What to Do When a Client Dies: A Therapist’s Guide to Grief and Healing

This blog began because of one of you—an amazing reader of my newsletter. 

After I shared about losing my dad during the COVID pandemic, and what it was like to return to therapy work just seven days later, she wrote to me. She told me about losing a dear client and asked if I could write about this kind of loss. 

Her request is what led me to interview Khara Croswaite, LPC, who has been studying and writing about what she calls confidential grief—the grief therapists hold when we lose a client but cannot openly talk about it.

This post is a companion to that conversation, which you can find on my YouTube channel. You can certainly read this as a stand alone to the topic as it’s where I’m sharing my reflections from my conversation with Khara. I would recommend watching the full interview as well though, so you can really benefit from her expertise and wisdom. 

Ultimately, I hope that if you’ve ever faced client loss, you’ll find here both validation and a reminder that you don’t have to carry it in silence.

Why Therapist Grief Feels So Isolating

As therapists, we’re trained to consult about clinical issues: suicidality, trauma, boundaries, you name it!

But when a client dies, there’s no built-in norm for saying: “I lost a client and I am grieving.” Instead, we’re told, implicitly and sometimes explicitly, to just keep going.

Khara reminded me that this silence isn’t unique: “This is something a lot of us are navigating but are not talking about. There’s no safe place yet.”

Confidentiality is real, of course, but the silence around our grief can leave us isolated at the exact moment we need connection the most.

Naming What’s Normal After Client Loss

One of the most powerful things Khara shared with me was that she lost a client just three months into her career.

At the time, she didn’t realize how formative that experience would be. Looking back, she can now see how much it shaped her, both in her own grief and in her decision to begin surveying therapists about client loss years later. 

That survey ended up capturing the experiences of 200 clinicians and revealed something essential: our grief is common, but we’ve been left without language or support for it.

As she put it: “The top impact of these losses was anxiety. It’s normal to feel hypervigilant, to be anxious, to be ruminating on who’s next.”

So if you’ve ever found yourself:

• Scanning for danger

• Bracing for the phone to ring

• Lying awake at night with looping questions
  please hear this: You are not broken. You are grieving, and your grief makes sense.

Rituals and Meaning-Making When Funerals Aren’t an Option

Many therapists wonder if they should attend a client’s funeral. In practice, most don’t. Confidentiality, liability, fear of being blamed, and the impossibility of explaining how you knew the deceased are real barriers.

That doesn’t mean we don’t need closure. Khara often encourages clinicians to create private rituals, telling me: “Allow yourself to think creatively about what will give you conscious closure. There are so many options.”

Some examples include:

• Writing a letter to the client

• Creating art or planting something in the ground

• Wearing a symbolic tattoo or piece of jewelry

• Participating in a walk or dedication event

For me, those rituals have been woven into everyday life. I think of one client every time I see a wreath, and another when I buy gluten-free baked goods. They live with me in those ordinary, sacred reminders.

Navigating Family Contact and Confidentiality

When families reach out after a client’s death, the contact can feel both human and disorienting. Sometimes it’s an email. Sometimes a voicemail. Sometimes, a jarring phone call that drops you into shock.

I remember just a few months ago, getting a text from my client’s phone number, and then realizing it was her sister texting me to say my client passed. Talk about jarring, talk about sadness, talk about being alone. 

And with all this, Khara was clear about one important truth: “They’re still protected by HIPAA. We don’t get to say, ‘Yes, they were my client.’”

That reminder is helpful for all of us as trauma therapists—we don’t have to rush into these conversations. We are allowed to pause, breathe, and seek consultation before we respond.

And that’s exactly what I did with my client’s sister - I expressed my gratitude for the information and left it at that. 

For some therapists, this is where malpractice coverage can be an unexpected lifeline. 

In BRAVE, I’ve seen members reach out to their malpractice provider during moments of crisis. At first, they were terrified, convinced that calling would make things worse. But what they found instead was relief. 

The risk management teams listened, offered concrete guidance, and reminded them that they were not alone. One member even shared that after her first call, she now feels empowered to use that support anytime she needs it. That’s what it’s there for!

The Question of Returning to Work

Most therapists don’t have the privilege of extended time off. We return to work still raw, still reeling. As you know intimately (I’ve written before about going back to work just seven days after my dad died) we often don’t get to choose the timing of our return.

Khara named the reality bluntly: “Unfortunately most of us are thrown back into the fire before we’re ready. It’s about utilizing the coping skills you would give a client.”

And you know, sometimes healing shows itself later, in small ways: realizing you didn’t hold your breath when a client mentioned cancer, or that you didn’t over-ask about suicidality. 

Those are the quiet indicators of progress, even when you don’t notice them at first.

If you have ever lost a client, perhaps long ago or recently, check in with your brain and body as you think about stepping back into sessions after loss. 

Pause for a moment and notice what your body is doing right now. 

• Is there tightness, holding, bracing? 

• Can you soften, even just a little? 

This is the same kind of permission you can give yourself in those first sessions back—permission to breathe, to ground, and to not have it all together.

Why Community Matters Most

If there’s one thing I hope you take away from this blog post it’s this - The losses don’t break us. The silence does. 

Client loss has a major impact on us as therapists because we care deeply about the people we serve. But it doesn’t stop us in our tracks because we can’t handle grief, but because we’re told to hold it alone.

Khara reminded me of this truth: “Every response is normal. Hypervigilance is normal. Anxiety is normal. Avoidance is normal. Compartmentalization is normal. Community helps us heal it because we hear, oh, it’s not just me.”

This is why BRAVE exists (and perhaps the future communities Khara mentions at the end of the interview too!). To be a place where therapists can name their experiences, receive reflection and validation, and remember they are not alone in this work.

Conclusion

If you’ve lost a client, you will never forget them because, dare I say it, you love them. We love our clients in the most special and intimate way, and saying goodbye to them is always difficult.

Khara said it best: “You’ll never forget this client, ever. And just let yourself sit in that sadness: you’re right. You’ll never forget them—for the good, the bad, and the ugly.”

Healing doesn’t mean erasing grief. It means remembering the fullness of the relationship and allowing yourself to be human in the midst of it.

Before you go, be sure to watch the full interview with Khara Croswaite on YouTube.

And if you’re looking for a place to process these realities with others who understand, join BRAVE today. We can’t wait to welcome you!