Climate-grief and eco-anxiety groups

1. Introduction

Version followed: the Good Grief Network (GGN) 10-Step Program as GGN describes it on its own program and FAQ pages (online, ten weekly meetings); the Climate Psychology Alliance (CPA) Climate Café Listening Circle as described on its training page; the Climate Psychology Alliance North America (CPA-NA) description of climate cafés; and the UWE Bristol "Challenging the Climate Crisis" guide for adapting climate cafés for young people. Where these differ (notably on whether action belongs in the group), the difference is named in the relevant step.

Climate-grief and eco-anxiety groups are not a psychotherapy. They are peer-led or facilitated community groups in which people share feelings about the climate and ecological crisis. Two main forms exist. Climate cafés are informal, open, respectful and confidential gatherings that focus on thoughts, feelings and experiences rather than on what participants are doing about the crisis, and are not designed to reach a conclusion [source: CPA-NA climate cafés]. CPA's version, the Climate Café Listening Circle, has no talks, no advice and no pressure to act, and is "for citizens, by citizens" [source: CPA CCLC training]. The GGN 10-Step Program, created by LaUra Schmidt and Aimee Lewis Reau, is a closed peer support group working one step per week; GGN states plainly that "this is not a therapy program" and describes its approach as inspired by the 12-step model used in Adult Children of Alcoholics [source: GGN 10-Step page; GGN FAQ].

The organisers' implied account of change is that climate distress is a reasonable response to a real threat that is usually pushed aside in daily life; being heard by others, in a safe container, reduces isolation and allows grief, fear, anger and guilt to be felt and metabolised, after which people can reinvest in meaningful effort without burning out [source: CPA CCLC training; GGN book page; synthesis of both]. Research supports treating such distress as widespread and not inherently pathological: in a survey of 10,000 people aged 16–25 across ten countries, 59% were very or extremely worried about climate change and over 45% said their feelings about it negatively affected daily life and functioning [source: Hickman et al. 2021]. Eco-anxiety measured with the Hogg Eco-Anxiety Scale correlates only weakly to moderately with depression, anxiety and stress, and its authors argue it is not an exaggerated reaction to a harmless situation [source: Heinzel et al. 2023]. Evidence status for the groups themselves: controlled outcome evaluations of climate cafés or the GGN program [uncertain: not verified].

The psychotherapist's roles are: (a) assessing a distressed client and deciding whether a group, therapy or both fit; (b) preparing, referring and debriefing a client who attends; (c) facilitating a café or circle if trained by the organising body (therapy qualifications are not required by CPA, and GGN facilitators are trained by GGN) [source: CPA CCLC training; GGN 10-Step page]; and (d) working with the meaning of climate loss in individual therapy as a climate-aware therapist [source: CPA-NA climate-aware therapist page].

2. Framework

The two group formats have different structures; the therapist-side work wraps around either.

A. Therapist-side pathway [synthesis]

Assessment. Goals: understand the client's climate distress, its functional impact, any co-occurring disorder, bereavement and risk. Move on when you can say whether the distress is primarily a realistic eco-emotional response, a disorder with climate content, or both.
Matching and referral. Goals: choose a drop-in café, a listening circle, a closed 10-step group, a youth café, climate-aware individual therapy, or a combination. Move on when the client has chosen and knows what the group will and will not offer.
Preparation. Goals: expectations (no advice, no cross-talk, sharing optional), a support plan, confidentiality. Move on when the client has a supportive contact and knows how to reach you or crisis support between meetings (GGN asks this of participants) [source: GGN 10-Step page].
Accompaniment and debriefing during and after the group.
Integration: meaning-making, values-based action and ongoing grief work in therapy or ending.

B. GGN 10-Step Program (version as published by GGN) [source: GGN 10-Step page; GGN ?p=1168 page; GGN FAQ]

Format: ten meetings over ten weeks, one step per week, small closed groups of up to 15 including a two-person facilitation team; online on Zoom at the same time weekly, each meeting two hours. Attendance at all ten is encouraged. Local affiliates also run in-person versions; one UK affiliate listing describes a closed group of up to 12 meeting weekly for ten weeks [source: ONCA event page].
Meeting structure, in order: introduction; group check-in; short grounding exercise; exploration of the step of the week; optional personal sharing in which everyone gets at least one chance to speak and there is no cross-talk; check-out; closing; a short poem [source: GGN 10-Step page].
The main work happens between meetings as participants apply each step in daily life [source: GGN 10-Step page].
Steps: GGN's book page names six of the ten themes: accepting the severity of the predicament; developing awareness of our own biases and perceptions; taking breaks; reinvesting in meaningful efforts; practising gratitude; sitting with uncertainty [source: GGN book page]. The FAQ lists themes including acceptance, mortality, privilege, gratitude, biases and boundaries [source: GGN FAQ]. The exact titles and order of all ten steps are set out in GGN's paid manual and in Schmidt, Lewis Reau and Rivera's book How to Live in a Chaotic Climate (Shambhala, 2023) [uncertain: full step list and order not verified].
Moving between steps is calendar-driven (one per week), not criterion-driven.
Facilitators complete GGN's live online training with the founders; the program page gives 36 hours and the FAQ gives 30 hours [uncertain: sources differ]. Training covers holding space, managing tension, emotional intelligence, body awareness and in-depth study of each step [source: GGN 10-Step page].

