The following material is reproduced with the permission of NOVA The National Organization For Victim Assistance From the NOVA Newsletter; Volume 12, Number 12 December, 1988. Copyright 1988 by NOVA. The author is Janice Harris Lord of Mothers Against Drunk Driving. SUGGESTIONS FOR JOURNAL WRITING AS A MEANS OF GROWING THROUGH CRISIS: 1. Identify as many feelings as you can which you have experienced today. You may have coped with grief, anger, loneliness, guilt, relief, denial, confusion, weakness, nausea, a heavy chest, crying, or sleep disturbance. [P.S. All of the above are normal feelings and experiences.] 2. If someone you loved was killed, take a memory trip through one event which you can rememberclearly with your loved one. Write about it in detail as you fully experience the memory. Don't be afraid to feel. 3. List as many "losses" other than the current crisis which you have experienced in your life. How were they similar and different? How did you cope with them? 4. Write about the person(s) you have felt most supported by since your victimization. When finished, write that person a note of grattitude. 5. Write about the persons who have pulled away from you since your victimization. Explore why. Who have you pulled away from? Why? 6. If grieving a death, take out a favorite picture of your loved one. Write about the things you appreciated most about him or her. Then write about how you feel now. 7. Write about some of the things you are angry about in relation to your victimization. Write about how you can express those feelings rather than holding them in. 8. Write about the guilt you feel: the "should-haves" and the "if onlys." Check what is rational and mark out what is irrational. Then write a letter to someone or to God asking for forgivness for those items which are rational. 9. Write about your fears: being alone, driving a car, money, the future. 10. If a death, write about one thing you plan to do to let go of what happened: taking off a wedding ring, putting up or taking down a picture, giving away some clothes or things. If you survived a personal victimization write about giving up some aspect of it which you may be clinging to. Write about how you think it will feel to do it. 11. Write down how you have helped yourself since your victimization: emotionally, spiritually, socially, physically, and intellectually. 12. Write about your three biggest "wants" in the months ahead. When do you believe you can accomplish them? -0- WHY HAVE SUPPORT GROUPS? In life, human beings do three things. They feel. They think. And they do. Following a criminal attack, feelings may overwhelm the victim's capacity to "think" and "do." Before ost victims can can engage in rational problem-solving and certainly before they can function actively in the world, intense personal feelings must be dealt with. Many victims feel lost in the victims' movement because some victim service programs and victim activist groups do not provide a resource to meet these emotional needs. If meetings, financial assistance, or information is all a program or group has to offer, the the victim's needs may not be met. As a matter of fact, victims may feel even angrier and more helpless and alone than before they were offered help because their one for" feeling better" has not been realized. The purpose of a Victim Support Group is to provide people in similar circumstances with an opportunity to share their experiences with the emotional aftermath of crime and how they cope with it. No one dominates in a support group. All are on equal ground as they share their experience. Although theraputic in many ways , it is not a "therapy" group, nor does it have an educational focus. The normal experience of grieving, the unique kind of grief that victims of similar crimes share, is the focus. All feelings are acceptable within a support group. Many studies have shown that letting out feelings of deep distress helps. Individuals actively upset, who can express anger or deep sorrow, show far less stress and emotional disturbance in the long run than those who try to deal with victimization in a "thinking" way. Those who appear to be "taking it very well" may actually be thwarting their own recovery. No other place in society offers victims of crime as much freedom to deal openly with their feelings, as a peer support group. Even relatives and close friends may be eager for victims to "get over it" and therefore refrain from bringing up the subject. Churches sometimes encourage victims to "consider it God's will" and go on as if nothing had happened. Victims of an event as devastating as a drunk driving crash, sexual assault, surviving the homicide of a loved one, or abuse by a loved one must expect a long and intense period of grief. The more sudden the death or injury, and the more sensless the reason, the more difficult will be the period of mourning. And no one knows that better than other victims. My next article will duscus who should facilitate the group. This is the first of thirteen articles from the NOVA News Letter, December 1988; copyright 1988 by NOVA. These articles are about developing an effective support group. These articles are is reproduced here with the permission of the National Organization of Victim Assistance. -0- WHO SHOULD FACILITATE THE SUPPORT GROUP? Some groups feel more assured if the facilitator is a professional. Advantages of professional facilitators include; (1) a place to meet (office), (2) referral capacity for those in need of medical or psychotherapeutic help beyond the group's capacity, (3) good skills at facilitating interaction among groups