Death Café · Atlas

1. Introduction

Version followed: the Death Cafe guidelines as published on the organisation's official "Holding your own Death Cafe" page (deathcafe.com/how). The downloadable full guide (PDF) and its archived earlier version are listed there; their wording beyond the page summary is [uncertain: not verified]. Studies of Death Cafés with specific populations (people experiencing homelessness, BMJ Open; Japanese organisers, BMC Health Services Research 2023) inform the adaptations.

Death Café is not a psychotherapy. It is a not-for-profit social format in which people meet, eat cake or other refreshments and talk about death, "with no intention of leading participants to any conclusion, product or course of action" [source: Death Cafe, Holding your own Death Cafe]. The guidelines say plainly that it is not bereavement or grief counselling and not a venue for information, guest speakers, research or consultation; the attendees set the topics [source: Death Cafe, how]. The first Death Café was held on 25 September 2011 in the Hackney (London) basement of Jon Underwood, who founded the movement; it was facilitated by his mother, the psychotherapist Susan Barsky Reid [source: Al Jazeera 2017]. Underwood took inspiration from the Swiss anthropologist Bernard Crettaz, whose cafés mortels began in Neuchâtel in 2004 [source: Al Jazeera 2017]. Underwood died in June 2017, aged 44 [source: Funeral Service Times 2017]. More than 16,000 Death Cafés had been held at the time of a 2024–25 study [source: Crooks et al., BMJ Open].

Core idea of how change happens, as the movement frames it: an open, respectful and confidential conversation about death, held without an agenda, helps people talk about mortality in a death-avoidant culture and reflect on how they want to live [source: Death Cafe, how; Crooks et al.; BMC HSR 2023]. Any therapeutic effect is a by-product, not a goal [source: Death Cafe, how]. For the psychotherapist, the work sits around the café: deciding whether a client might benefit from attending, preparing and debriefing them, assessing grief (including prolonged grief disorder), working with what the conversation stirs, and, where the therapist volunteers as a facilitator, keeping that role separate from clinical work [synthesis]. Cross-refer Domain VI 128 (grief counselling), Domain II 127 (prolonged grief treatment), and in this domain 112 (mourning rites) and 115 (hospice spiritual care).

2. Framework

Death Café has no treatment phases or session count; it is a single event, usually about two hours, which a host may repeat [source: Death Cafe, how]. The structure has three layers.

A. Hosting cycle (as the guidelines set it out) [source: Death Cafe, how]

Read the guide.
Assign roles: a host who organises and a facilitator who runs the conversation; aim for at least two Death Cafe people present, especially in a domestic setting.
Find a venue and date; confirm the date at least one month ahead.
Publicise (the official site lets hosts post forthcoming events).
Hold the event.
Write up and debrief.

Criterion for moving on: each step is complete when its practical task is done (venue booked, roles filled, referral options known) [synthesis].

B. The session (start, middle, end) [source: Death Cafe, how]

Start: explain what Death Café is and its principles, mention any donation request, set ground rules on listening, respect and confidentiality, outline the session and invite questions.
Middle: a round in which each person gives their name and says why they came; then ask what came up; only if needed, offer up to three open questions.
End: give notice before closing, thank attendees, ask for evaluations, and debrief with the hosts afterwards.
Format: the café model suits 6 to 12 people (3 to 20 is the acceptable range) with a facilitator present throughout; the salon model splits attendees into groups of 4 to 8 with facilitators moving between groups.
Attendance: generally adults; children only with safety measures in place and the other members' consent.

Criterion for moving from start to middle: ground rules are stated and questions answered. From the middle to the end: the announced time is approaching; the facilitator gives notice rather than stopping abruptly [source: Death Cafe, how].

C. The psychotherapist's work around the café [synthesis unless tagged]

Assessment: is the client's interest in death reflective, anxious, grieving, or a sign of risk? Screen for acute grief, prolonged grief disorder and suicidal ideation before recommending attendance.
Preparation: what the café is and is not, the client's goals, a plan for distress.
Attendance: the client goes alone; the therapist is not present in a clinical capacity.
Debrief: in the next session, what came up and what it means.
Integration: the material feeds grief work, existential themes, advance-care conversations with family, or mourning practices.

Move from assessment to preparation only when risk is assessed as manageable and the client chooses to go; move to integration when the client brings café material back [synthesis].