C. Climate café / Climate Café Listening Circle (CPA version) [source: CPA CCLC training; CPA-NA climate cafés]

Format: a single facilitated gathering, in person or online, always facilitated by two people; no talks, no advice, no pressure to act or to stay positive. Participants speak and listen from their own experience. No session count is specified; cafés are typically stand-alone or recurring drop-in events [uncertain: frequency not specified in the sources].
To host, CPA asks that you first attend a circle as a participant, then complete its training (7.5 hours over three sessions, closed cohorts of up to 16, covering climate psychology, facilitation skills, safe and fair spaces, setup online or in person, and the move from participant to facilitator); trained hosts join a peer community for support and buddying. Bringing a co-host is encouraged [source: CPA CCLC training].

D. Youth climate café (UWE Bristol adaptation) [source: UWE youth climate café guide]

Before the day: set goals and a shared vision, consider partners and funding, choose and visit an accessible venue, advertise (with parental permission for under-18s), prepare the space.
On the day: welcome with name stickers (pronouns optional), mingling and icebreakers, large-group introduction and ground rules, then small groups of about 4–6, opening with a broad topic about participants' relationship with the climate crisis; optional pair discussion and a quiet space.
This version pairs conversation with simple, accessible action-based activities (for example seed planting, a pledge tree or a reading corner) and explicitly balances grief and fear with hope and action, unlike CPA's no-pressure-to-act circle.
The guide traces the café idea to a 2015 presentation in Scotland by Jess Pepper of the Climate Reality Project, drawing on the Death Café format [source: UWE youth climate café guide].

3. Guiding principles

Distress is a response to a real threat. Practical meaning: do not frame the goal as eliminating anxiety; ask what the feeling is about and what it asks of the client [source: Heinzel et al. 2023, which questions whether "reducing anxiety" fits eco-anxiety; CPA-NA climate-aware therapist page].
Do not presume presence or absence of climate distress. Practical meaning: ask about it neutrally, as you would any stressor, and do not assume a client shares your views [source: CPA-NA and Climate Psychiatry Alliance climate-aware therapist pages].
Scientific consensus. Practical meaning: listed climate-aware therapists pledge to work consistently with the established scientific consensus; correct misinformation gently but do not turn sessions into lectures [source: CPA-NA climate-aware therapist page]. Café ground rules in the youth guide include agreement that human-caused climate change is real [source: UWE youth climate café guide].
No advice, no talks, no pressure to act. Practical meaning: in a café or circle, resist fixing, reassuring or recommending actions; reflect and hold [source: CPA CCLC training].
Feelings first, action optional. Practical meaning: reflection comes before action; actions can be discussed but are not the aim [source: CPA-NA climate cafés]. In youth settings, balance grief and fear with hope and accessible action [source: UWE youth climate café guide].
Peer support, not therapy. Practical meaning: as a facilitator you are a guide, not a therapist, and you share the emotional weight; do not diagnose or treat in the group [source: GGN FAQ].
Safety, fairness and belonging. Practical meaning: two facilitators, agreed norms, everyone gets a turn, no one dominates [source: CPA CCLC training; GGN 10-Step page].
Confidentiality. Practical meaning: state it at the start and its limits (risk to life, safeguarding) [source: CPA-NA climate cafés; limits synthesis].
No cross-talk. Practical meaning: in GGN sharing, people do not respond directly to each other's shares [source: GGN 10-Step page].
Self-care is part of the work. Practical meaning: participants arrange a supportive contact and a route to a therapist; facilitators use peer support [source: GGN 10-Step page; CPA CCLC training].
Group scope has edges. Practical meaning: GGN groups do not address acute grief from a personal bereavement; route those clients to bereavement support [source: GGN FAQ].
Inclusion and accessibility. Practical meaning: accessible venues, welcoming non-intimidating spaces, attention to who is missing [source: UWE youth climate café guide; CPA CCLC training].
Dual roles are managed, not ignored. Practical meaning: if you facilitate a public café, think through what happens when your own clients attend (APA Ethics Code Standard 3.05, Multiple Relationships) [source: APA Ethics Code; application synthesis].
Children and young people: safeguarding and permission. Practical meaning: parental permission for under-18s, assent from the young person, a safeguarding lead, and signposting [source: UWE youth climate café guide; safeguarding synthesis].

