I’ve been a fan of therapy since my teenage years, and yet somehow, after Adrian died, picking up the phone to call a therapist was one of the hardest things I’d ever done. What if she judged me? What if she thought I was weird or wrong for the ways I dealt with Adrian’s death? What if she told me I had to “move on”? These were some of my biggest fears.
Like many aspects of the loss experience, I’m finding my fears weren’t mine alone.
In conjunction with two beautiful therapists, Mary from Sarah’s Heart in San Antonio, Texas and Diane from Diane Biggs Psychotherapy in Ajax, Ontario, this latest post is a compilation of frequently asked questions about therapists and therapy, specific to the child loss experience.
General Questions about Therapy
Q: How do I know if I would benefit from therapy?
Being open to processing is an important indicator. The way you process also can help you select the therapist and type of therapy. e.g. Art therapy vs Cognitive approach.”
– Mary, Sarah’s Heart
“In my ideal world, mental health would be tended to as much and as openly as physical health. While we’ve come far in reducing the stigma around mental health and seeking therapy support, we’re not quite totally there yet! Therapy will not fix or take away your grief and this is not the intent. Megan Devine is one of my favourite grief author-therapists and writes, “grief isn’t a problem to be solved, it’s an experience to be carried.” Working with a therapist can share some of the weight of your grief and extend your network of support.”
– Diane, Diane Biggs Psychotherapy
Q: How do I know if I’m ready to try therapy?
“This is unique to you. There is no right or wrong time to start therapy. I know this isn’t a clear answer, but I truly don’t think there is one! Therapy can be a proactive and compassionate way to care for yourself. It should also be a supportive space to release emotions and talk about your child, as well as learn tools for coping with painful experiences. The focus and nature of sessions can and do evolve over time. Your initial hopes may be for your therapist to just listen compassionately and may gradually develop into exploring coping strategies, identifying ways to maintain an ongoing bond with your child, etc.”
– Diane, Diane Biggs Psychotherapy
“Ask yourself if you need a safe place to process. Also, therapy may help you if you are feeling overwhelmed, confused, stuck, wanting to die, or unable to function. Realize that you can choose a different course if you find therapy is not right for you.”
– Mary, Sarah’s Heart
Q: What different types of therapy are there? Which type(s) am I most likely to find helpful after loss?
“There are over 65 (and counting) types of therapy. The type is less important than the relationship with the therapist. Grief is a process not a pathology. Look for a therapist that is relatable, empathic and uses a variety of grief therapy methods. There often will be trauma involved when losing a baby, so also assess whether they have experience in trauma.”
– Mary, Sarah’s Heart
There are so many different types of therapy and many practitioners use a combination of modalities. This can be pretty confusing, even for therapists! I’ve included a link to a pretty comprehensive list with descriptions: https://www.psychologytoday.com/ca/therapy-types/cognitive-behavioral-therapy
I’ll also include links to some grief-specific resources sharing tips on finding a therapist:
https://refugeingrief.com/2020/01/07/how-to-find-a-grief-therapist/
https://whatsyourgrief.com/finding-a-grief-counselor/”
– Diane, Diane Biggs Psychotherapy
Q: How do I decide what type or therapist or therapy is right for me?
“I’ve outlined a couple of questions to help you get started finding the right fit below. You can often get a decent feel for a therapist’s style and philosophy about grief on their website or Psychology Today profile. These are also helpful questions to reflect on after an initial consultation or session:
• What are my best hopes for counselling?
• Do I want this to be short or long-term?
• Do I think trauma may be part of my experience? If so, I may want a therapist who is trained in trauma therapy or at the very least, trauma-informed therapy.
• How do they plan to support me in my best hopes?
• How do they talk about grief? A problem to be fixed or a natural and healthy response to be held and supported in? Are they comfortable using death-positive language (death, dying, etc.) or do they use euphemisms? Do they acknowledge your child and hold space for all your emotions or do they offer platitudes?
• The MOST important question: Do I feel comfortable with and supported by this individual?”
– Diane, Diane Biggs Psychotherapy
Related: Resources Blog: Questions to Ask When Interviewing a Therapist After the Loss of a Child
Q: How important is it that my therapist specialize in child loss or grief?
