+ Teaching Grief and Loss Online Katherine Walsh PhD, MSW, LICSW WESTFIELD STATE UNIVERSTIY
+ LEARNING OBJECTIVES 1. Assess ones own preparation for teaching this content online 2. Identify essential content to include in a course in grief and loss 3. Describe effective teaching methods for student mastery of essential content in grief and loss
+ What this presentation will cover Rationale for teaching this content and teaching it online Basic content of a course in grief and loss Course format and teaching methods Pragmatics and benefits of writing a textbook for online courses
+ Why offer this course? And why online? Professionals (in training) in all disciplines can benefit from this content STUDENTS ARE VERY INTERESTED IN THIS CONTENT ―I have enjoyed learning from you this summer. Though the content was difficult, it is a terrific course and I have learned a great deal. I especially thought the opportunity to explore my own thoughts, feelings, and beliefs was very beneficial in helping me realize how my experiences will impact my working with clients who encounter grief. I especially liked the textbook – it was a wonderful introduction to many new theories‖
+ A MANDATE TO TRAIN 2000 Soros Foundation Project on Death in America Grant From 1994 to 2003, the Project on Death in America (PDIA) worked to understand and transform the culture and experience of dying and bereavement. Over the course of nine years, PDIA created funding initiatives in professional and public education, the arts, research, clinical care, and public policy. PDIA and its grantees have helped build and shape this important and growing field, and have helped place improved care for the dying on the public agenda. $60,000 2 year Grant to develop distance learning courses on death and dying for social workers
+ From Death and Bereavement to Grief and Loss 463,0000 Children Placed in Foster Care in the U.S. 43% of marriages in the U.S. end in divorce 1 out of 10 (25 million) Americans are living with a disabling chronic illness Nearly 1 in 10 Americans over the age of 12 is living with substance abuse or dependence
+ 1st and 2nd Editions of the Text http://www.pearsonhighered.com/educator/product/Grief-and-Loss-Theories-and- Skills-for-the-Helping-Professions/9780205827091.page
+ COURSE CONTENT Introduction to grief and loss Symbolic and Tangible loss Self-preparation – personal experiences with grief Grief in children and adolescents Young and Middle adults Older Adults Normal and Complicated Grief
+ Course Content Continued Cultural and Spiritual Influences Anticipatory Grief in End of Life Care Interventions for Individuals Groups and Organizations: Social work roles and contributions Communities and Traumatic Grief Professional Resilience: Sustaining hope, helpfulness and competence
+ Instructor Manual Content Sample Syllabus For Each Chapter Discussion Questions Experiential Exercises Videos relevant to the chapter content Self-assessment (quiz) questions Teaching Tips Web resources Power point slides
+ Syllabus COURSE DESCRIPTION This course equips the professional practitioner to understand and respond effectively to individuals, families, groups, organizations and communities that have experienced both symbolic and tangible loss and grief reactions. The topics covered in the course, include theories of normal and complicated grief, grief reactions and the factors that influence them at different stages of the life span, cultural and spiritual influences, vicarious trauma and the impact of loss and working in close contact with grief on professionals, and skills and strategies that address therapeutic needs of vulnerable and resilient populations.