4. Intervention inventory

The organisers publish structures and principles rather than detailed procedures, so items 1–7 and 21–24 are therapist-side procedures and are largely [synthesis]; items 8–20 follow the published group structures, with step-level detail marked [uncertain] where the full manual text is not public.

1. Climate-distress intake conversation [synthesis]

Purpose / when: first contact with any client who mentions climate worry, grief, guilt, anger or hopelessness, or when you ask about it as a stressor.
Steps: (1) Ask neutrally whether the climate or environment features in their worries, without assuming either way (in line with the climate-aware principle of not presuming distress). (2) Map the emotions: fear, grief, anger, guilt, betrayal, powerlessness (the Hickman et al. 2021 survey found many young people reporting sadness, anxiety, anger, powerlessness, helplessness and guilt). (3) Ask what triggers them (news, a local event, a disaster, conversations, parenthood decisions). (4) Ask about functioning: sleep, work or study, relationships, avoidance of news or of nature. (5) Ask what they already do to cope and to act. (6) Ask about direct climate impacts (fire, flood, heat, displacement), which change the picture towards trauma and practical loss.
Example language (illustrative): "Some people carry a lot of feeling about climate change and some don't think about it much. Where are you with it?" / "When it hits hardest, what is the feeling: more fear, more grief, more anger, or something else?"
Watch for: the client testing whether you will dismiss or catastrophise; your own climate feelings leaking into the questions. Working: the client names specific feelings and their effects on daily life with less shame.

2. Measurement-informed assessment with eco-anxiety scales

Purpose / when: to put a number on severity and track change; useful before and after a group.
Steps: (1) Choose a measure. The Hogg Eco-Anxiety Scale (HEAS; Hogg et al. 2021) has 13 items across four dimensions: affective symptoms, rumination, behavioural symptoms, and anxiety about one's own negative impact on the planet; its dimensions were found distinct from stress, anxiety and depression [source: Hogg et al. 2021 ANU record]. The Climate Change Anxiety Scale (Clayton and Karazsia 2020) has 22 items rated on a five-point frequency scale; the EMERGE measures database lists four subscales: cognitive-emotional impairment, functional impairment, personal experience of climate change, and behavioural engagement [source: EMERGE CCAS record]. (2) Obtain the instrument from its published source and use it as licensed; do not adapt items. (3) Administer alongside a general anxiety and depression measure so you can see overlap. (4) Interpret by subscale (for example high rumination with low behavioural engagement versus high engagement with high personal-impact anxiety). (5) Repeat at review points.
Notes: no clinical cut-offs for severe eco-anxiety have been defined [source: Heinzel et al. 2023]; the CCAS has mainly been validated in the US [source: EMERGE CCAS record]; a German HEAS validation replicated the four factors [source: Heinzel et al. 2023]. Treat scores as descriptive, not diagnostic.
Example language (illustrative): "This questionnaire isn't a diagnosis. It helps us see which parts of the climate worry are heaviest for you, like the thinking loops or how it affects what you do."
Watch for: clients reading a high score as proof something is wrong with them; reframe it as a measure of how much they are carrying. Working: subscale scores guide the plan and shift over time.

3. Differential assessment: GAD, depression, OCD and trauma [synthesis]

Purpose / when: whenever distress is severe, impairing, or spreads beyond climate content; the HEAS dimensions overlap only weakly to moderately with general anxiety and depression, so co-occurrence must be assessed separately [source: Heinzel et al. 2023].
Steps: (1) GAD: is worry generalised across many domains (health, money, family), present before climate became salient, and hard to control? Climate may be the current topic of a wider pattern. (2) Depression: look for pervasive low mood, anhedonia beyond climate topics, sleep and appetite change, worthlessness and hopelessness about the self, not only about the world. (3) OCD: look for intrusive harm or contamination thoughts with compulsions such as repeated checking of one's carbon footprint, rigid rules, moral scrupulosity, reassurance-seeking, or rituals that bring brief relief and grow over time. (4) Trauma: after direct exposure to a climate-related disaster, screen for PTSD and practical losses. (5) Formulate both sides: the realistic concern and the disorder process. (6) Treat any disorder with its evidence-based treatment; the group can be an adjunct, not a substitute.
Example language (illustrative): "Your concern about the climate makes sense. I also notice the worry has a pull to it, checking and re-checking. Can we look at that pull separately from the concern itself?"
Watch for: pathologising realistic concern on one side, and missing a treatable disorder on the other. For OCD, a café's open sharing may become reassurance-seeking; discuss this before referral. Working: the client can tell apart "what I care about" from "what the anxiety makes me do".