3. Guiding principles

From the Death Cafe guidelines [source: Death Cafe, how]:

No agenda. The facilitator does not steer people towards any conclusion, product or course of action. Practical meaning: no teaching, no persuading, no advice about what to believe about death.
Not counselling. Death Café is not grief or bereavement counselling. Practical meaning: a therapist who facilitates does not treat anyone in the room; distress is met humanely and signposted.
Open, respectful and confidential. The space is one "where people can express their views safely". Practical meaning: state confidentiality and respect at the start and hold people to them.
Tolerance of others' views. The facilitator ensures the guidelines are respected, especially tolerance. Practical meaning: religious, secular and personal views on death sit side by side without debate to a winner.
Attendees set the topics. Practical meaning: begin with why people came and what came up; prompts are a fallback, not a plan.
Not-for-profit. Events are free or take a non-specific donation, never a ticket price; hosts may not promote their own business. Practical meaning: a therapist host does not market their practice or recruit clients at the event.
Professional identities set aside. Facilitators set their professional identities aside. Practical meaning: the therapist attends as a host or facilitator, not as "the expert in the room".
Refreshments are a core principle. Practical meaning: food and drink are part of the format, not decoration; the host is responsible for food safety; vegetarian food is preferred and vegan options suggested.
Equanimity and group skill. Facilitators listen to every aspect of death with equanimity and have good group skills. Practical meaning: only facilitate if you can hear graphic, angry, comic or spiritual talk about death without flinching or correcting.
Know where to refer. Hosts know where and how to refer people who need more support and do not admit anyone intoxicated. Practical meaning: have local bereavement, crisis and mental health contacts ready before the event.
Sponsorship limits. Sponsors are acknowledged only in the text, and some (large private death-sector organisations, political organisations, certain new religious movements, campaign groups on contentious death issues) are excluded. Practical meaning: keep the café free of commercial or campaigning influence.

From studies of adapted Death Cafés [source: Crooks et al., BMJ Open]:

Choice is non-negotiable. Attendance must never be compulsory. Practical meaning: never make a Death Café a homework task or a condition of a service.
Trauma-informed facilitation. Attendees cannot be expected to set aside complex trauma. Practical meaning: steer away from content that is overwhelming the room.
Clinical expertise is not group expertise. Palliative care or grief expertise does not by itself make a good facilitator. Practical meaning: a therapist still needs group facilitation skill and a co-facilitator.

Psychotherapist-specific principles [synthesis unless tagged]:

Assess before recommending. Practical meaning: screen grief, risk and readiness before suggesting a client attend.
Keep roles separate. A therapist who facilitates a public Death Café may meet current or future clients there; the APA Ethics Code Standard 3.05 (Multiple Relationships) applies where a relationship could impair objectivity or risk exploitation [source: APA Ethics Code]. Practical meaning: do not facilitate events your current clients attend; do not take on attendees as clients without considering the prior contact.
The client is the author of meaning. Concepts such as an afterlife, ancestors or continuing presence of the dead are held as the client and their tradition hold them, neither endorsed nor dismissed. Practical meaning: explore what the client believes rather than offering your own view.
Grief is not pathology by default. Prolonged grief disorder is diagnosed only when grief clearly exceeds cultural, social or religious norms and meets the DSM-5-TR or ICD-11 criteria [source: Treml et al. 2024]. Practical meaning: normal grief is welcome at a Death Café; impairing prolonged grief needs treatment, not only conversation.
Safe messaging around suicide. Practical meaning: talk about suicide openly and without method detail, and give crisis resources (988 in the US; Samaritans 116 123 in the UK and Ireland) [source: SAMHSA 988 fact sheet; Samaritans].

4. Intervention inventory

The Death Cafe guidelines describe a short set of hosting and facilitation procedures (4.1–4.11). The adaptation for vulnerable groups comes from Crooks et al. and the Japanese organiser study (4.12–4.13). The therapist-side procedures (4.14–4.24) are mostly [synthesis], built on the sourced grief, suicide-bereavement and cultural-assessment material cited in each. Death Café has no technique of its own beyond these; nothing has been added to the movement's own method.

