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NEW DIRECTIONS’
2004 LEADERSHIP
TRAINING WORKSHOP
By
Ruth Z. Deming, MGPGP Director,
New Directions Support Group, Inc. Abington,
PA New
Directions offers 2 leadership training sessions per year. This is the
handout we provide with each 2-1/2 hour training workshop. INTRODUCTION We
are indeed pleased that you have decided to come forward and join Our
Team. Please familiarize yourself with all aspects of New Directions,
including the separate sheet Quik Facts. Also thoroughly read our web
site. It contains our philosophy, which is of incomparable value to
people - like us - who seek to conquer the devastation that is mental
illness. THE
NEW DIRECTIONS MEETING The
New Directions meeting begins the moment a person walks into our church.
Everything is important, from the signage that directs newcomers to our
meeting place, to the greeting they receive from the greeters, to the
air of friendliness and tolerance that abounds. The presence of the
Leaders of the group send out unending positive energy to the group. The
members who attend that particular evening lend their
energy to the totality of the group. Know
that you, as a leader in the group, should have as your mindset: I am an integral part of what makes this group run. Feel free
to take initiative. If you see a new member who is ill at ease when they
first come in, go over and talk to them. What I often do is pair them up
with someone in the group so they will have someone to show them around.
You can think of it as a party, where you want everyone to feel
comfortable. Also, because you are an integral part of the group, do
small things that show you care. If you see a piece of paper lying on
the carpet, pick it up and throw it away. Treat the room as if it were
your own. There
are 2 official facets to the meeting:
Large Group Discussion (1/2 hour) and Small Group Discussion (75
minutes). The Small Group is at the heart of the meeting. This is what
people come for. Large
Group takes care of official business and announcements. It’s
particularly important during Large Group that the members know the schedule
for the rest of the evening. The person in charge needs to reiterate the
schedule: Large group meets for half hour – 10-minute break – meet
back in Small Group at 8:30 – finish up at 9:45. Group also needs to
know which small group to go to. Another
purpose of the Large Group is that it lets our members have a good look
at who’s there: the vast
variety of people with from all different walks of life, different ages,
ethnic groups, all of whom share similar mindsets and the desire to
share their own personal worlds with others who understand. I
think of the Large Group as a warm-up to the Small Group, allowing
members to know the range of our openness and tolerance and that it’s
OK to laugh at ourselves. The role of humor can’t be overstated. LEADING
THE SMALL DISCUSSION GROUP
Thank
you for stepping forward to become a leader of the Small Discussion
Group. Your role is an important one. You are already doing most of what
I’ve written in this guidebook. All we’re doing here is putting it
into writing, which confers a certain formality and knowledge base to
the process. We
like to have as many trained leaders as possible. When it’s time to
break into the Small Group make sure you find a group where there’s
already no leaders. Also, decide if you wish to lead that particular
night or not. Sometimes we just don’t feel like being a leader on a
particular night, but would rather be part of the group. This is fine. One
of the main problems I see at the meeting is the gathering together into
the Small Group after the break. You, as a leader, should take
initiative to make sure people get into their groups. As
to the meeting proper, there is really no right way to run a group. Each
group is as different as the members who constitute the group: Their
blend of spontaneity, wisdom, humor and desire to prevail over hard
circumstances is what makes the Small Group so effective. “Talking”
is one of the most important ways of healing. It’s called
“storytelling.” Everybody has a story. And everybody needs to tell
it. To the right person. That’s why New Directions is so important. We
are the perfect place for people to tell their story. As
with life itself, there is always something new to be learned. Keep your
eyes and ears open and you will learn new things at every meeting
you attend. This is what we want to do:
learn new things and new approaches to dealing with our illness
or those of our family members. This includes information on:
doctors, medication, family relationships, job relationships,
alternative solutions. We
have a great advantage. We can share information with others. We are a
network of committed intelligent individuals. GROUPS,
BRIEF HISTORY
New
Directions is only one of many groups in our society in which we
participate. Our foremost group is our family group, the basis of all
other groups. Think of other groups you may be part of – a book
discussion club, bridge club, bowling team, etc.