4. Grief assessment, including personal bereavement and prolonged grief

Purpose / when: when the client describes ecological grief (loss of places, species, imagined futures) or when a personal death is also present.
Steps: (1) Distinguish ecological or anticipatory grief from bereavement through a death. (2) Prolonged grief disorder in DSM-5-TR and ICD-11 applies to the death of a person, centres on persistent longing for or preoccupation with the deceased with intense emotional pain and impairment beyond cultural norms, after a minimum time since the death that the two systems set differently [uncertain: not verified against the manuals]. Ecological grief alone does not meet it. (3) If the client is recently or complicatedly bereaved, route them to bereavement support; GGN states its groups do not address acute grief from a personal loss [source: GGN FAQ]. Cross-refer Domain VI 128 grief counselling and Domain II 127 prolonged grief treatment. (4) Ask about disrupted or missed rites (for example a funeral missed through pandemic restrictions or migration) and about the client's own mourning practices. (5) For children, assess grief developmentally and involve carers [synthesis].
Example language (illustrative): "You've told me about the woods you grew up in being cleared, and about your father's death last spring. Those are different griefs and both matter. Which one feels loudest right now?"
Watch for: climate grief carrying displaced personal grief; a client using the group to avoid an unmourned death. Working: each loss gets named and its own space.

5. Risk assessment and safe messaging [synthesis]

Purpose / when: at intake and whenever hopelessness about the future, "no point" statements or thoughts of death appear.
Steps: (1) Ask directly about suicidal thoughts, intent, plans, past attempts and protective factors, using your service's current risk-assessment approach; do not infer low risk because the content is "about the world". (2) Ask about access to lethal means and discuss safe storage or removal; never discuss methods. (3) Agree a safety plan with warning signs, coping steps, people and services. (4) Give crisis resources: 988 Suicide & Crisis Lifeline (US); Samaritans 116 123 (UK and Ireland). (5) In groups, use safe messaging: avoid presenting suicide as a response to climate change, avoid method detail, emphasise help-seeking and that feelings can change. (6) Brief facilitators (with consent) or advise the client how to tell a facilitator if they become unsafe.
Example language (illustrative): "When people feel the future is closing down, sometimes thoughts of not wanting to be alive come in. Has that happened for you?"
Watch for: the 75% of young people who find the future frightening [source: Hickman et al. 2021] are not at risk by default, but hopelessness is a risk factor to explore. Working: the client has a plan they can name and uses it.

6. Matching and referral to a group or a climate-aware therapist

Purpose / when: once assessment shows the client might benefit from shared, non-clinical support.
Steps: (1) Describe the options as their organisers do: a drop-in climate café (informal, confidential, feelings-focused, no conclusion) [source: CPA-NA climate cafés]; a CPA Climate Café Listening Circle (two facilitators, no talks, no advice, no pressure to act) [source: CPA CCLC training]; a GGN 10-Step group (ten weekly two-hour meetings, closed, up to 15 people, peer support, "not a therapy program") [source: GGN 10-Step page]; a youth café with activities [source: UWE youth climate café guide]. (2) For clients wanting professional help focused on climate, the Climate-Aware Therapist Directory run by CPA-NA and the Climate Psychiatry Alliance lists licensed clinicians (US, Canada, UK) who are members, attest good standing and pledge to work with the scientific consensus; the organisations do not verify licences, so the client should check them [source: CPA-NA and Climate Psychiatry Alliance pages]. (3) Weigh fit: a closed ten-week group suits someone wanting structure and continuity; a drop-in suits someone testing the water. (4) Check cost (GGN offers scholarships, sliding-scale fees and payment plans; no refunds) [source: GGN 10-Step page], access, language and time zone. (5) Let the client choose.
Example language (illustrative): "A climate café is a one-off conversation where people just say how they feel, nobody gives advice. The Good Grief Network runs a ten-week group with a set theme each week. Which sounds more like what you want?"
Watch for: referring a client to a group to avoid your own discomfort with the topic; referring someone with an untreated disorder to a group in place of treatment. Working: the client attends with realistic expectations.

7. Preparing a client to attend [synthesis, drawing on published norms]

Purpose / when: before a first café or first 10-step meeting.
Steps: (1) Explain the norms: no advice, no talks, sharing is optional, in GGN there is no cross-talk and everyone gets at least one chance to speak [source: GGN 10-Step page; CPA CCLC training]. (2) Explain that facilitators are guides, not therapists [source: GGN FAQ]. (3) Help the client name a supportive contact and how they will reach you or crisis services between meetings, as GGN asks [source: GGN 10-Step page]. (4) Rehearse how much to share and how to pause or leave. (5) Discuss confidentiality: what they hear stays there; what they bring back to therapy is about their own experience, not others' identities. (6) Agree when you will debrief.
Example language (illustrative): "In this group nobody will try to fix your feelings, and you won't be asked to fix anyone else's. You can just listen the first time if you want."
Watch for: social anxiety or trauma histories that make groups hard; a client expecting therapy or solutions. Working: the client arrives knowing what will happen.

