Group Process Skills in the Model of Peer Family Education

Group Process Skills in the Model of Peer Family Education

As you teach the course, you will become aware that a powerful group process is underway. We are dealing directly with family trauma. We are presenting a vast amount of information which will counter normative family denial and challenge stereotypes about mental illness. We are providing a safe place for families to unburden their pain. Our purpose in this course is to guide family members to emotional understanding, insight, healing, and action. The course is designed to support you in assisting families toward their goal. The following group process skills will help you in this effort.

1. Instrumental and Affective modesof working with a group. There are two alternating modes, or styles, you will use in teaching this course.

The instrumental modeis task-oriented, “executive director” mode which lets people know that you are clearly in charge of the class, and that it is vital for the group to complete the assigned work. Families in distress are actually relieved to see someone take responsibility, so don’t worry about asserting yourself. Being “the boss” means that you will start and end class on time, observe time limits for class discussions, run the lectures without interruption, and not feel shy about asking families to adapt to the way we structure.

In the affective mode, the focus of attention shifts from “work completion” to processing of feelings and subjective responses. This type of group direction is facilitative and interactive. Here the teacher becomes a true peer – a family member struggling with the painful realities of mental illness. In this role you serve the group by encouraging people to express reactions and emotions. This is the mode we are most accustomed to from participating in family support groups.

Your familiarity with affective mode of running a support group creates a “problem dynamic”. You may have a tendency to favor this style of direction, and families in your class will want to dwell on current problems and use the course as a support session. You must exert your executive role and resist the pull of the group into the “Endless saga” of illness. This means communicating to the group your conviction that the course work is primary and will enable them to make meaningful changes in their lives. (This is why we encourage families in Class 1 to attend the local support group so that their need to talk about immediate problems can be met in the appropriate setting.)

2. Using lectures and discussions to express these modes: The course is constructed to help you shift naturally from the instrumental mode (in the lecture) to the affective mode (in the discussion).

Lecture: Each class is scripted as a set piece which is designed to put “food for thought” on the table. In order to deliver the breadth and depth of the course it is essential that you stay with the script and complete the lecture on time. You will certainly want to add your own interesting “asides”, but don’t make the mistake of straying from the script. It is there to support you and set the stage for the discussions that follow.

Discussion: Here you shift to the affective mode. The object of discussions is to draw people out, get them talking, bonding and discovering their own strengths. As a hall mark of this course, we believe that families attending these classes bring the most essential ingredients to family education – their own valor, sense of humor and street smarts. Always give the lead to family members in discussions; be sure that you are not monopolizing the discussions as a teacher. Let the families in your class who have experience with the various brain disorders “be the experts”.

3. Specific group process skills for facilitating discussions

Listening: You will no doubt be nervous as a first time family educator, so don’t forget to listen. Stay as attentive as you can and continually ask what people think. It’s more important for you to “take things in” than to perform and “put stuff out”. Be sure to acknowledge contributions; be mindful that for many family members in your class, no one has ever really listened to them.

Waiting: nervousness can also make it hard to tolerate silences in the group during discussion. Silences usually mean that the group is thinking, or someone is getting up the courage to speak out, etc. See if you can ”wait out” these pauses until someone in the group breaks the tension. If silences go on too long, ask your co-leader to comment on the subject at hand.

Coaching: Coaching means helping someone into the discussions, or into expressing their feelings. Also, in the early part of the course, the lecture text often suggests that you get a discussion rolling by giving a brief example of your own.

Squeaky Wheel: The first step in handling someone monopolizing the discussions is to acknowledge and respond to what they are saying. Often people talk too much because no one will recognize the validity of their point of wheel. So try “oiling” the squeaky wheel: “I can see why you would feel that way; I think you are dealing with a very frustrating issue.” Then take a step to shift attention to others in the class. You can do this by saying, “Let’s see what other members of the group think about that,” or more pointedly, “We need to get on with the agenda for tonight, but let’s talk together about your situation during the break (at the end of class, etc.)” Another way to handle someone continually “taking over” discussion is to establish a group rule that no one talks twice until each person has commented once.

If someone is disrupting the class to the point where everyone is getting miserable, talk to that person privately and tell them they must stop. The NAMI program is for everyone there, equally, and no one person can be permitted to ruin it for others. Here we are modeling basic principle of the course: We do not allow the most disruptive person in our midst to dominate the scene and rob us of life’s good experiences.

4. Handling “hot potatoes”

In a group setting where we talk openly about family trauma, people are bound to get emotionally upset, particularly around “hot potato” topics such as cutting, suicide, violence, involuntary commitment, and loss. There is an absolutely ironclad rule to follow when this happens: Do not avoid these reactions; get people’s feelings out in the open. This is how to handle “hot potatoes” as a group process:

1. First the leader ‘owns’ the hot potato:_“I have always feared that my child might try suicide”; I am more scared of possible violence than anything else”, “Doing an involuntary commitment made me feel terribly guilty,” etc.

2. Then the Leader tunes the whole group in to the subject, asking for a show of hands: “How many people have worried about this?” “How many here have felt terrified by possible violence, suicide, etc.?” In this way the “hot potato” becomes the group experience. The family member in trauma is validated, and everyone in the group gives permission to talk about “the untalkable.” With this kind of safety in numbers, members of the group can now share feelings freely, and so can the person who is upset. Let the group talk together and “air” the subject.

3. After the group discussion, go back to the “Emotional Stages” chart, Stage 1: Tell them everyone of us has experienced the fear and dread of this stage; it comes with the territory. Say that it’s really hard to deal with these frightening aspects of mental illness, but we cope better if we get our fears and concerns out into the open.

4. Finally make the point that family members in the group are heroes and heroines of courage and determination to get through traumatic events like these.

What we are modeling in this group process is very important. We don’t sweep “hot potatoes” under the rug, and we are very forthright in dealing with families’ emotional reactions to them.

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