Whole Health Facilitated Groups “Taking Charge of My Life and Health” (Location) (dates)

Welcome Back – Day 2! Check-in, review Day 1 and overview of Day 2. PULSE CHECKS??

Module 10 – Skill Building Practice: Mindful Awareness

Facilitator leads participants through mindful awareness practice

This is Water https://www.youtube.com/watch?v=fGCo_wx97mo This is Water video Out of presence and other focused listening comes effective reflection and inquiry. Show David Foster Wallace’s Video-commencement speech, This is Water 3

Module 11 – Skill Building: Reflection and Inquiry Day 2 Module 11 Reflection & Inquiry for WHGF

Listening is a core skill that allows us to do other skills well: Reflection Inquiry Out of presence and other focussed listening comes effective reflection and inquiry. VETERANS HEALTH ADMINISTRATION 3

Listening “People are generally better persuaded by the reasons which they have themselves discovered, than by those which have come into the mind of others.” Pascal VETERANS HEALTH ADMINISTRATION 3

Other Possible Responses Give advice Tell our story that relates Ask information questions Provide Information Ask a “leading” question Provide a judgment (“That’s Good!” “That’s not so good!”) Out of presence and other focussed listening comes effective reflection and inquiry. Note to presenter: Present these bullets as things we are NOT training you to do VETERANS HEALTH ADMINISTRATION 3

Gives participant back his/her words, thoughts, feelings Reflection Gives participant back his/her words, thoughts, feelings Lets them know you have heard them and builds rapport Allows them to hear what s/he has said, helps clarify Provides a “mirror” for participant VETERANS HEALTH ADMINISTRATION 4

Parroting and/or paraphrasing Summarizing Reflections Parroting and/or paraphrasing Summarizing Reflecting feelings and values Double-sided reflections VETERANS HEALTH ADMINISTRATION 7

Parroting It’s a statement, not a question Can be powerful Reflections Using the participants’ same words It’s a statement, not a question Can be powerful It can be powerful because we are so used to people hearing what we say and then making it about themselves, trying to give us advice or fix or change us, rather than simply reflecting back what we have said. VETERANS HEALTH ADMINISTRATION 8

Reflections Parroting Example: Participant: “I need to make some changes but I don’t know where to begin.” Facilitator: “You don’t know where to begin.” VETERANS HEALTH ADMINISTRATION 10

Reflections Parroting Example Participant: “I’m afraid to try doing things differently.” Facilitator: “You’re afraid...” Allows client to hear what they have just said. Allows for clarity and understanding. They could say “Well no I’m actually not afraid, I’m just overwhelmed at the thought of having to do things differently.” Trainers may demonstrate parroting briefly with each other. VETERANS HEALTH ADMINISTRATION 9

Paraphrasing: Restate what the participant has said using other words Reflections Paraphrasing: Restate what the participant has said using other words We often paraphrase in casual conversation. VETERANS HEALTH ADMINISTRATION 11

Paraphrasing Example: Reflections Paraphrasing Example: Participant: “It’s important for me to spend time with my family.” Facilitator: “You really value your family.” VETERANS HEALTH ADMINISTRATION 12

Paraphrasing Example: Reflections Paraphrasing Example: Participant: “I’m afraid to try doing things differently.” Facilitator: “Trying new things is not always easy for you.” Trainers may again demonstrate or elicit examples from larger group. VETERANS HEALTH ADMINISTRATION 12

Paraphrasing Example: Reflections Paraphrasing Example: Participant: “I have tried several ways to talk to my son and haven’t been successful.” Facilitator: “You’ve learned what doesn’t work for you.” VETERANS HEALTH ADMINISTRATION 13

Summarizing: Reflections Brings several key points from participant together in one statement Can be used as a transition to another person or topic. VETERANS HEALTH ADMINISTRATION 14

Reflections Summarizing From the examples: “Your family is very important, so you’ve explored different ways to relate and haven’t been successful. But you’re ready to try again because you know you need to.” VETERANS HEALTH ADMINISTRATION 15

Reflections Summarizing: “You have brought a lot of thoughts, ideas, and challenges to our conversation today. Which one is most important to address today?” Summary may be used to transition or close a discussion, and can include broader themes rather than details. VETERANS HEALTH ADMINISTRATION 16

Reflection of Feelings and Values Goes beyond what the participant has said A guess or hunch at deeper meaning, inferred value, or emotion. Adds additional or different meaning beyond what the client has just said...a guess as to what the client may have meant. May be used with eliciting values. Intuitive Hunch. VETERANS HEALTH ADMINISTRATION 16