8. Opening the space and agreeing norms (facilitator)

Purpose / when: at the start of every café, circle or 10-step meeting you facilitate after training by the organising body.
Steps: (1) Welcome; introduce both facilitators (CPA circles always have two) [source: CPA CCLC training]. (2) State what the space is: a place to share feelings about the climate and ecological crisis, not to debate, teach or plan actions [source: CPA-NA climate cafés; CPA CCLC training]. (3) Agree norms: listening when others speak, respecting different experiences, not assuming what others know [source: UWE youth climate café guide]; for GGN, bring an open heart and mind, respect differing views, be authentic, be patient, be kind [source: GGN 10-Step page]. (4) State confidentiality and its limits [limits: synthesis]. (5) Say that support is available afterwards and where [source: UWE youth climate café guide].
Example language (illustrative): "This is a space for what we feel, not for solutions. Nobody here has to be positive. What's said here stays here, unless someone's safety is at risk."
Watch for: a participant wanting to debate climate science or politics; gently return to experience. Working: participants start speaking in the first person.

9. Check-in and grounding

Purpose / when: at the start of each GGN meeting (check-in then a short grounding exercise) [source: GGN 10-Step page]; also useful in cafés [synthesis].
Steps: (1) Invite a brief round in which each person says their name and how they are arriving. (2) Lead a short grounding practice, for example noticing breath, feet on the floor, or sounds in the room [specific exercise: synthesis; GGN's own grounding scripts are in its manual, uncertain: not verified]. (3) Invite people to notice what they are carrying today without needing to share it.
Example language (illustrative): "Let's take a moment to land. Notice where your body meets the chair. You don't need to change anything, just notice."
Watch for: grounding that pushes trauma survivors into body awareness they find unsafe; offer eyes-open options and the choice to opt out. Working: the room settles and shares become slower and more personal.

10. Sharing round without cross-talk (GGN) / listening circle (CPA)

Purpose / when: the core of both formats: each person speaks from their own experience and is heard.
Steps: (1) Offer a prompt (in a café, a broad opener; the youth guide suggests starting with easy questions such as a favourite green space, then participants' relationship with the climate crisis) [source: UWE youth climate café guide]. (2) In GGN, after the step of the week is explored, invite optional personal sharing; everyone has at least one chance to speak; no direct responses to another's share [source: GGN 10-Step page]. (3) In a CPA circle, people speak and listen from their own experience; no advice, no talks [source: CPA CCLC training]. (4) Facilitators track time so no one dominates and quieter members get space [synthesis]. (5) Use prepared prompts if conversation stalls and steer back to the climate and environmental focus if it drifts [source: UWE youth climate café guide].
Example language (illustrative): "Thank you. Let's have a moment before the next person." / "Who hasn't had a chance yet and would like one?"
Watch for: cross-talk, advice disguised as sharing ("what you should do is..."), one person's distress capturing the group. Working: shares become personal, others nod or are moved, and people report feeling less alone.

11. Holding difficult emotions without advice, rescue or forced positivity

Purpose / when: when a participant expresses despair, rage, guilt or tears.
Steps: (1) Stay with it: reflect briefly, do not reassure or offer solutions; CPA circles exclude advice and pressure to act or stay positive [source: CPA CCLC training]. (2) Normalise without minimising ("many people feel this"). (3) If distress escalates, one facilitator can quietly offer a pause or a check-in outside the group while the other holds the room (the reason for two facilitators) [synthesis]. (4) Afterwards, check the person knows where further support is [source: UWE youth climate café guide]. (5) If there is any indication of risk, follow intervention 5.
Example language (illustrative): "That's a lot of grief, and it makes sense. We don't need to make it better right now. We can just let it be here."
Watch for: group members rushing in with hope or tips; a facilitator who is a therapist slipping into treatment mode. Working: the person can stay, and the group's tolerance for strong feeling grows.

12. Step theme: accepting the severity of the predicament

Purpose / when: GGN names this among its steps [source: GGN book page]; therapeutically useful when a client oscillates between denial and panic.
Steps (therapist integration, synthesis; GGN's own step content in its manual and book, uncertain: not verified): (1) Invite the client to describe what they know about the climate situation and how they hold it. (2) Notice avoidance (not reading news, changing the subject) and flooding (doom-scrolling). (3) Explore what acceptance would mean for them: not giving up, but no longer spending energy on not-knowing. (4) Allow the grief that comes with acceptance.
Example language (illustrative): "What would it be like to let yourself know how serious this is, without having to solve it today?"
Watch for: acceptance turning into fatalism or hopelessness; check for depression (intervention 3) and risk (5). Working: less oscillation, more steady capacity to talk about it.

