Counselors Share What It's Like to Lose a Client to Suicide

Alexandria, Va. (September 12, 2023) — Mental health and school counselors need far more support than they typically receive for one of the field’s most traumatic occupational hazards: a client’s suicide, according to reports in the Journal of Counseling and Development, a journal of the American Counseling Association.

As the U.S. marks National Suicide Prevention Month, counseling researchers are calling on schools and local agencies to recognize and address the emotional and professional toll that mental health professionals suffer when they lose a client or student to suicide. In addition to personal grief, these professionals may experience self-doubt or fear the possibility of other suicides. And because of confidentiality concerns, they can’t widely acknowledge their relationship with the deceased. But counselors affected by suicide say their employers and colleagues provide lax support or interventions to help them cope with their emotions, researchers report. 

“Evidence shows that counselors receive little empathy from their agencies, which expect them to return to work without proper intervention or aid,” said Lena Salpietro, PhD, of the University of North Florida and her colleagues.

The impact of suicide is especially noteworthy in school settings. Nearly 80% of school counselors surveyed have worked with a student who attempted suicide, and over a third report having experienced a student death by suicide, according to a separate article in the journal written by counseling educator Jaimie Stickl Haugen, PhD, of William & Mary School of Education, and her colleagues.

“Understanding the ways a student suicide may uniquely impact school counselors can support training, policy reform and advocacy efforts to bolster supports for counselors following a student’s death,” Stickl Haugen and colleagues wrote.

Grief, Shock and Self-Blame

Salpietro’s team recruited a small sample of licensed counselors, mainly from a Facebook group for mental health professionals who have experienced a client death. The participants worked in a variety of settings, including private practices, community agencies, hospitals and prisons. All had experienced a client suicide within the previous five years.

Participants reported a range of emotions about a client’s death, including grief, shock, self-blame and even anger at the client. Most sought therapy or engaged in other forms of self-care. (They also described participating in the study itself as therapeutic.)

Most participants said they had supportive co-workers, family members and friends after losing a client to suicide, but they also cited a lack of empathy from their supervisors and other therapists. Others said they were offered no debriefings or support services. And many said they wished they’d had more discussion about client suicide in their training and profession.

“You’re going to be destroyed by it,” one participant said, “and no one has prepared us for that. I wish there were information on supporting people going through it.”

In the second study, Stickl Haugen and colleagues interviewed school counselors who had experienced at least one student suicide during their careers. The counselors worked at public elementary, middle and high schools. Some respondents reported feelings of guilt and failure, questioning what signs about the students’ mental health they may have missed. The counselors reported becoming more vigilant about suicide risk.

Trauma that Deserves Validation

Authors in the two studies called on school districts, counselor training programs and professional organizations to foster more conversation and education around the effects of client or student suicide. They say, for example, that supervisors should provide workload reduction or time off to struggling therapists and provide more information about self-care in the wake of a client’s death.

“We also need to shift how we view client suicide,” Salpietro and colleagues wrote. “While suicide may be ‘part of the job,’ reducing the dominant narrative and response to client suicide to this platitude is enormously damaging. Suicide generates trauma that deserves validation.”

The articles are free to read at “Confidential grief: How counselors cope with client suicide,” and “‘It’s like losing a family member’: School counselors’ experience with student suicide.”

NOTE TO JOURNALISTS: To get copies of the full journal articles or schedule interviews with the authors, please contact ACA at news@counseling.org.

Founded in 1952, the American Counseling Association (ACA) is a not-for-profit, professional and educational organization that is dedicated to the growth and enhancement of the counseling profession. ACA represents nearly 60,000 members and is the world’s largest association exclusively representing professional counselors in various practice settings. Driven by the belief that all people can benefit from the power of counseling, ACA’s mission is to promote the professional development of counselors, advocate for counselors, and ensure that ethical, culturally inclusive practices protect our members’ clients and all people who seek counseling services.