Part A. Hosting and facilitating a Death Café (for a therapist who volunteers as host or facilitator)

4.1 Assigning roles and co-facilitation

Purpose and when: before any event, so that one person handles logistics and another holds the conversation [source: Death Cafe, how].
Steps: (1) Name a host (venue, date, refreshments, publicity, evaluation) and a facilitator. (2) Aim for at least two Death Cafe people present, especially in a home. (3) Agree in advance who will step out with anyone who becomes distressed [synthesis]. (4) If you are a therapist, agree with your co-host that you attend as a facilitator, not a clinician [source: Death Cafe, how, on setting professional identities aside].
Example language (illustrative): "I'll keep the conversation moving; if anyone needs a quiet word outside, you take the room and I'll go with them, or the other way round."
Watch for: one person doing everything; a therapist co-host drifting into a clinical role. Working: roles are clear before the doors open and no one is left alone with a crisis.

4.2 Choosing a venue and refreshments

Purpose and when: during planning; the guidelines treat refreshments as a core principle and want a venue that helps people relax [source: Death Cafe, how].
Steps: (1) Pick a setting people can relax in (homes, cafés, community spaces, halls, tents and parks have all been used). (2) Weigh cost, comfort, access to refreshments and location. (3) Choose a refreshment model: potluck, attendees buying their own, or hosts or others providing. (4) Prefer vegetarian food and offer vegan options; take responsibility for food safety. (5) Check step-free access and a quiet side space [synthesis].
Example language (illustrative): "There's tea, coffee and cake; help yourself at any point. If you need a breather, the side room is free."
Watch for: clinical rooms that make the event feel like a service; venues where people can be overheard. Working: attendees settle quickly and talk freely.

4.3 Publicity and informed choice

Purpose and when: when advertising; people need to know what the event is and is not so that attending is a real choice [source: Crooks et al.].
Steps: (1) Confirm the date at least a month ahead and post it (the official site lists forthcoming Death Cafés) [source: Death Cafe, how]. (2) Say clearly that it is a discussion over refreshments, not counselling, a talk or a sales event. (3) State that it is free or donation-based. (4) For groups who may find dark imagery off-putting, use clear, hopeful visuals and plain wording [source: Crooks et al.]. (5) Keep the name "Death Café" visible, or explain the topic plainly if you rename it, so people know what they are agreeing to [source: Crooks et al., which reports differing views on the name].
Example language (illustrative): "A relaxed, confidential conversation about death and dying over tea and cake. No speakers, no agenda, no counselling. Free."
Watch for: wording that implies therapy or grief support. Working: attendees arrive knowing what to expect.

4.4 Opening the session and setting ground rules

Purpose and when: the first part of the session [source: Death Cafe, how].
Steps: (1) Welcome people. (2) Explain what Death Café is and its principles: no agenda, not counselling, not-for-profit. (3) State any donation request. (4) Set ground rules on listening, respect and confidentiality. (5) Outline how the session will run and when it ends. (6) Invite questions. (7) Mention, without dwelling on it, that support contacts are available at the end [synthesis].
Example language (illustrative): "This is a space to talk about death in whatever way matters to you. There's no right view and nothing to sell. What's said here stays here. We'll finish at the time on the poster, and there's a list of support contacts by the door."
Watch for: a lecture-length introduction; skipping confidentiality. Working: people nod at the ground rules and the first speaker starts readily.

4.5 Introductions round

Purpose and when: the start of the middle section; each person gives their name and why they came, which lets attendees set the agenda [source: Death Cafe, how].
Steps: (1) Invite everyone in turn to give a name and a sentence or two on why they came. (2) Allow a pass. (3) Listen for themes (recent loss, own illness, curiosity, work with the dying, fear) without commenting on each. (4) Note privately anyone who signals acute distress [synthesis].
Example language (illustrative): "Let's go round once: your first name, and what brought you here today. Passing is fine."
Watch for: one person's account taking most of the round; disclosures of recent traumatic loss. Working: everyone is heard once and the group has a list of shared interests.

4.6 "What came up" and open questions as a fallback

Purpose and when: after the round; the facilitator asks what came up, and offers up to three open questions only if needed [source: Death Cafe, how].
Steps: (1) Ask the group what struck them in the round. (2) Let the conversation run. (3) If it stalls, offer one open question at a time, up to three in the session. (4) Keep questions open and non-leading [synthesis].
Example language (illustrative): "Hearing all that, what came up for you?" If needed: "How would you like to be remembered?" or "What has your culture or family taught you about death?"
Watch for: the facilitator filling silences or steering towards a favoured topic. Working: the group talks with little prompting.

