Bereavement support is an essential element in the provision of comprehensive oncology care. Predictive models to identify individuals who are at higher risk for psychological distress could be used in oncology clinics to facilitate early referral or greater psychological support for family members. Staff members wishing to introduce this service can build on skills already developed leading traditional oncology support groups, and can utilize cofacilitation with a mental health professional to ease the anxiety of assuming a new role and obtain mentoring. Recruitment for a group might be achieved by inviting family members of patients who have died within a specific time frame or by issuing press releases to local papers and church bulletins. Offering bereavement support in the oncology setting is especially helpful to family members who might otherwise be unaware of such a service and who now have the opportunity to attend.

This article examines the use of the initiation ritual of primitive people, described in the works of Mircea Eliade, as a model for counseling cancer patients, giving both meaning and structure to the interactions between patient and counselor. Within this model the patient's encounter with death, whether feared or actualized, can be used as impetus toward personal growth, whatever the stage of the person's disease process. Case examples are given to illustrate how the model can be used in practice. Comparison is also made between stages and components of the initiation ritual and other techniques used to alter a person's consciousness.