The first year has a shape. There is the blur of the first weeks, when there are things to arrange and people in the house. Then the house empties and the calendar starts: the first birthday without them, the first holiday, the anniversary of the diagnosis, the anniversary of the day. And underneath all of it, the nights — the side of the bed that stays cold, the waking at the hour it happened, the two o'clock replay of what you said and did not say. Grief and sleeplessness arrive together so reliably that we treat them together.
Book An AppointmentMost grief does not need a counselor. It needs time, company and permission, and it gets through on those. What we look for is not how much someone is hurting but whether the hurt is still changing.
The second column, when it has lasted a year or more and is running your life, is what the current diagnostic manual calls prolonged grief disorder. It is uncommon, it is not a character flaw, and it is one of the clearer cases where counseling changes the course of things.
It does not try to get you over it. Nobody here believes in five stages that you pass through in order, and nobody will tell you where you ought to be by now. What grief counseling does is give the loss a place that is not your bedroom ceiling: an hour a week where the whole of it can be said, including the parts — relief, anger, guilt, the things left unfinished — that do not get said to family.
Beyond that, the work is practical and cognitive. Grief carries thoughts that can be gently examined: that you should have seen it coming, that moving forward is a betrayal, that you cannot manage the parts of life they used to handle. Our counselor works from cognitive behavioral therapy, with mindfulness and solution-focused approaches alongside it, which in plain terms means the sessions have a direction — toward being able to hold the memory and still live — rather than circling.
We see most patients via telehealth with North Carolina-licensed clinicians, and a limited number of clinicians also see patients in person. Many people grieving find video easier than they expected: no waiting room, no drive home afterwards with wet eyes, and the session happens in the house where the absence is.
Broken sleep after a death is close to universal, and for the first month or so it is simply part of the shock. The trouble is what happens after that. Lying awake becomes the one time of day nothing distracts you, so the bed turns into the place where the grief waits. Some people start staying up to avoid it; some wake at the same hour every night; some sleep in a chair because the bed itself is the reminder. Within a few months the sleeplessness has its own momentum and no longer rises and falls with the grief.
That is why this counseling happens at a sleep clinic. When the nights have taken on a life of their own we treat them directly with Cognitive Behavioral Therapy for Insomnia inside the same course of care — the sleep gets steadier, and the grief work gets a rested person to do it. It is not a detour from the counseling; for most people it is what makes the counseling possible.
Loss is one of the things we work with alongside sleep. Our therapy and counseling page shows how the pieces fit together.
Grief counseling here is one person's work, and we would rather introduce her than describe a service. MaryBeth is a licensed clinical mental health counselor based in Greensboro who lists grief among the things she works with, and who is also trained in CBT-I — which is what lets the nights be treated in the same sessions.
MaryBeth Borreca is a Licensed Mental Health Counselor (LMHC) in Florida with more than five years of counseling experience and a Master of Science in Clinical Mental Health Counseling from the University of North Florida. She has completed specialized training in Cognitive Behavioral Therapy for Insomnia (CBT-I). MaryBeth is known for remaining fully present with each client, forming a unique therapeutic relationship and creating a space that feels both comfortable and appropriately challenging. She tailors sessions to individual needs while drawing on evidence-based treatment approaches. New clients can expect their first session to focus on getting acquainted, collaboratively setting treatment goals, and determining together whether the therapeutic fit feels right.
If the sleep is what you need help with first, every one of the 5North Carolina clinicians currently taking new patients treats insomnia; thefull roster is here.
The North Carolina plans we are currently in network with are Aetna, Blue Cross Blue Shield, Cigna / Evernorth, Medicare, UnitedHealthcare / Optum, UnitedHealthcare Medicare Advantage and Veterans Affairs Community Care Network. Grief counseling is billed like any outpatient therapy, and Medicare covers it. If you are not sure what your plan does, let us check before the first appointment.
There is no waiting period. Early grief is not an illness and counseling in the first months is not about fixing it; it is about having somewhere to put it that is not your sleep, your work or the people who are grieving alongside you. If what you mostly need is a place to say the unsayable once a week while the rest of your life carries on, that is a perfectly good reason to book.
The honest marker is movement. Grief that is doing its work changes shape over a year — the waves get further apart even if they do not get smaller. Grief that has stalled looks the same at month fourteen as it did at month two: the longing is constant, life feels meaningless, you cannot believe it happened, and you have organized your days around not feeling it. When that persists a year or more after the loss, clinicians call it prolonged grief, and it responds to structured therapy in a way that time alone has not.
Usually it starts as grief and becomes insomnia. The first weeks of broken sleep are the body doing what bodies do after a shock. But if you are still lying awake three months on, the sleep problem has typically learned to run on its own — the bed has become the place where the thoughts arrive — and it will not necessarily leave when the grief eases. That is the point at which we treat the sleep directly, with CBT-I, in the same course of counseling.
Yes. Counseling is billed as an outpatient behavioral health visit, and the North Carolina plans we work with cover it the way they cover any therapy. Coverage is tied to a clinical diagnosis rather than to the word grief itself; your counselor will talk you through what that means for your plan before anything is billed.