members, and (4) victims need not fear losing control because the skilled professional will know how to handle anything that comes up. Others feel professional involvement is not necessary and is undesirable, especially if the professional is not a victim. There are pros and cons to each type of group facilitator. If a professional is chosen, a fee may be required. The critical factors regarding the use of a professional are that (1) the professional must have an understanding of the unique pain or grief of the kind of victims that will be involved in the support groups, and (2) the professional must realize that his or her roll is simply to facilitate interaction among group members, not to dominate the process or to teach. The input of all members is equally valuable in a support group. If a professional facilitates the group, it is useful to have a victim as co-facilitator, who can speak from personal experience. The victim will lend credibility to the leadership team. On the other hand a multitude of problems can arise if there is no professional involvement. The "victim" facilitator may have difficulty separating his or her own experience from that of other victims and may have a tendency to expect other victims to cope in his or her way. The victim facilitator must realize that he or she, too, must only facilitate the interaction of the other group members. He or she must be empathetic, able to listen, and willing to learn from the others in the group. The victim facilitator must be able to talk easily about his or her own experience, sharing with successes and failures, and allow all the others to do the same. Succession of facilitator can be a problem in "victim only" groups. If a victim is not an appropriate facilitator, how does a group remove him or her, especially when the service is volunteer? The initial stages of the group require leadership as well as facilitation, but a strong leader may move into control that is damaging. A plan for changing facilitators should be made early in the formation of the group if a professional is not used. Some groups have one facilitator serving for three months, then someone else assumes the role. Another warning for "victim only" groups is that "pity parties" may magnify the ill effects of the victimization if there is not support for moving on through stages of grief or trauma. No one should be forced to move until ready, but healthy grieving or reconstruction of life is somewhat like pealing an onion. As one layer is dealt with, another is exposed. As phase after phase is leaned into and fully experienced, it should be peeled away to allow another phase to be dealt with until finally the victim no longer needs the group. While an important function at support group meetings is allowing victims to tell their stories time after time, the focus of the story should change. Different pieces of it will be worked through, allowing new pieces to emerge if healthy movement through the grieving process is being achieved. Considering all the above, it is generally recommended that one of two approaches to be taken: either a professional victim service provider facilitates the group at least in its formative stages; or if the facilitator is also a victim that he or she meet separately with a victim service provider as an adjunct to facilitation in order to continue to grow personally and to get advice and feedback on problems that may arise in the group. If all the victims in the group have been recently victimized, it may be especially important to consider using a professional facilitator at first because otherwise the victims may only devastate each other. If at all possible victims who have moved farther through recovery should be included in groups even though they may feel they don't need it. Their very presence and demeanor give hope to newer victims. -0- WHO SHOULD COME TO YOUR MEETINGS? All family members, including children over five should be encouraged to attend. Following a disaster, there is a tendency in families not to talk about it because someone "always gets upset." Out of loving concern, family members feel that they should not bring up anything that will cause unpleasant feelings. This is unhealthy. Within the group setting, where the goal is clearly to deal with feelings, family members may share things with each other that they are afraid to share at home. These discussions can lead to very healthy and helpful resolutions during and following the group experience. In some communities with numerous victims, a sibling support group may be formed. Siblings often suffer doubly because they are so overwhelmed with their parents' grief that they assume "caretaker" roles with the parents and feel they have no outlet for their own grief. Rarely are their friends helpful because of their own need to avoid the subject. Therefore others who are in a similar situation and sharing their own experiences may be quite valuable. In most cases it is useful to separate different types of victims into separate groups. Even within a group such as survivors of drunk driving crashes, it is preferable to separate those who have had a loved one killed from injured victims. Each may think his own grief is more profound than the other's and there may not be the quality of support available that each needs if all are in group together. Despite this generic rule, some successful "generic" victim groups have been started and maintained. In such cases, the success has often been dependent upon the group establishing some basic guidelines for group conduct. -0- WHEN SHOULD THE GROUP MEET? Victims whose tragedy is recent may