Guilt After Causing a Car Accident: ICBC-Covered Counselling in Vancouver for At-Fault Drivers

Notice: For general interest only; may contain inaccuracies. Not a diagnosis, treatment, prognosis, or professional, clinical, or legal advice. Reading this creates no counsellor-client relationship. By reading this page, you agree to these terms. Full disclaimer. In an emergency, call 911.

این مقاله به زبان فارسی: عذاب وجدان بعد از تصادفی که مقصرش بودید: مشاوره با پوشش ICBC در ونکوور

Short answer: yes, you can get counselling if the crash was your fault, and in British Columbia ICBC pays for it. Enhanced Care benefits are available to every BC resident injured in a crash regardless of who caused it, and psychological injury counts. Twelve counselling sessions are pre-approved in the first 12 weeks, with no doctor’s referral. The guilt, shame and replaying that follow an at-fault collision are a recognised trauma response, and they respond to treatment. Samuel Ezzatilord, PhD, RCC, CCC, LMCC, sees at-fault drivers in downtown Vancouver and by video across BC and bills ICBC directly.

Why do at-fault drivers so often go without help?

Most people who cause a collision assume that support is meant for the other party. They tell themselves they do not deserve it, or that asking for counselling will look like an attempt to excuse what happened. Some fear that anything they say will be used in the fault decision. So they go back to work, avoid the subject and wait for the feeling to pass. For many it does not pass. It turns into poor sleep, avoidance of driving, irritability at home and a private conviction that they are a dangerous person.

Is this guilt, shame, or post-traumatic stress?

Often all three, and it helps to tell them apart.

• Guilt is about an action: “I looked at my phone”, “I misjudged the gap”. It points toward repair.
• Shame is about the self: “I am careless”, “I am a bad person”. It points toward hiding.
• Post-traumatic stress shows up as intrusive images of the impact, a racing body at intersections, nightmares and avoidance.

Clinical writing on trauma has long noted that shame and guilt can keep post-traumatic symptoms going (Lee et al., 2001). A study of drivers who had caused serious collisions found post-traumatic symptoms together with marked guilt and shame (Lowinger & Solomon, 2004). Where someone else was badly hurt, many drivers also describe what researchers call moral injury: lasting distress after an event that violates one’s own moral code (Litz et al., 2009).

If you recognise yourself here, you can text or WhatsApp Samuel at 604-721-0604. One line is enough to start.

Why does my mind keep replaying it?

Replaying is the mind’s attempt to find the moment where things could have gone differently. With hindsight every warning sign looks obvious, so the replay always ends in the same verdict: you should have known. Kubany and Manke (1995), who developed cognitive therapy for trauma-related guilt, described this as hindsight bias. People judge their past decision using information they only gained afterwards. They also tend to take all of the responsibility and to overlook road conditions, the other driver’s speed, fatigue or a split-second timing that nobody could have controlled (Kubany & Manke, 1995).

Does ICBC really cover counselling when I was at fault?

Yes. ICBC states that Enhanced Accident Benefits are available regardless of fault (Insurance Corporation of British Columbia, n.d.). For counselling this means:

• 12 sessions with a registered clinical counsellor are pre-approved within 12 weeks of the crash.
• You do not need a doctor’s referral to begin. You need your ICBC claim number.
• After 12 weeks, or after 12 sessions, further treatment can be requested through a treatment plan that the counsellor submits.
• Samuel bills ICBC directly, so you do not pay and wait for reimbursement.

Fault still matters for your driving record and premiums. ICBC determines responsibility separately, and that decision does not remove your access to care.

The first call is free and takes 20 minutes. There is no receptionist and there are no forms. You speak with Samuel directly, and he can tell you on that call whether your claim is still inside the pre-approved window.

What does counselling for at-fault guilt involve?

