2018 HANS KAI FACILITATOR RESOURCES
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HANS KAI 4 Trans FACILITATOR MANUAL
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Section One ................................................................................................................................................................................. 1 Introduction ................................................................................................................................................................................ 1 We are a Treaty People So, you are starting a group!
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Section Two ................................................................................................................................................................................. 7 Facilitation and Presentation ....................................................................................................................................................... 7 Workshop Objectives 1: Process vs. Content 2: Understanding Facilitation 3: Laying the Groundwork 4: Verbal Communication Skills 5: Non-Verbal Communication Skills 6: Overcoming Nervousness 7: Hacking Hans Kai 8: Choosing Your Delivery Methods
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Section Three ............................................................................................................................................................................. 29 Tips and Tools ........................................................................................................................................................................... 29 1: Creating Fantastic Flip Charts 2: Creating Compelling PowerPoint Presentations 3: Wow ‘Em with the Whiteboard 4: Vibrant Videos and Amazing Audio 5: Pumping it Up a Notch
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Section Four Working with a group............................................................................................................................................ 40 1: Group Development Dynamics 2: Group Thinking 3: Group Decisions Creating a Short List 4: Dealing with Difficult People 5: Addressing Group Dysfunction 6: Getting a Group Back on Track
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Section Five Hans Kai Content ................................................................................................................................................... 60 1 – Indicators 2 – Security 3 – Self-Care 4 – Balance 5 – Healthcare 6 – Changes 7 – Clans
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Section One Introduction
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We are a Treaty People All Canadians, as Treaty peoples, share responsibility for establishing and maintaining mutually respectful relationships. The Truth and Reconciliation Commission states this is the basis of reconciliation. A critical part of this process involves repairing damaged trust by making apologies, providing individual and collective reparations, and following through with concrete actions that demonstrate real societal change. They stated these 10 principles as underlying the work we are called to do, and the resilience of Indigenous people shows that is possible for us to do the work that needs to be done. From “What We Have Learned”, the report of the Truth and Reconciliation Commission
1. The United Nations Declaration on the Rights of Indigenous Peoples is the framework for reconciliation at all levels and across all sectors of Canadian society. 2. First Nations, Inuit, and Métis peoples, as the original peoples of this country and as selfdetermining peoples, have Treaty, constitutional, and human rights that must be recognized and respected. 3. Reconciliation is a process of healing of relationships that requires public truth sharing, apology, and commemoration that acknowledge and redress past harms. 4. Reconciliation requires constructive action on addressing the ongoing legacies of colonialism that have had destructive impacts on Aboriginal peoples’ education, cultures and languages, health, child welfare, the administration of justice, and economic opportunities and prosperity. 5. Reconciliation must create a more equitable and inclusive society by closing the gaps in social, health, and economic outcomes that exist between Aboriginal and non-Aboriginal Canadians. 6. All Canadians, as Treaty peoples, share responsibility for establishing and maintaining mutually respectful relationships. 7. The perspectives and understandings of Aboriginal Elders and Traditional Knowledge Keepers of the ethics, concepts, and practices of reconciliation are vital to long-term reconciliation. 8. Supporting Aboriginal peoples’ cultural revitalization and integrating Indigenous knowledge systems, oral histories, laws, protocols, and connections to the land into the reconciliation process are essential. 9. Reconciliation requires political will, joint leadership, trust building, accountability, and transparency, as well as a substantial investment of resources. 10. Reconciliation requires sustained public education and dialogue, including youth engagement, about the history and legacy of residential schools, Treaties, and Aboriginal rights, as well as the historical and contemporary contributions of Aboriginal peoples to Canadian society. 1
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Kairos Blanket Exercise The KAIROS Blanket Exercise is an interactive learning experience that teaches the Indigenous rights history we’re rarely taught. Developed in response to the 1996 Report of the Royal Commission on Aboriginal Peoples—which recommended education on CanadianIndigenous history as one of the key steps to reconciliation, the Blanket Exercise covers over 500 years of history in a one and a half hour participatory workshop.
Blanket Exercise participants take on the roles of Indigenous peoples in Canada. Standing on blankets that represent the land, they walk through pre-contact, treaty-making, colonization and resistance. They are directed by facilitators representing a narrator (or narrators) and the European colonizers. Participants are drawn into the experience by reading scrolls and carrying cards which ultimately determine their outcomes. By engaging on an emotional and intellectual level, the Blanket Exercise effectively educates and increases empathy. Ideally, the exercise is followed by a debriefing session in which participants have the opportunity to discuss the experience as a group. This often takes the form of a talking circle. Terms of Use Please do your best to work in partnership with Indigenous people when delivering this workshop, paying special attention to the protocols of the traditional territory you are on. Be mindful that the Blanket Exercise may cause strong emotions and act as a potential trigger for participants, particularly those who are Indigenous (but who may not have self-identified). Please offer support during and after the workshop to ensure that the Blanket Exercise is as safe an experience as possible. See the Health Support page for more information. We encourage widespread use of the KAIROS Blanket Exercise; however, we ask that you always acknowledge KAIROS as the creator of this teaching tool, including in all promotional materials, and that you use the term “KAIROS Blanket Exercise” and the acronym “KBE.” If people want more information, please refer them to www.kairosblanketexercise.org. If you are charging participants a fee, please talk to us first. KAIROS would like to see a portion of the proceeds go towards supporting the Blanket Exercise program. In addition, we want to ensure it is not a profit-making endeavor. If your organization is interested in using the Blanket Exercise as a regular workshop or training tool, please contact us at blanketexercise@kairoscanada.org. The first step will be to negotiate a Memorandum of Understanding that outlines and clarifies expectations, roles and responsibilities.
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So, you are starting a group! Who are we? Rainbow Health Co-operative is BC's largest trans owned organization. We support individuals and families living with transition related to gender. We are a 100% volunteer not-for-profit community services co-operative incorporated in British Columbia. Our federal charitable status is pending. Our Membership is open to all, but our focus is the transgender community. We assist existing groups and establish new ones through the Hans Kai 4 Trans (HK4T) , Canada's most comprehensive gender wellness program. HK4T is part of the Hans Kai family of programs which are provided across Canada through partnership with Norwest Community Health of Winnipeg, the originators of the Hans Kai program. We help you get started Getting a group underway is a lot of work. Deciding on a format; developing materials, inviting guests, promoting your event, everything together adds up to a big list, especially for a volunteer. We help by sitting in as one of your co-hosts while your group gets settled in. We help with the scheduling, promotion and registration of the group. We post meeting information in one of our regional Meet-up Pages, list your meeting on the XQQ calendar and register your group into the various directories where people search for support including 211BC. There will always be a time when you have a conflict in your schedule and need someone to step in and host when you can’t. Your co-facilitator can be the most important member of your group. How you divide up duties is between the two of you, but the co-facilitator often takes care of the business side of the meeting; helping with promotion, getting the notices out, attending the monthly meeting for facilitators and the simple things like opening and closing the space. Help build group continuity. It takes a lot to get any group going, and once you do, it is rewarding to see it keep going. Sometimes other things in life need attention and you just need someone to fill in for a while. Sometimes it is time to hand off the torch to others in the group. Whatever happens, we help you through the transition. One way we assist is by helping the groups determine its purpose, define a charter, and keep copies of what has been decided. Help make your group, sharing, safe, inclusive and self-sustaining If people wanted to go to a show, they would be at the Odeon watching Bruce Willis, not sitting in a room with others who share similar interests and challenges. It is important that each group develop its own guidelines that encourage participation from everyone. We call this a framework of robust inclusion and each group needs to develop its agreement that incorporates it as a component. We cover $10 / month in expenses, (we suggest the healthy snack), but groups need to be self-supporting for their other direct costs. Help by supporting YOU. Many people want to start groups because they themselves feel a similar need, but it is important to remember your role as facilitator is different than that of a participant. Sometimes you may need to vent yourself – and it may be due to things going on within your group. We maintain a monthly meeting where group facilitators can get together themselves and share. An ongoing support forum for group facilitators is available to you anywhere, anytime (or at least where there is internet service). We are also available for one on one ‘debriefing’ when you really need to talk something over, or brainstorm on promoting group interaction.
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Help you manage your group. After a group has met for a while – the group members can end up in a bit of a rut. They can feel like there is nothing new or of interest that motivates them to return to the next meeting. We help with this in a couple of ways – first organizing special events, mainly through our Hans Kai for Trans program, but we also provide a monthly handout that has a new icebreaker and a suggested topic for the month, usually with a group exercise. Help organize special events and resources. Sharing is an important aspect of any group – but so is developing activities that maintain group interest or attracts new members to your group. These can be part of your group’s activities or a bigger event your group can participate in. The occasional special guest is often a good motivator to get people to show up. We help you find external resources for your group.
Add content and guest speakers to your groups meeting. Groups who participate in Hans Kai for Trans can request workshops. Workshops are designed to last about 45 minutes, or about half of a regular meeting – but a group can always extend their discussion around the topic if they choose. We add new workshops proposed by our members, so enquire if there is a workshop you would like to see. We provide a monthly bulletin – The Rainbow Connector, which provides a new ice breaker and group exercise each month. It also provides the login sheet and deposit slips if needed. One of the responsibilities is for the group host to see that this is completed and returned in the postage paid envelope we provide. Help you promote your group. We maintain a master list of all groups and group members across BC. We maintain a master list of all groups on the XQQ website and include that list in the print copy which is published four times a year. We send out a weekly email that includes a link to groups and lists special events coming up. Meetup Link - We maintain a Meetup page for each region where we post all events and meetings. We post your meeting / event there. Local press / Craigslist - We maintain posting for each region where for all events and meetings. We post your meeting / event there. Facebook Page – On our Rainbow Health Coop Facebook page, we maintain a separate page for each region where we post all events and meetings. We post your meeting / event there. We share that posting through other Facebook groups and pages that are used by folks in each region. You should promote your meeting on your pages as well. XQQ.ca – XQQ is our primary communications tool for all group activities. Our strategy is to attract attention to the various support groups by maintain fresh and relevant content for the community. We would love to do a story about you or your group. We also appreciate any contribution. We divide the content up into several streams: News, (current issues of interest) Stories, (fiction, poetry, biographies), Thoughts, (Opinion blogs or single pieces), and calendar events. Help find a sponsor for your group. Some sponsors are organizations, and some are individuals. A sponsor can engage in a number of ways from being a part of the group directly to being the keepers of the group’s mission statement. Some sponsors help in other ways. We think every group is stronger if they have a sponsor, and we try and find a sponsor for your group if you don’t have one. While it never hurts to get a bit of financial support where ever you can, your sponsor should be more than that. Your sponsor should understand the purpose of your group and help you fulfill that purpose. Your sponsor should also be there when you need support and a first person to turn to if you have a matter you cannot resolve yourself, especially if it is with your co-facilitator.
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Help you find a place to meet. We share space at the YES Centre, which is at 107- 1208 Wharf Street. This location is at the base of the building, facing out on the inner harbor. Access is good by transit or car from any part of the greater Victoria area. Both spaces are fully accessible but still offer a discrete and secure way to meet. The building shares restrooms which are gendered and chair accessible. The space includes a meeting room that easily accommodates 10 to 12 people seated casually in a group or up to 25 in presentation mode. The room has a modular conference table that can be configured in several ways or moved out of the way for group seating. The YES Centre another meeting room that is a bit smaller. It is set up with a conference table suitable for 8. So, let’s get started Peer-Facilitated Groups are organized by community volunteers. Each group is asked to maintain QMUNITY’s Code of Respect. One facilitator in each group needs to participate Are You Experienced? – Celebrating Rainbows Safely. We include these training sessions in an extended session of the peer facilitator support meeting four times a year. Our Rainbow Polishing Tips are help tips for group organizers. This is also attached. Please read through it, you will find it covers many of the things you need to consider to make sure your group gets off to a good start. We fill this requirement as co-host until someone completes the training. Write the group announcement You need a group name – it should be 80 characters or less. You need a description. Let everyone know what your group is about. We try to make all our meetings open to all – and let the topics attract those who are interested. You might say something like “of special interest to trans men”. You can list the things the group will do or talk about. What is your group about? Is it a support group that socializes? Or is it a social group that provides a bit of support, but mainly gets together to do things? Is it for people in active transition or concerned about a particular area of being queer. Keep the description fairly short, less than 1,000 words but make sure the reader gets a sense of what you will be doing. Send us the Group Name and Description when you have it ready and we will get it posted. Tell people about the group We help – but it is up to you to promote the group. It is your biggest job when starting a group. Post it on Facebook, add links in blogs, tell people you know. Postering in coffee shops and similar is a bit more work but catches people you might miss otherwise. We post in all the coffee shops right around the center. We will inform other partner organizations, post on Craigslist, our website and social media pages, and include in our general press release for local media. Think about how to be self-supporting There are many ways in which people can help, and instilling an understanding of these needs in the group from the beginning is the right time. Many people have access to resources they can contribute besides their time and money. Ask them. Alcoholics anonymous has run itself for almost a century on the dollar or two each member tosses into the hat at each meeting. This seems a reasonable standard for each group to meet and it is up to you how to handle it. Our guideline is $2/month/person. Finally – Please promote membership in Rainbow Health As a co-op we depend on our members. Membership is simple to sign up for and a regular membership is $5.00 for life. We include membership cards with each monthly package, please help us promote the cooperative. There is much to be done to improve community health, and we do get better together.
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SUPPLEMENTAL RESOURCES FOR THIS TOPIC
Here are some links to online resources about creating a group statement step by step http://nonprofithub.org/wp-content/themes/nonprofithub/img/landingpages/mission/nonprofithub-missionstatement.pdf https://www.extension.iastate.edu/agdm/wholefarm/html/c5-09.html http://www.diycommitteeguide.org/article/vision-mission-and-values
CHECK IN AND ICEBREAKER Topic
What are the colours of our flag?
Where When Who Terms Check in Notices Territorial Avowal
Head Phones Time Access Count Away Check Needs Include short notices here
Parking Lots
Ask someone to share, use your own or one from suggestion box
Icebreaker
Who is like this? – an exercise to move people around
MATERIALS
Index cards for names Markers
PREPARATION
Have participants fill out their name card. Then, ask participants to stand in a circle, shoulder to shoulder. They should place their name card at their feet. Then they can take a step back. You as the facilitator should take the place in the center of the circle. Explain that there is one less place than people in the group, as you are in the middle and will be participating. You will call out a statement that applies to you, and anyone to whom that statement applies must step forward then find another place in the circle. Examples: • Who has a cat at home? Who is wearing blue?
ACTIVITY
Odd person out stands in the center and make a new statement. Repeat until everyone has changed place from where they startedThe rules: You cannot move immediately to your left or right, or back to your starting place – No kicking, biting or shoving!
Rainbow Health Co-op materials are licensed for noncommercial use through a Creative Commons 4.0 License web: rainbowhealth.coop phone: (888) 241-9992
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TODAYS TOPIC
EXAMPLE GROUP FLAG – THIRD BAND NOT YET COMPLETED
Introduction We come together to take care of each other, but with us in the room is something else we need to take care of – the group itself. A group that is properly cared for becomes selfsustaining. That’s our goal. We start with four steps – 1, Finding what we have and what we need, 2, Learning how to think together, 3, Deciding how we make decisions, 4, Deciding how we shares responsibilities. Materials Small US and Canadian Flags, Pride or trans flag 3x3 post it notes – three colours One large sheet of paper, pens, markers, tape The four images attached with this guide. PREPARATION
Draw an outline of a flag on the piece of paper or whiteboard separating it into three bands – like the French flag Hand out post it notes of each colour to each person.
Activity
Take the small Canadian flag. Get people to say the first thing they think of. Repeat for the US flag. Finish discussion by asking If this group had a flag – what would it look like? Take out the trans and pride flag. We will discuss several questions to get started in deciding what our group flag will look like. First Question- What am I bringing to the group? Write answers. Go around the circle and have each person share and put their note on the flag within one band. Second Question - What do I need from this group? Repeat the sharing and posting. You the leader go last. You post the symbols you prepared and explain each one briefly. At this point the group flag should look like the picture. Third Question – What do I want this group to do / be? Complete the flag and set stage for second exercise
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Section Two Facilitation and Presentation
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Workshop Objectives Research has consistently demonstrated that when clear goals are associated with learning, the learning occurs more easily and rapidly. With that in mind, let’s review our goals for today. By the end of this workshop, you should be able to: • • • • • • • • • • • • • • • • •
Define facilitation and identify its purpose and benefits. Clarify the role and focus of a facilitator. Differentiate between process and content in the context of a group discussion. Provide tips in choosing and preparing for facilitation. Identify a facilitator’s role when managing groups in each stage of group development Identify ways to help a group reach a consensus: from encouraging participation to choosing a solution. Provide guidelines in dealing with disruptions, dysfunctions, and difficult people in groups. Define what interventions are, when they are appropriate, and how to implement them. Perform a needs analysis and prepare an outline Select presentation delivery methods Practice verbal and non-verbal communication skills Knock down nervousness Develop and use flip charts with color Create targeted PowerPoint presentations Utilize white boarding for reinforcement Describe how video and audio enhance a presentation and list criteria for determining what types to use Enrich the learning experience with humor, questions, and discussion.
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1: Process vs. Content Facilitators are process experts; they are as interested in the “how?” as much as the “what?” To produce quality output, you must arrive at it functionally. In this module, we will discuss the difference between process and content, and which among the two should be a facilitator’s focus.
About Process Process refers to the way a discussion is happening, independent of the subject matter or issue being talked about. Basically, process talks about how a group works together. It includes how members talk to each other, how they identify and solve problems, how they make decisions, and how they handle conflict. It takes into account group dynamics, non-verbal messages, and situational elements. Process elements include: •
Meeting Flow. How does the meeting begin? How do they transition to another item in the agenda? Who keeps the ball rolling? Are there topic jumps? How does the meeting end?