want to meet weekly. The intensity of their rage and sadness may cause them to fear they are "going crazy." The interaction with others who have gone through it is extremely valuable. If the group continues for a while without the addition of new victims the group may decide to meet bi-weekly. Some groups meet monthly. A weekday evening is generally the most desirable. Some groups may be able to meet during the day, but if a victim is always to have a group to go to, it is nearly mandatory that one be available during the evening hours. Information about the support group may be given with the initial contact with a victim or at the time of crisis intervention. However, it may be several weeks before a family is ready to attend a group. They may feel too overwhelmed to reach out at first, so follow-up information and encouragement to attend is suggested. Some victims do not want to participate in support groups or other types of counseling in the aftermath of tragedy. They may want to get involved in other ways, through active work in legislation, through advocacy in the criminal justice process, or by helping out with clerical work in a program. They may want simply to try to survive day-to-day living or get through their own trial. Because of such different reactions, victims should be given a full range of options with a victim assistance program or grassroots organization. However, victims should be discouraged from becoming volunteer advocates or group leaders prior to the close of their own case in the criminal justice process. Further, they should be encouraged to do a careful self-assessment of their own grief, anger, fears, and other emotions prior to becoming involved in such activities. Victims should stop attending support groups when they feel they no longer need it. This may be a few weeks for some; it may be months for others. Some are involved for years. Even after they have progressed through the stages of their own grief process, they can be of invaluable help to newer victims who come into the group. Most victims know when they need the group, when they can be of help to others, and when they should no longer be involved. Some victims come and go from support groups as they feel a need or a desire to help. For the few victims who need help in assessing their relationship with a support group, the facilitator or the resource counselor may be able to help them determine when it might be appropriate to take a break. Whenever victims decide to leave a support group, it is strongly suggested that they attend the group one last time to say good-bye to other group members and to express appreciation for all they have experienced. This enables the remaining group members to have a sense of "completeness" with the victim and to have the opportunity to establish individual independent relationships if desired. WHERE SHOULD THE GROUPS MEET? If a professional facilitates the group, he or she will generally be willing to have the meeting in his or her facility. If not, victim's homes are suitable. It is suggested that the location of the group not change from home to home, but remain in one place if at all possible. To prevent this from becoming a burden to the host family, others should share in providing refreshments, etc. Seating in a circle is suggested. This encourages discussion with the feeling of equality among all members including the facilitator. Home meetings help to establish relaxing and supportive environments. If the group meets in an office or other facility where chairs are lined up, the chairs should be moved to a more informal arrangement. GETTING STARTED. Victims come to support group with three basic needs. 1. They need to know that they are not the only persons in the world who have suffered this particular kind of pain and grief; 2. They need to learn that certain feelings and reactions are not "bad" or "crazy" and 3. They need information and practical advice on how to cope. Support groups should last no longer than 1 1/2 to 2 hours, although victims will tend to want to stay longer and have informal fellowship. Group process should begin at the time announced. A suggestion is from 7:30 to 9:30 p.m. The first meeting should begin with the facilitator suggesting some ground rules for the group. These should be agreed upon or modified based on group discussion, but the issues behind the rules should be discussed. The foremost concern should be the group's agreement on confidentiality of communication within the group. Without total assurance of privacy and confidence, some victims will be reluctant to speak. A second ground rule an explicit acknowledgment that all expressions of feelings are allowed, with the exception of physical violence. A third rule should address attempts by group members to critique facts, analyze or provide advisory opinions on what happened in a victimization or in the criminal justice system or other institutions in the aftermath. While victims should be encouraged to talk about their perceptions and their understandings of the events, all too often groups can get sidetracked in criticizing law enforcement investigations or making suggestions to a victim about how to handle the criminal justice system. Often well meaning individuals in groups may give counterproductive advise to victims in an attempt to be supportive. For instance, one victim was told by his group to sue the judge in his case. Since that action is impossible within our present system of justice, the victim was given false hope for venting his anger. some groups also want to establish a rule that no victimization is less worthy than