 percent at moderate risk, and 10 percent at high risk. The actual figures were 58.4 percent, 35.2 percent, and 6.4 percent. The authors conclude that services, community organizations, and informal networks should prioritize care according to each level of need, rather than offering the same response to everyone.

Clinical care belongs where grief is complicated

A widely cited review of bereavement interventions found that routine intervention for uncomplicated grief has little empirical support, and that the more complicated the grief process, the better the chance an intervention is effective. That is an argument for reserving clinical treatment for the people who need it, and for offering something lighter, with a clear route back to clinical care, to the many who do not.

The middle is where people go unreached

Medicare requires hospices to offer bereavement services but does not specify which services, and a national sample found wide variation in what hospices provide, particularly in format (Becker and Cagle, 2021). In a study of 6,160 bereaved family members of hospice patients, services did not reach almost half of those identified as at risk (Ghesquiere and colleagues, 2016). A 2025 review found that families want individualized support before and after a loss. One-to-one non-clinical support is one way to reach people who do not want counseling or a group.

What the person receives

Non-clinical grief support helps a person make sense of their own experience, draw on the supports they already have, and rebuild routines and goals on their own terms. In practice that looks like:

• Listening that helps the person clarify their own experience, rather than advice
• Room for guilt and anger, worked with rather than reassured away
• Help thinking through decisions, without being told what to decide
• A realistic picture of grief, including waves that return months or years later
• Rebuilding routines and goals the person defines
• A practitioner who recognizes when clinical care is needed and makes the connection

Sources: Aoun and colleagues, Who needs bereavement support? A population based survey of bereavement risk and support need, PLoS ONE, 2015. Schut and Stroebe, Interventions to enhance adaptation to bereavement, Journal of Palliative Medicine, 2005. Becker and Cagle, 2021. Ghesquiere and colleagues, 2016.

Boundaries

Where non-clinical support does not belong

This is worth stating early, because it is the question underneath the question. A practitioner who blurs this line is a risk to the family and to whoever gave them the name. Non-clinical grief support, including grief coaching, does not diagnose, treat, prescribe, provide psychotherapy, assess clinical risk, or serve as crisis intervention, and no credential changes that.

It also does not compete with clinical care. Non-clinical support can run alongside therapy with appropriate coordination, and a qualified practitioner coordinates rather than takes over.

The difficulty

Why vetting falls to you

That is why the other three categories on your list feel easier. A crisis line is a known quantity. A national peer organization is a known quantity. A therapist can be checked against a state board in a minute. An individual non-clinical practitioner can be checked against nothing, which is why most lists leave the category off.

This is not a criticism of trained practitioners, many of whom are well prepared and take the work seriously. It describes a situation your team has to navigate without a licensing board to lean on.

There is a consequence that is easy to miss. A professional who cannot confirm a practitioner's preparation may reasonably decline to put their own name behind the referral, so the category tends to get left off rather than evaluated case by case. The person who wanted one-to-one non-clinical support then gets a group they will not attend, or a therapy referral they will decline, and no referral happens at all.

That pattern is visible in written policy. Information and referral services, including 211 systems, publish inclusion and exclusion criteria for their community resource databases, and those criteria commonly require that a for-profit provider hold a license or certification where the field is licensed, and exclude providers whose services cannot be verified. Each system sets its own policy, so the wording varies. None of it is aimed at grief coaching. Much of it excludes the category as a side effect. Employee assistance clinical panels typically require state licensure, with the same result.

Examples of published policy: 211 Long Island inclusion and exclusion criteria and 211 Connecticut inclusion and exclusion criteria. Standards for resource database inclusion criteria are maintained by Inform USA, formerly the Alliance of Information and Referral Systems.

The rest of this page is what to use instead, at no cost.

The standard

The six criteria

• Grief-specific education. Training whose subject is grief and loss, from any credible source, rather than a general qualification that mentions grief in passing.
• Documented practice. Real experience working with grieving people, evidenced rather than asserted.
• A written scope of practice. A clear statement of what the practitioner does and does not do.
• Defined referral thresholds. Named indicators for when a person requires licensed clinical or emergency care, and a stated response to warning signs of suicide or self-harm.
• Accountability to published ethics. A code of conduct held by a body outside the practitioner's own business, with a route for your organization to raise a concern.
• Independently verifiable standing. Something you can check without going through the practitioner.

Criteria that only one credential can satisfy are not criteria. They are a preference. A practitioner without a credential may meet all six, and should be evaluated against them individually.

In conversation

Six questions to ask any non-clinical practitioner

1. What is your grief-specific education, and where did it come from?

2. How much experience do you have working with grieving people, and can you document it?

3. What is your scope of practice, and what do you not do?

4. What would cause you to refer someone to licensed care, and what would you do in that moment?

5. Who holds you accountable, and what happens if someone raises a concern?

6. Can I verify your standing independently, and how?

Safety

The answer that matters most

A competent practitioner refers to licensed or emergency care when a person presents with:

• Risk of harm to self or others, escalated immediately to emergency or crisis support
• Clinical conditions beyond the non-clinical scope, such as clinical depression or an anxiety disorder
• Features consistent with Prolonged Grief Disorder, or trauma requiring clinical treatment
• Substance use or other conditions requiring licensed care

Under the INBGC standard, scope of practice and referral is one of the six topic areas the Board Examination covers, weighted equally with the rest. Read the full Code of Ethics and Scope of Practice.