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Participation. How many people contribute to the discussion? What is the quality of their contribution? Are there highs, lows, and shifts in group participation? How are silent people treated?
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Communication. How do group members communicate with one another? Is the verbal communication congruent with the non-verbal communication? Who talks with whom? Who interrupts whom?
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Roles. What roles do each member of the group play? Are these roles self-assigned or assigned by others? Are the roles productive? How do the members of the group respond to these roles?
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Power/ Influence. Who has high influence? Who can move the group into a particular action whether positive or negative? How do they exert this power? Is the group democratic, authoritarian, or permissive when it comes to discussions? Are there shifts in power/influence? Are there rivalries? Do there seem to be coalitions and alliances?
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Problem-Solving Process. Is the problem stated in clear workable terms? Does it seem clear to everyone what the issue is? How does the group arrive at solution? Is this method acceptable and fair to all members?
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Decision-Making Process. How are the best interests of all participants represented in the decision making process? Are there self-authorized decision-makers? Does the group arrive at a consensus? Is the way of deciding acceptable to all members of the group? How are people who disagree with the majority treated?
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Group Atmosphere. What is the general feeling in the group? How are feelings handled? Are they encouraged and validated? Is this group capable of care? Are there significant emotional attachments between members?
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About Content Content refers to the subject matter of a discussion: the actual words or ideas that were spoken independent of contextual variables like non-verbal cues and procedural variables. It refers mainly to the literal meaning of words and makes no reference to connotations, subtexts, and insinuations behind messages. In a meeting, content are the agenda topic, the suggestions put forward by the staff members, the solutions they arrive at. Content in a facilitated discussion should all come from the group and not the facilitator. Example: The content of the meeting may be “how to change the company’s image to that it will appeal to a younger market.” In contrast the process element in the same meeting is brainstorming to solicit as many options as possible.
A Facilitator’s Focus Which between process and content should a group facilitator attend to? Ideally, a facilitator should attend to both process and content. After all, process and content feed one another. Good meeting processes create better content; keeping to relevant content makes for a great discussion process. A productive discussion can only happen when the content is on track and the meeting flows in a functional way. However, facilitators are primarily process experts; they manage information flow and treatment. They are not encouraged to provide content input in any way. While some knowledge of a meeting’s topic can help a facilitator manage a meeting better, a facilitator should not put forward personal opinions and suggestions, or make judgments and decisions for the group. They’re also content neutral; they should never take sides in a debate. When a facilitator adds to the content of a discussion, the facilitator’s role is confused from neutral guide to biased participant or a trainer/ coach. If a content expert is needed (one whose task is to clarify technical issues in a discussion e.g. a lawyer for union issues, or an Organizational Development consultant), they can be included as participant in the group for expert reference. Here is an example of a facilitator focusing primarily on process instead of content: Imagine that a group discussion is stuck. The group can’t seem to generate a good, viable idea for their project. A content expert in this situation can provide a range of alternatives they can try--- after all he or she has specialized knowledge in this area. But a facilitator is a process expert. Instead of giving suggestions, a facilitator would seek to identify why idea generation is not proceeding well. Maybe the group is tired? Maybe the problem needs to be redefined? In these cases, a facilitator can encourage a working break to get the thinking juices flowing, or ask the group to re-define the problem to encourage a different perspective, respectively.
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Managers who fail to learn facilitation skills are getting buried. Their traditional “direct control” approach to managing just does not work when there is so much to do and so little time to do it Richard Weaver & John Farrell
2: Understanding Facilitation Groups are powerful resources in any organization. When you tap into groups, you don’t just get the best of individual members, you also get the best of group interaction. The result is a more dynamic, creative and empowered team. To get the most of groups, you need facilitation skills. In this module, we will discuss what is facilitation, what is a facilitator and when is facilitation appropriate.
What is Facilitation? Facilitation is a manner of handling group meetings in a way that takes the focus away from just one leader, and instead distributes leadership to all members of the group. There is premium on democracy, group involvement, and cooperation. The focus is not just on getting things done, but also in feeling good about it. Consultant Dave Sibbet defines facilitation as “the art of leading people through processes towards agreed-upon objectives in a manner that encourages participation, ownership, and creativity from all involved.” Facilitation is often contrasted with presentation, which is delivering information or decisions to a group. Facilitation is group-centered while presentation is leader-centered. For this reason, facilitation is incompatible with an autocratic management style. Example of the difference between facilitation and presentation: FACILITATION: “How do you think the company can solve this problem? Does anyone have any ideas?” PRESENTATION: “This is how we will solve the problem…”
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What is a Facilitator? Group-centered meetings require an individual or individuals in the case of larger groups to manage the process. This person(s) is a facilitator. A facilitator is a person who helps groups to arrive at their objective by ensuring that everyone’s contribution is heard and the processes being used are both productive and empowering to all. Facilitators work primarily through leading and blocking techniques, basically directing traffic within a group discussion. Facilitation can also involve managing group member’s emotions, defusing tensions and encouraging team cohesiveness. In some cases, facilitators help in setting and revising meeting structure, and managing conflicts. To be effective, facilitators have to be neutral to the discussion, not partial to any members, and acceptable to everyone involved. They should not take a position in any of the issues raised, nor should they advocate a solution -- or attempt to directly solve the problem. Having an objective “third party” facilitator ensures that group members would feel safe about voicing out their opinions. Knowledge of group process and an appreciation of democratic management are pre-requisites to becoming an effective facilitator. Sensitivity and keen observation skills are also non-negotiable. What about Co-Facilitators Responsibilities as Facilitators Facilitators set clear boundaries in regards to: no dating group members, no initiating contact, or accepting invitations for contact outside of the roles as facilitator. Facilitators need to be seen by participants as safe, non-partial people the members can go to if they are having problems in the group. Along with this goes creating a non-sexualized environment. These boundaries are the same for all QMUNITY volunteers, regardless of their program. These boundaries exist to protect participants
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It’s amazing what you can accomplish when it doesn’t matter who gets the credit. Anonymous
3: Laying the Groundwork A facilitated approach is not just a technique; it’s an attitude and disposition to doing things that should be shared by the whole organization. To best benefit from group facilitation, you need to set the stage for it. In this module, we will discuss choosing a facilitated approach, planning for a facilitated meeting and collecting data.
Choosing a Facilitated Approach In an earlier module, we discussed about the situations where facilitation is appropriate and situations when facilitation is not appropriate. These factors can be a guide if facilitation is the best approach to managing a meeting in your organization. If your organization has decided that facilitation is appropriate, the following are some steps you should take: •
Orient the participants about what facilitation is, and what it can do for them. If a team is new to the facilitated approach, they might find difficulty with the process. For example, individuals from a hierarchal organization might feel uneasy contributing when there are senior members in the group. In situations where there’s conflict, the group might even expect the facilitator to adjudicate the issue or at least offer an opinion. It’s important then to level everyone off with what facilitation is (and what it isn’t) before you start implementing it in your group. If there are significant reservations about changing to a facilitated approach, surface them so that they may be addressed.
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Make sure that facilitation has the administration’s support. The incentive to make the most out of a facilitated discussion can be nullified if the people who make decisions still prefer a top-down, autocratic approach. While it’s not guaranteed that ideas and proposal produced by facilitated teams will get approved, administration should at the very least communicate their openness to the team’s efforts.
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Choose the right facilitator. Facilitators can be from within the organization or a freelance professional. It is important that you pick a facilitator who is not part of the problem-context or the solution, and is generally perceived as unbiased with no conflict of interest. They must also possess the right attitude and disposition in handling people’s contribution.
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Planning for a Facilitated Meeting The following are some things you can do in preparation for a facilitated meeting: •
Set the venue. Facilitation works best if the venue is conducive to a comfortable discussion. Chairs arranged in a circle are always better than a classroom set-up, to emphasize equality among all members. Privacy is a must. If you need to use materials like flip chart paper, markers, and nametags, prepare them beforehand. It also helps to prepare not just the venue of the meeting proper, but the surrounding areas as well. It’s not unusual for facilitators to invite meeting participants to break out in smaller discussion groups, or even “take a walk” to blow off steam. As such, preparations for these activities should be made before the meeting.
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Set aside time. Facilitated meetings should not be rushed; minding the reason why it works well. The length of a facilitated meeting the agenda and the number of participants, but the recommended 30 minutes to one hour.
process is depends on duration is
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Prepare a Facilitation Plan. As a facilitator, never go blindly into a While an experienced facilitator would likely have enough skills enough it”, it always pay to be prepared.
meeting. to “wing
Make sure you know what the objective of the meeting is, expectations of the group and/or the organization from you, and the profile of your participants. Decide ahead how you are going to begin and end the meeting, and how you plan to manage the meeting itself. For this process, it helps if you research and gather relevant information beforehand (more on this later), and prepare a Facilitation Plan (see the next page). •
Make plans for documentation. To better be able to follow up, and identify process issues in a group, it always helps if a meeting is documented. Typically, groups assign a secretary to take minutes of a meeting. However, traditional minutes usually deal with just content. For best results, consider assigning a process observer: someone to document process elements in a group.
•
Prepare Psychologically. Lastly, it’s important that you take the time to prepare internally if you’re going to facilitate a meeting. Being a facilitator can be a mentally, sometimes even emotionally, demanding job. You want to make sure that you are in a relaxed frame of mind before you facilitate. Deal with personal issues that can interfere with the process, and note your biases and assumptions about the group or the subject of the meeting.
Below are samples of meeting guides provided to Hans Kai 4 Tran facilitators each month:
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Collecting Data The more information a facilitator has about the group she will be facilitating, effective he or she can be.
the more
The following are some tips in collecting data as preparation for facilitating a
meeting:
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Communicate ahead with the person who invited you to facilitate the understand what is expected from the meeting and what is expected as a facilitator. If there are presenters and content experts in the it’s also best to meet with them beforehand to ensure that you are both on the same page.
•
Ideally, you should also be able to interview or survey participants ahead of time. This can give you time to understand the dynamics of the situation, as well as establish rapport. Ask about the group’s history, their view of the meeting subject, and how the group normally accomplishes things. It also helps to know ahead if there are reservations about inviting a facilitator.
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Request documentation about the group’s previous meetings e.g. minutes or progress reports. They will give you an idea of where the group is at the moment.
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If there’s a sensitive issue involved, know as much as you can about the situation – and even the personalities involved. For instance, knowing that there’s underlying tension about a specific topic will tell you to approach it cautiously. Similarly, knowing who the participants in conflict are can guide you when dividing participants into working groups. Note though: always triangulate your information gathering method so that you don’t get just one side of the story.
•
Understand the subject matter of the meeting. While facilitators are not content experts, you must know enough about the topic to be able to track the discussion. For example, familiarize yourself with the terms and language of the group. You lose precious time by having to ask the group to explain terms to you.
meeting to from you meeting,
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Good communication is as stimulating as black coffee, and just as hard to sleep after. Anne Morrow Lindbergh
4: Verbal Communication Skills Communication skills are needed to be able to provide an excellent presentation. Without being able to verbalize your ideas and opinions there is very little chance of having a successful presentation. We will begin by looking at listening and hearing skills, asking the correct questions and finish with communicating with more power.
Listening and Hearing: They Aren’t the Same Thing Hearing is the act of perceiving sound by the ear. Assuming an individual is not hearing-impaired, hearing simply happens. Listening, however, is something that one consciously chooses to do. Listening requires concentration so that the brain processes meaning from words and sentences. Listening leads to learning. This is not always an easy task. The normal adult rate of speech is 100-150 words per minute, but the brain can think at a rate of 400-500 words per minute, leaving extra time for daydreaming, or anticipating the speaker’s or the recipient’s next words. Listening skills, however, can be learned and refined.
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Asking Questions Three types of questions are useful in a presentation; open questions, clarifying questions, and closed questions. Open Questions: Open questions stimulate thinking and discussion or responses opinions or feelings. They pass control of the conversation to the respondent. Leading open questions include: Why, what, or how. A statement such as “describe the characteristics of the car” is really an open question. Examples of open questions
including words in include:
• Describe the style of the leader of the meeting. • How do you feel when you hit a home run? Asking questions is both an art and a science. Your questions in a presentation should be: • Clear and concise, covering a single issue • Reasonable, based on what participants are expected to know • Challenging, to provoke thought • Honest and relevant, eliciting logical answers Clarifying Questions: A clarifying question helps to remove ambiguity, elicits additional detail, and guides you as you answer a question. Below are some examples:
• You said you liked apples more than oranges, why is that? • What sort of savings are you looking to achieve? Closed Questions: Closed questions usually require a one-word answer, and shut off discussion. Closed questions provide facts, allow the questioner to maintain control of the conversation, and are easy to answer. Typical leading words are: Is, can, how many, or does. Below are several examples of closed questions: • Who will lead the meeting? • Do you know how to open the emergency exit door on this aircraft? Phrasing: To evoke an answer, your question should use phrasing that is: • Clear and concise, covering a single issue • Reasonable, based on what participants are expected to know • Challenging, to provoke thought • Honest and relevant, directing participants to logical answers. Directing Questions appropriately: Should you direct your questions to individuals or to an entire group? When you direct a question to an individual, you: • Stimulate one participant to think and respond • Tap the known resources of an “expert” in the room If you choose to direct your question to the group instead, you: • • •
Stimulate the thinking of all participants Provide participants the opportunity to respond voluntarily Avoid putting any one person on the spot.
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Communicating with Power It’s been said that you have between thirty seconds and two minutes to capture your participants’ attention. It’s critical to engage people from the beginning. Voice: 38% of the message received by a listener is governed by the tone and quality of your voice. The pitch, volume, and control of your voice all make a difference in audience perception.
Characteristics
Description
Tips
Pitch
How high or low your voice is
Avoid a high-pitched sound. Speak from your stomach, the location of your diaphragm.
Volume
The loudness of your voice must be governed by your diaphragm
Speak through your diaphragm, not your throat
Quality
The color, warmth, and meaning given to your voice
Add emotion to your voice. Smile as much as possible when you are speaking
Command: Selecting a good opener is an important way to take command of an audience. Making judicious use of certain types of remarks will endear you to the audience from the moment the program starts. • A dramatic story • A reference to a current or well-known news story • A personal experience • A rhetorical question • A historical event • Adventure, either past or present. More Tips • • • • •
Did we say practice? And practice again? Smile Stand up straight and tall Rivet your participants with eye contact Dress like your audience, or one level above it.
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The most important thing in communication is hearing what isn't said. Peter F. Drucker
5: Non-Verbal Communication Skills Understanding your body language and other physical queues is very important when you are presenting material in front of an audience. Your non-verbal communication skills are just as important as your verbal skills. Combined they make up the complete communication package that you use when you are presenting your material.
Body Language Non-verbal communication is the process of communication through sending and receiving wordless messages. It is the single most powerful form of communication. Nonverbal communication cues you in to what is on another person’s mind, even more than voice or words can do. One study at UCLA found that up to 93 percent of communication effectiveness is determined by nonverbal cues. Another study indicated that the impact of a performance was determined 7 percent by the words used, 38 percent by voice quality, and 55 percent by non-verbal communication. Body language is a form of non-verbal communication involving the use of stylized gestures, postures, and physiologic signs which act as cues to other people. Humans unconsciously send and receive non-verbal signals through body language all the time. Your words represent only 7% of the message that is received. Your body language represents 55%. But your body language must match the words used. If a conflict arises between your words and your body language, your body language governs.
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Gestures Gestures are an important tool for a presenter. The challenge is make gestures support the speaking, reinforcing ideas. Below are several basic rules for the use of gestures: •
Make most gestures above the waist. (Those below the waist suggest failure, defeat, and despair.) • Hold your forearms parallel to the waist, with your elbows about 3 inches from the side. • Make your hands part of your forearm, opening them, with your fingers slightly curved. (Limp hands may indicate a lack of leadership.) • Use both hands to convey power. Gestures of direction, size, shape, description, feeling, and intensity are all effective when speaking.
The Signals You Send to Others Signals are movements used to communicate needs, desires, and feelings to others. They are a form of expressive communication. More than 75% of the signals you send to others are non-verbal. People who are excellent communicators are sensitive to the power of the emotions and thoughts communicated non-verbally through signals. Types of Non-Verbal Signals: Other than gestures already discussed, signals include: • Eye contact • Posture • Body movements. They all convey important information that isn't put into words. By paying closer attention to other people's nonverbal behaviors, you will improve your own ability to communicate nonverbally. Intervals of four to five seconds of eye contact are recommended. It is also important to use a tone of voice to reinforce the words in your presentation. For example, using an animated tone of voice emphasizes your enthusiasm for a participant’s contribution in a debrief session. As a presenter, your words should match your non-verbal behaviors. If they do not, people will tend to pay less attention to what you said, and focus instead on your nonverbal signals.
It’s Not What You Say, It’s How You Say It Tone of Voice: We are all born with a particular tone of voice. While most people are not gifted with a radio announcer’s voice, we can learn to improve our tone of voice. The idea is have your voice sound upbeat, warm, under control, and clear. Here are some tips to help you begin the process. • • • • • • • •
Make sure you are breathing from the diaphragm. Stay hydrated by drinking lots of water and avoid caffeine due to its diuretic effects Stand up tall; posture affects breathing, which affects tone. Smile; it warms up the tone of your voice. If your voice is particularly high or low, exercise the range of your voice by doing a sliding scale. Record your voice and analyze the playback. Practice speaking in a slightly lower octave. Deeper voices have more credibility than higher pitched voices. It will take getting used to pitching your voice down an octave, but it will be worth the effort. Get feedback from a colleague or family member about the tone of your voice.
