Life after suicide: psychotherapists and practitioners speak about their experiences of working with suicidal clients and the impact it has on them when their client dies

Suicide is a significant problem in Britain. The Office for National Statistics (2016) states that in 2014 that there were 6,122 suicides and considerably more who attempted to end their life. For practitioners working alongside suicidal clients it can have a major effect on them if their client dies.
The first phase of this research project used an online survey which covered a broad range of questions in relation to the impact of working with suicidal clients. The responses were analysed using descriptive statistics and thematic analysis.
In the second phase of the research project, sixteen participants were interviewed using a narrative approach in order to hear at first-hand their experiences of working with suicidal clients. The transcripts were analysed using both narrative and thematic analysis.
The findings highlighted how overwhelmed practitioners felt at the time of their client’s death expressing shock, sadness, anger, guilt and helplessness. In addition the findings revealed that years later practitioners were still marked by the experience stating “You don’t forget”, “Thinking about it produces a feeling of horror” and “It creates anxiety and apprehension when I encounter similar patients”.
The findings identified that practitioners faced challenges with decision making, transference and countertransference and risk assessment. They were unprepared for the emotional impact following the suicide of their client and the need for intentional self-care. It was also recognised that practitioners required support at a personal and professional level and that training needed to be fit for purpose.
Analysis from a mixed methods pluralistic perspective would suggest that there is not a single answer to aiding practitioners when their client dies. The recommendation is made that practitioners would be best supported if the issue of client suicide is recognised as a shared responsibility, between employers, professional bodies, training providers, supervisors and practitioners, and working together to maintain standards of care, support and training. This will aid and prepare practitioners for working with suicidal clients, and should their client die by suicide, practitioners will have a greater degree of support to enable them to negotiate the practical, emotional and professional challenges in the days, months and years which follow.