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

 

 

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Terri Daniel

33 Comments

  1. Melissa Wentland Moreno on July 24, 2022 at 8:29 pm

    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)

    • Terri Daniel on July 24, 2022 at 8:42 pm

      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.

      • Susan Torpey on October 13, 2022 at 1:48 am

        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.

        • Terri Daniel on October 13, 2022 at 10:05 am

          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.

          • Scarlett Lynsky on February 9, 2023 at 10:39 pm

            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.



          • Terri Daniel on February 9, 2023 at 11:53 pm

            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.



        • Rebecca Heuston on April 30, 2024 at 4:15 am

          Become an instructor. And then teach me

  2. Kathy McKim on October 13, 2022 at 5:50 pm

    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!

  3. Delta waters on October 14, 2022 at 3:33 pm

    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.

    • Terri Daniel on October 14, 2022 at 6:34 pm

      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.

      • Delta Waters on October 26, 2022 at 5:20 pm

        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.

        • Terri Daniel on October 26, 2022 at 5:31 pm

          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?

          • Delta Waters on October 26, 2022 at 6:46 pm

            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!



  4. Lori on January 27, 2023 at 7:19 pm

    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?

    • Terri Daniel on January 28, 2023 at 12:38 am

      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/

      • Mike on March 3, 2023 at 2:27 pm

        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?

        • Terri Daniel on March 3, 2023 at 2:38 pm

          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.

          • Mike on March 3, 2023 at 7:14 pm

            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.



  5. Mike on March 13, 2023 at 1:02 am

    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/

    • Terri Daniel on March 13, 2023 at 1:07 am

      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.

      • Mike on July 11, 2023 at 5:29 pm

        The site below I listed earlier will allow you to take their course without the requirements you listed above but you won’t get the certificate after completion. I talked to them in two different occasions verifying this.

        Thanks for all the info.

        https://aihcp.net/pastoral-thanatology-ce-courses-program/

  6. Kari on December 7, 2023 at 10:47 pm

    Hello,
    I have been a medical Social Worker for the past 35 yrs. 17 yrs of this has been with Hospice. I would like to get a certificate as a death doula. However, I don’t need an extensive course. How can I get certified with the skills I have been using for the past 35 yrs?

    • Terri Daniel on December 8, 2023 at 12:19 am

      As a 17-year hospice social worker, you’re already a death doula. Why would you want to seek that certification? You don’t need it, unless you feel there’s more you’d like to learn about death and dying. These courses will give you some good “book learning,” but no hands-on experience at the bedside. If you’d like to get the certificate based on your experience, there’s probably a way to purchase a “fast track” of some kind. You’d have to ask the various people who offer those courses.

  7. Angie Buchanan on December 11, 2023 at 8:29 pm

    Interesting thread. I offer a 3-day certification training. A student directed me here and I disagree with much of what I’m seeing. We live in a death denying culture. It used to be that we cared for our dying and our dead in our own homes. We did that for much longer than the way we’ve been led to believe we have to do it now. My perspective is that one does not need to have academic privilege, medical or otherwise, to be able to do this work. Death is not a scheduled event, and many folks find themselves in the presence of it unexpectedly, with no tools. The purpose of our training is to reclaim family directed choice at end of life. We offer a comprehensive toolbox to help people do that and we can do it in three days. We are also authorized to issue 23 CEU’s for nurses, clergy, and massage therapists. Death midwives are not medically trained, and we are not funeral directors but, partnering with these professions is helpful and we not only suggest and encourage that, but we also appreciate it when it happens. We encourage our students to develop relationships with many other professions because death by nature is an interdisciplinary venture. I frequently train hospice organizations. (I also train clergy groups and mental health professionals) but not everyone knows that hospice exists, or they live in rural areas where it is unavailable, or they think it’s a death sentence. There is a huge landscape that exists between the medical profession and the funeral industry. That is where the death midwife steps in. We provide information on an emotional, spiritual, and practical level so that the average person has the tools that empower them to make choices that do not have to involve excessive medical intervention, and that equip them to navigate the funeral industry which can be expensive and predatory. To advocate for longer, more expensive programs is in my opinion unnecessary, and an overreach often motivated by a need to claim ownership of something that belongs to each and every human being – death. To regulate and monetize this work via academia is just another form of colonization. I oppose it.
    -Angie Buchanan, Certified Death Midwife
    http://www.DeathMidwife.org

    • Terri Daniel on December 11, 2023 at 8:37 pm

      Everything you’ve said is true about American death attitudes and the need for midwifery. But I don’t think anybody can be “certified” for anything in only three days, especially with no hands-on, supervised experience. Does your program require any pre-requisites, such as 6 months as a hospice volunteer, or shadowing a nurse or chaplain from a hospice? None of those things has anything to do with academic privilege. It’s just common sense that people who are certified in something should have practical experience.