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The newcompletely leader is a facilitator, not an order If I ever lost my nervousness I giver. would be frightened half to death. JohnLynde Naisbitt Paul
6: Overcoming Nervousness Nervousness is normal when giving a presentation. After all, public speaking is the top fear in the top ten lists of fears. Nervousness can strike at different points in a presentation: • At the beginning • If you feel the audience has slipped away from you • If your memory betrays you. This module will provide you with concrete strategies for overcoming presentation jitters.
Preparing Mentally Visualization is the formation of mental visual images. It is an excellent way to prepare your mind before a presentation. There are several types of visualization: •
Receptive visualization: Relax, clear your mind, sketch a vague scene, ask a question, and wait for a response. You might imagine you are on the beach, hearing and smelling the sea. You might ask, “Why can’t I relax?”, and the answer may flow into your consciousness.
•
Programmed Visualization: Create an image, giving it sight, taste, sound, and smell. Imagine a goal you want to reach, or a healing you wish to accelerate. Jane used visualization when she took up running, feeling the push of running the hills, the sweat, and the press to the finish line.
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Guided Visualization: Visualize again a scene in detail, but this time leave out important elements. Wait for your subconscious to supply missing pieces to your puzzle. Your scene could be something pleasant from the past.
The process for Effective Visualization • • • • •
Loosen your clothing, sit or lie down in a quiet place, and close your eyes softly. Scan your body, seeking tension in specific muscles. Relax those muscles as much as you can. Form mental sense impressions. Involve all your senses; sight, hearing, smell, touch and taste. Use affirmations. Repeat short, positive statements and avoid negatives such as “I am not tense”; rather, say “I am letting go of tension.” Use affirmations. Repeat short, positive statements that affirm your ability to relax now. Use present tense and positive language. As an example: o Tension flows from my body o I can relax at will. o I am in harmony with life. o Peace is within me.
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Visualize three times a day. It’s easiest if you visualize in the morning and at night while lying in bed. Soon, you will be able to visualize just about anywhere, especially before a presentation.
Physical Relaxation Techniques People who are nervous tend to breathe many short, shallow breaths in their upper chest. Breathing exercises can alleviate this. You can do most breathing exercises anywhere. Below are some exercises that will assist you in relaxing. •
Breathing Exercises: Deliberately controlling your breathing can help a person calm down. Ways to do this include: breathing through one’s nose and exhaling through one’s mouth, breathing from one’s diagram, and breathing rhythmically.
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Meditation: Meditation is a way of exercising mental discipline. Most meditation techniques involve increasing self-awareness, monitoring thoughts, and focusing. Meditation techniques include prayer, the repetition of a mantra, and relaxing movement or postures.
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Progressive Muscle Relaxation (PMR): PMR is a technique of stress management that involves mentally inducing your muscles to tense and relax. PMR usually focuses on areas of the body where tension is commonly felt, such as the head, shoulders, and chest area. It’s a way to exercise the power of the mind over the body.
•
Visualization: Visualization is the use of mental imagery to induce relaxation. Some visualization exercise involves picturing a place of serenity comfort, such as a beach or a garden. Other visualization exercises involve imagining the release of anger in a metaphorical form. An example of this kind of visualization is imagining one’s anger as a ball to be released to
and latter space.
Appearing Confident in Front of the Crowd In addition to everything we’ve discussed, below are some tips for maintaining your confidence when you’re “on”. • • • •
Get a good night’s sleep Practice your words along with your visuals Have a full “dress rehearsal” If you are traveling to a new site out of town, try to arrive early in the evening and locate the site. That way you won’t be frazzled in the morning, trying to locate the venue.
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It takes three weeks to prepare a good impromptu speech. Mark Twain
7: Hacking Hans Kai We will look at the beginning steps to follow when creating a plan to improve your Presentation Skills. The first thing to look at is to perform a Needs Analysis. This will help you to understand your audience and provide you with the answers to a few basic questions. A basic outline and some minor research would then be utilized to help create the basic program that will assist you in developing greater Presentation Skills.
Performing a Needs Analysis A needs analysis measures what skills employees have -- and what they need. It indicates how to deliver the right training at the right time. The results answer the following questions: 1. 2. 3. 4.
What is the audience with the problem or need for change? What tasks and subtasks does an expert perform to complete a work process? What gaps exist between experts, average, and poor performers of a work process? How do we translate the needs into objectives to promote a strong learning outcome?
The method can be simple; observation, careful note taking, and asking questions work. Question Methods Audience?
Interview key stakeholders and listen to their concerns about the problem. Define who needs help to overcome the problem. Identify and describe the audience and the work.
Tasks?
Observe the work being done by recognized experts. Take careful notes and ask questions where needed. Document the proper performance of the work tasks.
Gaps?
Observe other workers doing the tasks. Compare results with the performance of experts. Document identified skill gaps.
Outcome?
Develop a complete list of tasks for performing the work completely and correctly.
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Writing the Basic Outline To develop the outline, group the tasks that fit together logically, and create that reflect the goal of the subtasks. •
headings
Handling a Call
o Answer call o Listen to customer’s problem o Express empathy for the trouble o Open a new support ticket o Resolve the complaint per the list of allowable resolutions • Documenting Call Resolution o Document the resolution in the call notes o Close support ticket Add headings for an introduction and workshop objectives at the beginning -- and a wrap-up and evaluation at the end, and your basic outline is complete.
Researching, Writing, and Editing Researching: The needs analysis has likely produced much of the supporting content required to build the program. However, if information gaps exist, return to your expert performers (also termed subject matter experts) and ask questions. Writing: If you’re using a word processor, create a template so your material is consistent from the beginning. Assign a preliminary time length to each module based on the total time available for the presentation. (You’ll validate it later.) When writing, aim for brevity. The more you say, the less the audience remembers. Make sure to validate your finalized content before you move on to editing. Editing: As you edit, write for the ear, not for the eyes. Make sure sentences are words or less and only convey one thought. Use simple, familiar words. Make sure have provided the definitions of any terms important to the learning experience. Try up your module titles.
twenty that you to spice
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I never teach my pupils; I only attempt to provide the conditions in which they can learn. Albert Einstein
8: Choosing Your Delivery Methods Now it's time to determine what methods you will use to deliver your presentation. We will be beginning by covering basic delivery methods. Once we have a good foundation and grasp on the basic methods we will delve into more advanced methods.
Basic Methods Lecture: If you must lecture occasionally, use strategies to make the delivery more interactive. Discussion: A discussion facilitated by the presenter can be rich in interactivity. Small Group learning experiences: A small group experience provides direction toward specific learning goals, and provides a high degree of participant involvement. •
Dyads (Groups of 2). Using pairs provides unlimited options for simple interactive experiences. You can say, “Turn to the person on your right and…” Using dyads manages the attention span, the extent of influence, and the focus of the goal. The learning experience is relatively intimate.
•
Triads (Groups of 3). Trios expand the focus and experience opportunities. A measure of intimacy is still retained, but multiple viewpoints can be contributed. Triads are useful for producing definitions, establishing priorities, or providing an ongoing support system.
Case Study: The case study method is the presentation of detailed information about a particular situation, often problem solving. Case studies can be very creative exercises, and they are well-suited for small groups. Here are six guidelines for developing a case study: 1. 2. 3. 4. 5. 6.
Determine the principle you wish to have the case emphasize Establish a situation that demonstrates the principle Develop appropriate symptoms Develop the characters Write the case Provide questions to guide the learners as they process the case study to solve a problem.
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Advanced Methods After you feel comfortable with basic delivery methods, you can begin to explore some of the more challenging ways to present and facilitate learning experiences. Role play: Role playing allows participants to act out a behavioral role. This exercise -- done with small groups or the large group -- allows members to expand their awareness of varying points of view, and provides an experiential learning opportunity. A role play can be used in several ways; to solve a participant problem, clarify or sharpen an issue, or demonstrate a skill approach to a task. Importantly, it gives people an opportunity to practice a skill or approach in a safe environment and use the experience later on the job. Here are several tips for managing a role play exercises: •
Obtain volunteers, rather than making assignments
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Use role play later in the training session, when participants know each other better
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Select low-threat situations, such as a work group holding a staff meeting.
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Problem solving: Problem solving experiences are increasingly popular in training presentations because they allow participants to gain “real world” experience that often provides direct transfer back to the job. There are three phases to a problem solving exercise: 1. Defining the problem and generating data about it 2. Generating potential solutions 3. Selecting an implementing a solution. Below are several of the many proven methods that are available to help participants with each phase.
Phase Defining the problem and generating data about it
Generating potential solutions
Selecting and implementing a solution
Method
Description
Pareto Analysis
Vilfredo Pareto, a mathematician and economist coined the “80/20” rule. A Pareto Analysis allows you to group and analyze data for a problem such as defects in a model of kitchen faucet.
Force Field Analysis
Kurt Lewin defined driving forces and restraining forces that influence the solution to a problem.
Brainstorming
Brainstorming allows a group to generate a large volume of ideas about a problem, or potential solutions. Later, the results must be condensed to a workable number of ideas, typically through grouping, and then voted on.
The Delphi Technique
Originally used by the RAND corporation, the Delphi technique allows the anonymous generating of ideas which are then filtered.
Ranking
Participants rank options on a given scale, with or without criteria.
The Journalist’s Six Questions
Use “who, what, when, where, why and how” questions to generate data.
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Basic Criteria to Consider A training presentation may use any combination of delivery methods as long as the result is to achieve learning outcomes -- and consider organizational requirements constraints. The four-step process below will help you select the best training options to meet your training needs.
net and delivery
1. List all possible learning methodologies that could be used to achieve the objectives
session
2. Identify possible delivery options for the learning methodologies 3. Identify the organizational, presenter, facility, and resource parameters and their impact on the delivery options. 4. Recommend your delivery strategies. At a bank, the outcome of the process might look like this:
Objective
Delivery Strategy
Expansion/Notes
List the five key customer support principles at the bank
Lecture only the principles, using the flip chart or PowerPoint for emphasis, and then add interactivity
Find a lead-off story
Demonstrate a performance problem with a customer support team in a bank
Role play
Use triads
Generate ideas for improving customer support service
Brainstorming
Develop a group problem-solving exercise to provide follow-up practice
Find extra space Procure additional flip charts for groups
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Section Three Tips and Tools
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It's a visual world and people respond to visuals. Joe Sacco
1: Creating Fantastic Flip Charts Information written on flip charts enhances the learning process. During a presentation, the use of flip charts serves to inform participants, record information, and focus attention on a topic. They represent a simple, low-cost learning aid -- with no requirements for power or technology, and no worries about burned-out bulbs or darkened rooms. Flip charts add versatility to a presentation, and allow the presenter to use creativity to enhance the learning process.
Required Tools At a minimum, you will need a flip chart easel, several pads of flip chart paper, a few sets of colored markers, and masking tape for posting the results of exercises. Also handy are several packages of sticky notes to flag specific pages, and a straight edge. You may want to plan to cover up information that you will reveal at a given time during the presentation and then have some pre-cut paper available, sized appropriately for the text. If you are bringing pre-written charts to an off-site presentation, you will also need some type of container to protect the pages.
The Advantages of Pre-Writing There are many good reasons to pre-write your flip chart content. • • • Tips: • • •
Confidence: You are in control of the material for your presentation – design, organization, and appearance. This also helps reduce nervousness. Appearance: Your material has a specific “look and feel” that is not necessarily easy to achieve when prepared during a session. Time: With your charts ready ahead of the presentation, the time during a presentation is used for learning activities, not writing, which keeps your back to the participants. Always print; never use handwriting Consider using a straight edge to stem tendency to write “downhill” If you are using charts in a sequence, number them.
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Using Colors Appropriately Good use of color can make the difference in the dynamics of a presentation -- and participants’ acceptance of the content. Conversely, the effect of a great chart can suffer from the poor use of color. According to the Optical Society of America, blue, black, and green offer the greatest visibility, and blue is the most pleasing color. Avoid purple, brown, pink, and yellow for any type of general printing. The use of two or three color combinations can be very effective. Here are several rules. • Red and orange should only be used as accent colors for bullets, underlines, or arrows, or for key words when everything else is in black or blue •
Avoid orange and blue together
•
Never use yellow.
When creating your charts, take some time to think about the colors you are using, and how they can enhance the understanding of your topic.
Creating a Plan B Paper is not permanent, even if you are presenting at your own location. And if you’re flying with your materials or shipping them, packages do occasionally get lost or damaged. You will need a backup plan in case something happens. Below are some tasks for creating your Plan B. • • • • • •
Keep documents on your computer organized by course, reflecting the content and order sequence of each flip chart. Make paper handouts of the most critical information on the charts. Take pictures of the chart pages, and have the camera or images with you on site. If you have time to re-create some of your charts, enlist a volunteer to help you reconstruct the most critical ones. If you will be returning to the site, consider leaving a set of your charts with a trusted colleague until you return. As time permits, duplicate your charts in PowerPoint. Although you will probably continue to use flip charts, having them available in PowerPoint becomes a backup.
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Ask yourself, ''If I had only sixty seconds on the stage, what would I absolutely have to say to get my message across?" Jeff Dewar
2: Creating Compelling PowerPoint Presentations Microsoft PowerPoint is a commanding tool for creating visual screens for a presentation. Visuals created in PowerPoint and projected on a screen are often easier to see in a large room than information displayed on a flip chart. Using PowerPoint offers the following benefits: • Allows you to add emphasis to important concepts, helping to increase retention of information • •
Adds variety to your presentation
Makes it easier to display images, charts, or graphs possibly too complex for a flip chart.
Also, PowerPoint files can easily be shared with participants or others after the session.
Required Tools To create and use a Microsoft PowerPoint file to support your presentation outline, you will need: • •
Microsoft Office PowerPoint software for Microsoft Windows or Macintosh OS A Windows or a MAC computer equipped with the minimum hardware and software specifications for your version of PowerPoint • An LCD or DLP projector • A projection screen Optionally, you may wish to add the following to your toolkit: • • •
Storage media such as a USB memory stick or CD-R disc An extension cord A laser pointer for emphasis during the discussion of a PowerPoint slide.
Tips and Tricks Use the following suggestions to enhance the benefit of your PowerPoint presentation. Overall Appearance •
Display only one major concept on each slide
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• Use short phrases or bullet points rather than paragraphs • Limit each line of text to no more than 7-8 words • Allow only 7-8 lines of text per slide • Use images sparingly; one or two per slide • Leave a good amount of blank space in your presentation • Create a title for each slide • Use effects, transitions animation, and sound very sparingly. Fonts and Color • • • •
Use simple sans serif fonts such as Helvetica or Arial for readability Select a point size of 32 or larger for titles, and 20 points for body text Use colors that work well together, such as yellow or white on a dark blue background. Check the readability and visibility of your fonts and color choices with the lighting in the room in which you will present. Preparation • Make sure to match your slides to the purpose of the presentation • Develop a template and stick to it for a consistent look and feel Computer • • •
Check your equipment, computer settings, and room lighting in advance Before your presentation, turn off screensavers, instant messaging, and email notifications Make sure that your computer’s power management console will not automatically shut the system down after a set amount of time.
Creating a Plan B While technology allows you to make great enhancements to a presentation, it also offers more opportunities for technical trouble. Here are some suggestions to keep your presentation moving along, even if the technology isn’t. • •
• • •
Make one or more backup copies of your PowerPoint file on the computer on which you plan to show the presentation. Before the presentation, download and install the free Microsoft PowerPoint Viewer available at www.microsoft.com. In the event that your PowerPoint software won’t run, you will still be able to use the viewer to show your PowerPoint slides. Copy your PowerPoint file onto a USB Drive. That way, if you have a computer problem, you can move the file to another one, if available. Bring sufficient printed copies of your presentation for participants. If logistics prevent that, plan to have at least one copy available for photocopying on site. If all else fails, write your key points on a flip chart.
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Technology makes it possible for people to gain control over everything, except over technology. John Tudor
3: Wow ‘Em with the Whiteboard A whiteboard is the name for any glossy-surfaced writing board where non-permanent markings can be made. Unlike the predecessor chalkboard, there is no chalk dust, and markings remain longer than they would on a chalkboard. Whiteboards have been around since the 1970’s, and are now vastly improved and more affordable compared to early models. The use of a whiteboard helps to promote interactivity during a presentation.
Traditional and Electronic Whiteboards Traditional Whiteboards: Traditional whiteboards are attached to the wall, or are available in free-standing frames. Unlike pre-written flip chart paper sheets, whiteboards cannot easily be moved from site to site. However, they are usually larger, and are useful for recording the results of small group exercises or spontaneous information arising in a discussion. Traditional whiteboards cost less than $100, or up to $1,000. A traditional whiteboard requires a set of wet or dry erase whiteboard markers, a whiteboard eraser, and whiteboard cleaning solution. Electronic Whiteboards: An electronic whiteboard looks like a traditional whiteboard, but is a unique combination of hardware and software. The surface is connected to a computer and a projector. A projector beams the computer's desktop onto the board's surface, where users control the computer using a pen, finger, or other device. Uses include: •
Operating any software that is loaded onto the connected PC, including web browsers and proprietary software • Using software to electronically capture text or marks written on the whiteboard • Translating cursive writing to text • Controlling the PC. Because the markings on the whiteboard are digitized, the resulting electronic information can be stored, printed, or shared in real time with participants in other locations. Electronic whiteboards cost more than $1,000.
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Using Colors Appropriately Colors on a whiteboard are often more vivid than those on a flip chart. Otherwise, most of the same rules apply: •
Blue, black, and green offer the greatest visibility, with blue the most pleasing color.
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Avoid purple, brown, pink, and yellow for any type of general printing.