“One of the most important aspects of therapy is feeling safe, connected, and comfortable with your therapist. However, most therapists will have additional training, experience, and comfort level with different client populations. Grief, especially around child loss, is a uniquely painful experience with unique needs for support. I will always refer grieving folks to another provider who specializes in grief if I am not able to see them myself.”
– Diane, Diane Biggs Psychotherapy
“Many find comfort in knowing that their therapist is a specialist in grief and child loss but what is most important is the relationship with the therapist. A good therapist will tell you if they are prepared to help with child loss/grief. Many find a therapist they are already seeing understand them and can process the loss in the context of their complex self/life.
I think groups that are specialized to your loss are more helpful than general grief groups.”
– Mary, Sarah’s Heart
Related: Resources Blog: Facebook Groups for Bereaved Families
Q: Will therapy take my grief away? I don’t want to change how I feel. / What if I don’t want to “heal” or “get over” my loss?
“Therapy will not take away your grief. Therapy will help you process your grief and find a way to be in the world with the loss as a part of you.”
– Mary, Sarah’s Heart
“The goal of grief therapy is never to “get over” grief or “move on.” Grief is a natural and healthy response to loss and we are not trying to change or fast-forward it. My role is that of a compassionate guide and to hold space for painful emotions and experiences, as well to support clients in integrating their experience, creating ongoing meaningful connections with their children, and working toward making small changes that are client-led.”
– Diane, Diane Biggs Psychotherapy
Finding a Therapist
Q: How do I find a therapist?
“This is going to vary depending on your location. I’m located in Canada (Ontario) and a good place to start is asking your medical team and others who are providing support. They will often have connections with therapists in the community who specialize in grief and bereavement. Other bereaved parents who are within the same province are fantastic resources here as well. If you are open to virtual counselling, there’s a lot more room to expand your options. Psychology Today is another resource. You can enter your preferences in terms of location, experience, training, etc. and take it from there!”
– Diane, Diane Biggs Psychotherapy
“Ask agencies in your area that specialize in grief and loss. Ask trusted persons in your life for recommendations. If you have insurance you could start with their list of therapists that accept your insurance. Most importantly, interview the therapist to find the one that you feel safe and comfortable with.”
– Mary, Sarah’s Heart
Related: Resources Blog: Professional Organizations Supporting Bereaved Families
Q: How do therapists choose which insurance plans to accept? What should I do if I don’t have insurance and I can’t afford therapy?
“Which insurance plans therapists accept are most often professional choice. Insurance companies generally require the therapist to apply and accept the company’s structure. If you want to go a therapist that does not take your plan, you can ask if they would be willing to become a provider for your insurance.
Some therapists only accept cash but may have a sliding scale to make it more affordable. Some agencies provide therapy for free or at a reduced cost.”
– Mary, Sarah’s Heart [United States]
“In Canada/Ontario, most extended benefit plans will cover counselling/therapy services with a psychologist, psychotherapist, or social worker. All benefit providers and plans are different, so you will need to check your plan to determine which designation is covered and amount of coverage.
There are some resources who provide short-term individual or group counselling at no charge to the client. These may be in individual and/or group form and are provided below:
Infant Loss: https://www.babysbreathcanada.ca/
Pregnancy/Infant Loss: https://pailnetwork.sunnybrook.ca/
Support groups: https://bereavedfamilies.net/about-us/”
– Diane, Diane Biggs Psychotherapy [Canada]
Q: It hurts too much to make the initial phone call to schedule therapy. Is it weird if I ask a friend to do it for me? Are there other ways to make that connection?
“I am always happy to send information about myself, background, and next steps to a support person; however, I do need the client to connect with me to schedule the therapy session and provide necessary information. I recognize that phone calls can feel overwhelming—email is totally fine and many providers have secure online intake forms, so you are able to do this at your own pace.”
– Diane, Diane Biggs Psychotherapy
“It is okay to have a friend set it up but you might want to start with having them set up a phone call. Also, many therapists are able to connect by text or email.”
