In 1989, I completed the research for my doctoral dissertation exploring ritual as a psycho-therapeutic strategy for maladaptive grief. Twenty years later, I am still using the principles I uncovered to assist grieving clients to develop therapeutic rituals. This article describes the elements that need to be in a ritual in order for it to be perceived as therapeutic. Other issues for the practitioner will be outlined. The article’s focus will be on using a ritual when an individual experiences their grief as “stuck” or maladaptive, usually some months or years into the process. I also use the information to assist grievers who have recently suffered loss to create more meaningful death-related rituals such as wakes, funerals, scattering of ashes, and road-side memorials.