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The use of two or three color combinations can be very effective; however orange should only be used with red as an accent color. Never use yellow, and avoid orange and blue together.
Creating a Plan B Traditional Whiteboards: When using a traditional whiteboard, have extra markers on hand, because they tend to dry up easily. If your presentation is longer than one day, plan to make a backup of your work from the computer to a USB flash drive in the event that they are erased overnight. Electronic Whiteboards: If you are working with an electronic whiteboard and encounter technical issues, you can show a previously created PowerPoint presentation through a projector. Plan to carry at least one copy of the PowerPoint handouts for duplication if needed. You can always quickly jot down key points on a flip chart. Regardless of which type of whiteboard is used, key content should be available in a master or on flip chart pages as a backup.
handout
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A good video can make all the difference. Brian May
4: Vibrant Videos and Amazing Audio Audio and video are very much a part of our everyday lives, so they are accepted --and even expected media in a presentation. They are attractive options for a presentation because they provide learners with more dimensions by which to receive information. While video and audio both represent a one-way communication to participants, the opportunity to use them as part of learning exercises or in the ensuing discussions adds value to the presentation. Video There are three main ways to obtain video material: • Creating your own media using a small personal video camera • Purchasing off-the-shelf video designed for training presentations • Hiring a professional video production company. Your media budget, the amount of available preparation time, your comfort and skill level with video, and the type of presentation will all influence the direction. Audio Audio can be used as a standalone option, as part of the video, or even created by the participants, such as an exercise to write and sign a song.
Required Tools For video with audio you will need some type of player, depending upon the media type: •
A DVD-ROM or Blu-ray player if you are using a video disc •
A laptop or PC with software to play digital video
You will also need a projector and a projection screen. Speakers are optional, but recommended for more than the smallest room and group. Although today's cameras are light-sensitive, you may also need some simple lighting, such as a handyman light from a hardware store. If you want more than the onboard audio built into the camera, get a simple lavaliere or handheld microphone. Finally, especially if budget is an issue, consider using one or more personal video devices -- such as iPods with iTunes software. You'll also need a handful of inexpensive ear buds. You can pass the iPods around the room at certain times, or have participants up to view and listen to the material. While perhaps less formal than the others, this solution, is much more portable if your presentation is delivering off-site.
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Tips and Tricks Purchased Off-The-Shelf Video • Check reviews of the media online • Shop around for the best prices • Preview the work before you purchase • Test the video in conjunction with the exercise with a colleague before the presentation. Personally created video • Plan by creating a simple outline that matches your presentation content • Create a storyboard using PowerPoint, a word processor, or paper before you record • Check your equipment thoroughly • Do a practice run before your final recording. • Transfer the recording immediately to a computer for backup. Professionally produced video from a production company • • • • • • • •
Create an outline. (The storyboard may be provided by the production company.) Carefully create a request for proposal, and interview several companies Preview finished samples of each company's work Ask for a client list, and check with several of them Plan to dedicate an in-house resource person to work with the production company Manage costs through a preproduction meeting, trimming, if necessary, where it makes sense Maintain frequent two-way communication during the project If all proposals come in nearly equal, trust your instincts based on the relationships you have formed with the prospective companies
Creating a Plan B Regardless of the method you use for your audio and video, it is essential to have a backup plan in the event that something goes awry with the technology. • • • • • • •
Have one or two backup copies of your media, perhaps on a USB flash drive and a DVD Test everything before the presentation For higher-end productions, have a technician on standby if possible Record and back up the audio track separately; if the video fails you will still have the audio Create a handout with the key concepts contained in your video Capture screen shots directly from the video (if permissible by copyright) and add them to a PowerPoint file If sequence isn't an issue, and you have access to a technician later, adjust your agenda to utilize the video later in the program. If, for any reason, none of the above is feasible, consider substituting a role play between you and the selected participants. Above all, today's participants understand the “gotchas” when technology is involved, and will probably be empathetic as you carry on your presentation as if it was no big deal.
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A sense of humor is a major defense against minor troubles. Mignon McLaughlin
5: Pumping it Up a Notch Bringing it to the next level is something you can accomplish after feeling comfortable with all of the previous topics discussed. You can add the little touches that will produce a lot of value during your presentation.
Make Them Laugh a Little Humor is a popular way to liven up a presentation. It makes the audience align with you, and sends a signal that you are in charge. Handled properly, humor enriches a presentation. When considering humor, make sure that whatever content you choose meets four criteria: • You think the joke or lines are funny • You can repeat the piece confidently and comfortably • Your choice is not offensive to anyone (gender, race, age, disability, politics) • Your audience will understand and appreciate what you are saying. • A joke should have a punch line, delivered with all you’ve got. Here are some tips for collecting and using humor: • Jot down jokes as you hear them in everyday life; classify them as your collection grows • Deliver any humor verbally only, and keep things light • Match your humor to the demographics of the audience • Research and consider using local humor if you’re working off-site • Don’t be afraid to poke fun at yourself. If a joke or delivering humor with words isn't within your comfort level, consider sharing a lighthearted cartoon, doing a simple magic trick, or doing something else that is unexpected and evokes a reaction and some emotion from the participants.
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Ask Them a Question Questions can be used in many ways, and at just about any time during your presentation. • •
As an opener To check whether the desired learning is occurring, or to extend the learning experience • To diffuse a difficult or uncomfortable situation • To fill a long pause • To get a feel about the mood in the room. As we learned in module four, Verbal Communication Skills, you can use open, clarifying, or closed, questions, depending upon your needs.
Encouraging Discussion Much of the discussion during your presentation will be structured to fit with the learning exercises. If a remark or question is made during a discussion that is off topic or something that should not be dealt with at the time, you can always add it to the parking lot, and return to it during the wrap-up to bring closure. As an adjunct, the exercise below provides participants with a different method for fielding a discussion in conjunction with a learning topic.
Dealing with Questions Q&A Sessions: If time permits in your presentation, you may choose to hold a general question-and-answer session. Since as the presenter you are in control, you can decide when to stop the discussion. In a large room, be prepared to repeat each question. If no questions arise, be prepared to ask one yourself. You can use an open question to begin the session: “What questions do you have?” Restating Negative Questions: If a question is phrased negatively, restate it. For example, "Why have so many of his staff displayed chronic absenteeism?" can be restated as "Let's explore what we can do to reduce absenteeism in the team." Off-topic: Don't forget about the parking lot if you receive an off-topic question. Leveraging experience in the room: There may be situations when you wish to redirect a question to one of the participants. Again, you are in charge, so call upon someone and keep the discussion moving on afterward. The following exercise is a fun, light way to prompt a group to ask questions to tackle a project or a problem.
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Section Four Working with a group
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Every company has two organizational structures: the formal one is written on the charts; the other is the everyday relationship of the men and women in the organization. Harold H. Geneen
1: Group Development Dynamics Groups are not stagnant entities; they change. Initial uncertainty and ambiguity give way to stable patterns of interaction, while relationship between members wax and wane. To be an effective facilitator, you must be sensitive to the changes happening within groups. In this module, we will discuss one of the most widely-used theories of group development: Tuckman and Jensen’s Model of Team Development. We will also discuss how a facilitator can best respond to groups depending on what stage of development they are in.
Stage One: Forming The initial stage of group development is the forming stage. It is commonly referred to as the orientation stage or the “getting-to-know-you” stage, as group members still don’t know much about each other or about the organization. If the organization itself is new, then there might not be any existing structure or rules in the group yet. During the forming stage, members tend to feel tensions and uncertainties. After all, group members are dealing with people they hardly know, and this initial unfamiliarity may leave them feeling uncomfortable and constrained. Often, members are on guard, carefully monitoring their behavior to make certain they avoid any embarrassing lapses of social poise. Without the benefit of a long and solid relationship with the group, involvement and commitment to the organization may be low. There may also be extreme dependence on leaders, dominant personalities and other group members. The forming stage is characterized by many tentative and testing behaviors: explorations of the boundaries of both rules and tasks. During the forming stage, it is important for the facilitator to: • • • • •
Establish rapport among group members Encourage members to be comfortable with one another Make everyone feel accepted in the group Establish rules and guidelines for both task and relational behavior Encourage the group to be comfortable with the organization
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Stage Two: Storming A natural offshoot of uncertainty and ambiguity is the need to clarify expectations, establish patterns, and put a structure into place. Clarity, patterns, and structure are what make a group stable. However with many different personalities and perspectives to reconcile, these things don’t always evolve smoothly. The natural formation of sub-relationships within the group can also add to the pressure. Enter the second stage of group development: the storming stage. The storming stage of group development is characterized by conflict, whether overt fighting or subtle tensions. This happens when at least two people disagree on a way of doing things or a way of relating. Conflicts in groups also occur when particular members assert control or dominance in some form, and other members resist. Coalition-building and fractionalization of the group can happen as members take sides on an issue. The emotional atmosphere in groups during the storming stage can be characterized by tension, anger, frustration, and discounting of other people’s responses. A facilitator guiding a team in the storming stage should remember that conflict is normal, even necessary element, in group development. Conflicts are signs that there are processes that need streamlining, or issues that require a definite response. When conflicts surface within groups, facilitators can help the group see an opportunity to set a structure (which is the next stage.) During the storming stage, it is important for the facilitator to: • • • •
Defuse tensions Promote positive communication in the group Identify problems areas Facilitate conflict resolution processes
Stage Three: Norming The third stage of group development is the norming stage. If the conflict areas during the storming stage are addressed properly, the result should be the establishment of norms. Norms are rules or standards of behavior within a group. They can be explicit (such as a company policy) or implicit (unspoken expectations). Norms help groups to meet their goals. At the very least, norms help the group maintain some degree of stability so that tasks can be done. During the norming stage, group members develop greater cohesiveness and possibly intimacy. There is greater security in opening up to others and suggesting new ways of doing things. The norming stage is a period of clarity in terms of the group’s identity, dynamics, and direction. If you’re a facilitator handling a group in the norming stage, it helps to: • Practice skills in identifying possible solutions • Define roles and expectations • Manage change • Help the group to reach a consensus Evaluating new systems and protocols and making revisions if necessary are also part of the norming stage.
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Stage Four: Performing When groups are able to successfully implement a new rule or system, they can begin a period of optimum productivity. With stability in place, there is room for creativity, initiative, stability, open relationships, pride, learning and high morale. Group energy is no longer taken up by set-up matters, and can be channeled fully to the work. The group goes into the height of task success: the performing stage. The relationships among group members also become more relaxed and involved. Because the task details are already clearly defined, and there is no need for vicious power struggles, there is more room for closeness and deeper relationships among members. To get to the performing stage is the goal of all organizations. As a facilitator, your task is to guide the group towards this stage. One important thing to remember though is that optimal productivity often occurs later in a group’s life, and a period of storming and norming are pre-requisites to it. At this stage, the role of the facilitator is to help maintain the group in the performing stage. Tasks include providing support and motivation in each task, and reinforcing best practices. What happens if the group gets new members or encounters new tasks? What if a new issue comes about threatening peak performance? In these cases, the group can go back to earlier stages. For example, if new groups members make pre-existing rules obsolete, or a new conflict area is spotted, then the group returns to the storming stage to hash out a new system. It is said that in the life course of a group, it will return to the storming stage regularly. See figure in the next page. An effective facilitator can point out that that re-accomplishing developmental tasks characteristic of earlier stages (e.g. establishing rapport) may be needed to adapt to new changes. An Illustration of Tuckman and Jensen’s Stages of Team Development:
Forming
Storming
Performing
Norming
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A genuine leader is not a searcher for consensus but a molder of consensus. Martin Luther King, Jr.
2: Group Thinking The aim of facilitated discussions is to create participatory groups: one where the goal is cooperative rather than competitive decision-making. All members should have equal input in the process, and equal opportunity to voice opposition to an idea or conclusion. In this module, we will discuss the key facilitation skills needed to build consensus: encouraging participation, gathering information, presenting information, synthesizing and summarizing.
Encouraging Participation Consensus is more likely to happen if members feel encouraged to contribute. The following are some of the ways a facilitator can encourage participation in small groups: • Provide preparation guidelines in the meeting agenda. Participants are more likely to contribute, if they feel confident that they have something to add to the discussion. It’s helpful then to send out a meeting invitation with guidelines what to review and study in preparation for the meeting. It is also better if you can also send out guide questions ahead of time. •
Before starting a group meeting, check on everyone’s comfort level. Some people are at ease being in meetings; others have difficulty. There are also situational factors, such as an uncomfortable seat or a poorly ventilated room, which can hamper group participation. Inquiring if group members are comfortable before starting a meeting can help a facilitator establish rapport with the group, and address hindrances to group participation.
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State at the start of the meeting that members’ participation is not just welcome, but is integral to the process. Sometimes, all it takes is for the facilitator to explicitly say that members are allowed and encouraged to participate for the discussion to be a lively one. These guidelines can be made part of the orientation process.
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Acknowledge responses. Show that you have heard and understood a contribution. You can do this in nonverbal and verbal ways. Non-verbal ways include eye contact, nodding, and leaning forward towards the speaker. Verbal ways include praising (“I’m glad you brought that up.”, “That’s a good point.”), clarifying (If I may reiterate what you just said, you suggested that, is this correct?), and requesting for more information (“Tell us more.”, “Please go on.”).
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Avoid discounting responses. Similar, make sure that you’re careful not to give a response that might be interpreted as devaluing a contribution, or even ignoring it. Examples of discounting responses are “That was said already.” , “That’s irrelevant.” , “That’s it? Is there anything else?”
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Solicit group members’ responses. You can encourage participation by directly asking everyone their opinion on a subject matter. Example: “Can I get everyone’s opinion about this proposal?” or “Let’s share all our ideas. We won’t react until we’ve heard them all.”
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Build on responses. A good way to encourage participation is to integrate each member’s response with that of other members or with the whole group. Similarities and differences are surfaced, and the way each point relates to another is verbalized. This way, the discussion is moving and the individual contributions are seen as relevant to the whole. Ways to do this include: o
Universalizing – Helping the group see that their concerns are shared. Example: “Who else has felt this way?”
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Linking – Making verbal connections to what individual members say and feel. Example: “Bill thinks that there should be another meeting to prepare for the conference. This seems to be similar to what April was saying a while ago.” Or “Michael believes that the group should outsource all customer communication. Jonathan, on the other hand, feels that an in-house customer care staff will serve the company better. It seems we have two different but equally valid approaches to this problem.”
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Redirecting – To promote the involvement of all in the discussion. Example: “What do you think about that?” or “What do you think about Mark’s idea?”
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Intentionally keep silent. Intentional silence can also be a way to encourage participation, especially if a group is eager to contribute and needs no prompting.
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Thanking the Group. Lastly, affirming the group for their participation, and each member for their contribution, can encourage greater involvement in the succeeding meetings.
Gathering Information The following are some of the ways a facilitator can gather information during a discussion. •
Go-round. In this technique, each member of the group gets a turn to speak without getting interrupted. Sometimes, the amount of time each member is allowed to speak is limited to encourage fairness. In gorounds, each member gets to speak. Note that this method may not be applicable if you have many participants.
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Break Out Groups. In this technique, the facilitator divides the participants into smaller groups (anywhere from dyads up, depending on the size of the group and the subject to be discussed) and then later allots time for a representative from each group to share their point of view. This method is applicable when there are too many participants to do an efficient go round, or some discussion is necessary, but that discussion is more effective in smaller teams.
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BRAINSTORMING. Brainstorming is a method of gathering information that involves getting as many ideas from the group in limited time. During brainstorming, participants can verbalize any idea they have, good or bad, and a documenter logs it in a flip chart. Only when all the ideas have been exhausted, or there are already enough ideas for consideration, does the group check out each idea one by one. For best results the time for brainstorming is limited.
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FISHBOWL Method. This method is best when an intense discussion of a subject is needed, but the group is too large for the time allotted. In the fishbowl method, a sample of the group discusses the topic, while the rest function as observers. Ideally, the discussion sample should represent the diversity in the group.
Presenting Information In order for a discussion group to reach a consensus, it is important that they are well-informed of the facts of the issue, as well as the positions of the different parties concerned. In this sense, an effective facilitator is one that can guide group members in presenting important information to the plenary. The following are some tips in presenting information in groups. •
Separate presentation from discussion time. Assign a time particularly for presentation of information. Going back and forth between discussion and presentation can disrupt group process and may even make for ineffective decision-making. For best results, place the presentation time on the agenda, and assign presenters before the meeting proper. • If there are more than one side to an issue, or more than one option in consideration, make sure you assign equal time for each. Process can be helped if each party feels that they are being treated fairly. Being given equal time as another party can facilitate this. And even if there are no conflicting parties in the group, giving each subject or each proposal the same time as the others can ensure that decisions that would be made at the end of the meeting are not biased in any way.
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Use a multi-media guide if possible. When presenting information, it helps to know that information can be presented in visual (the use of colorful presentations, hand-outs, demonstrations, flipcharts, videos, etc.), auditory (descriptive narratives and reports) and bodily/kinesthetic (activities to learn key points) ways. Use the method that fits the learning style of the group and the subject of the presentation. Note that the use of projected visual aids may require a darkened room, making the meeting less conducive for group interaction.
Synthesizing and Summarizing A synthesis is an integration of key points or key process movements in the discussion. An example of synthesizing is listing issues that have been resolved and issues that are still up for discussion. A summary, on the other hand is a short recap of what has been discussed or what has happened. Syntheses and summaries are not just conducted at the end of each meeting, but also during the discussion proper. Synthesizing and summarizing key discussion points is facilitative during a meeting. There are many reasons for this. First, synthesis and summaries show that the discussion is on track and following the agenda. It can also clear confusing discussions, and help members see where the group is at any moment. These processes also give the group a sense of accomplishment --- the synthesis and the summary is usually an indication of movement in the discussion. The following are some ways a facilitator can synthesize or summarize during a group discussion:
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Let the group summarize or synthesize for themselves. Example: Ask group members “What have we discussed so far?”, “What did you learn from this discussion?” or “What have we decided about this situation?”
