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Title of Course: Bereavement Groups – Successful Facilitation Strategies CE Credit: 2 Hours Learning Level: Intermediate Author: Carrie L. Hill, PhD Abstract: Loss is a universal experience. We all have faced loss in some way, whether it is the loss of a job, our independence, or a relationship. However, one of the most difficult kinds of loss is bereavement – the death of a loved one. Clients who have lost someone close to them require special assistance to help them work through their grief and adjust to life without their loved one. Bereavement groups are an effective and powerful way to serve these clients. This course will provide you with the knowledge and tools to develop, facilitate, and sustain a bereavement group. Topics will include various group types and logistical considerations, a suggested format for conducting a bereavement group, the role and necessary qualifications of the group facilitator, solutions to common challenges, ethical principles that are relevant to bereavement groups, and suggested plans for promoting and sustaining a group. Learning Objectives: 1. Describe the nature, purpose, and benefits of a bereavement group 2. Identify the various group types and logistical considerations for planning a group 3. Identify typical conversations and topics for bereavement groups 4. Describe a suggested format for conducting a bereavement group 5. Define the role and necessary qualifications of a bereavement group facilitator 6. Identify solutions to common challenges that occur during bereavement groups 7. List ethical principles that are relevant to bereavement groups 8. Formulate a plan for promoting and sustaining a bereavement group

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Bereavement Groups: Successful Facilitation Strategies Introduction Loss is a universal experience. We all have faced loss in some way, whether it is the loss of a job, our independence, or a relationship. However, one of the most difficult kinds of loss is bereavement – the death of a loved one. Clients who have lost someone close to them require special assistance to help them work through their grief and adjust to life without their loved one. Bereavement groups are an effective and powerful way to serve these clients. This course will provide you with the knowledge and tools to develop, facilitate, and sustain a bereavement group. What is a Bereavement Group? A bereavement group is a formal gathering of those who have lost a loved one. The group is led by a professional facilitator who assists the group in discussing feelings, offering support, learning from each other and exchanging coping skills as members adjust to life without those whom they have lost. What is the Purpose of a Bereavement Group? There are many reasons to develop and offer a bereavement group. Some purposes of a bereavement group are to:

• Assist members in telling their unique stories • Help members express their feelings about their loss • Allow members to explore how their lives will change now that their loved one is gone • Provide an opportunity for members to meet regularly for mutual emotional support • Create a safe place to discuss difficult issues • Educate members about the bereavement process • Help members acquire coping skills and enhance self-care

What Are the Benefits of Participating in a Bereavement Group? Some clients are uncomfortable with the idea of attending a bereavement group – they would rather deal with their loss individually. Others feel that it requires too much effort. Attending a bereavement group is a personal choice, but it is important for clients to know that those who participate:

• Receive encouragement and hope from other group members • Realize that they are not alone in their bereavement journey • Have the opportunity to share information and resources • Become part of a supportive community • Meet new people that often become good friends • Have a chance to experience personal growth and development

Topic 1: Group Types and Logistics Topic Introduction: Now that you know the benefits of a bereavement group, you may find yourself asking, “How do I start a group where I work?” This topic assists you to identify the type of bereavement group you would sponsor. It also asks you to identify logistics for your group that will help assure its success.



Types of Bereavement Groups When planning a bereavement group, it is important to decide what type of bereavement group you want to develop. Bereavement groups can vary in regard to focus, structure, and duration. Focus of Groups Bereavement groups can primarily focus on providing support, education, or social opportunities, or some combination of these.

Support: Bereavement support groups focus mainly on providing emotional support to members through guided conversation. Although education and socializing might be part of the group, emotional support is the primary purpose. Education: Bereavement education groups focus mainly on providing information about the grief process by hosting guest speakers, showing videos, or discussing reading materials. While emotional support and socializing might be part of the group, education is the primary purpose.

Social Opportunities: Bereavement social groups focus mainly on providing opportunities for members to socialize and do enjoyable activities together as a means of forming friendships that can ease the grief process. While emotional support and education might be part of the group, socializing is the primary purpose. Structure of Groups Bereavement groups can be open or closed. Open: Open groups allow new members to join at any time and current members to leave at any time, or skip meetings as they wish. Open groups typically work best when the focus is on providing social opportunities, and sometimes when the focus is on providing emotional support. Closed: Closed groups are designed for a set number of participants; new members do not join once the group meetings have begun. Closed groups usually work best when the focus is on providing education, and sometimes when the focus is on providing emotional support. Duration of Groups Bereavement groups can be ongoing or time-limited. Ongoing: Ongoing groups meet consistently (e.g., weekly or monthly) for an indefinite length of time. Ongoing groups typically work best when the group is open to new members at any time. Time-Limited: Time-limited groups meet consistently (e.g., weekly or monthly) for a set number of sessions. There is a clear agenda for each meeting, which usually builds upon the progress made during the previous meeting. Time-limited groups typically work best when the group is closed to new members.



Logistical Issues to Consider Your bereavement group will be much more successful if certain logistical issues are considered during the planning stages.

1. Number of Members - The number of members will naturally fluctuate over time. However, a bereavement group generally functions best when its size is limited to 10 – 15 members. Very small groups (i.e., only a few people) are more difficult to engage, while very large groups (i.e., over 15 members) can feel impersonal.

2. Location - The location of the bereavement group should have several characteristics: • Private, to ensure confidentiality • Quiet, to minimize disruptions • Spacious enough to comfortably seat everyone • Easy to find, with ample parking • Accessible for those who are handicapped or hearing impaired • Emotionally comfortable for the members (e.g., if members have recently lost a loved one, gathering at a

library or community center might be more appealing than meeting at a hospital or hospice agency) 3. Day & Time - Be sure to choose a day and time that are convenient for your group members. If your group will

mostly consist of working adults, an evening or weekend group will work better. If you work mostly with retirees, they tend to prefer mornings or afternoons in order to avoid night driving. Choosing a day and time when traffic is lighter will also be appreciated.

4. Length of Meetings - Most bereavement groups last between one and two hours, regardless of the focus of the group. This allows enough time for sharing, support, an educational presentation, a social pursuit, or some combination of these activities. Meetings that are limited to an hour or less tend to feel rushed, while sessions that last over two hours can be exhausting for group members.

5. Method of Communication - Ideally, a bereavement group will meet consistently in order to provide stability and structure to group members. However, in the event of illness or emergency, a session may need to be cancelled or its location must be changed. It is important to have a method of communication established to notify group members of any last minute announcements. Postcards, newsletters, and telephone trees have all been used as successful methods of communication.

