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Using Service-Learning to Integrate Death Education Into Counselor Preparation a
Heather L. Servaty-Seib & Sara J. Tedrick Parikh
a
a
Department of Educational Studies , Purdue University , West Lafayette , Indiana , USA Accepted author version posted online: 17 Jul 2013.Published online: 27 Aug 2013.
To cite this article: Heather L. Servaty-Seib & Sara J. Tedrick Parikh (2014) Using Service-Learning to Integrate Death Education Into Counselor Preparation, Death Studies, 38:3, 194-202, DOI: 10.1080/07481187.2012.738774 To link to this article: http://dx.doi.org/10.1080/07481187.2012.738774
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Death Studies, 38: 194–202, 2014 Copyright # Taylor & Francis Group, LLC ISSN: 0748-1187 print=1091-7683 online DOI: 10.1080/07481187.2012.738774
Using Service-Learning to Integrate Death Education Into Counselor Preparation Heather L. Servaty-Seib and Sara J. Tedrick Parikh
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Department of Educational Studies, Purdue University, West Lafayette, Indiana, USA
Service-learning can be a meaningful and effective tool for integrating death education into counselor preparation. The authors describe the design, implementation, reflection process, and evaluation of a service-learning based support program for grieving families and offer suggestions for death educators interested in service-learning as pedagogy. Their evaluation indicated that students who took a graduate-level group counseling course with a service-learning component exhibited lower distress in death-related clinical situations than students who took the course without the service component. Service-learning is closely aligned with death education aims and can be used to enhance counselor preparation program curricular alignment with relevant accreditation standards.
A review of the current state of death education emphasized the urgent need (Wass, 2004) to integrate death education into counselor preparation. This review, however, focused on grief counselors. We argue that it is critical for all counselors, regardless of discipline, be trained in the area of thanatology. Even when counselors in training do not specialize in death and dying, they cannot avoid working with dying or grieving individuals during their careers. An ongoing challenge is balancing accreditation standards (e.g., Council on Social Work Education [CSWE], Council for Accreditation of Counseling & Related Educational Programs [CACREP], and American Psychological Association Commission on Accreditation [APA CoA]) with critical curricular content areas such as death and dying (e.g., Harrawood, Doughty, & Wilde, 2011). We provide an example of using service learning to integrate death education into counselor preparation in an existing group counseling course. We begin by defining service-learning and offering key points of synthesis between service-learning as pedagogy and graduate-level counselor training and death education. Then, our case example follows four primary phases Received 25 June 2012; accepted 25 September 2012. Address correspondence to Heather L. Servaty-Seib, Counseling & Development, Department of Educational Studies, Purdue University, 100 N. University St., West Lafayette, IN 47907. E-mail: servaty@ purdue.edu
(e.g., design, implementation, reflection, and evaluation; see Eisenhauer, Marthakis, Jamison, & Mattson, 2011). Within each section, we summarize our process, describe challenges, and offer suggestions for death educators.
SERVICE-LEARNING, GRADUATE EDUCATION, COUNSELOR PREPARATION, AND DEATH EDUCATION Service-learning is a particular approach to experiential learning that balances student learning and community service (Furco, 2002). More specifically, the definition of service-learning we use is as follows: a credit-bearing, educational experience in which students a) participate in an organized service activity that meets identified community needs, and b) reflect on the service activity in such a way as to gain further understanding of course content, a broader appreciation of the discipline, and an enhanced sense of civic responsibility. (Bringle & Hatcher, 1996, p. 222)
National conversations on graduate education and civic engagement suggest that graduate education ‘‘seems to be the next frontier of the service-learning and civic-engagement movements’’ (O’Meara, 2007, p. 2). Although graduate students desire to connect their learning to the real world (Cherwitz & Sievers, 2003), there
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remains a significant disparity between community engagement opportunities available to graduate versus undergraduate students (O’Meara, 2007). Indeed, many students likely ‘‘experience the transition to graduate school as a withdrawal from public and community service that was a vital part of their undergraduate years’’ (Stanton & Wagner, 2006, p. 2). The lack of graduatelevel service-learning opportunities is particularly surprising considering how well the pedagogy matches with the complexity of graduate-level training, including professional development and socialization into a discipline. Also, as tomorrow’s faculty members, graduate students need modeling of community involvement and civic engagement (O’Meara, 2007). Scholarly literature on graduate-level service-learning is limited. Gerontology appears to be overrepresented, including courses in gerontology programs (Peacock, Flythe, & Jones, 2006) and gerontology courses in other disciplines including social work (Faria, Dauenhauer, & Steitz, 2010), physical therapy (Beling, 2003) and multidisciplinary health care (McWilliams, Rosemond, Roberts, Calleson, & Busby-Whitehead, 2008). The connection between multicultural competence and servicelearning is also represented in the fields of counseling (Baggerly, 2006), psychology (Hagan, 2004), and education (Donovan, 2008). Scholarly reports on service-learning with graduate students vary somewhat in purpose and structure. Most scholarship describes positive, meaningful outcomes of service-learning courses in the form of students’ gains in attitudes, knowledge, and=or skills. Using a pre–post design and random assignment to service- or nonservicelearning, physical therapy students engaged in servicelearning learned more and were less biased against older adults than their nonservice-learning peers (Beling, 2003). Dorfman, Murty, Ingram, and Li (2007) found positive mixed-method, pre–post positive outcomes for gerontological social work student, but had no comparison group. Service-learning in counselor preparation directly connects with ethical responsibilities to contribute to the public good and provide a portion of work pro bono (American Counseling Association’s Code of Ethics, 2005; American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct, 2010; National Association of Social Workers, 2008). Within psychology, experts challenge the field to modify curricula to more clearly meet the needs of society through a focus on socially responsive knowledge (Altman, 1996) and suggest service learning as particularly wellsuited for educating counselors and psychologists regarding the variety of roles (e.g., outreach, prevention, social advocacy) they will engage in as professionals (Kenny & Gallagher, 2000). In school counseling, Wilczenski and Cook (2009) strongly advocated for the
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use of service-learning and argued that school counseling, as an ethic of care, is enhanced by the dynamic and reciprocal nature of service-learning. Thanatology scholars also recognize service learning as a potentially powerful tool for death education (e.g., Noppe, 2007). Scholarship on death education initially stressed humanistic factors such as personal awareness, reflection, and self-understanding (Feifel, 1977), all elements core to service-learning. In addition, meta-analyses on death education have indicated experiential teaching reduces students’ death anxiety (e.g., Maglio & Robinson, 1994). Despite these clear links, only one published article focuses on integrating death education and service-learning. Basu and Heuser (2003) integrated service-learning into two newly developed, upper-level, undergraduate death education courses in sociology and political science. They delineated key elements of their process and lessons learned, and advocated increased service-learning in death education. The existing literature offers no illustrations of integrating death education and service-learning in fields involving direct service contact with grieving or dying individuals and families. Thanatological content is difficult to integrate into counselor training programs because of accreditationrelated curricular demands. Accreditation standards in social work, school counseling, and psychology require curricula on material considered more general to clinical practice including individual therapy, diversity, and group work (see APA CoA, 2009; CACREP, 2009; CSWE, 2008). Accreditation demands often overshadow programs’ ability to cover critical content such as death and dying issues. Research suggests limited death and dying content in counseling (Offer, Granello, & Wheaton, 2012), clinical psychology (Dexter-Mazza & Freeman, 2003), and school psychology (Seadler, 2000). However, literature indicates a great need for counselors (Cohen & Mannarino, 2011; Servaty-Seib & Taub, 2010) to know about thanatology as death is the most universal of all life stressors. Death competence, ‘‘specialized skill in tolerating and managing clients’ problems related to dying, death and bereavement’’ (Gamino & Ritter, 2012, p. 23), is an ethical imperative of many mental health-related disciplines. Further, beginning counselors report greater distress associated with death and dying than other clinical situations (Kirchberg & Neimeyer, 1991). Narratives of counselors in training indicated that a 2-credit course on death education provided enhanced openness to thinking about and discussing death, greater awareness of personal death attitudes, and decreased negative affect related to death (Harrawood et al., 2011). Harrawood et al. called for (a) additional research on counselors’ self-knowledge about death and openness to thanatological content, and (b) inclusion of grief and loss in accreditation
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standards. We fill a gap in the literature by providing a case example of integrating death education and servicelearning into an existing course.