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Ask a group member/ group members to provide a synthesis or summary.
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Offer your tentative synthesis/ summary and seek for the group’s clarification. For example: “This is what we have discussed so far….Did I miss anything out?”
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Refer to the agenda or published documentation in a flip chart paper. “So far, we have discussed Topic A and B. These are our resolutions…”
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Identifying the Options The following are some ways groups can identify options during decision-making. Some of these ways are also the ways of gathering information discussed earlier. •
Brainstorm. Brainstorming is the process of coming up with as many ideas as you can in the shortest time possible. It makes use of diversity of personalities in a group, so that one can come up with the widest range of fresh ideas. Quantity of ideas is more important than quality of ideas in the initial stage of brainstorming; you can filter out the bad ones later on with an in-depth review of their pros and cons. • Facilitated SWOT Analysis. Some teams create each option as a group, and they do so by conducting a facilitated analysis of the organization’s strengths, weaknesses, opportunities and threats, as they relate to the problem. Parallel Thinking. Six Thinking Hats is a system designed by Edward de Bono which describes a tool for group discussion and individual thinking involving six colored hats. "Six Thinking Hats" and the associated idea parallel thinking provide a means for groups to plan thinking processes in a detailed and cohesive way, and in doing so to think together more effectively. The most import thing about these processes is that they are conducted in a consultative fashion.
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Choose always the way that seems the best, however rough it may be. Custom will soon render it easy and agreeable. Pythagoras
3: Group Decisions The steps outlined in the previous module are just ways to set the stage towards consensus-building. When it comes to the actual decision point, it helps that a facilitator knows ways to guide a group towards optimal decision-making. In this module, we will discuss ways to identify options, create a short list, and choose a shortlist. We will also use a way of deciding not often considered by many, called the multi-option technique.
Creating a Short List There are many criteria a facilitator use to help a group create a shortlist. The following are just some of these ways: •
Costs and benefits. An ideal solution is one that has the least costs and most benefits.
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Disagreeing parties’ interests. An ideal solution has factored in the impact on all parties concerned and has made adjustments accordingly.
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Foresight. An ideal solution doesn’t have just short-term gains bit long term ones as well.
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Obstacles. An ideal solution has anticipated all possible obstacles in its implementation and has made plans accordingly.
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Values. An ideal solution is one that is consistent with the mission-vision of the organization and or its individual members.
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Choosing a Solution •
Decide on a criterion (or criteria). Ask the group to come up with the criteria to be used to evaluate each option. These criteria could be costs and benefits, consistency with the values of the organization, feasibility, etc. Once criteria are set, the facilitator can guide the group into weighing each option according the criteria.
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Survey which options members like. A facilitator can also conduct a quick survey of what each group members like in the list. You can select the solution either by strict consensus or by majority vote.
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Survey which options members don’t like. Similarly, a facilitator can ask the group which options from the short list are no-no’s and eliminate them from the list.
Using the Multi-Option Technique When coming up with solutions to an issue, you are not limited to choosing one best one. You can also pick several solutions to a problem, and follow through on these many solutions simultaneously. This is process called the multi-option technique. For instance, in addressing a problem about lagging sales, approaches can be related to poor advertising, poor market selection, or a problem in the product itself. A group following the multi-option technique will assign a person or team to follow through on each option. One team can create a better advertising campaign; another team can look for a better market; while another team can improve the product. In succeeding meetings, each team will report their results as separate teams. The solutions followed through in a multi-option technique are not necessarily complimentary to one another, although groups have the option to follow through on only complimentary ideas. But if the group wants to see two opposing scenarios with different assumptions, they can do so. How can a facilitator conduct the multi-option technique? The group can brainstorm several options, and the facilitator can help the group select which of the many options they want to pursue further.
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SUPPLEMENTAL RESOURCES FOR THIS TOPIC
Two Heads Better Than One Topic Where When Who
Group Decision Making
Check in
Head Phones Time Access Count Away Check Needs Include short notices here
Notices Territorial Avowal
Parking Lots
Ask someone to share, use your own or one from suggestion box
Icebreaker
House of Cards – set goals for this meeting
MATERIALS
Deck of playing Cards Markers, flip chart paper Pass out one playing card to each participant, facedown. Tell them not to look at the card. Ask participants to look at their playing cards. They are to find others with their suit, but they are not allowed to talk or show their card. For example, if a person had a spade, they may illustrate that by pretending to dig a hole. Once participants are in their groups, they are to introduce themselves and come up with a list of five things that they would like to learn during the workshop. Once groups have created their list, have each group present their list and combine topics on the flip chart. Use this as a guide during the workshop. If there are any topics that will not be covered, list these in the parking lot. Rainbow Health Co-op materials are licensed for non-commercial use through a Creative Commons 4.0 License
PREPARATION
ACTIVITY
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Exercise Introduction We come together to take care of each other, but with us in the room is something else we need to take care of – the group itself. A group that is properly cared for becomes selfsustaining. That’s our goal. We start with four steps – 1, Finding what we have and what we need 2, Learning how to think together 3, Deciding how we make decisions 4, Deciding how we shares responsibilities Lost at Sea Exercise ranking chart for each group member Materials
Lost at Sea Ranking Chart
Items
Step 1 Your Rank
Step 2 Team Rank
Step 3 Coast Guard
Step 4 Differ 1&3
Step 5 Differ 2&3
A sextant A shaving Mirror Mosquito netting 25 litres of water Case of army rations
Activity Lost at Sea You have chartered a yacht with three friends, for the holiday trip of a lifetime across the Atlantic Ocean. Because none of you have any previous sailing experience, you have hired an experienced skipper and two-person crew. Unfortunately in mid Atlantic a fierce fire breaks out in the ships galley and the skipper and crew have been lost whilst trying to fight the blaze. Much of the yacht is destroyed and is slowly sinking. Your location is unclear because vital navigational and radio equipment have been damaged in the fire. Your best estimate is that you are many hundreds of miles from the nearest landfall.
Atlantic Ocean Map Floating seat cushion 10 litres of oil/gas mix Transistor Radio 20 sf of black plastic 1 can shark repellent
You and your friends have managed to save 15 items, undamaged and intact after the fire. In addition, you have salvaged a four man rubber life craft and a box of matches.
1 litre of 160 proof rum
Your task is to rank the 15 items in terms of their importance for you, as you wait to be rescued. Place the number 1 by the most important item, the number 2 by the second most important and so forth until you have ranked all 15 items.
2 cases of chocolate bars
15 feet of rope
Ocean fishing pole
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Facilitator Guide – Exercise answers
Break Suggestions
The US Coastguard says that the basic supplies needed when a person is stranded in the middle of the ocean are things you can use to attract attention and aid in survival until rescue arrives. The trans-Atlantic trip takes about 20 days, more or less depending on winds. Articles of navigation are useless because it is impossible to store the food and water needed in the scenario described. Without the signalling devices there is little to no chance of being spotted and rescued.
Five Minute Break – Hacky Sack Activities Koosh Ball Hand Dancing Resistance tubes https://youtu.be/gJ NyLgS56-8 Talking stick Sharing Circle Trigger Warnings
ITEMS A sextant
Coast Guard
15
A shaving Mirror
1
Mosquito netting
14
25 litres of water
3
Case of army rations Atlantic Ocean Map Floating seat cushion 10 litres of oil/gas mix Transistor Radio 20 sf of black plastic 1 can shark repellent 1 litre of 160 proof rum 15 feet of rope 2 cases of chocolate bars Ocean fishing pole
4 13 9 2 12 5 10 11
Team Coast Differ Differ Rank Guard 1&3 2&3 Useless without chronometer and tables The most powerful tool to communicate your presence No mosquitos in the middle of the ocean – useless This is several days of rations is carefully used Basic food intake Worthless without the navigation equipment Useful if someone falls overboard Ignited and used for signalling
Pita bread / dip Grapes Yoghurt Chicken Wraps Bran muffins
RETURNING MEMBERS PLESE JOT IN YOUR NAME
NEW MEMBERS
Useless in the middle of the ocean
PLEASE FILL IN YOUR NAME AND EMAIL ADDRESS
Collect rainwater and provides shelter
Y O U R
N A M E
To repel sharks of course!
Y O U R
E M A I L @ A D D R E S S . C O M
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Useful to clean injuries – otherwise useless except to add to the gas A variety of uses – but none high on the list for survival Reserve food supply
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No guarantee you can catch fish –
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Healthy Snacks Oranges Veggies and Dip Rice crisps and Humus
INLCUDE $5 IF YOU WANT TO BE RAINBOW HEALTH MEMBER
RAINBOW
YES
NO
YES
NO
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I think you have to work with people, and when I talk about managing relationships, don’t think about the derogatory “managed relationships. Anil Ambani 4: Dealing with Difficult People Group process can get hampered by the presence of difficult members. A skilled facilitator should know how to deal with difficult people, so that the discussion will remain on track and the group atmosphere will remain pleasant and conducive to participation. In this module, we will discuss how to address disruptions, common types of difficult people in groups and how to handle them, and how to let the group resolve issues on their own.
Addressing Disruptions Disruptions in groups can be in any form. They can be from the members, or from the environmental factors. The following are ways to deal with disruptions in groups: •
Refocus the discussion on the agenda. This intervention is similar to the intervention on keeping the discussion on track. If a disruption occurs, gently remind the group of the topic.
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Identify the intention behind the disruption and address it. Don’t focus on what was said. Instead, focus on why the person said it. Example: repeated interjections can mean that a member does not feel like he or she is being listened to.
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Reiterate rules. You may refer to ground rules set at the beginning of the session.
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If no rule against the disruption exists, then take it as an opportunity to set one.
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Common Types of Difficult People and How to Handle Them The following are some of the common types of difficult people in groups and how to handle them. Type of Difficult Person Dominating
Aggressive
Description These are members who monopolize the conversation and even overtly block other members from making a contribution. Members who resort to personal attacks.
Typical Behavior “I am the only one with experience in this matter. Let me tell you what to do.”
“You just don’t know what you’re doing!”
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•
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• Quiet and NonParticipative
Group members can be quiet for a variety of reasons: they can be shy, intimidated, or uncomfortable joining in the topic.
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Overly Talkative
Members talk too much.
• • •
Ways to Deal with Them Solicit other members’ opinion. “We appreciate your experience and we’ll take what you said into account. But let’s see what others think too.”
Reiterate the ground rules. “We have agreed that there will be no personal attacks.” Get back on topic. “Remember all comments are useful as long as they relate to the topic. Re-state their position in objective terms Establish eye contact and invite them to join in. “We’d like to hear from people we haven’t heard from before. Could you give us your take on this issue?” Remind them of the time limit. Tell them you can only discuss one point at a time. Ask them for key summary points.
Helping the Group Resolve Issues on Their Own The following are two ways a facilitator can help groups resolve issues on their own: Ignore. For cooperative teams, natural facilitators will emerge if the facilitator doesn’t make immediate interventions. Promote direct feedback. Ask the group members what they think about the situation or a particular person’s behavior. Example: “Mike, can you tell Bob the effect on you when he interrupts you?”
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The key elements in the art of working together are how to deal with change, how to deal with conflict, and how to reach our potential. Max DePree
5: Addressing Group Dysfunction All groups have the potential to be dysfunctional: incapable of achieving goals. This is because each person is different, and each group has their own unique history. A facilitator must know how to recognize signs of group dysfunction, and skilled to address them. In this module, we will discuss three ways to address group dysfunction: setting ground rules, restatement and reframing issues and keeping the discussion on track.
Using Ground Rules to Prevent Dysfunction One of the best ways a facilitator can anticipate problems in a group discussion is to set ground rules. Ground rules orient participants with what is expected from them. Moreover, they set boundaries of acceptable and unacceptable behavior during the discussion. For best results, ground rules must be set in a consultative fashion, with the rules, and sometimes the consequences of violation of rules, negotiated among members of the group and agreed upon by consensus. When setting ground rules, it is important to both verify if the rules are understood, and if they are acceptable. Make sure too that a documentation of the ground rules is available for everyone, either as a hand-out or posted in a flipchart paper for everyone to see. Ground rules in a group meeting can relate to: •
How to make the most of the meeting. For example: practice timely attendance, participate fully.
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How to make a contribution to the discussion. For example: do the members raise their hands and ask the facilitator for permission to speak; use I-messages.
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How members should treat other members. For example: “don’t interrupt whoever is speaking, listen actively to whoever has the floor, accept that everyone has a right to their own opinion, no swearing or any aggressive behavior.
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Issues relating to confidentiality. Example: all matters discussed in the group shall remain within the group. This is also the moment for the facilitator to reveal if the minutes of the meeting will remain solely for his or her reference, or will it be given to an authority in the organization.
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How violations of ground rules would be addressed. Example: the use of graduated interventions from warning to expulsion from the group.
Restating and Reframing Issues The way an issue or problem is phrased can influence group members’ attitudes towards it. After all, different words have different meanings and connotations. A simple example is the difference between the words “problem” and “challenge” in reference to a situation, or “victim” and “survivor” in reference to a person. Restatement is similar to paraphrasing; it is changing the wording of an issue, but the main idea is the same. For example: simply changing “this suggestion seems to have made some members of the group angry”, to “there seems to be a strong concerns about the suggestion” can lessen the antagonistic nature of the statement. Reframing is similar to restatement, except reframing goes deeper. In reframing, a facilitator changes the way a problem is conceptualized in order to facilitate a consensus or support a conflict resolution. In some cases, the problem is reframed in order to support the position of two parties in contention. The meaning may or may not change, but the spirit of the statement remains the same. For example, instead of saying “we’re here to talk about how to approach salary cuts,” a facilitator can say “we’re here to talk about how the company can provide employee security despite limited funds.” In group facilitation, simply restating or reframing an issue can lessen the adversarial nature of a position, or invite a fresh way of looking at things. When the issue is phrased in neutral or workable terms, it becomes conducive to a reasonable discussion. How can a facilitator successfully re-state or reframe an issue? The main skill necessary for these processes is active listening. An effective facilitator must be sensitive to what each party needs and be able to incorporate these interests when phrasing an issue. Having an appreciation of the language of the group, and their unique perspective, are also important in this process. Some of the ways of restating and reframing includes: •
Changing “hot buttons” or value-laden words into neutral ones.
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Reminding the group of larger goals/ smaller goals the entire group is working on.
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Changing a problem into workable terms.
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Approaching an issue from another perspective.
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Getting People Back on Track A group discussion can go off-topic for many reasons. Sometimes, the purpose of the meeting wasn’t really clear. In other times, the discussion naturally led to an interesting issue not part of the agenda. And in other times, there are individuals who initiate and maintain off-topic discussions. Regardless of the reason, the following are ways to get a discussion back on track: •
Review the agenda. A facilitator can create check points in the agenda and constantly refer to it as the discussion progresses. For example: “Let’s take a moment to take a process check. Are we still following our agreed upon agenda?”
•
Reflect to the group what is happening, and reintroduce the correct topic. Example: “I appreciate the participation and enthusiasm. But it seems that we have gone off the agreed upon agenda. I believe the topic under discussion is…” • Offer to put the off-topic on a “parking lot” for possible later discussion. For example: “You raised a good point Mary. Maybe we can look at that later it today, or set a separate meeting for it.” • Ask the group if they are finding the discussion helpful to the goal. This intervention is recommended for unstructured meetings, where a foray into an off-topic is not necessarily a negative thing. For example: “I noticed that there has been a long debate in the group about this idea. Is this discussion helpful for everyone?”
•
Ignore the off-topic discussion and reintroduce the correct topic. If you feel that acknowledging a topic detour will just result in more dysfunction (e.g. it will provoke a long, defensive response), then it may be best to just ignore it. Instead, summarize the last thing that was said related to the topic, and ask a question that continues from it. For example: “If I may get back to what Louis was saying earlier. He said….Does anyone agree with his observation?”
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It is always possible to argue against an interpretation, to confront interpretations, to arbitrate between them and to seek for an agreement, even if this agreement remains beyond our reach. Paul Ricoeur
6: Getting a Group Back on Track In general, facilitators neither inject themselves in issues nor direct the flow of discussion; they merely go where the group wants to go. There are occasions, however, when stronger responses are needed to make the group more functional and productive. In this module, we will discuss what these stronger responses are, why they are necessary, and when is it appropriate to use them.
Why Intervention May Be Necessary Facilitators are part of a group for a reason: to help the group achieve their goals in the most democratic and cooperative way possible. Ideally, groups should have cooperative members with knowledge, skill, and personality to assist this process. However, in the real world, groups are much more complicated. Indeed, even well-meaning group members can create dysfunctional teams. For this reason, intervention may be necessary. An intervention is an injection of one’s self in the process in pursuit of a specific goal. Interventions are what separate a facilitator from a mere participant--- the participant’s statements are contributions, whereas a facilitators’ statements are interventions. Technically, anything that a facilitator does, both verbally and non-verbally, in the course of his or her role in a group is an “intervention.” However, the term intervention is usually reserved to relatively stronger interference in a group’s natural way of doing things. The following are some of the reasons why intervention may be necessary: •
•
To help the group achieve their goals. If an on-going dynamic in the group is keeping the entire team from reaching their objective, then it’s time to intervene. For example: if a coalition exists in members, decisionmaking might get skewed to one side of the issue. To protect group process. If the integrity of the chosen methodology in getting results is being compromised, then a facilitator must intervene.
