Arizona's Hospice of the Valley has put together an excellent grief resource for teens, which includes a booklet, "Teen Grief: Coping with the Loss of a Loved One," and three short videos that give a straightforward overview of grief, primarily in the words of bereaved teens themselves. The videos illustrate the sections of the booklet:

•"Teen Grief" defines grief, what it is and how it unfolds in a teen's everyday life.
•"Getting Through Grief" focuses on how to cope with grief, both in the year immediately after a death and over a lifetime.
•"Secondary Losses: Since You've Been Gone" looks at how a teen's perspective, roles, and relationships change in the aftermath of a loss.

The series combines expert information on the nature of bereavement with very personal stories from eight teenagers who have experienced the death of a loved one. In fact, the strength of the "Teen Grief" series is how these young people share a real picture of what their grief has been like and what their struggles still are. They certainly talk about the lessons they've learned and the growth they've experienced since their loss, but they also also tell of the sadness, confusion, pain, and difficulties they've encountered along the way.

I was on a panel at the American Association of Suicidology (AAS) national conference last week in Austin, Texas, that introduced new guiding principles for Suicide Bereavement Support Groups (SBSG) in the United States. The guiding principles were developed by an AAS work group last year, and have been approved by the AAS board of directors. These guiding principles provide a starting place for the development of best practices for support groups designed to help people who have lost a loved one to suicide cope with their grief.

Work group chairperson Doreen Marshall of Argosy University facilitated the presentation in Austin on Saturday, and she was joined by me and fellow work group member Susan Beaton of Australia's Beyond Blue.* According to Marshall, the work group intended for the principles ...

... to be less prescriptive, easy to implement, and require few resources ... We felt it was ... important to develop guiding principles by which survivors could ... evaluate the groups they were leading and attending in addition to providing some guidance toward best practices.

Beaton, who played a role in the development of Australia's support group standards -- on which the AAS guiding principles are based -- said many lessons are being learned as the field of suicide grief support increasingly focuses on strengthening the effectiveness of support groups and other services. Her aspirations include ...

... further research ... to determine types and modalities of suicide bereavement support related to better client outcomes, ... a national community of practice for SBSG facilitators, ... [and] funding ... for ongoing evaluation.

A recent study published in the British Journal of Psychiatry on the views of people bereaved by suicide regarding news coverage of a suicide fatality found that currently available media guidelines for appropriate coverage of a suicide may not adequately take into account the needs of survivors of suicide loss.

[There is] a tension, and a difference of emphasis, between guidance for the press based on strategies to prevent copycat suicides (especially avoidance of certain details) and the perspectives of bereaved people (who feel they have a right to expect sympathetic and accurate reporting). There is a tension between a guideline that suggests that certain information should be withheld/not disclosed and a perspective that favours (in reports of an individual case) an accurate account, which may include such information (such as an image of the person who died).

At issue is the fact that ...

... systematic reviews of the literature have concluded that suicide rates may rise after media reports of suicide, especially if the dead person was a celebrity, if the report glamorises the suicide, if reporting is prominent, or if the method of suicide is discussed in detail.

Of course, those findings have influenced the media guidelines issued by suicide prevention proponents (see the U.S. guidelines), and the importance of preventing copycat suicide is paramount; but the bereaved's concerns about news reports of suicide also ought to be taken into account. The study of survivors showed that some want to share their story through news reports but others do not, so it would be helpful to have information and assistance readily available to the newly bereaved -- including how to take care of their own needs and what impact news coverage has on suicidal behavior -- so they can make make informed decisions about talking with the media.

I presented an experiential workshop for survivors of suicide loss -- titled "Suicide Bereavement: Personal Meanings"¹ -- at the Massachusetts Suicide Prevention Conference last week, and of the 17 people who attended, two identified themselves as clinicians who are survivors of a client's suicide. I am very pleased that they chose to attend, because the definition of "survivor" ought to be broad enough to include anyone who has been deeply affected by a suicide. For many clinicians, a client's death by suicide certainly causes profound grief, and they deserve compassionate support for their bereavement no less than any other "category" of survivor does.

Thankfully, there is a comprehensive resource available for clinicians who lose a client to suicide, the Clinician Survivor Task Force website,² maintained by John McIntosh for the American Association of Suicidology. The task force provides ...

... consultation, support and education to psychotherapists and other mental health professionals to assist them in understanding and responding to their personal/professional loss resulting from the suicide death of a patient/client and/or family member.

