Free Essay About Counseling Script
Linda Xiang was referred to a counselor by her concerned husband. The Xiang's teenage son committed suicide five weeks ago and Linda has had extreme difficulty functioning since his death; she rarely leaves bed or talks to concerned family members, has not returned to work, and is barely eating.
Counselor: How are you today, Linda?
Linda: How do you think I am? I just can't I still can't believe he's gone. He's gone. My baby is gone.
Counselor: I am so sorry, Linda. I can't imagine how hurt you are feeling right now.
Linda: Oh God. The grief is enough, the guilt I just can't stop thinking that if I, if we, had just known, it could have been different. This didn't need to happen. I failed him.
Counselor: It sounds like one of your reactions to this tragedy is to blame yourself for your son's death. That't a very common reaction to such a terrible loss.. How are you coping with those feelings?
Linda: Coping? I'm not coping. I'm just barely making it through the days. I can't get out of bed. I can't eat. I can't talk to or face anyone. I'm falling apart. I have no idea how I'm supposed to move forward.
Counselor: You may not feel like you're coping, but- you're still here. You're surviving your pain, one day at a time. Has anything or anyone been helping you to do that?
Linda: I guess. My husband has been a lot of help, even though he's hurting too. He makes sure I eat sometimes. And I keep trying to remind myself that my daughter is still here and she still needs me.
Counselor: It's amazing how hard you're all working to support each other, even though you're each feeling your own pain.
Linda: I guess. We're family. That's what you do.
Counselor: Is there anyone outside of your husband and daughter that you feel comfortable talking to when you're feeling your worst?
Linda: I don't know. Everyone says they want to be there for me and listen, but I just feel like no one can possibly understand how much this hurts. I just want the pain to stop. I can't take it anymore.
Counselor: Have you had thoughts about harming yourself?
Linda: I have. I think about it everyday. I just can't imagine ever feeling okay again.
Counselor: I'm so sorry to hear that, although it is a very understandable fear to have so early in your grieving. Have you made any plans to harm yourself?
Linda: To kill myself? No. I feel like I'm dying of grief, but I wouldn't ever do that to my husband and daughter. I couldn't leave them feeling like I do now about him. I can't do this to them again.
Counselor: When you're having those thoughts, is there anything that helps to ease your distress?
Linda: Those are the times I talk to my husband. At least I know he understands.
Counselor: I'm impressed that you're able to reach out in those moments. A lot of people can't do that. How does your husband handle it when you express those thoughts?
Linda: He handles it well. Like I said, he understands.
In this exchange, I employed validation, listening, and empowering interventions, which includes encouraging family and friends to seek and provide support to each other, as well as demystifying the complex emotions surrounding suicide and assuring survivors that their reactions are understandable and normal given the traumatic nature of their loss (Dass-Brailsford, 2007, pp. 109-110). Lastly, when the client expressed a lack of desire to continue living, I employed probing questions from common suicide management techniques to assess the client's own suicide risk and safety secondary to her grief, according to suicide prevention recommendations outlined by the World Health Organization (2006, p. 14).
I selected these approaches based on the client's demonstrated difficulty processing the traumatic loss of her son, her apparent difficulty adapting and employing positive coping strategies in the face of her grief, and her difficulty reaching out to loved ones when not actively experiencing suicidal ideations. As a mother, the client may not be accustomed to reaching out to others for help, as she may be used to assuming a great deal of emotional responsibility for her husband and children, and may not readily employ this as a coping skill. The loss of a family member to suicide is also associated with prolonged grief and warrants a warm, accepting, empathetic approach that validates the client's emotional response to the event.
Jordan and McIntosh (2011) reviewed several studies that interviewed parental survivors of child suicide and found that on average, over 50% of parents expressed dealing with prolonged grief, depression and suicidal ideations, a severe and prolonged disruption in normal family routines, and considered themselves “deeply traumatized and immobilized” after the loss of their child (pp. 116-117). Given how recent her loss was, coupled with her lingering shock over finding out about her son's depression in such a tragic way, her difficulty resuming daily routines is understandable, especially in light of the above research, that indicates the client's response is not uncommon among fellow parent survivors of suicide.
In subsequent exchanges with the client, I would focus on encouraging her to develop coping skills that decrease her feelings of isolation by connecting her with others who understand the unique traumatic grief that she is struggling with. This could be accomplished by encouraging her to seek support from those within her family and friends who are also grieving their loss, or by referring her to an online support group for survivors of suicide that she can access from within her home, without requiring her to talk on the phone or face-to-face. I would work with the client to set realistic objectives centered on employing positive coping skills, increasing her support system, and beginning to resume daily routines in manageable, small increments- for example, getting out of bed for one hour each day to talk with her daughter after school, or making a cup of tea for herself in the evening. I would also work with her to create a plan for how to respond to suicidal ideations in the future should she begin to feel unsafe.
Dass-Brailsford, P. (2007). A Practical Approach to Trauma: Empowering Interventions
(93-114). Thousand Oaks, CA: SAGE Publications.
Jordan, J.R., McIntosh, J.L. (Eds). (2011) Grief After Suicide: Understanding the Consequences
and Caring for the Survivors. New York, NY: Routledge.
World Health Organization. (2006). Preventing suicide: a resource for counsellors. Geneva,
Switzerland: Department of Mental Health and Substance Abuse, Management of Mental and Brain Disorders.