Thursday, February 10, 2011

New Directions' Guidelines for Leading the Small Group Discussion

Support groups such as New Directions are an outgrowth of Group Therapy. If you wish you can view this 4-minute clip from a therapy session conducted by the father of the modern group, Irv Yalom, MD (b.1931), of Stanford University.

When I received my MGPGP degree (Master, Group Process and Group Psychotherapy) from Hahnemann University in Philadelphia, we studied Yalom's classic textbook Theory and Practice of Group Psychotherapy.

The incredibly prolific author has added a fifth edition, and has written novels, essays, and other textbooks into the bargain. All make for marvelous reading.

I've written a 19-page summary of being a group leader of a support group which you can read here.

In the interest of brevity, however, let me review the salient points of being a good leader.

I'll focus on the small groups we hold at the Willow Grove Giant Supermarket in their coffeeshop. Our meetings vary from 5 people to as many as 16. We do excellent work. Helen Kirschner is the regular leader and as I'm fond of saying, our 'lay' leaders do as outstanding a job as those who attend school for years.

However, there's quite a difference from the Yalom professionally-run group above and our support groups. True group therapy aims to change a person's behaviors by getting deep into their psyche. This does indeed require lots of training and a study of personalities, all in the name of creating an individual who can 'love and work' up to his potential.

Our goals are to help a person achieve coping skills and strategies to manage their psychiatric condition. We have people in our group who are diagnosed with: bipolar, depression, schizophrenia, schizoaffective disorder, and Asperger's syndrome. If they didn't tell you, you wouldn't know.

Here are some guidelines:

- Be mindful of the clock. Start on time, finish on time. Be sure everyone knows one another. We wear name badges at our nighttime meeting. Okay to spend more time with someone who is 'in need.'

- Allow the person to speak uninterrupted. If someone hones in and wants to talk about themselves, look at them and say, "Hold that thought, Terry isn't finished yet."

- When Terry is finished people will give feedback: suggestions, ideas. Have a discussion with Terry about whether these are helpful. He is taking in the information and will sort it out later on. Give him plenty to think about. Suggest he write it down, if need be.

- Ours is a proactive group. We do expect people to make changes as a result of the interactions they have in group. But change will come as the person is ready to incorporate them. Rome wasn't built in a day. Okay to follow up with a phone call or an email to see how the person is doing.

- Allow people to express their feelings. Let's say Mary just lost her job but is glossing over it. We know she's unhappy about it. Ask her if she wishes to talk about it, that it's okay to express the full array of feelings: anger, sorrow, relief, disbelief, shock. B/c we're creatures of habit, loss takes time to sink in. If I worked somewhere for 21 years and then got fired, my brain wouldn't know what to make of it for quite a while.

Keep in mind: The intellect knows, but the emotions are slow to follow. This is normal.

- Leader must train her brain pathways to remember people's stories. The memory path actually gets stronger the more we ask of it, tho, obviously, repetition is the best way to remember someone's story. If the leader can't remember someone, she can say, 'Please refresh my memory.' Best not to have someone in the group you recognize by sight but w/o any content. Simply ask. The person will not be offended.

- The greatest triggers of unhappiness are Loss. Loss of job and loss of relationship, including divorce or death. Grieving must be fully processed or it will lead to a depression. Note the difference between bereavement and clinical depression. In grief, a person is sad and pensive but can get out of bed in the morning and eat.

- Compliment people frequently, remembering things they have done well lately. You have the unique power to make people feel good about themselves.

- Set up 'call teams' if a person is in need. For example, Laura had worked steadily for many years but was suddenly let go. For her, this would be such a challenge that we had people call her every few hours to make sure she didn't sink into depression or lethargy. Her 9-5 circadian rhythms had been torn apart and we knew her body and mind would have a difficult adjustment.

- Setting goals. One of our great strengths is that during each meeting we have people set a goal. The goal is something that is do-able, but with the push of the group behind it, the person has extra-added incentive to do it and report favorably to the group the next time we see them.

We remind the goal-setter that if he does not accomplish it, that is fine. We don't pressure people, except where we feel it's necessary, such as the need to follow-up with the doctor.

- Befriend people in our group. We have a terrific bunch of people in our group. A few are socially awkward but really want to develop their social skills. We actively encourage people to call one another and become friends.

Our new programs, Mike's Hike's & Sunday Excursions, and Game Nite at someone's house foster the goals of socialization. People have made astounding progress.

- As group comes to a close, ask what the person is doing the rest of the day. Or, for a night meeting, what their plans are for the next day. Encourage those out of work to:

..Make a to-do list.

..Get out of the house every single day for an outing w/a friend or for an appt. This is crucial! If they have nothing to do, suggest they meet another group member for coffee.

..Continue their job search either at home or out among people such as taking the laptop to Panera's or Starbucks to be among people. It's lonely working at home and we are a gregarious species.

- At the following meeting ask how everyone has done completing their goals.

So we see that this little support group has great influence in guiding people along their life's journey. People are most grateful to us.

Upon occasion, I send a postcard to someone with encouraging words.

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