Are Death Doula Training Programs Substantial Enough?
July 24, 2022
A few weeks ago I was asked by an aspiring death doula for recommendations about the best training programs. The poor woman had no idea what she was in for by opening the door to one of my favorite rants.
I encounter self-proclaimed death doulas on a regular basis, and when I ask about their training, I’m almost always disappointed in what I hear. Most have no experience at the bedside of a dying person other than with a close family member, and their training involves nothing more than an online workshop… with no actual clinical experience.
Practitioners lament that this discipline is not taken seriously by hospitals and hospices, and it isn’t hard to see why; most graduates of most death doula programs don’t have the kind of bona fide credentials required for working in a clinical setting.
So when I’m asked for my opinion about how to make a career out of it, this is what I suggest:
What’s Really Needed to Become a Death Doula
1. At least six months experience as a hospice volunteer should be a pre-requisite for entry into a doula training program. But most programs have no pre-requisites at all; they just want to enroll as many people as possible. To be truly skilled in this area, you need to experience death care with patients that are not your own loved ones. Attending the death of your own family member does not qualify you to attend the death of a stranger.
2. Most doula programs don’t require any hands-on experiential training or clinical supervision, which is not only unfortunate, it’s unethical to “certify” someone in a clincal discipline with no actual experience in that discipline. These programs should require a minimum of 30 hours supervised training/internship in a clinical setting — supported by academically-sound study materials — before any sort of certification is granted. As an example, one online, self-study program I encountered offers death doula “certification” for $189, using no resources than their own self-published book.
3. Previous education or experience is critical. In my opinion, doula trainees should have some education (or experience) in a related field, such as nursing, psychology, gerontology, social work, etc. Specific training in family dynamics, spiritual care, grief theory, counseling techniques, multi-cultural competency and compassionate communication should be mandatory. As should exposure to current research in thanatology and bereavement.
Finding the Right Programs
Without meeting the criteria mentioned above, you really don’t have any practical skills at all, which is why “death doula” is not a certifiable profession in the health care field. However, if the program you choose offers an academically-sound curriculum, you’re off to a great start. The woman who asked for my recommendation was interested in a course at a college in Vermont, and she sent me the syllabus to look at. The required reading didn’t include any academic material at all… the two books required for the course were not even at undergraduate level (and one of them was written by the instructor).
If your goal is be hired by a hospice, hospital or nursing home, please consider a bona-fide academic program like the one offered by Marian University in Thanatology. These course are offered at many colleges these days, and if your goal is to have a professional career in this field, it’s worth it to spend the time and the money getting a substantial education.
If you don’t want to go the full academic route, I also recommend this program facilitated by the great Richard Groves (a two-year apprenticeship). In addition, to add extra credibility to your credentials, consider seeking certification in thanatology from the Association for Death Education and Counseling (ADEC). Finally, if you’re just looking for some foundational knowledge in death care that doesn’t provide actual academic or professional credentials, these are two good programs:
https://sacredcrossings.com
https://www.consciousdyinginstitute.com/
For more on this issue, please read this insightful article by Delta Waters, RN.
© 2022 by Terri Daniel
HI Terri
I am a Nurse Practitioner in hospice/eol care and I would like to be trained to be a death doula. Of course I have a certificate as a spiritual care volunteer 30+ years ago …. and I may have had more training that the death doula currently has.
I have an educational background and currently work in a hospice. I would love to start a death doula certification course and use your expertise and outline.
Do you have any faith in the two current death doula training programs that I have seen in Northeast. I was planning on taking a weekend training in NYC -then covid hit. all bets were off and everything was chaos..
I still feel that this is VALUABLE work and want to train others in it.
Do you have any suggestions for me to create a new program.
I was thinking of approaching the BOCES continuing adult educations program of local community college.
Just looking to pick your brain.
my cell is 914-262-6216 ( i am in metro NY)
Hi Melissa!
Are you talking about getting doula training for yourself, or are you talking starting a program where you are training others? With your experience and credentials, you don’t need any additional education, so I assume you’re talking about becoming a doula instructor. I think you would be perfect for that. And I think that you would create a program that requires a good solid foundation in clinical experience/supervision and academics. Approaching a local college is a good place to start.