– Mary, Sarah’s Heart
Q: How do I know if I can trust my therapist? What do I do if I don’t trust my therapist / don’t feel like I can trust my therapist?
“Therapist follow a code of ethics and you can check with their licensing board to make sure they are in good standing. Trust should build over time with a therapist and if it doesn’t please find a different therapist. As therapists, we realize that we are not a good fit for everyone.
If a therapist violates their code of ethics report it to their licensing board.”
– Mary, Sarah’s Heart
“It is so important that you feel comfortable and safe with your therapist! Most therapists offer a brief phone or video consultation at no charge before scheduling your first appointment. I encourage prospective clients to connect with me before scheduling, so they can get a sense of who I am, ask me any questions, and feel out if my personality/style/training is the right fit for supporting them.”
– Diane, Diane Biggs Psychotherapy
Preparing for & Participating in Therapy:
Q: How should I prepare for therapy? How can I make therapy less scary?
“The therapist will start with an assessment that will guide you in telling your story. Realize you can say you are not ready to talk about certain things. I think it helps to realize the therapist is not there to judge you or tell you what to do/think/feel. Remember therapists have issues and struggles they work through in their lives too.”
– Mary, Sarah’s Heart
“It is totally okay to let your therapist know you are feeling nervous about therapy—they will likely have some compassionate words, as well as ideas about how to increase your comfort. I often start with a grounding or mindfulness ritual in sessions to help both client and myself to feel comfy and settled! Virtual (video and/or phone) counselling is offered by most therapists at this time, due to Covid-19. If you feel more comfortable in your own space, with items that help you feel safe (cozy blankets, pictures of your child and/or your child’s belongings are just some examples) this can be a less scary option. Many of my virtual clients bring a pet to their session. My pup, Lucy, hangs out too sometimes when invited!”
– Diane, Diane Biggs Psychotherapy
Q: Will I automatically be diagnosed with postpartum depression? Do therapists differentiate between postpartum depression and grief?
“Never should a diagnosis be automatic; it will be based on the criteria and ongoing assessment. The therapist will differentiate between grief and other possible diagnoses.”
– Mary, Sarah’s Heart
Q: Will I have to take medication? What if I don’t want medication?
“The choice to use medication is always yours! Some people find it helps them function, but know there are not medications that can take your grief away. Therapy can help you decide what would be best for you. Most therapists do not prescribe medication but they can refer you to a practitioner or your primary care provider.”
– Mary, Sarah’s Heart
Q: What will a therapist do if they don’t agree with how you’ve chosen to deal with your grief? Will a therapist ever push you in a direction you don’t want or aren’t ready for?
“You therapist may suggest ideas or directions, but it is always your choice as the client on how you proceed. Therapists have specialized training and education, but you are the expert in your own life and experience—collaboration is key here. Your feedback is really important in helping your therapist to understand what you are and are not comfortable with. This opens up the conversation and allows for collaboration on an alternative or slower moving plan.”
– Diane, Diane Biggs Psychotherapy
“The therapist is there to work with you! A therapist will help you explore the impact of your grief and how you are dealing with it, but you are in charge. Therapists will make recommendations at times but it is your decision how to proceed.”
– Mary, Sarah’s Heart
Q: I’m feeling some really dark thoughts. I’m scared to share them / scared my therapist is going to judge me for them.
““Dark thoughts” during a great loss are not abnormal and processing can help you cope in the healthiest way. Many people have thoughts that can feel scary and with processing they become more manageable. If the therapist thinks you are going to harm yourself they will develop a plan with you to assure your safety.”
– Mary, Sarah’s Heart
“Part of my initial session is acknowledging that “dark thoughts” often co-exist with grief and checking in on if that is happening for the client. These thoughts can feel scary and isolating-your therapist can better support you if they are out in the open. As a human and a therapist, I can very honestly say that there is no room for judgement in my heart, only compassion. Your therapist will also ensure that you have a safety plan, access to crisis resources, and collaborate with you to identify additional supports as needed.”
– Diane, Diane Biggs Psychotherapy
Q: What if I cry? What will my therapist think of me?