4.7 Including quieter people and moving the discussion on

Purpose and when: throughout, so that the conversation stays shared and tolerant [source: Death Cafe, how].
Steps: (1) Notice who has not spoken and invite them in without pressure. (2) If a topic loops or stalls, summarise briefly and open a new thread. (3) If views clash, restate the tolerance ground rule and invite each person to speak from their own experience [synthesis]. (4) In the salon model, move between groups to do this in each [source: Death Cafe, how].
Example language (illustrative): "We've heard a lot about funerals. Is there anything else people came wanting to talk about?" / "We'll hold different beliefs about what happens after death here. Let's hear each one without needing to settle it."
Watch for: debates over religion or assisted dying turning into argument; one dominant speaker. Working: several voices are heard and disagreements stay respectful.

4.8 Managing difficult situations and signposting

Purpose and when: when someone becomes distressed, intoxicated, disruptive or at risk. The guidelines ask facilitators to manage difficult situations and hosts to know where and how to refer people; they give no detailed procedure [source: Death Cafe, how]. The steps below are [synthesis] except where tagged.
Steps: (1) Before the event, prepare a contact list: local bereavement services, GP or primary care, crisis lines (988 in the US by call, text or chat; Samaritans 116 123 in the UK and Ireland) [source: SAMHSA; Samaritans]. (2) Do not admit anyone who is intoxicated [source: Death Cafe, how]; for groups where substance dependence is common, decide case by case on behaviour [source: Crooks et al.]. (3) If someone is tearful, acknowledge it briefly in the group and let them choose whether to continue. (4) If distress is acute, the co-facilitator offers a quiet space. (5) If someone mentions suicidal thoughts, the co-facilitator talks with them privately, asks directly about current safety, and helps them reach crisis support or emergency services if needed. (6) Afterwards, record what happened and debrief.
Example language (illustrative): "Thank you for sharing that. Take whatever time you need. Would you like to keep going, or step out for a few minutes with Sam?"
Watch for: the group turning into an impromptu grief group around one person; a therapist-facilitator starting a clinical assessment in front of the group. Working: the person is supported and the group continues.

4.9 Closing the session and evaluation

Purpose and when: the end section [source: Death Cafe, how].
Steps: (1) Give notice as the end approaches (the guidelines suggest 5 to 20 minutes). (2) Invite final reflections [synthesis]. (3) Thank attendees. (4) Ask for evaluations (the organisation publishes an evaluation form). (5) Point again to the support contacts [synthesis]. (6) Stay on briefly over tea for anyone who wants a private word [source: Crooks et al., describing practice in adapted cafés].
Example language (illustrative): "We've got about ten minutes left. Is there anything you'd like to say before we close?"
Watch for: an abrupt stop mid-disclosure. Working: people leave calm, often talking to each other.

4.10 Host debrief and write-up

Purpose and when: after the event [source: Death Cafe, how].
Steps: (1) Hosts and facilitators debrief together: what went well, any difficult moments, any follow-up owed. (2) Write up the event; the official site hosts write-ups. (3) Leave out anything that could identify attendees or their stories [synthesis, from the confidentiality principle].
Example language (illustrative): "What did you notice tonight? Is there anyone we're worried about, and have we done what we said we'd do?"
Watch for: write-ups that breach confidentiality; facilitators carrying distress home unprocessed. Working: concerns are acted on and lessons carry to the next event.

4.11 Running the salon model

Purpose and when: for larger numbers; attendees split into groups of 4 to 8 and facilitators move between them [source: Death Cafe, how].
Steps: (1) Do the opening (4.4) for everyone together. (2) Split into small tables. (3) Facilitators move between tables, using 4.6 to 4.8 at each. (4) Bring everyone back for the close (4.9) [synthesis on the joint close].
Example language (illustrative): "We'll break into tables of about six. We'll come round, but each table runs its own conversation."
Watch for: a distressed person at a table no facilitator is watching. Working: each table sustains its own conversation.