Mini-Quiz: 1. An educational bereavement group focuses primarily on providing:

a) Emotional support b) Information on the grief process

c) Social opportunities to connect with others

2. If you have a dozen members in your bereavement group, you have met the criteria for ideal size.

a) True b) False Answers to Mini-Quiz: 1. b, 2. a Topic Summary: When selecting the type of bereavement group, consider focus, structure and duration. Groups may primarily focus on support, education, or social opportunities. Or, they may encompass all of these. Group structure may be open—accepting new members continuously—or closed. The group’s duration may be ongoing, or limited to a set period of time. Optimal group size is 10-15 members. The location should be accessible to everyone, with ample parking. The day, time and length of meetings need to match the preferences of the members. Finally, consider how you will stay in touch with members in between scheduled group meetings.



Topic 2: Group Conversations and Topics Topic Introduction: Once you’ve considered what type of group you have or want to have, and set up your logistics, you’ll need to start thinking about what happens when the group convenes. This topic helps you identify common conversations that take place naturally in bereavement groups, and educational topics you might want to prepare for the members. Bereavement Group Conversations What do people really talk about during bereavement groups? Many different types of conversations take place. It is important for the bereavement group facilitator to be prepared for a wide range of emotions and interactions. Revisiting the Death Group members will want to revisit the death of their loved one and exactly how it happened. Some members will want to repeatedly go over the experience in painstaking detail. Sometimes this is to fully experience the pain of the loss; other times it is because the person feels guilt or uncertainty about how the situation was handled. For example, if a decision was made to not resuscitate the person who died, the survivor may question whether the right decision was made. Feeling the Loss Group members will want to talk about how much they miss their loved ones. This involves describing small details about how the deceased looked, talked, walked, or held a wine glass a certain way. Minutiae become very prominent when a person is grieving a loved one. The smallest incident – finding a dish put away in the wrong place and knowing that the deceased had done it before the accident – can spur on a whole stream of emotions and memories that the survivor will want to express. Some group members will admit that they still “talk” to their loved ones whom they have lost and will ask if this is normal. It is the job of the bereavement group facilitator to ask other group members to give reassurance that this is in fact a part of the bereavement process. The facilitator can supplement group members’ comments with research or handouts about what is a normal grief reaction. Getting Along Day-to-Day Many people who have lost a loved one find themselves confronted with daily challenges that were previously handled by the deceased. Home repairs, mowing, cleaning, cooking, paying bills, car repairs, and laundry are just a few of the activities that the survivor may now have to master. Being forced to learn new skills can create despair, depression, or anger in the survivor. Group members will want to express these feelings as well as seek advice from other members about how to accomplish these tasks. Dealing with Relatives and Friends Unfortunately, family members and friends are not always the best sources of support for survivors. Many do not know how to handle their own grief and are uncomfortable when a survivor (e.g., a widow, widower, or adult child of the deceased) wants to discuss emotional issues. Group members may feel that the bereavement group is the only place where they can truly be themselves in regard to their grief. Some will need to voice frustrations about their family and social relationships. They may recount stories of people saying insensitive things to them. All will want to share how the loss has affected their relationships and will seek advice about how to restore or strengthen these ties.



Moving On As group members work through their grief, they will begin to feel more like their “old selves” again. Eventually, they will feel ready to move on with their lives, having integrated the bereavement process into their life experience as a whole. Moving on can be frightening as well as exciting. Group members will ask for reassurance that it is indeed okay to never forget, but to still move forward and start experiencing joy again. Bereavement Group Topics Bereavement groups that focus on education and/or emotional support often cover a distinct topic at each meeting. There is no rule about what topics should be covered or in what order they should be addressed. Many times, bereavement group members will provide suggestions for topics; these ideas should be welcomed as valuable input. Below are some key categories and a list of possible topics for bereavement group meetings. For more ideas as well as supplementary educational materials, see the Resource List at the end of this course.

Understanding the Grief Process

• Introduction to Bereavement • The Emotional Side of Grief • The Physical Side of Grief • Recognizing Depression • Giving Yourself Time to Grieve • The Dangers of Avoiding Grief • Unfinished Business

Coping with Feelings

• Dealing with Anger • Dealing with Guilt • Dealing with Fear • Dealing with the Reactions of Others • Grief Rituals • Keeping a Grief Journal • The Power of Music

Self-Care

• Caring for Yourself: Nutrition • Caring for Yourself: Sleep • Caring for Yourself: Exercise • Humor: Learning to Laugh Again • Relaxation Techniques • Spirituality and Grief

Relationships and Dealing with Others

• Anniversaries and Holidays • Helping Children with Grief • Maintaining Your Social Connections • Redefining Family and Friends

Moving On

• Adjusting to a New Life • Choosing Your Own Path • Putting the Loss in Perspective • Redefining Yourself • Returning to Old Hobbies • Volunteering as a Way to Heal • Searching for Meaning



Learning Activity: Read and answer these reflective questions. The answers are for your own personal reflection and benefit.

1. Depending on his or her personal experience with loss, facilitators can also find bereavement group topics to be emotionally charged. Look back over the topic list and circle any that seem emotionally charged for you. Make a note of your experience with that topic. Ask yourself if you could be sufficiently detached from your own experience to present or facilitate that topic. If not, that topic might best be delivered by another presenter or facilitated by a co-facilitator.

2. Many times we have topic experts within our own workplace or another community-based agency. Next to the

education topics listed previously, jot down names of people or organizations you might contact to provide a speaker or educational materials for a group.

Topic Summary: Bereavement groups typically talk about the common experiences of their members: revisiting the loved one’s death; feeling the loss and missing the loved one; adjusting to new responsibilities; coping with the reaction of family and friends, and; preparing for a life without the loved one. When your group focuses either on education or support, you will want to be responsive to the needs of the members by preparing short educational programs. Some recommended areas for presentations or written materials are: Grief process; Coping with feelings; Self-care; Relationships; and Moving on. Topic 3: Group Formats and Dynamics Topic Introduction: Now that we have considered some of the practical aspects and topics of bereavement groups, we begin to explore how the group format influences the way groups function and evolve. Then we look at what happens to members as they interact with each other. From this topic, you’ll be able to describe an ideal group meeting format and the dynamics of the bereavement group over time. What Is the Format of a Bereavement Group Meeting? Regardless of the focus of your bereavement group, it is important to follow a format that the members can come to expect. Consistency and stability will allow the members to relax and open up to each other. Here is a typical bereavement group meeting format: Pre-Meeting Social Time; Welcome/Introductions; Discussions/Educational Program/Social Activity, Closing, and; Post-Meeting Social Time. Pre-Meeting Social Time Make sure the meeting room is set up at least a half-hour in advance so members can arrive early and socialize. If you plan to serve refreshments, make sure the coffee is brewed and the snacks are out so members can enjoy this as they catch up with one another. Welcome and Introductions Start by welcoming everyone to the session. If you are facilitating an open group and there are new members, be sure to introduce yourself and explain your role as the facilitator (for more information, see Facilitator Role and Qualifications). Remind everyone that this is a bereavement group where sensitive issues may be discussed, and it is important to ensure that “what is said in the group, stays in the group” (see Ethical Principles of Bereavement Groups). Give new members an opportunity to introduce themselves.