13. Step theme: awareness of biases, perceptions and privilege

Purpose / when: GGN names developing awareness of biases and perceptions as a step and lists privilege among its themes [source: GGN book page; GGN FAQ]; use when a client's climate story is shaped by their position (geography, class, race, nationality) or when blame and guilt dominate.
Steps (synthesis): (1) Ask how their background shapes how they see the crisis and who they see as responsible or affected. (2) Explore unequal exposure to climate harm and whose voices are missing. (3) Distinguish proportionate responsibility from global guilt. (4) Link to values.
Example language (illustrative): "Where you live and what you have shapes how this lands for you. What do you notice about that?"
Watch for: shame spirals, or defensiveness; keep it exploratory, not moralising. Working: more nuanced, less self-punishing views.

14. Step theme: taking breaks and boundaries

Purpose / when: GGN names taking breaks as a step and boundaries as a theme [source: GGN book page; GGN FAQ]; use for burnout, compulsive news consumption, or activists who cannot rest.
Steps (synthesis): (1) Map the client's exposure to climate information and activism. (2) Identify signs of overload. (3) Plan deliberate breaks and limits without framing them as abandoning the cause. (4) For OCD-like checking, treat limits as part of exposure-based work, not as avoidance.
Example language (illustrative): "Rest isn't giving up. What does a real break look like for you, one you don't have to earn?"
Watch for: breaks becoming avoidance and guilt; distinguish restorative rest from numbing. Working: steadier energy and less guilt about rest.

15. Step theme: practising gratitude

Purpose / when: GGN names practising gratitude as a step [source: GGN book page]; useful when grief has crowded out what is still present.
Steps (synthesis): (1) Invite the client to notice what they still value: places, people, other species, moments. (2) Hold gratitude alongside grief, not instead of it. (3) Optionally link to a between-session practice (intervention 18).
Example language (illustrative): "Alongside everything that's being lost, what are you glad still exists in your life?"
Watch for: gratitude used to silence grief ("I should just be grateful"); bypassing. Working: the client can feel both at once.

16. Step theme: sitting with uncertainty and mortality

Purpose / when: GGN names sitting with uncertainty as a step and mortality as a theme [source: GGN book page; GGN FAQ]; use for intolerance of uncertainty and existential dread.
Steps (synthesis): (1) Name what is unknown about the future. (2) Notice the urge to resolve it (prediction, reassurance-seeking, catastrophising). (3) Practise staying with not-knowing for the length of the conversation. (4) Where mortality fears arise, explore their meaning; for intolerance of uncertainty within GAD, use evidence-based GAD treatment.
Example language (illustrative): "Nobody knows exactly how this will go. What happens in you when we just leave that open for a minute?"
Watch for: existential exploration triggering acute distress or suicidal thinking (intervention 5). Working: less need for certainty before acting or resting.

17. Step theme: reinvesting in meaningful efforts

Purpose / when: GGN names reinvesting in meaningful efforts as a step [source: GGN book page]; the youth café guide pairs conversation with accessible action and balances grief and fear with hope and action [source: UWE youth climate café guide]. Use when a client is ready to act, not as a cure for feelings.
Steps (synthesis): (1) Clarify values. (2) Generate actions of a size the client can sustain (personal, local, collective, professional). (3) Prefer actions with others, which also reduce isolation. (4) Plan rest alongside action (intervention 14). (5) Review meaning, not only output.
Example language (illustrative): "Of everything you could do, what feels meaningful to you, not what you think you're supposed to do?"
Watch for: action as avoidance of grief; over-commitment and burnout; in CPA circles, keep action optional, since the format has no pressure to act [source: CPA CCLC training]. Working: actions feel chosen and sustainable.

18. Between-meeting practices: journaling, rituals for losses, loving-kindness

Purpose / when: GGN states the main work happens as participants apply each step in daily life [source: GGN 10-Step page]; its book is described as containing about 30 practices and reflection questions, including journaling, dancing through grief, rituals for losses and loving-kindness meditations, and as drawing on the work of Joanna Macy [source: GGN book page]. Use between meetings or between therapy sessions.
Steps (therapist integration, synthesis; the book's own practice instructions are uncertain: not verified): (1) Agree one small practice linked to the week's theme. (2) For a ritual for a loss (a place, species, or imagined future), the client is the author: they choose what is marked, the form, the setting and who is present; the therapist only helps them think it through. (3) Journaling: open, reflective writing about the week's theme. (4) Review in the next session or meeting what the practice brought up.
Example language (illustrative): "If you wanted to mark the loss of that river as it was, what would feel right to you? It doesn't have to be anything anyone else would recognise."
Watch for: practices that become another obligation or a new compulsion; rituals that intrude on a client's religious tradition without their wish. Working: the client reports the practice helped them feel or connect, not just complete a task.