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CASE EXAMPLE: INTEGRATING DEATH EDUCATION INTO A GROUP COUNSELING COURSE We cover four phases: (a) design, (b) implementation, (c) reflection, and (d) evaluation. I (the first author) taught the group counseling course four times without a service-learning component (2003–2005, 2008) and four times with a service-learning component (2006–2007, 2009–2010); the second author assisted with program implementation and evaluation. Across all eight semesters, the primary focus was on providing a theoretical and experiential overview of the basic elements of group dynamics and group process. Prior to integrating service-learning, the emphasis was on knowledge versus skill competencies. Students practiced group leader behaviors through leading their fellow students in group exercises (approved and supervised by instructor). Students developed other group leader skills by designing a group plan integrating group theory, research, and intervention strategies. Students also observed and identified group process events during in-class exercises and videos and through a group observation assignment. Design The design phase of the service-learning integration was multidimensional. I (the first author) sought training on service-learning, located a service-learning mentor, and received two small grants to assist in initial funding of the service-learning project. I also reflected on my personal commitment to integrating death education into the curricula of the school counseling and counseling psychology doctoral programs. I talked with faculty colleagues regarding how service learning that integrated thanatological content would actually increase the fit between program curricula and accreditation standards. Because I knew that I would be integrating a servicelearning component into my group course, my next step was to develop a brief, grief-related, group-based intervention that counselors-in-training could provide. Using my previous experience with programs focused on providing support for grieving families, I developed the BRIDGe (By Remembering I Develop & Grow), an eight-session, family-focused, psychoeducational support program for grieving families (contact the first author for mission and objectives). The BRIDGe is based on theory and research (e.g., Metel & Barnes, 2011) and all members of grieving families attend
sessions together. Family members participate in separate and related group sessions and come together at the end of each evening to discuss their experiences. Although each meeting is centered on a specific topic (see the appendix for session topics), the manner in which each topic is addressed (e.g., through conversation versus hands-on activities) differs by age group. Community partnerships are a critical factor of service-learning (Eisenhauer, 2011a). Faculty planning to engage in service-learning must meet with potential partners prior to implementation and even conduct a needs assessment. Although a needs assessment can prove useful, potential collaborators may not always be aware of or open to the thanatological issues facing community members. I approached three different school districts before I found one open to collaboration; connecting with a specific school counselor who knew the day-to-day needs of the children and families proved more effective than approaching district-level administrators. Input from collaborators should be sought during early planning for service-learning projects. For example, my school counselor collaborators made crucial suggestions about supervision structure, day=time=place of BRIDGe meetings, and marketing. Regarding course structure and syllabus, I expanded the knowledge, skills, and attitude objectives (see Association for Specialists in Group Work, 2000) in preparation for integrating BRIDGe. Although the wording of many knowledge objectives did not change, their depth and complexity changed qualitatively. For example, all students learned to ‘‘identify the essential group dynamics involved in understanding group interactions.’’ However, there is a distinct difference between learning this objective through course reading and living those group dynamics while actually facilitating sessions. With the BRIDGe, I added skill-related objectives not previously possible (e.g., ‘‘develop co-facilitation skills’’). I also added thanatology objectives such as ‘‘recognize the idiosyncratic nature of grief’’ and ‘‘exhibit comfort with discussing grief with group members.’’ Faculty must prepare students for service-learning (Eisenhauer, 2011b), particularly in thanatological contexts (Gamino & Ritter, 2012). To prepare students for service-learning, I explicitly defined service-learning in the syllabus, discussed the direct connections between course objectives and implementation of the BRIDGe, and emphasized the importance of reflection activities in allowing them to make their own connections between course concepts and their group facilitation. Prior to initial implementation in 2006, I realized that there would not be enough time during the regularly scheduled class periods to educate students on grief. Therefore, in addition to integrating thanatology content throughout, I developed a 4-hr workshop on best practices in working with grieving individuals and families. In this workshop,
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students learn key grief=mourning theories, empirical findings related to grief, how children=adolescents= adults grieve differently, and unique factors to consider when working with grieving families as opposed to individuals. Students also spend workshop time in death awareness activities (e.g., drawing their concept of death) and preservice preflection activities such as writing letters to themselves. Students seal the letters and do not read them until the final supervision session, following the conclusion of the BRIDGe. Our suggestions for the design phase include
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. reflect on your expertise in thanatology and what
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element(s) of the field you could reasonably integrate into counselor preparation using servicelearning; discuss your interest in death education and service-learning with colleagues and determine how you can connect your work with the overarching needs of the program(s) and with relevant accreditation standards; expand your knowledge of service-learning through connecting with campus offices overseeing experiential learning, locating a service-learning mentor, and accessing scholarly resources (e.g., texts, articles from your discipline, organization websites); determine the best fit for the structure of the service-learning project(s) including a whole class project such as the BRIDGe, small group projects, or individual projects; build solid relationships with community collaborators; elicit and integrate their feedback into the process of project development; seek internal and external funding (e.g., Campus Compact, foundations); develop intentional ways (e.g., preflection, pedagogical conversations) to prepare students to get the most from their service-learning and death education experiences; and carefully consider how your combined servicelearning and death education efforts will be viewed in reappointment, promotion, tenure, and related faculty decisions within your department (ServatySeib, 2011b).
Implementation I (the first author) implemented the BRIDGe within a group counseling course. Graduate students in school counseling and counseling psychology facilitate BRIDGe support group sessions and, therefore, can immediately apply the knowledge, skills, and attitudes they acquire through course readings, lectures, and discussions. During the first eight class periods, students receive traditional didactic material associated with
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group counseling and techniques and complete an examination. During the last eight class periods, I work together with students and four supervisors to implement BRIDGe at a local school. Students co-facilitate one of four simultaneous, age-based groups (i.e., children, pre-teens, teens, adult=caregivers), and a supervisor sits in with the same group of facilitators throughout the program. Each evening of the program begins with pre-group supervision. When the families arrive, they share a meal (typically donated by a local restaurant) and disperse to group meetings, which last about 75 min. Family members then come together for 15 min to share an important experience from their group time. Each class period ends with cofacilitators receiving supervision from their respective supervisors. The last session of BRIDGe includes a closing candlelight memorial activity, which marks the end of the program. A key element of the BRIDGe each year is marketing the program and recruiting families. Marketing involves mailing brochures and posters to a number of key groups within the local community including school counselors, mental health facilities, funeral homes, pediatric and family physicians, and cemeteries. Over the course of implementation, we have learned the importance of sharing information about the program through in-person networking and offering psychoeducational presentations to local community groups (e.g., Compassionate Friends, childcare facilities). Our suggestions for the implementation phase include . connect with individuals who are open to volun-
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teering time to assist with your service-learning project (e.g., food pick-up, advanced students to complete intakes, basic trouble shooting during implementation); determine if there is a need for liability insurance for students and=or supervisors; both are required for the BRIDGe; Offer supervision training if your project includes the use of volunteer supervisors; Seek donations for supplies and food from local businesses; and take advantage of multidisciplinary resources on your campus. The BRIDGe logo, brochure, and poster were designed by a graphic design student for minimal cost.
