Emma Bradshaw, our Clinical Director, on why counselling isn't always the right first response to loss, and what better bereavement support looks like.
One of the most common misconceptions about grief I see is that anyone who has been bereaved must need counselling. I completely understand where it comes from. It comes from kindness, from wanting to be sure that a person in pain is not left to cope alone. However, the evidence tells a more hopeful story about human beings than that.
Research over the last two decades has consistently shown that most people are far more resilient following bereavement than we tend to assume. Although grief can be deeply painful, many people still adapt over time through their existing coping strategies, their relationships and the community around them. In fact, psychologist George Bonanno, who spent years following bereaved people, found resilience to be the most common response to loss.
Targeted therapy benefits those experiencing prolonged grief, significant functional impairment or traumatic grief reactions, rather than everyone who has experienced a loss.
As a clinician, this leaves me with something I think our whole sector should consider more often. If we assume therapy is the answer for everyone who grieves, are we helping, or are we medicalising one of the most human experiences there is? Grief is not an illness. It is what love does when the person is gone. And a service that treats every bereaved caller as a patient in need of treatment has misunderstood something important about both grief and people.
So when someone calls us after a loss, we do not automatically reach for the referral form. We listen first. A qualified counsellor spends that first conversation understanding where the person actually is. How recent the loss is, how they are managing the ordinary business of eating and sleeping and getting through a day, what they themselves want, and whether anything sits underneath that could complicate things, earlier losses, existing mental health conditions, pressures that were already there before the bereavement arrived. Two people can describe the same loss and leave that call with quite different plans, and that is the system working, because every experience of grief is unique.
Picture someone who calls us three weeks after losing a parent. They are barely sleeping, crying without warning, and frightened by how strange they feel. Knowing that they need support but not necessarily what form it should take, they may naturally seek counselling because it is the form of help they recognise and trust. But a few weeks in, most people cannot face a structured weekly appointment, and clinically they rarely need one. What this person needs is a counsellor available at any hour who can stabilise them, tell them that the waves and the numbness and the flashes of anger are grief behaving normally, and remind them they can call again tonight if tonight is bad. That is real care. The fact that no sessions were booked does not make it any less so.
Months later, the picture often changes. This is when people may face new challenges. Like dreading going back to work, a family relationship that has soured since the death, the paperwork that will not end. Here, short, focused therapy sessions work well, built around getting over that particular wall.
And of course, some grief needs more room than that. For people carrying a more complex picture, we now offer Extended Counselling with several of the organisations we work with, a longer plan with the same counsellor and space for more open goals.
And sometimes the most caring thing we can say is that the right help is somewhere else. Grief after a traumatic or sudden death, where intrusive images need trauma-focused therapy. The loss of a child. Grief that remains unrelenting long past a year. In these situations, our counsellors help the person find the right specialist route, through their GP or organisations such as Cruse, Child Bereavement UK and Sands, because pointing someone towards the best support for them at that time is part of the job.
The number of sessions in the contract tells you very little. Ask instead how a provider assesses what each grieving person needs.
And if someone on your team ever mentions that they called about a loss and did not end up in counselling, it may help to know what was happening behind that call. They will have been listened to, understood and offered what fitted where they were at the time, with the door left open for whatever comes next.
An EAP is often most effective when it helps people draw on their existing resilience and the support already around them, rather than positioning itself as the primary route to recovery. The aim is rarely to treat grief. It is to offer timely reassurance, normalisation and guidance at the point these help most, while making sure anyone with more complex or persistent needs can reach specialist care. Grief changes over time. Good support changes with it.
HealthHero’s employee assistance programme gives your workforce access to counselling after a loss, mental health support and more, whenever they need it, supporting your people through bereavement and everyday life.