19. Closing: check-out, closing and poem; signposting

Purpose / when: the end of every meeting; GGN closes with a check-out, a closing and a short poem [source: GGN 10-Step page]; café facilitators make sure attendees know where to get further support [source: UWE youth climate café guide].
Steps: (1) Leave enough time; do not end on an unprocessed share. (2) Brief check-out round (a word or a sentence on how each person is leaving). (3) Closing words; in GGN, a short poem (choose one that is public-domain or that you have permission to read) [poem choice: synthesis]. (4) Give support information, including crisis lines (988 US; Samaritans 116 123 UK and Ireland) [synthesis]. (5) Facilitators check privately with anyone who seemed very distressed.
Example language (illustrative): "Before we close, one word for how you're leaving tonight."
Watch for: someone leaving visibly distressed, or a last-minute disclosure. Working: people leave settled and know where help is.

20. Youth climate café adaptation

Purpose / when: running or advising on cafés for young people, in schools, universities or youth settings.
Steps: (1) Plan with partners and the young people themselves; choose and visit an accessible venue [source: UWE youth climate café guide]. (2) For under-18s, obtain parental permission and seek the young person's own assent [source: UWE guide; assent synthesis]. (3) Arrange name stickers with optional pronouns, mingling and icebreakers, then a large-group introduction and ground rules [source: UWE guide]. (4) Split into small groups of about 4–6; open with easy questions and offer pair discussion and a quiet space [source: UWE guide]. (5) Pair talk with simple activities, for example seed planting, a pledge tree or a reading corner [source: UWE guide]. (6) Agree a safeguarding lead and procedure, and how disclosures will be handled [synthesis]. (7) Signpost further support.
Example language (illustrative): "There are no right answers here. You can talk, listen, or plant some seeds while you think."
Watch for: adults lecturing; a young person disclosing harm unrelated to climate (follow safeguarding procedures); anxiety spreading through a group. Never name minors in notes beyond what your service requires. Working: young people return, and report feeling heard.

21. Debriefing a client after group sessions [synthesis]

Purpose / when: in individual therapy after each meeting or after a café.
Steps: (1) Ask what the client felt during and after. (2) Ask what they heard that resonated, without naming or describing other participants. (3) Notice shifts in isolation, shame, hopelessness or functioning; repeat the eco-anxiety measure at the end of a ten-week program (intervention 2). (4) Work with what the group stirred: personal grief, family conflict about climate, parenthood decisions. (5) Decide together whether to continue, change format, or end.
Example language (illustrative): "What stayed with you from the group this week?"
Watch for: the client bringing back other members' stories in identifying detail; group norms conflicting with therapy goals (for example a client with OCD using shares for reassurance). Working: the client links group experience to their own change.

22. Climate-aware stance in individual therapy

Purpose / when: working with climate distress directly in therapy, with or without a group.
Steps: (1) Hold the CPA-NA and Climate Psychiatry Alliance stance: recognise the crisis as a real threat to wellbeing; address cognitive, emotional, personal, societal and existential effects; respond with compassion; do not presume distress is present or absent [source: CPA-NA and Climate Psychiatry Alliance pages]. (2) Those organisations describe nature, living systems, climate science and climate media as possible tools for working through psychological conflicts [source: CPA-NA page]; use these only where they serve the client's goals [synthesis]. (3) Explore family and relationship conflict about climate (differing views, decisions about children, career). (4) Use your usual evidence-based methods for any disorder, adapting content to realistic concern (for example values-based action rather than disputing the threat) [synthesis]. (5) If you wish to be listed as climate-aware, check the directory criteria: membership of one of the three organisations, licensure in good standing in the US, Canada or UK (or supervised post-graduate trainee status for CPA-NA), and the scientific-consensus pledge [source: CPA-NA and Climate Psychiatry Alliance pages].
Example language (illustrative): "I'm not going to tell you your fear is irrational. I'd like to help you carry it in a way that doesn't flatten the rest of your life."
Watch for: imposing your own climate politics; collusion with avoidance; overlooking disorder because the topic feels shared. Working: functioning improves and the concern remains, held more flexibly.