+ Upon completion of this course students will: Assessment Method 1. Identify one’s own personal philosophy and issues regarding death 1. Journal entries and loss and how these may impact on Team/teacher discussion your work with individuals and families responses experiencing loss (EPAS 2.1, 2.2, 2.3) 2. Identify and understand normal grief 2. Journal entries and factors that contribute to Team/teacher discussion unresolved loss and complicated responses bereavement (EPAS: Exam questions 2.1.6, 2.1.7, 2.10b) 3. Describe the impact of different 3. Journal entries types of Team/teacher discussion losses at different stages of the life responses cycle. Exam questions (EPAS 2.1.3, 2.1.4, 2.1.7)
+ ASSIGNMENTS Weekly Journal Students will keep a written integrative journal every week throughout the course, as listed in the syllabus. Journal entries can be drawn upon for team/teacher and class discussions as well as the exam. The journal is YOUR learning tool and will consist of reflections on the readings and audiovisual supplements and your own practice with grieving client systems. For some journal entries there will be assigned exercises to complete. The weekly DISCUSSION All students participate with the instructor in the discussion which is a very important learning tool for you and your classmates. (It is also an important part of your grade). Students will be assigned to a discussion group in which you are required to actively participate each week. The discussion questions are listed for each module in the syllabus and in MySocialWorkLab on the Pearson web site
+ Weekly Videos A cautionary note regarding course material: The readings, exercises and supplementary materials have been chosen for their themes of loss, which are relevant to the topic of the course. However, some of the material may elicit unanticipated emotional reactions. There may also be material in some of the supplementary audiovisual recommendations that can be objectionable to some viewers. This is one of the reasons students are offered a choice of videos. To assist you in making choices, a description and review of each video is included in the Video Reviews at the end of this syllabus. Students should exercise discretion and self-care in making choices and completing course assignments. Example: Crazy Heart This 2009 film features Jeff Bridges as Bad a country western singer on the last fumes of his talent. He smokes and drinks as if trying to settle a long-ago bet between his liver and his lungs about which he would destroy first. The chorus to his signature song observes that ―falling feels like flying, for a little while.‖ That time has long since passed for Bad, who is scraping the bottom and trying not to complain too much about it (except when he can get his agent on the phone). Drinking, cheating, love gone wrong — a lot of country music expresses the weary stoicism of self- inflicted defeat. Loss and abjection are two of the chords that define the genre. A third is redemption
+Syllabus Module 1 Readings: Grief and Loss Text: Preface and Chapter 1: Loss experiences that generate grief reactions (pp.1-12) Video: The following videos address symbolic loss. Choose one and think about how the characters manifest grief in reaction to symbolic losses: Lorenzo’s Oil, Spitfire Grill, Angela’s Ashes, Kramer vs. Kramer, Seabiscuit, Antwone Fisher, Stepmom, Crazy Heart. Journal: Exercises: Visit http://www.pbs.org/wnet/onourownterms/tools/index.html and scroll down to complete both assessment tools : 1. (under patient tools) “Self – assessment of your beliefs about death” and (further down the page) 2. “Test your Knowledge”. Discuss your reactions to what you have learned from completing these self-assessment tools. Team/teacher discussion: Complete the Exercise for Chapter 1, p. 11. Share with your team mates your responses to the exercise. ( by clicking on the Team/teacher Discussion posting for week one. (To send your response, click on the message I have posted and then click on Add New Message). Remember, to read your teammates’ responses, click on the small + to the left of the posted topic. Topics: Review of symbolic loss as well as loss associated with death and dying. (Self-evaluation).
+ SUGGESTED DISCUSSION PROMPTS for Chapter 3 1. Discuss what settings you plan to work in in the future and in what context you might encounter grieving children or adolescents in these settings. 2. Discuss what, if anything, in the reading that surprised you about grief in early childhood (infants, toddlers and preschoolers)? 3. Discuss what you believe will be the most challenging aspects for you as a helping professional when encountering grieving children or adolescents 4. Based on what you have learned about grief reactions in adolescents, what are some ways that you can prepare yourself or the organization you work in (now or in the future) to support grieving adolescents?
+ Sample Team/Teacher Discussion 1. Describe the settings that you are currently working or completing your practicum in. 2. Identify the types of losses the clients you encounter in the setting have experienced 3. Describe the emotions someone experiencing those losses might experience 4. How might the feelings associated with these losses be manifested in behavior you could observe?
