Lois Thomson-Bowersock Counseling: Grief & Loss Inventory

Lois Thomson-Bowersock, LCDC, ADC II, ICADC, CET
1733 Woodstead Court, Suite 101
The Woodlands, Texas 77380
Phone: (281) 419-5255 Fax: (281) 419-5251

Family

Grief & Loss Inventory

Source of My		__________________________________________________________________________________________________
Grief or Loss:		__________________________________________________________________________________________________

Causes	Affects My	What I Do/Did to Cause It or Make It Worse	What I Want	What I Need	Plan of Action
	Self-esteem, pride, relationships, finances, emotional security, sexual relations, ambitions, family, safety, etc.	Selfish. Dishonest, fearful, inconsiderate, manipulative, etc.	I Want	I Need	I Will