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##  Coping with Loss and Grief through Online Support Groups. ERIC/CASS             Digest.                                                                      

The death of a loved one is a natural and inevitable life                       experience.  Those who must cope with the loss, experience various              grief reactions. Typically, people discuss their grief reaction with            someone they know or do not discuss it at all. Current technology               now enables people to cope with grief through participation in                  online support groups from the comfort and privacy of their                     home. GRIEF AND HEALINGThe grief process is typically                     nonlinear, repetitive and painful to transcend.  It involves                    adaptation to many changes, and it is marked by repetitive cycles of            progression followed by stagnation or regression.  The three aspects            of grief are emotional, physical and behavioral (Rando, 1988). 
*              Emotional reactions include fear, anxiety, depression, confusion,               search for meaning and anger. 
* Physical symptoms include changes             in eating and/or sleeping patterns, fatigue, increased risk for                 illness and weight increase/decrease. 
* Behavioral responses                  include diminished interest in usual activities, acting out or                  withdrawal from and/or rejection of support systems. ONLINE                   SUPPORTOnline support groups for loss assist members in facing              the void left by the loss of a loved one and help to reduce members'            feelings of isolation and their sense of feeling overwhelmed.  These            are common reactions during the grieving process. Members in an                 early phase of grief can share their reactions with others in the               group while members in a later phase can offer support and problem              solving. Facing holidays and special occasions are considered                   difficult for most members, especially if this will be their first              occasion or holiday since the loss of a loved one (Weinberg,                    Schmale, Uken & Wessel, 1996).  Likewise, those who are terminally              ill and/or their loved ones face similar anxieties if they                      anticipate that approaching holidays and special occasions may be               the last ones they celebrate together.  See Gary and Remolino (2000)            for an excerpt from a typical online support group for                          loss. 
Online support groups are a relatively new and growing cyber            service.  They can be accessed through use of a computer and modem              in conjunction with an Internet service provider (ISP) such as                  America Online (AOL).  Once connected through an ISP, online support            groups may also be reached through Internet portals (e.g., Yahoo) or            through specialized web sites (e.g., www.death-dying.com).  Gary and            Remolino (2000) provide a sample of websites for loss and grief.                Each ISP, website or portal sets its own standards and procedures               regarding regulations, quality control, crisis management,                      disclaimers and training of group leaders. IMMEDIATE RESPONSE TO              GRIEF ONLINETraumatic events that were once considered local                dramas acquire national and international significance as a result              of instant and extensive media coverage.  Coverage of events such as            the numerous school shootings and their resulting deaths between                1997 and 1999 illustrates this point. These events produced a range             of emotional reactions in victims and television viewers, including             anger, anxiety, depression, and fear. Noteworthy is the role that               the Internet is playing in helping people to cope immediately with              tragedies involving death such as the recent school shootings. For              instance, many ISPs immediately responded by establishing online                support groups devoted to a particular school shooting.  People went            online to try to understand these school tragedies, to reach out to             others, to learn how to make schools safe, to cope with school                  violence, to handle grief reactions, and to recognize danger signs              of violence in high-risk youth. 
Once the shock wore off and the               grieving began, online support groups for loss were overwhelmed in              the days and weeks following many of the school shootings.  New                 members, either from the local area of the shootings or from among              television viewers, joined veteran online support group members to              seek support and to express anger, outrage, and other emotions.                 Dialogues were strained, and many members seemed to experience                  inhibition when disclosing intimate feelings.  Sessions required                strong facilitation skills to encourage participation. Perhaps the              strain was partially due to numbness caused by the current trauma,              new members' lack of familiarity with the mechanics of online                   support groups, awkwardness about the online support group's                    interactive process, or feel overwhelmed by the wide range of                   emotions expressed online.  For veteran members who were already                coping with a personal loss, the school tragedies or other traumatic            news events can resurrect previous and unresolved loss issues and               unrelated grief issues. BENEFITS OF ONLINE SUPPORT GROUPS FOR                 LOSS* Increased Access to Support.  Intimate, honest dialogues              and expressions of grief can be stigmatizing.  Relatives and                    neighbors may be overwhelmed or unable to offer support and avoid               the subject, pushing the frustrated and grieving person into                    isolation.  Online support groups reduce their sense of isolation               and loneliness, a predominant reaction for most people in the midst             of the grief process or for those who might otherwise grieve alone              and not seek a face-to-face support group or support                            person (Weinberg et al., 1996). 
* Specialized Online Support                  Groups. Some loss groups may need to be age- and/or gender-specific             or focus on specific needs or characteristics of loss (Koocher,                 1996). Specialized online support groups can be formed more                     successfully than traditional support groups that are limited by                geographic boundaries.  For example, teens and children may need                age-specific groups in order to discuss loss issues based on their              developmental level (Koocher, 1996).  They may be encountering their            first experience with death, may be uncomfortable seeking help from             adults or may be unable to relate to adult issues about loss in                 adult online support groups.  Similarly, adults may encounter                   difficulty helping teens and children cope with grief.  Youth can               access online support groups as long as a parental security block               has not been imposed. Parents, however, should be aware of their                child's Internet use and should be encouraged to capitalize on the              youth's participation in online support groups to strengthen family             communication. 
