Support After Abortion: assessing client readiness for a group healing program

[This information is available in a Twitter thread here.]

On June 21, I tuned into Support After Abortion’s monthly healing providers webinar, which is designed for licensed clinicians (social workers, mental health counselors, and similar) to receive training and support when helping clients work through an abortion experience. You can see the full webinar below. I took some notes I’d like to share here:

Karin Barbito, SAA’s Special Projects Manager, talked about how she had an abortion and, years later, volunteered for a pregnancy resource center. The PRC asked if she had received healing since her abortion. She hadn’t realized that was an option. She went through a healing program and it helped her enormously. Now she works with SAA to develop programs in order to get more people the support that so helped her.

Lisa Rowe, SAA’s CEO and a licensed clinical social worker, talked about working with Karin during COVID to develop 44 healing programs virtually for people. Karin pointed out that many people prefer anonymity in their groups. In-person groups can be more intimidating and they may worry about running into someone from their community who they aren’t ready to share this experience with. Virtual groups allow anonymity.

Karin and Lisa both emphasized the transformative power of group programs: people can heal through shared experiences within a safe space. However, the success of these programs requires a lot of preparation and trained facilitating. Lisa strongly recommends that providers considering facilitating such a group first experience group work as a participant, so they can get a clearer idea of what participants need from the group facilitator. For example, what will the rules of the group be (e.g. no interrupting) and how will they be enforced? As another example, many participants become anxious when the group is nearing an end because they don’t want to lose the connections they’ve formed. Facilitators should be ready with next steps.

It’s also important to make sure clients are “group ready.” One participant may share a story that is triggering to another. People might use language others aren’t used to. A participant might not be ready yet to talk in group settings. There could be too much anger.

It’s crucial to assess a client’s circumstances before starting a healing program. Do they have a therapist? Does the therapist support them participating in this group? Do they have more pressing traumas to work through? Are their basic needs (such as housing and food security) being met on a daily basis? Assess if they are in an emotional and logistical place to engage a healing program. It’s plausible some clients will be a “no for now,” and instead the priority is helping them work through other circumstances. They may want to revisit the abortion healing conversation another time.

Lisa explained some clients say things like “You’re the only person I’ve ever told and I can’t tell anyone else.” But if counselors show up for their clients, it invites them to a new understanding of how others can show up for them as well. It may help them connect to others in their life and be able to open up more about this issue.

Karin talked about how her past addiction issues were based on wanting to numb her emotional pain. She and Lisa agreed that it’s difficult for people to work through healing if they’re struggling with addiction. In the context of assessing whether a client is ready for group programs, the addiction issue merits a separate assessment. Is this person in recovery? How long have they been in recovery? What does “recovery” mean to them? (Does it mean active participation in programs, a certain amount of time sober, something else?)

Lisa said SAA is seeing that abortion pills create are creating a complex type of trauma. People are reaching out a lot sooner after an abortion experience because they can’t forget or dismiss what they saw, and with abortion pills they often go through the experience entirely alone.

One listener on today’s call mentioned during Q&A that he had once been in therapy for some time, and his therapist had asked him (as a common background question given the issues he was working through) if he had experienced any childhood sexual trauma. He had not. He noticed the therapist asked more than once, but it wasn’t the case for him. However, in retrospect he believes the therapist had been correctly sensing that some trauma that was in some way sexually related played a role in his issues, but the therapist never asked him if he had any experience with abortion. And at that time in his life he never would have brought it up. He later contacted his therapist to let her know that had been a huge issue for him, and that she may consider including that in her standard questions with other patients.

Lisa concurred. She said the mental health industry is not well trained for helping people with abortion. Abortion has remained primarily in the political space, not the clinical mental health space, and therapists often aren’t trained to address it.

Support After Abortion has developed an assessment tool for determining client readiness for group programs. To access this and other materials and training to help people heal from abortion, contact Support After Abortion here.