A Counselling Case Study Exploring Loss
Sue and Tom lost their child Jill to leukaemia approximately one year ago. Tom suggested that Sue attend Professional Counselling because she still doesn’t seem to be able to cope with everyday living. For ease of writing the Professional Counsellor is abbreviated to C.
A précis of the session is as follows
In the first session C concentrated on building rapport with Sue and listening to her story. Sue felt that it was the first time that anybody had really listened. She felt that her friends and family didn’t want to even mention her daughter as they didn’t want to upset her. A lot of useful information was gathered throughout this session which is summarised below.
Essential Case Information
Her husband Tom feels that she should be more advanced in her recovery because he himself is coping much better and ‘getting on with life’. Sue is dwelling on guilt prone thoughts such as “Why her, she was so young, I’m still alive”, “I didn’t tell her I loved her before she died” and “What did I do wrong”.
Sue and Tom have a son David who is 12 and are currently divided on parenting styles, whereas before the death they were fairly similar in their approach. Tom feels that David should be able to do what he wants. He feels that life can be short and therefore doesn’t want to be restrictive. Tom feels that Sue is being over protective whereas Sue feels that she has already lost one child and doesn’t want to lose another. She feels that she couldn’t protect Jill and is now doing everything she can to protect David.
Jill was diagnosed with leukaemia only six months before she passed away. Sue was working part-time before Jill was diagnosed but gave up work to be with Jill during treatment. Sue has not returned to work. Before, when Sue was working part-time she was also doing all the housework, now Sue can’t “even” (her words) get the housework done.
As Sue was very talkative and needed to get a lot of things off her chest in the first session C just focused upon building rapport and trust by fully attending to what was said. Therefore at the beginning of the second session C started the process of establishing goals by asking the client what she wanted to achieve out of counselling. It was also determined when and how Sue would know that counselling was no longer required.
C then wanted to normalise some of Sue’s responses by providing her with some information about the stages of Grief and Loss. C was careful to highlight that each individual moves through and expresses the stages differently.
C then asked Sue if she could identify with any of the stages and what stage she felt she was currently in. Sue felt she could relate to the first four stages and that currently she was in the Guilt stage. C then asked Sue what stage she felt Tom was in. Sue felt that Tom was in the Acceptance Stage or may have moved on to complete recovery.
Again C highlighted to Sue that it is normal for people to move through the stages of grief and loss at different rates. C then spent some time examining how Sue felt about being in a different stage to Tom.
C also discussed the length of time (6 months) that Sue had to come to terms with her impending loss before the loss actually occurred. Sue felt more relieved by discovering that it can be normal for someone to become stuck in a stage when they have little time to come to terms with a death before hand.
At the end of the session Sue left with an affirmation that she had constructed with the assistance of C to affirm the normality of her current Grief and Loss behaviour. The affirmation Sue constructed was “The feelings I am experiencing are normal for the stage I am in. I will progress to the next stage when I am ready”. As Sue and Tom’s communication skills are quite good Sue is also going to discuss the stages of grief with Tom and highlight to him that people progress through the stages at different rates, in order to ease Tom’s concerns about Sue’s progress.
In the following sessions it was apparent that Sue was feeling more comfortable with the stage she was at and was now accepting her feelings. Consequently, other issues could now be worked upon to assist her to progress smoothly through the remaining stages of the grief process.
The first thing C wanted to know before further progress could be made, was Sue’s Personality Need Type. The administration of the profile indicated that Sue was a Personality Type A with a score of 9,9. Sue was amazed at the accuracy of the profile, although she felt that a lot of these behaviours had not been displayed for a long time. This lead to a discussion about the effects of not meeting needs and how it might contribute to her uncomfortable feelings at the moment. Issues that were discussed in detail included the fact that she used to gain recognition within her work environment and from home entertaining as well as by the praises she used to receive about being able to juggle raising a family, the housework etc.
The discussion then moved to ways that Sue could actually gain some need gratification now whilst she is still grieving. C made a point of acknowledging that Sue is not going to be able to do all the things she used to as of yet. This lead quite nicely into an awareness of the need for time management training. C highlighted how a loss can upset routines and the loss of a routine can be a loss in itself. It was explained that time management training may assist Sue in regaining a routine as people often need to relearn skills they had previously in order to help them get back on track.
This left future sessions to explore the new parenting issues which the loss has created. Sue agreed for Tom to join the counselling process at this stage to explore the differences. Once Tom and Sue acknowledge each others thoughts and feeling about the loss of Jill and how this impacted on their thoughts and fears regarding David they were in a better position to co-develop a suitable solution.
Once this issue was resolved there was no further need for counselling. It is important to note that Sue has not finished the grieving process but now has more skills and resources to deal with the final stages without continued counselling support.