The Winnipeg Suicide Prevention Network has published "A Guide for Early Responders Supporting Survivors Bereaved by Suicide" (free download*), which fills a real need in the field of suicide grief support. Those who work in law enforcement, emergency medical services, and fire departments are often the first people on the scene of a suicide fatality, and their compassion and helpfulness can make a big difference to the loved ones of the deceased.

Early responders play a vital role in supporting people who have lost someone they care about, someone they know who has died by suicide. Suicide loss is profoundly different than other loss and grief in that it is a intentional act that can have crippling effects for the family, friends and other survivors. Suicide ... is a complex, multi-faceted problem leaving some survivors who have a loved one die by suicide with their life as they knew it changed forever.

The guide begins by explaining the unique characteristics of suicide loss and describing the reactions of survivors that commonly occur, framing its advice with this very helpful observation:

Whatever reactions, feelings, or questions the survivor has ... this is understandable and alright considering the terrible situation and loss they have experienced. There is no right or wrong way to feel, respond or grieve.

My favorite definition of peer support suggests that survivors of suicide loss are helpful to one another because we "feel a connection":

This connection, or affiliation, is a deep, holistic understanding based on mutual experience where people are able to "be" with each other without the constraints of traditional (expert/patient) relationships.

In part, I write this blog (and do the other things I do that put me in touch with survivors) because I believe in our connection with one another as a healing force in our grief. In today's post -- to do what I can to widen the circle and hopefully strengthen that connection -- I'd like to identify some other blogs written by survivors. Below are brief descriptions of more than half a dozen blogs from people bereaved by suicide, along with a quote from one of the posts in each blog.

The Alliance of Hope for Suicide Survivors Blog is a reflection of Ronnie Walkers' commitment to spreading the word about the needs of the suicide bereaved and about the help that's available to meet those needs (Ronnie, AOH's executive director, lost her stepson to suicide). There are several fresh posts by a variety of authors every week on the AOH blog, such as "Learning along the Journey" by Susan Futterman Paroutaud, who writes only six months after the suicide of her husband:

I've learned still more since his death ... that I could have only done what seemed appropriate at the moment, and no more. I could not have controlled him nor would I have wanted to. And I have come to realize that an infinite number of crossroads stretched before the both of us.

Anyone who quickly needs to know (or share with someone else) the most essential information about suicide bereavement can do so in one click with this introduction to suicide grief support. (To link people to this post, use the short address bit.ly/suicidebereavement.)

The introduction is free and has been reviewed by experts in the field. It covers
• recommendations on how to be helpful to someone who has lost a loved one to suicide (for example, promote a sense of calm by listening patiently to the survivor);
• descriptions of the most common issues and emotions survivors face in the aftermath of a suicide (for example, distress over questioning why this happened);
• symptoms of possible reactions to trauma (for example, being "on the lookout" for danger, which is called hypervigilance);
• indicators of when a survivor might need to seek professional help (for example, if someone is coping by using alcohol or other drugs);
• the key needs suicide bereaved people have after the initial crisis has passed (for example, help with activities to remember and honor the deceased); and
• information and resources on what to do if a survivor is at risk of suicide (for example, use the National Suicide Prevention Lifeline, 1-800-273-TALK/8255).

Not only is the introduction to suicide grief support authoritative and brief, but also all of its content can be downloaded for free as a slideshow or PDF document and used in presentations or as a handout (as long as credit is given to its developer). The content of the introduction was developed in collaboration with a work group of the Consumer-Survivor Subcommittee of the the National Suicide Prevention Lifeline that included a dozen crisis centers specializing in supporting the suicide bereaved.

Expert information about grief after suicide -- plus links to nearly a hundred of the top resources for survivors of suicide loss and those who care for them -- are available from the Suicide Grief Support Quick Reference. The free online tool features content that is up-to-date and dependable, including:

• Introduction - Suicide Grief Support: Explains survivors' experiences and needs, describes reactions to trauma, and covers how to be helpful
• Resources for Survivors: Links to websites, booklets, and handouts designed for survivors, and offers information on support groups, school and community postvention, and special populations (such as the military and people of color)
• Resources for Children: Lists websites, materials, and information about how to help children after a suicide
• Online Support for Survivors: Provides links to discussion forums, listservs, chat rooms, and blogs especially for survivors of suicide
• Guidance for Caregivers: Points to information on key principles as well as to resources for survivors who are also caregivers