| | Print | Email

The Effects of A Support Group Intervention on Adult Children of Holocaust Survivor's Self-Reports of Feelings of Isolation:


Jodeme Goldhar, MSW, RSW
Paula David, MSW, RSW
Baycrest Centre for Geriatric Care
Toronto, Canada

The Agency:

The Baycrest Centre includes a chronic care hospital; the Jewish Home for the Aged, Supportive Housing, Day Care Services, Community Outreach programs and a wide range of clinics and speciality services. Family education and support are key components of the service and part of the organisational mandate includes health promotion and education. The Holocaust Resource Project is an aspect of this service and a Second Generation Group comes under its auspices.

Initiating a group for adult children of Holocaust survivors originally carried a dual purpose. Group leaders wanted to share the expertise and experience of the Centre in the area of aging survivors as well as learn from family members what specific and unique approaches to care might be beneficial. Adult children of survivors responded to this dual mandate and further articulated one of their own. They wanted the benefits of mutual aid and support with many of their own life issues as the Second Generation. Their response to the common affective responses associated with the intergenerational transmission of trauma often evidenced during individual counselling gave rational for this research.

In planning a group for adult children of Holocaust survivors it is important to have a comprehensive understanding of the need, purpose, composition, structure and content.

Problem and the Manner in which it has been selected:

During individual counseling situations, social workers became cognizant that the majority of adult children of Holocaust survivors reported feeling alone. This ïfeeling' was in the context of their family history, narrative, worldview and many attitudes towards family. Furthermore, they reported feeling as though "it was their Holocaust too" and as a result felt that non-adult children of survivors were unable to relate to many of their thoughts and feelings.

The children of survivors, by virtue of the trauma their parents shared, have unique commonalties. The authors, through an on-going assessment, felt that the needs of these clients could best be suited to a group process, complementing other services the individuals might be receiving. The purpose of this study is to examine whether or not the group is an effective intervention in reducing the targeted behavior of feelings of isolation by group members.

Type of Study Employed:

This study employs a single system design to research. It follows an A-B design. The purpose of this paper is to establish the Baseline (A) component of this study and establish the intervention (B) phase.

Purpose of the Study:

To determine if group work is an effective intervention in reducing feelings of isolation in adult children of Holocaust survivors.

Purpose of the Group:

The purpose of this group, in accordance with the aforementioned needs, is to bring adult children of Holocaust survivors together as a way to reduce feelings of isolation and to provide group counseling and the benefits of mutual aid and support to the participants.

A Literature Review: Substantiating Evidence for the Need to Provide Support to Adult Children of Holocaust Survivors.A Rationale for Group Intervention:

Children of Holocaust survivors were born during or after the Holocaust to parents who suffered extreme victimization at the hands of Nazis. Some children were born in Europe and then moved and were raised in Israel, the United States, Canada, Australia, South Africa or South America (Newman, 1979). Many were born shortly after their parents arrived in their newly adopted homelands. Rosenbloom (1985) reports that adult children of aging survivors identify themselves as "heirs" to the Holocaust and want to be understood from within this perspective. This may be related to the fact that family is a loaded concept for survivors of the Holocaust because of the total destruction of extended family members.

Various research surmises the uniqueness of bonds in Holocaust families (Rosenbloom, 1985, Klein-Parker 1988). For instance, children of Holocaust survivors have been perceived by their parents as the meaning to continue living and the reason to exist (Pilcz, 1979). In turn, the children are known to have feelings of burden and intense guilt in developing autonomy because of the pain their parents endured during the cruel separation from the people they loved in earlier years (Klein-Parker, 1988).

Children of Holocaust survivors have a unique role to play that has been described as both a burden and a privilege (Klein-Parker, 1988). They know their parents lost their entire families and chose to create new ones. Many of them have been named after murdered relatives and their parents may compare them to lost loved ones, including lost children. As such, children of Holocaust survivors may assume more responsibility for their parents than children of families who are not confronted these the atrocities. Danielli (1988) reports that "Children of survivors seem to have consciously, and unconsciously absorbed their parents' Holocaust experiences into their lives".

