Does Grief Counseling hurt people?

[FireStarterRN]

I've always thought that this whole grief counseling business was ridiculous. Whenever there's a tragedy, grief counselors are rushed to the scene. It just seems like even ancient people knew how to handle grief through their cultural process and then move on with life.

Here's an article that suggests that grief counselors actually impede people and make them less self-reliant. But, that's probably what the psychological industry wants, is for people to rely on them, then they have more clients.

http://findarticles.com/p/articles/mi_qn4155/is_20060319/ai_n16213185

What do you think? If this is posted in the wrong section, maybe the moderators can move it.

[Jo Dirt]

I so agree with TeleRNer. Years ago we hung a wreath on the door, stopped our clocks, covered mirrors and wore black for a solid year. There may have been something to that. Today I see people working the day their loved one died. I know, everyone grieves differently, but

our culture has changed so much that we may need the councelors.

I was looking on Vanderbilt Med Center's website where they were bragging about benefits, one being their policy on grief pay, they said they give three days pay to an employee who loses a spouse, child, parent, sibling...how caring and thoughtful ...for some reason this just turned me off.

I don't think I would want to work for Vanderbilt.

[TazziRN, RN]

I have not read the article, nor have I read the responses. This is my two cents, based on my own experiences. My brother died in 1989, and I was totally lost. I thought I was handling things well, but I had to not only work but take care of my parents, because everyone kept telling me "You have to take care of your parents, they're beside themselves with grief right now." Nobody thought about what I might be going through. After all, I couldn't possibly be grieving as bad as my parents, since he was only my brother but he was their son.

A couple of months later I got a call at home from a coworker. I found out later that she was elected to call me, since she had been my preceptor when I started as a new grad. She very gently told me about a counselor who specialized in grieving and suggested I call her. I said "I don't need counseling, I'm fine."

Answer: "No, you're not fine. You really need to talk to someone."

Thank God I listened to what she was trying to say. I contacted the person whose name she gave me, and I spent the next three months in therapy. I yelled, I cried, I hurt......and I healed.

God bless grief counselors.

[TazziRN, RN]

I was looking on Vanderbilt Med Center's website where they were bragging about benefits, one being their policy on grief pay, they said they give three days pay to an employee who loses a spouse, child, parent, sibling...how caring and thoughtful ...for some reason this just turned me off.

I don't think I would want to work for Vanderbilt.

Now I've read the responses!!!

MM, three days is standard. I've never seen a facility offer more than that. You can take more time off, but three days is all they'll pay you for. I was gone for about 2 weeks. My boss was very understanding and let me have all the time I wanted, but I had to take PTO for the rest of the time.

[gonzo1, ASN, RN]

I'm really glad the counselors are there for the people who may need them. There have been several times in my life I would like to have had someone to talk to. I wish my hospital had a debriefing team because there have been a couple of ER occurances when it would have been nice to have had someone to discuss this with. Instead you just clean up and go on to the next patient.

Additionally, it seems that our society does not allow proper grieving time anymore, we are told to get on with life and I think that is very hard on some people.

[Jo Dirt]

Now I've read the responses!!!

MM, three days is standard. I've never seen a facility offer more than that. You can take more time off, but three days is all they'll pay you for. I was gone for about 2 weeks. My boss was very understanding and let me have all the time I wanted, but I had to take PTO for the rest of the time.

Oh, ok. Well, that makes more sense. I can understand three days pay, but the way I initially read it to me it looked like they were saying you have three days to get over it and get back to work.

[elkpark]

I agree with EricEnfermero: I have been a psych CNS (psychotherapist) for a long time, and, unfortunately, there are minimally trained people out there who have figured out that there is big $$$ to be made in CISM (critical incident stress management) and "grief counseling." I'm not saying that every therapist who tries to help people through a crisis has poor motives or is a bad person, but (again, unfortunately) there are now a lot of what I can only refer to as hucksters out there in those particular areas (also, nearly anyone, regardless of her/his (lack of) credentials, can call her/himself a "therapist" as long as s/he is careful to avoid a few protected titles -- buyer beware!!). And the documentation is not just "one unpublished study," as someone else commented -- there is a growing body of evidence (and discussion within the psychotherapy community) that some of this stuff does much more harm than good.

Here is a link to another article, well worth reading if you're interested in this topic, on the new "trauma industry" that I used in the psych nursing course I taught until recently --

http://findarticles.com/p/articles/mi_m1568/is_4_37/ai_n15998616

[jjjoy, LPN]

The case of the contested argument that grief counseling is harmful and concerns over the "trauma industry" are two different things.

http://www.apa.org/releases/grief_counseling.html

[elkpark]

It was not my intention to suggest that all grief counseling, across the board, is harmful rather than beneficial, and I tried to make that clear in my post. Heck, I have done trauma and grief counseling myself in the past, and have known plenty of colleagues who are terrific at it.