another's tragedy. This avoids comparative or competitive ventilation. Finally some groups have found it useful to explicitly bar victim-blaming from the group discussions. Even among victims of similar tragedies, sometimes individuals slip into blaming attitudes - particularly if victims or survivors are expressing their own sense of self-blame or guilt. After the discussion of ground rules, the facilitator usually begins by asking each person to tell the story of his or her victimization. This simply enables the victims to begin to address goal number 1: that they discover that much of their victimization experience is similar. If the group is fairly large, this may take the entire session. The first time victims describe their victimization, a great deal of emotion may be elicited. This should be acknowledged and validated. Silences or periods of crying are to be accepted. As the victims tell their stories each time a new family comes into the group the stories will become easier to discuss, but care should be taken to continue to comfort and validate reactions. Group members should be told they do not have to talk unless they want to. However, it is rare that a victim will choose not to reveal at least something. After each has told his story, decisions will need to be made about how, where and when future meetings will be held. The first meeting should close with all victims being offered the opportunity to talk about how the group has helped them. A group hug (all members putting their arms around each other in a circle and being silent for a moment) is sometimes an effective closure. -0- ONGOING MEETINGS [Part One] Victim support groups may be "open" in that new victims are welcome at any time. Or they may be time-limited. A time-limited group may establish a time frame for taking in new members, for example, they may meet weekly for six weeks, with no new members taken until a new six week segement begins. Or, a time-limited group may simply establish a time frame for total group meetings. For example, they decide to meet for eight weeks or eight months. if the group is open and ongoing the entire group should once again tell their stories when a new victim family joins the group. This establishes a basis for ongoing communication and understanding. After the first meeting, at each meeting the ground rules should be reviewed and the group should be asked to "touch base." Touching base involves asking members to tell about anything they have experienced or felt that they would like to talk about since the last group meeting. While the focus of support group is on feelings here and now, from time to time victims will ask advice of each other. This "thinking" activity is perfectly appropriate and is to be encouraged with two cautions: one must beware of the group becoming a problem-solving group only; and, the group should avoid giving uninformed advice. Remember, the goal of the group is to deal with reactions and emotions. This may be the only place victims can do that. It is only after the passage of timethat some victims will be able to show how they feel, admit that they are suffering, and acknowledge that they are in the need of help. They may not be able to analyze their reasons for coming initially. Their needs and problems emerge as the discussions progress. It should always be made clear that the group is a safe place for discussion among people affected by the same problem regardless of the diversity of their needs and degree of progress through grief. Many unresolved issues may come to the surface. Anger, frustration, and other emotions may be demonstrated quite openly. Participants should always be allowed to fully express themselves. After all, the point is to permit the consideration and validation of these feelings. From time to time there may be a need for some explanation of the grieving process. Victims should be given information on grief, trauma of victimization, and crisis theory at the beginning of the group sessions, but for the sake of those who have not read the materials or may forget certain aspects of the materials, the facilitator may need to go over such information occasionally during group sessions. This may be particularly helpful if the group tends to be stuck in one particular phase of grieving, or if victims do not experience the freedom to move from one concern to another. Rarely will discussion starters be needed if the first agenda is to have everyone talk about what they are feeling when the group convenes. However, if the group seems slow to begin, the facilitator may want to prompt discussion through the following processes. She or he might begin by asking the group to think about the tragedy they have experienced. And, as they are thinking, the facilitator asks the group to think about where they were when it happened or they were notified of the disaster, what they saw, heard, felt, smelled at the time of the event or notification, and how they reacted. Those three questions usually trigger immediate response. ONGOING MEETINGS [Part Two] Another method of facilitating discussion at later meetings is for the facilitator to discuss particular feelings that victims or survivors may experience. GUILT is a feeling that most victims face from time to time. The facilitator may suggest that group members talk to each other and how they experienced guilt, and, if they were able to overcome it, and how they did it. ANGER and RAGE are common feelings of victims and survivors. Some feel them so intensely that they fear for their sanity. It may be helpful to begin a discussion of anger by pointing out that underneath