An important note before you start looking
There is some convincing research evidence, and my own professional experience confirms it, that you can start counselling too soon after your loss.
You will already know the whirlpool of emotions you feel in the early months of your loss. At times you feel numb. At other times you want to scream with anger and despair. Your emotions are all over the place. This is a normal, natural and healthy part of grief. It is a very individual, personal process, to go through at your own pace. Counselling can upset this natural pace and rhythm. It may even make things worse for you. If you do choose to see a bereavement counsellor, a well-qualified one should explain this to you. They should reassure you and perhaps point you towards some recognised coping strategies, but they should be in no hurry to accept you as a client. Nearly half of bereaved people, given the right environment, manage grief on their own. A further third perhaps need the support of families, friends and maybe spiritual help from a church, temple, mosque or synagogue. Only 10 to 15% of bereaved people are effectively helped by counselling. The peculiar situation of Covid-19 may change those figures. Perhaps more than 15% can be helped by counselling, but as yet, nobody knows.
Choosing from a directory
The first thing is to find a reliable counselling directory. You will find many online directories. Some are connected to a professional body such as The British Association for Counselling and Psychotherapy, BACP, or the United Kingdom Council for Psychotherapy UKCP. For privately run commercial directories there may be advertisements from people not affiliated to a professional body. In the United Kingdom, anyone can set themselves up to call themselves a counsellor, or they may have done some minimal training which would not allow them to be a member of UKCP or BACP. You will find the UKCP pages at www.psychotherapy.org.uk and the BACP at www.BACP.co.uk. If you are reading this from other parts of the world, your country will have its own professional organisations and regulations. Follow the links to find a therapist near you, or if you are going to be working online, the ones who, from their profile, appear to offer what you need.
Narrow down your choice
Notice that counsellors advertise what issues they feel able to work with. You will soon notice that some advertise that they can work with just about every issue and problem, whilst others appear to have just a few specialisms. I doubt that you would choose a hospital consultant that claimed expertise in many fields of medicine and surgery. In my view, the same should apply to counselling and psychotherapy. Those with few specialisms other than bereavement and loss could be your best choice.
You will notice that some therapists are accredited. This means that their professional body has assessed the therapist’s knowledge and competence and that they make the grade. However, it’s the therapist’s humanity and the relationship she or he can form with you that really counts, so don’t make accreditation your most important criterion. Talking of she or he, most clients, given the choice, select a female counsellor, perhaps believing that women are always more caring than men. If a man has trained as a counsellor, you can trust that he is a caring human being. Don’t just decide by gender. You can also lose out if you choose a counsellor from their name. A dear friend of mine is one of the most skilled and compassionate psychotherapists I know, with 20 years of experience. She supervises trainees and newly qualified counsellors. However, she has a name which identifies her as ‘foreign’, and she sometimes finds that her newly qualified supervisees get more clients than she does.
Making your final choice
Narrow your list of bereavement counsellors down to three or four possibles, and phone each of them. If I was looking for a bereavement counsellor for one of my family, these are the questions I would ask on the phone.
How long have you worked with bereavement? What specific training have you completed? How many bereaved clients have you worked with?
If I was happy with all those answers, I would then ask what models of grief they would be likely to use. I would expect them to mention Tonkin’s Circles, the Dual Process Model, and Continuing Bonds. I would be impressed if they also mentioned meaning-making and relearning the world.
If they mentioned Elisabeth Kübler-Ross stages without mentioning any of the other models, I would cross them off my list. These stages were not originally written to describe grief and have convincingly been discredited for use in counselling. Yet they linger on in the world of counsellors who have never actually studied bereavement theory.
Meeting the counsellors still on your list
Remember that you are employing the counsellor. They are working for you and you want to get it right. I personally do not charge for the first session because I would like to see clients shopping around before they part with the fee, to end up with the right counsellor for their needs.
If you have already satisfied yourself on the phone that the counsellor has the knowledge and experience, now it’s down to the relationship. The relationship between you and the counsellor is more important that anything else. If it doesn’t feel right on first impression, this probably isn’t the counsellor for you, however skilled or knowledgeable she or he may be. Listen to your instincts. By the end of the session, which should be between 45 minutes and an hour 15 minutes, you will know how the counsellor leaves you feeling. If you have uneasy doubts, walk away. You are the employer, and you owe them nothing.
By the end of this first session, a good counsellor will have helped you to tell the story of your loss carefully and with as much detail as you feel safe to give. They are likely to have asked you questions about how you are coping day to day, and how you manage your grief. They will check on any prescribed medication and any self-medication such as alcohol use. They should also ask about your sleeping pattern and any weight changes since your loss. It’s likely that they will ask if at any time you have felt like ending your life, and what you do to keep yourself safe.
At the end of the first session, the counsellor should be able to suggest what they think would help, say if they are able to help you, and answer any questions you may have.
If this counsellor looks like a likely candidate for the job of supporting you, these are some of the questions you should ask:
What arrangements do you have for your supervision? All counsellors and psychotherapists in the UK must have regular supervision with another counsellor who usually has an extra qualification in counselling supervision. It’s at least an hour each month, often more if the counsellor has lots of clients.
What notes do you keep, and how do you store them? Most counsellors will keep notes that allow them to follow your progress. If they are paper notes you should feel reassured that they are kept safely locked up. If they are stored on a computer in the UK, the counsellor should be registered with the Information Commissioner’s Office and abide by GDPR regulations (General Data Protection Regulation). You should feel confident that you notes are secure and password protected.
Are you insured against professional liability? Whether you trip over the mat in the counselling room or suffer health consequences as a result of the counsellors actions, you should be able to make a claim and your counsellor should have adequate professional liability insurance to cover it.
What is your fee? Expect to pay from £45 up to £100 per hourly session. Because of the greater costs involved, the London area is expensive. More money does not necessarily mean better counselling. Some counsellors offer reduced fees for clients on low income.
Once you have chosen your bereavement counsellor
In the first, paid session, the counsellor should note down your contact details. They should also ask who you GP is, in case of emergencies. They will explain the contract they will agree with you, which ideally should be in writing. This will include whether or not they will charge you for any appointments you miss and how much notice you need to give of cancelled sessions.They should also discuss that what you talk about is confidential, and that they will only break this confidentiality in very extreme circumstances, such as if you are likely to harm yourself or others.
Accessing free, or cheap counselling via a charity
Much of what I have written above, still applies to bereavement help you can receive from charities, including the questions you should ask. Here are a few extra pointers.
Many charities use volunteers or counselling students on placement. For this reason, they call what they offer ‘Bereavement Support’. Most bereavement support is similar to counselling, but some is more practical, advice-giving help (such as benefits advice and access to social support) rather than emotional support.
Charities either train their own volunteers and placement students or use training from large charities like Cruse.
Some hospices have bereavement services that support people bereaved for all kinds of reasons. It is worth asking your local hospice what they can offer, although most can only help if your relative was their patient.
Some of the training that volunteers receive is of excellent quality. The best volunteers can be better that some private counsellors because of this specialist bereavement training. Any charity is only as good as the supporter you find yourself face to face with. If you are not happy, it’s worth saying so and seeing if anyone else is available.
Trainee volunteers and counselling students on volunteer placements may need to write more detailed notes on your sessions than a counsellor would. You have the right to ask questions about this. Trainees may also be expected to make digital sound recordings of your sessions. They need your agreement to do this.
There are now agreed service standards for bereavement counselling and bereavement support services which you can read here