Surviving family members of unexpected deaths (accidents, murders, suicide) are often ill equipped to process pain, cope with daily functions, fulfill social roles and maintain health. Finding one's own spiritual resources in such crises can be immensely helpful. This pilot program integrates spiritual support responses into Israel’s Ministry of Labor & Social Affairs’ Sudden Loss and Bereavement Centers and targets parents in order to build and enhance family resilience and well-being.
Sudden crisis and loss, especially in traumatic situations, complicates and exacerbates the grieving process. Individual family members may experience a diminished sense of existential security and feel shame or guilt. If coping mechanisms break down or are not strong at the outset, people can be left struggling to function in their daily routines at home and at work and to fulfill their family roles and social relationships.
When this happens to parents or significant adult caregivers of children, the results can be catastrophic. Young people who are coping with sudden loss and bereavement already face increased risk of falling prey to psychological, emotional, and social distress, but when support from their caregivers is absent as well, this risk increases dramatically.
This is even more extreme for young people whose families were in conditions of risk prior to the traumatic event. The compounded effects may cause damage that can last a lifetime. Thus, it is crucial to provide broad, flexible, and effective sets of therapeutic responses to help individuals and families cope with such crises in ways that suit their characters and needs. Spiritual support is an effective care option for some and should be an alternative response for families suffering from sudden loss or bereavement.
JDC-Israel together with the Israel Ministry of Labor, Social Affairs & Social Services launched a three-year pilot program integrating spiritual care into the basket of services provided to families in the Ministry’s national network of Sudden Loss and Bereavement Centers. The program targeted, in particular, widowed/bereaved parents and other significant adult caregivers, with the aim of building family resilience and enhancing the wellbeing of children.
The death of a loved one frequently arouses complex feelings not only of sadness but also of fear, anger, a sense of impermanence, and an inability to believe that goodness still exists in the world. Spiritual care is designed to help family members connect to other parts of their life: to themselves, to their families and communities, and to their belief system about what lies beyond this world, whether that relates to inner spirituality, tradition, or religion. These connections draw out the personal resources necessary to cope, accept, and construct renewed meaning and hope after traumatic loss.
The methods used in spiritual support mostly have a different focus from those used in other types of therapy. The spiritual care counselor uses intention and presence to build with the client a supportive space for grieving, identifies sources of inspiration that allow the client to move forward, and facilitates the client’s self-expression and emotional release. Techniques commonly utilized include guided imagery, music, literature, art, personalized prayer, ceremonies and memorials, textual study, and breathing and relaxation exercises.
Individuals that turn to or are referred to one of the 8 Sudden Loss and Bereavement Centers in the country are offered a variety of options. These include: psychotherapy, group therapy, and sometimes art therapy or horseback riding therapy. As a result of this innovation, clients are now offered spiritual care and support by spiritual care professionals trained in the pilot program.
The pilot program has focused on three objectives:
· Fostering a national cohort of trained spiritual care providers who work at Sudden Loss and Bereavement Centers across Israel
· Creating a training curriculum for these professionals
· Integrating modules on spiritual support into professional development workshops for other members of the Sudden Loss and Bereavement Center counseling staff
Following the Sudden Loss and Crisis: Spiritual Support for Families pilot, the program is now in the final stages of being fully adopted and integrated into the 8 Ministry of Labor, Social Affairs & Social Services’ Sudden Loss and Bereavement Centers.
There has been a yearly increase in referrals to individual spiritual support and spiritual support groups, a better understanding by the social workers when to refer, and very good feedback from both professionals and family members, all of which is expressed in the evaluation which accompanied the pilot project.
What Makes Your Project Innovative?
Israel’s 8 Sudden Loss and Bereavement Centers found that many times the services offered were not adequate and did not respond to individual needs. Crisis services focused on individual or group therapy/counselling, without tapping into spiritual resources. Some clients sought something unique that responded to their shattered world of lost meaning and a strong need for establishing hope and comfort.
Israel is home to diverse backgrounds, cultures and religions. Offering spiritual support within the centers allows clients to tap into their individual spirituality, connectedness and meaning. Training social workers to include pluralistic spiritual support within a government service is an innovative unique process.
Another important innovation is extending spiritual support beyond illness, elder care and hospice to supporting individuals in life crises. This includes training professionals who have been trained for end of life, to respond now to those grieving after loss.
What is the current status of your innovation?
Looking back at the stages of generating ideas and design, it is very satisfying to see how far we came since the idea was just a thought. This project was able to bring spiritual support into a main stream government work and implement it into the service of loss and grief centers throughout the country. The implementation stages included: Introducing the concepts and tools of spiritual support to the professionals in the field; Recruiting and orienting well trained spiritual care providers to work with loss and grief; recruiting and providing ongoing training and supervision to all staff throughout the program.
The program was accompanied by qualitative and formative evaluation, which has shown we have reached our program goals.
The concept of this program disseminated to include spiritual support ideas in the work of school counselors school setting, and can and should be implemented also in other fields such as special needs families, retirement, trauma etc.
Collaborations & Partnerships
• Israel Ministry of Labor, Social Affairs & Social Services: the government ministry adopting and integrating the program into its service provision
• Sudden Loss and Bereavement Centers: perceiving the effectiveness of the program content for clients, and usefulness for professionals
• Non for profit organizations for therapy service in the project: implementing spiritual support into services for other populations.
