What to Expect from Groups
by Anne Coscarelli, Ph.D.
Every group, Center, hospital, or organization will have their own group guidelines. I have generated some information about our Center's approach which may be helpful.
Learning in a Group
When dealing with an unexpected illness, most people do not have prior experience to tell them how to handle the new and sometimes difficult situations. In other situations in life, people receive training or education when they need to know how to do something new or different.
Our groups are designed to help with this unfamiliar territory. Through a group, patients and family members will have the opportunity to learn new skills, gather information and resources, and share experiences so they are better prepared for the challenges ahead.
Groups can help reduce the isolation and help individuals to realize that they are not alone in their experiences.
Research has taught us that patients can benefit in a variety of ways by learning about their illness or by learning techniques to help them cope more effectively with the illness or effects caused by its treatments.
A group situation provides an optimal situation for learning. It allows the delivery of important information to more than one person.
A group setting also allows individuals to pool their experiences and to learn from each other.
There are different kinds of group experiences.
Some groups focus on the delivery of information and function more like a classroom situation. There are usually some opportunities to share experiences, but it is not the primary purpose of the group. However, patients can often provide and receive support in these types of groups.
Some groups are more experiential and help develop healing through these experiences. Specific skills are often taught that may lead to better management of stressful situations, improved fitness and well-being or the processing the experience through the act of making something.
Other types of groups are more focused on individuals sharing their own experiences and using the group to talk through these experiences. Traditionally, this has been the type of group that most people think of when they imagine a “support group.”
Sometimes people are concerned about participating in a group because they think it makes them seem weak or not able to handle their own situation. These kinds of thoughts are not helpful because they may keep someone from utilizing valuable resources. Participating in a group does not mean that a person is deficient in some way.
Participating in a group is a way for an individual to utilize and benefit from the resources of others. It is also an opportunity to share personal experiences and lessons that have been learned along the way thereby helping others.
Participants will receive the maximum benefit from the groups if they make a commitment to attend every session if it is a time limited group or regularly if it is an ongoing group.
Since this may be a first group experience, we would like to share some guidelines that apply to almost any group whether it is like a class or more like a support group.
Sharing and Support
Significant learning can take place by sharing experiences and discussing them. It is best if group members remember to share their own experiences and when others offer their experiences to provide support. Support does not necessarily translate to giving advice.
It is important that every group member feel comfortable sharing experiences and offering support. No one individual experience is more important than another.
To feel comfortable in sharing, we need to create a supportive environment. At first this will be the group leader’s responsibility and, over time the participants’ responsibility as well.
People are more likely to feel that the environment is safe when others listen to them, show that they understand, avoid making negative remarks or judgments and feel cared about by other members of the group. It is everyone’s responsibility to behave in a way that fosters care and support.
Problem Solving and Brainstorming
An important aspect of learning will be sharing some experiences that are problematic. An individual may share a particular situation that he/she is having difficulty managing.
Everyone can participate in finding solutions for a problematic situation or share how they may have handled similar situations.
Often, when people are stumped by impossible situations, a technique called brainstorming is used.
Brainstorming is when everybody suggests as many solutions as possible without any concern of how practical they are or how ridiculous they might sound.
All of the ideas are written down and then the group begins to review which of the ideas might work.
This process often unblocks the individual’s problem-solving abilities and can offer a key to a locked door.
It is also important to keep in mind that a solution that has worked for one person may not work for someone else and individuals need to be able to select what feels right to them.
When and How Much to Talk
There are no set rules about how much any one person should talk in a group situation.
We want to encourage participation, however, we want to make certain that everyone has equal opportunities to talk. It is important for group member to self-monitor and notice whether they are using up more time than others do. While some situations may require more attention such as changes in disease status or times when decisions about care need to be made, overall, there should be a fair division of time among the members.
Participants who are concerned that they are talking too much can ask the group members for feedback.
In groups where information is being presented feel free to ask questions whenever clarification is needed. In more open-ended groups, any time is the right time to talk as long as another participant is not interrupted.
At times group members may give advice or make suggestions to each other, sharing ways that they have handled a particular situation. Keep in mind, however, that advice giving is not the primary purpose of most groups.