23. Facilitator competence, self-care, supervision and dual roles

Purpose / when: if you facilitate cafés, circles or 10-step groups.
Steps: (1) Train with the organising body: CPA requires attending a circle as a participant first, then its training; GGN facilitators complete GGN's training with the founders [source: CPA CCLC training; GGN 10-Step page]. (2) Co-facilitate; CPA circles always use two facilitators and GGN uses a two-person team [source: same]. (3) Use the peer community or supervision for your own climate feelings; GGN describes facilitators as sharing the emotional weight [source: GGN FAQ; CPA CCLC training]. (4) Dual roles: if your own clients attend a group you run, or group members later seek therapy with you, assess the multiple relationship under APA Ethics Code Standard 3.05 and decide in advance how you will handle it (for example referring group members to other therapists) [source: APA Ethics Code; application synthesis]. (5) Be clear in publicity that the group is not therapy, even if you are a therapist [synthesis]. (6) Check with your insurer whether facilitating a peer group, and any outdoor or community venue, is covered [synthesis].
Example language (illustrative): "In this group I'm here as a facilitator, not as anyone's therapist. If you want therapy, I can help you find someone."
Watch for: your own grief or burnout; slipping into clinical interventions in a peer space. Working: you can hold the space and leave it.

24. Outdoor or nature-based gatherings: safety and boundaries [synthesis]

Purpose / when: when a café, circle or session is held outdoors, on a walk or near water.
Steps: (1) Check the host programme's own safety guidance and venue risk assessment. (2) Plan qualitatively for weather, terrain, allergies, ticks, hydration and accessibility, with a weather and cancellation plan. (3) Confidentiality: agree how to handle being seen or overheard in public, and what to do if you meet someone the client knows. (4) Boundaries: agree travel arrangements in advance, and touch only with consent before and during, a right to stop, never sexual. (5) Near water: no immersion or swimming as part of the group; for any open-water activity route participants to RNLI, the Outdoor Swimming Society, Swim England or national lifesaving bodies' guidance, and note cold-water shock, hypothermia, drowning and the need for medical screening (heart conditions, epilepsy, pregnancy, medications); cross-refer Domain X 196 (cold-water immersion) and 022 (blue care, wild and open-water swimming).
Example language (illustrative): "If we're on the path and someone you know walks past, how would you like us to handle it?"
Watch for: participants with mobility needs being excluded; weather turning. Working: everyone can take part safely and privacy is protected.

5. Handling problems

Client is stuck in hopelessness or doom [synthesis]: assess for depression and risk (interventions 3, 5); separate hopelessness about the world from hopelessness about the self; use the uncertainty and reinvesting themes (16, 17) once safe. If depressive disorder is present, treat it.
"Resistance": the client minimises their distress or says therapy cannot fix the climate [synthesis]: agree that therapy cannot fix the climate; offer it as a place to carry the feeling and decide how to live with it. Do not push the topic if the client does not want it; the climate-aware stance is not to presume distress [source: CPA-NA page].
Overwhelm in group [source/synthesis]: one facilitator offers a pause or support outside the room while the other holds the group (two-facilitator model from CPA and GGN); afterwards, signpost support [source: UWE youth guide]. In therapy, slow down, ground, titrate.
Non-attendance or dropping out of a ten-week group [synthesis]: GGN encourages attending all ten meetings and does not refund [source: GGN 10-Step page]; explore what made it hard (timing, intensity, group fit) without shaming; consider a drop-in café instead.
Cross-talk, advice-giving or debate in the group [source/synthesis]: restate the norms (no advice, no cross-talk) [source: GGN 10-Step page; CPA CCLC training]; speak privately to a repeat offender; return to first-person feeling.
Climate denial or hostile participants [synthesis]: café ground rules may include agreement that human-caused climate change is real [source: UWE youth guide]; state this in publicity, and redirect debate respectfully.
Rupture with the therapist over climate views [synthesis]: name the rupture, own any imposition of your views, return to the client's own values and goals.
OCD presenting as climate guilt [synthesis]: compulsive footprint checking, rigid rules or reassurance-seeking need OCD treatment (exposure and response prevention by a trained clinician); groups may reinforce reassurance-seeking, so delay or plan referral with that in mind.
Personal bereavement surfacing [source/synthesis]: GGN groups do not address acute personal grief [source: GGN FAQ]; refer to bereavement support and see Domain VI 128 and Domain II 127; assess prolonged grief as described in intervention 4.
Young people: anxiety contagion or safeguarding disclosures [source/synthesis]: small groups, quiet space, activities and signposting [source: UWE youth guide]; follow safeguarding procedures for disclosures; involve parents or carers with the young person's knowledge where safe.
Facilitator burnout [synthesis]: use the facilitator peer community [source: CPA CCLC training] and personal supervision; take breaks (step theme 14 applies to you too).
Clients directly affected by disasters [synthesis]: prioritise safety, practical needs and trauma assessment; a feelings-only café may not be the right first step.
Suicidal crisis [synthesis]: follow your risk procedures; 988 (US); Samaritans 116 123 (UK and Ireland); in groups, follow safe-messaging principles and avoid any detail of methods.
Cost and access barriers [source/synthesis]: GGN offers scholarships, sliding-scale fees and payment plans [source: GGN 10-Step page]; cafés are often free; online formats help people with mobility limits but may exclude those without reliable internet.

Sources

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