A substantial proportion of therapists will at some point in their professional life experience the loss of a patient to suicide. Our aims were to assess how therapists react to patient's suicide over time and which factors contribute to the reaction. One third of the therapists, mostly women, suffer from severe distress. The impact is not different for therapists in institutional settings and therapists in private practice. The item "overall distress" immediately after the suicide predicts emotional reactions and changes in behavior. Our data suggest that identifying the severely distressed subgroup could be done using a visual analogue scale for overall distress. As a consequence, more specific and intensified help could be provided to these individuals.