This guide to facilitating support groups offers bereavement caregivers practical strategies for creating and maintaining a productive environment for mourners. Logistical considerations such as setting up and publicizing a new group are discussed, as is the importance of prescreening new members. Tips for creating a set of ground rules are provided, and the pros and cons of creating structured and unstructured meetings are considered. Responding constructively to problems in the group is also discussed, with helpful, time-proven models provided for evaluating progress.
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The Understanding Your Grief
Support Group Guide Starting and Leading a Bereavement Support Group
By Alan D. Wolfelt
Center for Loss and Life TransitionCopyright © 2004 Alan D. Wolfelt, Ph.D.
All rights reserved.
How to Lead
Tasks, Qualities, and Skills of an Effective Leader
A support group leader serves the group by enabling members to achieve the purpose of the support group. That purpose is generally to create a safe place for people to do the work of mourning in a way that allows them to reconcile the loss and go on to find continued meaning in life and living. Sensitive, skilled leadership is often a vital link to a group's fulfillment of its goals.
Obviously, your specific support group may have varying purposes and goals that guide its existence. No matter the goals, however, the group leader's responsibilities remain largely the same. They are responsible for assisting the group in:
determining the group's purpose
outlining the group's structure and length
pre-screening potential members
clarifying expectations and assisting in the development of group ground rules
Now let's explore some of the specific tasks that are often a part of a bereavement support group leader's job description. Again, keep in mind that every group has its own unique requirements.
Articulating a guiding philosophy: Identifying the basic tenets (theoretical orientation) that guide your "way of being" and providing a rationale for any skills or techniques you make use of in group.
Planning and leading group meetings: Preparing for, organizing, and facilitating the group meetings.
Listening: To model and to be an effective listener, you must really hear and allow participants to "teach you" and each other what they are thinking and feeling.
Understanding and facilitating group process: Having knowledge of and being skilled in facilitating group process. (I cannot emphasize enough the importance of leaders getting some fundamental training, not only in the grief process, but also in group process.)
Modeling openness and caring: Providing a role model by being warm, caring, and empathetic and by consciously seeking ways to help the group achieve its purpose.
Remaining flexible: Having an awareness of the need to modify the group activities and skills to fit the unique needs of a specific group or a specific meeting.
Being responsive to conflicts and problems that evolve: Guiding the group through difficulties that may come up and responding appropriately to destructive behavior in the group.
Learning about effective group leadership roles: Participating in training opportunities that allow you to assess current skills and develop new ones.
Following up with members outside of the group: Some members will appreciate opportunities to talk individually, while others may need referral for a counseling relationship. It is also the group leader's responsibility to help members transfer learning in the group to daily life.
Evaluating group progress: Monitoring the group's capacity to achieve its purpose and make any changes to improve this process.
Let me emphasize how important your job description as a group leader is. It should outline your understanding of the specific responsibilities you have as a leader. If you don't have a job description, create one using the above information as a model. This will help you: 1) clarify the details of your role as a group leader; 2) help you get started in your new role; and 3) avoid unstated expectations. A "seat of the pants" orientation to group facilitation is dangerous and minimizes your responsibility as a leader. With appropriate preparation and training, your leadership role will be both satisfying and enjoyable.
Basic needs of grief support group members
Each member must understand the purpose of the group.
Each member must feel a sense of belonging and acceptance.
Each member must feel understood.
Each member must be aware of and respectful of the ground rules.
Each member must feel encouraged to be an active participant in the group (while respecting "quiet" members).
Each member must be able to see the face of other members (so arrange the seating appropriately).
Grief support group leader qualities
One of the foundations of good support group leadership is communication. To be helpful to your group members, you must communicate with them effectively and make them feel cared for.
We all have probably observed people whom we would call "natural helpers." Actually, the helping skills that seem so natural to them are more likely characteristics and qualities they have learned and developed over time. The most important quality is empathy, but there are others described below, as well. You, too, have the capacity to learn and make use of these helping qualities.
Empathy is the ability to perceive another's experience and then — this is the key — communicate that perception back to the person. As a support group leader, I listen to you, and though I cannot experience your experience, I begin to have a mental picture of the essence of what you are describing.
Perhaps the most vital part of this characteristic is the ability to convey accurate empathy. Empathetic responsiveness requires the ability to go beyond factual detail and to become involved in the other person's feeling world, but always with the "as if" quality of taking another's role without personally experiencing what the other person experiences. (If you actually experienced the same emotions as the person you are trying to help, you would be over-involved.) To have empathy for another person does not constitute the direct expression of one's own feelings, but rather focuses exclusively on the feelings expressed by another, thereby conveying an understanding of them.