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To prevent the escalation of an issue. Generally, facilitators should let the group handle things on their own. But some hot issues are better nipped in the bud, or they might blow up into a larger issue can create serious damage. To sample “skills” to the group. In some occasions, group members lack the skills to deal with a group issue, e.g. two conflicting issues. In these cases, intervention may be necessary to expose the group on more functional processes.
When to Intervene The following are some situations when intervention may be necessary: •
The group is stuck. This means that the process is not producing results, or the process is not progressing to the next level.
•
The group is about to move on to the next agenda without realizing that an important aspect of the discussion is unresolved or unaddressed.
•
The group continues to follow a negative pattern despite soft interventions. (We will discuss levels of interventions in the next
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Something unethical is going on in the group, like a personal attack subtle/blatant intimidation.
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Group process is being hampered by a dominant person or clique.
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Group members are misunderstanding each other.
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The facilitator perceives tension and suspiciousness in the group.
section.) or
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Levels of Intervention There is a guiding principle in medicine that goes: don’t prescribe strong medicine when a milder one will do. Similarly, interventions in facilitation range from non-directive to directive, subtle to explicit, non-intrusive to very intrusive. It helps to know what the levels of intervention are in order to decide what response to give to different situations in a group. The following are the different levels of intervention: •
No intervention. Unless there is a pressing concern that requires a facilitator’s intervention, the first level of response is to do nothing. By not responding to a concern, a facilitator is effectively letting the group take care of the problem, and implement their own solution. Note though that even if a facilitator is not directly responding to the problem, he or she may be actively gathering information about the group and how they process their own issues.
•
Reflective Technique. The first few levels of intervention are geared towards increasing awareness within the group that a problematic situation is in place. One way to do this is to objectively state what you notice is going on. Note that you are not supposed to voice out your opinions or evaluations of the group dynamic; merely bring to awareness something that the group may not have noticed. The group is left to confirm or refute the facilitator’s observations. Either way, the result may be further clarification. Example: “I noticed that four of you had been very quiet since we started.”
•
Solicit the Group’s Observations. As much as possible, let the group members identify themselves what is happening within the group. One way to do this is to solicit feedback through general leads. Example: “Jane. What can you say about what is happening right now?”
•
Interpret observations. This becomes necessary when the group has difficulty seeing the implications of what is going on in the process. NOTE: always phrase your interpretations in tentative fashion, as if seeking confirmation from the group if your observations are correct or incorrect. Example: “I’m noticing that the energy is low? Are we focusing on the right issue? Or is there something else that we have more energy for?”
•
Suggest solutions. If the group seems to be stuck, suggest a way to deal with the problem. Note: suggest only process changes. And always get the approval of the group. Example: “We seem to be stuck, would you like to try a different approach?”
•
Restructure the process or an aspect of it. Change the group process by re-organizing the structure of dialogue (dyads, small groups, etc.), using problem solving processes, inserting a “process break” or changing the original agenda.
•
Confront. This is directly mentioning the problem, or the difficult individual. Note that confrontation is a very strong intervention, and must be used only as a last resort, when all other softer interventions have been exhausted. Example: “I noticed that you are always encouraging the other members of the group to leave the meeting prematurely. And twice now it has disrupted the process. May I know what the reason why you’re doing this is?”
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Intervention Techniques In the previous module, we introduced intervention and the different levels of intervention. In this module, we will focus on particular intervention techniques: use of processes, boomerang it back, and ICE it.
Using Your Processes As process experts, the best way a facilitator can intervene in an unproductive or dysfunctional group is by introducing a process that would directly address the problem or issue. For example, if a group’s problem is the monopoly of the floor by certain members, a facilitator can introduce the round robin discussion to ensure that everyone gets their turn to speak. If the problem is the lack of information about the issue in contention, the facilitator can make presentation part of the agenda. If the problem is a lack of understanding between management and staff, the facilitator can break the group into pairs of management and staff.
Boomerang it Back To “boomerang” an issue back is to present an issue back to the group for them to resolve. The reflective technique (discussed in the previous module) is one of the basic ways of mirroring an issue to a group. Another way to do this is to rephrase a group’s concern into a question addressed to the group. For example, when a group member says “maybe we are just too tired to think of a new idea for this project”, a facilitator can simply say “do you think you are too tired?” Or if a group member asks a facilitator a question, the facilitator can just bounce the question back. Example: if a group member asks “should we continue this project?” the facilitator can simply reply “What do you think? Should you?”
ICE It: Identify, Check for Agreement, Evaluate How to Resolve Another way to intervene is to use the ICE technique. ICE stands for: • Identify • Check for Agreement • Evaluate How to Resolve. When you ICE it, you surface what the problem is, verify with the group its accuracy (or at least their agreement), and then start the process of looking for solutions. Example: “What do you think is going on in the group right now? So, if I understand correctly, this is what is happening? Is this correct? How do we go about addressing this problem?”
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Section Five Hans Kai Content
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1 – Indicators Blood Pressure – Blood Sugar Your Hormones – The minimum effective dose
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Schedule for this session
Check-in 15 Minutes Slides – 20 min Six Hats Sharing Manage the risk 20 min Break + Chat 20 min First Round Sharing – 20 min Check out–15 min 2 hours
Group Wellness Works A Group Wellness Program
HANS KAI This program brought to you by co-ops co-operating to build a better world – join us today
Original content is covered by a Creative Commons Attribution-NonCommercial-ShareAlike License CC BY-NC-SA Other work subject to the terms of its author
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As Treaty Peoples, we are responsible for establishing and maintaining mutually respectful relationships.
We acknowledge with respect the Indigenous peoples on whose traditional territories we live, whose historical relationship with the land continues to this day and we apologize for our collective treatment of them
INDICATORS
BALANCE
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SECURITY
HEALTH CARE
SELF-CARE
CHANGES
CLANS
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INDICATORS
HANS KAI What we hope to explain today SOME DEFINITIONS WHAT IS WELLNESS? WHAT IS A PROGRAM? WHAT IS Gender Dissonance vs Dysphoria? A short break The common risks of medical transition Tracking personal health indicators
What is wellness? (Fill in the blanks)
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Wellness is…. "A state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity."
"A conscious, selfdirected and evolving process of achieving full potential."
National Wellness Institute
World Health Organization
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Social Determinants of Health
Six Dimensions of Wellness
Copyright 1976
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This is what we say….
Wellness is the minimum effective dose of rest, nutrition, activity and socialization to maintain ourselves above the level of symptoms. Wellness integrates our bodies, our gender, our minds, our selves and our communities”. Rainbow Health Co-operative -
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HOW DO WE ASSESS WELLNESS? SOCIAL
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PERSONAL
HEALTH
WELLNESS
Health refers to the entire range of our well being
Wellness refers to the range above the level where negative indicators are present
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Minimum Effective Dose The MED is simply the smallest dose that will produce a desired outcome and anything beyond the MED is wasteful.
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A wellness program focuses our time and effort in self-care by providing information, tracking health indicators, and providing feedback to keep ourselves above the level of negative indicators -
PARETO’S PRINCIPLE
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THE OTHER SIDE OF THE COIN -
It goes away I have a backache
I take aspirin It does not go away for a week I go to my chiropractor They do an adjustment
STIMULUS, HIGH RESPONSE -
One day I notice I have less pain I go to the gym for a fourth week I go to the gym for a third week I go to the gym for a second week I go to the gym for a week I have a backache It does not go away for a week I learn about the condition
STIMULUS, LOW RESPONSE -
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AUTONOMOUS BEHAVIOUR
COMPLIANCE BEHAVIOUR
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A group wellness program leverages our self-care efforts by utilizing our programming as social animals
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HANS KAI Summary Maintains habits that enhance wellness Informs about self-care Applies the minimum effective dose Maintains awareness of symptom indicators States when and how to seek help Develops capacity for long term effort Provides individual feedback on results
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HANS KAI Group Wellness Works
QUESTIONS?
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Blood Pressure People taking control of their health.
Blood Pressure What is blood pressure? • The force of the blood pushing against the walls of the blood vessels as it flows through them • The amount of blood your heart pumps and the amount of resistance in the arteries affects your blood pressure
What are the two numbers about? • The systolic, or high number, measures the pressure in the vessels as your heart is pumping – during a beat • The diastolic, the low number, measures the pressure in the vessels as your heart is relaxed – between beats
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What is normal blood pressure? • Average person Person with diabetes below 135/85 (home)
below 130/80
• Consistent, 3 to 4 readings in a row, that are higher should be reported to health care provider
Abnormal Blood Pressure • 130-179/85-109 is high and should be passed on to health provider at next visit • >180-199/110 -119 should call their health care provider to arrange appointment • >200/120 would indicate an emergency – immediate appointment or go to ER immediately
What are the symptoms of high blood pressure? • None for most people • Pressure in the head, light headedness, blurred vision, nausea and vomiting, chest pain, shortness of breath
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Why is blood pressure important? • High blood pressure means that the heart has to work harder • High blood pressure increases risk for heart disease • High blood pressure + blocked arteries increases your risk for heart attack or stroke
Lifestyle management of blood pressure: – – – – – – –
Increased physical activity Stress Management (for some) Moderate alcohol consumed Healthy body weight Smoking cessation Healthy eating – DASH Less sodium
Which meal is higher in sodium (salt)? A. Kentucky fried chicken dinner
3100 mg
B. Baked lemon chicken breast, herbed potatoes and green beans 160 mg C. Baked salmon, steamed rice and broccoli 200 mg D. Bowl of cream of mushroom soup and a reuben sandwich with sauerkraut 4460 mg
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Healthy Habits for Blood Pressure • Limit canned and processed foods • Limit salted snack foods and fast foods • Use less salt in cooking and at the table • Use garlic, lemon, herbs and spices • Salt substitutes - check with your doctor
Demonstration • Sitting comfortably • Feet flat on the floor • Arm relaxed and supported at heart level • On the bare arm (not on top of sleeves) • Do not talk or read while taking blood pressure
• Wear loose non-restrictive clothing • Heavy physical activity 2-3 hours prior can raise the numbers • Be well rested and relaxed • Remember that smoking and caffeine intake within 30 minutes of blood pressure reading can raise the numbers
Demonstration
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Metabolic Syndrome •
Metabolic syndrome is not a specific illness but a series of risk factors:
1.
Increased Waist Circumference Men: Equal to or over 102 centimetres (40 inches) Women: Equal to or over 88 centimetres (35 inches) Elevated Blood Pressure Equal to or over 135/85
2.
3. 4.
5.
Elevated Triglyceride Level Equal to or over 1.7 Low HDL “good” Cholesterol Men :Less than 1.04 Women: Less than 1.29 High Fasting Blood Sugar Equal to or over 5.6
3 or more of the above risk factors = metabolic syndrome
Metabolic Syndrome Why should I be concerned?
• Associated with increased risk of developing diabetes or having a heart attack or stroke • Early screening of these risk factors can make a difference • Treatment of these risk factors can prevent complications down the road (adopting healthy lifestyle can minimize all of these risk factors)
Questions?
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Diabetes People taking control of their health.
What is diabetes? • To use glucose (sugar) for energy, the body needs insulin • With diabetes, body makes too little or no insulin, or cannot properly use the insulin it makes • Not enough insulin = blood glucose levels increase • Over time, high blood glucose levels can lead to serious complications
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Type 1 Diabetes •Pancreas produces little or no insulin • Affects about 10% of people diagnosed with diabetes • Diagnosed most often in children and young adults • Insulin injections are needed • Caused by genetic and environmental factors
Type 2 Diabetes • Affects about 90% of people with diabetes • Diagnosed most often in adults • Cells in the body do not use insulin properly (insulin resistance) and/or body does not make enough insulin • Managed with meal planning, physical activity, blood glucose testing, medication and sometimes insulin
Gestational Diabetes • Increases risk of developing diabetes later in life • All pregnant women should be tested
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Prediabetes •
Blood sugar levels are higher than what is considered normal but below what is considered the level for a diagnosis of diabetes (fasting blood sugar between 6.1 – 6.9)
• Increased risk for developing type 2 diabetes and heart disease
Risk Factors for Diabetes • Parent, brother or sister with diabetes • Age (> 40 years old) • Certain ethnicities (South Asian, Asian, Latin American, African, Aboriginal)
• High blood pressure, high cholesterol • Obesity (especially higher waist circumference) • Having a baby over 9 lbs • Having gestational diabetes
Q&A What is the most effective test to diagnose diabetes? a) Fasting blood glucose test b) Urine test c) Vision test d) Non-fasting blood glucose test
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Q&A Which is not a sign / symptom of type 2 diabetes? a) Weight loss b) Energetic c) Blurred vision d) Having to pee very often
Q&A Type 2 diabetes is when: a) The body is allergic to insulin b) You have low blood sugar c) The body does not use insulin properly d) The body does not produce insulin
True or False Eating too much sugar in the form of candy, soft drinks and other sweets can cause diabetes?
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Blood Sugar Targets For people who don’t have diabetes: • Before meals/fasting 4-6 • 2 hours after a meal 5-8 HbA1C < 6.0%
For people who do have diabetes: • Before meals/fasting 4-7 • 2 hours after a meal 5-10 HbA1C < 7.0% LDL cholesterol < 2.0
Checking Your Blood Sugar You will need: Glucometer (blood sugar tester), drummet (contains the strips), one-time use lancets (purple and white), sharps container (yellow) 1.
Wash hands with soap and water or hand sanitizer
2.
Clean the glucometer with an alcohol swab before use each time.
3.
Press the middle button on the glucometer down, then let go (a strip will pop out of the bottom). The glucometer will turn on.
Checking Your Blood Sugar 4. Turn then pull off the purple head of the lancet, hold up to finger and press the purple button until you hear a click (you should feel a small poke). If you don’t see any blood, gently squeeze your finger to increase the blood flow. 5. Hold blood sample up to the strip (the strip should soak up a small blood sample) 6. Glucometer will show your blood sugar reading within 5 seconds 7. Write down your reading in your logbook
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Checking your Blood Sugar 8. Hold the glucometer above the sharps container. The strip should be over the opening of the container. Press the middle button down, then let go to get rid of the used strip. â&#x20AC;˘
Let your Hans support person know if you need more supplies (lancets, drummets, alcohol wipes)
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When your sharps container is full, drop it off at your pharmacy and get a new one from them (this is free of charge). Be sure to close the sharps container before placing it back in your toolkit. The lid should snap shut but not be closed so tightly that it will not reopen.
Questions?
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Questions?
Healthy Waists • According to the National Institutes of Health, increased waist circumference is a measure of increased risk for: • Type 2 Diabetes • Heart Disease (heart attack, stroke) • High Blood Pressure • “Apple” and “Pear” Shapes
Waist Circumference • Women – Goal: Less than 35 inches (88 cm) • Men – Goal: Less than 40 inches (102 cm) • Some people depending on their culture may need to have even lower goals for their waist circumference
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Demonstration â&#x20AC;˘ Place the tape measure half way between your hip bone and your lowest rib. This will likely be just above your belly button. Wrap the tape measure around you in a circle. Make sure the tape measure is level all the way around. The tape measure should not push in or indent the skin. Relax, exhale and measure. â&#x20AC;˘ It is best to measure your waist circumference on bare skin. If you are wearing clothes, be sure to measure the same way each time.
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Schedule for this session
Check-in 15 Minutes Slides – 20 min Six Hats Sharing Manage the risk 20 min Break + Chat 20 min First Round Sharing – 20 min Check out–15 min 2 hours
Hormones, The Minimum Effective Dose A Group Wellness Program
HANS KAI This program brought to you by co-ops co-operating to build a better world – join us today
Original content is covered by a Creative Commons Attribution-NonCommercial-ShareAlike License CC BY-NC-SA Other work subject to the terms of its author
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1
As Treaty Peoples, we are responsible for establishing and maintaining mutually respectful relationships.
We acknowledge with respect the Indigenous peoples on whose traditional territories we live, whose historical relationship with the land continues to this day and we apologize for our collective treatment of them
INDICATORS
BALANCE
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SECURITY
HEALTH CARE
SELF-CARE
CHANGES
CLANS
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HANS KAI
4 TRANS Wellness is the minimum effective dose of rest, nutrition, activity and socialization to maintain ourselves above the level of symptoms.
A wellness program balances our self-care efforts for: our bodies our minds our emotions our gender and our communities
A wellness program specifies the minimum effective dose of rest, nutrition, activity and socialization to maintain ourselves above the level of symptoms.
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A wellness program monitors Health Indicators whether gender dissonance or blood pressure
A wellness program integrates self-care and shared-care
A wellness program reinforces behaviours which are low reward but necessary
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A wellness program remedies Chronic conditions such as Gender Dissonance
HANS KAI
4 TRANS
What we hope to explain today Hormones Blood Sugar Hormone Readiness Hormone Therapy Risks Risk Management
INDICATORS Hormones, The minimum effective dose
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What are Hormones? Hormones are chemical messengers that are secreted directly into the blood, which carries them to organs and tissues of the body to activate target cells.
What body parts produce hormones? ď&#x201A;§How many of the endocrine glands can you name?
