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Report: Building a Network of Grief Support on College Campuses
 

Report: Building a Network of Grief Support on College Campuses

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www.studentsofamf.org
National Students of AMF (supporting one another and Actively Moving Forward) is a nonprofit organization that connects and empowers college students grieving the illness or death of a loved one to support one another. The organization accomplishes its mission by creating Students of AMF Campus Chapters on college campuses nationwide, raising awareness about the needs of grieving college students, including through the annual National College Student Grief Awareness Week, and hosting national grief support programs, such as the “We Get It” Supportive Blog, and events, such as the National Conference on College Student Grief.

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    Report: Building a Network of Grief Support on College Campuses Report: Building a Network of Grief Support on College Campuses Document Transcript

    • This article was downloaded by: [University of Pennsylvania], [David Fajgenbaum]On: 02 April 2012, At: 13:24Publisher: RoutledgeInforma Ltd Registered in England and Wales Registered Number: 1072954 Registeredoffice: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK Journal of College Student Psychotherapy Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/wcsp20 Building a Network of Grief Support on College Campuses: A National Grassroots Initiative a b c David Fajgenbaum , Benjamin Chesson & Robin Gaines Lanzi a University of Pennsylvania, Philadelphia, Pennsylvania, USA b Hedrick, Garduer, Kincheloe & Garofalo, LLP, Charlotte, North Carolina, USA c University of Alabama at Birmingham, Birmingham, Alabama, USA Available online: 30 Mar 2012To cite this article: David Fajgenbaum, Benjamin Chesson & Robin Gaines Lanzi (2012): Building aNetwork of Grief Support on College Campuses: A National Grassroots Initiative, Journal of CollegeStudent Psychotherapy, 26:2, 99-120To link to this article: http://dx.doi.org/10.1080/87568225.2012.659159PLEASE SCROLL DOWN FOR ARTICLEFull terms and conditions of use: http://www.tandfonline.com/page/terms-and-conditionsThis article may be used for research, teaching, and private study purposes. Anysubstantial or systematic reproduction, redistribution, reselling, loan, sub-licensing,systematic supply, or distribution in any form to anyone is expressly forbidden.The publisher does not give any warranty express or implied or make any representationthat the contents will be complete or accurate or up to date. The accuracy of anyinstructions, formulae, and drug doses should be independently verified with primarysources. The publisher shall not be liable for any loss, actions, claims, proceedings,demand, or costs or damages whatsoever or howsoever caused arising directly orindirectly in connection with or arising out of the use of this material.
    • Journal of College Student Psychotherapy, 26:99–120, 2012 Copyright © Taylor & Francis Group, LLC ISSN: 8756-8225 print/1540-4730 online DOI: 10.1080/87568225.2012.659159 Building a Network of Grief Support on College Campuses: A National Grassroots InitiativeDownloaded by [University of Pennsylvania], [David Fajgenbaum] at 13:24 02 April 2012 DAVID FAJGENBAUM University of Pennsylvania, Philadelphia, Pennsylvania, USA BENJAMIN CHESSON Hedrick, Garduer, Kincheloe & Garofalo, LLP, Charlotte, North Carolina, USA ROBIN GAINES LANZI University of Alabama at Birmingham, Birmingham, Alabama, USA About one in four college students report grieving the death of a family member or close friend within the past year. Although grief may be difficult at any time, there are several factors unique to the college age and environment that can make it particularly difficult. These factors include geographic distance from home and usual support systems, academic demands, college’s “care- free” social life, lack of grief support from peers, and many college campuses’ limited resources for grief support. Thus, grieving college students are at greater risk than their peers of a host of academic, social, and developmental issues. In spite of this “silent epidemic,” few targeted, supportive interventions existed on college campuses until 2006, when National Students of AMF was created by grieving college students to support their fellow grieving students. National Students of AMF primarily achieves its mission by creating Campus Chapters, which are university-recognized student organizations. They include a targeted, peer-led Support Group for grieving stu- dents to connect with others who “get it” and a Service Group that We wish to acknowledge National Students of AMF Board of Mental Health Professionals, particularly Dr. Andrea Walker, for your expert advice and counsel in developing this pro- gram, all of the members of National Students of AMF who have shared their time, love and support with so many others, and the Lisa J. Raines fund for financially supporting this research. Address correspondence to David Fajgenbaum, National Students of AMF, 3344 Hillsborough St, Ste 260, Raleigh, NC 27615, USA. E-mail: davidfajgenbaum@gmail.com 99
    • 100 D. Fajgenbaum et al. encourages students to channel their grief towards championing causes that have impacted them. Abundant anecdotal evidence suggests that students, especially males, who shy away from sup- port groups and professional counseling, have found participation in service activities in honor of deceased loved ones to be a prefer- able therapeutic outlet. Campus Chapters also leverage the “student voice” to promote the other, often underutilized supportive grief resources on campus. Today, there are 43 university-recognized Campus Chapters. In this article, we discuss findings and outlineDownloaded by [University of Pennsylvania], [David Fajgenbaum] at 13:24 02 April 2012 several vital steps that university counselors and administrators can take to facilitate the continued growth of supportive outlets, like National Students of AMF, for grieving college students. KEYWORDS college, student, grief support, mental health About one out of four college students (rates range from 22–30%) have reported grieving the death of a family member or close friend within the last 12 months (Balk, 2008; Balk, Walker, & Baker, 2010). Though grief is unique to each person, common grief reactions can include depression, emptiness, anger, loneliness, fear, and guilt (Balk, 1997; LaGrand, 1981; LaGrand, 1985; Rando, 