Part B. Adapting the format

4.12 Trauma-informed adaptation for vulnerable groups

Purpose and when: for cafés with people experiencing homelessness or other groups with high rates of trauma, bereavement and exclusion [source: Crooks et al.].
Steps: (1) Co-facilitate across disciplines (for example palliative care with homelessness or mental health services). (2) Make facilitation trauma-informed: steer away from content that may trigger others. (3) Keep groups small. (4) Agree a group agreement on confidentiality, substance use and respect. (5) Choose a familiar venue, while checking it does not feel coercive to anyone. (6) Offer support after the session: debriefs, informal check-ins, staying on over tea. (7) Signpost non-tokenistically, for example by making a referral during the session or helping someone reach a service, rather than handing out a leaflet. (8) Explore and manage risks fully before delivery.
Example language (illustrative): "If today brings anything up, I'll be around afterwards, and if you want, we can call the bereavement service together."
Watch for: the café feeling like one more service done to people; residents in early recovery sitting with active users [source: Crooks et al.]. Working: residents raise concerns they had not voiced to staff, as reported in a hostel-based café facilitated by a palliative-care psychologist [source: Crooks et al.].

4.13 Deciding whether bereaved and non-bereaved attendees meet together

Purpose and when: at the planning stage. Japanese organisers differed between "inclusion" (mixing attendees with and without grief) and "purification" (keeping them apart); organisers who started from personal experience more often took one of these positions explicitly [source: BMC HSR 2023].
Steps: (1) Decide whether your café is open to everyone or aimed at a particular group. (2) If open, say so in publicity and prepare for recently bereaved attendees (4.8). (3) If someone's acute grief would be better held elsewhere, offer a grief group or bereavement service alongside, not instead of, the café [synthesis].
Example language (illustrative): "This café is open to anyone. If you've had a recent loss, you're welcome; we also have details of local bereavement groups if you'd like more support."
Watch for: a café drifting into a bereavement support group without the safeguards one needs. Working: the format stays a conversation, and grieving attendees have somewhere further to go.

Part C. The psychotherapist's work with a client who attends or wants to attend

4.14 Assessing fit before recommending a Death Café

Purpose and when: when a client raises death, mortality fears, a loss, their own illness, or interest in a Death Café [synthesis].
Steps: (1) Ask what draws them: curiosity, fear of death, recent loss, caring for someone dying, their own diagnosis, or work with the dying. (2) Screen current risk, including suicidal thoughts (see 4.21). (3) Assess grief severity (4.15). (4) Consider trauma history, substance use and current stability [source: Crooks et al., on distress and retraumatisation risk]. (5) Tell the client clearly that the café is a conversation, not counselling [source: Death Cafe, how]. (6) Leave the decision to the client; never make it a task [source: Crooks et al., on choice].
Example language (illustrative): "A Death Café is a group of strangers talking about death over tea. It isn't therapy and nobody will guide you. What are you hoping you'd get from it?"
Watch for: a wish to attend that hides suicidal thinking; acute traumatic grief that a public group could overwhelm. Working: the client's reasons are clear and the risks are named and planned for.

4.15 Grief assessment, including prolonged grief disorder

Purpose and when: for any bereaved client, before and after attending [source: Treml et al. 2024 for the criteria].
Steps: (1) Take a loss history: who died, when, how, the relationship, and secondary losses. (2) Ask about yearning or longing for the person and preoccupation with them. (3) Ask about identity disruption, disbelief, avoidance of reminders, intense emotional pain, difficulty re-engaging with life, numbness, meaninglessness, loneliness, guilt, anger and blame. (4) Check the time criteria: DSM-5-TR requires the death to have been at least 12 months earlier (for adults), with symptoms nearly every day for at least the last month; ICD-11 requires persistence for at least six months after the loss. (5) Check that the duration and severity clearly exceed the client's cultural, social or religious norms, and that impairment is significant. (6) Rule out or identify depression, PTSD and substance use. (7) If prolonged grief disorder is likely, offer or refer for targeted treatment (Domain II 127) rather than relying on the café. DSM-5-TR wording beyond this summary is [uncertain: not verified]. Child and adolescent time thresholds are [uncertain: not verified].
Example language (illustrative): "Many people still miss someone intensely a long time after a death. I'd like to understand how it is for you day to day: how often the longing comes, and what it stops you doing."
Watch for: pathologising grief that fits the client's tradition; missing a co-occurring depression or PTSD. Working: you can say whether this is expected grief, prolonged grief disorder or another condition, and you choose care accordingly.