Reflections Example: Participant: “I’m not getting the service I think I deserve...” Facilitator: “You have higher expectations of your caretakers and you’re frustrated.” VETERANS HEALTH ADMINISTRATION 12

Double-Sided Reflection Used when a participant presents two sides of an issue, ambivalence, and/or value-conflicts Intent is to explore and honor both sides, pros & cons, benefits & costs Can be helpful to illustrate physically by raising one hand, “On the one hand...” and then the other, “And on the other hand...”. VETERANS HEALTH ADMINISTRATION 16

Double-Sided Reflection Double-Sided Example: Participant: “I know exercise is important for me; and yet I just don’t seem to be able to get off the couch.” Facilitator: “On the one hand, spending some time on the couch has appeal, and on the other hand exercise is important for you. ” VETERANS HEALTH ADMINISTRATION 16

One person is the speaker for 2 minutes Reflections Practice One person is the speaker for 2 minutes The other person(s) practice reflections Switch roles after 2 minutes Speaker should pause several times in the 2 minutes to let the listener practice reflecting. Speaker should address one of the following questions:

Listening Exercise Questions – Choose only one If time or money were no issue, what would you be doing with your life? Think about one or two people who inspire you. What about them is inspiring? What parts of your current job or life activities do you enjoy most?

Inquiry or Asking Questions A foundational skill in facilitating Two main types of questions: Closed Open VETERANS HEALTH ADMINISTRATION 17

Inquiry or Asking Questions Closed-Ended questions: Elicits Yes/No or one word answers Generally, are not as effective in leading to new insight/understanding Closed-ended questions can be answered most often with yes or no. They generally do not lead to new insight or deeper understanding. VETERANS HEALTH ADMINISTRATION 18

Closed-ended questions: Inquiry Closed-ended questions: Can be useful for Transitions (Are you ready to set a goal?) Permission (May I offer you some resources?) They can however be useful at different times and situations. e.g. Asked at a transition such as “Are you ready to set a goal?” “Are you willing to say more about...?” “Are you ready to talk about another area of your health?” e.g. Can also be helpful and respectful to ask a closed-ended question before offering resources. e.g. “May I offer you some resources?” “Would it be helpful to brainstorm some ideas together?” VETERANS HEALTH ADMINISTRATION 19

Inquiry or Asking Questions Open-ended questions: Reflects curiosity for the sake of the participant’s self discovery Not easily answered with yes/no, specific piece of information or a single word Encourages participant to talk/volunteer new information Present or future focused May lead to new awareness or insight Open-ended questions reflect curiosity for the sake of the client’s self discovery and learning, versus informational questions for the sake of the coach. There is a difference between “What matters most to you?” “What’s important to you about that?” and more informational questions like, “How many children do you have?” “What is your address?” VETERANS HEALTH ADMINISTRATION 21

Open-ended questions: Inquiry Open-ended questions: What? How? Tell me more about… “Why?” questions may solicit defensiveness depending on the tone of voice. VETERANS HEALTH ADMINISTRATION 22

Open-ended questions – Examples: Inquiry Open-ended questions – Examples: What matters most to you? What do you want your health for? What brings you joy and happiness? What were your aspirations when you were younger? VETERANS HEALTH ADMINISTRATION 25

How to Ask Open-ended questions: Inquiry How to Ask Open-ended questions: Ask a succinct, clear question Pause and wait for the answer This may mean a moment of silence Do not fill the space Listen to what is said VETERANS HEALTH ADMINISTRATION 24

Inquiry Practice One person is the speaker The other person(s) listens and asks questions Switch roles after 2 minutes Use the following topic: Share a decision you have recently made, or are currently in the process of making. (One thing the listener may want to ask about are the values that are involved in this decision.) Group Practice Directions (same as previous page): 1. Have participants stand up, forming inner and outer concentric circles, allowing each participant to face a partner and experiment with other-focused listening. If everyone does not have a partner, a mentor or trainer will need to step in and participate. 2. The participants in the inner circle will begin as the Speaker while the participants on the outer circle will begin as Listener. Each speaker will have 2 minutes to answer one of the questions on the next slide. 3. The listener will simply listen (without responding, affirming, or giving advice), noticing without judgement if they listen in an other-focussed way or if they are more self-focused, aware of their own thoughts, emotions, bodily sensations, other sounds, sights, smells etc. If/when they notice they are listening in a more “self-focused” way they can simply notice this without judgement and return to focus on the speaker. 4. After 2 minutes, outer circle will move one space to their right preparing to listen to the next inner circle participant. Outer circle will listen to 3 inner circle participants total before swapping and becoming the Speaker for three inner circle participants, allowing the inner circle to practice listening. The whole exercise should take about 15 min with about 5 minutes to debrief observations of the exercise below. Debrief Experience from the perspective of what it was like to listen or be listened to in this way. VETERANS HEALTH ADMINISTRATION