1995; Sklar, 1990). Although bereavement is a normal life transi- tion that most meet with resilience (Bonanno, 2004), there are instances of complicated grief reactions, which involve maladaptive coping mechanisms, produce functional impairment, and last at least six months (Prigerson et al., 1995). A lack of emotional support is a risk factor for complicated grief (Stewart, 1999) and is especially relevant to grieving college students who are often geographically distant from their usual support systems (Schnider, Elhai, and Gray, 2007). The prevalence of grief among college students along with the potential mental health impact of such experiences make grief work a crucial part of a college mental health professional’s practice (Servaty-Seib, 2004). Likewise, mental health professionals in administrative, clinical, training, and research-related roles are uniquely positioned to assist this population (Servaty-Seib, & Taub, 2010). THE GRIEVING COLLEGE STUDENT’S ENVIRONMENT While the process of grief may be difficult at any time during one’s life, there are several factors unique to the college age and the college environment that can make grief among college students particularly difficult (Moos & Schaefer, 1986). These factors include geographic distance from home and usual support systems, academic demands, college’s “carefree” social life,
    • Building a Network of Grief Support 101 lack of grief support from peers, and college campuses’ limited resources for grief support. Campus life in the United States involves dealing with competing demands for jobs, making career choices, coping with academic pressures, and maintaining a “carefree” social life (Balk & Vesta, 1998). This care- free atmosphere often promotes the use of alcohol and other drugs, and many bereaved college students may turn to alcohol and drug use (Kadison and DiGeronimo, 2004; LaGrand, 1985). In the midst of this environment, bereaved students may wish to turn to friends to talk about the death of aDownloaded by [University of Pennsylvania], [David Fajgenbaum] at 13:24 02 April 2012 loved one (Balk et al., 1998). However, few nonbereaved peers are com- fortable talking about death or are willing to assist their bereaved peers (Balk, 1997; Balk et al., 1998; Balk & Vesta, 1998; Rickgarn, 1996; Vickio, Cavanaugh, & Attig, 1990). Few nonbereaved students understand the poten- tial importance, significance, intensity, or duration of grief (Balk, 1997; Balk and Vesta, 1998). Furthermore, a recent study found that there has been a general decline in empathy among college students in recent years (Konrath, O’Brien, & Hsing, 2011). This general lack of understanding and specific lack of grief support from peers can cause grieving students to feel isolated and unsupported (Balk, 2001; Balk, Tyson-Rawon, & Colletti-Wetzel, 1993; LaGrand, 1985). OPPORTUNITY FOR SUPPORT There are a variety of supportive services that could mollify some of the consequences of grief on college campuses nationwide. According to Schlossberg, Waters, and Goodman (1995), individuals who use mul- tiple coping strategies are able to more effectively cope with transitions (Schlossberg et al, 1995). Specifically, health risks and psychological prob- lems can be lessened or avoided if proper support is made available to the bereaved and subsequently utilized (Leick and Davidsen-Nielson, 1991; Lieberman & Videka-Sherman, 1986; Nerken, 1993; Rando, 1984; Reif, Patton, & Gold, 1995; Sanders, 1992;). Research has shown that group work is one of the most effective approaches to supporting the bereaved (Harvey, 2000; Price, Dinas, Dunn, & Winterowd, 1995;Worden, 1991; Zimpfer, 1991). Among bereaved college students, pilot studies of support group and counseling group interventions indicate positive effects, but these studies have not evaluated long-term benefits (Balk, Tyson-Rawson et al. 1993; Berson, 1988; Dodd, 1988; Janowiak, Meital, & Drapkin, 1995). Loss support groups allow people to share common problems and provide mutual aid, thus helping the bereaved develop a community and new social support systems (Janowiak et al., 1995). Benefits from support group involvement include improved emotional, mental, and physical stability during and after
    • 102 D. Fajgenbaum et al. participation (McCallum, Piper, & Morin, 1993; Thuen, 1995; Yalom and Vinogradov, 1988; Zimpfer, 1991;). Similarly, many bereaved students find it helpful to speak with friends, counselors, Resident Assistants, clergy, and professors (Balk & Vesta, 1998). In fact, referrals to appropriate student services offices can provide much needed support and information to grieving students (Balk, 2008). Professional counseling can help the bereaved to express their feelings, nor- malize their emotions, and help them to conceptualize the meaning of the loss (Larson, 1993). Nevertheless, counseling psychology has directed rela-Downloaded by [University of Pennsylvania], [David Fajgenbaum] at 13:24 02 April 2012 tively limited attention to death and dying in research, training, and practice (Servaty-Seib & Taub, 2010). Professors have regular contact with students and may be able to detect the negative academic effects of bereavement at an early stage. Resident Assistants may be most likely to observe changes in daily functioning due to bereavement (Servaty-Seib & Taub, 2008). Many bereaved students report using religious or philosophical beliefs to cope with death and make sense of it (Neimeyer, 2002; Park, 2005). Even though the central mission of a university is to create a support- ive environment for learning and scholarship, universities have been largely inattentive to the unique needs of their grieving students (Balk, 2001). This finding was corroborated in a comprehensive study we conducted of 54 uni- versity administrators (counseling center directors, deans of students, VPs of student health) to assess current university practices, policies, and pro- grams regarding bereaved college students. Confirming and extending Balk’s work, we found that professional counseling was the primary resource avail- able, other general resources (campus ministry, local bereavement centers, etc.) were underutilized, and very few universities provided additional, tar- geted resources. Nevertheless, university administrators’ responses revealed a desire for change. They stated that students are in greater need of support from friends and peers than from counselors and that universities should provide an array of resources to match these needs (Fajgenbaum & Lanzi, 2007). CALL FOR CHANGE Several researchers have made calls for greater university engagement (Balk, 2001; Balk, 2008; Fajgenbaum & Chesson, 2007; Rickgarn, 1996; Servaty- Seib, 2006; Taub & Servaty-Seib, 2008; Wrenn, 1999;). Over a decade ago, Balk (2001) declared the need for engaging members throughout the university community to provide an array of specific approaches for supporting bereaved students as well as educating the campus commu- nity about bereavement. Specifically, Balk stated the need for a center to improve peer support through training nonbereaved peers, provide struc- tured interventions for students at risk of complications, raise awareness