Association of spiritual support: Widening the scope of the field.
Users, Stakeholders & Beneficiaries
Clients: now have another whole new option to receive support, in finding spiritual resources to help them in times of deep grief.
Government officials from other fields: now see that even a field which was so unknown can have a chance of bringing real change, and are more likely to take the service and approach seriously.
Spiritual care providers: as members of this new field in Israel, they gain confidence and are empowered as they make their way into new fields and applications
Results, Outcomes & Impacts
This project was able to bring spiritual support into a main stream government work and implement it into the service of loss and grief centers throughout the country. The implementation stages included:
Introducing the concepts and tools of spiritual support to the professionals in the field: 60 mental health professionals exposed to main ideas.
Recruiting and orienting 27 well trained spiritual care provided to work with loss and grief
Providing ongoing training and supervision to all staff throughout the program.
198 individuals received spiritual support during the pilot phase.
The program was accompanied by qualitative and formative evaluation, which has shown we have reached our program goals.
The concept of this program disseminated to include spiritual support ideas in the work of school counslers school setting, and the clear model makes possible be implemented also in other fields such as special needs families, retirement, trauma etc.
Challenges and Failures
Bringing the field of spirituality into a professional realm normally structured with "classic" therapy is a real challenge. There are many doubts, questions and resistance. Also, the word spirituality in itself may bring suspicion: is it an attempt to brain wash, to make people religious, to use their time of need as a window to change them?
These challenges were met with diligent work, patience, and slow recognition of the benefits of the program,
We also faced some big organizational change during our project which slowed us down for six months. However, once that was resolved the progress made up for it.
Where we succeeded in individual care, we have failed mostly with creating spiritual support groups We thought we would have 12 groups but we only had 4. We recognize this as an unrealistic plan, since we learned that support groups in this field are always difficult to establish, and discerned for future reference what made for the successful groups which did work.
Conditions for Success
For such an innovation to succeed its essential to have a committed director of service who sees the need and believes in spiritual support as an important innovation. The agency taking on the project must have mental health professional staff willing to learn and grow, for the benefit of their clients, and recruit well trained spiritual care providers who are able to re-orient to loss and grief. To all this staff, one must ensure adequate professional supervision at all times and a well managed system of referrals to establish routine
From our experience, it is essential that the operating organization can handle change, think creatively and support staff.
Its important to have extra budget support for the period of pilot program, until the program can be disseminated into an ongoing budget.
Students undergoing personal crisis or coping with the turbulence of adolescence are often haunted by significant and complex questions about life, death, and good and evil. Their thoughts often are unanswered by parents, teachers, and other adults .
The Spiritual Support for Families provided a basis for the development of a school-based Students in Crisis spiritual support program. This program is developing training for school guidance counselors in spiritual care in order to draw out the personal resources necessary to cope, accept, and construct meaning and hope for teens in school.
School guidance counselors are being trained in various techniques: breathing & relaxation exercises, guided imagery, music, literature, art, personalized prayer, ceremonies & memorials, and textual study. By integrating Spiritual Care in their work, they are able to offer additional options to help school students find means for self-expression and grapple with the issues they are facing.
Mental health professionals who are not familiar with the ideas and tools of spiritual care tend to be very weary about bringing a new service to the clients. The best way to work with this is by having joint days of learning, experiential workshops to learn the methods together and to establish mutual trust. This cannot be a one time workshop but must continue on an ongoing basis.
Its important to recognize that the idea of bringing spirituality into the service comes more naturally to some people than others. This goes both for professionals and for clients. Therefore, its best to begin the innovation in the centers that are more inclined and more open to it.
We thought at first that through the evaluation and the experience we would come to understand what is the profile of a client best suited for receiving spiritual support: Young or old? recently bereaved or after many months? years? parents who have lost their children, siblings or grandparents? But, what we have learned is that there is no such guiding rule. The only thing that became clear is that as the social workers doing the intake became more familiar and trusting of the spiritual support, they were more able to discern when to refer to it.
The model for spiritual support groups is co facilitators- a social worker with spiritual care provider.We have learned that several things can make a group work:
Beginning a group with a larger number so when some members inevitably leave, the group can still exist
Having a structured model that can contain the pain in the group.
Use creative modules to both bear witness to the stories as well as bring hope and meaning.
Mutual trusting relationship between the two co facilitators and ongoing supervision to preserve this.
Overall. most important of all to have a committed, strong and kind professional director to be leader for the whole project.
As mentioned earlier, religion and spirituality are not identical.
Spirituality contains a wider range of possibilities than religion; while religion referees mostly to institutional practices and rituals, spirituality refers mostly to inner connectedness to one self, to community and to the Beyond; to arguing pain and crisis of faith and finding renewed meaning and hope. Both concepts can contain one another but are nit the same.
That is why, whoever wishes to establish such a program will need to make it very clear to themselves first and to the partners after- that the spiritual support is not there to tell others what spirituality is, but to provide a safe space for them to explore what their own spiritual resources are.
We believe this a key component for this program.
- Implementation - making the innovation happen
- Evaluation - understanding whether the innovative initiative has delivered what was needed
- Diffusing Lessons - using what was learnt to inform other projects and understanding how the innovation can be applied in other ways
18 February 2021