Many children of survivors have integrated and internalized both the known and unknown circumstances of their parents and may suffer from the trauma status that their parents face (Safford, 1995). In some instances, children of Holocaust survivors disclose their involvement in fantasy as a tool to understand what was done to their parents and how they survived (Safford, 1995). Adult children are often troubled by guilt, a similar guilt experienced by their parents for not being able to undo their parent's early life trauma.

Similarly, literature discloses that other children report an inability to be given permission to have stress and hardship in their own lives (Klein-Parker 1988, Newman 1979). This is seen to reflect the understanding that no matter what the children confront in their life it does not rank in comparison to the extremity of their parent's pain. As a result of feeling invalidated for their own feelings towards their current life obstacles, these children may take on the need to suffer in order to identify with their parents (Newman, 1979). These overwhelming expectations created feelings in children to make up for their parents losses and therefore led these same children to experience frustration for never being able to fulfil this far reaching and unrealistic task.

It is interesting to realize that although children of survivors were generally born after 1945 and never experienced persecution or abuse, they recapitulate their parent's symptoms and behave similar to the survivors themselves (Klein-Parker, 1988). As previously mentioned, children may incorporate their parent's guilt. They may also feel an obligation to retell the history of the holocaust, and they may even have nightmares of persecution.

The above information is not intended to create a cognition of pathology related to the adult child of Holocaust survivors but rather works to create an awareness of the types of relationship and affective responses to this type of trauma in families. In recent years, adult children of Holocaust survivors have worked hard to reclaim their own experiences and feelings in order to combat labeling and diagnosis that manifests as a result of the symptomology. Adult children have raised social consciousness and often express a collective identity and the need to wok together. These same children emphasize strength, vitality and high rate of success. For instance, research reports children to disclose an ability to be inspired and dedicated to responsibility because of their family constellations and the life-affirming attitudes by which their were raised. The adult children of Holocaust survivors collectively have clarified the richness of the legacy as well as the challenges.

In summary, it is obvious that adult children who never directly experienced the Holocaust often show signs similar to that of their parents which show marked signs of affective reactions. It is important for social work practitioners to be cognizant about the factors that potentially impact and mitigate the life circumstances of these adult children. As such, the aforementioned content speaks to the manner in which adult children of Holocaust survivors feel a sense of isolation regarding the laden content of their experiences. A social work group intervention works to address the self-reports of isolation as a way to combat feelings of loneliness.

The Adult Children of Holocaust Survivors Group:

The support group for adult children of holocaust survivors is called "Aging Parents, Aging Children". The group is co-facilitated by the authors. It is a program experienced for the first time by both facilitators. The group is offered to the second generation in order to provide counseling and the benefits of mutual aid and support to these clients. The social workers, in offering this group, work to reduce member's self-reports of isolation. Literature as discussed previously, on the second generation, elaborates on the need for autonomy, separation and individualization among children from their parents in survivor families. The children of survivors, by virtue of the trauma their parents shared, have unique commonalties and Holocaust perspectives that social work must understand in order to respond appropriately.

Members defined their needs and spoke of the manner in which their issues needed to be addressed. This was helpful to the leaders as each member became an active agent in their participation and individualized needs brought to the group were then worked through with in it. This process is particularly rewarding for the group leaders as it provides the opportunity to learn from group members regarding the manner in which their own issues of loneliness in the context of their families has impacted their lives respectively.

Single Subject: The Group :

The outlined group best reflects a support and self-help paradigm, since these types of groups provide peer support and mutual aid in relieving the stress related to difficult life situations. The group is composed of adult children of Holocaust survivors, who are dealing both with caregiver issues associated with their aging parents or the recent loss of an elderly parent. The age of the members is generally in the late forties and early fifties. In all cases except one, both parents of the group members were survivors.

How the Dependent Variable is Operationalized and Measured:

In order to operationalize group member's self-reports of feelings of isolation a questionnaire was created and administered to each member at the end of each group meeting. The first five sessions were established as the baseline. These sessions were used as an open forum for discussion without any specific interventions employed by the group facilitator. At the end of each session, group members filled out a seven-question questionnaire, which looked to reflect the intensity of each member's feelings of isolation after each group session without the use of the intended intervention.

The questionnaire employed reflects an ordinal scale in that each member's response was measured on a scale of 1-5 (with 5 being the highest level of intensity). For instance, members were asked seven questions some of which included; do you feel as though no one else can relate to your experience as a child of Holocaust survivors? Questions of this nature operationalize feelings of isolation. The questionnaire also reflected the magnitude to which each member felt those feelings.

