Group Sessions

This material is adapted from an excellent resource pack, Women, Food & Health, resource pack for working with groups, South Manchester Nutrition & Dietetic Service, 1992.

Copies are available from The Resources Library, Lynfield Mount, for those working in the Bradford District. For more details of the pack click here.

Points to consider:

1) Setting up the group

• Use an established group
• Advertising - very clear - venue & timing
• Recruitment - selected from practice population, e.g. CHD risk, Diabetic

or self selection via advertising - posters and fliers and recommendations from GP's and other practice team members.

NB: Getting this right is really important. There is no point in going to lots of trouble planning programmes of activities if no-one turns up.

2) Timing

Depending on target group, e.g. older people - during the day, mothers - morning or early pm (so have time to pick children up from school), working people - evenings.

3) Venue

• Accessible to all - disabled access toilets
• Temperature - can you control it?
• Size - big group/small room, small group/big room
• Is it near public transport?
• Are refreshments available - tea/coffee/water and small snack (fruit not biscuits)
• Comfort
• Electric points
• Space for activities

4) Communication

Are all participants able to understand what is being said? Do you need:-

• Interpreter
• Signer
• Written information in Braille

* Information for deaf or hard of hearing and people who are partially sighted.

Creating a Supportive Atmosphere

• Greeting everyone personally and showing an interest in them
• Provide comfortable chairs
• Arrange in a circle
• Ensure room is private and you won't be interrupted
• Allow time in the first session for the people to get to know each other
• Time for an informal chat over a drink
• Small group work or work in pairs
• Consider ice breakers - try to make them as non-threatening as possible and appropriate for the group

Three ideas for ice breakers

• Participants asked to write their name on a large piece of paper in the form of a crossword and say a bit about their name. Start with the group leader.

E.g.

     S

     URGEN

     S

  SARAH

     N  R

          TOM

          H

          U

          RAZWANA

• Ask the first person to make a noise then the second to repeat it and make one of their own, the third to repeat the first and second and add one of their own. The group leader to go last and repeat all the noises and one of their own. This can be very funny. Can try animal noises. Difficult if the group is large.
• Ask people in groups to draw a coat of arms describing in pictures things about themselves and their lives, e.g. work, hobbies, where they come from, interests, families. Need flipchart paper and pens.

Some suggestions for making sessions accessible to people who are deaf or hard of hearing

Hearing problems are common, particularly in older people. You may therefore wish to consider the following with all groups that you work with.

• Choose a venue that has an induction loop system installed
• Use a room that is small, although not too cramped. Large rooms do not assist in communication
• Follow these rules when communicating:-
  • always face the person/people who have a hearing difficulty
  • speak clearly and not too quickly
  • do not shout, as this distorts the shape of your mouth
  • use clear lip movements
  • have good eye contact. Use facial and bodily expressions and movements to help illustrate what you are talking about
  • do not mask your face with your hands
  • do not stand against a bright window
  • make sure that there is enough light. Face the light
  • do not use jargon
  • have a paper and pen to hand, for writing down names of places and people that are not easily lip read or expressed by gestures.
• If appropriate, have a helper who can use sign language or learn sign language yourself
• Make introductions and set ground rules. This may help to get over initial feelings of isolation
• Keep a logical order to each session. This will make things easier to follow
• Ask everyone to speak clearly and not too quickly
• Avoid large group discussions as they are difficult to follow. Smaller groups or pair work may be preferable with ideas being written down, e.g. on a flipchart
• Handouts prior to the session are very useful. They enable the person with a hearing difficulty to take a full part in the discussion
• Support verbal information with handouts and/or visual aids whenever possible
• Make full use of a variety of visual aids, e.g. flipchart, and represent information with physical objects, e.g. food items
• Ask individuals how best they can be contacted in case of emergencies, e.g. if you are not able to get to the course. It may not be appropriate to use the telephone
• If you do not understand what a deaf person is saying to you, ask them patiently to repeat it, as many times as is necessary.