    • Building a Network of Grief Support 103 about bereavement on campus, and conduct research. Servaty-Seib (2006) further called for “swift interventions” to reach students, such as drop-in, peer-run support groups and bereavement training of faculty members and resident assistants (Servaty-Seib, 2006). Building on this, Taub and Servaty- Seib (2008) called for training about loss and bereavement for resident assistants and faculty/staff, specialized training in loss and bereavement for counseling center staff, and the creation of programs (e.g., grief groups and grief workshops) to support grieving students (Taub and Servaty-Seib, 2008). At the time that we conducted our study in 2007, only one university admin-Downloaded by [University of Pennsylvania], [David Fajgenbaum] at 13:24 02 April 2012 istrator reported having a university-recognized organization dedicated to the needs of grieving college students (Fajgenbaum & Lanzi, 2007). That student-run organization was “Students of AMF,” which offers targeted peer- support for grieving students. Students of AMF was originally founded by one of the authors, Fajgenbaum, at Georgetown University where, at the time, he was a student grieving the death of his mother. Since that time, the “grassroots” efforts of Students of AMF at Georgetown University and National Students of AMF Support Network, which Fajgenbaum and Chesson cofounded a year after Fajgenbaum estab- lished the alpha chapter at Georgetown, have been cited frequently in the literature and have “obtained wide institutional and even national support” (Balk, 2008; Balk, 2009; Balk, 2010; McGowan, 2008; Perkey, 2010; Sandersa, 2011; Wescott, 2008). The remainder of this article highlights this grassroots effort and its role on college campuses. NATIONAL STUDENTS OF AMF CASE REPORT: BUILDING A NETWORK OF SUPPORT ON COLLEGE CAMPUSES The National Students of AMF Support Network (NSAMF) was created in 2006 by grieving college students to support grieving college students. NSAMF represents a nationwide, grassroots, collaborative effort blending the experiences of grieving college students with the expertise of mental health professionals, bereavement researchers, university administrators, and non- profit leaders to pursue the goal of enhancing the level of support provided to grieving college students. History The vision for NSAMF began in 2005 during Fajgenbaum’s sophomore year at Georgetown University. During his mother’s 15-month battle with brain cancer, Fajgenbaum struggled with feeling alone and unsupported. Two weeks before she died, he promised her that he was going to create a program in her memory to support grieving students who, like him, were struggling. Following his mother’s death, Fajgenbaum began to work with
    • 104 D. Fajgenbaum et al. other grieving students and administrators at Georgetown University from the Counseling Center, Campus Ministry, Student Health, Student Affairs, and Residential Life to identify what was currently available on campus and what additional resources could be helpful. This planning group found that psychotherapy through the counseling center was the only “grief support service” available on campus and no avenues were in place for peer-support. The student representatives most commonly reported feeling “alone on cam- pus,” “helpless with regards to my loved one’s experience,” “guilty for being away at school,” and “like no one gets it.” The needs assessment andDownloaded by [University of Pennsylvania], [David Fajgenbaum] at 13:24 02 April 2012 student reports offered intervention possibilities and helped to identify a multifaceted response. Shortly thereafter, the Georgetown University Students of AMF Support Network was founded. The acronym “AMF” stands for “Ailing Mothers & Fathers,” but the support network includes all college students grieving the illness or death of a family member or friend. (“AMF” are also the initials of Fajgenbaum’s mother [Anne Marie Fajgenbaum]). The student organization endeavored to meet the needs of grieving college students by providing a range of early interventions, including a peer-led grief Support Group, a Service Group of bereaved and nonbereaved students that would champion causes affecting support group members, and a faculty mentoring program for support group members. What began as a group of five bereaved students grew to include more than 400 members of the Georgetown community. The group was named the 2005 “Outstanding Direct Service Program” by Georgetown University. Soon, dozens of college students from around the country learned about Georgetown’s unique program and requested information about starting chapters at their universities. The second author, Chesson, who was a sopho- more at the University of North Carolina-Chapel Hill at the time, launched the beta chapter and the group flourished. Shortly thereafter, Fajgenbaum conducted research with Dr. Lanzi on college student bereavement and university policies, practices, and programs. Supported by a grant from Georgetown University, the two authors surveyed 54 directors of counseling centers and Deans of Students. Fajgenbaum, Chesson, and Lanzi determined that this lack of support extended far beyond Georgetown and UNC. After months of requests from grieving college students about estab- lishing a chapter of Students of AMF at their campuses and dozens of testimonials from students, faculty, and staff on Georgetown’s and UNC’s campuses about the positive impact the initiative was making, Fajgenbaum and Chesson created a vision for a national organization dedicated to reach- ing every grieving college student. Funded by a grant from the University of North Carolina, Chesson and Fajgenbaum set out to pursue their vision. NSAMF was formally established as a nonprofit organization in April 2006. First, Fajgenbaum and Chesson, both college students, enlisted the support of nonprofit, for-profit, and academic leaders on the Board of