Regaring my faith in doula programs, I don’t approve of the ones that “certify” people without requiring any supervised clinical hours or bona fide academic work.
I worked the last 20 years of my career in Hospice. I am an LPN, who was at the bedside for 12÷ hours per shift with people who were at end of life. I gave the appropriate personal care, nursing care, education to loved ones, and emotional support to all who were present. I was present for many as they took their last breath. I don-t agree with you that you need a bachelor’s degree in a related field to be a death doula. The heart of a Hospice nurse, and appropriate training from a Hospice organization gave me what I needed to become a CHPLN, (Certified Hospice Practical Licensed nurse) as I passed the certification test set forth by the Ohio Board of Nursing during my first few years with Hospice. After 20 years of experience, working with many excellent Nurses, Chaplains, and Physicians, I feel that I could qualify as a death doula.
You are actually supporting my point exactly. You had clinical experience. You are an LPN. That’s top of the line, the best trianing possible. You ARE a death doula. True, no degree is necessary if experience can be substituted. But these doula programs don’t require that type of experience. Most of them just confer a certificate after a couple weekends of online workshops.
I completely see your point about any would-be death doula needing experience at the bedside of many dying people, but… I’m not convinced that hospice nursing necessarily qualifies one as a death doula. The mainstream medical world has MUCH to learn about how to support dying people and their families. It would seem to me that a Nurse might need to unlearn some some things in order to work well as a death doula. I come from the world of birth and I would certainly never say that because a person has been a Labor and Delivery Nurse for 20 years that they ARE a birth doula. Know what I mean? Of course, I acknowledge that a person might be drawn to hospice (or birth) work because of their innate skill and comfort there. There are nurses who intuitively have the skills of a doula, but they either have it or they do not. I do not think that it is taught by their nursing program. Perhaps this is a small distinction, but it feels relevant to me.
Thanks for your comment, but I don’t agree at all. An experienced L&D nurse is a birth doula. An experienced hospice nurse is a death doula. If you don’t think so, then tell me please, what is the difference? You refer to “the skills of a doula,” but how do those skills differ from a nurse who’s done the same work for decades? You’re right that those skills cannot be taught in school; they come from experience. After years of experience on the job, the labor nurse and the hospice nurse have developed those skills, as would a doula with the same experience. I’m not a nurse, nor have I ever taken a doula training course. But I’ve worked in hospice — first as a volunteer and then as a chaplain — for 15 years. And I consider myself to be a death doula, based on my professional experience and academic training in death & dying… both of which are lacking in the doula programs that are popular now.
I really appreciate the information and discussion about death doula training and preparation. I sincerely hope that higher quality doula training programs will be more widely available in the future. To me, it’s scary that people could believe that ‘graduating’ from some of these doula training programs prepares them to work with/help people during their dying and death. I completely agree that relevant, appropriate prior education, background, and requisite skills be required prior to doula training, followed by high quality end-of-life doula training programs which include multi-cultural competencies and require clinical experience and supervision in the field. Well said!
Terri!
Thank you for saying this… Out loud. I am an RN who has years of hospice experience. I retired last year and decided to take a death doula certification course to see what was all about. I thought getting certified would look good to the general public. I won’t mention the name of the training but it was created by a very popular person in the field. I came out the other side with two major takeaways. That my clinical background is a major asset and that the doula program was a great opportunity for me to unlearn being the large and in charge nurse and remember the heart of nursing which is my bedside care and compassion. The second takeaway was that I am horrified at the program’s creator for making the attendents, by and large lay people, think they can hang a shingle out and call themselves a doula now. I felt that it was sloppy at best and dangerous at worst to give most of these people the go ahead to practice. Most had just been at a loved ones death, thought it was an amazing experience and wanted more of it. There’s a huge difference, as you know, between being with a loved one while they’re dying and showing up at a bedside of a stranger and their family. I felt the pseudo psychology training could open up unresolved traumas for those they were serving and they wouldn’t have the professional chops to deal with it outcomes. This does lead me to also question this.. traditionally bedside helpers, both at births and deaths, we’re organically chosen by the communities in which they resided. They were usually older women who had ” seen it all.” I don’t think all clinically trained people are good candidates to be death doulas and I don’t think you necessarily need clinical training to be an outstanding one. I think the answer to this is the apprenticeship model to which you refer. I was a home birth midwife apprentice for YEARS before I caught my first baby in my own. There’s so much to unpack in this topic. Thank you again.