Before you add someone

Practical questions worth asking

What do you charge, and how do you structure sessions?

Practitioners set their own fees and session structures. INBGC does not set, approve, or publish what a practitioner charges. Ask for the fee, the session length, and whether they work in packages or single sessions, so a family knows what to expect before they call.

Can this be billed to insurance?

Generally no. Because this support is non-clinical, it is usually not reimbursable through health insurance, and most practitioners bill privately. Some employers, employee assistance programs, and community organizations fund it directly. If cost is a barrier for the people you serve, ask what the practitioner offers, since some hold sliding-scale or reduced-fee spots. Note it beside the entry where they do.

Do you work in person, by video, or both?

Both are common. Video widens the pool available to someone in a rural area or without transportation, which matters more than it might appear when your list is organized by geography.

How is confidentiality handled, and what are the limits?

A practitioner should be able to state their confidentiality practice and its limits without hesitating, including the circumstances in which they would break it to prevent serious harm or because the law requires it. If your organization needs any information back from the practitioner, that requires the person's consent and should be agreed in advance.

Who do you work with, and who do you not?

Ask directly about age. Supporting grieving children and adolescents requires preparation distinct from adult work, and many practitioners work only with adults. Ask about group work as well as individual, and about the kinds of loss they have real experience with, since someone strong in bereavement may have little experience with divorce, estrangement, or job loss.

Do you carry professional liability insurance?

Ask, and ask for the carrier and the coverage amount. Provider networks that contract with licensed clinicians generally require it, and it is a reasonable question to put to any practitioner you are considering. Your own organization may already have a coverage threshold it applies to contracted providers, and the same figure is a sensible reference point here. INBGC does not require certificants to carry coverage, so treat the answer as information rather than as something the credential guarantees.

What languages do you work in, and what is your availability?

Both are practical barriers that surface after a referral rather than before. Ask about language support, current waiting time, and how quickly someone can be seen, so you are not sending a grieving family toward a wait they did not expect.

If someone you serve wants support and nothing on your list fits, they can describe their situation through Find a Grief Coach. There is no cost, and no certificant can pay to be matched ahead of another.

For your policy

Policy language you can adopt

The fourth clause is written to accept an equivalent credential deliberately. A policy that names one credentialing body and no criteria is a policy about a brand. One that names the criteria is a policy about safety, and it holds up if the field changes. Program Administration will provide the published scope of practice and referral indicators in a form your team can circulate, at no cost.

The shortcut

When a credential does the work for you

That is what a credential is for. It is not a substitute for judgment, and it does not mean a practitioner will be the right fit for the people you serve, which is why the practical questions above still apply. It means the six questions have already been answered by someone with no financial interest in the answer.

INBGC does not provide foundational grief support training, so the board has no stake in where a certificant studied. The Advisory Board maintains the standard, and Program Administration applies it to individual candidates. Nobody with a commercial interest in how many people certify helps define the requirements.

For how to verify a credential, raise a concern about a certificant, or request written verification for a credentialing file, see referring someone for grief support. No one who references the standard or verifies a credential is ever charged.

In practice

Applying these criteria in your setting

Hospice and palliative care

The gap appears when a family needs individual support your program cannot sustain across the full bereavement period, or when that period ends and the person is not finished grieving. It also appears when the loss a family is carrying is not the death you served them through. For what the Medicare Conditions of Participation require of a bereavement program and where these criteria fit within them, see hospice bereavement requirements under 42 CFR 418.64.

Funeral and death care

Families often return long after the service, asking where to turn next. Aftercare is defined differently at every firm, and the resource sheet is frequently the whole program. Vetting the individual entries in advance is what turns that sheet from a formality into something you would stand behind.

Chaplaincy and spiritual care

Where your relationship with a person ends by design, the handoff is usually to a group, a congregation, or a list. The gap is the person who wants continued one-to-one support, including someone who wants a practitioner who will work respectfully with their faith rather than around it.

Employee assistance and human resources

EAP provider panels typically require state licensure, so a non-clinical practitioner will not be in network. The gap is the employee whose loss is real but is not a clinical condition, who does not want counseling sessions and does want somewhere structured to put it. These criteria apply to the community resources you point people toward outside the panel, and to any non-clinical support an employer funds directly.

Therapist referral networks

The gap is the client who does not meet criteria for treatment, or who has completed it and still wants support while they rebuild. Question four matters most here, since it determines whether a practitioner will recognize a clinical need and route someone back to you.

Senior living and healthcare systems

Repeated loss and bereavement overload are common in these settings, and staff grief is real alongside resident and family grief. These criteria apply to any external practitioner your team may name to a resident, a patient, or a family, whether that name comes from your own list or your hospice partner's.

Common questions

Version and citation

Using and citing these criteria

These criteria are published as a stable reference so that an organization can adopt them, cite them, and know what it adopted. Revisions are published at this address with a new version number and date, and the version you cite remains identifiable. The criteria are based on the INBGC professional standard for non-clinical grief support, Version 1.6, and are updated when the standard changes a referral requirement.

Version 1.1, published September 2026.

You may reproduce these criteria and the sample policy language in your own referral protocol, inclusion policy, vetting checklist, staff training, or intake procedure, in whole or in part, with attribution. No permission is required, no fee applies, and there is no requirement to notify INBGC that you have used them.

Download Version 1.1 as a PDF for circulation, printing, or a policy file.

Questions about this document may be sent to verify@inbgc.org.