Psychological Therapy for Grief in Santa Cruz
Professional support through grief: the death of a loved one, a breakup, loss of health, miscarriage or abortion, being laid off, migration. A cognitive behavioral approach that respects each person's own timing, in person in downtown Santa Cruz and online in Bolivia.
Sessions are held in Spanish. Therapy in English is available with psychologist Jazmín Villazón.
Spanish original clinically reviewed by Junisse Montaño, MSc, Clinical Psychologist · College of Psychologists No. JMP-1004-25 · Last reviewed:
What is grief, and when does it become a clinical process?
Grief is the natural and expected response to a significant loss. It is not a disorder: it is one of the most universal human experiences. When someone we love dies, when a relationship ends, when we lose a job, a physical ability, a life project or a country, our emotional system reacts with sadness, anger, confusion, emptiness and, sometimes, relief. All of them are valid responses.
In most cases grief is processed naturally with time, support networks and one's own rituals. Seeing a psychologist becomes useful when the process gets stuck, when the symptoms significantly interfere with functioning (working, caring for children, sleeping, eating) for months, or when complications appear such as suicidal ideation, problematic substance use or severe isolation. In the ICD-11, the WHO describes a specific category, Prolonged Grief Disorder (6B42), for cases where the pain remains intense and disabling beyond 6 months after the loss; but we want to stress this: most grief does NOT fall into that category, and seeking help before 6 months is entirely legitimate if the process feels overwhelming.
Signs that grief needs professional support
There is no "normal" amount of time to process a loss. But these signs suggest that the process could benefit from clinical support:
- Suicidal thoughts or thoughts of "wanting to stop existing" (even passive ones, without a plan). Any suicidal ideation during grief deserves an immediate evaluation.
- Being unable to return to basic functioning (work, self-care, relationships) beyond 2-3 months after the loss.
- A persistent sense of unreality, of "living in slow motion" or of being disconnected from your own body.
- Being unable to talk about the person you lost, to look at photos or to visit places: avoidance that becomes chronic instead of easing with time.
- Intense and persistent guilt: "I could have done more", "it was my fault", "I don't deserve to live if she is not alive".
- Starting or increasing the use of alcohol, anti-anxiety medication or other substances "so as not to feel".
- Persistent physical symptoms with no medical cause: severe insomnia, significant weight loss, overwhelming fatigue, diffuse pain.
- Multiple losses close together in time (accumulated grief) that find no room to be worked through.
- Losses that are "not socially recognized": miscarriage or abortion, breakups, migration, the death of a pet, the suicide of a family member; grief that the people around you minimize and that therefore becomes harder to process.
How we work through grief
We do not "cure" grief: the pain of an important loss should not disappear, because it is tied to the love we feel. What we can do in therapy is help integrate the loss into your life without it consuming you, identify and work through the knots that keep the pain stuck, and rebuild a sense of continuity after the world has changed.
The approach we use draws on CBT and on two grief-specific models: Robert Neimeyer's meaning reconstruction approach and Katherine Shear's Complicated Grief Treatment (now called Prolonged Grief Disorder Therapy). In practice it looks like this: first we create a space where the pain can be expressed without censorship or pressure to "get over it". Then we work on rigid beliefs that keep the suffering going (disproportionate guilt, the feeling that recovering means betraying the person you lost, fear of forgetting). When avoidance becomes chronic, we gradually approach the memories, places and conversations that were being avoided. And we build what is called a "continuing bond": a healthy way of keeping the person you lost present without that bond freezing us in place.
Grief does not follow a fixed timeline. Some processes come to a close in 4-6 months; others (especially traumatic losses, suicides, the death of a child) require longer support. What matters is not the length but the direction: is the pain being integrated, or is it crystallizing?
When to seek help?
If your loss is recent and you feel you need a space to process it, there is no need to wait for the grief to become "complicated": seeking help early can prevent blockages and make the process easier. If months or years have passed since a loss and you feel that something got stuck (you cannot talk about it, you avoid remembering it, you feel guilty when you are doing well), now is also the time.