    • Building a Network of Grief Support 105 Directors. Next, several prominent college student mental health leaders and college student grief experts agreed to serve on the Board of Mental Health Professionals and endorsed the organization’s goals. Then, a number of college students volunteered to serve as unpaid NSAMF staff. Finally, to ensure that the organization did not turn away any grieving college students, National Students of AMF dropped “Ailing Mothers & Fathers” from its name, but kept “AMF” as a continued reminder of the legacy behind the program. Considering the goal of improving the resources available to grieving college students, it was particularly important to develop a true sense ofDownloaded by [University of Pennsylvania], [David Fajgenbaum] at 13:24 02 April 2012 collaboration and include the voices of college students, university adminis- trators, mental health professionals, and bereavement experts when deciding what should be offered and a corresponding implementation strategy. To achieve this, NSAMF volunteer staff gathered and synthesized testimonials and feedback from more than 50 grieving college students and univer- sity administrators and created a framework for Students of AMF Campus Chapters. This provided the basis from which the Board of Directors and Board of Mental Health Professionals developed a Strategic Plan and a Campus Chapter Guide. The Strategic Plan and the Guide define NSAMF’s strategies on a national, campus, and individual student level and sets forth how NSAMF executes these strategies and what specific goals guide NSAMF leadership. Lastly, Fajgenbaum and Chesson enlisted the financial support of dozens of donors. With a clear vision, professional expertise, and finan- cial support in hand, NSAMF was able to begin national operations, which continue to expand today. Overview of NSAMF NSAMF is a national, grassroots nonprofit organization that aims to support college students grieving the illness or death of a loved one. The organiza- tion accomplishes its mission by creating Students of AMF Campus Chapters on college campuses nationwide, raising awareness about the needs of grieving college students, and hosting national grief support programs and events, like the National Conference on College Student Grief. In the last 5 years, the organization has developed 43 Campus Chapters (they are offi- cially recognized as a student organization by the college or university), sup- ported over 1,500 grieving college students, and worked with students from over 160 different colleges and universities to start up Campus Chapters. Overview of Campus Chapters Campus Chapters are student-led, faculty/staff-advised, and university- recognized student organizations. Campus Chapters consist of a peer-led grief support group, a service group open to the entire campus community,
    • 106 D. Fajgenbaum et al. and a mentoring program that connects grieving students with supportive faculty. The Support Group connects grieving college students with others “who get it” and empowers members to support one another. The group also offers information about and connects students with other supportive resources available on campus, such as professional counseling. The Service Group empowers college students to get involved in community service and, if grieving, to channel their grief towards positive outlets. NSAMF Campus Chapters enhance the level of grief support offered on college campuses in several ways. Each Campus Chapter adds three griefDownloaded by [University of Pennsylvania], [David Fajgenbaum] at 13:24 02 April 2012 support resources: a peer-led grief “support group,” a “service group,” and a faculty/staff “mentoring” program. Furthermore, although several other grief support resources already exist on many college campuses, they are often underutilized or unknown by college students. Therefore, each Campus Chapter utilizes the student voice to connect grieving college students with other active coping strategies already available on their college campus. For instance, Psychological Counseling Center services and contacts within the Center are shared at every Support Group meeting. By actively market- ing these resources to students campus-wide, Campus Chapters are able to reach students that would not typically participate in active coping strategies. A student from Western Oregon University shared the following comment: “I felt so alone and was ready to leave school completely, but getting involved with AMF changed everything.” SUPPORT GROUP The Support Group, which is open only to grieving college students, is a peer-led, open-format, open-discussion group that brings grieving students together to share their thoughts, feelings, and experiences in a positive, supportive, and uplifting environment. Support Group meetings are held every two weeks in an informal, private, on-campus location. Support Group meetings are not counseling sessions and are not professionally led. With this caveat made clear at the beginning of each meeting, members are invited to share experiences, not advice. Nevertheless, careful planning by the Support Group leader is essential to help ensure a Support Group’s success. The Support Group Leader is determined by the Campus Chapter leadership based on ability to establish connections with peers, not based on knowledge about grief support. Support Group Leaders undergo leader training, which is overseen by the NSAMF Board of Mental Health Professionals. The first meeting of each semester begins with an opportunity for mem- bers to share topics they would like to discuss during the semester. Each 60–90 minute meeting begins with a student sharing a personal story or the “leader” posing an agreed upon topic. At meetings, students discuss specific situations they have encountered, empathize with one another, and share
