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Section 2. Creating and Facilitating Peer Support Groups

Example 1: Interview with the facilitator of a grief recovery support group

David Hallenbeck, along with assistant Bill Hazelitt, facilitates a grief recovery support group sponsored by Rumsey-Yost Funeral Home in Lawrence, Kansas. The support group is offered as a free public service to the community.

CTB: Can you tell me a little bit about your support group?

Hallenbeck: We started it back in 1989, and we have two sessions a year. The fall session starts in September and goes through January, and the spring session starts in February and goes through May.

CTB: So is it a closed group with people who go through for the entire period, or can people join at any point during it?

Hallenbeck: Well, there's a certain point - probably about six or seven weeks into it - where I close the group to any newcomers, because we've traveled far enough along by then as far as confidentiality and trust and things like that.

CTB: Aside from the newspaper ad, what ways do you use to recruit people?

Hallenbeck: Well, it has grown quite a bit just by word of mouth and different doctors and people referring people to us. We do some radio advertising, and there 's just a lot of communication between families we work with at the funeral home and other funeral homes in the surrounding counties.

CTB: Right... most of the research I've been doing has all said that word of mouth seems to be the best way to let people know about this kind of thing.

Hallenbeck: Well, we have a kind of first hand referral process. Someone has been through it, then that person will go home or he'll go back to work and tell people what it did for him. It just gets strong referral.

CTB: How many years have you guys been doing the support group?

Hallenbeck: Well, this fall, this coming fall it will be ten years. We've had, I think, somewhere around 120 people go through the program.

CTB: Wow. How many people are in the group each time?

Hallenbeck: Group size has ranged anywhere from six or seven up to eighteen.

CTB: How does a typical meeting go? How do you start off and how do you wrap it up?

Hallenbeck: We just basically start by just reviewing the week and seeing how everyone's week has been. Our support group is not one that just comes back and rehashes the same horror stories week after week. There is a different reading assignment or writing assignment that all the participants are expected to do. So each week it's a different aspect or different phase of working through the grief.

CTB: Have you ever had to deal with re-directing people in the group who might be a lot more talkative than the others, or off topic? What are some ways you do that?

Hallenbeck: Well, if somebody just habitually comes in just trying to monopolize the whole conversation, then usually I will meet one-on-one with them and just talk about that. And if they're not comfortable with letting other people share in the conversation, then I might suggest that we just go through the same steps one-on -one together, or I might refer them to some other community resource. Support groups aren't for everybody. It just takes a lot of dedication and perseverance to get you motivated to even get to the meeting to begin with.

CTB: Sure. What kind of folks generally end up taking part in the group? Is it usually made up of people who've had a really recent loss?

Hallenbeck: Sometimes. Some people come because of something recent and then once we get into the homework and going through the process they may realize that they were still having issues with some grief episode 20 or 30 years ago. We just want to help them go back and clean up some of that stuff.

CTB: Is there anything that you see as unique about the way this group functions?

Hallenbeck: Well, it's task oriented. We go through the Grief Recovery Handbook (The Grief Recovery Handbook: The Action Program for Moving Beyond Death Divorce, and Other Losses, by John W. James and Russell Friedman, Harper Collins). They call it an action program for moving beyond death, divorce and other losses. And so each week I always say, "Well, next week will be the toughest one yet." And they'll do it, then two weeks after that I'll say, "Next week's assignment will be the toughest one," because each week just builds on the last one. And there are a lot of other programs I've seen or been a part of or used that haven't been quite that action -filled. I like it because it has you go back and really take a look at your whole life's story, all the ups and downs, and see how that all fits together in the fabric of your life today.

CTB: What do you do at the end of the period, when you're having your last couple of meetings, to bring closure to the group?

Hallenbeck: Well, there are four main written assignments during our three or four months together. We usually just go down to Three Sisters Inn down at Baldwin and have dinner together for a celebration of the journeys we've been on. A lot of the groups from the ten years we've been doing this are still getting together on a monthly basis. They may get together for supper or just get together and visit and catch up. A number of lifelong friendships that have been established.

CTB: I think it's probably really helpful to encourage people to develop social relationships with each other outside the group, so they feel able to give each other support not only just during the meeting. Is there anything else that you would like to add?

Hallenbeck: Well, we're open to practically any age. The youngest so far have been college age, and it's ranged up to 82 years old.

Some groups seem to gel together and others - even though it's been a good experience together - you can tell it hasn't pulled together like some of the others may have. Yet no matter whether the group gelled or not, we find when they evaluate their experience in the group that it sort of becomes a mutual admiration society. The strength and perseverance people have shared with each other have really touched them all.