Discussion/Educational Program/Social Activity If your bereavement group is focused on emotional support, allow members to take turns sharing their thoughts, concerns, and questions. Another option is to have each member check in briefly; citing subjects they would like to discuss, and then facilitate a discussion of the issues mentioned. If your bereavement group has an educational focus, proceed with the video, guest speaker, or review of reading materials. Be sure to allow time for members to ask questions and discuss the topic presented. If your bereavement group is primarily a social gathering, continue with the social activity, being sure to monitor the emotional undertones of the activity and facilitate discussion as necessary. Closing Finish by (a) thanking everyone for attending and (b) summarizing what was learned or accomplished during the meeting. This is also the time to make any announcements about your organization or about the next meeting. Post-Meeting Social Time Members will want to linger for a bit after the meeting to socialize again and perhaps make plans to meet together before the next session. Make sure that refreshments are replenished for this post-meeting social time. Three Phases of a Bereavement Group Bereavement groups develop and change over time. As group members get to know each other, the interactions between them will become more genuine and real growth can occur. As a facilitator, it is important to monitor the general progress of the group and point out where positive changes have occurred. Bereavement groups generally move through three phases: Building Cohesion; Therapeutic Change, and Looking Ahead.

1. Building Cohesion - This is the first phase of a bereavement group when members are becoming acquainted with each other and with the whole idea of being in a group. Some members might be unsure whether they really want to participate. Others might be anxious for the group to start tackling difficult issues right away. The key characteristic of this first phase is that members are forging connections with each other and building cohesion as a group of people who have each suffered a very difficult loss. This common bond fuels the energy of the group and moves it forward to the next phase.

2. Therapeutic Change - The middle phase of a bereavement group is when therapeutic change takes

place. Group members are comfortable with each other and invested in getting something out of their participation. Whether the focus of the group is emotional support, education, social interaction, or a combination of these, group members find themselves sharing their feelings about their loss, learning from others about how to cope, and experiencing a cathartic release from the pain surrounding their grief. When members begin to feel more oriented towards the future, the group has moved into the final phase.

3. Looking Ahead - In the final phase of a bereavement group, members come to the realization that they

will be able to move on with their lives without those whom they have lost. Although there will still be difficult times, they feel well-equipped with coping skills and a strong support network. Group members help one another realize the progress each has made during the course of the group. It is crucial for the facilitator to help group members develop personal plans to ensure their emotional and social needs will be met when they are no longer attending the bereavement group.



If your bereavement group is a closed, time-limited group, it is more likely that group members will progress through the phases together. On the other hand, if your bereavement group is an open, ongoing group, members will move through the phases in a more individual fashion. Either way, it is helpful for facilitators to be aware of the phases so they can gauge the status of the group as well as the progress of each group member. Mini-Quiz: 1. Which of these is NOT part of an ideal meeting format?

a. Closing or summary b. Community referrals

c. Pre-meeting social time d. Welcome/introductions

2. When group members begin talking about their personal plans for the coming year, they are in which dynamic

phase? a. Building cohesion b. Looking ahead

c. Practical considerations d. Therapeutic change

Answers to Mini-Quiz: 1. b, 2. b, Topic Summary: Regardless of the focus of your group, a consistent format provides members with emotional stability. Plan to have Pre and Post-Meeting times so that members can connect with each other outside the group. Remember to start each meeting with a welcome and close each meeting with a summary. Structuring your meetings provides a solid foundation that helps members make the journey from building cohesion, through therapeutic change, to looking ahead and planning their new lives. By understanding these group dynamics, you will be better able to nurture the group along its path and to resolve any challenging situations that arise. Topic 4: Facilitator Role and Qualifications Topic Introduction: At this point you are knowledgeable about the focus, logistics and topics of bereavement groups. You realize that structure is important and that groups move dynamically over time. You may be wondering, what is the role of the facilitator in all this? Whether you or someone on your team is facilitating the group, this topic prepares you to define the role and necessary qualifications of a bereavement group facilitator. Role of the Bereavement Group Facilitator

Bacal (2003) defines a facilitator as an “individual whose job is to help to manage the process [my emphasis] of information exchange.” Though you may decide to present educational material as a part of your group’s meeting, your purpose in doing so is not to teach or ensure that the members master this content. Rather you offer the content as a method to focus the group’s attention on an aspect of bereavement. The group will naturally regard you as source of knowledge about the bereavement

process. It’s your job as facilitator to recognize that group members are their own best experts on their own unique bereavement experiences. Encourage members to talk about their grief to promote self-understanding. Facilitate and steer discussions to best meet the needs of the group members. One way to encourage open participation and sharing of experiences is to create a safe, confidential atmosphere where group members feel welcome to share their thoughts and feelings. Some specific techniques to encourage sharing are outlined in the next section, Identifying Solutions to Common Challenges.



Your process-oriented role means you will listen to members more than react to group members. In doing so, you’ll promote a non-judgmental atmosphere characterized by acceptance and respect for all group members. Bear in mind that your ultimate purpose is to support members in their journey towards life without those whom they have lost. Finally, you must be able to recognize when a member requires more assistance than can be offered in a group setting and make outside referrals when appropriate. Qualifications of a Bereavement Group Facilitator Now that you’ve read about the role of a facilitator, you might be wondering if you or someone on your team has the qualifications to be one. Use this list of qualifications as a guide to help you recognize a facilitator’s strengths, and areas for development. Communication skills

• A good listener who can really hear what group members are trying to express through body language as well as words

• Has the ability to summarize group themes and articulate ideas and concepts • Rather than providing all of the answers and information, aspires to help group members learn from each other • Informs without lecturing

Emotional transparency

• Is emotionally present • Is modest and genuine in his or her desire to help others • Demonstrates a non-judgmental attitude • Is able to integrate humor into the bereavement groups at appropriate times • Shows compassion and a caring attitude • Is empathic (i.e., strive to deeply grasp the subjective world of each group member)

Knowledgeable

• Is knowledgeable about the bereavement process • Is Aware of community resources that could be helpful to group members who need additional assistance • Is open to feedback about how to improve the bereavement group

Culturally aware

• Shows sensitivity to the cultural values and beliefs represented by group members Co-Facilitators While many bereavement groups are led by one facilitator, it is not uncommon for two co-facilitators to share the responsibilities. There are several advantages to having co-facilitators:

• In the event that one co-facilitator cannot attend a meeting, the session does not need to be cancelled because the other co-facilitator can still attend.

• If a group member becomes upset and leaves the room, one co-facilitator can assist the person while the other

co-facilitator continues to conduct the meeting.



• Co-facilitators can focus on different aspects of the bereavement group (e.g., one can attend to group process while the other provides educational information when appropriate).