* Universality of Grief.  Others struggle, too, and            this is not always evident to grieving people who tend to isolate               themselves.  Universality unites people as they share similar                   thoughts, feelings, fears, and/or reactions (Yalom, 1995) with their            cybercommunity.  They realize that grief is normal, they feel                   validated, and they heal as they complete the grief                             process. LIMITATIONS OF ONLINE SUPPORT GROUPS FOR LOSS*                   Anonymity Breaches.  Limit the disclosure of personal and                       identifying information when registering for and participating in               on-line support groups.  Grieving members who are often lonely and              feel isolated or desperate may attempt to continue conversations                with specific members at the conclusion of a session.  Personal                 communication between members is discouraged as it can culminate in             the exchange of identifying information, thus placing a vulnerable              member at risk for cyberstalking or at risk for one's physical                  safety and privacy. 
* Differing Stages of Group Development and               Phases of Grief.  Online support groups for loss are open                       continuously to new membership. Fluctuations in membership make it              difficult for online support groups to maintain the working stage of            group development for extended periods (Corey & Corey, 1997).  Group            cohesion is also diluted by each member's individual grief                      reactions, resulting in a diverse membership that needs support                 throughout the grief process.  These limitations reduce the efficacy            of online support groups as a sole support source for some                      members. 
* Hoax Perpetuations.  People with unscrupulous motives              can deceive an online support group, however, online support groups             for loss do not attract many hoaxes. 
* Limited Feedback.  Those               with cultural or familial barriers that inhibit open discussions                about death or emotional expressions of grief may perceive less                 personal feedback, absence of face-to-face contact, decreased                   intimacy and reduced intensity as incentives to participate. 
*                Accountability. Participation in online support groups raises some              accountability, ethical and legal questions that currently remain               unanswered. Accountability is unclear and confusing because online              support groups function without regard to geographic borders or                 local or national laws. Furthermore, professional requirements (or              lack of) for hosts are inconsistent. CONCLUSIONOnline support             groups provide assistance by linking grieving people who seek                   support, especially if support is not available in their local                  community. However, they are not appropriate for everyone and should            not be considered a panacea. REFERENCESCorey, M., & Corey,                G. (1997). Groups: Process and practice (5th ed.).  New York:                   Brooks/Cole. 
Koocher, G. (1996).  Pediatric oncology: Medical                 crisis intervention.  In R. Resnick & R. Rozensky (Eds.), Health                psychology through the life span: Practice and research                         opportunities (pp. 213-225). Washington, DC: American Psychological             Association. 
Rando, T. (1988).  Grieving: How to go on living when            someone you love dies. Lexington, MA: Lexington Books. 
Gary, J. &             Remolino, L. (2000).  Coping with loss and grief through on-line                support groups. In J. Bloom & G. Walz (Eds.), Cybercounseling and               cyberlearning: Strategies and resources for the millennium (pp.                 95-115). Alexandria, VA: American Counseling                                    Association. 
Weinberg, N., Schmale, J., Uken, J., & Wessel,                   K. (1996).  On-line help: Cancer patients participate in a                      computer-mediated support group.  Health and Social Work, 21(1),                24-29. 
Yalom, I. (1995).  The theory and practice of group                    psychotherapy (fourth ed.).  New York: Basic Books. 
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Juneau            Mahan Gary is an Assistant Professor at Kean University, Union,                 NJ. 
Linda Remolino hosts an online support group and is a School              Counselor at West Orange Board of Education, West Orange, NJ. 
ERIC            Digests are in the public domain and may be freely reproduced and               disseminated.  This publication was funded by the U.S. Department of            Education, Office of Educational Research and Improvement, Contract             No. ED-99-CO-0014. Opinions expressed in this report do not                     necessarily reflect the positions of the U.S. Department of                     Education, OERI, or ERIC/CASS.                                               **Title:** Coping with Loss and Grief through Online Support Groups. ERIC/CASS             Digest.                                                                      **Document Type:** Information Analyses---ERIC Information Analysis Products (IAPs) (071); Information Analyses---ERIC Digests (Selected) in Full Text (073); **Available From:** ERIC Counseling and Student Services Clearinghouse, University of               North Carolina at Greensboro, 201 Ferguson Building, P.O. Box 26171,            Greensboro, NC 27402-6171. Tel: 336-334-4114; Tel:                              800-414-9769 (Toll Free); Fax: 336-334-4116; e-mail:                            [email protected]; Web site: http://ericcass.uncg.edu.                       **Descriptors:**  Coping, Counseling,  Grief,  Internet,  Social Support Groups,                 Technology                                                                   **Identifiers:**
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