“That you are human. It is 100% okay to bawl in therapy! And swear. Or to not do any of these things—you do you. Your therapist should be comfortable with holding strong emotion. I try to normalize from our first conversation that it is totally okay to bring whatever energy you have at the moment to our time together. I am human too and not a therapist-robot—I will sometimes get choked up or teary-eyed.”
– Diane, Diane Biggs Psychotherapy
“I would think you are experiencing emotional pain which is part of the human experience. I also would know you are courageous for processing your pain.”
– Mary, Sarah’s Heart
Q: Will a therapist ever think a client is weird?
“I cannot speak for all therapists but my experience is that therapy helps me see the person as a complex human like everyone.”
– Mary, Sarah’s Heart
“I can only answer for myself here and will say…I’m human too and can be pretty weird! Joking aside, I truly do not judge clients for what they are doing/saying/being. I am totally in awe of the folks that I have had the honour of walking with through their grief journey. Notice that I’m saying that I’m human a lot?! I really want to underline that therapists are people too—just with a different lens to support you.”
– Diane, Diane Biggs Psychotherapy
Q: What if therapy is too intense for me?
“I recognize that therapy can feel like an intense experience and especially emotionally charged after the death of a child. It is important for me to be to non-judgmental, welcoming, and work at a pace that is comfortable for my client. The concept of titration is important here as well—starting with support and slowly accessing difficult areas, paired with ongoing support and distress tolerance strategies. As always, please let your therapist know if you are feeling uncomfortable with the pace or intensity.”
– Diane, Diane Biggs Psychotherapy
“It’s okay to ask to slow it down or take a break.”
– Mary, Sarah’s Heart
Q: If a therapist is worried about you what will they do? What happens if I tell my therapist I am feeling suicidal?
“Therapy can help you process the feelings, develop healthy coping and together develop a plan to keep you safe.” (Also see Mary’s answer to the next question)
– Mary, Sarah’s Heart
“I touched on this in the “dark thoughts” question earlier—your safety is our priority. Therapists have an ethical obligation for assess for suicide risk. This should be done compassionately and collaboratively with clients to identify distress tolerance strategies, connect with support people, and if needed, connect with more intensive (crisis) resources in the community. Again, zero judgment here—only compassion and support.”
– Diane, Diane Biggs Psychotherapy
Q: Can a therapist ever call the authorities about something shared in session?
“If the therapist assesses you a danger to yourself or others and you are not able to participate in a treatment plan they will involve authorities that can assist in keeping you safe. Also, therapists are required by law to report abuse of child/elder/adult with disabilities.”
– Mary, Sarah’s Heart [United States]
Q: What do I do if I don’t feel like therapy is helping me?
“Discuss it with your therapist so you can explore any obstacles, take the therapy in a different direction, or find a different therapist.”
– Mary, Sarah’s Heart
“If you are comfortable doing so, chatting with your therapist about your concerns, what is/isn’t working, and revisiting your particular hopes for therapy is really helpful. Your therapist’s number one goal is to support you and they should be open to feedback and pivoting if needed.”
– Diane, Diane Biggs Psychotherapy
Q: Will it hurt my therapist’s feelings if I find another provider or quit therapy?
“Absolutely not—all therapists have their own styles, personalities, and training. I talk about this from the first session—if something that I am doing is not working, I encourage clients to chat with me about this if they are comfortable doing so. Feedback is a good thing! But it’s also totally okay to ask to be referred to another provider—the most important thing is that you are being supported in a way that feels right to you.”
– Diane, Diane Biggs Psychotherapy
“A professional therapist will focus on what is best for you. Always do what is best for you; the therapist has resources available to handle their needs/feelings.”
– Mary, Sarah’s Heart
Questions about Therapists:
Q: Do therapists ever get triggered by what is shared in therapy? How do they handle that?
“Being human, authentic, and compassionate with clients is so important to me. I have also experienced pregnancy loss, which is one of the many reasons I’m so passionate about this work. To protect my own mental health, as well as be able to show up for my clients in a way I feel good about, I practice what I call “compassion with boundaries.” For me, this is recognizing what my triggers are when possible, using grounding tools myself during sessions, processing and containing (closing up) on my own after sessions, and accessing supervision as needed. I also often remind myself of the difference between empathy and compassion. Empathy is feeling another’s pain, while compassion is walking alongside them in their pain.”