You know that empathy has been communicated when your group members feel that you "understand." As you know, to say simply "I understand how you feel" is not enough. The response goes beyond the "I understand how you feel" level to the "You really are feeling a sense of loss" level. In other words, empathy is communicated both verbally and nonverbally by understanding the person at the emotional level.
Respect is your ability to communicate your belief that everyone has the inherent capacity and right to choose and make decisions. Respect requires a nonpossessive caring for and affirmation of another person, respecting another's right to be who and what they are. This quality involves a receptive attitude that embraces the other person's feelings, opinions and uniqueness — even those radically different from your own.
So, the dimension of respect is communicated when support group members feel they have been allowed to give input without being pressured and when their opinions have been considered important. Remembering what the person has said, demonstrating sensitivity and courtesy, and showing respect for the person's feelings and beliefs are the essences of communicating respect.
Warmth and Caring
The warm and caring support group leader cultivates a sense of personal closeness, as opposed to professional distance, with group members. Showing you are warm and caring is particularly helpful in the early phases of building a helping relationship. The dimension of warmth is communicated primarily nonverbally. It often has to do with posture, affect, facial expression, and other nonverbal cues.
Warmth is a very powerful dimension in the helping process. In fact, when a discrepancy exists between verbal and nonverbal behavior, people almost always believe the nonverbal. A person's nonverbal behavior seldom lies. Consequently, a person who has excellent verbal communication skills, but lacks "warm" nonverbal behavior, would more than likely be perceived by group members as not helpful, indifferent, cold, or uncaring.
Genuineness is the ability to present oneself sincerely. As a support group leader, this is your ability to be freely yourself — without phoniness, role playing, or defensiveness. It's when your outer words and behaviors match your inner feelings.
The dimension of genuineness involves disclosing how you really feel about an issue. One important caveat: try not to tell others how you feel too early because your opinion may interfere with their ability to open up and express their own unique and equally valid thoughts and feelings. Genuineness can be very helpful, but timing is important. You can earn the right to be genuine with others through first developing the relationship.
Grief support group leader skills
In addition to the innate and learned grief support group leader qualities described above, there are a number of skills for you to learn and practice if you are to be the most effective grief support group leader you can be. It is my bias that the skills or techniques that are most useful evolve out of the work of the members and are specific to the unique meeting. In other words, at any given meeting the members will "teach you" what skills will be needed.
Instead of using skills to "make something happen," use them to elaborate on what is already happening. Skills are means, not ends. In using skills, you always want to keep clearly in mind the primary purposes of your group. The use of specific skills should also be dependent on the population you are working with (support versus therapy group) and the unique personality of the individual group member (e.g., some members can tolerate or even seek confrontation while others cannot). Of course, cultural influences must also be respected whenever you use specific skills.
It's also very important that you find an experienced mentor to teach you these skills and provide you with supervision early on. Better yet, plan to attend a training on group process from an experienced group facilitator. This is just an introductory summary. You will need a mentor to help you develop these group skills over time.
As a responsible leader, you will need to work on not only the qualities and skills I've set forth in this chapter. You will also need to be sensitive to the need to consciously create conditions for mutual trust to grow within the group.
One important way is by facilitating the honoring of stories. It is through the personal experiences of the members that people do the "work of mourning," and, as they do the work, mutual empathy and trust naturally build over time. The more time you allow for sharing stories, the deeper the expression of feelings will be, and the more rapidly your group's trust, relationships, and sense of community will grow.
Naturally, as trust builds, members feel more comfortable expressing a multitude of thoughts and feelings. In the beginning, participants tend to express "safer" feelings, but as trust increases, they often share more vulnerable feelings such as fear, helplessness, and anger. Obviously, as participants take greater risks in expressing themselves and continue to experience compassion and empathy from other members as well as you, the leader, community grows.
Do remember that as you lead grief groups in "honoring stories," personal sharing may be difficult for some members. Effective leadership means never forcing participation but encouraging and supporting participation.
You also build trust by providing a "safe place" for the expression of grief (mourning). To create an atmosphere for authentic mourning, encourage and support group members when they respond in compassionate ways to one another. As the group members witness the support in action from you and fellow members, they will come to realize that this group is a place in which they can honestly express what is going on with their grief.
Model for participants that it is not their responsibility to solve each other's problems but instead to support one another as they encounter the wilderness of grief. As participants realize they can express their grief without others giving unsolicited advice, they are more likely to trust each other and the group process.
And finally, to maintain trust, don't hesitate to revisit group ground rules when necessary. This is particularly true when it comes to confidentiality. Sound leadership requires that you make sure that participants understand how important it is not to repeat to others what group members express in the group. Model it, revisit the ground rules form time to time, and emphasize the importance of it. Without confidentiality, you have no trust.
