Heavy Heart Assessment Heavy Heart Assessment
A tool for reflecting on the weight of your grief journey.
Confidential Clinical Record
Client Name
Date
How to use this tool
Grief is not a linear path, but understanding the intensity of your feelings can help us navigate the way forward. For each statement below, please indicate how often you have felt this way over the past two weeks . There are no right or wrong answers—only your honest experience.
Experience Never Rarely Sometimes Often Always I find myself longing for the person I lost.
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| I feel "stuck" or unable to move forward with my life. |
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| Memories of the loss are intrusive and painful. |
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| I feel a sense of numbness or detachment from others. |
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| I avoid places or people that remind me of the loss. |
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| I struggle to engage in daily responsibilities (work, school, chores). |
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| I feel that life has lost its meaning or purpose. |
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| I feel angry or bitter about the loss. |
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Personal Reflection
What part of your day currently feels the most difficult to manage?
Are there specific triggers (sounds, smells, dates) that have been particularly intense lately?
This assessment is a starting point for dialogue. If you are in immediate distress, please reach out to emergency services.
Waves of Grief Slides Waves of Grief
Navigating the internal landscape of loss and rediscovering steady ground.
The Non-Linear Path
Expectation
A straight line through stages, ending in "closure" or a return to normal.
Reality
Loops, zig-zags, and waves. Healing isn't forgetting; it's integration.
Landmarks of the Journey
01
Shock & Denial
A natural buffer that protects the mind from being overwhelmed by the initial impact.
02
Anger & Guilt
Searching for a reason or someone to blame. The "Why?" and "What if?" phase.
03
Bargaining
Attempting to negotiate with fate or a higher power to postpone or undo the loss.
04
Depression
Deep sadness and withdrawal as the full reality of the loss begins to sink in.
05
Acceptance
Coming to terms with the reality and beginning to look toward a new way of being.
Finding Meaning
Transforming the pain into a lasting connection and personal growth.
The Oscillation
Loss Oriented
"Feeling the pain"
Grief work & crying
Intrusive thoughts
Breaking bonds
Denial/Avoidance of life
Restoration Oriented
"Learning to live"
Managing life changes
Doing new things
Distraction from grief
New identities/roles
Knowing When to Ask for Help
Grief is a heavy burden, but it shouldn't be an immovable one. Seek support if:
Persistent Stagnation
Feeling exactly as intense 6-12 months later.
Isolation
Complete withdrawal from all social connections.
Functional Impact
Inability to perform basic daily self-care.
Despair
Intrusive thoughts of self-harm or hopelessness.
Guide to the Compass Clinician Scoring Guide
Instrument: Heavy Heart Assessment
Purpose
The Heavy Heart Assessment is a screening tool designed to quantify the subjective experience of grief intensity and identify potential indicators of Prolonged Grief Disorder (PGD). It focuses on emotional longing, cognitive intrusion, and functional impairment.
Important Note:
This tool is intended to supplement clinical judgment, not replace it. Always consider cultural contexts and the specific nature of the loss.
Scoring Mechanics
Never 0 pts
Rarely 1 pt
Sometimes 2 pts
Often 3 pts
Always 4 pts
Total Score Range: 0 — 32
Mild/Typical Intensity: 0 — 12
Moderate Intensity: 13 — 24
Severe Intensity (High Risk): 25 — 32
Thematic Interpretation
Yearning & Longing (Items 1 & 3)
High scores here indicate deep emotional attachment and difficulty with reality testing. Focus on building "internalized connection" exercises.
Avoidance & Numbness (Items 4 & 5)
Significant avoidance suggests trauma-related grief. Consider titration of exposure and somatic grounding techniques.
Functional Impact (Item 6)
If "Often" or "Always," prioritize behavioral activation and daily structure as immediate interventions.
Clinical Discussion Questions
"I noticed you marked 'Always' for longing. Can you describe what that feeling feels like in your body?"
"You've been avoiding reminders of the loss. What is the scariest part about encountering those memories right now?"
"Looking at your reflection answers, the mornings seem particularly heavy. What is the very first thought that hits you when you wake up?"