it is nearly always a reflection of deep hurt or sadness. Some people find sorrow overwhelms anger and will need encouragement to begin to talk about anger. Women particularly seem to feel that it is not "ladylike" to be angry. Men, on the other hand, may find it easier to be angry, but feel embarrassed to go beneath the anger to experience the sadness. The reading of poetry can be a discussion starter. Much has been written since the beginning of time regarding the depth of pain. Poets seem more able to elicit feelings from us than prose writers. Therefore, the reading of poems, whether they be classic or the personal writings of group members, will quite naturally lead to discussion of feelings. The same may be true of quotations or fragments of prose. Responses to poems are often "I wish I could have said that" or "that's exactly what I have always wanted to say." FEARS are another topic for discussion. Many victims report overwhelming feelings of anxiety, including fears of being alone and fears of the crime happening again. Uncontrollable crying, irritability, insomnia and nightmares are also common. Depression is sometimes accompanied by suicidal thoughts. As victims share their fears with each other they will be helped to know that they are normal and that other victims are experiencing and surviving the same thing. REVENGE is usually a topic of significant interest to victims. Victims should be reassured that feelings of revenge are normal, particularly in the aftermath of acts of purposeful human cruelty. However, those feelings of revenge can be distinguished from acts of vengeance. In fact, most victims rarely act out their feelings of rage or helplessness. And they tend to know instinctively that it rarely accomplishes anything positive. It is usually very helpful to share vengeful fantasies about offenders with each other during group sessions. The desire for revenge, like rage and helplessness, are to be leaned into. felt, and experienced, but the victim's "thinking capacity" must be pulled into view before decision making about vengeance occurs. Care should also be taken that victims not become so preoccupied with vengeance that they fail to look at what lies underneath. Preoccupation with vengeance can serve as a distraction and a defense against dealing with the painful feelings inside. Family members need not look too carefully at their own weaknesses, their own frailties, as long as the problem is framed in terms of another's criminality ant the desirability of that individual being punished. The vengeful may be fully and safely experienced within the group. It is useful for the victim to take responsibility for them. This may lead to catharsis which will help the victim avoid subsequent vengeful behaviors. The preoccupation with vengeance should not be allowed to estrange one from other parts of his own humanity. The primary goal of continuing attendance at the victim support group is for victims to help each other move through the response to crisis and the grieving process to get to a point where memories of the tragedy and their losses can be endured. For those who have suffered the murder or death of a loved one, the goal is to reach a point where the life of the loved one is celebrated and grief spasms occur less frequently and less intensely. For those who have been assaulted, maimed, or violated, the goal is to reconstruct a new life with the tragedy becoming a part of its unique history. Specifically, movement may take place through the following "tasks": ONE: Acknowledgment of the reality of the crisis and the loss; TWO: Acceptance of the entire range of feelings involved in the crisis response and grieving; THREE: Readjustment of the life style to integrate the pain of the victimization, to cope with the limitation of physical or financial injuries, or to live without the deceased (or cope with the limitations of the injured victim); FOUR: Establishment of a new emotional relationship with the deceased or others who are living with the tragedy; FIVE: Beginning to feel comfortable with a renewed emphasis on life, the present and future, and new relationships. For those involved in Task One, gentle reminders are necessary that the victimization happened or the victim is dead and those remaining must eventually go on. Victims suffering permanent injuries, dislocation, or financial disaster must struggle in their own way to accept what won't change. If the difficulty is Task Two, the victim must feel that the group is a safe place to vent all feelings, positive and negative. There is a tendency among all victims to think of life before a tragedy as one of bliss or joy, simply because it represents an equilibrium or balance they were used to. There is a tendency for remaining family to describe deceased victims as "bigger than life," i.e., "the best husband who ever lived" or " the dearest child who was ever born." Both of these tendencies are normal for a while, but it is eventually necessary to explore the more ambivalent feelings and develop a balanced memory of life before the victimization. As victims or survivors begin to see life before the victimization in a more realistic sense, they are more able to construct a new life. They must be helped to see, however, that negative feelings do not cancel out the positive attributes as they review their relationship with the deceased realistically. If Task Three is causing difficulty, problem-solving is in order. The victim is to be encouraged to overcome helplessness by trying out new skills and developing new roles. This may be the point where a victim may consider joining a