PM3045: Peer Healing: A Grief Group for Today's Teens

Background: Over 190,000 children in the US have lost one or both parents to COVID-19. Early parental death is a profound loss associated with lower educational and occupational outcomes as well as higher rates of depression, substance abuse, and suicide. The hidden pandemic of orphanhood coincides with the continued shortage of child psychiatrists, and community mental health services are emerging as increasingly important avenues to address child mental health needs. Previously, the Family Bereavement Program, a skills-based group program shown to mitigate the negative sequelae of parental bereavement, was updated and adapted for virtual, peer-led delivery. The process involved collaboration with over 15 subject-matter experts including the developer of the FBP. In this study, the updated curriculum was pilot-tested at community grief centers to assess the feasibility of the program and its acceptability to bereaved adolescents.

Methods: Pilot sites were recruited through a national grief support organization. Grief centers with two co-facilitators (one adult, one adolescent) were eligible. Facilitators were given full curriculum materials and a brief orientation. Each pilot site recruited participants for their group. Participant attendance and in-session engagement as well as inter-session completion of home practice was recorded. Adult and teen facilitators provided feedback in a semi-structured group interview following every session. Pilot sessions and feedback meetings were audio-recorded to ensure accurate reporting of qualitative data. The study was IRB approved (#20-0729).

Results: Three pilot sites were selected. Two pilot-sites have completed at least six sessions. Each group consists of three co-facilitators (a teen and adult from the pilot site, one teen from the research group) and 3-4 participants.

(1) Curriculum: The skills-based structure allowed for clear learning objectives without feeling like class, and the peer-led format fostered a comfortable atmosphere for support without feeling like counseling. Participants seemed to benefit most from the discussions, but the fun activities provided an important balance. (2) Timing: It was difficult to keep track of time and to interrupt a discussion that was going well. Some sessions may need more time to be completed without being rushed. (3) Instructions: Setting up certain in-session activities interrupted the flow of the sessions, as the instructions assumed a level of familiarity with certain websites that not all facilitators had. Moreover, discussions in which talking points were provided were easier to lead than ones in which a specific script was provided. It would be beneficial to have examples of appropriate responses for difficult comments from participants.

Conclusion: Our skills-based, peer-led grief group curriculum is a feasible and promising approach for virtual grief support for teens. However, more extensive development of facilitator training materials will be required for reliable implementation. Data regarding common issues encountered by facilitators will be critical.