However, it is also the case that there are now plenty of folks with extremely limited training and credentials out there who see this as an easy way to make money, and I assure you they are out there, basically taking advantage of people who are extremely vulnerable and not in a position to make an informed choice about seeking help (and guess what, those people and their work are not reflected in any of the legitimate research studies on the benefits of grief and/or crisis intervention, because they're not affiliated with legitimate research institutions). It was not my intention to smear the entire legitimate psychotherapy community -- I'm part of that community! It's the "shadow" "therapy" industry out there that I was expressing concern and reservations about ...

[rn/writer, RN]

My biggest concerns with current "special event" counseling are that it may be incomplete and that it has taken on a faddish popularity and may attract people who are not properly trained.

When something tragic happpens, seems like busloads of grief counselors are shipped in to help people process what took place. If the counselors are competent, this can be a good and helpful thing. If they aren't, they can be useless or worse, damaging. Those in charge need to be certain that the counselors are qualified and capable before unleashing them on the ones who need help.

Eventually, the dust settles and then what? I'd like to see follow-up at one month, three months, six months, and a year. Nothing as flashy as the initial onslaught. But give these folks a quiet opportunity, especially in schools and workplaces, to talk to someone after the fuss and publicity have died down.

Often, it takes weeks, if not months, for grief to bubble to the surface. And healing isn't linear. You can be tootling along just fine only to fall into a black hole you didn't anticipate. If this occurs months later, you're likely to have people look at you funny and say, "But that's over and done with."

Kids especially need to hear that grief is what it is. It can take all kinds of weird forms and may not look like grief at all. Instead, it can take the shape of anger or obsession or escapism of various forms. They need to be reassured that it isn't disloyal to move on with their lives, nor is it twisted to keep thinking about a lost friend even a year later.

After the initial shock wears off, depression can take time to appear and its onset can be so gradual that it isn't recognized. Another area where counselors can be of help is to educate the families and friends about things to take stock of periodically so that long-term effects can be recognized.

Many years ago, if someone died, especially a child, there was the erroneous belief that the less said about it, the better. Clothing and toys were immediately removed. Investigations were rare, and the lack of explanation and the impenetrable wall of silence left people arrested in their grief. If anyone seemed down or confused, they were told to forget their sadness and act as if all was well. Little wonder that so many folks from that era felt (and still feel) like they had huge holes in their spirits.

Have we come too far in the opposite direction where grief seems to be a command performance? I don't know. I do know that I tire of hearing reporters telling loved ones how they must be feeling. The purple prose that fills written news accounts is nothing but lousy journalism. As a nation, we seem to share a form of voyeurism that, upon examination, includes as much relief that we are not among the stricken as it does sympathy for those who are. We lose some dignity (and take it from the mourners) when we root around for vicarious feeeelings like pigs after truffles.

A good balance seems to be a healthy recognition of the loss, remembrance of the missing, explanations where necessary, and permission to move on when ready. This should also include permission to not be shattered if such is not the case.

[danissa, LPN, LVN]

My biggest concerns with current "special event" counseling are that it may be incomplete and that it has taken on a faddish popularity and may attract people who are not properly trained.

Eventually, the dust settles and then what? I'd like to see follow-up at one month, three months, six months, and a year. Nothing as flashy as the initial onslaught. But give these folks a quiet opportunity, especially in schools and workplaces, to talk to someone after the fuss and publicity have died down.

Often, it takes weeks, if not months, for grief to bubble to the surface. And healing isn't linear. You can be tootling along just fine only to fall into a black hole you didn't anticipate. If this occurs months later, you're likely to have people look at you funny and say, "But that's over and done with.":yeahthat:

[jjjoy, LPN]

That original article "Therapy culture can hurt more than it helps" goes a long from it's initial reporting of a study that showed that 46% of widows/widowers over the age of 65 "were able to cope with the loss of a spouse without much grieving" to criticizing "our culture's practice of almost literally imposing it [grief counseling] on those going through any kind of difficulty."

So the study reports that almost 50% of elderly widows and widowers in one study felt that they were able to cope well with the loss of their spouse... then the author diverges to an unsubstantiated opinion piece criticizing the "therapy industry."

I agree that we needn't always coddle everyone after the slightest set-back. I just don't see how the first study quoted has much to do with the author's next assertion that the "therapy culture" may in fact be hurting us. The sociologist and psychiatrist quoted in the article clearly disapprove of "'grief counselors' rushing into schools under every provocation, both major and minor, and helping children 'cope'", but I see no assertion on the part of the author that grief counseling in general is a harmful. Meanwhile, the author gives no examples of the therapy culture in action. If a grief counseling team was issued to help a kindergarten class deal with the death of the class hamster, I would agree that that's overkill.

[Multicollinearity, BSN, RN]

Elkpark, thank you for posting that article. I read all nine pages, and it was very, very interesting. I had no idea about this industry.