If there is suicidal ideation, self-harm or problematic substance use, do not wait: the first appointment can be within the same week. If there is imminent risk, call 168 (Santa Cruz medical emergencies) or go to the emergency department of the nearest hospital, where they must see you without an appointment in an emergency. If you need to talk to someone, Familia Segura answers free of charge and in confidence at 800 11 3040, every day from 6:00 a.m. to midnight.
A relevant cultural note: in Santa Cruz and across Bolivia many families process grief through collective rituals (wakes, novenas, anniversaries) that serve a real function in working through the loss. Psychological therapy does not replace those spaces: it complements them, especially when the collective is not enough to hold individual pain or when the loss falls outside socially recognized rituals.
Specialist in grief and loss
Junisse Montaño
Clinical psychologist with outstanding training in Bolivia and Spain. Master's degree in Clinical and Health Psychology from ISEP Barcelona. My practice is grounded in Cognitive Behavioral Therapy, offering practical, evidence-based tools to overcome anxiety, depression and life crises. My office is a safe, judgment-free space where we work together so you can regain your emotional well-being and build the life you want.
College of Psychologists No. JMP-1004-25Colegio de Psicólogos de Santa Cruz (Santa Cruz College of Psychologists)View full profile →
Cost of therapy: 190 Bs per session (60 min). A 4-session package is 650 Bs and a 10-session package is 1,500 Bs. Sessions are available in person in Santa Cruz and online throughout Bolivia. See all fees.
Frequently asked questions about grief and loss
Answers to the questions we hear most often in our practice.
How long is it "normal" to grieve for someone?
There is no right amount of time. The first weeks and months are usually the most intense; between 6 months and 2 years, the symptoms tend to become integrated: the pain remains, but it no longer dominates daily life. Some losses (children, suicides, traumatic deaths) take longer. What matters is not the clock but the direction: are you able to resume basic functions, talk about the person, feel moments of well-being without guilt? If the answer is still "no" after 6-9 months, it is worth seeking help.
Does therapy help if the loss was years ago?
Yes, a great deal. Old grief that was never processed does not "disappear": it crystallizes into patterns (avoiding dates, being unable to talk about the person, recurrent depression, unexplained anxiety) that therapy can unblock. We have worked with people who come to process the death of a parent 15 years later, or a miscarriage or abortion they were never able to name. There is no "statute of limitations" on grief.
My partner broke up with me and nobody understands why I'm taking it so hard. Is it grief?
Yes. Breakups are a legitimate form of grief, especially when there was a shared plan or you lived together. But socially they are minimized ("just get over it", "you'll find someone better"), which makes them harder to process. In therapy we approach breakups with the same clinical respect as any other loss: they are no less valid because no one died.
What if the person who died and I had a complicated relationship?
Ambivalent grief (where anger, relief and guilt are mixed with sadness) is usually MORE difficult, not less. When the relationship had unresolved wounds (an absent parent, an abusive partner, an estranged child), death closes off the possibility of repair, and a complex mix of emotions emerges that the people around you often do not validate. In therapy we make explicit room for every emotion, including anger and relief, without judgment.
Is it normal to feel relieved after a loss?
Yes, particularly when the person was suffering (a long illness, chronic pain) or when the relationship was full of conflict. Relief is not betrayal or a lack of love: it is acknowledging an emotional reality. What usually complicates things is the secondary guilt about feeling relief, not the relief itself. In therapy we separate those two levels.
Do you work with grief after a miscarriage, an abortion or a perinatal loss?
Yes. Perinatal grief (miscarriage, termination of pregnancy, fetal or neonatal death) is one of the least socially recognized forms of grief, and for that reason one of the hardest to process. It is treated with the same clinical seriousness as any other grief, with the additional care of not imposing any moral or religious framework: the therapeutic space is secular and respects your own understanding of the loss.
Sources and references
This page draws on leading health organizations and clinical guidelines. The links open in a new tab.
- BereavementMedlinePlus · U.S. National Library of Medicine
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