• Co-facilitators can seek feedback from each other, process each meeting as a team,

and share the responsibilities of preparing for sessions. If you choose to have co-facilitators for your bereavement group, be sure that they are compatible and that they each meet the qualifications of a bereavement group facilitator. Co-facilitators who are not compatible might have difficulty sharing group leadership, which will ultimately undermine the success of your bereavement group. Topic Summary: The primary role of a bereavement group facilitator is to manage the group process in such a way that members have the opportunity to heal. Though group members will naturally regard the facilitator as an expert on the subject, the facilitator must remember that each member is his own best expert on how to recover and move on. To perform the role successfully, facilitators need to possess good communication skills, be emotionally available and transparent, be knowledgeable about the bereavement process, and have sensitivity to cultural and ethnic differences. When starting a group, weigh the advantages and disadvantages of co-facilitators. Co-facilitation provides more resources for handling group dynamics and members in crisis. On the other hand, co-facilitators must be compatible in their facilitation approach and style, and each meets the qualifications for a good facilitator. Topic 5: Identifying Solutions to Common Challenges Topic Introduction: Good listening and communication skills are critical to a facilitator’s success with a group. While there may be meetings where everything runs smoothly and the facilitator feels little need to intervene in the discussion, there will surely be other more challenging times when members disagree, and the discussion becomes heated. Or the opposite challenge may occur; the discussion loses steam and no one contributes. This topic will help you identify common group process and group dynamic challenges and their solutions. Group Process: Challenges & Solutions Group process refers to the way a group develops over time as a result of the verbal and nonverbal interactions that take place among group members. A bereavement group might flow smoothly or experience bumps and interruptions depending on group process. The bereavement group facilitator guides the discussion in such a way that the group is more likely to move forward. It takes practice and skill to shape a bereavement group discussion in such a way that group process is enhanced while group members are still ensured the flexibility to share whatever is on their mind. Here are some common challenges that can occur during group process and some suggested solutions: The Discussion Is Stagnant When very few members are contributing to the session, try opening up the discussion by asking:

• “What do others think about (Mary’s) situation?” • “Has anyone else in the group had a similar experience? Please share.” • “I’m not familiar with the research on this particular grief reaction. Does anyone else have information to share

that could help (Mary) understand her experience?”



The Discussion Is Losing Focus If the discussion gets off track or is splintering into several issues at once, try refocusing the discussion by saying:

• “Let’s take a moment to consider where we are now in relation to the topic we were discussing.” • “Would it be helpful for me to summarize what has been said so far about dealing with anger and the ideas

you’ve proposed for managing this feeling?” • “These other issues are interesting, but it might be best to reserve a future session to discuss them in more

detail. Let’s get back to the main issue we were discussing today.” The Group Members Are Disagreeing Sometimes group members will disagree on an issue that they are very passionate about, and the disagreement is preventing the group from moving forward. Try making these points:

• “I know there are differing opinions about whether and how soon a widow or widower should pursue another relationship – but remember that there are no rights or wrongs in this group. Let’s remember to respect each person’s feelings and opinions.”

• “Even though we seem to be at an impasse on this issue, let me point out a few ideas that I’ve noticed everyone seems to agree upon.”

• “Do we have to come to an agreement on this issue? Or can we look at this as an opportunity to learn from each other about different ways that people use grief rituals to facilitate healing?”

Group Dynamics: Challenges & Solutions Group dynamics refer to the influence of group members’ personalities and experiences on how members interact and relate to each other. Unless you design a specific bereavement group for those who have lost a spouse, those who have lost a child, those who have lost a sibling, etc., the bereavement experiences of group members could vary greatly. Even in more specifically-focused bereavement groups, there are almost always differences in personality that will affect group dynamics. Below are some of the challenges that can occur and possible solutions: A Group Member Is Unusually Withdrawn If a group member is extremely reluctant to speak, it may be a sign of shyness, unease, or depression. Perhaps the group member has not been able to express his or her grief to any friends or relatives and is doubtful whether the group will help.

• Try implementing an ice breaker that invokes participation from all group members so the withdrawn member doesn’t feel singled out.

• Break the bereavement group into small groups of two or three people and have them introduce themselves or discuss a manageable topic (e.g., how they found out about the group).

• Refer to the group member’s previous comments as they relate to the current topic of discussion.

• Be sure to reinforce the group member with positive feedback when he or she does participate.



A Group Member Is Dominating the Discussion Sometimes a group member will continually bring the conversation back to his or her own situation, even when the member has received adequate attention during the session. The group member is usually a poor listener and often interrupts other group members. He or she might deviate from the topic being discussed and raise irrelevant issues.

• Gently explain that there is not enough time to address the group member’s concerns during the current session, but offer to integrate key concerns into future meetings.

• Redirect the group member’s remarks back to the original topic by finding a connection between his or her comments and the original topic.

• Offer to talk with the group member one-on-one after the meeting. • Call on other group members to get them involved in the discussion again. • Acknowledge the value of what the group member is saying but indicate that the group must move on now.

A Group Member Is Hostile If a group member is overly argumentative, hostile, or negative, it could be a personality trait, a sign of depression or an indication that the member is having a particularly difficult time confronting his or her grief. A member like this needs to be treated with compassion while the facilitator tries to minimize the effect of the hostility on others.

• Give the group member some time to express his or her anger, then ask for feedback from other members (e.g., “Has anyone else felt incredibly angry toward others since your loss? How have you handled your anger?”)

• Try to reframe the group member’s situation, asking for input from other group members. • Although the group member’s hostility may scare or upset you, avoid sounding defensive or frightened –

maintain your composure and empathy. • Make sure that other group members do not side against the hostile member. Instead, elicit their help. • Try to refocus the group member’s attention to another issue related to that session’s topic.

A Group Member Offers Opinions as Facts Some group members think that they have an answer for every question and that they are always right. They often try to assert their opinions as if they were facts. This may confuse other group members as to what information about bereavement is really correct. It can also make members feel self-conscious or that they lack adequate knowledge about the bereavement process.

• Listen to the group member’s opinions but also ask for others to state their views so a variety of perspectives are heard.

• Summarize all of the opinions that have been shared and emphasize the value of diversity among group members.

• If the group member states something that is blatantly incorrect (e.g., a statistic about depression or a recommendation that everyone should be over their grief in six weeks), gently explain that the research on bereavement suggests something different. Offer to bring in educational materials to the next session that address any obvious discrepancies.

• Try saying, “It sounds like that strategy worked really well for you, but it may not work for everyone. Remember that the bereavement process is highly individual. Can anyone give an example of another strategy that has worked for them?”



A Group Member Is in Crisis It is normal for tears to be shed during bereavement groups. However, some group members may cry uncontrollably throughout the session. They might become overwhelmed, frantic, or unable to speak because they are so upset. Some may have attended the bereavement group because they need immediate assistance.