Each of these groups has a reward or a goal. New
Directions’ goal is: How
to live with our illness – or that of our family member. There are
other rewards as well: friendship, getting out of the house, feeling
accepted and not alone or “different,” knowing that other people
share your same condition. Read
our mission statement: “To
help individuals reach their highest potential; to move beyond their
diagnosis to lead meaningful, productive and joyous lives, even if that
means changing our goals and our lifestyles to accommodate our illness.
Our highest priority is for our members to participate in society to the
fullest: through work, volunteerism, involvement in the community, and
by developing lasting and loving relationships in our lives. We are also
committed to community education programs to instill education and
dispel prejudice.” Focus
of group is on “problem-solving” and “compassionate caring.” The
group is conducted by “lay” people. New
Directions has 2 types of groups: the “large group” and the “small
discussion group.” This guidebook discusses your role as leader of
Small Group. The
small discussion group – 6 to 8 people - is the core of ND. This is
where people open up and talk. They tell their story. Again,
storytelling is a great healing process. It’s best done with no
interruptions. Everyone
in the group adds their own personality, their own ideas and wisdom to
the group. These individual differences among people give color, depth
and richness to the group.
Note
from Amy,
veteran group leader: “I believe very strongly in explaining “the
role of ND” to newcomers – and reinforcing it for others. The
concept of a support group is sometimes unfamiliar. Research shows that
support groups help with the patient’s recovery. Sometimes I refer to
the 3-legged stool that props us up during recovery:
meds, clinical caregivers, social supports.
GUIDE
TO BEING A LEADER Here
are some guidelines to help you…
some important points to be aware of. We’re including
“scripts” to help you verbalize things. Feel free to vary them as
you express your own personality. In
essence, being a good leader includes: Good eye contact – relaxed and
in-tune body language – careful listening – empathy – remembering
what people have said and tying these things in with what new members
say – look around an gauge members’ responses to things.
Mostly, rely on your own personal thoughts and
feelings about what is going on around you in the group. As
stated earlier, you are no doubt doing ALL of these things. But by
reading it in print, you will have a surer sense of your own competency
as leader. Don’t be afraid at the end of the group to take a friend
aside and ask, How did I do? Also, after you lead your first group,
please call Ruth to discuss and get feedback. Just
be yourself.
Be yourself the way you would when you’re with a group of friends. Be
relaxed and comfortable. Body language is very important in conveying
that you are relaxed and are actively listening.
The group will then follow your lead. They, too, will feel
relaxed and comfortable enough to share their stories. Be
a good listener.
Focus on what each person has to say. By listening carefully, you are
setting the tone that we listen carefully to each person. Let
each person have their say.
The person needs to talk without interruption. Show this to the group by
not interrupting. Occasionally, clarification is needed, and you or
someone else may interrupt by saying something like, “Is this your
daughter you’re talking about?” Should the group continue to
interrupt, hold up your hand (body language)
and say, “Please. Let’s let Joan finish her story.” You
don’t need to be an authority.
As a leader, you’re not expected to be an authority or to know
everything. Your role is to facilitate discussion. For example, if
someone asks a complicated medical question, just say, “That’s a
question your doctor needs to answer.” Or, you might say, “Let’s
see if the Group has any experience with this.” It’s
okay to say, “I don’t know.” Feel comfortable with that. Again,
turn to the Group to answer specific questions. Utilize the group as
much as possible. Facilitate
discussion.
As a group, the members should do most of the talking. The leader or
facilitator is there to guide them. This includes bringing the group
back to focus if they go off track. Also, discourage “side
conversations” if they last too long. You
may also sum up what has been said. For example, if 3 people are
talking about the same thing – for example, problems with medication
– you can say, “The experiences of the 3 of you show us that each
case is different, and that no medicine works for everybody.” As
we said, although you are the group leader, the group should do most of
the talking, as in a group of friends talking together. If people
look toward only you for an
answer, it’s often
a good idea to turn to the group. “Well, let’s hear what the group
has to say about this.” Starting
out.
The leader gives an opening statement. Even though he or she has
said this at other meetings, it’s important to repeat it at the
beginning of each group. “Hi, my name is
Karen and I’ll be your leader tonight. We want to welcome newcomers
and are glad you came tonight. Everything we say in group is
confidential. What we say will not leave this room. We have until 9:45
to talk. Everybody will have a chance to speak.” Why
is this statement important? What points does it cover? First you are reassuring people it’s okay to be honest
because confidentiality is assured. You are setting limits – the group
will go for an hour. You are acknowledging the newcomers and making them
feel welcome. You will also reassure people that you, as leader, will
take care that no one gets lost in the group, that everyone will have a
chance to speak, should they wish. Watch
the clock… Pace yourself.
