THE
BEREAVED
THROUGH SUBSTANCE
USE GUIDELINES
were
launched in June 2015
and represented the
culmination of joint
research between the
Universities of Bath and
Stirling on the
experiences of families
bereaved through
substance use.
In the introduction, the guidelines invite
practitioners to seek effective clinical supervision
while working with family members following
bereavement.
Although the focus is on practitioners who
come into contact with substance-related deaths,
the research could be equally valid for family
support practitioners – particularly if they are
working with the family and the client in
treatment, where family meetings are integrated
into the care plan.
McAuley & Forsyth (2011) conclude that ‘when
someone dies of a DRD it is not only the needs of
friends, family, or witnesses that need to be taken
into account. The presence of grief-related reactions
in almost 90 per cent of this sample suggests that
staff who were involved in the care and treatment
of the deceased also need to be considered when
dealing in the aftermath of the event.’
Their study of the impact of a drug-related death
on those who have experienced it as part of their
caseload found that 65 participants were identified
as having experienced at least one drug-related
death on their caseload and 88 per cent identified at
least one reaction: ‘The most common feelings
identified were sadness (83 per cent); guilt (40 per
cent) and anger (37 per cent): 26 per cent reported
feeling helpless; 21.5 per cent had cried and 18.5 per
cent had difficulty in concentrating.’
As a counsellor and clinical supervisor, I have
witnessed the following thoughts and feelings
from both family members and practitioners:
Guilt – ’I should have...’
Grief
Disbelief: ’They were doing so well...’
Anger – Perhaps directed towards the treatment
system for its perceived failures.
Sad reflection: ‘What if..?’
Practitioners can also be supporting families with
a loved one’s addiction as they experience a series
of losses, ‘a living bereavement’, that includes the
fear that their loved one may die. The intensity of
this work can, without proper support, have
considerable impact on the psychological well-
being of the practitioner, particularly if they are
involved in a serious case review and/or an
appearance at the coroner’s court.
The trauma therapist Michael Gavin
) acknowledged in
2015 how challenging working with trauma can
be: ‘People tell you stories of unbearable
experience, and you have to listen’.
He states that the aim of supervision is to make
therapy as safe and effective as it can be for both
practitioner and clients or patients. For example,
practitioners might be helped to improve their skills
in specific ways (see box).
McAuley and Forsyth (
Journal of Substance Use
,
February 2011) add that ‘providing a debriefing
session and one-to-one support, like that
proposed by Redinbaugh et al (2003), on both the
events leading up to death, and staff feelings and
emotions in its aftermath, should be available to
those who need it and, therefore, should be
considered for future policy and practice. It can
also deter any notion of a ‘blame culture’ being
developed and promote a working environment
where each death can be used as an opportunity
to reflect and learn lessons for the benefit of
future practice’.
Esther Harris is an independent practitioner in
counselling and clinical supervision
Helping families through the guilt and anger of losing a loved one can be
gruelling for practitioners.
Esther Harries
looks at how to be prepared
Burden of grief
February 2016 |
drinkanddrugsnews
| 11
bereavement
Although the focus is on
practitioners who come
into contact with
substance-related deaths,
the research could be
equally valid for family
support practitioners...
To find out more go to:
PRACTITIONERS MIGHT BE HELPED TO
:
Master the skills of self-awareness,
mindfulness, and of managing both
their own arousal, and that of clients.
Find and cultivate their own reliable
sources of safety and resilience, both
internal and external.
Build a capacity for a calm yet assertive
personal presence.
Foster their individual talents, style
and insights as a basis for a sense of
personal authority.
Find a way back to common sense (not
so common!) and a sense of humour
in the face of the unbearable and
‘unspeak-about-able’.
