Becoming Amazing at Running Group

Davey Do · Dec 9, 2016

Excellent questions, Laurenjulia. I admire your endeavor to explore methods to make groups interesting to patients .

It is said that we learn as much from bad teachers as much as we learn from the good ones; we learn how not to instruct from the bad ones.

I have led groups for years in a variety of settings. Working in chemical dependency treatment allowed me to hone my public speaking skills, for the nurses were requested to lead an array of groups including, but not limited to, a good morning group, affects of chemicals on the body's systems, implementing 12 step principles into one's life, and good night groups.

While working at a community mental health center, I was asked to give a two hour, first thing in the morning, affects of alcohol and drugs on the body's systems to a large number of court-ordered clients.

Talk about a difficult audience to play to! Nobody wanted to be there, given the time and circumstances.

First, I was myself- well, my social self- positive, animated, and interested in the topic at hand. I needed to know about and believe in what I was selling because challenges were constantly hurled at me. I don't stand still while I'm giving information, walking around and gesturing. Watching a moving target is more interesting than staring at a stationary one.

Now, if I wanted to make a serious point, I would stop, look directly at the audience, pause, and enunciate each word clearly and then repeat it two or three times. A little drama goes a long way.

I used audience participation, asking questions where I was reasonably sure they knew the answer and give the participator positive reinforcement. Everybody likes positive attention and that positivity is contagious.

One example where I used drama and audience participation was to discuss the alimentary canal. I would ask, "When you drink a liquid, is gravity the only thing that makes it go into your stomach?" Usually the consensus was, yes- gravity causes liquids to go down into your stomach. "So, if I stand on my head and drink, the liquid in my mouth won't be able to go into my stomach? Well, I'm going to show you about something called peristalsis." I would pick two volunteers from the audience, have them assist me to stand on my head as I drank from a cup of juice through a straw. Then I would speak, showing the liquid was not in my mouth. I would stand and say, "Let's give a round of applause to our two volunteers". It was almost like a game show environment.

This exhibition would lead onto related topics such as the cardiac/pyloric sphincters, peristalsis, opiates slowing peristalsis, alcohol destroying transitional epithelium, causing lower esophageal varices, and so on.

I could go on and on about the various methods utilized to keep a group interesting, but let's suffice it to say that if the group is fun and interesting for you, it's probably going to be fun and interesting for your audience.

Good luck and the very best to you, Laurenjulia!

Davey Do · Dec 9, 2016

I thought of more info, Laurenjulia:

I needed to know about and believe in what I was selling because challenges were constantly hurled at me.

One of the biggest pitfalls to a group is a participant who challenges you- a naysayer or a hatchet man- what the comedians call hecklers. We're probably all aware of the incident with Michael Richards when he used racial slurs against some hecklers: ouch! Never attack the challengers-always attack their premise.

A challenger can easily change the tone of a group and produce negative outcomes.

There's a technique called aikido- channeling an opponent's force against you toward a desired goal. Perhaps Michael Richards could have used aikido and gotten out of his situation unscathed!

Maybe the best way to explain this concept of aikido is with an example when I worked in CD tx and was knocked off my feet during a good night group: The purpose of this group was to end the day on a positive note, so each participant would relay at least one positive thing that happened to them that day. The group was proceeding well when one participant, Jay, said, "Dave, I don't know why they let you run this group. You're no good at it. In fact, you're not fit to empty a bed pan !"

Jay's comment caught me by surprise and knocked all the wind out of me. The only thing I could say was, "Well, thank you for your opinion... next?" and the tone of the group was definitely changed.

It turned out Jay had just gotten off the phone with some bad news and took his negative feelings out on me. After talking with a seasoned nurse, Jay apologized for his actions. I accepted his apology but I was at a loss at how to deal with such a situation.

The director of the chemical dependency program, a recovering addict himself, shortly thereafter had a talk with me. He advised me, that when ever such a situation would occur in the future, to turn the attention back on the participant. For example, he would have said, "Jay (call the participant by name), your comment wasn't appropriate to this group," (State a fact.) "What makes you say such a thing?" (Put the participant in the limelight and challenge his actions.) "Then, when the participant has stated the rationale for his actions, bring the group back into the subject at hand with something like 'You see, sometimes we addicts have trouble expressing our emotions appropriately. We've used chemicals to suppress negative feelings. One of the purpose of treatment is to learn how to deal with our feelings appropriately without chemicals.' "

That advice has buoyed me through some difficult group challenges. Once I felt relatively confident with this technique, I developed some of my own.

Humor is always good. If you can get a group to laugh, you have control; you have the fortified power of the group. The challenger can be made part of that humor. I've used a Robin Williams line from "Dead Poets Society": "We're not making fun of you- we're just having fun near you! "Most times, however, I sacrifice myself to the humor for the good of the group.

In order to keep control of a group, I've also gone as far as to request the negative participant to leave. In one instance, the participant, Tom, who was diagnosed with schizophrenia, refused to leave. I responded with, "Okay, you can stay. Group- we're going into another room!" My guess is that Tom saw the power I had over the group and chose to leave. He too, later apologized for his behavior. I bestowed kudos uponTom for his apology and insight, so all is well that ends well.

BeenThere2012, ASN, RN · Dec 9, 2016

Davey Do....Excellent teaching here.