How might counseling professionals interact with clients facing their own or a loved one's serious illness or death and help prepare them for this severe stress and loss? Counseling professionals are encouraged to do no harm, be sensitive to beliefs and traditions, use life stories, and help resolve unfinished business.
Counselors and psychotherapists work with individuals at various stages of their lives. When individuals and their families face dying and death, through sudden or chronic illness or trauma, the counseling professionals working with them may feel overwhelmed at the tremendous stress of this experience. Aside from the personal trauma associated with their own or a loved one's illness, counseling professionals experience the greatest stress when confronted by a client's severe ill health, and these professionals need to first deal with their own death anxiety (Kirchberg, Neimeyer, & James, 1998;Neimeyer & Van Brunt, 1995). The aim of this article is to better prepare counselors for interaction with clients facing the ultimate and most severe stress. "It is most desirable to consider all of us terminal, both patients and therapists, and to devote ourselves to transforming disgust and despair into transcendance [sic] and ego integrity for everyone" (Richman, 1995, p. 322).
Whether clients choose to deal first with the more practical, earthly matters such as finances, family responsibilities, and loss of the known or first with the more philosophical, theological, religious, or spiritual matters, many people need to confront their problems in both areas-when time and opportunity allow-before they can feel at peace with the end-of-life events happening to them. Their journeys will be far more satisfactory if knowing and sensitive counselors guide them along the scariest, roughest roads they face when winding down their lives. Reduction of fear and anxiety and acceptance of one's inescapable dying and death are essential for a peaceful outcome at the end of life.
As Murillo and Holland (2004) wisely reminded, though pain management might be well used, the dying often face other troubling physical problems such