    • Building a Network of Grief Support 107 various coping techniques that they have utilized, such as how to cope with grieving during the holidays. There is no curriculum and no expectation for members to participate in the discussion. Several significant goals are typi- cally achieved: help students to feel less isolated by interacting with other bereaved students; give students the opportunity to help others and in doing so help themselves; offer quite possibly the only forum for discourse about grief, in turn normalizing and legitimizing students’ grief-related thoughts; and direct students to other resources, if interested. A student from Georgia Southern University shared the following comment about his experienceDownloaded by [University of Pennsylvania], [David Fajgenbaum] at 13:24 02 April 2012 with a Campus Chapter Support Group. It has been so empowering to be part of a group where they know how I feel even before I’ve told them my story because they’ve all been there, and they want to be there for me. SERVICE GROUP The Service Group, which is open to all students on campus, motivates and empowers students to volunteer and raise awareness for service projects. Each service group is free to choose its own projects, ranging from par- ticipating in a local cancer walk to volunteering at a children’s hospital; activities are often chosen in honor of a loved one or in support of a cause that has directly impacted the campus community. Campus Chapter Service Groups may partner with other service groups on campus and participate in those organizations’ fundraising activities. Participation often serves as a pos- itive, therapeutic outlet for students to direct their grief. Service events also offer an opportunity to get nonbereaved students involved with the Campus Chapter. Support Group members often feel great comfort and support when their nonbereaved peers participate with them in Campus Chapter Service Group activities. A student member shared the following comment about her involvement with a Campus Chapter Service Group: AMF attended the Walk to D’Feet ALS in honor of my dad. I felt like I could actually do something besides feel sad and helpless about my dad’s illness. We raised money for the walk and many of my friends and other members of AMF joined me, for which I was extremely grateful. MENTORING PROGRAM Although not a component of every Campus Chapter, several chapters also include a mentoring program that connects students with preselected faculty mentors. The members of the support group nominate and select 10–20 fac- ulty or staff members on campus to serve as mentors. If the faculty/staff
    • 108 D. Fajgenbaum et al. members agree, then they are paired with support group members to sup- port the students on an as needed basis. Students and mentors may connect as much as once a week for coffee, during times of crises, or only once a semester by e-mail. PROMOTING THE CAMPUS CHAPTER In order to reach out to the most students, a variety of approaches to promo- tion are utilized. All chapters are encouraged to place flyers around campus,Downloaded by [University of Pennsylvania], [David Fajgenbaum] at 13:24 02 April 2012 send letters to department heads, write e-mails to electronic mailing lists, place a story in campus newspapers, include events in community calen- dars, and utilize a Facebook page. While all of these approaches successfully promote the Service Group, not all are effective for reaching Support Group members. Grieving college students typically need to hear about the group from an individual, particularly a faculty member or close friend, even if through e-mail, before attending a meeting. INTERACTIONAMONG CAMPUS CHAPTERS , THE COUNSELING CENTER , AND OTHER ON - CAMPUS RESOURCES Campus Chapters also utilize the student voice to highlight other resources available on campus. When students inquire about Students of AMF, Campus Chapter leaders use the opportunity to share additional information about Counseling & Psychological Services, Campus Ministry and other faith-based organizations, and other local support groups (i.e, local hospices). Chapter leaders are instructed to meet with the director or the outreach coordinator from the university counseling center during the early stages of developing a chapter to clearly define the role of a campus chapter as adding a resource to, and offering a student voice in support of, the existing cam- pus safety network. The leader should emphasize that the Campus Chapter is not attempting to replace any part of the campus safety network. However, some students who would not consider going to a counseling center for help may be more willing to talk informally with a peer (Balk, 2008). In addi- tion, chapter leaders may present information about the Campus Chapter at counseling center staff meetings, display flyers throughout counseling cen- ters, distribute counseling center handouts to support group members, and exchange links between the two groups’ Web sites. Considering that university counseling centers are expanding their focus beyond direct psychological counseling (Kitzrow, 2003) and that there are more students with severe psychological issues who are enrolling in univer- sities (Gallagher, 2009), Campus Chapters and university counseling centers must have a strong working relationship to broaden the safety network to reach unsupported students. Based on 6 years of observations, we conclude
    • Building a Network of Grief Support 109 that the most successful campus chapters utilize a strong working relation- ship with the counseling center. For instance, students at the University of Pennsylvania are frequently referred to the Support Group by the Counseling Center and conversely are encouraged to see someone in the Counseling Center by leaders in the Support Group; many students participate in both modes of support. Support Group leaders are trained to identify and seek additional help for students who experience serious changes in daily func- tioning, such as social isolation, skipping classes, weight fluctuations, risky behaviors, or aggressive behaviors (Servaty-Seib & Taub, 2008). If a mem-Downloaded by [University of Pennsylvania], [David Fajgenbaum] at 13:24 02 April 2012 ber expresses suicidal or homicidal thoughts, the group leader is instructed to immediately contact the faculty advisor, the counseling center contact, campus security, and emergency 9-1-1. In addition to widening the campus safety net, Campus Chapters also provide faculty and administrators with an additional resource to share with students. An Associate Dean from a private university shared the following comment about a Campus Chapter: This is a wonderful idea! A number of my advisees are dealing with the serious illness and/or death of a parent and I suspect that many of these may feel more comfortable in a well-run group than in the one-on-one framework of counseling or would welcome a group as well as what CAPS can offer. CASE REPORT: MARISSA The following is a glimpse into the experience of one college student who participated in NSAMF. Marissa was two months into her freshman year in college and it was parents’ weekend. She was looking forward to seeing her parents for the first time since moving in. Her father arrived in a wheelchair; however, Marissa found out that he had been diagnosed with ALS six months prior. Marissa’s parents chose not to tell her, because they did not want her to make her college decision based on his disease. Marissa was devastated and insisted that she drop out of school immediately. In her own words: I felt completely isolated. I had only been at X [University] for a couple of months and, though I’d made some friends, I felt like no one else could understand what I was going through. Everyone just wanted to have fun, and we rarely talked about our families. That week, a front page story ran in the student newspaper about “a student-led grief support group” called “Students of AMF.” Marissa’s mother insisted that Marissa go to one meeting before she dropped out. Marissa agreed, though reluctantly. After attending the support group meeting, Marissa described a welcomed change:
    • 110 D. Fajgenbaum et al. I immediately felt like a huge weight had been lifted. I wasn’t alone. In fact, I became close friends with a girl who had lost her father in the previous semester. I felt so lucky to have found other students who could offer me support and guidance, and could give me a chance to talk about my family. I also learned that several members of the group also saw a counselor, so I decided to give it a try. I really benefitted from participating in both services. During Marissa’s sophomore year, she became the Treasurer of AMF and also worked on increasing membership. Marissa’s AMF chapter partic-Downloaded by [University of Pennsylvania], [David Fajgenbaum] at 13:24 02 April 2012 ipated in a service event in honor of her father that fall. She invited her nonbereaved friends to participate as well, which for the first time opened up lines of communication with them about her father. During her junior year, Marissa became the Vice President and the Director of the Faculty Mentoring Program. “My Mentors are so kind to me and make me feel like I have someone to turn to even though my family is so far away.” As a senior, Marissa became the President of Students of AMF at her university. During this time, her father died. Not only do I continue to receive support from the other group mem- bers, but I also get to help students who are new to AMF, which makes me feel so happy. AMF has helped me more than I can say. I honestly believe that it’s the main reason I was able to stay in school—which is what my dad wanted—rather than moving home. It has made me feel more connected to the community and offered me a place to talk about the sorts of things that don’t come up over pizza in the cafeteria or by a keg in someone’s backyard. It showed me that I was not alone in feeling torn between being at school and being at home. The greatest support I receive from AMF comes from the mem- bers who’ve already lost parents, whose example shows me that life does continue after the death of a parent. They personify the most powerful aspect of AMF’s contribution to the community, and to me: hope. Marissa is now a second year Law Student at George Washington University and a member of the National Students of AMF Board of Alumni/Student Leaders. OVERVIEW OF NATIONAL OPERATIONS NSAMF provides an array of resources to facilitate the creation of Campus Chapters and empower students to support one another. NSAMF contin- ually updates and distributes a Chapter Toolkit guide and Support Group Leader guide, which include best practices regarding how to lead Support
    • Building a Network of Grief Support 111 Group meetings, how long they should be, where they should be held on campus, and how they should be promoted. Chapter Leaders are paired up with a volunteer Chapter Coordinator to guide them through the process outlined in the Toolkit. NSAMF hosts monthly conference calls to discuss chapter development. NSAMF offers direct financial sup- port for costs, such as T-shirts/promotional items, refreshments at meetings and events, and printing/copying. NSAMF covers all expenses for one or two chapter leaders from each campus to attend and receive fur- ther training at the annual National Conference on College Student Grief.Downloaded by [University of Pennsylvania], [David Fajgenbaum] at 13:24 02 April 2012 Training at the conference focuses on support group facilitation, mar- keting on campus, and leadership skill improvement. Occasionally, the Board of Mental Health Professionals is called on for specific advice related to a campus or a student member. Finally, NSAMF devotes pro bono Google Adwords resources to raise campus awareness about Campus Chapters. Although chapter development is the primary way NSAMF endeavors to achieve its mission, it also engages in national programming, including raising awareness about the needs of grieving college students and hosting the annual National Conference on College Student Grief. NSAMF’s awareness-raising strategy focuses on social media, television and print media exposure, and word of mouth. NSAMF was selected as a 2007 BRICK Award winner, which placed the organization on network televi- sion (the CW© ) and on the back of 40 million bags of Cool Ranch Doritos® . Reader’s Digest© selected NSAMF as one of 10 “Make it Matter” stories of 2008, and the organization was also featured on NBC’s Today Show© in 2008. Eli Lilly selected NSAMF as the recipient of the 2011 Welcome Back Award in Community Service for creating and improving “community pro- grams that foster a supportive, caring environment for those suffering from depression” (Eli Lilly and Company, 2010). Between 2008–2011, the NSAMF Web site, www.studentsofamf.org, averaged between 2,000 and 5,000 visits each month. The annual National Conference on College Student Grief, held ini- tially in 2008, provides a national forum for student leaders, grieving college students, university faculty, and college mental health leaders to discuss issues and future directions in college student grief support. Organizational operations are currently overseen by the Board of Directors and exe- cuted by a full-time Executive Director and a host of volunteers. The Board of Mental Health Professionals provides additional guidance for all Chapter Development operations. The Board of Advisors provides support for fundraising activities. The Board of Alumni/Students Leaders offers guid- ance and a student voice to the Board of Directors. A former student leader stated: “My involvement with AMF was the highlight of my college career, so I would really like to be able to give back and help other grieving college students in any way that I can.”