Reflection Reflection is a critical element of service-learning; multiple forms of reflection facilitate integrating the service experiences with course content (Stewart, 2011). Graduate students involved in the BRIDGe complete three different written reflections. First, they complete three structured reflection papers in which they connect
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their group facilitation experiences with course content in knowledge, skills, and personal reactions (contact the first author for full assignment description). Second, they observe another group during one night of the program and complete a reflection paper on that experience; students often comment that the observation facilitates personal reactions to grief issues. The final project is a synthesis paper in which students holistically consider all elements of the course (e.g., didactic material, group facilitation, relevant research, personal reactions) and reflect on their learning. Group supervision is a discussion-based reflection used heavily in the BRIDGe. Although definitions vary somewhat, group supervision is the process through which a supervisor oversees the professional development of a number of counselors in training within a group setting, often involving case presentations, didactic information, and interpersonal processes (Holloway & Johnston, 1985). Students receive whole class supervision prior to BRIDGe implementation, prior to each session, and on the final evening of the course, and they receive subgroup supervision (i.e., with group supervisor) following each session. BRIDGe supervisors encourage students to reflect on their experiences prior to supervision and come to each meeting with questions and comments. In all cases, the content of the group supervision sessions remains flexible but is consistently focused on reflection=debriefing and on connecting and applying course material to the process of the groups. Our suggestions for the reflection phase include . emphasize directly to students the importance of
reflection in the service-learning process to minimize any risk of reflections being perceived as ‘‘busy work’’; . use a variety of reflection-based activities; and . determine who should have access to students’ written reflections (e.g., supervisors, community partners) and inform students at the beginning of your class about who will have access to their papers and=or journal entries. Evaluation Service-learning scholars recommend evaluation that includes multiple stakeholders and both quantitative and qualitative measures (Furco, 2002; Gelmon, 2000). Evaluation is both formative and summative. With regard to formative evaluation, I (the first author) have modified the BRIDGe program based on stakeholder feedback. Following each annual program implementation, I seek verbal (e.g., focus groups, group supervision) and written feedback from students, supervisors, and family members. Examples of modifications include adding family time at the end of each session, providing
notecards with parenting tips, and adding a family member panel discussion for new facilitators prior to beginning the program. We also evaluate program impact on students and families. Student Impact We have evaluated the impact of the BRIDGe on student learning in two major ways, one inside and one outside of the class. Within the class, supervisors rate students after the first, fourth, and eighth sessions (1 ¼ below expected level, 5 ¼ above expected level) on eight skills including (a) group facilitation, (b) connecting learning to life outside group, (c) ethical practice, (d) cooperation with co-facilitators, (e) awareness of diversity, (f) accurate information on grief, (e) comfort with discussing grief, and (g) use of supervision. Repeated measures analyses of data from the two most recent implementations of BRIDGe indicated significant increases in total skills for Spring 2009, F(2, 9) ¼ 5.10, p ¼ .033, g2p ¼ :53, a ¼ .93, and Spring 2010, F(2, 7) ¼ 5.15, p ¼ .042, g2p ¼ :60, a ¼ .95. Outside the class, we compared course perceptions from students enrolled in the group course with and without the BRIDGe. The online survey included an information letter, demographic=background questions, and the Counseling Situations Questionnaire (CSQ; Kirchberg & Neimeyer, 1991), which contains two subscales: distress regarding death and non-death related counseling situations. In addition, we included seven single-item quantitative measures and four open-ended questions (contact the first author for survey). The survey did not mention the BRIDGe. Of those who took the course without the BRIDGe (n ¼ 53), 12 completed the survey (response rate ¼ 22.6%); of those who took the course with the BRIDGe, (n ¼ 47), 13 completed the survey (response rate ¼ 27.7%). Response rates are only estimates as it is not possible to determine if prospective participants actually received the recruitment email; retaining updated emails for alumni is difficult. Participants in the BRIDGe and non-BRIDGe groups were predominantly women (84.6% and 91.7%, respectively) and White (84.6% and 100%, respectively, see Table 1). A one-way MANCOVA with age, number of group sessions led in career, and number of death losses as covariates indicated a significant difference between BRIDGe and non-BRIDGe groups, F(9,12) ¼ 3.99, p ¼ .014, g2p ¼ :75 (medium effect size; Cohen, 1988). BRIDGe students, when compared to non-BRIDGe peers, rated the course as more memorable, F(1,20) ¼ 11.595, p ¼ .003, g2p ¼ :37 (small effect size), practical, F(1,20) ¼ 9.030, p ¼ .007, g2p ¼ :31 (small effect size), and personally rewarding, F(1,20) ¼ 26.160, p ¼ .000, g2p ¼ :57 (medium effect size); and, they reported less distressed in working with clients with death and
DEATH EDUCATION AND COUNSELOR PREPARATION TABLE 1 Means and Standard Deviations of Participant Background Information and Variables by Group BRIDGe (n ¼ 13) M (SD) Age 27.38 (5.42) Death losses 4.00 (2.31) Group sessions led 44.54 (43.63)
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Variable CSQ (nondeath) CSQ (death-related) Memorable Informative Practical Acad. Challenging Useful Personally rewarding Interesting
Non-BRIDGe (n ¼ 12) M (SD) 31.17 (4.11) 6.50 (3.66) 66.25 (33.65)
M (SD) 21.77 15.62 4.54 4.23 4.62 3.85 4.33 4.69 4.08
(3.96) (3.97) (.52) (.83) (.51) (.69) (.75) (.48) (.86)
t(df)
1.95 (23) 0.063 2.06 (23) 0.051 1.38 (23) 0.180
M (SD) 23.92 17.92 2.75 3.92 4.00 3.67 4.33 3.67 3.92
p
(4.12) (2.54) (.62) (.51) (.74) (.89) (.65) (.65) (.67)
F
p
2.08 5.11 11.60 2.57 9.03 .33 .17 26.16 1.26
0.165 0.035 0.003 0.124 0.007 0.573 0.686 0.000 0.274
Note: Number of group sessions led throughout professional career. CSQ ¼ Counseling Situations Questionnaire.
dying-related concerns, F(1,20) ¼ 5.112, p ¼ .035, g2p ¼ :20 (small effect size). These effect sizes suggest meaningful differences between the groups. Groups did not differ on distress from working with clients presenting with non-death concerns. Each author read the open-ended responses independently and repeatedly. We developed categories and discussed the categories, using consensus to further analyze and reach conclusions. The qualitative findings complemented the quantitative findings and suggested that students highly valued the opportunity for servicelearning. For example, in response to the open-ended question about usefulness, all (13 of 13) BRIDGe students either directly or indirectly referred to their service-learning experience. Themes included enhanced preparation for practicum, clinical skill development, and confidence in their clinical skills. Conversely, nonBRIDGe students most often commented (eight of 12) that the class itself functioning as a group. The predominant theme in their responses was an overarching desire for more ‘‘hands on’’ experience within the course (i.e., a desire for a service-learning experience). Family Impact Family attendees between 2006 and 2010 (N ¼ 26) completed a modified 8-item Client Satisfaction Questionnaire (Larsen, Attkisson, Hargreaves, & Nguyen, 1979; alpha ¼ .81 with current sample). Adult respondents indicated high perceived quality of the service and satisfaction with help received (M ¼ 3.73 and 3.58, respectively; 4 ¼ excellent), and perceived that the service
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helped them deal more effectively with their grief (M ¼ 3.42; 4 ¼ helped a great deal). In addition, they reported that they would return to the program and recommend it to a friend (M ¼ 3.65 and 3.96, respectively; 4 ¼ yes, definitely). Open-ended written comments included themes of appreciation for (a) the opportunity to connect and interact with other grieving families, (b) information about grief, and (c) including separate age-based meetings and joint family time. The greatest evaluation-related challenge for the BRIDGe has been assessing impact on family members. A pre–post evaluation process is optional but family participation has been limited. The highest level of participation was from families during the first year of the program, particularly parents reporting on their children’s functioning. Pre- and posttest measures of child adjustment as assessed by the Child Behavior Checklist (Achenbach & Rescorla, 2001; based on nine evaluations, both mother and father ratings for three children and only father ratings for three children) indicated a significant decrease in emotional and behavior problems over the course of the program, t(8) ¼ 2.64, p ¼ .03. Minimally successful strategies to increase family involvement have included a monetary incentive, reducing the number of measures, and mailing packets rather than requiring an in-person meeting. For future programs, we may integrate structured quantitative and qualitative measures into the BRIDGe intake interview, add an exit interview with the same measures, and ask permission for responses to be used for research purposes. Our suggestions for the evaluation phase include . develop a multidimensional evaluation approach
and integrate it from the start of your servicelearning effort (Servaty-Seib, 2011a); . seek IRB approval from your institution and your community partner as necessary; . consider collaborating with other faculty (or an advanced graduate student) who are engaged in service-learning so you can assist each other in data collection; it is helpful for data to be collected by someone other than the instructor of the course; and . determine the most appropriate constructs to assess and use existing measures whenever possible (see Bringle, Phillips, & Hudson, 2004).