4.16 Preparing a client to attend

Purpose and when: after 4.14 when the client decides to go [synthesis].
Steps: (1) Describe the format: an introductions round, open discussion, refreshments, about two hours [source: Death Cafe, how]. (2) Help the client decide how much to share; they can pass. (3) Rehearse a way to leave if overwhelmed. (4) Agree a self-care plan for afterwards. (5) Give crisis contacts (988 in the US; Samaritans 116 123 in the UK and Ireland) [source: SAMHSA; Samaritans]. (6) Book the debrief.
Example language (illustrative): "You can just listen. If it gets too much, it's fine to step out. Afterwards, what will you do for yourself that evening?"
Watch for: unrealistic hopes that one evening will resolve grief; anxiety that rises as the date nears. Working: the client goes with a plan and realistic expectations.

4.17 Debriefing after a Death Café

Purpose and when: in the next session after attending [synthesis].
Steps: (1) Ask what happened and what stayed with them. (2) Ask about emotions during and after, including any surge of grief or anxiety. (3) Re-check risk if distress rose. (4) Note new themes (fear of dying, unspoken wishes, family silence, faith). (5) Agree what to take forward: therapy themes, a conversation with family, or no further attendance.
Example language (illustrative): "What's still with you from the café? Was there a moment that hit harder than you expected?"
Watch for: rumination or sleep disruption after attending; shame about having spoken. Working: the client can describe the event and name one meaningful thing it raised.

4.18 Integrating café material using the dual process model

Purpose and when: when the client is grieving and the café has surfaced loss-related or life-rebuilding themes [source: Stroebe and Schut 1999 for the model; application is synthesis].
Steps: (1) Explain that grieving involves loss-oriented coping (facing the death and absence) and restoration-oriented coping (new roles and rebuilding daily life), and that healthy coping moves back and forth between them [source: Stroebe and Schut 1999]. (2) Map where the café conversation took the client. (3) Identify whether they are stuck on one side, for example avoiding all grief or unable to turn to daily life. (4) Plan small steps toward the neglected side [synthesis].
Example language (illustrative): "Grief tends to swing between facing the loss and getting on with life. At the café you were right in the loss. How much room is there in your week for the other side?"
Watch for: using the model as a prescription. Working: the client recognises the swing and feels less like they are grieving "wrongly".

4.19 Working with continuing bonds and the client's own mourning practices

Purpose and when: when a client wants to keep a connection with the person who died, or to honour them through their tradition's practices [synthesis; the continuing-bonds literature is uncertain: not verified].
Steps: (1) Ask how the client stays connected now: rituals, objects, visits, prayer, conversation with the dead, anniversaries. (2) Ask what their family and tradition expect. (3) Explore which practices comfort and which feel obligatory or distressing. (4) Support the practices the client chooses, holding beliefs about the dead as the client holds them [synthesis, principle of attribution]. (5) Where a practice is tied to a religious tradition, offer to involve the client's religious leader if they wish.
Example language (illustrative): "What do you do now that keeps her close? Does it bring comfort, or does it feel like a duty?"
Watch for: imposing a "letting go" model; missing practices that maintain avoidance. Working: the client's practices feel chosen and sustaining.

4.20 Disrupted or missed mourning rites

Purpose and when: when a funeral or rite could not happen as the client wished (pandemic restrictions, migration, distance, estrangement, a death abroad, an unrecovered body) [synthesis].
Steps: (1) Ask what should have happened and what did. (2) Name the losses: being absent, not seeing the body, not following the tradition. (3) Explore guilt and anger. (4) If the client wishes, plan a later or adapted rite with family or the religious community, the client as author (cross-refer 112 mourning rites). (5) Revisit grief severity (4.15).
Example language (illustrative): "You couldn't be there for the funeral. What would it mean to mark his death now, in a way that fits you and your family?"
Watch for: complicated guilt; family conflict over who decides. Working: the client finds a form of marking the loss that feels right to them.

