The Human in the Helper: I’ve had it happen twice

Caitlin loves her job and it shows. She works with youth involved in the juvenile justice system and has loved that system for over 15 years. It’s a career choice not many colleagues would commit to, especially when working with a population that assumes greater risks of loss, compassion fatigue, and vicarious trauma. Even though she finds her work rewarding, Caitlin has also experienced every Adverse Psychological Event (APE) known within our field, including the not often talked about ones, like client violence directed towards others. “I had two clients murder people in the community.”

Caitlin is willing to share her story to help others while also acknowledging how difficult it can be. “I had four deaths in an 18 month span,” she recalls. For her two clients who killed people, these tragedies happened after they had closed out of services. “The support I received around this happening was different because they weren’t active clients.” Caitlin reflected on how the support was minimal in supervision and consultation because of the clients not being active on her caseload. She named how it felt like leadership was relieved to not have to staff these cases, and redirected her to focus on her current caseload of at-risk kids. She heard messages like, ‘It sucks that that happened. What are you doing for your current suicidal kids?’

Although Caitlin understood the focus of leadership on current clients, this messaging didn’t help her healing process as a person. She found herself questioning if she’d done enough for her clients. If there was something she missed. And then there was the grief. “I was surprised that I felt so much grief for the kids who engaged in violence. I thought things must have been pretty bad for them to do this.” Caitlin’s compassion confused colleagues, who did not hold compassion for her former clients at all, instead labeling them murderers and engaging in black and white thinking. “They are still traumatized kids,” Caitlin named.

A trauma lens helps Caitlin remain in this work with her clients, as well as her abundant compassion for what her clients have been through.  Even so, the losses still took a toll on her. She felt acute symptoms of grief in the first month, with flare ups anytime she saw her former clients in the news for their trials or sentencing. She had recurring nightmares with her clients in them. “They were always calling out for help. Someone had to help them.” What helped Caitlin most was having one colleague who understood what she was going through, because they worked with the same population. “One time I came into her office and cried,” Caitlin shared. “My mentor said, ‘Caitlin, you are working with people through some of the darkest moments of their lives. That doesn’t always mean they come out of the darkness by following your light.’”

Caitlin reflects on the importance of having a colleague or mentor who can hold this heaviness with us. Someone who aligns with our beliefs and gives us space to heal. Someone who supports the ugly cries and the dark humor. Someone who reinforces we aren’t alone. She also encourages colleagues to do their own psychological first aid, making sure to eat, sleep, and move their bodies. “You will want to freeze. Honor all your feelings. You will experience every stage of grief.” Caitlin doesn’t have any plans to pivot from this population because she operates from a belief that what we do as mental health professionals still matters. “For every horrible thing that happens, there are 10-20 that don’t end up that way. Those horrible things are still the minority.” Caitlin’s story provides a beacon of hope in light of something that feels so heavy and so powerless. We feel honored to be able to share her messages here.

Things happen to us as humans, even as we support our clients as professional helpers. Do you have a story you want to share the mental health community? Email us at croswaitecounselingpllc@gmail.com to learn more about the Human in the Helper Series!

Breaking Free of Confidential Grief

Photo by Luke Besley on Unsplash

I first discovered the term confidential grief when researching for my latest book on helping clinicians heal from client suicide. In what felt like a sign from the universe, the September edition of the Counseling Today magazine arrived, and had an article titled Counselors Share What It’s Like to Lose a Client to Suicide. I felt compelled to reach out to Dr. Lena Salpietro, one of the quoted professionals who shared the importance of validation and empathy from mental health leadership to clinicians who’d lost a client to suicide. I couldn’t agree more with her statements and I was beyond excited that not only were people talking about the life-changing experience that is losing a client to suicide, but that there was a name for the behind-closed-doors experience of grieving a client loss.

According to the original research study published in July 2023, confidential grief describes the secrecy of our pain and grief when losing a client to suicide. Out of fear, shame, and perceived judgement from our peers, mental health professionals don’t feel safe to share that they are going through grief and loss, and thus attempt to grieve in private. It also feels confidential because client matters remain confidential, which means we can’t share our experience as openly as if it was a loss from a different part of our life. All of these things add up to an experience where clinicians are suppressing their emotions, attempting to compartmentalize their grief, and could result in them leaving the field due to the lack of support.

So here I am inviting colleagues to break free from confidential grief. How do we bring client suicide into the light? How do we prepare clinicians for this life-altering experience? For folks who’ve felt comfortable sharing with me thus far, I’ve often heard that nothing prepared them for this experience. With 1 in 4 therapists predicted to lose a client to suicide in their career, this is adding another layer of pain that could be easily addressed. How do we create safe spaces for this grief? Here are a few ideas for mental health leadership:

1. Attend to the person first, professional second.

When a client dies by suicide, the first thing we focus on as mental health leaders should be the clinician standing in front of us in shock. How do we help them navigate this event with compassion? Do they want to talk about it? Do they want to sit here and experience the flood of emotions with someone they trust? Do they need us to cancel their appointments for the day so they can go home? We can offer various things that could support them in a time where they may feel frozen in place.

2. Talk about it!

Let’s normalize that clients die by suicide. Let’s talk about it in graduate school, in community mental health, in internships, and in private practice. Let’s explore it with supervisees as a possibility so they can feel more prepared. So much more healing can be accessed if we normalize the possibility of this happening within our field.

3. Create spaces for healing

Since suicide will happen for 25% of us, how do we create spaces for healing? Is it a one-on-one conversation? A support group? A journey to self-discovery? A healing retreat? The more healing spaces we can offer, the more clinicians can move towards post-traumatic growth. What spaces do you know of? What more can be added for colleagues experiencing client loss?

There are lots more ideas in my book Moving from ALERT to Acceptance: Helping Clinicians Heal from Client Suicide. This book captures ideas for clinicians wanting to heal, as well as ideas for the mental health leaders helping them with that healing. You don’t have to do this alone. I recently shared with a colleague that I identify as a Confidential Grief Specialist to therapists amidst other roles of consultant, trainer, and course creator. For years, colleagues have been sharing with me their hardships and challenges, everything from family abuse to trauma, to substance use, to client death. It’s one of the reasons I started surveying colleagues on their career experiences with Adverse Psychological Events (APEs) as mental health professionals. Although confidential grief exists because of the loss of clients to suicide, I believe this term can be expanded to cover all sorts of career-related stressors, which create the potential for burnout within our field. Adverse Psychological Events can include client suicide, client death, client violence, subpoena, and grievance. All are disruptive and painful for clinicians, all are not spoken about freely because of fear, shame, and judgement.

Let’s break free of confidential grief together. We have a name for the experience, now we can offer something different! I know there are many of us out there wanting to create a safe, empowered container for clinician healing. Let’s share what we are doing to combat confidential grief and connect soon in our efforts to support colleague healing!