victim assistance program's speakers' bureau or court monitoring program.. Self esteem will be enhanced as the victim succeeds in these new activities and the reality of the loss will become firm, which is healthy. If Task Four is incomplete, group members should give the victim clear permission to stop chronic grieving, sanction new relationships and activities and explore the stress involved in saying goodbye to the group and to the deceased. Staying in group too long may actually hinder the completion of Task Four. PART 3 HOW DO WE KNOW WHEN SUPPORT GROUP IS NOT ENOUGH FOR A VICTIM? Abnormal grief may require individual grief therapy from a qualified therapist. Often the victim will be aware that the grief is "more than he can bear" and and will seek out therapy on his own. Group facilitators, however, should look for clues of complicated grief and make an appropriate referral if necessary. Any of one of these clues (see list below and the "Lazare" reference at the end of this article) in and of themselves may not be sufficient for referral. However, each should be taken seriously and if a number of them are present, if any or some are intense, or the duration of the symptom is lengthy, referral is appropriate. 1. Speaking of the deceased brings intense and fresh grief after a period of several years since the loss. 2. Minor events trigger intense grief reaction. 3. Other themes of loss preoccupy the victim. 4. Material possessions of the deceased have not been moved after a period of several years. 5. Physical symptoms like those of the deceased now plague the victim. 6. persons and places associated with the deceased are avoided. 7. Hopelessness and despair resulting in withdrawal. loss of appetite and ability to sleep, inability to think clearly, and preoccupation with guilt and low esteem have become a way of life more than a year after the loss. 8. A compulsion to imitate behaviors or personality characteristics of the deceased has set in, especially if these are harmful. 9. Thoughts of suicide or other self destructive impulses recur frequently. 10. Grief spasms around the holidays, anniversaries, etc., are so intense that they are disabling to the victim. 11. Phobias about death, particularly as they relate specifically to the cause of are so severe that they interfere with daily functioning or cause intense personal distress. 12. Grave-side visits and other memorial places or events are avoided. The goals of good therapy are (1) to bring about change at the feeling level (from anguish to normal sadness, for example), (2) to bring about changes in behaviors, and (3) to relieve painful physical symptoms. Reference: Lazare, A., Unresolved Grief in A. Williams & Wilkens, 1979, pp 498-512. -0- WHAT IF THE GROUP GETS TOO BIG? It is important that everyone in support group have time to share what is in their minds and hearts. When the group gets too large for everyone to fell comfortable, the group should be split. Generally eight to twelve people make up a comfortable group. This will allow for a feeling of group support when some members are absent, and is not large enough to prohibit everyone from talking during the group time. CAN FACILITATORS BE SUED? A professional is assumed to be skilled at providing the services he or she offers. Therefore, he can be held liable for malpractice if victims are not appropriately dealt with. hence, it is suggested that any professional-especially a member of a licensed or regulated profession-who leads the group carry malpractice insurance. Support group members as such cannot be sued for how they work with each other unless physical touching in an inappropriate way becomes involved. If the members are all victims of equality, no one would be likely to sue another for having shared their own experiences. The assumption is that victims will absorb what is meaningful to them while rejecting the rest. Victims will know when it is best for them to leave the group. As to victim counselors who hold no special degree or license, opinions differ but the general rule is that a helper cannot be made liable for malpractice if there are recognized standards of practice for him or her to violate. That general rule may vary in one state or another, but where it is followed, it would seem to apply to the former victim who is both a chapter leader and support group facilitator and to the victim advocate/counselor who is the group facilitator. -0- THE ISSUE OF SUICIDE IN PEOPLE WHO ARE GRIEVING: Anyone who talks about suicide should be taken seriously. A great many victims wish from time to time to die to escape the pain, but few will have the desire to kill and be killed, which are additional elements of most suicides. As a helper, explore further any mention of death wishes and refer the victim to a professional if you feel he/she may be suicidal. The following are "Some Facts About Suicide" by E. S. Shneidman and N. L. Farbarow: Most people who kill themselves have talked about it or left definite warning signs. Take these things seriously. The best way to find out is to ask. Most people who commit suicide have attempted it before. Once an attempt has been made, that person is at higher risk for making another attempt or completing suicide. Young people are more likely to make successive attempts. The elderly are more likely to die with the first attempt. Persons addicted to alcohol or drugs are at a higher risk for committing suicide. They are frequently alienated from their family and other support groups. 