by Sharon Martin, LCSW
Coping with death is challenging no matter the circumstance. The death of a client presents unique challenges for social workers and other helping professionals.
You may find yourself asking: How do I grieve this loss? How do I honor this client’s memory? Where do I turn for support? Are my feelings normal? How am I supposed to behave? When I had a client die, I didn’t have any frame of reference or experience to draw on. I’d grieved the loss of several family members, but this was different. No one had prepared me for the death of a client.
The death of a client is unavoidable in your career as a social worker. Last week, I was meeting with a new supervisee who had just had his first experience with the death of a client. Then today, I was informed that one of my former clients had recently died. A couple of weeks before this, another supervisee had a client die. I have personally experienced several client deaths over the years (by suicide, car accident, shooting). It’s not uncommon, especially if you work with vulnerable populations. So, there is a high likelihood you will encounter a client’s death at some point in your career.
Factors Affecting Your Coping
Your personality, personal history, culture, and other experiences will all influence how you perceive and react to the loss of your client. The details of the relationship and circumstances surrounding your client’s death also play a big part in how it affects you. For example, the experience of the death of an older client in a hospice program will be very different from the experience of the death of a teenage client by suicide.
Another stressor may be that you are simultaneously grieving yourself and responsible for providing grief counseling to other clients. If you work in a residential setting or school, your other clients may have known your deceased client and need help to cope, as well.
Emotional support is important to healthy coping with any upsetting or traumatic experience. We usually turn to our friends and family for support. However, your friends and family may be limited in their ability to understand the complexity of your feelings about the death of your client. Seek support from those who understand. This may include your supervisor, co-workers, field instructor, or social work professors. Effective and supportive supervision is essential. Your own personal psychotherapy can be helpful, especially if this is your first experience with a client’s death, if it is reminding you of previous losses, or it is negatively affecting your daily activities.
The client-social worker relationship is different from any other personal or professional relationship. It’s important to fully accept that you have feelings—sometimes strong feelings—for your clients. As a social work supervisor, I try to normalize countertransference. But I also know from experience that it can still be hard to acknowledge your feelings about clients, especially any that we think are inappropriate or unacceptable. It is completely normal to have positive and negative feelings about clients.
Take some time to explore your feelings about your deceased clients. Your feelings often turn out to be more complicated than simply positive or negative. You may feel sad, angry, guilty, confused, ashamed, shocked, relieved—maybe even all in the same day. If we are honest with ourselves, we all have clients who frustrate or offend us. Our thoughts have not always been strengths-based. You may feel guilty about having negative feelings about your deceased client. But believe me, you are not the only social worker who has felt relieved when a client died. All of these feelings are valid. You need to recognize them, process them, and release them.
I also want to reassure you that having a client die doesn’t mean you aren’t cut out for this field. It is a huge reminder that you are human with real feelings, and that you don’t control your client’s actions. As social workers, we do our best to help, but so many things are out of our control. The death of a client can be an opportunity to evaluate your clinical skills and seek additional training or supervision, not because you aren’t a qualified social worker, but because we are all learning and growing.
The circumstances of your client’s death add another dimension to your feelings and ability to cope. If your client died by suicide, violence, or other tragedy, this will complicate your feelings. It is normal to feel disillusioned about your work and the world at large after a tragedy. You may question your effectiveness as a social worker. You may feel confused or let down by yourself, your employer, or your community.
Coping with a client’s death can also be difficult because confidentiality and professional boundaries can get in the way of the grieving rituals that we use in personal relationships. You may not be able to attend the funeral or memorial service, send flowers, or take food to the family. However, you may creatively find new ways to grieve and remember. If you are part of a team, you may be able to have your own private memorial with your co-workers, which maintains confidentiality. It is important to consult your supervisor or agency director, as the ethical and legal issues of a client’s death are largely beyond the scope of this article.
There is never a right or wrong way to grieve. However, you need to remember that you have a professional relationship with your client and need to respect client privacy, even after death. This can put you in awkward situations if the family calls and wants information or counseling. Social workers are used to helping, and it can be hard to say “no” and not give the family the answers they are looking for. In contrast, I’ve worked with the homeless population for many years, and it is disheartening when the client’s death reflects how alone he or she was. Sometimes, there is no grieving family to collect the client’s belongings or plan a memorial service.
Self-Care and Self-Compassion
Good self-care is also essential. Many social workers struggle with self-care in general. As a group, we tend to be caretakers and work in high stress environments. When coping with a client’s death, self-care is more important than ever. Be sure to get enough sleep, exercise, and eat well. Taking a few days off may be helpful, too.
Several years later, I still feel a profound sadness about the suicide of my former client. I so wish that he had reached out for help. I have been able to think about my work with this young man, and I take comfort in knowing that I provided him with much needed understanding and acceptance. I feel peaceful knowing I treated him the best that I could. I practice self-compassion by talking to myself in this way.
Some other things that helped me cope are:
• consulting with colleagues who’ve also experienced a client’s death
• quiet reflection
• reading the obituary and news articles about the death
• thinking about my client’s strengths and what I learned from him
• making a charitable donation
DeAngelis, T. (2008). Coping with a client’s suicide. GradPSYCH Magazine, 18. Retrieved from http://www.apa.org/gradpsych/2008/11/suicide.aspx
Halgin, R. P. (2008). When a patient dies…Should the therapist attend the funeral? Retrieved from http://www.psychotherapy.net/article/when-patient-dies
Veilleux, J. C. (2011). Coping with client death: Using a case study to discuss the effects of accidental, undetermined, and suicidal deaths on therapists. Professional Psychology: Research and Practice, 42 (3), 222-228. Retrieved from http://www.academia.edu/3768478/Coping_With_Client_Death_Using_a_Case_Study_To_Discuss_the_Effects_of_Accidental_Undetermined_and_Suicidal_Deaths_on_Therapists
Sharon Martin, LCSW, has worked extensively in community mental health providing psychotherapy and clinical supervision. She has a passion for training, supervising, and coaching new social workers. Sharon currently has a private practice in San Jose, CA, specializing in treating stress and anxiety, perfectionism, and co-dependency in adolescents and adults. She can be reached at http://www.SharonMartinCounseling.com or http://www.SocialWorkCoaching.com.