+ Example: Student Discussion Entry This year I will be completing my field practicum at the NERI school. The alternative school serves 15 adolescents who have demonstrated emotional and/or behavioral problems that inhibit them from completing their education in a public school setting. Some of the symbolic and actual losses that I have identified my clients having are: losing their biological parents(s) due to foster/ group home placement, parent being incarcerated, death of a parent or family member, moving away from a familiar neighborhood and friends, loss of interns because their practicum ending, and loss of innocence due to a criminal offense. I think it is safe to say that with all of the losses I have listed above students would display emotions of sadness, anger, betrayal, depression, dejection, and loneliness. While I understand each student will act out these emotions differently, I believe that these emotions will manifest in each child. Many children who experience a loss of family due to moving to a foster/group home and losing friends act out in anger and become aggressive. There may be a decline in grades and some become non compliant with school rules and regulations. With the other losses I have listed above you may observe girls becoming more promiscuous, or a decline in hygiene. Some children often set objects on fire or act out in other aggressive ways. Each child is unique in that they do not act identically the same when the same thing happens to them. Observing such behaviors may be an indicator that something is wrong and they need some time to grieve.
+Example: Exercise Module 1 •A Guide to First Steps •A Guide to Advance Directives •What Treatment Is Best For You? •Taking a Spiritual Inventory •Self-Assessment of Your Beliefs About Death and Dying www.pbs.org/wnet/onourownterms/tools/index.html
+Self-Assessment From On our own Terms web site This self-assessment does not give you any cute nicknames or tell you how well adjusted you are. What it does is give you insight into your attitude about death. After answering the questions, click on "What does your answer to these questions say?" to assess your responses. To the best of your memory, at what age were you first aware of death? __Under the age of 3 __Age 3 to 5 __Age 5 to 10 __Age 10 and up __Other
+Internet Resources http://www.nasponline.org/NEAT/grief.html This is the National Association of School Psychologists. The site discusses how teachers and parents can support children who have experienced loss. The site identifies expressions to grief, developmental phases, and tips for children and teens with grieving friends and classmates. http://www.cancer.org/docroot/MBC/MBC_4x_CopingGrief.asp?sitearea=MBC American Cancer Society’s information on grief
+ Required Readings: Grief and Loss Text, Chapter 4 Grief across the lifespan: Children and Adolescents Video: Select and watch a video from the list below that depicts a grieving child or adolescent. As you watch, compare the common reactions to grief identified in the text with the reactions of the character in the movie. Choices: My Girl, Soul Food, the Squid and the Whale, Ponette, CorrinnaCorinna, Terms of Endearment, My life as a House Journal Assignment: After watching the video and reading about children and adolescents’ grief, discuss what you believe is, or will be, the most challenging aspects for you of working with grieving children and adolescents and why. Team/Teacher Discussion (Chapter 4 in MySocialWorkLab): Identifying resources for children and families. Search the internet on a topic related to grief in children or adolescents. Identify three credible web sites that you believe have valuable information on grief for either professionals who are helping clients with grief or for clients who are experiencing grief. Share these web sites with an annotation with your discussion team mates.
+ Discussion Example For this week, I watched "Antwone Fisher." In this video, I observed that Antwone suffered the symbolic loss of therapy sessions with Davenport, on two different occasions. The first time, Antwone had initially refused to talk to Davenport but once he opened up to him, the 3 mandatory sessions they had seemed to help Antwone. When Antwone realized that the three sessions were it, he was very angry and I feel he felt abandoned yet again in his life. Considering his mother never came to find him after her release from jail, his father was murdered, and his foster family treated him poorly and eventually kicked him out, he never really had a stable support system in his life until he joined the Navy, I believe. The second time Antwone was discharged from therapy, he became very upset and angry again as Davenport would no longer see him because their sessions were "up." Antwone saw Davenport as someone he could open up to and trust. Davenport acknowledged that! That is why he encouraged Antwone to call him after Antwone tracked down his biological family. I also believe that Davenport and his wife had a symbolic loss when determined that he and his wife were not able to conceive children. Although they never had children, they were possibly grieving the fact that they were unable to create a biological family together. Davenports wife seemed to want to support for Davenport but Davenport, for a large part of the movie, would not talk to his wife about the issue at hand. It also seemed like Davenports wife wanted Davenport to provide her with support but he did not seem ready, at times, to talk about this symbolic loss. Maybe this is a stretch but I also feel that Antwone being sexually abused by Nadine (daughter at foster familys home) was a symbolic loss as he basically lost his innocence when she did what she did to him in the basement when no one was home. Antwone was forced to grow up, sexually, a lot sooner than he should have. He eventually opened up to Davenport about this but it took a long time for this to come out into the open.