• Allow the group member to express his or her feelings. • Use empathy. Try to understand the group member’s

experience. • Stay calm and speak slowly – becoming anxious will only

escalate the group member’s emotional state. • Try to guide the group member in a deep breathing exercise to help the person calm down. • Identify the issue that is upsetting the group member and attempt to help the member engage in problem

solving. • Encourage other group members to offer support. • Ask how other group members have dealt with similar emotional situations. Their responses should be framed

as suggestions, but not forced upon the group member as advice. Determine if the group member is having a “complicated grief reaction.” If the group member meets these criteria, a referral should be made for individual psychotherapy:

o Broad changes to all of the person’s personal relationships o A sense of meaninglessness o A prolonged yearning or searching for the deceased o A sense of rupture in the person’s personal beliefs

Overall, the diversity of personalities and experiences among group members will serve to enhance the quality of the bereavement group. However, difficult situations can arise. It is always helpful when the bereavement group facilitator is cognizant of group members’ unique characteristics and tries to include them in an accepting way. Group members who need additional attention can be referred to other community resources, such as hotlines, other group or individual services, or educational materials such as books and videos. Topic Summary: Facilitators faced with a stagnant discussion may ask the members to share their experiences. When the discussion is losing focus, the facilitator may bring it back by drawing the group’s attention to how it veered off course. When group members disagree, the facilitator may point out areas of commonality, or just help members agree to disagree. A reluctant group member can be drawn into the discussion through an icebreaker or small group activity. Remember to reinforce that participation. A member who dominates the discussion may be reigned in by acknowledging her contribution and simultaneously turning the group’s attention back to the topic. The facilitator may call on another member, or explain that the group must move on in the interest of time. Enlist the help of the group in understanding a hostile group member, taking care that they don’t take sides against the hostile member. Then refocus the group’s attention on another matter. When members offer opinions as facts, offer to provide research-based information if the group is interested. Or, ask the members if someone has a different experience or opinion. Finally, use the experience of a member in emotional crisis as an opportunity to teach calming skills to the group. Help that member identify the issue and request group support for strategies. If it appears that this member is having a complicated grief reaction, privately refer that member for outside assistance.



Topic 6: Ethical Considerations Topic Introduction: While you are facilitating the group, taking care to both to manage the process and respond to the dynamics, you also need observe certain ethical principles. These principles are generally accepted by professionals who work with therapeutic groups as providing an important framework for conducting groups. After completing this topic, you should be able to explain the ethical principles of bereavement groups. Ethical Principles of Bereavement Groups It is essential that bereavement group facilitators embrace and act upon the following ethical principles: Dignity & Worth: Each group member has dignity and worth as a human being and as a person who has suffered a major loss. Even when members express divergent beliefs about death and dying, or have very different loss experiences, the facilitator should encourage mutual respect and tolerance within the group. Confidentiality: What is shared in a bereavement group is private and should not be divulged except for the purpose of record-keeping within an agency. The only exception to this principle is if a group member expresses intent to harm himself/herself or others. Social Justice: The bereavement group should exhibit non-discriminatory practices and allow equal access to the group. All members regardless of age, sex, race, origin, sexual preference, etc. must feel welcome. Further, the facilitator should encourage non-discrimination based on religious and cultural beliefs so relevant to death and dying. Mutual Responsibility: The work that occurs in bereavement groups is a function of interdependence among group members. Each member is valued as an important contributor. The facilitator should foster an atmosphere where members believe they each have something to gain from listening to, and understanding the others. Cultural Sensitivity: A variety of cultural values, beliefs, and practices may be represented in a bereavement group. This diversity is welcomed; the bereavement group facilitator should practice sensitivity and openness to the different cultures represented. Empowerment: Group members have the potential to take charge of their own bereavement process and guide their own growth and healing. The facilitator should model respect for each individual to chart his or her own unique path to a new life. Self-Determination: Group members have the right to join or leave a bereavement group whenever they choose, and their input on group logistics, format, and topics is encouraged. Professional Competence: Bereavement group facilitators should possess the required knowledge and skills to lead a bereavement group. They also should strive to keep up-to-date on current bereavement knowledge and group strategies. Learning Activities: Read the following ethical situations. For each situation, answer the questions that follow. Ethical Situation A: A group member who lost her husband to cancer is furious at a doctor who she claims missed the diagnosis. She is certain that if this doctor had caught the cancer, her husband would still be alive today. She says, “No doctor like that deserves to live. I wish the worst for him. If I saw him now I would strangle him.”



The other group members become very uncomfortable with the woman’s comments. Some of them scold her during the meeting for being so harsh. One person approaches you afterwards and asks if the police should be notified that the woman is homicidal. You hear two others on the way out the parking lot saying that they wish the woman would be asked to quit the group.

1. Which ethical principles pertain to this situation? How?

2. How would you respond to this situation, keeping in mind all relevant ethical principles? Instructor Answers:


Dignity & Worth: The woman’s comments seemed so unforgiving that the other group members started to forget that each of them has dignity and worth as a human being and as someone who has suffered a major loss. Confidentiality: Because the woman’s comments were so dramatic, group members may be tempted to tell others outside of the group about her remarks. It is also unknown whether the woman is actually a danger to this doctor or if she was simply speaking out of extreme emotionality and anger. Social Justice: Some group members want the woman to be kicked out of the group. However, bereavement groups should exhibit non-discriminatory practices and allow equal access to the meetings. Mutual Responsibility: The group members do not feel like the woman who made the remarks is a worthwhile contributor to the discussion. They may see her as a world apart from them and, therefore, the group does not share any feelings of mutual reliance.

2. How would you respond to this situation, keeping in mind all relevant ethical principles?

• Remind group members of the respect each person deserves, regardless of how much anger is inside the

person. • Try to determine – preferably through a one-on-one meeting with the woman – whether she intends to

cause harm. If she does, you have a responsibility to report the threat. • Reiterate the importance of maintaining confidentiality (i.e., “What’s said in the group stays in the group.”). • Review the principle of social justice so group members understand the inappropriateness of exclusion. • Remind group members that progress in a bereavement group is only possible through interdependence,

especially when things get difficult. All group members are important contributors. Ethical Situation B In one of your bereavement group meetings, the discussion is about spirituality and grief. It turns out that several group members believe in an afterlife, but two others are agnostic about the issue, stating that they do not know what happens after death and do not believe they can know the answer to that question in this life. The members who believe in an afterlife become very passionate about convincing the two agnostics to change their beliefs. They insist that the agnostics are wrong and that it will be much easier to cope with their losses if they believe in life after death. The two agnostics begin to feel defensive. Eventually, they grow resentful of the pressure put upon them and they consider leaving the meeting.