    • 112 D. Fajgenbaum et al. DISCUSSION Despite the clear need for support on college campuses, few programs have attempted to meet this need and those that have attempted have been met with mixed success and poor student participation (Balk, 2001). NSAMF has been successful because of both the overall need and several unique characteristics and strategies of the organization. Notably, grieving college students, the very people NSAMF endeavors to serve, created and developed NSAMF and are instrumental in every decision. Each Campus Chapter andDownloaded by [University of Pennsylvania], [David Fajgenbaum] at 13:24 02 April 2012 Support Group meeting is entirely student-led. Fortunately, in addition to student leaders, NSAMF has also benefited in its planning and execution from the expertise of nonprofit leaders, pro- fessional staff, college student mental health professionals, and bereavement experts. The success of a Campus Chapter on a particular campus depends heavily on the campus leaders’ passion and leadership ability, the faculty advisor’s level of engagement, and the relationship between and engage- ment with the campus counseling center. The individual characteristics of the university, such as size, type, and mission, are less relevant to the success of the organization than one would expect. The Support Group utilizes principles of peer support, which is the primary modality that grieving students need according to university admin- istrators, and group work (Fajgenbaum & Lanzi, 2007). Bereaved college students report that attentive listening and personal presence, both accom- plished through group work, are the most helpful actions that an outsider can provide (Vickio, Cavanaugh et al., 1990). NSAMF Campus Chapters do not set out to replace any pre-existing services. Rather, they endeavor to supplement and connect students to the campus safety network. By utilizing the student voice to promote services already available on campus, it is hoped that more students in need will engage in available resources. NSAMF conducts its own fundraising activities to support each Campus Chapter. There are no chapter dues, and every Campus Chapter meeting and event is free. NSAMF Campus Chapters utilize civic engagement, volunteerism, and community service as a therapeutic modality, which is common in sev- eral other realms (Ostrander, 2004) but atypical in thanatology. Researchers in other fields have found that, in addition to the community benefits of volunteering, there is a direct personal benefit to helping others (Piliavin, 2003). This has certainly been the case for students within NSAMF Campus Chapters. Chapters provide opportunities for students to support others in need and also participate in service activities in memory or honor of an ill or deceased loved one. The benefit of having service as a therapeutic arm is most evident among males. Not unlike other realms of society, male students participate in Campus Chapter support groups much less frequently than females, but
    • Building a Network of Grief Support 113 they participate in equal or an even greater proportion in community ser- vice activities. Anecdotal evidence indicates that males find more therapeutic benefits from participation in service than the support group, because they are able to tangibly do something and because of stigma against males in support groups appearing “weak.” In addition to finding meaning and benefit in helping others, par- ticipation in NSAMF Campus Chapters enables students to maintain a connection with their loved ones through volunteering in their memory, cultivating memories, and sharing stories with peers. Chapters also provideDownloaded by [University of Pennsylvania], [David Fajgenbaum] at 13:24 02 April 2012 a mechanism for motivating, mobilizing, and developing student talents and leaders. The timing of this grassroots effort happened to coincide with several significant research discoveries indicating the large prevalence of college stu- dent grief and the significant impact it can have on academic performance and social development. Researchers had made several calls in the litera- ture for university programs and “swift interventions” to combat these issues (Wrenn, 1999; Balk, 2001; Servaty-Seib, 2006). Though NSAMF Campus Chapters do not exactly match the literature’s call for administrator-led offices for bereaved students, Campus Chapters organically evolved to con- duct several of the actions recommended by Wrenn, Balk, and Servaty-Seib: (a) a “place on campus” to go for support (Support Group), (b) improved support from nonbereaved peers (Service Group), (c) structured interven- tions for the at risk (referral to Counseling Services), (d) consciousness raising on campus (Service Group), (e) faculty assistance of bereaved stu- dents (mentoring program), and (f) a conference on these issues (National Conference on College Student Grief). Limitations One potential limitation of NSAMF is that licensed professionals do not lead Campus Chapter Support Groups and student-leaders may not be equipped to handle difficult situations. However, NSAMF’s peer-led, group structure is not uncommon among grief support avenues. The model has been informed by the input of hundreds of grieving college students and the advice of dozens of experts (Fajgenbaum & Chesson, 2007). Furthermore, Student Leaders are trained to facilitate support groups, identify when a student may need additional help, and reach out to the Faculty Advisor and uni- versity officials for advice and support during difficult situations. A second limitation is that NSAMF Campus Chapters are not equipped to provide the resources necessary for all grieving college students, particularly those with serious mental illness. For this reason, a protocol has been put into place and utilized on several campuses for helping students “whose needs are beyond the scope of what NSAMF can offer” find other resources. A third potential limitation is that NSAMF Campus Chapters are at risk of being led
    • 114 D. Fajgenbaum et al. by students in a harmful or inappropriate manner. To address this concern each student leader and faculty advisor is comprehensively evaluated during the start-up process. Systems are in place to ensure that if a student leader or faculty advisor acts harmfully or inappropriately, the NSAMF Board of Directors and Board of Mental Health Professionals will be alerted and act promptly. Fourth, although NSAMF has hundreds of testimonials to the bene- fits of participation, the program needs to be quantitatively and scientifically assessed for effectiveness and potential areas for improvement. NSAMF is currently seeking grants to support such research.Downloaded by [University of Pennsylvania], [David Fajgenbaum] at 13:24 02 April 2012 Current Activities and Future Directions NSAMF hired its second full-time Executive Director in July 2011. Current activities include sustaining existing and developing new Campus Chapters, aggressively marketing to college campuses that do not have Campus Chapters, developing long-term partnerships with national advocacy orga- nizations and potential funding sources, expanding the annual National Conference on College Student Grief, and creating an Alumni Network to keep alumni engaged with NSAMF. Future activities include hiring addi- tional full-time employees to lead chapter development, developing campus workshops about grief for students and faculty members, developing innova- tive methods to utilize social media and technology to connect and support grieving college students, and disbursing student tuition scholarships and research grants to evaluate program effectiveness. In addition to AMF, there is another student-led movement in the col- lege student grief arena. At Purdue University, several student government leaders and Heather Servaty-Seib, who is a faculty member and member of the NSAMF Board of Mental Health Professionals, proposed and success- fully campaigned for a student bereavement leave policy (H. Servaty-Seib, personal communication, August 15, 2011). Approved Spring 2011, the pol- icy provides consistent guidelines for the length of time a student can miss school for a death and gives students an opportunity to show evidence they can meet the learning objectives for missed assignments (Purdue University News Service, 2011). Action Steps for University Administrators and Counseling Center Directors Based on our research with university administrators and counseling cen- ters and work with NSAMF, we have identified several action steps that university administrators and counseling center directors can take to help grieving college students on three levels: student, campus, and national. Each is discussed below.
