Document Type

Dissertation

Degree

Doctor of Philosophy

Major

Education, Counseling

Date of Defense

4-20-2026

Graduate Advisor

Emily Oliveira

Committee

Emily Brown

Yuima Mizutani

Meredith Moore

Abstract

Individuals with substance use disorders (SUDs) experience frequent and cumulative losses, many of which remain unacknowledged due to stigma, criminalization, and societal blame, resulting in disenfranchised grief. Although addiction counselors are often on the frontlines supporting clients through grief alongside recovery, empirical research exploring how counselors perceive and address disenfranchised grief in clients with SUDs is lacking. Guided by Worden’s (2018) Four Tasks of Mourning and Relational-Cultural Theory (RCT), this qualitative research explored addiction counselors’ perceptions of disenfranchised grief and their approaches to treatment with this population in two studies. The first study asked the research question: How do addiction counselors perceive and make meaning of disenfranchised grief in clients with substance use disorders? Themes identified included: multitude of losses, grief as a risk factor, and barriers to grief processing. The second study asked the research question: How do addiction counselors perceive and implement treatment approaches for addressing disenfranchised grief in clients with substance use disorders? Themes identified included: client readiness for grief processing, creating safety and connection, and holistic integrated approach. Recommendations were provided for clinical practice, counselor education and training, and future research to better support individuals with SUDs through disenfranchised grief.

Available for download on Wednesday, May 05, 2027

Share

COinS