Selecting a Grief Counselor

Finding a good mental health professional in the midst of a trauma is somewhat akin to trying to find a good plumber in the middle of the night when water is pouring out of a hole in your wall. Your intentions may be clear but summoning the necessary energy, focus, and discernment to be a wise consumer of mental health services may be just too much—especially when you’ve got your finger in the dike and know it won’t take much to bring the whole thing crashing down around your ears. 

Intellectually most of us understand that we wouldn’t give a decorator free rein in our home or drop off our children at a daycare center without checking qualifications and making sure that we have a shared vision of services to be performed. Yet for many of us finding a counselor—and giving him or her access to our most tender places during perhaps the most difficult time in our lives—is achieved by searching online or going with a recommendation made by a friend. 

Finding a counselor takes work, and then deciding if it’s a good match takes even more. However, with a little bit of information about the types of counselors available, you may be able to narrow your initial search and increase the likelihood of finding a good match right away.

Keep in mind that the mental health professionals who are licensed through their state may be called something a little bit different or may have slightly different requirements from one state to the next, but generally they are similar to the descriptions provided below.

Psychiatrist 

A psychiatrist is a physician who completes medical school and then, like the other doctors who want to specialize, takes additional training in the field of mental health, in the same way a cardiologist learns more about the heart and a dermatologist learns more about the skin. Many psychiatrists don’t do traditional counseling. They typically assess and diagnose, then work with a psychologist or other type of counselor who provides the counseling service. One advantage to seeking the services of a psychiatrist is that he or she can prescribe medications. Survivors who may be helped through the short-term use of medications may find the services of a psychiatrist to be more efficient than going to another type of counselor who then has to work through a doctor to get a prescription. Survivors who are already dealing with mental health challenges may find the expertise of a psychiatrist to be helpful in terms of coordinating mental health interventions. One the other hand, some survivors find the traditional medical model—something’s wrong with the body that needs to be fixed—to be an unsatisfactory characterization of bereavement and trauma.

Psychologist

A psychologist is a mental health professional who has earned a doctor of philosophy degree in the mental health field. Their title is that of doctor although their training is not in medicine, so they are not physicians. In addition to their Ph.D., they have had a period of practice under the supervision of a more experienced psychologist and have passed a licensing test. Psychologists are trained to assess and diagnose problems and to intervene using techniques and methods that result in behavior change and improved quality of life. Because of their expertise in testing and diagnosis, survivors who may be dealing with issues besides those related to the recent death of a loved one may find the long-range view of a psychologist to be especially useful. Psychologists can help their clients better understand how past issues are influencing present issues and, with those insights, how behaviors can be adapted. However, for those who only want to focus on a specific issue and don’t want or don’t need a broader contextual analysis, a licensed counselor or social worker may be a good choice.

Licensed Professional Counselor

A licensed professional counselor, or LPC, has at least a master’s degree in counseling or a related field, has passed a state licensing exam, and has had several hundred hours of clinical experience under another LPC. The licensed professional counselor’s primary focus is on the individual and the issues that are causing them problems in their life with an eye toward improved functioning.

Licensed Marriage and Family Therapist

The licensed marriage and family therapist, or LMFT, has received training and licensing similar to that of an LPC but also has specific training and expertise in couples and family dynamics. That focus may be of particular interest to survivors who want to seek counseling as a family. Similar to social workers, LMFTs seek to identify ways in which the presenting issue is manifesting itself in the client’s relationships and environment.

Licensed Clinical Social Worker

A licensed clinical social worker, or LCSW, has an advanced degree in social work including an internship experience, several hundred hours of supervised practice, and an advanced licensing exam. It’s been said that a counselor changes a person from the inside out and a social worker from outside in. That may be a bit simplistic, but a social worker is specially trained to look at individuals within the broader context of their environment—their families, their professions, their daily activities, and their interactions with other people. Although the client’s specific issue will be the focus of intervention, the LCSW is trained to identify ways in which that issue is manifesting itself in other circumstances and relationships. For survivors who want to focus primarily on a particular issue, such as grieving the loss of a loved one, an LCSW may be a good choice. Those who want to work on broader issues, such as how a recent loss may be spotlighting unresolved issues from the past, may find an LPC or psychologist a more appropriate mental health partner.