Module 12 – Planning for Action and Goal Setting Stage III Day 2 Module 12 Stage III Plan for Action WHGF

Process Model for Group Facilitation Conduct PHI assessment. Stage I Explore Mission Aspirations Purpose Create vision. Explore values and value conflicts. Goals & Actions. Explore barriers. Training & Support. Accountability. Conduct PHI assessment. Define focus. Assess readiness. Stage III Plan for Action Stage II Reflect, Assess & Focus Add notes

Stage III - Goal Setting and Action Steps After determining focus: What is the goal? What are the action steps to achieve that goal?

Stage III - Definition of Goal and Action Steps Goal: What the participant plans/intends to achieve in a 2-6 month period. Action Steps: The specific actions the participant plans/intends to achieve in the next week in order to reach their goal.

Stage III - Goal-setting SMART Goals SPECIFIC MEASURABLE ACTION-ORIENTED REALISTC TIMED Refer participants to page 13 in the Participant Manual – Smart Goal Worksheet

Stage III - Goal-setting SPECIFIC What do you want to accomplish? Is it clear and concise?

Stage III - Goal-setting MEASURABLE How much? How many?

Stage III - Goal-setting ACTION-ORIENTED - Client is “doing something” - Client is in charge of the action

Stage III - Goal-setting REALISTIC - Able to reach - Has skills, resources needed or can obtain them easily enough

Stage III - Goal-setting TIMED - Timeframe for completion - Generally consider 2-6 month goals

Stage III - Goal-setting Considerations with SMART goals Is the goal really SMART? How does the goal align with vision, mission, and values? Are importance and confidence reasonably high?

Stage III - Determining Action Steps The goal is set – now what? Break down the goal in manageable (small) steps Decide actions before the next session SMART the Action Steps

Goal Setting and Action Steps SMART these examples and provide one SMART action step I want to lose weight. I want to exercise more. I want to find a new job. I want to reduce my stress. Elicit response from group. Example of weight.

Barriers/Challenges Barriers are anything internal or external that may get in the way of completing the action step. Any identified barrier should be followed by a contingency plan for dealing with the barrier when it arises.

Accountability to action: How would you like to be accountable for this step? To the Group? To self using a journal / tracking tool / mobile app / visual reminder? To a specific support person?

Arthur’s Transformation https://www.youtube.com/watch?v=qX9FSZJu448 https://www.youtube.com/watch?v=qX9FSZJu448 4.54 minutes and presenter should note that VA is not endorsing Diamond Dallas Page (DDP) but rather using video to reflect the importance of identifying realistic goals; what is realistic for one person may not be realistic for another

Activity: Smart Goal and Barriers Worksheets SMART Goal and Action Steps Worksheet Turn to page 13 in Participant Manual and complete Participants should be prepared to discuss in small group practices Barriers Worksheet Turn to page 14 in Participant Manual and complete Have participants complete the SMART Goal AND ACTION STEPS WORKSHEET on page 13 and Barriers worksheet on page 14 in the Participant Manual

Watch for discussions about: Demo #3 – Stage III Watch for discussions about: Goals setting & action steps. Explore barriers. Training & Support. Accountability Volunteers?

Module 13 – Group Management: Working with Difficult Group Dynamics Day 2 Module 13 a Working with Difficult Group Dynamics for WHGF

Principles to Consider Design Community Agreements before the group begins. Examples include: Respect one another Balance the time you speak with time others speak Bottom line Stay on Task No advice giving (without permission)

Principles to Consider Let the Group Know how you will address these issues if they come up Solicit from them how they would like to handle these situations

Addressing Difficult Group Dynamics Start with a broad request Remind them of Community Agreements Begin to hone your request if necessary Make a specific request of a group member Acknowledge their input and contribution Consider making a request outside the group

Addressing Difficult Group Dynamics Avoid Escalation of the situation Acknowledge strong feelings by simply reflecting Avoid telling the person how they should be, feel. There are no ‘sure cures’ to these dynamics Note to presenter: If time permits, ask participants about difficult group situations they have experienced and their ideas for handling these difficult situations

Module 14 – Trainee Practice Set-up

Practice Session #1

Homework – Action Steps Toward Goal