The leader must pace herself so that everybody has a chance to talk by
group’s end. She must also make sure each person speak for an
appropriate amount of time. Not everyone will speak the same amount of
time. This is fine. Often one person needs more time than others. This
is fine, as long as their topic doesn’t dominate the group. Tactful
way of talking.
We want to find tactful ways of saying things. Often this
requires that we practice in our minds what we are going to say before
we say it. (See the examples below as “tactful” and “kind” ways
of talking to people.)This is a good opportunity to practice
tactfulness, not only in group but in life
as well. Silence
is OK.
As a leader, don’t feel that you need to talk to keep the discussion
going. Silence is okay. The group leader may encourage a faltering
discussion by saying, “Well? What else?” Or make a joke about it.
“Well, I guess we’re all cured now
and can go home.” The group will talk when they are ready. If
the group remains unresponsive suggest, “Maybe we’re finished now
and ought to stop. What do you think?” Should
the group leader share?
Yes. Throw in details of your own experience. Monitor yourself
and don’t talk too much. When
you, as the leader, are having a bad day and need time to talk about
your own problems, arrange to have someone else lead the group. Take
turns at being leader.
You needn’t lead the group each time. Share the leader role with other
trained leaders. Figure out at the beginning of group who wants to lead.
THE
GROUP A
number of points are repeated here, but it is helpful to have them
re-stated, this time from the perspective of “Group.” Meeting
format.
Each group is different. There is no specific way to run a group. All
that’s important is that the group “works.” The running of a group
depends on (1) the leadership, as well as (2) the input of the members.
It is a partnership between the two. Two
basic ways of running a group:
The (1) “going around the circle” way and the (2)
“open-ended” way. “The
circle approach.”
In this style of group, each person speaks in turn, passing on from
person to person. This way the group flows systematically from one
person to another. Each person talks in their turn. Order is maintained.
Everyone knows what the next step will be. The regularity of the
circle approach can be reassuring to both leader and group members, thus
avoiding the anything-can-happen, spontaneity of the “open” group. The
leader may start off the circle by saying, “Okay, let’s go around
the circle. Nancy would you like to begin?” The
“open-ended” group.
This approach encourages spontaneity and a lively give-and take. One
person’s comments spur another person to respond. The leader of this
type of group may work harder than in the “circle group” as she
keeps track in her head of who has spoken and who hasn’t. Again,
everyone should have an opportunity to talk, so the leader needs to
create opportunities for every individual to speak. Karen
may open this group by saying: “Okay, who would like to start? Who has
something they would like to share?” As
mentioned, Karen must be aware of who has talked or not talked. She then
needs to bring in those people who have not talked or haven’t been
heard from much. “Bill, you haven’t had said much. Is there anything
you’d like to share?” Or you can specifically bring Bill in by
saying, “Bill, how do you feel about what we’ve been talking about?
Is there anything you’d like to add?” Or, “Bill, you look like you
have something to say?” Keep
the purpose of the meeting in mind at all times. Everything
in the group should be in
line with: managing the
mood disorder, or helping your loved one manage his/her mood disorder.
Conversation may stray. This is fine. But bring it back in focus. “OK,
thanks for the tips on new movies, but let’s get back to the topic.” Establish
a climate of listening.
The leader is the role model. He or she establishes a climate of
listening. By her body language, by her comments, she gives the message,
“You are all important. I am listening to what you have to say.”
Be
aware of limits and boundaries.
Tell members at the outset how much time you have. “We have an hour to
talk. The group will end at 9:45.” Limits
also include how much time people have to talk. Most people will figure
this out for themselves and conform to the style of the group. It’s
OK, however, if one person needs more time than another. Just make sure
that you hear from other people as well. There
also may be the “silent person.” Respect their silence if
they insist. It’s a good idea to give them an opportunity to speak
later on in the group when they’ve had a chance to “size up” the
group and feel more comfortable. “Judy, would you be interested in
saying a few words now?” Welcome
the newcomer.