Instructor Answers:


Social Justice: The group members who believe in an afterlife are discriminating against the two people who differ in their belief system by pressuring them to change their minds and suggesting that their convictions are wrong. Mutual Responsibility: Reciprocal learning among group members is essential to the group’s success. In this case, the group members who believe in an afterlife feel they can teach something to the agnostics, but they do not feel they can learn anything from them. Cultural Sensitivity: A diverse range of beliefs and practices should be welcomed in bereavement groups because this leads to greater insight and progress. Unfortunately, in this case, the group members who form the majority are not being sensitive to the minority view. Empowerment: Instead of recognizing the potential of the agnostics to take charge of their own bereavement process, the other group members feel they know what is best for everyone. Self-Determination: Group members have the right to join or leave a group whenever they choose, but it would be unfortunate for the two agnostic group members to leave because they felt pressured into adopting a different belief system.


• Review the principle of social justice so group members understand the dangers of discrimination. • Emphasize that all group members are important contributors. Encourage each group member to try and

learn something from every other group member, even if there are disagreements about certain issues. • Model cultural sensitivity to the group by practicing openness to the different belief systems represented. • Reiterate the principle of empowerment so group members appreciate their right to guide their own growth

and healing. Point out that different individuals must determine for themselves the best way to work through grief.

• Encourage the two agnostic group members to continue attending the meetings, but acknowledge their right to leave whenever they wish. If they choose to leave, be sure to offer additional resources that are available in your community.

Topic Summary: There are eight important ethical principles to bear in mind when facilitating a bereavement group. The first seven have to do with the climate of the group and the interaction of its members. The facilitator should help the group uphold the dignity and worth of each member, encouraging tolerance of differences that promotes both social justice and cultural sensitivity. The facilitator should foster an atmosphere of mutual responsibility for the healing work of the group. At the same time, he should balance mutual responsibility with the empowerment of individual members to find their own right path, and the self-determination of members to stay, offer input on, or leave the group. The facilitator must ensure that all members respect the confidentiality of each member; otherwise members will be reluctant to share their most private thoughts and feelings. As a professional, the facilitator must use good judgment as to whether or when confidentiality is superseded by the need to protect someone. A bereavement group facilitator is responsible for maintaining her professional competence to lead the group ethically and effectively.



Topic 7: Planning and Sustaining Your Group Topic Introduction: Once you’ve determined the type of group you’ll have and you’ve identified a qualified facilitator, you’ll want to begin attracting members and maintaining their attendance. This topic will help you formulate a plan to promoting and sustaining your bereavement group. Promoting a Bereavement Group As you plan your bereavement group, be sure to develop some creative ways to promote it. Getting the word out about your new group is essential for its success. Start by asking the following questions:

• How many group members do I want to recruit? • If I get an overwhelming response, can I start an additional group, or will I need to start a waiting list? • How does the bereavement group fit into the overall vision of our agency or organization? • Who is the audience I am trying to reach? • Where in the community can the bereavement group be promoted? • Who can I contact to help me spread the word? • What are some informal ways that I can increase awareness of the bereavement group?

After you answer these questions, you will have a better idea of how to promote your group. Here are some strategies that have been successful in marketing and publicizing bereavement groups: If your agency or organization has a newsletter, put an announcement in every issue. Hold an open house at your agency or organization and announce your new bereavement group at the event. Make a flyer or brochure describing your bereavement group and distribute it to:

o Doctors’ offices o Hospitals o Churches o Long term care facilities o Home health agencies o Hospice agencies o Local chapters of health organizations o Libraries o Community centers o Retirement communities o Senior citizens centers o Mental health agencies o Area Agencies on Aging o Public bulletin boards

Attend community health fairs and distribute your flyer or brochure. Send a short press release to:

o Local newspapers o Local television stations o Local radio stations o Community newsletters and bulletins



It is important to develop a rapport with individuals and agencies that have your information. Visit them often and remind them of your bereavement group. You will find that over time, most of your referrals will be generated through “word of mouth.” If you maintain relationships with all of your publicity outlets, it will ensure a steady stream of bereavement group attendees. Screening New Members When potential group members contact you – or you receive referrals for potential members – it will be important to have a screening process in place. The process can be brief and simple, but it should include the following components:

• A concise description of the bereavement group, including day, time, location, and overall purpose of the group • An explanation of your role as the bereavement group facilitator • Time for the caller to ask questions about the group, to assess whether the group will meet the person’s needs • Referral suggestions to other groups or to individual services if you determine that the group will not be able to

meet the person’s needs Maintaining Attendance Once your bereavement group has begun, it will be important to encourage consistent attendance. The bereavement process can include feelings of lethargy, difficulty focusing, and temporary memory problems – all of which can result in missed meetings. Some ways to encourage group members to return include:

• Calling group members a few days before the next session • Developing a telephone tree so group members can make reminder calls to each

other • Sending a postcard the week before the next session

If you are having trouble maintaining attendance, ask yourself the following questions:

• Is my bereavement group held in the best possible location? If the location is difficult to find or if parking is a problem, this can discourage people from attending.

• Is my bereavement group held at the right day and time? For example, if members need to drive through rush hour in order to attend the group, this might be a deterrent. Also, consider how often your sessions are held. Weekly meetings might be too taxing, while meeting every other month is probably too infrequent to build any cohesion or momentum.

• Are there any group dynamics that could be a turn-off for group members (e.g., a hostile or dominant group member)?

• Are the chosen session topics appropriate for the group members? • If it is an open group, do newcomers feel welcome, or have “veteran” members formed a bond that is difficult

for new members to penetrate? In addition to asking yourself these questions, it is helpful to ask for feedback on these issues from those still attending the bereavement group. Their insights may lead you to solutions that will increase and maintain attendance. Learning Activity: Creating My Plan: Print the planning template on the next page to create a plan for a bereavement group at your place of work. Use this opportunity to discuss how a bereavement group fits into the values and philosophy of your organization.



Bereavement Group Planning Worksheet

Group Type Focus (check one as primary focus) ____ Emotional support ____ Education ____ Social opportunities Group Structure (check one) ____ Open ____ Closed Duration ____ Ongoing ____Time-limited (specify weeks ______________)

Logistics Projected Start Date ___________ Number of Members _______ (cutoff) Location __________________________________________ Day _______ Time _________ AM PM Meeting length _________ Emergency communication by (phone, e-mail, etc.): _________________

Possible Educational Topics & Speakers ___________________________________________________ ___________________________________________________ ___________________________________________________ ___________________________________________________

Promotion Plan (newsletter ad, flyers, agency contact, etc.) ___________________________________________________ ___________________________________________________ ___________________________________________________ ___________________________________________________

Screening Process Potential members will call (name) _________________________________________at (phone) _____________________ for initial questions. Refer to ________________________________________________ any members not suited to this group.