Anchor Point Worksheet Anchor Point Worksheet
Coping Strategies for Weathering the Storm of Loss
Client Voyager
Date of Entry
Grounding Anchors
When grief waves feel too big, grounding anchors pull us back to the present moment. List three activities that help you feel "held" or stable (e.g., heavy blankets, walking barefoot, holding a warm mug, deep breathing).
Safe Harbors
These are the people, places, or even digital spaces where you can be your authentic, grieving self without judgment. Who or where are your safe harbors?
People
Spaces
The Emergency Storm Shelter
When an intense "grief burst" happens in public or at work, what is your 10-minute escape plan?
Step 1: The Exit (Where do I go?)
Step 2: The Soothe (What do I do?)
Step 3: The Return (How do I transition back?)
"Smooth seas do not make skillful sailors." — African Proverb
How are you feeling about your capacity to navigate this week?
Memory Lantern Activity Memory Lantern
Holding onto the light of who we love.
Artist Name
Hi there!
Grief can feel like being in a dark room sometimes. But even in the dark, we can build a lantern filled with happy memories. In each pane of the lantern below, draw or write something special about the person you miss.
The Laughter
What was something funny they always said or did?
The Lesson
What is something they taught you how to do?
The Place
Where was a place you loved to go together?
The Love
What did they do to show you they cared?
My Light Still Shines
Keep this lantern where you can see it whenever you feel the dark coming back.
Grief Trail Guide Worksheet Trail Guide
The Landmark Journey
Mapping your path through the Landscape of Loss.
Region: Middle School Transition
Explorer Name
Current Date
Instructions for the Trail
Grief isn't a straight line. It's more like a hiking trail through a giant mountain range. Some days you're in a dark forest, and some days you're at a high lookout point. Check the "Landmarks" below that you've visited lately, and write a quick note about what that landmark looks like for you.
The Fog of Shock
LANDMARK 01
Feeling numb, like things aren't real, or just feeling "blank."
What does your "fog" feel like?
Thunder Ridge (Anger)
LANDMARK 02
Feeling mad at the world, at the person who left, or even at yourself.
What makes you feel the most "stormy" right now?
The Deep Valley (Sadness)
LANDMARK 03
The heavy, quiet, tired feeling when you really miss them.
When do you feel most like you're in the valley?
The "What-If" Loop
LANDMARK 04
Thinking "What if I did this?" or "Maybe if I do that, things will change."
What is a "What-If" thought you've had lately?
The Sunlit Clearing
LANDMARK 05
Accepting that they're gone, but knowing you're okay and moving forward.
What is one thing that makes you feel hopeful?
You Are Here
There is no "wrong" place to be on this map. You might even be at two landmarks at the same time. If you had to mark your spot on the trail today, where would it be?
Grief Trail Slides The Landmark Journey
Mapping your path through the Landscape of Loss.
Explorer's Guide
The Trail Metaphor
Grief isn't a straight line. It's more like a hiking trail through a giant mountain range.
Some days are steep and hard.
Some days have beautiful views.
Everyone's trail is different.
"There is no wrong way to hike your grief."
LANDMARK 01
The Fog of Shock
Everything feels blurry. You might feel numb, like things aren't real, or just totally "blank."
Think about it:
Does your world ever feel like it's covered in a heavy fog? What does that feel like for you?
LANDMARK 02
Thunder Ridge
This is the Anger landmark. Feeling mad at the world, at the person who left, or even at yourself.
What makes you feel the most "stormy" or frustrated right now?
LANDMARK 03
The Deep Valley
The heavy, quiet, tired feeling of Sadness. It's when the "missing them" feels really deep.
When is the time of day you feel most like you're in the valley?
LANDMARK 04
The "What-If" Loop
Thinking "What if I did this?" or "Maybe if I do that, things will change." Your brain trying to find an exit.
Is there a "What-If" thought that keeps looping in your mind?
LANDMARK 05
Sunlit Clearing
Accepting that they're gone, but knowing you're okay. It's about finding hope and moving forward.
What is one thing—even a small thing—that makes you feel hopeful?
You Are Here
There is no "wrong" place to be on this trail. You might even be at two landmarks at the same time.
Where would you mark your spot on the trail today?