Do this at the outset. “Ronnie and Cilantro, we’re glad you came
tonight.” If the newcomer doesn’t feel like talking this is fine.
You can always stimulate their participation by asking, “Where did you
hear of us?” Immediately
identify
which people have pressing issues.
You can ask by saying, “Does anybody here need to talk
first?” If they are really in distress, satisfy these members’ needs
first. They are in need and are probably eager to talk. Your group
members will be glad to help. Group members rally around people who need
help. If need be, talk to the “needy” member after the group. Often,
group members will do this spontaneously. Also…. Set
up a ‘”call team.” Many
members need follow-up due to a difficult situation. During the group,
ask for a couple of volunteers to call the individual to “check in”
with them to reassure them. Allow
a person to fully tell their story.
Make sure a person can speak without interruption as they tell their
story. The person needs to make sure they are heard. After that, the
group may chime in. Stay
on topic.
Make sure that each person finishes their topic before a new one
is brought up. In the excitement of the group, a person may be
interrupted by someone else. Guide people back to the person who has
been interrupted. “Wait a minute, Jim. I don’t think Bob has
finished what he wanted to say.” Is
it OK to talk about doctors and about medication?
Absolutely. Doctors and meds are probably the 2 top things people want
to discuss. Medication:
Patients are hungry to discuss their medication with other people on
psychiatric meds. They also need to know each and every medication
available in the medication arsenal.
You, as leader, should, of course, emphasize the dictum “Not
every medication works the same for every person.” This is extremely
important for every group member to know, even while they gather the
names of all available drugs that can possibly help them.
You and the group should also encourage the person to give the
new medication time to work. And while this is in progress, the members
of your Small Group can set up a CallTeam to give telephone reassurance
or in-person reassurance to the person who is waiting for their new med
to kick in. Doctors.
The support group is a terrific place to talk about our doctors.
Sometimes people want to express how much help their doctor has been to
them and how the doctor has always been there for them. This is
wonderful. People need to hear about all the wonderful doctors out there
to treat us. Other times, the group member needs to express frustration
about their doctor or doubts that their doctor is doing a good job. By
just letting the patient get this off their chest, is of immense service
to the person, who may have no compass point to determine whether or not
the actions of their doctor are efficacious. Be aware that some people
feel “disloyal” in talking about their doctors in group, let alone
criticizing them. Let them know it’s normal to feel uncomfortable, but
it needs to be done for the patient’s mental health. At
the mention of feeling doubtful about one’s doctor, the group will
offer good commentary on what constitutes a good doctor. It’s not a
good idea for leader or members to
outright tell a person to change doctors (or medication).
Always remember that you are hearing one side of the story –
from the patient – and there may be other sides as well. Do, however,
let the patient know that it’s okay to get a second opinion or
consultation, and it’s also okay, should they choose upon reflection,
to change doctors. You and the group might try “role playing” with
them on how to approach their doctor about problems. “Dr. S, I was
disappointed you didn’t call me back when I said I was suffering side
effects. How shall we handle this in the future?” Encourage
partnership between doctor and patient.
This is a whole new concept to many psychiatric patients and should be
said again and again. In the old days, people put their psychiatrists on
a pedestal and felt it was wrong to question them. In today’s society,
we take a different approach. Our doctor and I are partners and are
working together on a mutual problem: mental illness, which requires
astute input and ideas on both sides. Encourage group members to go
prepared when they see their doctor. Bring in key points that occurred
between visits and their version of a “mood chart.” Encourage
problem-solving.
This is one of the most important functions of the group. The group is a
fabulous resource to help people with daily problems – acknowledging
that they are not the only ones that have this problem - such as getting
out of bed in the morning. Group
members represent a broad spectrum of practical experience. “Sam, I
really like that idea of starting your day with a walk around the
block.” Our
steps to recovery.
These common-sense, universal wellness techniques are listed in our ND
brochure and on our web site www.NewDirectionsSupport.org and should be
stressed during the meeting.
Stay
positive.
When the group finishes up with a person, end on a positive note.
“Larry, it looks like you’re really moving forward with sending out
your resumes.” Sometimes the situation is so difficult that it’s
hard to be positive. If this is the case, the leader might say,
“Let’s just hope for the best. We’ll be thinking about you.” Group
follow up.