IMPLICATIONS FOR DEATH EDUCATION AND COUNSELOR PREPARATION Service-learning is an innovative and practical pedagogy for integrating death education into counselor preparation. The dynamic and dense nature of servicelearning fits with the complexity of both death education and counselor preparation. Counselors in training
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engaged in death-related service-learning can develop as professionals, gain self-awareness, and experience transformational learning regarding a topic that is seldom addressed within counselor preparation programs (Harrawood et al., 2011; Offer et al., 2012). Through this case example, we illustrate how death education can be integrated into counselor preparation. We collaborated with a local school district; however, other potential collaborators include family grief centers, hospices, funeral homes, and cancer centers. We challenge faculty in counselor preparation programs to consider these suggestions to develop their own unique way of integrating death education into their curricula. As faculty knowledgeable about thanatology, we have an ethical obligation to weave death education into our curricula. Graduate students cannot avoid working with grieving and=or dying clients in their future careers; so need at least minimal death competence (Gamino & Ritter, 2012). Service-learning provides an excellent vehicle for integrating death education while also offering an opportunity to increase program correspondence with relevant accreditation standards. It allows faculty to model and directly facilitate students’ understanding of community needs, while encouraging civic mindedness. In addition, students observe faculty members in the role of engaged scholars who actively integrate research, teaching, and service (O’Meara, 2011; ServatySeib, 2011b). Service-learning can address beginning clinicians’ distress when facing death and dying situations. School counseling and counseling psychology graduate students who engaged in death-related service-learning (i.e., served as BRIDGe facilitators) reported lower distress in clinical situations involving death issues than did their non-BRIDGe peers. This result is consistent with past research with graduate students suggesting a connection between service-learning and improved comfort with older adults (McWilliams et al., 2008) and increased awareness of diversity-related inequities (Donovan, 2008). In addition, this finding is aligned with death education research that emphasized the importance of experiential teaching methods in affecting death anxiety (Maglio & Robinson, 1994).
IMPLICATIONS FOR RESEARCH Although narrow examinations have been conducted in fields such as counseling (Offer et al., 2012) and clinical psychology (Dexter-Mazza & Freeman, 2003; only related to suicide), a comprehensive and simultaneous assessment of offerings across many service provision disciplines (e.g., social work, rehabilitation counseling, counseling psychology) is warranted. In addition, such research needs to be conducted using an international
lens, as has been done on a limited basis within nursing and medicine (e.g., Downe-Wamboldt & Tamlyn, 1997). The emphasis on evaluation within service-learning as a pedagogy offers opportunities for faculty to integrate their teaching, engagement and research efforts. Future research on service-learning to integrate death education into counselor preparation should use multiple stakeholders as participants, standardized assessments, and sophisticated research designs (Gelmon, 2000).
REFERENCES Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA School-Age Forms & Profiles. Burlington: University of Vermont, Research Center for Children, Youth, & Families. Altman, I. (1996). Higher education and psychology in the millennium. American Psychologist, 51, 371–378. doi:10.1037==0003-066X. 51.4.371 American Counseling Association. (2005). Code of ethics. Retrieved from http://www.counseling.org/Resources/CodeOfEthics/TP/ Home/CT2.aspx American Psychological Association. (2010). Ethical principles of psychologists and code of conduct. Retrieved from http://www.apa. org/ethics/code/index.aspx American Psychological Association, Commission on Accreditation. (2009). Guidelines and principles for accreditation of programs in professional psychology. Retrieved from http://www.apa.org/ed/ accreditation/about/policies/guiding-principles.pdf Association for Specialists in Group Work. (2000). Professional standards for the training of group workers. Retrieved from http:// www.asgw.org/pdf/training_standards.pdf Baggerly, J. (2006). Service learning with children affected by poverty: Facilitating multicultural competence in counseling education students. Journal of Multicultural Counseling and Development, 34, 244–255. Basu, S., & Heuser, L. (2003). Using service learning in death education. Death Studies, 27, 901–927. doi:10.1080=716100342 Beling, J. (2003). Impact of service learning on physical therapist students’ knowledge of and attitudes toward older adults and on their critical thinking ability. Journal of Physical Therapy Education, 18, 13–21. doi:10.1300=J021v24n01_03 Bringle, R. G., & Hatcher, J. A. (1996). Implementing service-learning in higher education. Journal of Higher Education, 67, 221–239. doi:10.2307=2943981 Bringle, R. G., Phillips, M. A., & Hudson, M. (2004). The measure of service learning: Research scales to assess student experiences. Washington, DC: American Psychological Association. doi: 10.1037=10677-001 Cherwitz, R., & Sievers, J. (2003). Ethical commitments, professional visions, and intellectual choices: Students call for changes in graduate education. Communicator, 36, 21–22. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates. Cohen, J. A., & Mannarino, P. (2011). Supporting children with traumatic grief: What educators need to know. School Psychology International, 32, 117–131. doi:10.1177=0143034311400827 Council for Accreditation of Counseling, & Related Educational Programs. (2009). CACREP 2009 Standards. Retrieved from http:// www.cacrep.org/doc/2009%20Standards%20with%20cover.pdf Council on Social Work Education. (2008). 2008 educational policy and accreditation standards. Retrieved from http://www.cswe.org/File. aspx?id=13780
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DEATH EDUCATION AND COUNSELOR PREPARATION Dexter-Mazza, E. T., & Freeman, K. A. (2003). Graduate training and the treatment of suicidal clients: The students’ perspective. Suicide and Life-Threatening Behavior, 33, 211–218. doi:10.1521=suli.33.2. 211.22769 Donovan, J. (2008). Effective use of EE-learning in a graduate education course. Journal of the Scholarship of Teaching and Learning, 8, 61–78. Dorfman, L. T., Murty, S. A., Ingram, J. G., & Li, H. (2007). Evaluating the outcomes of gerontological curriculum enrichment: A multimethod approach. Gerontology & Geriatrics Education, 27, 1–21. doi:10.1300=J021v27n04_01 Downe-Wamboldt, B., & Tamlyn, D. (1997). An international survey of death education trends in faculties of nursing and medicine. Death Studies, 21, 177–188. Eisenhauer, M. J. (2011a). Community partnerships. In M. J. Eisenhauer, N. B. Marthakis, J. R. Jamison, & M. Mattson (Eds.), Charting a course for service learning: From curriculum considerations to advocacy: A faculty development workbook (pp. 34–50). Indianapolis: Indiana Campus Compact. Eisenhauer, M. J. (2011b). Student preparation. In M. J. Eisenhauer, N. B. Marthakis, J. R. Jamison, & M. Mattson (Eds.), Charting a course for service learning: From curriculum considerations to advocacy: A faculty development workbook (pp. 105–117). Indianapolis: Indiana Campus Compact. Eisenhauer, M. J., Marthakis, N., Jamison, J. R., & Mattson, M., (Eds.). (2011). Charting a course for service learning: From curriculum considerations to advocacy: A faculty development workbook. Indianapolis: Indiana Campus Compact. Faria, D. F., Dauenhauer, J. A., & Steitz, D. W. (2010). Fostering social work gerontological competencies: Qualitative analysis of an intergenerational service-learning course. Gerontology & Geriatrics Education, 31, 92–113. doi:10.1080=02701960903578378 Feifel, H. (1977). Death and dying in modern America. Death Education, 1, 5–14. doi:10.1080=07481187708252874 Furco, A. (2002). Issues of definition and program diversity in the study of service-learning. In S. H. Billig (Ed.), Studying service-learning: Innovations in education methodology (pp. 13–33). Mahway, NJ: Lawrence Erlbaum. Gamino, L. A., & Ritter, R. H. (2012). Death competence: An ethical imperative. Death Studies, 36, 23–40. doi:10.1080=07481187.2011. 553503 Gelmon, S. (2000). Challenges in assessing service-learning. Michigan Journal of Community and Service Learning, Fall, 84–90. Hagan, M. (2004). Acculturation and an ESL program: A service learning project. Journal of Multicultural Counseling and Development, 32, 443–448. Harrawood, L. K., Doughty, E. A., & Wilde, B. (2011). Death education and attitudes of counselor-in-training toward death: An exploratory study. Counseling and Values, 56, 83–95. doi:10.1080= 15401383.2011.579872 Holloway, E. L., & Johnston, R. (1985). Group supervision: Widely practiced but poorly understood. Counselor Education and Supervision, 24, 332–340. Kenny, M. E., & Gallagher, L. A. (2000). Service-learning as a vehicle in training psychologists for revised professional roles. In F. T. Sherman & W. R. Torbert (Eds.), Transforming Social Inquiry, Transforming Social Action: New Paradigms for Crossing the Theory=Practice Divide in Universities and Communities (pp. 189– 205). Norwell, MA: Kluwer Academic Publishers. Kirchberg, T. M., & Neimeyer, R. A. (1991). Reactions of beginning counselors to situations involving death and dying. Death Studies, 15, 603–610. doi:10.1080=07481189108252548