    • Building a Network of Grief Support 115 STUDENT-LEVEL STEPS First, many students troubled by grief present to the counseling center with problems that are secondary to the loss, such as reliance on drugs or insomnia. Thus, mental health professionals should conduct a thorough loss assessment as a part of all routine intake interviews. Both death and nondeath losses are important to understanding the experience of col- lege students who present for counseling (Servaty-Seib & Taub, 2010). Campus professionals must be familiar with current bereavement-related the- ories, attuned to the behaviors that could indicate an internal struggle withDownloaded by [University of Pennsylvania], [David Fajgenbaum] at 13:24 02 April 2012 bereavement, and prepared to intervene appropriately (Neimeyer, Laurie, Mehta, Hardison, & Currier, 2008). Second, it is important that campus pro- fessionals communicate directly with grieving college students that they are willing to speak with them during times of grief. A third critical component is that campus professionals educate bereaved students about the unique challenges that they may face and share information about the various, underutilized grief resources available (e.g., Campus Ministry, Residential Life). Fourth, campus professionals should encourage grieving college stu- dents, particularly males, to participate in service activities, such as a local cancer walk in memory or honor of a loved one. And, finally, campus profes- sionals can share information about NSAMF and its nationwide community of supporters with students and colleagues and encourage their students to start a Campus Chapter if one is not already established. CAMPUS-LEVEL STEPS First, campus leaders should determine if there is a contact or identifi- able location on campus where bereaved students can go to seek support, such as the counseling center, student health service, or campus ministry (Balk, 2001). Second, campus leaders should facilitate, as many university counseling center staff already have, the development of NSAMF Campus Chapters at their universities. If administrators are interested in helping to start a Chapter, they should contact NSAMF through www.studentsofamf.org for more information. If a Campus Chapter already exists, university admin- istrators and counseling directors can serve as Faculty Advisors or informal advisors to grieving students. At the very least, it is important that administra- tors share information with community members, including college students and other faculty/staff, about NSAMF. Third, holding an informational grief workshop on campus is another excellent mechanism for supporting stu- dents. NSAMF has many resource materials for planning one of these events. Fourth, campus administrators should determine if supportive policies, such as bereavement leave policies, are in place to assist bereaved students. If policies are in place, administrators should review current policies to determine if they are aligned with recommendations presented elsewhere
    • 116 D. Fajgenbaum et al. (see Servaty-Seib & Taub, 2010). If no policies exist, administrators should advocate for such policies. Finally, professionals can promote the idea of an annual memorial service or memorial garden for the loved ones of stu- dents who have died (see Hamilton, 2008, and Knudson, 2011, for further information for supporting). NATIONAL-LEVEL STEPS Active support of these student and campus-level efforts by campus coun-Downloaded by [University of Pennsylvania], [David Fajgenbaum] at 13:24 02 April 2012 selors is critical to sustaining them on the national level. First, the annual NSAMF National Conference on College Student Grief is an excellent way to learn more about the experiences, needs, solutions, and opportunities for supporting grieving college students. Second, national efforts can involve sharing information about NSAMF with colleagues from other universities, who may ultimately become interested in starting Campus Chapters. Third, NSAMF feeds off the experiences, ideas, and advice that university admin- istrators and counseling directors can offer. There are many roles for new volunteers, including serving on an advisory board or conducting quantita- tive research into the effectiveness of National Students of AMF programs in meeting the needs of bereaved college students. Fourth, national mental health membership associations should include college student grief the- ories as a standard part of program training (Servaty-Seib & Taub 2010). Finally, campus professionals should engage in continuing education regard- ing grief and mourning through organizations such as the Association for Death Education and Counseling (www.adec.org). CONCLUSION NSAMF is a grassroots, national organization, created through the collabora- tive efforts of grieving college students, college mental health professionals, and bereavement experts, to offer supportive interventions on college cam- puses. By creating student-led, student-focused outlets for grieving college students on college campuses, NSAMF provides an effective forum for grieving students to support one another. In order to most effectively achieve their shared mission of supporting college students in need, Campus Chapters and university counseling centers must develop a strong, working relationship. REFERENCES Balk, D. E. (1997). Death, bereavement and college students: A descriptive analysis. Mortality, 2, 207–220.
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