+ Sample Slide from the Powerpoints provided by the Publisher Developmental Issues: Infancy and Early Childhood Dependency/Attachment Limited object constancy Limited ability to verbalize Lack coping strategies to regulate tension
+ SUGGESTED TEACHING TIPS Students often engage easily with the topic of grief in childhood and adolescence, since many have experienced losses or known people close to them who have experienced loss in childhood and adolescence. The Internet search activity suggested for this chapter is usually very compelling for students and they can expand it to include YouTube videos or blogs that address grief in childhood and adolescence. If you have recommended students keep a journal, ask them to use the journal to talk what reactions are likely to be elicited in them through their encounters with grieving children and adolescents. If you have not assigned a journal, you might suggest they write a reflective paper on this topic to encourage self reflection and self-awareness of identification or countertransference.
+ For Distance Learning (Online) versions of the course: The distance learning format of this course enables the student to view power point presentations, and videos, listen to audiotapes and podcasts and utilize interactive internet-based resources at your home or office. A variety of videos and tapes are suggested which can be rented at your local video rental suppliers, including Netflix or public library, YouTube and other Video streaming outlets. Discussion groups, journals and experiential exercises can be adapted for in-class or online use
+ Teaching Social Workers: Changing perspectives on Grief Department of Children and Families Substance Dependence Programs Inpatient and Outpatient Psychiatric Services Correctional Facilities ElderDay Health, Skilled Nursing Facilities, Assisted Living Schools,Residential Group Homes, At-risk youth programs
+ The benefits of online format This course should definitely be offered as a required course! I feel like I learned a lot about a topic I often dismissed and didn’t address in my own life; that of loss. I have to say I’ve been able to start speaking of my own experiences with loss (symbolic and physical) and had not been able to do so in a healthy way before this course. I also learned to look at a person’s passing in a more positive way….a person’s life should be celebrated even in death. Being able to use tools such as advanced directives ease the process of losing someone. This course’s topics were perfect for an online course because of the personal exploration required. The videos were really helpful in applying the material from the text and web resources.
+ The Benefits of Online Format I feel that I may not have been able to open up so much and share so much emotion about loss and grief in a classroom setting face to face with other students. Something about the online made me feel safe to speak and share my thoughts and feelings with other classmates without feeling they would judge me or think differently of me. This is the first course my wife really appreciated me taking. Every Friday night we watched the videos for the course, and of course, she enjoyed the tearjerkers.
+ Benefits of Online Format I liked the way the class was set up, with weekly readings and posts, as well as journals. I found that hearing other people’s stories and experiences was very helpful and inspiring. I really enjoyed getting to watch videos as an assignment, because it broke up the monotony of weekly class work, and because I love watching movies! I am definitely planning on watching more of the movies you suggested, as well as some others that I found. I also enjoy reading books related to social work topics such as eating disorders, disabilities, substance abuse, etc. and now I can really understand these topics in relation to loss. When you gave the assignment ―what grief related topics you want to learn more about,‖ I chose eating disorders and really thought about them in relation to loss, which was something I hadn’t really thought to do before. I thought of a lot of different losses associated with eating disorders, both for the individual and for family/friends.
+ The importance of the topic This course was very helpful for me. After multiple losses, I felt my feelings were gone. I didn’t care for other people losses, I was hurt from mine. Why I was going to suffer from others’? Inside of me I was hurt but I didn’t want anyone to know. I remember times getting home crying all the way home. I didn’t want my children to see me crying so I stop before I opened the door at home or I cried while I was taking a shower. It wasn’t easy for me, but not anymore. I would recommend this course to be part of the school requirements. Thank you for all the articles, for the Grief and Loss book and for all the recommendations given throughout this course. I have enjoyed learning from you this summer. Though the content was difficult, it is a terrific course and I have learned a great deal. I especially thought the opportunity to explore my own thoughts, feelings, and beliefs was very beneficial in helping me realize how my experiences will impact my working with clients who encounter grief. I especially liked the textbook – it was a wonderful introduction to many new theories