CFIDS

There are many issues to consider when facilitating a support group meeting. And although you can't anticipate every issue that may arise, you should be aware of the following 12 positive and negative forces that affect all groups:

1. Group Size. Groups that are too large make it difficult to meet the needs of all the members and should be broken up into subgroups. Groups that are too small can create a sense of "forced intimacy."

2. Session Length. This will depend on the physical/mental ability of group members and size of the group. Enough time needs to be allowed for each member to have an opportunity to share, without allowing the session to last beyond the physical and/or mental durability of its members.

3. Setting. Take into consideration accessibility, privacy and comfort. Also consider the seating arrangement (a circle usually works best in creating a sense of cohesion).

4. Member Composition. Individual personalities, backgrounds and styles of expression need to be accommodated and worked with, even though a group may already have a sense of universality. Remain aware of who is in the group and how to best communicate with each person.

5. Level of Goodwill. Sometimes members in a group will be resistant, hostile or disruptive. It is wise to have a plan for dealing with this inevitable occurrence before it happens. It is equally important for group members to have some input in developing this plan.

6. Level of Commitment. When the level of commitment wanes, it is a sure sign that members are not getting their needs met. Evaluation on a regular basis is vital for maintaining a high sense of member satisfaction.

7. Level of Trust. Trust level in a group waxes and wanes as the group progresses. It is important to be aware of forces that can contribute to a low level of trust; fear of breach of confidentiality, fear of being criticized or judged, existence of cliques within a group, hostile group members and inadequate group leadership.

8. Members' Attitudes Toward Each Other. If a leader finds that certain members of a group simply do not care for each other and this interferes with group cohesion, meeting with those members individually may be necessary to try to resolve the problem.

9. Members' Attitudes Toward the Leader. The leader must be open to the fact that he/she may not be appropriate for the group; regular evaluation and feedback from the group members is vital.

10. Leader's Attitude Toward Members. The leader must also be aware of any biases or prejudices he/she may have toward certain group members or general populations. Members need to speak up if they perceive a bias or prejudice the leader may not recognize.

11. Interaction Patterns of Members and Leader. The group should try to speak to other members of the group as well as to the leader. The leader needs to remain aware of his/her level of interaction so he/she does not dominate the group.

12. Stage of Group. Groups are made of living people who grow and change, and as such groups are living, developing and dynamic as well. Groups go through different growth stages and issues or concerns need to be taken in the context of the developmental stage of the group.

Let's just forget it. Nothing ever happens anyway. We plan and plan and all our efforts go unnoticed. It's useless, so why bother. We're all sick and nobody can really do anything worthwhile. So let's just forget it.

Negative group members are often chronic complainers, seeing not only the worst-case scenarios in their own lives, but often in the group as well. Their disagreeable and complaining behaviors run counter to the vital group dynamics of cohesion and safety.

This is not saying that occasional negative attitudes are not permitted. Living with a chronic illness, fear and chronic pain are all valid reasons for a person to feel discouraged at times.

The real problem is the chronically negative attitude and how contagious it can be: if it is not dealt with rather quickly, the group can turn into a gripe session which is rarely, if ever, supportive or healing. Pessimistic members are likely to get angry with the leader or with other group members, will often gossip and break confidentiality outside of meetings, and can be hostile or abusive.

If you are in the middle of conducting a discussion group when a negative member begins to damage morale, try finding allies among the positive group members and encourage more participation from them, maintaining a constructive tone for the meeting. During this time, try to avoid eye contact with the negative member when asking questions of the group, so they do not have the opportunity to set a negative trend for the discussion.

Dealing with negative members can be difficult, but it is very important to confront the situation before it destroys the group. One strategy for addressing the issue is to have a leader (if there is one, if not, have a designated group member) talk with the troubled person outside the group and try to determine circumstances that may be causing the adversity.

If the person is so unhappy coming to the group, why are they still coming? What would help this person to be more positive? Sometimes people simply want the attention of the group or leader but are afraid to ask for it directly, so they act out unfavorably. Sometimes they feel (or are afraid of being) left out or that they are of little value to the group. It the person is offered a chance to participate in a productive or positive way, they may respond favorably.