4.21 Suicide bereavement and suicide risk

Purpose and when: when a client is bereaved by suicide or mentions suicidal thoughts in connection with a Death Café or loss [source: Samaritans guidance on people bereaved by suicide; SAMHSA 988 fact sheet].
Steps: (1) Recognise that people bereaved by suicide are at increased risk of attempting suicide themselves [source: Samaritans]. (2) Ask directly and calmly about suicidal thoughts, intent and plans, following your service's current risk-assessment practice [synthesis]. (3) Use safe-messaging principles: talk openly about suicide, avoid method details, avoid framing suicide as a solution or as inevitable [synthesis]. (4) If there is risk, do collaborative safety planning, including lethal-means counselling about safe storage and removal [synthesis]. (5) Give crisis resources: 988 in the US (call, text, or chat via 988lifeline.org; also for people worried about someone else) [source: SAMHSA]; Samaritans 116 123 in the UK and Ireland, free, day or night [source: Samaritans]. (6) Before recommending a public Death Café, consider whether a suicide-bereavement support group would be a better fit; Samaritans links to such groups [source: Samaritans].
Example language (illustrative): "When someone close dies by suicide, people sometimes have thoughts of suicide themselves. Have you had thoughts like that?"
Watch for: the client hearing method details or blame at a café; anniversaries. Working: the client can speak about the death and their own safety, and knows where to turn.

4.22 Children and young people

Purpose and when: when a child is bereaved or a family asks whether a young person may attend. Death Cafés are generally for adults; children may attend only with safety measures in place and the other members' consent [source: Death Cafe, how].
Steps: (1) Steer families toward child-specific bereavement support rather than adult Death Cafés. In the UK, Winston's Wish offers a free helpline, training and resources for professionals, including guidance on telling a child someone has died, anniversaries, bereavement by suicide or homicide, and children with SEND [source: Winston's Wish]. (2) Assess the child's grief with age in mind, as grief differs by age and circumstances [source: Winston's Wish]. (3) Get parental consent and the child's assent for any group [synthesis]. (4) Follow safeguarding procedures if there are concerns. (5) Use the CFI module for school-age children and adolescents where culture shapes the family's response [source: APA CFI supplementary modules].
Example language (illustrative), to a parent: "Death Cafés are mostly for adults. There are services designed for children her age; would you like me to put you in touch?"
Watch for: children exposed to adult content without preparation. Working: the child has age-appropriate support and the parent feels guided.

4.23 Cultural, spiritual and religious formulation

Purpose and when: when a client's way of grieving or thinking about death is shaped by faith, culture or a moral tradition, or when a Death Café conversation unsettles belief [source: APA CFI supplementary modules].
Steps: (1) Use the CFI supplementary module on spirituality, religion and moral traditions: explore identity and affiliation, the tradition's role in daily and family life, involvement outside the home, how the tradition helps with the problem (leaders, texts, practices) and any stresses or conflicts (contribution to the problem, distress, discrimination, disputes) [source: APA CFI supplementary modules, DSM-5 version; whether the DSM-5-TR text differs is uncertain]. (2) The module may be reproduced by clinicians for use with their patients [source: APA CFI supplementary modules]. (3) Where distress centres on a loss of faith or a religious conflict after a death, the DSM-5-TR "Religious or Spiritual Problem" may be recorded; ICD-10-CM Z65.8 "Other specified problems related to psychosocial circumstances" lists religious or spiritual problem under its Includes [source: ICD-10-CM Z65.8 (Unbound Medicine); DSM-5-TR wording uncertain]. (4) Approach with cultural humility: the client explains their tradition; you do not [synthesis].
Example language (illustrative): "Your faith says something about where your mother is now. How does that sit with you since the café?"
Watch for: debating beliefs; assuming the client fully shares their tradition's view. Working: the client feels their beliefs are understood and can use them as a resource.

4.24 Collaboration, referral and role boundaries

Purpose and when: when a therapist hosts or facilitates, or a client needs support beyond the café [synthesis unless tagged].
Steps: (1) Know the local pathways: hospice bereavement services, primary care, suicide-bereavement groups, child bereavement services, crisis lines. (2) If you facilitate publicly, set your professional identity aside and do not promote your practice [source: Death Cafe, how]. (3) Avoid facilitating events your current clients attend, and think carefully before taking an attendee on as a client; APA Ethics Code Standard 3.05 (Multiple Relationships) addresses relationships that could impair objectivity or risk exploitation [source: APA Ethics Code]. (4) Check whether your professional indemnity insurance covers voluntary non-clinical facilitation, and say plainly at the event that you are not there as a therapist [synthesis]. (5) With consent, liaise with a client's hospice team, chaplain or religious leader.
Example language (illustrative): "Tonight I'm here as a facilitator, not a therapist. If you'd like more support, there's a list of local services on the table."
Watch for: attendees seeking free therapy from you; blurred boundaries in small communities. Working: attendees know your role and get to the right service.

