1. The Power Of Groups in Bereavement
Good Grief:
The Power Of Groups in Bereavement

2. Objectives
Losing a loved one can be one of the most difficult trials a person can face. It’s a trial no one should have to face alone. Discover the power of group work in the bereavement process in this workshop as we explore the following objectives:
Identify appropriate and inappropriate helping behaviors individuals use when experiencing grief.
Describe the relationship between personal attitudes and experiences and one's effectiveness in recovering from the loss of a loved one, and
Describe the characteristics of complicated grieving processes.

3. Bereavement and Grief
Most in society use these terms interchangeably, but they have different meanings:
Bereavement is the state or fact of being bereaved or deprived of something or someone (Merriam-Webster Online, 2011). whereas, Grief is deep and poignant distress caused by or as if by bereavement (Merriam-Webster Online, 2017)
So then, bereavement is just the state of losing a loved one, and grief is the distress caused by that loss, and why a bereavement group like GriefShare is good to help those who are recovering from loss to move from “mourning to joy” (GriefShare, 2011), since those who come to GriefShare groups are “all in the same boat” of having lost a loved one, and through mutual aid, are able to recover in a good way (Shulman, 2012, pp ).

4. The Group
“GriefShare : Your Journey from Mourning to Joy” is a product of Church Initiative, in Wake Forest, NC, and is marketed to churches and religious groups.
It is a network of recovery support groups that meet all around the world. It helps individual and families who voluntarily come to walk through the journey of grief together to heal, re-establish hope, and move onto God’s continued purpose for them (GriefShare, 1011).
The format is 13 sessions of 1.5 hours of a video, group discussion, and 5 weekly Biblical devotions to reflect on between group sessions (GriefShare, 2011).
The group discussion takes the principles and skills of group work, and process from this group time this will be the focus of this presentation.

5. GriefShare at Northside Assembly of God
GriefShare has been offered consistently since 2012 at Northside Assembly, in response to many losses in church family. In 2014, we also began to offer this bereavement group to community members, who may see the sign on the church corner, or who find our church on GriefShare’s website.
Groups of no more than 4-6 are open for first 2-3 sessions, and then closed for rest of 13-week cycle.
Groups meets in Pastor’s office, away from other concurrent activities, and has a sofa, and comfortable chairs.

6. Appropriate and Inappropriate Responses To Grief
Grief is a universal occurrence; yet, everyone experiences it differently, and it’s course is also different for everyone (Kubler-Ross, 1997; Wilson, MacLeod and Houttekier, 2016).
The intensity of the grief response may be related to the quality and length of the relationship, the tremendous gap felt since that loss, and the length and intensity of the grief response (Howarth, 2011; Wilson , MacLeod and Houttekier, 2016).
As there is no manual for how to heal from grief, knowing appropriate and inappropriate responses are often missed, or not addressed (Altmaier, 2011).
Appropriate responses include expressing grief, being comforted and encouraged by supports, and talking about emotions. Inappropriate responses include isolating, avoiding supports, medicating against the pain of grief, and developing depression or other mental health conditions ( Altmaier, 2011; Knight and Gitterman, 2013; Howarth, 2011)

7. Beginning Phase of Group
Shulman (2012) discuss the stages of group, which are beginning, middle, and ending/transition, and generally what happens during each stage.
In beginning stages, members may be hesitant to come meet other strangers, and are careful to speak only about “surface” issues, until they risk to share more intimate information.
The first four session of GriefShare focus on each person’s unique grief experience (GriefShare, 2012):
Session 1: Is this Normal?
Session 2: Challenges of Grief
Session 3: The Journey of Grief- Part One
Session 4: the Journey of Grief – Part Two

8. Beginning Phase of Group
These four “strangers came together, each with his or her own grief, and tentative and guarded against taking on anyone else’s.
The focus of each is on the leader. They all have likely been in groups before, but the topic of this group causes anxiety. How the leader clarifies function, provides direction, reaches for feedback, begins to link members together, and provides genuine caring will determine if group members will return or not (Shulman, 2012).
Group members are also watching each other. They will be hesitant to share, even with structured questions at the end of the video.
The leader providing a listing of her contact information, as well as everyone else’s, serves to orient each member that this work will be done together, as a group.

9. Practice examples
Jack was referred to GriefShare when his acute grief symptoms did not improve after 8 months since the loss of his wife, and his prayer partners suggested he come.
Jane’s family became concerned, and looked for help for Jane when she refused to answer phones, visit or contact them for days and months after the loss of her husband.
After being married for 55 years, with no children during the marriage, Ruth came to group because she said she was driving herself crazy with the silence she felt in her soul.
Abi came after her mom, with whom she was very close, died. She had a friend in the group, and came to check it out, and stayed after the first session she attended.

10. The Relationship between Personal Attitudes and Experiences and One's Effectiveness in Recovering from Grief
The intensity of the grief response by surviving family members and friends may be influenced by whether the death or dying process of the loved one was high quality, or “good,” which related to members’ perception and past experiences of what constitutes “good” (Wilson, MacLeod and Houttekier, (2016)
Long periods of caregiving, or family member being in ICU for extended periods may lead to more distresses among family members after the loss (Wilson et al. 2016).
The stigma of seeking mental health services, even from grief, may cause some groups to refuse to consider groups or other services (Corrigan, Druss and Perlick, 2014).