Attendance Plan (call before session, telephone tree, postcard, e-mail, etc.) ___________________________________________________ ___________________________________________________ ___________________________________________________



Topic Summary: A successful bereavement group requires advanced planning. In addition to making decisions about the type of group and the logistics, you need to consider how you will promote the group, screen the members and maintain their attendance. A successful promotion plan is built on careful consideration of how best to reach your target audience. Some strategies include newsletter articles, an open house, flyers and press releases. You will also want a method for screening new members into your group once they begin contacting you. Be sure you know other community resources so you can steer members somewhere else if you determine that you can’t help them. To maintain attendance, consider forms of contact between meetings such as phone calls or postcards. If you are reminding members and still experiencing poor attendance or dropouts, use that feedback to reexamine the nature and dynamics of the group and whether it is meeting the needs of the membership. Topic 8: Group Process & Dynamics Scenarios Topic Introduction: By now you have learned about the nature, dynamics and group process of bereavement groups. You have learned some basic facilitation techniques you’ll need to use to guide your group and keep it focused. Rather than present new information, this section invites you to apply your knowledge of facilitation to typical bereavement group challenges. Application Scenarios Read the following bereavement group scenarios. Each deals with an issue related to group process or group dynamics. As a bereavement group facilitator, imagine how you would handle each situation. Jot down a few ideas for each example before reading the recommendations. Scenario A

You come to the bereavement group ready to talk about the scheduled topic, “The Physical Side of Grief.” As you begin to describe various physical symptoms (e.g., sleeplessness, changes in appetite, heart palpitations), group members start to compare medical conditions. Before long, the group has lost its focus and is discussing the latest medications for hypertension and high cholesterol. How would you go about bringing the group back to the original topic?

Recommendations for Scenario A: The goal is to refocus the group on discussing the physical side of grief without discounting the group members’ medical concerns. This can be accomplished by tying their comments back to your list of physical manifestations of grief. For instance, you could say:

“It sounds like several of us have medical concerns that can make the physical side of grief even more complicated. For instance, Mary – you had high blood pressure before your husband died. Because heart palpitations can be a symptom of grief, but can also occur alongside high blood pressure, you need to pay extra attention to your condition. Now that we’ve shared some of our medical problems with each other, let’s take a moment to return to our discussion of the physical side of grief.”

Let’s take the scenario a little further. What if you try the comments above but the group members do not want to return to the original topic? Mary – the member with high blood pressure – says, “I like what we’re talking about now. I’m getting some good advice for my condition. Why do we have to go back to what you were talking about?” Others chime in and agree with Mary. How would you respond?



Again, it is important to acknowledge the group members’ thoughts and feelings rather than dismiss them. Refrain from scolding them for straying from the topic. Consider the focus of your bereavement group. Are you offering a group to primarily provide emotional support, education, social opportunities, or some combination of these? If the focus is on education, you have a responsibility to provide educational information about bereavement to the group members – this purpose was explained to them upon their entry into the group. You could remind them of this by saying:

“I understand that you have medical concerns that you’d like to talk about, but let’s remember the purpose of this group – to provide bereavement education that can help you work through the grief process. It’s important that we focus on that goal during these 90 minutes each week. However, we can explore the possibility of starting a second group that would mainly focus on social opportunities, so you can talk about other issues like your medical problems. How do people feel about that idea?”

On the other hand, if the focus of your bereavement group is on providing emotional support, you may want to consider whether it is worth sticking to the agenda, or whether the group members would benefit more from talking about the issues most salient to them in that moment. You could ask:

“Are you telling me that – just for today – you’d rather talk about some pressing medical problems instead of the topic I had prepared? This is your group, and I respect your feedback. Let’s remind ourselves what this group is about and then decide how we want to proceed.”

Finally, if the focus of your bereavement group is to provide social opportunities, it is more common to let the group members dictate the topics discussed at each meeting. It is not as crucial to stick to the original subject. Scenario B You are facilitating a bereavement group where group members have experienced different kinds of loss (e.g., loss of a child, loss of a spouse, loss of a parent, etc.). One group member has been dominating the discussion. A widower, the man is positive that his loss was the most painful of anyone in the group. No matter what is said, the man jumps in and exclaims, “You think that’s bad, listen to what happened to me…” You can tell that the other group members are getting frustrated. What would you do? Recommendations for Scenario B: The goal is to steer the discussion back to a place where all group members have a chance to share and contribute. However, the dominant group member is clearly in need of compassion and understanding. It would not help to scold or ignore him. Instead, you could say:

“Tom, I can tell that you have a lot to get off of your chest. Your story has real value to the group. However, we only have 90 minutes each month to meet, and I want to be sure all of the group members have a chance to share like you have. Why don’t we hear from some of the others in the group now?”

Let’s imagine that you say this but Tom doesn’t comply. He is quiet for a few minutes, but as soon as someone expresses feeling lonely, he interrupts the person and says, “You think you’re lonely? At least you have some family left. I don’t even have a dog. Let me tell you about lonely….” How would you respond?



You have several options: 1. You could offer to cover some of the themes Tom is talking about at future sessions with the agreement that he will

allow others time to express themselves. “Tom, why don’t I cover the topic of loneliness next month? If we can do that, I’d like you to let the other group members have a chance to speak today.”

2. You could link Tom’s comments back to the original topic and then show a video on the subject. “Thank you for

sharing that, Tom. Your story about how you courted your wife touches upon our topic today – Anniversaries and Holidays. This is a good time to show a short video on how to handle these events after we’ve lost someone close to us.”

3. You could offer to talk to Tom one-on-one after the meeting. Offer this only if you really have time to meet with him

when the session is over. “Tom, it sounds like what you need to say is beyond the scope of this meeting. Why don’t you and I meet separately after the session is over? Right now, let’s return to what Susan was saying.”

If you try all of these approaches and Tom continues to dominate the bereavement group meetings, he might need individual treatment. Consider referring him to a bereavement counselor or mental health practitioner. Scenario C You are facilitating an open, ongoing bereavement group. A new member attends who is visibly upset upon her arrival. She is not able to participate in the discussion because she starts sobbing each time she tries to speak. The other group members try to console her, but they end up feeling helpless. It’s difficult to continue with the planned discussion because she is so distraught. How would you handle the situation? Recommendations for Scenario C: The woman clearly is in crisis. The primary goal is to help her calm down and then – if possible – the secondary goal is to restore order to the meeting. It is important for you to stay calm and speak slowly in a comforting voice. As the bereavement group facilitator, the group members will be looking to you for guidance in how to respond to the person in crisis. Some will feel uncomfortable with the level of emotion in the room. If they see you becoming frantic, they could mirror that. The person in crisis will only become more upset if she senses that you feel out of control. You could say:

“I understand that you are very upset right now. We’re all here to help you. Let’s start by doing some deep breathing so it will be easier for you to speak.”

(Demonstrate deep breathing and have all of the group members participate.)

“Very good. Now, try to tell us what’s upsetting you. Take your time.” If you are the only bereavement group facilitator, you might need to abandon your topic for that session and simply focus on resolving the crisis. Allow the woman to express her feelings and describe the issue that has her in crisis. If it is a practical issue (e.g., she is in charge of selling her deceased mother’s house, has no idea how to go about getting started, and feels overwhelmed), have the group members help her engage in problem solving. You could say:

“Although everyone’s experience is different, it could be that someone else in the room has lived through something similar. Even though it won’t be exactly the same experience, it might help to hear how someone else got through it. Does anyone have some suggestions to offer Jane?”