1. Stabilising the body. Sleep, startle and driving anxiety are addressed first, because a nervous system on high alert cannot think clearly about responsibility.
2. An accurate account of responsibility. Samuel goes through the event with you in detail: what you knew at the time, what you could control, and what share of the outcome belongs to other factors. The aim is accuracy. Counselling does not argue you out of responsibility that is yours, and it does not leave you carrying responsibility that is not.
3. Processing the memory. EMDR is used to reduce the intensity of the images and the body’s reaction to them (Shapiro, 2018). Neurofeedback can support sleep and calm arousal (Marzbani et al., 2016).
4. Working with the inner critic. Internal Family Systems (Schwartz & Sweezy, 2019) helps you understand the part that punishes you, which usually believes punishment will prevent another mistake.
5. Repair and return. Where it is appropriate, this may include an apology or another meaningful act, and a graded return to driving.

When should I get help?

If four weeks have passed and you still avoid driving, sleep badly, replay the collision most days or feel you no longer deserve good things, it is time. The pre-approved period runs for 12 weeks from the date of the crash, so earlier is simpler. If the crash was longer ago, treatment is still possible with ICBC’s approval. If you have thoughts of harming yourself, call or text 9-8-8, the Suicide Crisis Helpline, at any hour.

Fees may be covered, depending on eligibility, by ICBC, CVAP, FNHA, IFHP, RCMP, VAC, and most other insurers, and direct billing is available.

Frequently asked questions

Will what I say in counselling affect ICBC’s fault decision?

Counselling is confidential health care. ICBC receives treatment reports about your symptoms and progress so that it can fund care. Session content is not a statement about liability. If you have a legal matter, speak to a lawyer about it as well.

Nobody was hurt. Why do I still feel this bad?

Because your mind registers what could have happened. A near miss with a child or a cyclist can produce the same alarm response as an injury crash.

Someone was seriously injured. Can counselling really help?

It cannot change the outcome. It can help you carry it without destroying your health or your family, and it can help you work out what responsible repair looks like.

I was a professional driver. Will I be able to drive again?

Most people do return. A graded plan, starting with short, low-demand drives, is built into treatment.

How long does treatment take?

The number of sessions needed varies from person to person. Complex situations take longer, and ICBC can approve further sessions.

Can I have sessions in Farsi?

Yes. Samuel works in English and Farsi.

Book a free 20-minute call

Call or text 604-721-0604, message on WhatsApp at the same number, or book at drsamuel.ca/book-a-call/. Evening and weekend appointments are available, in person in downtown Vancouver or by secure video anywhere in BC. More detail: ICBC Counselling in Vancouver. جلسات به فارسی برگزار می‌شود.

References

• Insurance Corporation of British Columbia. (n.d.). Enhanced Care overview. https://www.icbc.com/enhanced-care-overview

• Kubany, E. S., & Manke, F. P. (1995). Cognitive therapy for trauma-related guilt: Conceptual bases and treatment outlines. Cognitive and Behavioral Practice, 2(1), 27–61. https://doi.org/10.1016/S1077-7229(95)80003-4

• Lee, D. A., Scragg, P., & Turner, S. (2001). The role of shame and guilt in traumatic events: A clinical model of shame-based and guilt-based PTSD. British Journal of Medical Psychology, 74(4), 451–466. https://doi.org/10.1348/014466501163670

• Litz, B. T., Stein, N., Delaney, E., Lebowitz, L., Nash, W. P., Silva, C., & Maguen, S. (2009). Moral injury and moral repair in war veterans: A preliminary model and intervention strategy. Clinical Psychology Review, 29(8), 695–706. https://doi.org/10.1016/j.cpr.2009.07.003

• Lowinger, T., & Solomon, Z. (2004). PTSD, guilt, and shame among reckless drivers. Journal of Loss and Trauma, 9(4), 327–344. https://doi.org/10.1080/15325020490890633

• Marzbani, H., Marateb, H. R., & Mansourian, M. (2016). Neurofeedback: A comprehensive review on system design, methodology and clinical applications. Basic and Clinical Neuroscience, 7(2), 143–158. https://doi.org/10.15412/J.BCN.03070208

• Schwartz, R. C., & Sweezy, M. (2019). Internal Family Systems Therapy (2nd ed.). Guilford Press.

• Shapiro, F. (2018). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures (3rd ed.). Guilford Press.

Written with expert editorial assistance.