Support Group Red Flags
Indications that trust may be lacking in a grief support group
The following symptoms may indicate that your group members haven't built enough trust among each other to make the group effective:
A general unwillingness to contribute to the group.
Long-winded expressions by only a few members.
A tendency to focus on others instead of oneself.
A belief by some members that the group cannot help them.
Can you think of any other indications that trust is lacking?
Suggestions for leading discussion
As group leader, your role is to facilitate — which literally means to "make easier" — purposeful discussion about the grief journeys of group members. This is a task that will require some planning and forethought on your part. Consider the following suggestions:
Plan each session
Write down your goals and expectations for each group meeting. For example, your objective in the first session may simply be to get to know each other. How will you accomplish this? In addition to letting members tell their stories, you may plan one or two group activities. You might also use music and appropriate readings as prompts for group discussion.
Have a routine
Especially when they're feeling vulnerable, people like the comfort of a routine. You might, for example, open each session with a short reading that you or another member has brought. Try to start each meeting slowly; participants may need a few minutes to "prepare themselves" before they can confront their pain.
Remember you're leading
Allow yourself to be a contributing member of the group, especially if one reason you started the group was to help you heal. But don't forget your role and responsibilities as group leader, either.
Be sensitive to differences among members
As group leader, you are probably an outgoing person who feels comfortable sharing experiences in a group setting. Not all members will be so forthcoming, however. Don't force people to talk unless they're ready. On the other hand, you'll also need to be on the watch for the member who likes to talk and monopolizes the group's time.
A word of caution: there is a fine line between strong group leadership and strong-arming your group. While members will appreciate your nurturing leadership, they will not appreciate too tight a rein on the group's interaction. (Always keep in mind what I said about "companioning" in the Introduction to this text. You must try to be both a companion and a leader at once!) Sometimes that means letting the group dynamic dictate what will happen next. Other times your "gentle firmness" will be welcomed as you guide the group in discussion.
Defining your leadership style
What kind of leader are you? Are you gregarious? Aggressive? Passive? Leaders I have found most effective in bereavement support groups lead unobtrusively but firmly. That is, they are warm and responsive at the same time they make others feel comfortable that someone is "in charge."
Two of the most important qualities in an effective group leader are: 1) flexibility; and 2) the ability to share authority. Being flexible is important because some meetings — especially as the group evolves — will naturally flow without much direction from you. That means that sometimes your meeting plans, no matter how well conceived, should be tossed out the window if the group dynamic takes everyone in a different direction. A good leader is never rigid.
The ability and willingness to share your role as leader is also very important. As the group evolves, one or two members will probably step forward as unofficial co-leaders. Encourage them. That may mean letting someone else lead a particular discussion or choose a particular reading. More important, though, it means letting the group dynamic — not your meeting plan — dictate the flow of each session when that dynamic is healthy and healing. The trick, of course, is to intervene and redirect when the dynamic is not healthy.CHAPTER 2
From Start to Finish
The Support Group's Five Developmental Phases
Why is it important to understand that bereavement support groups go through developmental phases? Because knowledge of these phases allows you to both respect and nurture the natural unfolding of the group's development. For example, if you were to expect in-depth self-evaluation of all members at the first meeting, you would not be respecting the reality that this kind of sharing generally does not happen until group trust has been established over time.
Groups tend to develop in a cyclical manner. This means that bereavement needs such as "the telling of the story" tend to be met again and again but at progressively deeper levels of meaning. Of course, individual group members have a vital influence on the process of group development; therefore the outline that follows is very theoretical.
Phase One: Warm-up and establishing of group purpose and limits
In the beginning of a support group, you can anticipate some normal anxiety about the general uncertainty of "what will happen here." Group members may be questioning their capacity to tolerate their own and others' pain. So, be aware that many group members will attend with a certain amount of hesitancy and some questions about whether or not they should even be here.
Excerpted from The Understanding Your Grief by Alan D. Wolfelt. Copyright © 2004 Alan D. Wolfelt, Ph.D.. Excerpted by permission of Center for Loss and Life Transition.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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Table of Contents
ContentsAlso by Alan Wolfelt,
Introduction - In Gratitude to the Grief Support Group Facilitator,
Growing Through Grief - The Role of Support Groups,
Getting Started - The Nuts and Bolts,
How to Lead - Tasks, Qualities, and Skills of an Effective Leader,
From Start to Finish - The Support Group's Five Developmental Phases,
Planning Your Meetings - The Understanding Your Grief Model,
When Things Are Not Going Well - Responding to Problem Members,
The Six Needs of Mourning - Evaluating your group's progress,
Putting Yourself First - Caring for the Caregiver,
A Self-Care Manifesto for Bereavement Caregivers,
A Final Word,
Select Reading List,
ALSO BY ALAN WOLFELT,