It is generally not a good idea to confront the negative member directly in front of the group. This could very easily escalate into an argument or give the individual even more to complain about.

Try not to spend too much time focusing on a negative member, which can cause feelings of resentment and alienation in other members of the group. Sometimes there is no other alternative than to ask a chronically negative member to leave the group. But keep in mind that a person's adversity is just a symptom of some unexpressed feeling.

So long as drawing this person out does not consume most of the group time, it is perfectly appropriate to try to let him/her know that the group cares about how miserable they appear to be. Attempt to reassure the individual that the group is concerned and interested in seeing this attitude resolved, so that meetings can be productive and healing for everyone involved.

SHARING THE LOAD
by Barbara Ponter excerpted from the article "Sharing the Load: A Few Ideas for Recruiting Members for Group Tasks" New Jersey Self-Help Clearinghouse

You know you can't do everything, and you also know that in a "mutual help" group you shouldn't. Other members must become involved. Here are a few examples to help you enlist other participants:

1. Identify and name the jobs that need to be done. Consider "brainstorming" at one of your meetings. Come up with a list of the jobs and be as clear as possible as to what will be involved. Circulate a sign-up sheet at meetings.

2. Ask potential volunteers individually in private. Be sure to indicate how you will support them if they have a problem.

3. Ask them to serve in a specific job BUT allow them to volunteer for something else as well.

4. Always specify how long they will be expected to serve, for example: three months, six months, etc. Consider a fixed term of one or two years for some jobs.

5. If you encounter problems in finding one individual to do a specific job, ask two people to volunteer to share the responsibility of that job. More people will accept if they know they won't be expected to do everything.

6. Be sure to continuously acknowledge people publicly for the jobs/tasks accomplished. This can be done at meetings, as well as through the group's newsletter.

7. Circulate or hand out skills/resources sheets. Every member is asked to complete a sheet with their name and skills description, type of personal contacts (journalist in the family, uncle is a caterer, etc.) and phone number.

Eventually you will have a list of names, skills and resources to match up with your jobs. It may be a helpful list to check for a replacement if someone suddenly becomes ill or leaves the group. The skills category may provide new and exciting positions, example: if someone just writes "gives great parties," sign them up to be the social chairperson! Remember, it is never too late to start a sign-up sheet. Identify the helpers now!

Tap the experience and contacts of your group members because a member’s personal knowledge of a speaker is usually a good reference. Also, a potential speaker may be more likely to respond to someone he/she knows personally. Does someone in your group know of a local professional, e.g., a physician, therapist, lawyer, or another who is knowledgeable and can be approached?
Contact local social service and government agencies and hospitals (sometimes they already have lists of possible speakers – contact public/community relations departments). If you know what you want, start at the top by writing a letter to the Director or C.E.O.
Local colleges and universities – write/call the chairperson of a specific department related to your group’s interest, for example, the Psychology Department for speakers to address stress, the Nursing Department for self-care instruction, etc.
Government agencies – Social Security Administration, Division of Vocational Rehabilitation, etc.
Lawyers – especially those specializing in discrimination law, financial planning, insurance, and disability law.
Professional associations - (for psychologists, social workers, nurses, doctors, county medical society, others) to ask for local speakers on subjects such as: stress management, a specific type of therapy, medications, choosing a good therapist/doctor, etc.
Alternative health providers – on herbal medicine, meditation, yoga, or another. (Use caution when exploring this option for minimizing risk to group members.)
Pharmaceutical company representatives - (a panel with several representatives will offer a more well-rounded presentation), or a local pharmacist on drug interactions and taking medicines wisely.
Representatives from other CFIDS support groups, to speak about their group’s best meetings, discussions, speakers, and other successful activities they have had.
Consider using a pre-recorded or “canned speaker,” i.e., tape of radio interview show (25 minutes long or less), conference presentation, portion of a TV program, etc. Or start a tape library of your own, by asking some of your “live guests” if you may tape their presentation for your group’s lending library collection.

Reference: “Finding Guest Speakers for your Group”; American Self-Help Clearinghouse,Denville,NJ.