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Larsen, D. L., Attkisson, C. C., Hargreaves, W. A., & Nguyen, T. D. (1979). Assessment of client=patient satisfaction: Development of a general scale. Evaluation and Program Planning, 2, 197–207. doi:10.1016=0149-7189(79)90094-6 Maglio, C. J., & Robinson, S. E. (1994). The effects of death education on death anxiety: A meta-analysis. Omega, 29, 319–335. doi: 10.2190=KEA9-2G73-AMJM-MNP6 Metel, M., & Barnes, J. (2011). Peer-group support for bereaved children: A qualitative interview study. Child and Adolescent Mental Health, 16, 201–207. doi:10.1111=j.1475-3588.2011.00601.x McWilliams, A., Rosemond, C., Roberts, E., Calleson, D., & BusbyWhitehead, J. (2008). An innovative home-based interdisciplinary service-learning experience. Gerontology & Geriatrics Education, 28, 89–104. doi:10.1300=J021v28n03_07 National Association of Social Workers. (2008). Code of ethics. Retrieved from http://www.socialworkers.org/pubs/code/default.asp Noppe, I. C. (2007). Historical and contemporary perspectives on death education. In D. Balk, C. Wogrin, G. Thornton, & D. Meagher (Eds.), Handbook of thanatology (pp. 329–335). Northbrook, IL: Association for Death Education and Counseling. Offer, A. M., Granello, D. H., & Wheaton, J. E. (2012). Grief counseling: An investigation of counselors’ training, experience, and competencies. Journal of Counseling & Development, 90, 150–159. O’Meara, K. A. (2007). Brief 20: Graduate education and civic engagement. New England Resource Center for Higher Education Publications. Paper 44. http://scholarworks.umb.edu/nerche_pubs/44 O’Meara, K. A. (2011, April). Making the case for engagement: Integrating faculty roles and documenting impact. Paper presented at the Indiana Campus Compact Service Engagement Summit, Indianapolis, IN. Peacock, J., Flythe, M., & Jones, K. (2006). A service-learning collaboration: A graduate gerontology program and a foster grandparent program. Educational Gerontology, 32, 335–349. doi:10.1080= 03601270600564096 Servaty-Seib, H. L. (2011a). Course assessment and evaluation. In M. J. Eisenhauer, N. B. Marthakis, J. R. Jamison, & M. Mattson (Eds.), Charting a course for service learning: From curriculum considerations to advocacy: A faculty development workbook (pp. 122–144). Indianapolis: Indiana Campus Compact. Servaty-Seib, H. L. (2011b). Reappointment, promotion, tenure, and faculty rewards. In M. J. Eisenhauer, N. B. Marthakis, J. R. Jamison, & M. Mattson (Eds.), Charting a course for service learning: From curriculum considerations to advocacy: A faculty development workbook (pp. 62–83). Indianapolis: Indiana Campus Compact. Servaty-Seib, H. L., & Taub, D. J. (2010). Bereavement and college students: The role of counseling psychology. The Counseling Psychologist, 38, 947–975. doi:10.1177=0011000010366485 Stanton, T. K., & Wagner, J. W. (2006). Educating for democratic citizenship: Renewing the civic mission of graduate and professional education at research universities. Stanford, CA: California Campus Compact. Stewart, T. (2011). Opening up service-learning reflection by turning inward: Developing mindful learners through contemplation. In T. Stewart & N. Webster (Eds.), Problematizing service-learning: Critical reflections for development and action (pp. 37–67). Charlotte, NC: IAP Information Age. doi:10.1080=09614524.2011.557422 Wass, H. (2004). A perspective on the current state of death education. Death Studies, 28, 289–308. doi:10.1080=07481180490432315 Wilczenski, F. L., & Cook, A. L. (2009). How service learning addresses the mental health needs of students in urban schools. Journal of School Counseling, 7, 1–20.
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APPENDIX BRIDGe Session Topics
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Session 1: Introduction to the program and to each other Session 2: Exploring the multidimensional aspects of grief Session 3: Exploring and understanding secondary losses
Session 4: Focusing on the experience of anger connected with death loss Session 5: Reviewing and remembering realistically the person who died Session 6: Sharing details of the loved one’s personality and uniqueness Session 7: Modifying the connection with the loved one who died Session 8: Reflecting on the BRIDGe experience and connecting to the future
Death Studies Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/udst20
Using Service-Learning to Integrate Death Education Into Counselor Preparation a
Heather L. Servaty-Seib & Sara J. Tedrick Parikh
a
a
Department of Educational Studies , Purdue University , West Lafayette , Indiana , USA Accepted author version posted online: 17 Jul 2013.Published online: 27 Aug 2013.
To cite this article: Heather L. Servaty-Seib & Sara J. Tedrick Parikh (2014) Using Service-Learning to Integrate Death Education Into Counselor Preparation, Death Studies, 38:3, 194-202, DOI: 10.1080/07481187.2012.738774 To link to this article: http://dx.doi.org/10.1080/07481187.2012.738774
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Death Studies, 38: 194–202, 2014 Copyright # Taylor & Francis Group, LLC ISSN: 0748-1187 print=1091-7683 online DOI: 10.1080/07481187.2012.738774
Using Service-Learning to Integrate Death Education Into Counselor Preparation Heather L. Servaty-Seib and Sara J. Tedrick Parikh
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Department of Educational Studies, Purdue University, West Lafayette, Indiana, USA
Service-learning can be a meaningful and effective tool for integrating death education into counselor preparation. The authors describe the design, implementation, reflection process, and evaluation of a service-learning based support program for grieving families and offer suggestions for death educators interested in service-learning as pedagogy. Their evaluation indicated that students who took a graduate-level group counseling course with a service-learning component exhibited lower distress in death-related clinical situations than students who took the course without the service component. Service-learning is closely aligned with death education aims and can be used to enhance counselor preparation program curricular alignment with relevant accreditation standards.
A review of the current state of death education emphasized the urgent need (Wass, 2004) to integrate death education into counselor preparation. This review, however, focused on grief counselors. We argue that it is critical for all counselors, regardless of discipline, be trained in the area of thanatology. Even when counselors in training do not specialize in death and dying, they cannot avoid working with dying or grieving individuals during their careers. An ongoing challenge is balancing accreditation standards (e.g., Council on Social Work Education [CSWE], Council for Accreditation of Counseling & Related Educational Programs [CACREP], and American Psychological Association Commission on Accreditation [APA CoA]) with critical curricular content areas such as death and dying (e.g., Harrawood, Doughty, & Wilde, 2011). We provide an example of using service learning to integrate death education into counselor preparation in an existing group counseling course. We begin by defining service-learning and offering key points of synthesis between service-learning as pedagogy and graduate-level counselor training and death education. Then, our case example follows four primary phases Received 25 June 2012; accepted 25 September 2012. Address correspondence to Heather L. Servaty-Seib, Counseling & Development, Department of Educational Studies, Purdue University, 100 N. University St., West Lafayette, IN 47907. E-mail: servaty@ purdue.edu
(e.g., design, implementation, reflection, and evaluation; see Eisenhauer, Marthakis, Jamison, & Mattson, 2011). Within each section, we summarize our process, describe challenges, and offer suggestions for death educators.