Thank you so much for your excellent perspective Delta. It’s voices like yours — with so much knowledge and experience — that need to be shaping the doula movement. It’s shameful how unregulated this new industry is. Programs like THIS ONE should be shut down.
There are simiar programs that certify people as “grief coaches.” Major scams.And so dangerous for vulnerable people who really need help.
Terri!
You actually spurred me on to writing on this topic myself. I found the shameful program you highlighted above on my own and included it in my published guest blog post….I just read your reply today. Great minds think alike! I have SO many other complaints about the doula program I took but do not want to be held for liable discussing it publicly. It would be my honor if you had the time to read my blog post.
https://palliativeprovocateur.com/2022/10/24/a-problem-with-death-doula-training/
Glad to know someone so articulate and soulful as you is in the death awareness community! Be well and continue on doing your good work.
Thanks so much for your comment. Yes, that program that I referenced was definitely SHAMEFUL. That’s great word for it.
I took a quick spin through your blog post, and I love it. In fact, I’d like to use it in my next newseltter. One issue though… it’s very long, and it’s hard to read with white text on a black background… two elements that actually make people NOT want to read it. It’s well-written, and I’d love for more people to read it. Any chance you could re-format it a bit?
Let me look into republishing it. It is a guest post for Palliative Provocateur and I may need permission. I could look into a rewrite as well. I’ll be in touch. Is there a more direct way to contact you outside of this format? Do you have access to my email that I provide here to publish comments? Let’s chat! And thanks for the invite!
I am a nurse practitioner and I want to offer death doula services. Do I need to complete the Death Doula Training? Which is the best for me?
I recommend the certificate in thanatology from either Marian University or the University of Maryland. Both programs are online:
Marian University
https://www.marianuniversity.edu/online-programs/ms-thanatology/
University of Maryland
https://www.graduate.umaryland.edu/thanatology/
Hi Terri thank you for writing this article! I am too interested in end of life training but with both the programs you listed you need a bachelors degree and unfortunately I don’t have one. Is there any other end of life trainings you know and would recommend for someone in my position?
Are you sure the program at University of Maryland requires a degree? it’s a certificate program (vs. a masters degree), and they might not require it. Check with them to confirm.
There are some doula programs that are good, particularly the ones offered by Sarah Kerr and Tarron Estes (Google them). But I don’t think they include bedside experience, and without that experience, you’re not really getting a viable education. You’ll have to get that experience on your own, and the way to do that is as a hospice volunteer.
It all depends on what your goal is. Are you hoping for a job as a death doula in a hospice agency? There IS no such job (everybody who works in hospice — chaplains, nurses, social workers, etc — is already a “death doula”). The only thing you can do with this type of training is open a private practice. If you were already a nurse or chaplain or social worker, the doula certificate would look good on your resume, but it will not qualify you for a paid position.
Thank you for the response! I’m volunteering through hospice right now. At some point I’m looking to become a private end of life guide but I will not do that without being competent in that field. I’ll look into the certificate you mentioned. I agree a two week course isn’t going to be enough for working with people and their families at the end of life.
Both the courses you recommended need a bachelors degree in human sciences but I found a regular certification program open to all here:
https://aihcp.net/pastoral-thanatology-ce-courses-program/
Actually, it lists these requirements for certification:
All candidates for Certification must have achieved one of the following prerequisites:
A health care licensed professional.
A college degree in the fields of health care, human services, psychology, or human behavior and has past experience working with the dying.
A college a degree in theology and/or ministry from a legitimate school providing curriculum to meet defined objectives for conferral of a degree.
A college level degree in a human behavior related field and has past experience working with the dying.
Holds a legitimate current certification in pastoral care.
Is a licensed minister or any legal clerical representative of a religion.
Currently works in pastoral care under the direct supervision of a clergy, church or other type of organization or has a sponsorship by a licensed clergy/minister to study pastoral thanatology.
Candidates must have achieved one of the above prerequisites and must be able to show evidence of the educational requirements as provided above.
Note: candidates must provide official documentation of at least one of the established prerequisites at the time of application for Certification. Failure to provide such documentation and evidence of education requirements will result in rejection of the application.