Understanding The Training, Credentialing Landscapes for End-of-Life Doulas

Unlike many roles clinicians work alongside, end-of-life doula work has no national certifying body and no license requirement, leaving various training organizations that each set their own standards for education and certification. For clinicians considering a referral relationship with a doula, or fielding questions from patients and families about how to vet one, understanding that landscape, and its limitations, can be useful context.

In an interview with CancerNetwork®, Kim Stravers, an International End of Life Doula Association (INELDA)–certified end-of-life doula and educator based in Phoenix, Arizona, walked through how training and certification vary across organizations such as INELDA, Going With Grace, and the University of Vermont’s program. Stravers explained that while these programs differ in format, ranging from online-only instruction to in-person retreats and mentorship-based models, they tend to share a common foundation centered on educating people about the physiological aspects of death and dying and supporting autonomous decision-making. She also detailed how INELDA’s certification process has evolved into a year-long, cohort-based commitment focused on continuing education, offering a candid assessment of what certification does and does not guarantee across the field.

Transcript:

CancerNetwork: What is the training and credentialing landscape for end-of-life doulas?

I will add that I’m also now an educator for INELDA, the International End of Life Doula Association. Just for transparency’s sake, I’m a trainer for that organization. Our training is different from, say, Going With Grace. It’s different from the University of Vermont. It’s different from any other program. They’re all unique to one another. I think we hold the same foundation in the sense of wanting people to be educated about the physiological aspects of death and dying, supporting people in their autonomous decision-making, being able to help people plan for their last moments, and also working with the people who care for them in all of those realms. [There are also] things like remembrance projects, making meaning, and holding supportive space for people to process what they’re experiencing, whether that’s a dying person hitting some milestones in their dying trajectory, or it’s the circle of care, as they experience first anticipatory grief and then the acute grief that comes post-demise. We train under really the same pillars of education, but the delivery may be different.

There is no national certifying body for end-of-life doula work. There is no license required for end-of-life doula work, so each organization is free to develop, present, and deliver their unique training program as they decide to put it out into the world. Everyone is able to decide for themselves if that’s a program that resonates with them from a value place, from an educational place, or even from a learning-style place. There are places that train online only. There are places that train online as well as have in-person options. There are places that do retreat style. There are places that include a continuation, sort of a community-based support system or a mentorship. It’s all a little bit different.

Certification is optional, so each organization might offer a certification that’s meaningful to that organization. In some cases, that means you achieve certification by taking a written exam; in other cases, you may have to supply some case studies from field work; in other places, it might be a combination of those things. With INELDA, our certification program has changed incredibly in its last iteration. It’s now a year-long commitment in a cohort-style environment that’s continuing education and professional development, refining the way that you deliver death work broadly in the world, rather than just giving somebody a rubber stamp and saying, “I reviewed your cases. It looks like you know what you’re doing, and you’ve hit standards that we’ve internally set as an organization to say that we vouch for you.” Even the word “certification,” I think, is quite squishy, and it’s up to the individual to decide if it’s the right path for them.