SERVICE-LEARNING, GRADUATE EDUCATION, COUNSELOR PREPARATION, AND DEATH EDUCATION Service-learning is a particular approach to experiential learning that balances student learning and community service (Furco, 2002). More specifically, the definition of service-learning we use is as follows: a credit-bearing, educational experience in which students a) participate in an organized service activity that meets identified community needs, and b) reflect on the service activity in such a way as to gain further understanding of course content, a broader appreciation of the discipline, and an enhanced sense of civic responsibility. (Bringle & Hatcher, 1996, p. 222)
National conversations on graduate education and civic engagement suggest that graduate education ‘‘seems to be the next frontier of the service-learning and civic-engagement movements’’ (O’Meara, 2007, p. 2). Although graduate students desire to connect their learning to the real world (Cherwitz & Sievers, 2003), there
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remains a significant disparity between community engagement opportunities available to graduate versus undergraduate students (O’Meara, 2007). Indeed, many students likely ‘‘experience the transition to graduate school as a withdrawal from public and community service that was a vital part of their undergraduate years’’ (Stanton & Wagner, 2006, p. 2). The lack of graduatelevel service-learning opportunities is particularly surprising considering how well the pedagogy matches with the complexity of graduate-level training, including professional development and socialization into a discipline. Also, as tomorrow’s faculty members, graduate students need modeling of community involvement and civic engagement (O’Meara, 2007). Scholarly literature on graduate-level service-learning is limited. Gerontology appears to be overrepresented, including courses in gerontology programs (Peacock, Flythe, & Jones, 2006) and gerontology courses in other disciplines including social work (Faria, Dauenhauer, & Steitz, 2010), physical therapy (Beling, 2003) and multidisciplinary health care (McWilliams, Rosemond, Roberts, Calleson, & Busby-Whitehead, 2008). The connection between multicultural competence and servicelearning is also represented in the fields of counseling (Baggerly, 2006), psychology (Hagan, 2004), and education (Donovan, 2008). Scholarly reports on service-learning with graduate students vary somewhat in purpose and structure. Most scholarship describes positive, meaningful outcomes of service-learning courses in the form of students’ gains in attitudes, knowledge, and=or skills. Using a pre–post design and random assignment to service- or nonservicelearning, physical therapy students engaged in servicelearning learned more and were less biased against older adults than their nonservice-learning peers (Beling, 2003). Dorfman, Murty, Ingram, and Li (2007) found positive mixed-method, pre–post positive outcomes for gerontological social work student, but had no comparison group. Service-learning in counselor preparation directly connects with ethical responsibilities to contribute to the public good and provide a portion of work pro bono (American Counseling Association’s Code of Ethics, 2005; American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct, 2010; National Association of Social Workers, 2008). Within psychology, experts challenge the field to modify curricula to more clearly meet the needs of society through a focus on socially responsive knowledge (Altman, 1996) and suggest service learning as particularly wellsuited for educating counselors and psychologists regarding the variety of roles (e.g., outreach, prevention, social advocacy) they will engage in as professionals (Kenny & Gallagher, 2000). In school counseling, Wilczenski and Cook (2009) strongly advocated for the
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use of service-learning and argued that school counseling, as an ethic of care, is enhanced by the dynamic and reciprocal nature of service-learning. Thanatology scholars also recognize service learning as a potentially powerful tool for death education (e.g., Noppe, 2007). Scholarship on death education initially stressed humanistic factors such as personal awareness, reflection, and self-understanding (Feifel, 1977), all elements core to service-learning. In addition, meta-analyses on death education have indicated experiential teaching reduces students’ death anxiety (e.g., Maglio & Robinson, 1994). Despite these clear links, only one published article focuses on integrating death education and service-learning. Basu and Heuser (2003) integrated service-learning into two newly developed, upper-level, undergraduate death education courses in sociology and political science. They delineated key elements of their process and lessons learned, and advocated increased service-learning in death education. The existing literature offers no illustrations of integrating death education and service-learning in fields involving direct service contact with grieving or dying individuals and families. Thanatological content is difficult to integrate into counselor training programs because of accreditationrelated curricular demands. Accreditation standards in social work, school counseling, and psychology require curricula on material considered more general to clinical practice including individual therapy, diversity, and group work (see APA CoA, 2009; CACREP, 2009; CSWE, 2008). Accreditation demands often overshadow programs’ ability to cover critical content such as death and dying issues. Research suggests limited death and dying content in counseling (Offer, Granello, & Wheaton, 2012), clinical psychology (Dexter-Mazza & Freeman, 2003), and school psychology (Seadler, 2000). However, literature indicates a great need for counselors (Cohen & Mannarino, 2011; Servaty-Seib & Taub, 2010) to know about thanatology as death is the most universal of all life stressors. Death competence, ‘‘specialized skill in tolerating and managing clients’ problems related to dying, death and bereavement’’ (Gamino & Ritter, 2012, p. 23), is an ethical imperative of many mental health-related disciplines. Further, beginning counselors report greater distress associated with death and dying than other clinical situations (Kirchberg & Neimeyer, 1991). Narratives of counselors in training indicated that a 2-credit course on death education provided enhanced openness to thinking about and discussing death, greater awareness of personal death attitudes, and decreased negative affect related to death (Harrawood et al., 2011). Harrawood et al. called for (a) additional research on counselors’ self-knowledge about death and openness to thanatological content, and (b) inclusion of grief and loss in accreditation
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standards. We fill a gap in the literature by providing a case example of integrating death education and servicelearning into an existing course.
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CASE EXAMPLE: INTEGRATING DEATH EDUCATION INTO A GROUP COUNSELING COURSE We cover four phases: (a) design, (b) implementation, (c) reflection, and (d) evaluation. I (the first author) taught the group counseling course four times without a service-learning component (2003–2005, 2008) and four times with a service-learning component (2006–2007, 2009–2010); the second author assisted with program implementation and evaluation. Across all eight semesters, the primary focus was on providing a theoretical and experiential overview of the basic elements of group dynamics and group process. Prior to integrating service-learning, the emphasis was on knowledge versus skill competencies. Students practiced group leader behaviors through leading their fellow students in group exercises (approved and supervised by instructor). Students developed other group leader skills by designing a group plan integrating group theory, research, and intervention strategies. Students also observed and identified group process events during in-class exercises and videos and through a group observation assignment. Design The design phase of the service-learning integration was multidimensional. I (the first author) sought training on service-learning, located a service-learning mentor, and received two small grants to assist in initial funding of the service-learning project. I also reflected on my personal commitment to integrating death education into the curricula of the school counseling and counseling psychology doctoral programs. I talked with faculty colleagues regarding how service learning that integrated thanatological content would actually increase the fit between program curricula and accreditation standards. Because I knew that I would be integrating a servicelearning component into my group course, my next step was to develop a brief, grief-related, group-based intervention that counselors-in-training could provide. Using my previous experience with programs focused on providing support for grieving families, I developed the BRIDGe (By Remembering I Develop & Grow), an eight-session, family-focused, psychoeducational support program for grieving families (contact the first author for mission and objectives). The BRIDGe is based on theory and research (e.g., Metel & Barnes, 2011) and all members of grieving families attend
sessions together. Family members participate in separate and related group sessions and come together at the end of each evening to discuss their experiences. Although each meeting is centered on a specific topic (see the appendix for session topics), the manner in which each topic is addressed (e.g., through conversation versus hands-on activities) differs by age group. Community partnerships are a critical factor of service-learning (Eisenhauer, 2011a). Faculty planning to engage in service-learning must meet with potential partners prior to implementation and even conduct a needs assessment. Although a needs assessment can prove useful, potential collaborators may not always be aware of or open to the thanatological issues facing community members. I approached three different school districts before I found one open to collaboration; connecting with a specific school counselor who knew the day-to-day needs of the children and families proved more effective than approaching district-level administrators. Input from collaborators should be sought during early planning for service-learning projects. For example, my school counselor collaborators made crucial suggestions about supervision structure, day=time=place of BRIDGe meetings, and marketing. Regarding course structure and syllabus, I expanded the knowledge, skills, and attitude objectives (see Association for Specialists in Group Work, 2000) in preparation for integrating BRIDGe. Although the wording of many knowledge objectives did not change, their depth and complexity changed qualitatively. For example, all students learned to ‘‘identify the essential group dynamics involved in understanding group interactions.’’ However, there is a distinct difference between learning this objective through course reading and living those group dynamics while actually facilitating sessions. With the BRIDGe, I added skill-related objectives not previously possible (e.g., ‘‘develop co-facilitation skills’’). I also added thanatology objectives such as ‘‘recognize the idiosyncratic nature of grief’’ and ‘‘exhibit comfort with discussing grief with group members.’’ Faculty must prepare students for service-learning (Eisenhauer, 2011b), particularly in thanatological contexts (Gamino & Ritter, 2012). To prepare students for service-learning, I explicitly defined service-learning in the syllabus, discussed the direct connections between course objectives and implementation of the BRIDGe, and emphasized the importance of reflection activities in allowing them to make their own connections between course concepts and their group facilitation. Prior to initial implementation in 2006, I realized that there would not be enough time during the regularly scheduled class periods to educate students on grief. Therefore, in addition to integrating thanatology content throughout, I developed a 4-hr workshop on best practices in working with grieving individuals and families. In this workshop,
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students learn key grief=mourning theories, empirical findings related to grief, how children=adolescents= adults grieve differently, and unique factors to consider when working with grieving families as opposed to individuals. Students also spend workshop time in death awareness activities (e.g., drawing their concept of death) and preservice preflection activities such as writing letters to themselves. Students seal the letters and do not read them until the final supervision session, following the conclusion of the BRIDGe. Our suggestions for the design phase include
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element(s) of the field you could reasonably integrate into counselor preparation using servicelearning; discuss your interest in death education and service-learning with colleagues and determine how you can connect your work with the overarching needs of the program(s) and with relevant accreditation standards; expand your knowledge of service-learning through connecting with campus offices overseeing experiential learning, locating a service-learning mentor, and accessing scholarly resources (e.g., texts, articles from your discipline, organization websites); determine the best fit for the structure of the service-learning project(s) including a whole class project such as the BRIDGe, small group projects, or individual projects; build solid relationships with community collaborators; elicit and integrate their feedback into the process of project development; seek internal and external funding (e.g., Campus Compact, foundations); develop intentional ways (e.g., preflection, pedagogical conversations) to prepare students to get the most from their service-learning and death education experiences; and carefully consider how your combined servicelearning and death education efforts will be viewed in reappointment, promotion, tenure, and related faculty decisions within your department (ServatySeib, 2011b).