Many times a person is going through a life change (moving, having an
operation) that will take time to complete. If Alice wishes, set up a
Call Team to check in with her on how she is doing. Some people just
naturally refuse help. So try and apply slight pressure to see if she
really indeed wants help but is too shy to ask. Encourage
“group talk.”
Foster connections and conversation between group members. “Lisa,
you’re talking about much the same thing Ray was speaking about a
moment ago. Why don’t you and Ray talk more now about how it felt
coming out of the hospital.” Their
experiences will then be shared and everyone else can chime in. Reality
checking.
The group is a valuable resource for “reality checking.” This
means that some people need to hear from others if they are on the right
track; if their perceptions are correct, rather than being skewed.
In other words, how does their “subjective” view of reality
compare with an “objective view?” Here are some examples that
members might ask help for: “Am I doing the right thing about my
getting a job?” Or, “Does it sound like I’m getting manic?”
Reality
checking also means that the group itself may find something amiss with
the person’s behavior and needs to tactfully inform that person. “You know, Mary, I think you really ought to see your
doctor. It seems like you’re spiraling downward and need to be around
people.” Have the group confirm this, so Mary is really convinced –
through reality checking – that she needs to see her doctor. Again,
tactfulness is the key. No one will listen to advice if they think they
are being attacked. Ask
Mary for confirmation that she has heard you. “What do you think,
Mary? Will you see the doctor?” Tactful
talk. This
is very important. Everyone in the group follows the tone of the leader in speaking tactfully
and non-judgmentally to people. For example, instead of directly
telling a person what to do, suggest that they do it. Modulate
your voice so it doesn’t sound like an attack.
“You know, Kathy, it seems to me like you need to talk to your
doctor.” Or, “You know, Kathy, if it were me, I would definitely get
in touch with my doctor.” An
untactful approach would be to say,
“Kathy, if you don’t see your doctor, you’re really going
to get in trouble.”
Kathy
may perceive the latter as a threat and resist getting help. Rely
on other people’s personal experiences to guide people.
“Kathy, I had the same experience. I forgot to tell my doctor about my
side effects and the problem only got worse. I’d suggest you speak to
your doctor right away.” Different
opinions.
People will inevitably have different opinions and experiences. If they
are at odds with one another, say something like, “Well, I see we have
a difference of opinion here. That’s okay.” Or “We differ.” We
don’t all need to think alike.” Talking
about God.
It’s fine to talk about God and anything else that gives us strength
and inspiration. People have numerous ways of gaining inspiration
throughout the day or in their darkest hours. We at New Directions are
interested in any approach that helps us get through our illness.
Wrap
up everything within group.
At group’s end, make sure problems have been sewn up. This doesn’t
mean that all problems will be solved. Just make sure that key problems
have been discussed and solutions suggested. Don’t leave anyone
hanging. Make sure everyone has something to take away from group
– resources, reassuring words, the telling of their story. Exchange of
phone numbers. End on an upbeat note. Closing
moments.
Thank the group members for coming and sharing. Be sure to give a
special thanks to the newcomers and encourage them to return. Also,
mention to the people who are struggling that our thoughts are with them
and, for all the members, encourage them to use the phone list
between meetings. PROBLEMS
YOU’LL ENCOUNTER IN GROUP …Difference
in opinions.
Not everybody is going to think alike. This is fine. When people
have differences of opinion and are at odds with one another, say
something like, “Well, I see we have a difference of opinion here.
That’s okay.” Or, “We differ. We don’t all need to think
alike.” …Side
conversations. A
few side conversations here and there during group are okay. However, if
many side conversations occur and if they are intrusive to the group,
put them to an end. “Hey, guys, let’s get back to being part of the whole
group.” …The
monopolizer is often the dread of the group and the leader. Be
assured that if you feel someone is monopolizing, your entire group feels the same
way. Know that the group wants you to stop the monopolizer and
the group will thank you for stepping in and stopping the
monopolizer. Dealing
with a monopolizer is usually the leader’s greatest challenge. The
monopolizer is probably unaware she is monopolizing. When
this occurs, the leader should say to himself, “OK, gotta watch for a
way to break in here.” Be bold. Change body positions to signal to the
group and the monopolizer that you are going to take charge of the
group. Here are some things you can say. “Kristin, I have to break in
here. We need to hear from other people.” Or, “Kristin, thanks for
sharing, but we need to move on.” You
can always cut the person off simply by speaking quickly when the
monopolizer takes a breath and interrupt them. This is fine. Simply
turn your body and your attention to someone else: “Jim, you look like
you have something to say. What’s on your
mind.” These behaviors will become second nature after practicing
them. The
early warning method.