Example 2: Interview with the facilitator of a support group for men who have sex with men

Harley Logan is an Information Outreach Specialist with the Douglas County AIDS Project in Lawrence, Kansas. To educate the public about safer sex, he facilitates two support groups for men who have sex with men.

CTB: Can you tell me a little about the structure of the support group?

Logan: Well, this is an informal discussion group that is for men who have sex with men. We really try to use that language -"men who have sex with men" instead of "gay and bisexual men"- because we don't want to turn off anyone who doesn't identify as gay or bisexual.

At first we tried to follow a structure called the Lifeguard program which was developed in California.

[Editor's note: Lifeguard 2000 was a project founded by the L.A. Gay & Lesbian Center.]

This is a series of workshops that has been approved by the Kansas Department of Health and Environment. This is a program that Topeka was using already, so it was already approved and we just decided to go with this. Like I said, it's a series of four workshops and comes with a notebook on how to do the facilitation.

CTB: So it's got a real structure to it?

Logan: It's very structured and, on the advice of the guy who did it in Topeka, I've pretty much taken it apart and adapted it and tried to let the group determine the direction or what topic were going to talk about. There were quite a few "touchy-feely" exercises which I didn't think would work very well with people here in Kansas, so we changed those, for example. I think this group works a lot better with younger people - say, college age - than it does for people in their forties, fifties and sixties.

CTB: What sort of age range have you had in the folks that showed up?

Logan: When I started the first group here at the United Way Center, it attracted mainly guys who were in their forties and older. I'm 32 and I was probably the youngest one present. This is the same thing that happened in Topeka when they ran an advertisement for their discussion group - the people who showed were much older. And it worked out okay because it's a discussion group about topics that the older men were comfortable discussing; it's about issues around just being gay, being happy, a little bit of soul searching, self-esteem, that kind of work. Sometimes younger people aren't really in tune to that just yet.

We eventually started a second group with Q&A up on campus [KU Queers and Allies, the LesBiGayTrans student organization at the University of Kansas], inviting the guys to the discussion group. With these younger kids we end up incorporating a lot more information about safer sex, and they have a lot more basic questions about sex, unlike these guys who are older and have been having sex a lot longer. I also try to stay in the facilitator role with both groups, rather than interject my own opinion. I find the group very interesting, so I really step out of that facilitator role a lot with the older group.

CTB: Do you find that doing a certain amount of self-disclosure helps bring the conversation along?

Logan: Yes, very much so.

CTB: So how does a typical group meeting go? How do you set up? And how do you get the discussions started?

Logan: The volunteers of the organization supply us with brownies or cookies or what have you. We sit around a table, we have coffee. The discussion varies. At the last meeting I passed around some index cards and we talked about dating in the nineties and I asked a few questions - things like, "What is a date? What are some reasons you may or may not date? Does a date have to lead to a second date or to even a longer relationship? Where do you meet people?" And we wrote our answers to those out anonymously and then read the responses off the cards. After everybody answered the questions it generated tons of discussion surrounding dating issues and how is it to be a man having sex with other men, dating at this day and age.

One of the workshops for one of the groups focuses on eroticizing safer sex, so we talk a lot about condom use and the endless variety of condoms that are out there... We do talk about everything. People who are very much into any particular scene really can enlighten the rest of us about exactly what goes on - we have people in all different venues and certainly at different places in their life with safer sex. Other times we've talked about the coming out process. People are certainly at different stages in that and how it is in their workplaces and how it is with their families, that kind of thing.

CTB: So you're finding a really big range of topics that people are interested in discussing?

Logan: Yes. We try to focus on being gay, being happy, and saying yes to safer sex, because I try to tie it back into the safer sex issue. A man who feels good about himself and is okay with being gay is going to take care of himself more than someone who is feeling bad about it and, for example, drinking a lot of booze before he can do anything with another man.

CTB: What is it like to handle people who really tend to dominate the discussion or who bring up irrelevant topics?

Logan: I really haven't had very many instances where that's happened. Really the biggest problem I have in the group is keeping that discussion going, trying to throw out ideas and get them talking more. We have a few moments of silence every once in a while. But as far as having to get someone back on track, I always try to validate what they have said and say, "You know, that's a very good point, " or "I hear what you're saying, but can you explain that more or relate that to the topic back at hand?" What really helped me with facilitation was when I went through the Kansas Department of Health and Environment training and Red Cross fundamentals training about how to present a topic on HIV and AIDS and how to present education to a group. That training really helped. I've learned a lot about how to ask open questions, how to repeat what they say, or to even use moments of silence to get them to speak more. So that's really helped; I've felt really fortunate that I've studied some of that.