Implementation I (the first author) implemented the BRIDGe within a group counseling course. Graduate students in school counseling and counseling psychology facilitate BRIDGe support group sessions and, therefore, can immediately apply the knowledge, skills, and attitudes they acquire through course readings, lectures, and discussions. During the first eight class periods, students receive traditional didactic material associated with
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group counseling and techniques and complete an examination. During the last eight class periods, I work together with students and four supervisors to implement BRIDGe at a local school. Students co-facilitate one of four simultaneous, age-based groups (i.e., children, pre-teens, teens, adult=caregivers), and a supervisor sits in with the same group of facilitators throughout the program. Each evening of the program begins with pre-group supervision. When the families arrive, they share a meal (typically donated by a local restaurant) and disperse to group meetings, which last about 75 min. Family members then come together for 15 min to share an important experience from their group time. Each class period ends with cofacilitators receiving supervision from their respective supervisors. The last session of BRIDGe includes a closing candlelight memorial activity, which marks the end of the program. A key element of the BRIDGe each year is marketing the program and recruiting families. Marketing involves mailing brochures and posters to a number of key groups within the local community including school counselors, mental health facilities, funeral homes, pediatric and family physicians, and cemeteries. Over the course of implementation, we have learned the importance of sharing information about the program through in-person networking and offering psychoeducational presentations to local community groups (e.g., Compassionate Friends, childcare facilities). Our suggestions for the implementation phase include . connect with individuals who are open to volun-
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teering time to assist with your service-learning project (e.g., food pick-up, advanced students to complete intakes, basic trouble shooting during implementation); determine if there is a need for liability insurance for students and=or supervisors; both are required for the BRIDGe; Offer supervision training if your project includes the use of volunteer supervisors; Seek donations for supplies and food from local businesses; and take advantage of multidisciplinary resources on your campus. The BRIDGe logo, brochure, and poster were designed by a graphic design student for minimal cost.
Reflection Reflection is a critical element of service-learning; multiple forms of reflection facilitate integrating the service experiences with course content (Stewart, 2011). Graduate students involved in the BRIDGe complete three different written reflections. First, they complete three structured reflection papers in which they connect
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their group facilitation experiences with course content in knowledge, skills, and personal reactions (contact the first author for full assignment description). Second, they observe another group during one night of the program and complete a reflection paper on that experience; students often comment that the observation facilitates personal reactions to grief issues. The final project is a synthesis paper in which students holistically consider all elements of the course (e.g., didactic material, group facilitation, relevant research, personal reactions) and reflect on their learning. Group supervision is a discussion-based reflection used heavily in the BRIDGe. Although definitions vary somewhat, group supervision is the process through which a supervisor oversees the professional development of a number of counselors in training within a group setting, often involving case presentations, didactic information, and interpersonal processes (Holloway & Johnston, 1985). Students receive whole class supervision prior to BRIDGe implementation, prior to each session, and on the final evening of the course, and they receive subgroup supervision (i.e., with group supervisor) following each session. BRIDGe supervisors encourage students to reflect on their experiences prior to supervision and come to each meeting with questions and comments. In all cases, the content of the group supervision sessions remains flexible but is consistently focused on reflection=debriefing and on connecting and applying course material to the process of the groups. Our suggestions for the reflection phase include . emphasize directly to students the importance of
reflection in the service-learning process to minimize any risk of reflections being perceived as ‘‘busy work’’; . use a variety of reflection-based activities; and . determine who should have access to students’ written reflections (e.g., supervisors, community partners) and inform students at the beginning of your class about who will have access to their papers and=or journal entries. Evaluation Service-learning scholars recommend evaluation that includes multiple stakeholders and both quantitative and qualitative measures (Furco, 2002; Gelmon, 2000). Evaluation is both formative and summative. With regard to formative evaluation, I (the first author) have modified the BRIDGe program based on stakeholder feedback. Following each annual program implementation, I seek verbal (e.g., focus groups, group supervision) and written feedback from students, supervisors, and family members. Examples of modifications include adding family time at the end of each session, providing
notecards with parenting tips, and adding a family member panel discussion for new facilitators prior to beginning the program. We also evaluate program impact on students and families. Student Impact We have evaluated the impact of the BRIDGe on student learning in two major ways, one inside and one outside of the class. Within the class, supervisors rate students after the first, fourth, and eighth sessions (1 ¼ below expected level, 5 ¼ above expected level) on eight skills including (a) group facilitation, (b) connecting learning to life outside group, (c) ethical practice, (d) cooperation with co-facilitators, (e) awareness of diversity, (f) accurate information on grief, (e) comfort with discussing grief, and (g) use of supervision. Repeated measures analyses of data from the two most recent implementations of BRIDGe indicated significant increases in total skills for Spring 2009, F(2, 9) ¼ 5.10, p ¼ .033, g2p ¼ :53, a ¼ .93, and Spring 2010, F(2, 7) ¼ 5.15, p ¼ .042, g2p ¼ :60, a ¼ .95. Outside the class, we compared course perceptions from students enrolled in the group course with and without the BRIDGe. The online survey included an information letter, demographic=background questions, and the Counseling Situations Questionnaire (CSQ; Kirchberg & Neimeyer, 1991), which contains two subscales: distress regarding death and non-death related counseling situations. In addition, we included seven single-item quantitative measures and four open-ended questions (contact the first author for survey). The survey did not mention the BRIDGe. Of those who took the course without the BRIDGe (n ¼ 53), 12 completed the survey (response rate ¼ 22.6%); of those who took the course with the BRIDGe, (n ¼ 47), 13 completed the survey (response rate ¼ 27.7%). Response rates are only estimates as it is not possible to determine if prospective participants actually received the recruitment email; retaining updated emails for alumni is difficult. Participants in the BRIDGe and non-BRIDGe groups were predominantly women (84.6% and 91.7%, respectively) and White (84.6% and 100%, respectively, see Table 1). A one-way MANCOVA with age, number of group sessions led in career, and number of death losses as covariates indicated a significant difference between BRIDGe and non-BRIDGe groups, F(9,12) ¼ 3.99, p ¼ .014, g2p ¼ :75 (medium effect size; Cohen, 1988). BRIDGe students, when compared to non-BRIDGe peers, rated the course as more memorable, F(1,20) ¼ 11.595, p ¼ .003, g2p ¼ :37 (small effect size), practical, F(1,20) ¼ 9.030, p ¼ .007, g2p ¼ :31 (small effect size), and personally rewarding, F(1,20) ¼ 26.160, p ¼ .000, g2p ¼ :57 (medium effect size); and, they reported less distressed in working with clients with death and
DEATH EDUCATION AND COUNSELOR PREPARATION TABLE 1 Means and Standard Deviations of Participant Background Information and Variables by Group BRIDGe (n ¼ 13) M (SD) Age 27.38 (5.42) Death losses 4.00 (2.31) Group sessions led 44.54 (43.63)
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Variable CSQ (nondeath) CSQ (death-related) Memorable Informative Practical Acad. Challenging Useful Personally rewarding Interesting
Non-BRIDGe (n ¼ 12) M (SD) 31.17 (4.11) 6.50 (3.66) 66.25 (33.65)
M (SD) 21.77 15.62 4.54 4.23 4.62 3.85 4.33 4.69 4.08
(3.96) (3.97) (.52) (.83) (.51) (.69) (.75) (.48) (.86)
t(df)
1.95 (23) 0.063 2.06 (23) 0.051 1.38 (23) 0.180
M (SD) 23.92 17.92 2.75 3.92 4.00 3.67 4.33 3.67 3.92
p
(4.12) (2.54) (.62) (.51) (.74) (.89) (.65) (.65) (.67)
F
p
2.08 5.11 11.60 2.57 9.03 .33 .17 26.16 1.26
0.165 0.035 0.003 0.124 0.007 0.573 0.686 0.000 0.274
Note: Number of group sessions led throughout professional career. CSQ ¼ Counseling Situations Questionnaire.