How many of the endocrine glands can you name
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Name one hormone produced by each
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What body parts produce hormones? 1. Pineal gland 2. Pituitary gland 3. Thyroid gland 4. Thymus 5. Adrenal gland 6. Pancreas 7. Ovary 8. Testes
1. Melatonin 2. ADH, Oxytocin, LH, FSH 3. T4, T3 4. Thymosin 5. Testosterone, Epinephrine 6. Insulin 7. Estrogen 8. Testosterone
Insulin • To use glucose for energy, the body needs insulin • • With diabetes, body makes too little or no insulin, or cannot properly use the insulin it makes • • Not enough insulin = blood glucose levels increase
Now for the OTHER hormones Testosterone Estrogen Progesterone Other chemicals that affect blood levels of hormones; such as Anti- androgens
Hormone therapy—the administration of exogenous endocrine agents to induce feminizing or masculinizing changes
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The Standards of Care VERSION 7 World Professional Association for Transgender Health
Hormone therapy is a medically necessary intervention for many transsexual, transgender, and gender-nonconforming individuals with gender dysphoria
The Standards of Care World Professional Association for Transgender Health
The criteria for hormone therapy are as follows: 1. Persistent, well-documented gender dysphoria; 2. Capacity to make a fully informed decision and to consent for treatment; 3. Age of majority in a given country 4. If significant medical or mental health concerns are present, they must be reasonably well-controlled
THiP Hormone Readiness Assessment VCH - Transgender Health Information Program
Who provides assessments? Any general practitioner, nurse practioner or family physician with some basic training can assess for and prescribe hormone therapy to adults. Do I need counselling to start on hormone therapy? Counselling is not typically required to get a prescription for hormones. How long does a hormone assessment take? It generally takes a few visits to your health care provider, over the course of 2-6 months, before starting on hormone therapy.
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Oral Estrogen
(e.g. Estrace)
Sublingual
Premarin
(PRegnant MARes urINe)
Estrogen Patch
(e.g. Estradot, Estraderm, Oesclim)
Injectable Estrogen
(e.g. estradiol valerate)
Medroxyprogesterone
(e.g. Provera)
Micronized Progesterone
(e.g.Prometrium)
Prediabetes
Risk Factors
Blood sugar levels are higher than what is considered normal but below what is considered the level for a diagnosis of diabetes
Relative with diabetes Age (> 40 years old) Certain ethnicities (South Asian, Asian, Latin American, African, Aboriginal)
(fasting blood sugar between 6.1 – 6.9)
High blood pressure, high cholesterol Obesity (especially higher waist circumference) Having a baby 9 lbs +
Ovary based feminizing hormone cycle Follicular <913 MidCycle 140-2380 Luteal 77-1145
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Men <150
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Injectable Testosterone
(e.g.testosterone cypionate or testosterone enanthate)
Testosterone Patch
(e.g.Androderm)
Testosterone Gel
(e.g.Androgel, or compounded testosterone gel/cream)
Oral Testosterone
(e.g. testosterone undecanoate)
Likely increased risk
ď&#x201A;§
Weight gain Venous thromboembolic disease (leg clots) Gallstones Elevated liver enzymes Hypertriglyceridemia Likely increased risk with presence of additional risk factors
Cardiovascular disease Possible increased risk
High Blood Pressure (Hypertension) Hyperprolactinemia or prolactinoma
Possible increased risk with presence of additional risk factors
Type 2 Diabetes
No increased risk or inconclusive research
Breast cancer
Likely increased risk
ď&#x201A;§
Weight gain Androgenic alopecia (balding) Polycythemia (blood disorder)
Acne Sleep apnea
Possible increased risk with presence of additional risk factors
No increased risk or inconclusive research
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Hypertension (high blood pressure) Type 2 Diabetes Cardiovascular disease Elevated liver enzymes Hyperlipidemia Destabilization of bipolar disorder, psychotic disorder Loss of bone density Breast cancer Cervical cancer Ovarian cancer Uterine cancer
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How to perform a breast self exam – Trans Women
How to perform a breast self exam – Trans Women Video
How to perform a breast self exam – Trans Men
Abnormal Blood Pressure • 130/85 -139/89 is high and should be passed on to health provider at next visit • >140/90-199/110 should call their health care provider to arrange appointment • >200/120 would indicate an emergency – immediate appointment or go to ER immediately
What are the symptoms of high blood pressure? • None for most people • Pressure in the head, light headedness, blurred vision, nausea and vomiting, chest pain, shortness of breath
What is normal blood pressure? • Average person Person with diabetes below 120/80 (home)
below 130/80
• Consistent, 3 to 4 readings in a row, that are higher should be reported to health care provider http://www.heartandstroke.com
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Blood Sugar Targets For people who donâ&#x20AC;&#x2122;t have diabetes: Before meals/fasting 4-6 2 hours after a meal 5-8 HbA1C < 6.0%
For people who do have diabetes: Before meals/fasting 4-7 2 hours after a meal 5-10 HbA1C < 7.0% LDL cholesterol < 2.0
Checking Your Blood Sugar 1.Wash hands with soap and water or hand sanitizer. 2.Clean the entire glucometer with an alcohol wipe before use each time. 3.Have your own bottle of strips ready. 4.Insert one strip into the glucometer (it will automatically turn on). 5.Turn then pull off the purple head of the lancet, hold up to finger and press the purple button until you hear a click. Gently squeeze your finger to increase the blood flow. Place used lancet into sharps container. 6.Hold finger with blood sample up to the side of the strip 7.Glucometer will show your blood sugar reading within 5 seconds 8.Wrap a band aid around your finger. 9.Remove the strip from the glucometer and place into sharps container. 10.Clean the glucometer with an alcohol wipe.
Getting Your Lab Results
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How to Register for Lab Results
Risk reduction
HANS KAI
4 TRANS
Summary Hormones, the minimum effective dose Diabetes is the hormone related illness affecting the most Canadians WPATH 7 outlines the requirements for hormone therapy (HT) Trans Health Information Program has guidelines for the different types of hormones There are significant “Likely Increased Risks” from HT You should develop a personal risk reduction plan
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HANS KAI Group Wellness Works
QUESTIONS?
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2 â&#x20AC;&#x201C; Security Eating for Health Living Good and Cheap
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Eating for Health
Test your nutrition IQ Q. Sunny Delight and Frutopia are examples of real juice? True or false Q. Instant packaged noodles (Mr. Noodle) are a healthy fast lunch? True or false Q. Fruit roll-up snacks belong to the Vegetables and Fruit food group? True or false Q. How many teaspoons of sugar are in a can of regular pop? a) b) c) d)
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Guiding Principles • • • • •
Achieve Balance Familiarize yourself with portion sizes Eat more fruits and vegetables Eat more whole grains Get Active!
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Healthy Eating Tips • • • • • • •
Follow “Eating Well with Canada’s Food Guide” Eat regularly spaced meals and don’t skip breakfast Eat a variety of foods Try to include fish and meat alternatives into your meals Limit foods high in calories, sugar, fat and salt Stay hydrated with unsweetened beverages Be active everyday
Canada’s Food Guide
Guidance on the quantity of food • Guidance is given for males and females, 2 years and older: • Children, teens and adults • A small amount of unsaturated fats is recommended • For intake of essential fatty acids
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What is one food guide serving? A “Food Guide Serving” is: – A reference amount – Not necessarily intended to represent what would be eaten in one sitting • Illustrations and different measures are used to help communicate what is one Food Guide Serving
Guidance on the quality of food choices: Vegetables & Fruit • Eat at least one dark green and one orange vegetable each day – For folate and vitamin A intake
• Have vegetables and fruit more often than juice – For fibre intake
Guidance on the quality of food choices: Grain Products • Make at least half your grain products whole grain each day – For fibre – To reduce risk of heart disease
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Increase your fibre intake • Women: 25 g fibre per day • Men: 35 g fibre per day – Have one high-fibre source daily • 2 tbsp ground flax • 2 tbsp All Bran Buds • Metamucil
– Eat a meat alternative 3x/week • Legumes: lentils, split peas, chickpeas • Beans
Advice for women of childbearing years • Extra calories are needed during: • The 2nd and 3rd trimesters of pregnancy • Breastfeeding • Including an extra 2 or 3 Food Guide Servings is expected to meet these additional needs
Advice for those over 50 •
Health benefits are associated with adequate vitamin D intake
•
Vitamin D requirements increase with age: • 600 IU (15 micrograms) for 1 – 70 years old • 800 IU (10 micrograms) for people over 70 years old
•
It is difficult to meet these vitamin D levels without recommending unrealistic amounts of some foods
•
A supplement containing 400 IU vitamin D, is recommended for people over age 50
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Food Safety • Wash hands often, especially before and after food preparation • Food should not be kept at room temperature longer than 2 hours • Air dry dishes or use paper towel • Look for expiry dates • Keep hot foods hot and cold foods cold • Ask people in your group if they have any food allergies • When in doubt throw it out!
Increase physical activity “F I T T” Principle • Aim for 30 minutes 5x/week (150 minutes of moderate to vigorous activity per week) – Does not have to be all in one session
Frequency Intensity Time Type • Muscle and bone strengthening exercises 2x/week
Fats: The Good, Bad and the Ugly • Good Fats:”unsaturated” fats - heart healthy: soft margarine, oils, nuts, salmon • Bad Fats: “saturated” fats - animal fats: butter, cheese, meat, dairy, tropical oils • Ugly Fats: “trans” fats - artery clogging: hard margarine, processed baked goods and other foods, shortening, “partially hydrogenated”
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Cholesterol • What foods have cholesterol – Shrimp, liver, egg yolks
• Did you know?? – High cholesterol foods are not the only foods that will raise cholesterol
Ways to decrease total fat intake Instead of: • • • • • • •
Choose:
Cream Oil Salad dressing Sour cream Mayonnaise Butter Fat in baking
• • • • • • •
Half and Half /No fat Non-stick spray/pan Calorie-wise, fat-free Light, fat-free Light, fat-free Soft margarine Applesauce
Shake the Salt Habit High salt foods: canned soups, deli/processed meats, condiments, pickles, pre-packaged foods, vegetable juices Ways to decrease salt: - use herbs and seasonings, powders (garlic/onion) - rinse canned foods first – gets rid of about 1/3 the salt! - limit salt at the table and cooking What are some of your ideas?
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Sugar Shock “Liquid Candy” Drink • 1 – 355 ml cola can • 1 – 591 ml sport drink plastic bottle • 1 – 710 ml cola plastic bottle • 1 – 473 ml glass bottle fruit beverage • 1 – 1L slush drink container • 1 – 1.25 L slush drink container • 1 - 500 ml plastic water bottle • 1 – 250 ml cup of Tang • 1 – cup ice cream sundae
Teaspoons of added sugar 9 12 18 15 31 38 0 14 19
Label Reading • Look at the amount of food • Read the % DV (5% and 15%) • Choose: Less of: More of: Fat Saturated and Trans fat Sodium
Fibre Vitamin A Calcium Iron
Portion Distortion 20 years ago vs. now
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Portion Distortion 20 years ago vs. now
Eat Better Together • Healthier meals with less fat, salt, sugar and more whole grains and vegetables • More control over ingredients • Increased communication among family members • Children less likely to engage in risky behaviors
Time Saving Tips Use thinner slices of meat, thin pasta (spaghettini) Assign family members tasks Use a crockpot (soups, stews, roasts) Make bulk meals over the weekend to use throughout the rest of the week • Use pre-cut veggies, bagged salads, pre-grated cheese • • • •
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Remember . . . • • • • •
Achieve Balance Watch portion sizes Eat more fruits and vegetables Eat more whole grains Get active!
Questions?
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3 – Self-Care Let’s Get Active Exercise, Rest, Water & Poop Gender – Dissonance vs Dysphoria Sexuality – Healthy & Affirming
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Letâ&#x20AC;&#x2122;s Get Active People taking control of their health.
Physical Activity
Where do you get your info?
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Barriers
Pain?
Stretching • No preworkout static stretching • Will not help with muscle soreness • Will not reduce your risk of injury • Helps with circulation
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Flexibility & Mobility • Flexibility - the capacity of a joint or muscle to move through its full range of motion. • Mobility - The ability to produce a desired movement. • Stability - The ability to resist an undesired movement.
Cardio Cardiovascular exercise also called cardiorespiratory exercise, or just 'cardio' involves movement that gets your heart rate up to improve oxygen consumption by the body.
Anaerobic exercise is short-lasting, high-intensity activity, where your body’s demand for oxygen exceeds the oxygen supply available. Anaerobic exercise relies on energy sources that are stored in the muscles and, unlike aerobic exercise, is not dependent on oxygen from (breathing) the air.
Muscular Strength & Endurance ‘Generally’ -Muscular strength is the amount of force a muscle or muscle group can put out or the amount of weight you can control. Muscular endurance is the ability of a muscle or group of muscles to sustain repeated contractions against a resistance for an extended period of time.
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Muscular strength and endurance are important for many reasons: • Increase your ability to do activities like opening doors, lifting boxes or chopping wood without getting tired. • Reduce the risk of injury. • Help you keep a healthy body weight. • Improve confidence and how you feel about yourself. • Lead to healthier, stronger muscles and bones. • Give you a sense of accomplishment. • Allow you to add new and different activities to your exercise program.
Body Composition • Note the space 5lbs takes up on a body • Weight Loss vs Fat Loss • More calories to feed muscles • Weight scale may show you gained weight when you begin resistance training
Posture is EVERYTHING! • • • •
Neutral Spine Hips Sitting Rotation
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Recovery
300-400 g, 10-20 min. Relax muscles Decrease inflammation Increase perspiration, helping to get rid of toxins and impurities • Stimulates vasodilatation, facilitating blood flow to the muscles • • • •
• Lower excessive CNS excitation or increase it • No need for more than 2x per week full body
Fear the ‘Wellness’ Pitch Statistics show that most acute Low Back Pain begins to improve after 2 to 5 days and typically resolves itself in less than 1 month with nonsteroidal anti-inflammatories (NSAIDs) and (tolerable) activities.” So, to say that a given intervention gave you relief from low back pain in 4 weeks time, going 3x per week for treatment, isn’t impressive as that’s likely to happen by simply resting at home.
Exercise
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How to use a pedometer • • • • •
Put your pedometer on as soon as possible each day as every step counts towards your daily total. Reset your pedometer each morning. The pedometer can be attached to your belt, skirt or jogging clothes, and should be lined up above your knee. The pedometer should be parallel to the ground (not tilted).
Activity Goal Setting •
• • • •
To determine your current level or baseline, wear your pedometer for a week and divide your totals steps by seven. To safely progress to higher activity levels, you should try to increase your daily steps once per week by 10-15% from your current level Aim for 7,500 steps per day if you are looking to maintain your health and weight. Aim for 10,000 steps or more per day if trying to lose weight, improve your health or increase your fitness. 2000 steps is the equivalent of walking approximately 1 mile and the equivalent of expending approximately 100 calories. It takes approximately 5 minutes of walking to accumulate 500 steps.
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Canadian Physical Activity Guidelines (18-64 years) To achieve health benefits, adults aged 18-64 years should accumulate at least 150 minutes of moderate- to vigorous-intensity aerobic physical activity per week, in bouts of 10 minutes or more.
It is also beneficial to add muscle and bone strengthening activities using major muscle groups, at least 2 days per week.
More daily physical activity provides greater health benefits.
Guidelines for Older Adults (65 years and older) To achieve health benefits and improve functional abilities, adults aged 65 years and older should accumulate at least 150 minutes of moderate- to vigorous-intensity aerobic physical activity per week, in bouts of 10 minutes or more. It is also beneficial to add muscle and bone strengthening activities using major muscle groups, at least 2 days per week. Those with poor mobility should perform physical activities to enhance balance and prevent falls. More daily physical activity provides greater health benefits.
Gatherer 9-15km/day Hunter 20-50 km/week
> 8 hr/day < 4hr/day sedentary
Canadians 20-79 reporting vigorous physical activity (150 min) = 52%
Reality 150 minutes = 15% 30min/day = 5%
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To be healthy, you need to adopt an ABNORMAL BEHAVIOR
Questions?
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Schedule for this session
Check-in 15 Minutes Slides – 20 min Six Hats Sharing Manage the risk 20 min Break + Chat 20 min First Round Sharing – 20 min Check out–15 min 2 hours
Gender Wellness Dissonance vs Dysphoria A Group Wellness Program
HANS KAI This program brought to you by co-ops co-operating to build a better world – join us today
Original content is covered by a Creative Commons Attribution-NonCommercial-ShareAlike License CC BY-NC-SA Other work subject to the terms of its author
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1
As Treaty Peoples, we are responsible for establishing and maintaining mutually respectful relationships.
We acknowledge with respect the Indigenous peoples on whose traditional territories we live, whose historical relationship with the land continues to this day and we apologize for our collective treatment of them
INDICATORS
BALANCE
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SECURITY
HEALTH CARE
SELF-CARE
CHANGES
CLANS
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Self-Care Gender Wellness
HANS KAI What we hope to explain today WHAT WHAT WHAT WHAT WHAT
IS GENDER DYSPHORIA? IS GENDER DISSONANCE? IS COGNITIVE DISSONANCE? IS WELLNESS? IS A PROGRAM?
Schedule for this session
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CD-10-CM Diagnosis Codes > Mental, Behavioral and
disorders F01-F99 > ScheduleNeurodevelopmental for this session
Disorders of adult personality and behavior F60-F69 >
F64 Gender identity disorders
2017 ICD-10-CM Diagnosis Code F64.0 Transsexualism Clinical Information Severe gender dysphoria, coupled with a persistent desire for the physical characteristics and social roles that connote the opposite biological sex. The urge to belong to the opposite sex that may include surgical procedures to modify the sex organs in order to appear as the opposite sex.
Schedule for this session In adolescents and adults gender dysphoria diagnosis involves a difference between one’s experienced/expressed gender and assigned gender, and significant distress or problems functioning.
Schedule for this session
A form of cognitive dissonance experienced by trans people due to a misalignment of their subconscious and physical sexes. Gender dissonance differs from the psychiatric term “gender dysphoria,” which typically conflates this cognitive dissonance regarding one’s sex with the mental stresses that arise from societal pressure to conform to gender norms.