5. Handling problems

The Death Cafe guidelines address difficult situations only in general terms (manage them, know where to refer, seek advice from the practitioners page or the team) [source: Death Cafe, how]. Responses below are [synthesis] unless tagged.

A participant breaks down over a recent loss. Acknowledge it briefly, offer the choice to continue or step out with the co-facilitator, and return the group gently to the shared conversation. Afterwards, offer bereavement contacts. Do not turn the session into counselling [source for the not-counselling principle: Death Cafe, how].
A participant mentions suicidal thoughts or wishing to die. Treat it seriously: the co-facilitator speaks with them privately, asks directly about safety, and helps them reach crisis support (988 US; Samaritans 116 123 UK and Ireland) or emergency services if risk is imminent [source for resources: SAMHSA; Samaritans]. Debrief the facilitators afterwards. In the group, avoid discussing methods and redirect calmly if someone does.
Someone dominates or preaches. Restate the tolerance and listening ground rules, thank them, and invite others in (4.7). If they persist, a quiet word at the break. Agenda-pushing (selling, campaigning, proselytising) conflicts with the no-agenda and no-promotion principles [source: Death Cafe, how].
Heated disagreement (assisted dying, afterlife, religion). Invite each person to speak from their own experience rather than argue a case; the café is not there to reach a conclusion [source: Death Cafe, how, on no intended conclusion].
Silence or a stalled group. Ask what came up; offer one of up to three open questions only if needed [source: Death Cafe, how]. Silence is not failure.
An intoxicated attendee. The guidelines say not to admit them [source: Death Cafe, how]. In settings serving people with substance dependence, adapted cafés decide case by case on behaviour rather than ban outright [source: Crooks et al.].
Retraumatisation, including from being in the room. In vulnerable groups, distress may come from the setting as well as the topic, and could lead to increased substance use or self-harm afterwards [source: Crooks et al.]. Keep groups small, steer away from overwhelming content, and offer follow-up check-ins.
Attendees feel "over-signposted" or dismissed. People experiencing homelessness reported this; make signposting active and personal, such as a referral during the session or help to reach a service [source: Crooks et al.].
A client wants the café to replace therapy. Explain that the café is a conversation, not treatment; keep therapy for grief that is impairing, especially possible prolonged grief disorder (4.15; Domain II 127).
A client returns more distressed after attending. Debrief (4.17), re-check risk and grief severity, slow the pace, and consider pausing attendance. Treat this as information about what the client is carrying, not as failure.
A client avoids death topics in therapy but goes to cafés, or the reverse. Explore what makes one setting safer than the other; use the dual-process idea of oscillation to normalise moving between facing and setting aside the loss (4.18) [source for the model: Stroebe and Schut 1999].
Family pressure or conflict over mourning practices. Use the CFI spirituality module (4.23) to map tradition and conflict; support the client's own choices; offer joint sessions or contact with a religious leader only if the client wishes.
Cultural mismatch with the format. Some find the name or open talk about death too morbid or intimidating [source: Crooks et al.]. Do not push attendance; explore what forms of talking about death fit the client's culture (the Japanese temple-based cafés are one community-anchored example [source: BMC HSR 2023]).
A current client turns up at the café you facilitate. Acknowledge them as any attendee, keep their status confidential, and discuss in the next session whether they want to continue attending; consider stepping back from facilitating that event series (APA Ethics Code Standard 3.05) [source: APA Ethics Code].
An attendee asks you for therapy. Explain you are there as a facilitator; give local service details. If you consider taking them on, weigh the prior contact as a multiple-relationship question [source: APA Ethics Code].
Facilitator burnout or personal grief. Debrief after each event [source: Death Cafe, how]; use supervision; step back from facilitating during your own acute bereavement.
A child or adolescent wants to attend. The guidelines permit children only with safety measures and the members' consent [source: Death Cafe, how]; usually refer to child-specific bereavement support (4.22) [source: Winston's Wish].

Sources

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