dying-related concerns, F(1,20) ¼ 5.112, p ¼ .035, g2p ¼ :20 (small effect size). These effect sizes suggest meaningful differences between the groups. Groups did not differ on distress from working with clients presenting with non-death concerns. Each author read the open-ended responses independently and repeatedly. We developed categories and discussed the categories, using consensus to further analyze and reach conclusions. The qualitative findings complemented the quantitative findings and suggested that students highly valued the opportunity for servicelearning. For example, in response to the open-ended question about usefulness, all (13 of 13) BRIDGe students either directly or indirectly referred to their service-learning experience. Themes included enhanced preparation for practicum, clinical skill development, and confidence in their clinical skills. Conversely, nonBRIDGe students most often commented (eight of 12) that the class itself functioning as a group. The predominant theme in their responses was an overarching desire for more ‘‘hands on’’ experience within the course (i.e., a desire for a service-learning experience). Family Impact Family attendees between 2006 and 2010 (N ¼ 26) completed a modified 8-item Client Satisfaction Questionnaire (Larsen, Attkisson, Hargreaves, & Nguyen, 1979; alpha ¼ .81 with current sample). Adult respondents indicated high perceived quality of the service and satisfaction with help received (M ¼ 3.73 and 3.58, respectively; 4 ¼ excellent), and perceived that the service
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helped them deal more effectively with their grief (M ¼ 3.42; 4 ¼ helped a great deal). In addition, they reported that they would return to the program and recommend it to a friend (M ¼ 3.65 and 3.96, respectively; 4 ¼ yes, definitely). Open-ended written comments included themes of appreciation for (a) the opportunity to connect and interact with other grieving families, (b) information about grief, and (c) including separate age-based meetings and joint family time. The greatest evaluation-related challenge for the BRIDGe has been assessing impact on family members. A pre–post evaluation process is optional but family participation has been limited. The highest level of participation was from families during the first year of the program, particularly parents reporting on their children’s functioning. Pre- and posttest measures of child adjustment as assessed by the Child Behavior Checklist (Achenbach & Rescorla, 2001; based on nine evaluations, both mother and father ratings for three children and only father ratings for three children) indicated a significant decrease in emotional and behavior problems over the course of the program, t(8) ¼ 2.64, p ¼ .03. Minimally successful strategies to increase family involvement have included a monetary incentive, reducing the number of measures, and mailing packets rather than requiring an in-person meeting. For future programs, we may integrate structured quantitative and qualitative measures into the BRIDGe intake interview, add an exit interview with the same measures, and ask permission for responses to be used for research purposes. Our suggestions for the evaluation phase include . develop a multidimensional evaluation approach
and integrate it from the start of your servicelearning effort (Servaty-Seib, 2011a); . seek IRB approval from your institution and your community partner as necessary; . consider collaborating with other faculty (or an advanced graduate student) who are engaged in service-learning so you can assist each other in data collection; it is helpful for data to be collected by someone other than the instructor of the course; and . determine the most appropriate constructs to assess and use existing measures whenever possible (see Bringle, Phillips, & Hudson, 2004).
IMPLICATIONS FOR DEATH EDUCATION AND COUNSELOR PREPARATION Service-learning is an innovative and practical pedagogy for integrating death education into counselor preparation. The dynamic and dense nature of servicelearning fits with the complexity of both death education and counselor preparation. Counselors in training
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engaged in death-related service-learning can develop as professionals, gain self-awareness, and experience transformational learning regarding a topic that is seldom addressed within counselor preparation programs (Harrawood et al., 2011; Offer et al., 2012). Through this case example, we illustrate how death education can be integrated into counselor preparation. We collaborated with a local school district; however, other potential collaborators include family grief centers, hospices, funeral homes, and cancer centers. We challenge faculty in counselor preparation programs to consider these suggestions to develop their own unique way of integrating death education into their curricula. As faculty knowledgeable about thanatology, we have an ethical obligation to weave death education into our curricula. Graduate students cannot avoid working with grieving and=or dying clients in their future careers; so need at least minimal death competence (Gamino & Ritter, 2012). Service-learning provides an excellent vehicle for integrating death education while also offering an opportunity to increase program correspondence with relevant accreditation standards. It allows faculty to model and directly facilitate students’ understanding of community needs, while encouraging civic mindedness. In addition, students observe faculty members in the role of engaged scholars who actively integrate research, teaching, and service (O’Meara, 2011; ServatySeib, 2011b). Service-learning can address beginning clinicians’ distress when facing death and dying situations. School counseling and counseling psychology graduate students who engaged in death-related service-learning (i.e., served as BRIDGe facilitators) reported lower distress in clinical situations involving death issues than did their non-BRIDGe peers. This result is consistent with past research with graduate students suggesting a connection between service-learning and improved comfort with older adults (McWilliams et al., 2008) and increased awareness of diversity-related inequities (Donovan, 2008). In addition, this finding is aligned with death education research that emphasized the importance of experiential teaching methods in affecting death anxiety (Maglio & Robinson, 1994).
IMPLICATIONS FOR RESEARCH Although narrow examinations have been conducted in fields such as counseling (Offer et al., 2012) and clinical psychology (Dexter-Mazza & Freeman, 2003; only related to suicide), a comprehensive and simultaneous assessment of offerings across many service provision disciplines (e.g., social work, rehabilitation counseling, counseling psychology) is warranted. In addition, such research needs to be conducted using an international
lens, as has been done on a limited basis within nursing and medicine (e.g., Downe-Wamboldt & Tamlyn, 1997). The emphasis on evaluation within service-learning as a pedagogy offers opportunities for faculty to integrate their teaching, engagement and research efforts. Future research on service-learning to integrate death education into counselor preparation should use multiple stakeholders as participants, standardized assessments, and sophisticated research designs (Gelmon, 2000).
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APPENDIX BRIDGe Session Topics
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Session 1: Introduction to the program and to each other Session 2: Exploring the multidimensional aspects of grief Session 3: Exploring and understanding secondary losses
Session 4: Focusing on the experience of anger connected with death loss Session 5: Reviewing and remembering realistically the person who died Session 6: Sharing details of the loved one’s personality and uniqueness Session 7: Modifying the connection with the loved one who died Session 8: Reflecting on the BRIDGe experience and connecting to the future