If you recognize an experienced monopolizer will be in your group that
evening, take him aside and say, “Bill, I know you have a lot to say
to the group, but we need to monitor your talking so other people have a
chance to speak. I’d like to work with you on this.” Then suggest
you and Bill come up with a
system whereby Bill will
check in with you while he’s talking. You can suggest, for example,
that he watch you for signs that he’s doing OK:
thumbs up. Or, perhaps, the universal cough or clearing of throat
to let him know his time is up. …One-
person focus.
Sometimes a person will have such a compelling story that the whole
group will rally around them – for too
long a period of time. Make sure your compelling storytellers do not
take over the group. Remember, it’s okay to spend more time on a
person who needs it – but, again, make sure you are giving other
people a chance to speak. …The
intrusive person
who knows everything and has
to comment on everything that is said. This is a subtle form of
monopolization and is also the dread of the group. “Emily, we
appreciate your enthusiasm and your comments, but it’s better not to
respond to everything that is said.” She is also a candidate to be
taken aside before the meeting. Again, this is difficult to do, but to
run a good group this issue has to be taken care of.
…Negative
people. Some people have a negative turn of mind and don’t say
anything positive. You can’t change them. While they’re talking you
might say, “Well, Jane, all that certainly is a problem. Can you see
anything positive about your situation?” Or just, “Well, Jane, we
certainly understand what a problem that is for you.” …Crisis. Infrequently, someone may be in crisis and needs
immediate attention from their doctor or needs to go to the emergency
room. The ill individual plus one or two members of the group should
leave the group to tend to this person. “Sally, are you feeling really
so bad that you might need to see a doctor tonight?” Gauge Sally’s
response. (If Sally’s in trouble, tell Ruth.) If necessary, Sally can
then call a family member to help or you can simply drive her to the
emergency room, or follow her in your car. Don’t worry. This happens
rarely. Again, be sure to mention this to the group director. …Give
a brief report to Ruth after
the meeting. “Good group. Things went well. One person is having some
difficulty. We set up a ‘call team.’”
Ruth, as the director, needs to know what’s going on at all
times. Not in intricate detail, just the basics.
* SOME
CONCEPTS AND QUOTES USED BY THE GROUP Each
case is different. No two cases are alike. No
medication works the same on everybody. There
is a great variation in the way medication works for different people. Make
a list of questions or problems when you see your doctor. It
often takes time for medication to kick in. Be patient. If
you have doubts about your psychiatrist, get a consultation with another
one. SOME
TERMS & CONCEPTS USED IN GROUP
Share Safe
place Reality
checking Suggestions Caring
- compassionate Stories Meds Recovery Phone
list “Check
with your doctor” Buddy
system No
medication works the same for everybody. There is a great variation
among
individuals. “Let’s
see what the group thinks about this” Having
a bad day - struggling Consultation
with another doctor Check
it out on the Internet Common
Daily Problems for Group Members Many
group members have trouble with family members. Or work situations
(co-workers, boss). Family members may be described as: Harsh
Judgmental
Unaccepting
Doesn’t understand What
can you as a leader say? Realize that many people who are important in
our lives will never change their attitudes. Ask the group how they deal
with this – and also how they can educate their family on their needs!
Ask for suggestions from people who have good relationships with their
family members. Use their wisdom as a guide.
Suggest
the family member attend a meeting. PROMOTE
ND AND THE HELP YOU CAN GET FROM US Encourage
buddy system, suggest people may wish to be buddies Encourage
networking among members, suggest people exchange phone numbers Encourage
use of our resources (library, volunteer jobs, social events, morning
meeting ) Brag
about the group, how wonderful it is. This will allow people to feel
they’re
in good, capable
hands, and that by listening to our philosophy, they will get better. Send
people to our always-evolving website. Ask
people for their feedback – good and bad. Ask
people for ideas.
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