The workers then collated the questionnaires and each member's responses were recorded and a group average was determined. It is important to note however that a single system design could be employed focussing on each group member and a comparative study could be done to that of the group response. In this instance, the group's response was deemed critical, as the group service itself was being evaluated.

Group member's self reports is considered a valid measure. As such, this single system research design utilizes self-reports as a tool to measure feels of isolation. The questionnaire was employed as a means to operationalize the dependent variable of feelings of isolation. It is important to note however that because this measurement has not been tested and re-tested it may not be considered a reliable measure. Therefore, while it is a valid measure for this particular study, it may have limitations in other studies.

Analysis of the Intervention Data:

The intervention was employed from the sixth session until the eleventh session. These meetings focused on the intervention of topic specific group discussion. At the end of each group, members filled out a questionnaire, which was intended to reflect the magnitude of their feelings of isolation. The average group response was determined and the data was recorded. Self-reports of feelings of isolation both during the baseline and intervention phases demonstrated that the average response from members is that their feelings of isolation rate lower in intensity level compared to the data established during the baseline. The bar graph demonstrates the mean response to both the baseline and intervention phases of this research. This is a clear way to visualize the manner in which the baseline is evidenced in comparison to how the intervention phase was successful. Once again, the baseline shows a high magnitude of feelings of isolation regarding the average group response to the employed questionnaire and the intervention phase show a lower magnitude of feelings of isolation regarding the average group response.

Statistical analysis illustrated that the group average response to feelings of isolation once the intervention has been employed. The celeration line is based on the data accumulated during the sixth, seventh, eighth, ninth, tenth and eleventh meetings. It seems that the group's average response to feelings of isolation is predicted to maintain a lower level of intensity if there is opportunity to maintain employment of an intervention.

The evidence indicates that with the intervention there was a 50% decrease in the magnitude of reported feelings of isolation. As such, this statistic shows that the intervention was both statistically significant and successful.

Summary:

Now that an intervention has been employed and measured it becomes clear that a group, with specific topics for discussion, works to decrease members self-reports of feelings of isolation. The data signifies the stability and effectiveness of the employed intervention. The intervention, an independent variable, was employed during the sixth group session. The intervention utilized changed the manner in which the group was conducted. As such, the group was no longer an open group for free flowing discussion; rather specific topics were addressed. The topics for group discussion were gathered by the social worker during the first five meetings as a way to partialize the many different issues that seemed to be facing the group generically. A list was put together by the social worker and much preparation and the gathering of information and resources on each topic was utilized. The following sessions employed the intervention and proved to be effective.

The group has been in existence for three years as of this writing and has further evolved. The participation and commitment levels of its members have increased as a direct result of the described intervention, so that the structure of meetings has also evolved. The initial formalized intervention and subsequent response is now maintained on a more informal basis and with more responsibility for the content of meetings going to group members. The results of the initial single subject study gave the group its impetus and direction allowing it to become an ongoing and effective social work outreach tool.

References

Danieli, Y. (1988). Treating Survivors and Children of Survivors of the Nazi Holocaust. In Ochsberg, F.M. (Ed.), Post-Traumatic Therapy and Victims of Violence, New York: Brunner/Mazel.

Klein-Parker, F. (1988). Dominant Attitudes of Adult Children of Holocaust Survivors Towards Their Parents. In Wilson et al (Eds.) Human Adaptation to Extreme Stress: From Holocaust to Vietnam, New York.

Newman, Lisa. (1979). Emotional Disturbances in Children of Holocaust Survivors. In The Journal of Contemporary Social Work, (1) 43-50.

Pilcz, M. (1979). Understanding the Survivor Family. In Steintz and Szony; Living after the Holocaust: Reflections of Children of Survivors in America, New York.

Rosenbloom, M. (1995). Implications of the Holocaust for Social Work. In The Journal of Contemporary Social Work, 76 (9) 567-576.

Safford, Florence. (1995). Aging Stressors for Holocaust Survivors and their Families. In The Journal of Gerontological Social Work, 24 (1-2) 131-153.

NB. For the purposes of an e-journal, the authors have omitted statistical data and graphs. © Goldhar and David, September 2000.