Office of Palliative Care

Creating Safe Spaces for Discussion


No Roadmap: Caregiver Journeys was specifically designed to generate discussion of caregiving and the crucial role informal caregivers play in its delivery.  Because the film touches on difficult situations that might trigger emotional responses in viewers who have experienced hospice care with family members or loved ones in the past, we have found it useful to provide an introduction to the film and guidance for facilitating discussion afterwards.

Before screening the film, simply inform viewers that it contains potentially emotional material pertaining to the care of parents and spouses who eventually become hospice patients and that it is not uncommon for some viewers to become emotional while watching the film.  Equally important, be sure to point out that the caregivers portrayed in No Roadmap are in many ways the ideal.  The sacrifices they make in order to care for their loved ones is inspiring.  Some viewers, however, may respond defensively to these portrayals because they see them as passing judgment on anyone who cannot make similar sacrifices.  It is, therefore, recommended that viewers be told upfront that the film’s primary objective is to foster open dialogue and that multiple and even conflicting points of view on the topic of caregiving are welcome.

Establishing a “safe space” for learners to explore their responses, either before or after watching the film, increases the likelihood for meaningful dialogue.  Below are six guidelines for creating such a space, adapted from Hanna Sherman, MD, from the Center for Courage and Renewal.  Whether facilitators decide to use them or construct their own, the most rewarding discussions require openness and the willingness to listen to multiple and often contradictory points of view.  Importantly, the concept of safe spaces provides a valuable model for conducting meaningful and productive conversations with patients and their families in clinical settings.

  • Choose for yourself when and how to participate.  There is always invitation, never invasion; always opportunity, never demand.  This is not a “share or die” event.
  • Make space for silence and reflection.  Slow down and pay attention to the “inner voice” that is trying to speak.
  • No fixing.  Our views of reality may differ, but speaking one’s truth does not mean interpreting, correcting or debating what others say.  Seek instead, through listening and open questions, to help each other find his or her own clarity.
  • Embrace differences.  Speak using “I statements.”  Listen with an open mind to others’ thoughts and responses.
  • When the going gets rough, turn to inquiry.  “I wonder why they feel/think this way?”  “I wonder what pushed my buttons?”
  • Observe confidentiality.  Safety is built when we can trust that our words and stories will remain with the people with whom we choose to share, and are not passed on to others without our permission.


Margaret Sanders, M.A., LSW

Kathleen Enoch

Building Caregiver Partnerships

This site contains a free compendium of educational tools and resources on issues of family caregiving for health professions faculty, providers and students.

Co-sponsored with Summa Health and funded by the Arthur Vining Davis Foundations.

Office of Palliative Care

Department of Family & Community Medicine