If it is a more emotional issue or if the woman has difficulty articulating what is wrong, try to determine if she is having a complicated grief reaction (See “A Group Member is In Crisis”). If she meets the criteria, consider referring her to individual psychotherapy. If you have a co-facilitator, one of you can accompany the woman to a separate room while the other continues the bereavement group meeting. The co-facilitator who is with the woman can then attempt to calm her down, address any immediate problems, and determine whether the woman can rejoin the group or should be referred to individual services. The co-facilitator who is still with the group members should allow them to express their feelings about what just happened before shifting to the scheduled session topic. Topic Summary: In Scenario A we saw that the group veered off topic. The facilitator first acknowledged the member’s concerns and then redirected the group back to the topic. But the member pushed back. The facilitator then needed to consider the focus of the group—educational, emotional support, social—before deciding how to handle the member’s request to change topics. In Scenario B the facilitator needed to manage the participation of a member who was dominating the discussion, preventing others from full participation. The facilitator might acknowledge the member’s concerns while returning the discussion to the other member who had been speaking. Alternatively, the facilitator might link the member’s issues with the current or next topic was also considered. Finally, a facilitator might need to meet privately with a dominating member to determine whether this member needs more help than the group can provide. The impact of a new member joining an open group was illustrated by Scenario C. The facilitator, while remaining calm, needed to instruct the new member to breathe deeply in order for her to recover enough to speak. If there were only one facilitator, he or she would need to focus the group’s attention on helping the woman in crisis. If there were two facilitators, one could continue the earlier group agenda while they other works separately to help the new member. Resource List The following books and websites can help bereavement group facilitators keep current, generate ideas for session topics, and provide educational materials to use during bereavement group meetings. Kϋbler-Ross, E. (1969). On death and dying: What the dying have to teach doctors, nurses, clergy, and their own families.

New York: Simon & Schuster. Wolfelt, A. D. (2004). The understanding your grief support group guide: Starting and leading a bereavement support

group. Laguna Hills, CA: Companion Press. Association for Death Education and Counseling (www.adec.org): Well-respected association that offers a vast list of

publications, resources, and related websites. CareNotes (www.carenotes.com): Provides professionally-written booklets on dozens of bereavement topics for a

reasonable price. The Compassionate Friends (www.thecompassionatefriends.com): Largest grief organization in the United States

provides several brochures that can be accessed online, including some in Spanish. Grief, Loss, & Recovery (www.grieflossrecovery.com): Contains articles, poems, and memoirs about bereavement. Growth House, Inc. (www.growthhouse.org): Award-winning portal to articles, information and resources about death,

dying, grief, bereavement, hospice care, palliative care, and many related issues. Hospice Foundation of America (www.hospicefoundation.org): Includes articles and publications about grief and loss as

well as information about HFA’s annual “Living with Grief” Teleconference. Living with Loss Magazine (www.bereavementmag.com): Quarterly publication that also features online articles,

booklets, and audio-visual products.


http://www.adec.org/

http://www.carenotes.com/

http://www.thecompassionatefriends.com/

http://www.grieflossrecovery.com/

http://www.growthhouse.org/

http://www.hospicefoundation.org/

http://www.bereavementmag.com/


References Bacal, R. (2003) The role of the facilitator: Understanding what facilitators really do. The International Association of

Facilitators, retrieved 8-16-06 from http://www.iaf-world.org/i4a/pages/index.cfm?pageid=3291. Corey, G. (1991). Theory and practice of counseling and psychotherapy (4th ed.). Pacific Grove, CA: Brooks/Cole. Cutcliffe, J. R. (2004). The inspiration of hope in bereavement counseling. Philadelphia: Jessica Kingsley. Deits, B. (2004). Life after loss: A practical guide to renewing your life after experiencing major loss. Cambridge, MA:

Perseus Books. Fazio, S., Kennedy, K., Kirk, T., & Lennox, C. (1995). The support group manual. Chicago: Alzheimer’s Association. Hooyman, N., & Kiyak, H. A. (1999). Social gerontology: A multidisciplinary perspective (5th ed.). Boston: Allyn & Bacon. Kersting, K. (2004). A new approach to complicated grief. APA Monitor, 35 (10), 51. Knight, B. G. (1996). Psychotherapy with older adults (2nd ed.). Thousand Oaks, CA: Sage. Kurtz, L. F. (2004). Support and self-help groups. In C. D. Garvin, L. M. Gutiérrez, & M. J. Galinsky (Eds.), Handbook of

social work with groups (pp. 139-159). New York: Guilford Press. Munday, J. S. (2005). Overcoming grief: Joining and participating in bereavement support groups. Skokie, IL: ACTA

Publications. Northen, H. (2004). Ethics and values in group work. In C. D. Garvin, L. M. Gutiérrez, & M. J. Galinsky (Eds.), Handbook of

social work with groups (pp. 76-89). New York: Guilford Press. Rawson, P. (2005). Grappling with grief: A guide for the bereaved. New York: Karnac. Sutton, A. L., & Liechty, D. (2004). Clinical practice with groups in end-of-life care. In J. Berzoff & P. R. Silverman (Eds.),

Living with dying: A handbook for end-of-life healthcare practitioners (pp. 508-533). New York: Columbia University Press.

Wray, T. J. (2003). Surviving the death of a sibling: Living through grief when an adult brother or sister dies. New York: Three Rivers Press.

Author Biography Carrie L. Hill earned her Ph.D. in Counseling Psychology with a Minor in Gerontology from Indiana University – Bloomington in 2001. She has spent over 10 years working for agencies in the health, human service, and senior markets, including Caregivers Home Health in Woodstock, Illinois; the Center for Gerontology at Ball State University; Williamsburg Manor in Muncie, Indiana; the Life Management Institute in Anderson, Indiana; the Jefferson Center for Mental Health in Arvada, Colorado; the Indiana State Women’s Prison; the Indianapolis Veterans Center; the Buffalo VA Medical Center in New York; and the Alzheimer’s Association in St. George, Utah. Through these experiences Carrie has developed her skills as a writer of educational, training, informational, fundraising, and marketing materials for the health, human service, and senior markets. She is the Southern Representative to the Executive Board of the Utah Gerontological Society and serves as Editor of its newsletter. Carrie also has published over a dozen journal articles and book chapters on subjects related to gerontology, multicultural issues, and psychology. To learn more about her freelance writing business, Blooming Hill Writing Services, see http://home.earthlink.net/~carhill.


http://www.iaf-world.org/i4a/pages/index.cfm?pageid=3291

http://home.earthlink.net/~carhill

learning level: intermediate - pdresources · loss is a universal experience. we all have faced...

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