      • Angie Buchanan on December 11, 2023 at 9:22 pm

        No – no prerequisites required. I disagree that those things define “common sense.” Death belongs to everyone. There is a difference between a certification and licensure. Certification does not refer to the state of legally being able to practice or work in a profession. That is licensure. Usually, licensure is administered by a governmental entity for public protection purposes. Licensure and certification are similar in that they both require the demonstration of a certain level of knowledge or ability. (ie: Microsoft offers a certification for proficiency in Excel that takes about 6 hours. When I was a police officer/paramedic, I had multiple certifications, breathalyzer, CPR, polygraph, hostage negotiation – all of which were 8-hrs or less trainings)
        The institute for Credentialing Excellence holds the Board Certification for nurses, engineers and computer specialists. This is their formal definition.
        “One of the most common types of certification in modern society is a professional certification, where a person is certified as being able to competently complete a job or task, usually by the passing of an examination and/or the completion of a program of study. *Some* professional certifications also require that one obtain work experience in a related field before the certification can be awarded. Some professional certifications are valid for a lifetime upon completing all certification requirements. Others expire after a certain period of time and have to be maintained with further education and/or testing. Certifications can differ within a profession by the level or specific area of expertise to which they refer.” Institute for Credentialing Excellence (http://www.credentialingexcellence.org)
        I have trained North American Indigenous groups, church groups as well as other marginalized populations (charitable organizations who serve the unhoused) who then use the information I provide to care for their own communities. Those who take my training are certified because they attended the classes and passed the exam. Not only do they have the packet of materials that comes with the training but they forever have access to a rich resource of professionals that I have also trained. Funeral directors, mental health professionals, medical professionals, clergy, veterinarians, massage therapists, and a host of other professions that are drawn to this work. One person with this knowledge can be invaluable to large groups.

        • Terri Daniel on December 11, 2023 at 11:48 pm

          I understand the difference between licensure and certification (I’m a college professor). I doubt Microsoft would certify people in Excel if they couldn’t demonstrate their ability to use it.

  8. amy r carr on March 2, 2024 at 1:39 pm

    I just happened upon this discussion and I just want to thank you. I’m an occupational therapist and have spent the majority of my career in critical care. I’ve seen many things so much worse than death, sadly. I was thinking about pursuing becoming a death doula as I start to retire from O.T. Thanks again for sharing your highly informative perspective. Fascinating, really.

  9. Cherie on March 28, 2024 at 3:34 pm

    I really appreciate this perspective! I happened upon this discussion when seeking the difference between the end of life doula trainings and end of life certification through a community college –

    https://www.bucks.edu/healthcare/conedhealth/end-of-life/

    I am a licensed psychologist in private practice who is looking to enhance my skills and knowledge working with folks who are confronting terminal illness. Although I would like to volunteer for a hospice in the future, I am not interested in making a career as a death doula. I do believe psychologists could be more prevalent in supporting those who are or confronting end of life issues and existential questions. Could I please ask your opinion on which of the 2 trainings referenced do you believe would be best someone like me? Thank you

    • Terri Daniel on March 28, 2024 at 3:49 pm

      The way to tell if a program is viable is this…. if they required bedside experience (supervised clinical hours) before issuing a certificate, then I would say it’s a good program. If all they require is a weekend or two of online learning with no practical experience, I would not endorse such a program. Most of the certificates issued by most of these programs aren’t worth the paper they’re printed on. There’s a difference between a certificate stating that you’ve completed a course and a certificate that verifies your competence in a field or practice.

  10. Cassie W. on May 8, 2024 at 2:16 pm

    Thank you so much for this insight – it’s certainly helpful in narrowing down my options. I am curious – what are your thoughts on the profession itself? Do you think death doulas are needed in end-of-life care? Thank you for your thoughts!

    • Terri Daniel on May 8, 2024 at 2:22 pm

      Yes, but I don’t think anybody’s quite figured out what that would look like. The biggest role I can see is in hospice care as trained companions. Nurses, chaplains, CNAs, social workers and other staff don’t have a lot of time to spend with patients, and a doula on staff could arguably spend more time at the bedside, pretty much doing what volunteers do, but with a special skill set.

      • Melissa on May 24, 2024 at 3:41 am

        Hi Terri,
        Thank you so much for your response to everyone’s questions on here.
        I did read your recommendations and the two programs you felt were well rounded on-line curriculums. Since that post are there any in Southern
        California (San Diego) that you can recommend in person or online? Just curious.
        Thank you in advance for your time.
        Melissa

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