95 % of those who attempt suicide either do not want to die or are not sure. They are ambivalent. Part of them wants the emotional pain to end and focus on relief at any cost. Another part of them wants to live. Allow them to talk about the part of them that wants to die, then focus the conversation on the part that wants to live. Look for other ways to escape from or diminish the pain. Talking about suicide with someone who is suicidal will not give him or her the idea to commit suicide. In fact, talking about their feelings and plans often brings relief and is the first step in crisis intervention. Women are three times as likely to attempt suicide. Three times as many men as women actually commit suicide. Women most often use drugs; men most often use a gun. Five times as many male teenagers as female teenagers commit suicide. Marked improvement in the mental state of a suicide attempter is a warning signal. A person in crisis may make the decision to attempt suicide. With the decision comes a sense of relief, an increase in energy, and an apparent improvement. This is the time to be most concerned for the safety of the person in crisis. A SUGGESTED MEMO TO PROSPECTIVE NEW MEMBERS" TO: First Timers, Victim Support Group FROM: <> The victim support group that you have expressed interest in joining is structured to help each participant gain a better understanding of loss and the resulting grief, and to help promote change and growth in your life as a participant. For the group to be successful and beneficial to you, you need a basic understanding of what it takes to make the group work. The following information should add to this understanding: 1. Though you may make some wonderful friends and acquaintances within the group, the main function of the group is not social, but to provide support while working through grief. 2. In order to enhance this support, getting to know and trust each other is extremely valuable. You should make an attempt to attend as regularly as possible. 3. Please consider being an active participant, not just an observer. It is always up to decide how much to disclose. Meaningful sharing is important and beneficial. 4. Be prepared for disruptions. Other unresolved issues may come up for you as a result of the group process. You may decide to deal with these in individual therapy, and then return to the group. 5. Have realistic expectations of what may be gained through the group process. Don't expect the group to totally eliminate problems or change your life. The group process is intended to be a start. 6. Remember, you are not, sick because you are joining the group. This is an opportunity to gain insight into yourself and others as a result of your shared experience. 7. Be willing to give other participants open and honest feedback when appropriate. We need each other to grow! 8. Be willing to accept and try to understand feedback that is directed to you. Don't be afraid to ask questions. 9. Be willing to support other participants through listening, empathizing, and telephone calls during the week. 10. When you feel you are ready to leave the group, please come to one final time to say good-bye to other group members. As a member of the group, you should be prepared for painful moments. You may find yourself reopening or reliving events from the past or related to your loss. There will be ups and downs. At times you may feel like you are making progress and at other times having set backs. You should remember that all of what you experience in the group is part of the process and may ultimately result in a return to a more normal life, positive change and continued growth. If you are tempted to avoid group because you know it may be painful, you need to come. If you reach the point where the group bores you, it is time to leave the group. A CLOSING THOUGHT: Raising plants is one of mankind's successful activities. Success comes perhaps from the fact that the gardner does not try to thrust impossible patterns on his or her plants. The gardner respects their peculiarities, tries to provide suitable conditions, protects them from more serious kinds of injury - but lets the plants do the growing. He or she does not poke at the seed in order to make it sprout more quickly, or seize the shoot when it breaks ground and try to pull open the first leaves by hand. Neither does the gardner trim the leaves of different kinds of plants in order to have them all look alike. The attitude of the gardner is appropriate for victims dealing with other victims in the support group setting. Victims do their own growing and they best can do that through the push of their own budding growth. This growth is most likely in an environment of warmth and support and caring. REFERENCES: Lazare, A., "Unresolved Grief" in A. Williams & Wilkins, 1979, pp 498-512. Silverman, Phyllis R., "Mutual Help Groups," Sage Publications, 275 So. Beverly Dr., Beverly Hills, CA 90212 (1980) Paperback $9.95. Worden, J. William, "Grief Counseling and Grief Therapy, New York: Springer Publishing Co., (1982) A SUGGESTED "SUPPORT GROUP AGREEMENT" I understand that: 1. The purpose of the group is to help people work through the normal emotional reactions to victimizations. 2. Active participation in the group is encouraged, but I will not be pressured to participate. What I say and the amount of sharing is up to me. 3. Every reasonable effort will be made to maintain confidentiality concerning the participation of all other group members. 4. If I am in counseling or therapy, it is my responsibility to notify my counselor of my participation in the group. No information will be released to my counselor without my written consent. ___________________________ _________________ Signature Date