11. Middle Phase of Group
During this stage, as members begin to affiliate more, it is important for the leader to use containment skills, as well as elaborating skills to ensure that members stay on topic (Shulman, 2012).
The next five session of GriefShare focus on assisting members in identifying feelings that have previously prevented them from giving and receiving mutual aid, which is a hallmark in groups (GriefShare, 2012; Shulman, 2012):
Session 5: Grief and your Relationships
Session 6: Why?
Session 7: Guilt and Anger
Session 8: Complicating Factors
Session 9: Stuck

12. Middle Phase of Group
Other skills used by the facilitator are empathic skills and focused listening to assist clients in telling their story, and moving from the general to the specific (Shulman, 2012). Focused listening helps to identify process over content, and when it is appropriate to stop and allow, or to move on (Howarth, 2011).
It is also important to support members as they share “taboo” areas, as doing so is a true sign of work being accomplished (Altmaier, 2011; Knight & Gitterman, 2013).
Demand for work skills, such as partializing member concerns, holding members to focus, challenging the illusion of work, and pointing out obstacles are used in this middle phase of the group (Shulman, 2012).

13. Practice Examples
As members begin to affiliate more, mutual aid develops, and more trust develops. Members share more, and real work begins (Shulman, 2012).
One member risked to share that what she missed most were the tender touches of her husband in bed late at night. Other widows in the group agreed, and this caused more trust within and without the group.
Two widows from one group began to meet for dinner during the middle of the 13 sessions. They developed a friendship, and then added another GriefShare member. They said that they had grown to support and encourage each other outside of the group, as well as within.
Another member shared how unfair it felt that after working so hard together in their own business, only to find out 5 months into retirement that his wife had ovarian cancer, and she was gone within 4 months of that. The others in the group teared up and encouraged this member, which also increased the mutual aid within the group.

14. Ending Phase of Group
During Endings/transition, members are encouraged to consider what is next in their own journeys (Shulman, 2012).
The 13th session of GriefShare asks members to risk to identify “next steps,” and liken it to God’s purpose that His plan continues for the survivor (GriefShare, 2011). This session is followed the next week by a shared meal, where members share their next steps.
Two members who had cycled through GriefShare twice, both widows, now facilitate GriefShare for other widows in the community.
One widow and widower who both completed GriefShare three years ago, are now a very sweet couple at church.

15. Complicated Grieving Processes and how They Impact the Grief Response
Complicated grief is described as grief that goes unaddressed with interruptions in functioning for at least 12 months after the loss, and includes persistent yearning for and preoccupation with the deceased, difficulty in accepting the death, a sense of being alone in the company of others, and a belief that life is meaningless without their loved one (Knight & Gitterman, 2014).
Individuals suffering from complicated grief are more susceptible to develop hypertension, cardiac problems, and cancer (Knight & Gitterman , 2014).
Individuals who are experiencing complicated grief are “stuck” or “numb” in their grief. Without intervention, those experiencing complicated grief, the more likely they will develop significant mental health problems, like major depressive disorder and anxiety (Knight & Gitterman, (2014).
Risk factors for complicated grief include sudden and violent death, suicide or homicide loss, social isolation, and preexisting mental heath problems for the bereaved individual (Knight & Gitterman, 2014).
GriefShare leaders need to be aware of this, and refer for medical and mental health services, when appropriate.

16. References
Altmaier, E. A. (2011. Best practices in counseling grief and loss: Finding benefit from trauma. Journal of Mental Health counseling, 33(1), Retrieved from
Bereavement In Merriam-Webster Online. Retrieved January 20, 2017, from
Corrigan, P. W., Druss, B. G, and Perlick, D. A. (2014). The impact of mental illness stigma on seeking and participating in mental health care. Psychological Services in the Public Interest, 15 (2) Doi: /
Grief In Merriam-Webster Online. Retrieved January 20, 2017, from
GriefShare. (2011). Your Journey from Mourning to Joy Member book. Church Initiative: Wake Forest, NC.

17. References (Continued)
Howarth, R. A. (2011). Concepts and controversies in grief and loss. Journal of Mental Health Counseling, 33(1), Doi:
Knight, C. And Gitterman, A. (2014) group work with bereaved individuals: The power of mutual aid. Social work, 59(1), Doi: /sw/swt050
Kubler-Ross, E. (1997). On death and dying. New York: Simon & Shuster.
MacKinnon, C. J., Smith, N.G., Henry, M., Berish, M., Chochinov, H. M., & Cohen, S. R. (2014). Meaning-based group counseling for bereavement: Bridging theory with emerging trends in intervention research. Death Studies, 38(3), Doi: 1080/
Shulman, L. (2012). The skills of helping individuals, families, groups and communities (12th ed.). Belmont, Ca: Brooks/Cole Cengage Learning.
Wilson, D. M., McLeod, R. & Houttekier, D. (2016). OMEGA-Journal of Death and Dying, 74(2), Doi: /