Giving feedback is a skill, but it is often something that most people do not think about. There are a variety of ways to give feedback, and some are better than others.
It is important to think about the impact that advice/suggestions will have on others before offering it. Evaluate personal experiences and determine what has been helpful and what has not been helpful.
Getting Off The Track
Sometimes discussions will get off the track.
If a participant thinks this is happening, then he/she should feel free to speak up.
The group leader will try to keep things on track. When it does get off track, the group facilitator may call “time out” or give a hand signal to stop one discussion and move the group on to something else.
Benefiting From A Group Experience
The individuals who will be most likely to benefit from the group experience are those who actively participate. This includes active listening, asking questions when information is not clear, and participating in the exercises and discussions. It also means completing homework if this is part of the group.
The group sessions sometimes provide opportunities to practice. However, like learning to play tennis, the real test of learning new approaches comes only with practice in real situations.
If a group member has difficulty with an assignment, bring these difficulties to the group and let the collective experience of the group and leader assist.
Depending on the type of group, benefits from the group can be maximized if members think in advance about the challenges that they are facing and want help resolving. These problems can be brought to the group. Generally, the group will help develop alternative effective responses to difficult situations. It is then up to the participant to decide which responses to try and then work on implementing them.
Most people feel that when they discuss issues with their doctor, psychologist or social worker, they are confiding in them. They trust that what they say will not be repeated to others without permission. Confidentiality is expected.
Group participants should be able to rely upon the members of the group in the same way, expecting confidentiality.
In a group situation this means that group members will not disclose the names of other people in the group, information about their diagnoses, or any other personal information. If there is a need to share something that was particularly meaningful with someone, e.g., a partner or family member, be sure to disguise the information in such a way that the identity of the person is not revealed.
If everyone subscribes to this agreement of confidentiality, it will encourage a feeling of honesty and trust. This becomes especially important for individuals who have a public name. Cancer affects people of all shapes, sizes and notoriety, and all these different types of people should have the opportunity to participate in groups without fear that their personal experiences will be made public.
The Center will not provide lists of names and phone numbers to group members. However, if members wish to exchange telephone numbers, they are welcome to do so. The group leader will reproduce any list that is generated by the group.
When joining a group, a participant is making a commitment to be there for themselves and for others in the group. Regular attendance within the constraints of cancer therapy is important.
If a group member is unable to attend a group, it is important that he/she contact the Center so we can notify the facilitator of the absence and the reason for it. This demonstrates commitment to the group and reassures group members who might be concerned.
If a group participant misses three or more sessions without informing the Center, they need to contact the Center to determine whether the group is still appropriate. Participants who miss these sessions will be dropped from the group roster until they have made a telephone call or come to the Center for a personal appointment with a clinician overseeing group enrollment. For time-limited groups, participants should consult the Center if there are more than two absences.
Transitioning In and Out of Groups
Groups and group membership will change from time to time. Group members will come and group members will leave. This is most relevant in ongoing groups, but it affects all groups in various ways.
Joining a group or leaving a group is a time of transition for the individual and the group. This is a natural process and it often helps to have rituals associated with these transitions.
In some situations, the changes created by cancer may make a group no longer appropriate for a member. Transitions are necessary to better meet the needs of the individual and to preserve the intent of the group for other group members as well.
Transitions can be hard when people become highly connected to others in their groups. It is important to acknowledge these relationships.
The common types of situations that may require transitions include:
Transitions will sometimes involve individuals completely leaving groups or it may result in them moving from one group to another.
Transitions may occur because a group member initiates them or because the facilitator or Center recommends the transition.
Although each group may establish specific guidelines for transitions, we recommend the following:
Group Facilitators and Communication
Groups are led by a variety of different facilitators and their relationship with the Center varies. Because some facilitators maintain private practices outside of the Center, they are not available on a regular basis for individual consultation or information.
Communication with facilitators should be directed through the Center.
Questions about enrollment in the group should be directed to the Center, not the individual facilitator unless otherwise directed.
To inquire about enrollment in our groups, please contact the Center
by phone at (310) 794-6644 or by email.
We wish you well in your group experiences. If you have any questions about these guidelines, please discuss them with a member of our staff.