For information on various signing methods/aids/equipment for people with a hearing impairment contact:-

The Royal National Institute for the Deaf (North of England Regional Office), 30 Broad Street, Salford, M6 5BY. Tel. 061 745 7875 or The Royal National Institute for the Deaf (Head Office), Tel. 071 387 8033 - for details of your Regional Office.

Some suggestions for making sessions accessible to people who are blind or partially sighted.

• Thoroughly familiarise newcomers with their new surroundings
• Try to have a consistent layout for the room you are using. Ensure that the floor space is clear of obstructions
• Ensure that the room has appropriate lighting. Too much light is a problem for partially sighted people
• Make introductions, set ground rules and ask people to sit in the same places each week
• When a person speaks or makes a contribution to the discussion, ask them to say their name first so that the blind person knows who is speaking
• Good verbal communication is essential. Always read out written information on handouts, flipcharts, etc.
• Avoid glare and bright light. Do not stand in front of bright windows
• Any visual display material is best on matt coloured paper which does not reflect the light
• Use bold lettering and good spacing for any written information
• Make full use of other senses such as touch, taste and smell, e.g. by representing information with physical objects such as food items
• It may be appropriate to have the information from the sessions put onto audio cassette or into Braille. Local agencies will often do this for you free of charge - check with your local library.

For information on various communications methods/aids/equipment for people with a visual impairment contact:-

The Royal National Institute for the Blind

Tel. 071 388 1266

Always consult individual people about their own individual needs

Preparation

Think about your aims and objectives and what you would like your outcomes to be - would weight maintenance or change to a healthy diet be a positive outcome?

Write this down it is worth coming back to.

• Remember your scales if you have decided to weigh people. This has to be a personal choice and no-one should be pressurised into being weighed or sharing their weight with other group members.
• Number of sessions - negotiate with the group but have an idea yourself.
• Some ideas for how the programme should run and ideas for activities.
• Use of lesson plans can be helpful but be prepared to abandon them completely.

Examples of possible Group Structures

1) Weekly health and slimming group - discuss weight reduction, offers individual advice and support.

2) Run a programme of, for example, 6 sessions on food health and well being - could invite speakers/health professionals to provide sessions on diet/exercise, e.g. dietitian, fitness instructor, walking group leader, Tai Chi instructor.

3) Slimming club and evening health club where clients can self refer and attend as frequently as necessary. Could also offer exercise advice and support.

4) Lifestyle changes clinic, e.g. 8 week cycles and cover various topics on diet and exercise.

Example Plans of Group Sessions

6 week plan

1. Introduction - welcome, outline course content, ground rules, health benefits
2. Healthy Eating (1) - food facts and fallacies, ideas for healthy eating
3. Exercise - benefits, details of local facilities, BEEP
4. Healthy Eating (2) - changes made so far, problems, gaining control of eating
5. Psychological issues - food and mood, comfort eating
6. Review and evaluation - share achievements, changes made, future plans.

8 week plan

1. Food quiz and taste challenge - goal setting
2. Food portion sizes and fat content - balance of good health
3. Motivation, benefits of a healthier lifestyle - cycle of change
4. Exercise and activity
5. Food labelling and store tours - tour of a local supermarket to discuss suitable food choices
6. Planning and preparing meals - recipe ideas
7. Eating out - alternatives, advice
8. Review - share ideas, triggers for eating

This is an example of a 10 week plan:-

A final evaluation is included but a weekly one is not and will need to be devised or not included as you wish.

Plans

1. Getting Started - Introductory Session

2. Healthy Eating

3. Food, Weight and Health

4. Positive Thinking and Self Control

5. Gaining Control Of Your Eating

6. Comfort and Compulsive Eating

7. Self Esteem, Self Confidence and How To Make The Most Of Yourself

8. Cost Of Food and Other Economic Factors

9. Cooking Recipe and Meal Ideas

10. Going onto Other Things - Final Session