The end-of-life space has been shrouded in mystery, mainly since we simply do not talk about it. That's why we at Eirene have started the "Intimate Conversations on Death" series.
In this series, we spend time chatting with people in the end-of-life space to learn about new perspectives and offer new ways of navigating and discussing death.
In this latest instalment, we speak with Claire Molloy and Philip Robbins of Therapy Alliance to discuss the role that counselling plays in the grief journey.
What’s the role of social work in loss, grief and end-of-life? Through your years of experience, how have you seen social work being a supportive and useful process?
Social Workers who provide support for those experiencing grief, loss, or end of life can have several roles, including providing a safe space for people to talk about their experience, listen and help seek understanding. They help people express and process their feelings, validate them, and enable people to experience life after loss. Social workers on palliative care teams working with patients at the end of life can help them understand their treatment and assist someone dying with goals they may have, such as tending to important relationships or getting affairs in order. They can connect family members to other services they may need after their loved one dies.
Although one-on-one counselling or palliative care service often comes to mind regarding social work in this area, there are Social Workers in many different settings who are also supporting people experiencing loss and grief. This includes Social Workers working in the school system, community housing, mental health agencies, and child welfare.
What are some common feelings and emotions to experience when grieving the loss of a loved one?
Everyone reacts differently to losing someone or working through the process when someone you love is dying. The way we experience grief can look different from person to person within each experience. However, some common feelings and emotions that people experience when grieving the loss of a loved one can include:
- sadness, depression, and yearning
- shock, disbelief, and confusion
- guilt over unresolved issues
- a sense of relief that their loved one’s suffering has ended
- people can also experience a lack of feeling or numbness
These emotions and experiences can also have an impact on us cognitively, physically, and behaviourally. We might notice the following changes in ourselves:
- difficulty concentrating and focusing on tasks
- a change in eating and sleeping
- dizziness, headaches, or upset stomach
- memories and thoughts about who or what has been lost
- withdrawing from usual activities.
Can you describe community resources you found helpful to clients?
There are a number of supports for grief and loss, including individual counselling, therapeutic group programs, and peer-led support groups. There are supports that people can access that are fee for service or publicly funded. These can include services offered through hospital-based settings, Family Health Teams, community counselling agencies, faith-based organizations, and private therapists. During the pandemic, some of these services have been offered in a virtual format. There are also books and other written resources available online or through specialized retailers who provide material from the helping fields.
Two services in the Toronto region that offer grief-focused support to individuals are Dr. Jay Children’s Grief Centre and Bereaved Families of Ontario.
Are there any gaps that you see in the counselling space for grievers?
While the cost of private therapy and other services can be a barrier to getting support, services that are publicly funded may also have waitlists. There may be fewer resources available in rural areas or in areas that are less resource-rich, such as outside of Toronto.
Further gaps include services that don’t offer support in certain languages or that are culturally specific, distance and time to travel to these services, or during the pandemic, those services have been offered online. Those who don’t have access to a computer or reliable internet have then gone without. There also seems to be a lack of free services offered to those in immediate need of support following a loved one's death. When those who need immediate support cannot access it, they may find themselves in a moment of crises and end up accessing support through the hospital emergency department or even calling 911.
Therapy and counselling are great resources, but what if someone cannot afford them? Do you have any suggestions for resources that are accessible for those who do not have benefits or financial support?
Many publicly funded services support grief and loss, including Family Health Teams, community counselling agencies, and mental health agencies. There can be waitlists for these services, and in some communities, the availability of services is more limited. Some therapists provide sliding scale rates. An example of a platform that people can go to for affordable rates is Open Path Collective.
You have many years of experience working at the Children’s Aid Society of Toronto. What kind of impact have you seen grief have on families?
We have seen the impact grief can have on families firsthand. When families are experiencing the loss of a loved one, this can impact the family dynamic. Since everyone deals with grief differently, the family members may not understand why others are behaving and dealing with the loss differently than they are. The interpersonal relationships within that family unit may start to change or become strained, thereby adding to their grief. Given what we know about how grief can impact individuals emotionally, cognitively, and behaviourally, we can understand how grief can impact one’s ability to care for their children during such a difficult time.
Something that is important in supporting parents dealing with grief is having a supportive person or network of people who the parent can talk to, or go to for practical support that might give that parent some respite and time to seek professional support.
About Therapy Alliance
The end-of-life process or the death of a loved one can lead to a range of emotions and experiences that significantly impact individuals and families. People often cope using their own strengths, supports, and events to honour the person they lost. Sometimes people feel counselling support is needed in addition to these resources.
Counselling support can help in circumstances where one deals with feelings that accompany the terminal diagnosis of a family member or a dedicated person to talk to shortly after the death of a loved one or even after some time has passed after death. The feelings of grief continue to have an adverse impact on one’s ability to live their daily life. A counsellor's support may also be useful if there are inter-related issues such as family conflict or secondary losses such as the assistance a loved one provided.
Therapy Alliance can provide you with this additional support on either a one-time basis, through ongoing counselling, or by referring you to other resources in your community that could help.
I provide individual and group counselling to adults experiencing depression, anxiety, grief and loss, and parenting issues. I have a special focus on men who have challenges with anger and interpersonal difficulties. My philosophy is that EVERYONE is capable of making meaningful changes no matter what your experience has been, and I will listen and respond with care and respect, and support people to uncover what they do best and use that to make helpful changes, and to feel better!
I am a Registered Social Worker and have a Master’s Degree in Social Work. I use an anti-oppressive framework, and my therapeutic approach includes Cognitive Behavioural Therapy and Solutions focussed practice. I am also a Certified Trainer and Facilitator of a treatment program for fathers called Caring Dads.
For almost 20 years, I have been supporting children, youth, and families from all walks of life to overcome many different challenges so they can achieve their full potential and be happy human beings. Whether you are struggling with grief and loss, anxiety and depression, or major life transitions, I will work collaboratively to form a strong therapeutic alliance.
My approach is to create a safe space for individuals to express themselves and delve into their challenges with courage and confidence. I work from a non-judgemental and relationship grounded stance rooted in multi-modal therapies such as Cognitive Behavioural Therapy, Narrative Therapy, and Solutions Focussed Brief Therapy. I have a Master’s in Social Work, and I am a Registered Social Worker.