What is the first step in initiating grief therapy?

• A. Assess affect using SUDS
• B. Set up the contract with the patient
• C. Select Gestalt therapies
• D. Assess the grief therapy category

Answer: (B)

Setting up the contract with the patient is the first step because grief work needs a clear, agreed-upon framework before anything else happens. A therapeutic contract outlines goals, boundaries, confidentiality, session length and frequency, fees, and what happens if either person needs to pause or end therapy. This creates safety and trust, which are especially important when exploring intense grief and vulnerable emotions. With the contract in place, both therapist and client know what to expect, making the process more focused and collaborative from the outset.

Tools like assessing affect with a SUDS scale are useful, but they come after the therapeutic framework is established. Choosing a specific therapy approach (such as Gestalt methods) or deciding how to categorize grief therapy are decisions that follow once the relationship and expectations are set and the patient has given informed consent.