Licensed Master Level Social Worker

This provider has earned a master’s degree in social work, including the internship, and has taken an initial exam. They may or may not be on their way to becoming an LCSW, but their clinical work is done under supervision. That doesn’t mean that a supervisor will sit in on your counseling session, merely that the LMLSW will consult and seek guidance from his or her supervisor on a regular basis.

Where do we go from here?

Clearly there is a lot more to accessing mental health services than just “seeing a counselor.” However, by giving some thought to what you envision the counseling process achieving, some types of mental health professionals may seem like the more obvious choice and help you narrow down your search. 

Your work, however, isn’t finished once you’ve scheduled an appointment. As a consumer, it’s your job to monitor both the service provider and the services you are receiving. In the face of advanced degrees and impressive-sounding titles, it’s human nature to believe that you are receiving competent care. You may believe that it is somehow not your place to question the services you are receiving. To the contrary, you have every right and obligation to make sure that you are getting the support you need.

Training and Philosophy

As you are calling around, feel free to ask about the counselor’s education and training. What licenses does he hold? What degrees has she earned? Reputable counselors will feel comfortable answering questions about their qualifications. Ask about their therapeutic philosophies. What kinds of techniques do they like to use? How do they typically proceed with clients whose issues are similar to yours?

Experience

Even a highly qualified mental health professional may simply not have worked with very many people who have experienced the sudden, traumatic death of a loved one. That does not make them less competent; it may simply mean that they are not right for your needs. It’s appropriate to ask a therapist about his or her experience with trauma. How many similar clients has she seen? Does he belong to any trauma or bereavement-specific professional organizations or done any continuing education in this area?

Relationship

This is a highly subjective category but the bottom line is: does this person seem like someone you will be able to work with effectively? Does his or her demeanor, answers to your questions, and office environment make you feel safe and respected? If it does not feel right, then it probably is not right for you. Research has demonstrated that a good therapeutic relationship, more than any other factor, predicts counseling effectiveness.

Competence

Although the vast majority of mental health professionals are both well trained and emotionally stable themselves, for your own emotional wellbeing certain boundaries must be maintained. If your counselor becomes distraught when you tell your story, if your relationship crosses over the line from professional to personal, if your counselor is sharing what feels like too much of his own personal information, if you feel like you have given it a fair shot but you don’t seem to be feeling better, then it’s time to look for someone else. Just as you would not continue to take your car to a mechanic who cannot fix the problem or shop at a store with disinterested, rude, salespeople selling products you do not like, you are not under any obligation to continue counseling. Take your business elsewhere. 

Affirmation of Growth 

Most people who seek mental health services to help them with a specific issue, such as a significant change or loss as opposed to a chronic mental health condition, will not need to be in counseling forever. Part of the therapeutic experience is moving toward the time when counseling is no longer necessary. At appropriate times, your counselor should explore that with you and affirm the strides that you are making. If your counselor is making it sound as though you will be in therapy for months on end, or is resistant to reducing the number of times you meet, and you feel as though maintaining the same schedule is no longer in your best interest, then at least get a second opinion.  

As a licensed professional, your counselor has to maintain the standards set by his or her licensing entity, adhere to a code of ethics and abide by a conflict resolution process when there has been a complaint.  With most licenses, you can find out if someone really does hold that license or has had any complaints filed against them. You can also find out the procedure for filing your own complaint if a serious problem arises. Much of the information can be easily found on the Internet and can further assist you as you explore your counseling options. 

Catherine Doherty, a 20^th century social rights activist, is credited with having said, “Someone has said that it is possible to ‘listen’ a person’s soul into existence.” For many survivors, good counseling has been their soul’s bridge back from despair to life. With a little bit of information and the will to be a good consumer, you can find a counselor who can be an important part of your healing journey.

From the pen of...
Stephanie Frogge is a staff associate on the TAPS Helpline. She has more than 30 years of experience in the area of trauma response and crime victim services, and is the former national director of victim services at Mothers Against Drunk Driving. She is a trained mediator and holds a master’s degree in theological studies from Brite Divinity School.

Find Help in Your Community

For help connecting with a grief counselor in your local area, call TAPS at 800-959-TAPS (8277) or email info@taps.org. Our staff can try to connect you with individual counseling through programs that offer pro bono services such as at the VA’s Vet Centers or with Give An Hour. Learn more about how to find support in your community through TAPS community resources.