Have you experienced grief for a client?
One of the many challenges we face, in our careers as psychologists, is what do we do when one of our clients die?
It can bring up many aspects for us to process and perhaps a disenfranchised grief.
The topic of client death doesn’t come up too much in our training. As therapists, there is a high level of private intimacy that can arise in our relationships with clients. And this has nowhere to go for therapists, when the client passes away. Even with appropriate boundaries, we’re human and we would be rather soulless, if we felt nothing for our clients. We feel their highs and lows in therapy (with boundaries of course), so wouldn't we feel their loss?
I received news that a client I was to see this week, died suddenly on the weekend. I was surprised by the level of immediate emotion I displayed (but that’s what emotions are like right?!). Possibly, as the client had made some wonderful changes and had started the year well and has left behind children and partner and a range of familial issues due to COVID19.
Often times, our work is heavy (and we can dismiss this, as therapists, as we become so accustomed to it) and we need to give ourselves permission to experience whatever we feel.
I gave myself some time to cry and offer self compassion to myself. And some inner negative self talk popped up of course, that I have no right to these feelings and I should be more boundaried than that (yep super helpful). I bought myself a my favourite hot chocolate and pondered what might be an appropriate an ethical condolence to send. I decided to be human and treat this as providing a condolence that I would for anyone, whom I had a level of involvement with.
Your experiences may differ according to the length of time you have seen your client, the way they passed, their age, the kind of therapeutic relationship you had with them and the overall life they led.
My suggestions to deal with client grief:
Give yourself a time out and permission to pause and take stock
Validate your feelings
If necessary/possible, cancel some of your sessions if you need to
Go for a walk/get moving
Call/text a psychology peer
Seek supervision
Send a card - if you know it is clear that the family were aware that the client saw a psychologist (my client and other family members attended the practice and the partner contacted us to let us know) and depending on your relationship with client. In this circumstance, we may send a meal voucher, from the practice. The client was a long termish client and had made some important gains in during therapy. Seek supervision on this if you need to
Treat yourself kindly - channel your self compassion
These are fluid of course and not an exclusive list, as there is no rule book
Type of death e.g suicide is probably another topic for conversation, as therapist guilt can arise here (but do remember that your influence only goes as far as the 50 minutes we offer each session - there are so many other extraneous variables that occur that influence our clients). We do effective risk management, but there is only so much risk we can ameliorate.
If you have faced the loss of your clients, what came up for you? And if you haven't faced a loss, it will inevitably happen. Treat yourself kindly, take time to reflect and remember you're a human first and a mental health professional, second.
Sarah Purvey is a clinical psychologist, supervisor, clinical lecturer and clinic director of Eastern Shore Psychology in Hobart, Tasmania. Sarah sees adults and predominantly works with clients healing from trauma and parents. Sarah regularly supervises psychologists and also runs online workshops for mental health professionals, considering transitions into rewarding private practice careers.
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