– Diane, Diane Biggs Psychotherapy
“Yes, therapists can be triggered. If they are not able to focus on you they should seek their own help and refer you to someone else.”
– Mary, Sarah’s Heart
Q: How do therapists keep their personal feelings separate? How do therapists compensate when a patient’s views are different than their own?
“Therapists are trained to focus on your values and goals not their own. Therapists are not there to work through their feelings, but sometimes they can share the impact you have on them to help you understand how you impact others. For example, if you constantly interrupt I might explore with you whether others might feel frustrated when interacting with you.”
– Mary, Sarah’s Heart
“This can and does come up in the therapeutic relationship. Part of our training through education and ongoing supervision is around boundaries, acknowledging our own biases and world views, and identifying if these are impacting our work as a therapist. Therapists often access peer, group, or formal supervision to work through these and other topics.”
– Diane, Diane Biggs Psychotherapy
Q: Do therapists go to therapy?
“Absolutely! I see a therapist regularly and always plan to—this is an important part of self care for me.”
– Diane, Diane Biggs Psychotherapy
“Yes! Some are required to attend therapy as part of their training but many choose to attend at various times in their lives.”
– Mary, Sarah’s Heart
Q: Does my therapist talk about me with his/her colleagues?
“A therapist may seek guidance from a consultant or supervisor. Some agencies also review cases as a staff. All the professionals/staff involved in review/consultation/supervision are required to maintain your confidentiality within the law and professional code of ethics.”
– Mary, Sarah’s Heart [United States]
“Many therapists practice within an organization or group. If they are in private practice, they may choose to participate in a consultation group or individual supervision. This is a great way to continue learning, receive and give support, and get a fresh perspective. I am part of a group practice in addition to my private practice, periodically access clinical supervision, and participate in peer consult groups; however, names and other identifying information are never shared.”
– Diane, Diane Biggs Psychotherapy [Canada]
Q: What information can my therapist share with my employer or for legal matters?
“They can only share with your employer if you grant permission.
If the therapist assesses you a danger to yourself or others they will involve authorities that can assist in keeping you safe. Therapists are required by law to report abuse of child/elder/adult with disabilities. If you sue a therapist they can use interactions with you in their defense.”
– Mary, Sarah’s Heart [United States]
Q: What are the hardest parts about being a therapist?
“For me, it’s my own limitations and finding balance between professional life and self-care.”
– Mary, Sarah’s Heart
“For me, it’s keeping a healthy work/life balance. I truly love the work that I do, as well as constantly learning new ways to support clients. I also have a strong tendency to want to help everyone, everywhere, at anytime. Turning off that part of my brain is hard for me, but I have learned that I need to practice what I preach in “showing up for myself, so I can keep showing up for others.” I’m a work in progress on this one!”
– Diane, Diane Biggs Psychotherapy
Q: Is it appropriate to ask a therapist to attend a funeral or memorial service?
“I have been honoured to be invited to funerals, memorial services, and other activities honouring the individual who has died. I am comfortable with this professional boundary-wise, but every therapist will have their own comfort level. Either way, it is appropriate to extend this invitation if it feels supportive for you.”
– Diane, Diane Biggs Psychotherapy
“It is okay to ask but realize some will not be able to attend for personal or professional reasons.”
– Mary, Sarah’s Heart
Q: What do therapists think about “alternative” treatment options such as acupuncture, meditation, or hypnotherapy?
“Different therapists will have different views but many will embrace a holistic approach. I encourage the use of different modalities.”
– Mary, Sarah’s Heart
“Our physical and mental health is so intertwined—I believe there is great value in holistic health and there is also a growing body of research supporting the benefits of meditation upon mental health especially. Here’s a link exploring the intersection of mindfulness and grief if you would like to read more: https://whatsyourgrief.com/mindfulness-and-grief/”
– Diane, Diane Biggs Psychotherapy
Related Posts:
Resources Blog: Questions to Ask when Interviewing a Therapist After the Loss of a Child
