Substance-Related Bereavement Counselling 2/2: What do Clients Need?

In part one (Substance-Related Bereavement Counselling 1/2 – A Helpful Framework), I shared five, interconnected characteristics that potentially affect bereavement when the death is substance-related. Here, I will show how these characteristics can be redefined as client needs. These needs can be met through counselling and this in turn facilitates grieving.  

1 Substance use 

The need for information about the substance(s) involved and the associated behaviour, and an opportunity to make sense of what it means. 

2 Unfinished business associated with the person who died and their substance use 

The need to create a narrative of, and also work through, unfinished business and the associated emotions, such as guilt and blame. 

3 The death 

The need to make sense of, and create a narrative of, the death and subsequent events related to it such as an inquest, as well as work through any unfinished business associated with the death and its aftermath. 

4 Stigma, disenfranchised grief and lack of social support 

The need to develop ways to cope with stigma and work through any associated shame; find social-support that is not stigmatising and/or develop self-support; and find ways to remember a loved one that are not complicated by stigma. 

5 Coping with specific difficulties 

The need for specific information about and support with these difficulties, such as an autopsy, coroner’s court proceedings, media intrusion, severe grief etc. 

So, in the example used in Part 1, counselling can meet the client’s needs to understand addictive substance use and associated behaviour, work through unfinished business, make sense of the death, create an accurate and compassionate narrative of what happened, develop resilience against stigma, develop support, and cope better with a difficult bereavement. 

It takes practice to recognise a client’s needs and then consider what of those needs we can help them meet and what other needs we should refer them on to others to meet.  

Additionally, there is a diversity of these bereavements, and each bereaved person and the person they are grieving for is a unique individual. Therefore, in order to counsel a client effectively, you need to consider their unique experience of each of these characteristics, how their characteristics influence each other, and what their associated needs are. This will facilitate working through the substance-related characteristics of their bereavement. 

It can help to produce a client’s unique version of the figure in Part 1 (or a spider diagram or similar visual representation) to capture the parts of their bereavement and how they interconnect.