A subconscious, intrinsic, self-understanding that all people experience regarding their own sex embodiment. Cissexuals tend not to notice or appreciate their own subconscious sex because it is concordant with their physical sex. In contrast, trans people tend to be excruciatingly aware of their subconscious sex (as it is at odds with their physical sex).
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Cognitionforthe of knowing; Schedule thisact session perception
Gender Schedule for this session Dissonance
Ineffable ideas that cannot be expressed in spoken words
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(Fill in the blanks)
How do we describe the in·de·scrib·a·ble
Six Dimensions of Wellness
we are more basic…. “Wellness is the integration of our bodies, genders, minds, selves and communities into the minimum effective dose of rest, nutrition, activity and socialization to maintain ourselves above the level of symptoms.
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Rainbow Health Co-operative
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Where
Does Self-Care Fit into Health?
Social Heath
Personal
Indicators
Heath Indicators
Example: Blood Pressure
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Gender Dissonance Gender Dysphoria Anxiety Depression
Develop
Capacity for long term effort
Time for self-care Reward for behaviour change
HANS KAI Summary A Wellness Program: Develops habits that enhance wellness Informs about self-care Applies the minimum effective dose Maintains awareness of health indicators States when and how to seek help Develops capacity for long term effort Tailored to the individual and provides feedback on results
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4 â&#x20AC;&#x201C; Balance Achieving Balance Emotional and Mental Wellness
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Achieving Balance
Stress What is stress? •Body’s way of responding to demand •Chemicals released give us energy and strength How do we know we’re stressed? Fight or flight Environment Internal Fatigue Types of stress – episodic, chronic
Thoughts about Stress While stress does involve events and our response to them, these are NOT the most important factors. It is our thoughts about the situations in which we find ourselves that is the critical factor.
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3 Stages of Stress •Stage 1 - Body activity is increased – heart rate, rapid breathing, sweating, butterflies •Stage 2 – body uses up its resources (feel tired, fatigue, memory loss, cold/flu, increased consumption of coffee, smoking, alcohol •Stage 3 – Energy stores are drained. Serious illness can develop – heart disease, mental illness, insomnia, personality changes
Coping Mechanisms Short Term:
Long Term:
• ?
• ?
Physical Activity Mingling
Walking Backwards
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Mental Health Mental health is defined as a state of well-being in which every individual realizes her own potential, can cope with the normal stresses of life, can feel productive and fruitful and make a contribution. Taking care of yourself and asking for help when you need it are signs of health and strength. Older adults may experience depression more than others due to so many changes in roles and social networks.
Non-REM Sleep – 75% • Stage 1: Light sleep, between being awake and falling asleep • Stage 2: Onset of sleep, disengaged from surroundings, body temperature drops, regular breathing & heart rate • Stages 3: Restorative sleep – Breath slower, Blood Pressure drops
REM Sleep – 25% Rapid-Eye-Movement Sleep • • • • •
Electrical activation of the brain Very relaxed muscles Body immobile Eyes dart back and form Provides energy to the brain and supports mental function
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Effects of Poor Sleep • • • • • • •
Hand/eye coordination Hormonal function – fat regulation Memory, poor attention Impaired judgment Mood Carb craving Weakened immune system
What gets in the way?
Pain
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Strategies Recognize what you can change Meditation Progressive Muscle Relaxation Emotional Support Physical Activity
Questions?
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Schedule for this session
Check-in 15 Minutes Slides – 20 min Six Hats Sharing Manage the risk 20 min Break + Chat 20 min First Round Sharing – 20 min Check out–15 min 2 hours
Mental & Emotional Wellness A Group Wellness Program
HANS KAI This program brought to you by co-ops co-operating to build a better world – join us today
Original content is covered by a Creative Commons Attribution-NonCommercial-ShareAlike License CC BY-NC-SA Other work subject to the terms of its author
-
1
As Treaty Peoples, we are responsible for establishing and maintaining mutually respectful relationships.
We acknowledge with respect the Indigenous peoples on whose traditional territories we live, whose historical relationship with the land continues to this day and we apologize for our collective treatment of them
INDICATORS
BALANCE
-
SECURITY
HEALTH CARE
SELF-CARE
CHANGES
CLANS
2
HANS KAI
4 TRANS Wellness is the minimum effective dose of rest, nutrition, activity and socialization to maintain ourselves above the level of symptoms.
A wellness program balances our self-care efforts for: our bodies our minds our emotions our gender and our communities
A wellness program specifies the minimum effective dose of rest, nutrition, activity and socialization to maintain ourselves above the level of symptoms.
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3
A wellness program monitors Health Indicators whether gender dissonance or blood pressure
A wellness program integrates self-care and shared-care
A wellness program reinforces behaviours which are low reward but necessary
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4
A wellness program remedies Chronic conditions such as Gender Dissonance
BALANCE Mental & Emotional Wellness
Anxiety and Depression Anxiety: • Generalized fear without a focus that you are aware of • Can come from distance in an attachment relationship • a fragmented sense of self, future worry • fear of future events but unsure of what to be fearful of Depression: • • • •
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Sadness that last longer than two weeks Can become chronic from self-condemnation We turn anger on ourselves to create an illusion we have control Can be simply caused by brain chemicals. See your Doctor
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Anxiety and Stress are not the same
Stress is a response to a threat in a situation Anxiety is a reaction to the stress Managing stress reduces anxiety
What is Stress?
Individual meanings Different for everyone Strain or tension
What causes
N – anything that is new or a novelty. U – unpredictability or unpredicted. T- any threat to the personality. S – feeling a poor sense of control; either real or imagined.
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The Triple A Approach To Stress Alter
The situation
Avoid Accept
The First A - Acceptance We have the capacity for normal stress
Accept
Be as positive as possible
Needs to be done
Going to the dentist
Stress Activates Thoughts and Feelings It’s supposed to Come and go in your mind and body. You cannot control them. You are not them; they are a part of you. You can develop a relationship of acceptance and acknowledgement with them. They can be your friends, allies, and radar to navigate relationships. We have a great capacity to feel so we always have more space for them. Feelings cannot kill us. So calm down.
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Six Core Emotions: Come from deep within your consciousness
Six Core Emotions: Using them effectively vs ineffectively Happiness – things are optimal; keep moving in that direction Sadness – you have suffered a loss; slow down and take care of yourself Fear – be cautious, protect yourself of the danger it tells you is there Anger – you’ve suffered injustice; use the energy to solve the problem Surprise – used a lot in humour; we don’t tense up so it goes away quickly Disgust – way past dislike perhaps as far as repulsive
Capacity to accept comes from The flip side of stress is not relaxation; it is resilience.
The healthful ability to come up with a Plan B in the face of a stress full situation
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The Second A - Avoidance
Identify stressors Remove them Avoid
Take care in using avoidance
Not appropriate whenâ&#x20AC;Ś Just to please others
Avoiding or altering it would reduce your stress more
Feel like you have no choice
The Third A â&#x20AC;&#x201C; Alter Think positively and having a positive attitude Improving specific skills Doing something differently
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1 Be Proactive 2 - Begin with the End in Mind 3 - Put First Things First 4 - Think Win-Win 5 - Seek First to Understand, Then to be Understood 6 – Synergize 7 - Sharpen the Saw
Mindfulness Exercise Would you like to take part in an exercise to become more aware of thoughts and feeling? Would you like to get better at feeling instead of rejecting, avoiding, or suppressing them?
HANS KAI Summary
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HANS KAI Group Wellness Works
QUESTIONS?
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5 â&#x20AC;&#x201C; Healthcare Primary Care Through the Years Get What You Pay For
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Primary Care Through the Years People taking control of their health.
Outline 1. Introduction 2. Annual Check-up 3. Pediatrics – What is involved in a health review 4. Adults – What is involved in a health review 5. Fall Prevention/Senior Concerns 6. Who to see when
Introduction • Everyone should have a primary health care provider • M.D. vs N.P • It pays to prepare – list of concerns and questions - have your medication list with you
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What is an annual check-up? • A time to touch base with your health provider • Will check-in to see generally how you are doing with your health • May also include recommended screens • May not include a head-to-toe exam
Pediatrics Each annual visit could include: • Body measurements – ht, wt, head circumference, BP • Developmental markers • Lifestyle assessment and education • Physical assessment • Immunizations • Parental Concerns/Safety issues
Development • Gross motor • Fine motor • Language • Independence • Socialization For adolescents also include: • Puberty changes
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Lifestyle Assessment • Nutrition • Exercise • Dental Care • Safety issues For Adolescents also include: • Substance Use • Reproductive Health
Immunizations 2 month – Diphtheria, Tetanus, Pertussis, Polio, Haemophilus influenzae, Pneumococcal – total 2 injections 4 month – same as 2 month - boosters 6 month – same as 2 month - boosters 12-15 month – Varicella, Measles, Mumps, Rubella, Meningococcal – total 2 injections 18 month – same as 2 month - boosters 4-6 year – Diphtheria, Tetanus, Pertussis, Polio, Measles, Mumps, Rubella Grade 4 - Hepatitis B, Meningococcal Grade 6 – Girls only – Human Papilloma Virus Grade 9 – Tetanus, Diphtheria
Adults Each visit could include: • Body Measurements – weight, BP • Lifestyle Assessment and Education • Health Screenings • Appropriate Immunizations • Address Concerns • Medication Review – Herbal, OTC, Prescribed • Health History Review
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Lifestyle Assessment • • • •
Nutrition Exercise Pattern Use of Nicotine, Alcohol, Recreational Drugs Stress Management
Health Screens • • • • • • • •
Cholesterol Diabetes Blood Pressure Stool for Occult Blood Cervical Mammogram – 50 – 69 years old, every 2 years Vision – every 3-5 years Hearing – T.V. turned louder? Miss conversations?
Fall Prevention • Balance, muscle tone and bone strength • Vision and hearing • Unsafe conditions - in the home - outside • Proper nutrition • Appropriate footwear
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Vaccines - Adults Tetanus – every 10 years Flu vaccine – annually – especially recommended with young children, elderly and people with chronic disease Pneumonia vaccine – at age 65 or earlier if you have a chronic disease
Who? What? Where? Health Care Provider Health Links – ph: 204 -788-8200 24/7 phone line Quick Care Clinic – 363 McGregor Ave. Mon- Fri 1-8:30 Sat/Sun/Holidays 9-4:30 ER
Questions ??
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2 0 1 8
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6 â&#x20AC;&#x201C; Changes Surgical Choices and Care
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Schedule for this session
Check-in 15 Minutes Slides – 20 min Six Hats Sharing Manage the risk 20 min Break + Chat 20 min First Round Sharing – 20 min Check out–15 min 2 hours
Your Body Surgical Choices and Care A Group Wellness Program
HANS KAI This program brought to you by co-ops co-operating to build a better world – join us today
Original content is covered by a Creative Commons Attribution-NonCommercial-ShareAlike License CC BY-NC-SA Other work subject to the terms of its author
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1
As Treaty Peoples, we are responsible for establishing and maintaining mutually respectful relationships.
We acknowledge with respect the Indigenous peoples on whose traditional territories we live, whose historical relationship with the land continues to this day and we apologize for our collective treatment of them
INDICATORS
BALANCE
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SECURITY
HEALTH CARE
SELF-CARE
CHANGES
CLANS
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A wellness program balances our self-care efforts for: our bodies our minds our emotions our gender and our communities
A wellness program specifies the minimum effective dose of rest, nutrition, activity and socialization to maintain ourselves above the level of symptoms.
A wellness program monitors Health Indicators whether gender dissonance or blood pressure
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A wellness program integrates self-care and shared-care
A wellness program reinforces behaviours which are low reward but necessary
A wellness program remedies Chronic conditions such as Gender Dissonance
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HANS KAI What we hope to explain today Review how a wellness program works Surgical choices and care
CHANGES Surgical Choices and Care
WPATH 7 Standards of care
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ACCESSING SURGERY IN BC Top Surgeries Breast Augmentation Chest Contouring
Hysterectomy 6 months Orchiectomy 6 months A number of surgeons do these surgeries
ACCESSING SUGERIES IN CANADA Phalloplasty Metoidioplasty Vaginoplasty Vulvoplasty Labiaplasty ? Primary care – responsible for surgical readiness Post – surgical Montreal regime TCBC Nurse support for trans post surgery is optional
ACCESSING SURGERY OUTSIDE OF CANADA Any surgery outside of Canada is typically private MSP decision – not common – go to website Out of country option for masculinizing bottom surgeries may be available United States – Expensive with exchange Thailand – Affordable, but travel is major factor Serbia - Affordable, but travel is major factor http://www.transhealthcare.org/
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What costs associated with gender-affirming surgery will not be covered by MSP? While MSP pays for the cost of the above surgeries, there are some costs that are not covered. These include: 1. Travel costs to and from Montreal for lower surgeries and surgical revisions. Please note that masculinizing bottom surgeries, erectile and/or testicular implants require at least two trips to Montreal. 2. Supportive garments (for breast construction and chest surgery) I canâ&#x20AC;&#x2122;t afford the cost of my flight(s) to Montreal for gender-affirming surgery. What are my options? You can apply to Hope Air, a Canadian charity that arranges free flights with commercial carriers, for Canadians who must travel to health care.
A Group Wellness Program
EXPLICIT IMAGES OF GENITALIA AND SURGERY
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Bottom surgeries Trans masculine
Other surgeries Trans masculine
Hysterectomy Metoidioplasty Phalloplasty Scrotoplasty Testicular implants
Top Surgery Body Sculpting
SURGICAL PREPARATION & REQUIREMENTS Trans masculine Electrolysis Required for phalloplasty Must start 1 year prior to surgery
Weight Primary care determines surgical readiness
Other pre-conditions Diabetes Smoking SLIDE NEEDS COMPLETION
METOIDIOPLASTY Clitoris is released from its surrounding tissue and urethra lengthened using clitoral hood or vaginal mucosa
Flap of skin from the labia minora is then wrapped around to create a small phallus
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METOIDIOPLASTY RESULTS Metoidioplasty
Metoidioplasty, scrotoplasty, testicular implants
Phalloplasty
Phalloplasty
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A Group Wellness Program
Bottom surgeries Trans feminine Penectomy Orchiectomy Vaginoplasty - inversion Vaginoplasty - other Vulvoplasty Labiaplasty Clitoroplasty
Other surgeries Trans feminine Augmentation Saline / Silicone
Facial Feminization Trachea Shaves Body Contouring Liposuction
SURGICAL PREPARATION & REQUIREMENTS Trans feminine Electrolysis US – Required by most Canada – Optional Best started 1 year prior to surgery and stopped 2 months before surgical date
Weight Primary care determines surgical readiness
Other pre-conditions Diabetes Smoking
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8 Post surgical
7 Labias formed
6 Neo vagina drawn in
5 Cavity created
4 Neo vagina formed
3 Cavernosa removed
2 Glans released
1 Testes removed
Vaginoplasty – penile inversion
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Vulvoplasty
Labiaplasty - Clitoroplasty Before labiaplasty
After labiaplasty
Orchiectomy
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Post surgical aftercare â&#x20AC;&#x201C; trans feminine trans masculine BOTH Wound Care Pain Management Mobility Swelling Separate
Separate
Sex
Dilation Douching
HANS KAI Summary
Surgery
ACCESS PREPARATION
COSTS TRAVEL AFTER CARE PLAN RECOVERY SCHEDULING
HANS KAI Group Wellness Works
QUESTIONS?
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2 0 1 8
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7 â&#x20AC;&#x201C; Clans Families of Origin and Choice
F A C I L I T A T O R
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Working Together Respecting boundaries and working without a leader
Check-Ins •
Check-ins are a great way to start off every meeting.
•
They give everyone a chance to give an update about how they’re feeling
•
It also gives the group a better understanding of people’s actions for the rest of the meeting
•
With a check-in you only have to share what you want
Boundaries •
There are many ways of thinking about boundaries – – – –
•
Borders between countries Fences around a playground Personal boundaries Personal values
Our boundaries are defined by our experiences, our beliefs and our culture.
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Boundaries • In Hans it’s natural for some people to open up about personal health information or life experiences. • It’s also natural for some people to not be as comfortable opening up.
Boundaries • If one person feels comfortable enough to share information it doesn’t mean you or anyone else must. • Everyone has the right to set their own boundaries
Boundaries • Hans groups should be a safe space for everyone. • Respecting people’s privacy, beliefs and boundaries is key to a successful group.
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Consensus • Consensus means that decisions are made in a way that everyone has had an equal say • A group using consensus requires a culture of cooperation, openness and involvement • It only takes one ‘no’ to block the decision
Consensus
With consensus everyone brings a piece of the puzzle. You can’t finish the puzzle unless everyone has a say.
Consensus • If someone says ‘no’ you must work together to reach a compromise where everyone is comfortable enough to say ‘yes’ OR at least not say ‘no’ • Remember, just because you can block (say no) doesn’t mean you always should. • Ask yourself “Is this something I can live with?”
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Consensus • When someone says ‘no’ then the group needs to have a conversation. • It helps the conversations move smoothly if one person becomes a facilitator. • A facilitator should be chosen prior to the meeting and the same person should not always be the facilitator.
Topic
E.g.: What should we eat next meeting?
Suggestions
E.g. Let’s have red pepper hummus
No
Block
Someone says no to the idea
Discussion
No
Consensus
Everyone agrees
Chat about why someone said no E.g. Charlie is allergic to red peppers
Adjusted Suggestion
Make new suggestions that respect and include everyone's thoughts E.g. Let’s have regular hummus
Tuckman’s Stages •
When people get together in a group they don’t usually jump right into things perfectly
•
There are always some growing pains along the way
•
In 1965, Dr. Bruce Tuckman developed a model with four phases that every group goes through when developing. 1. Forming 2. Storming 3. Norming 4. Performing
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Tuckman’s Stages Forming • This is where all groups start out •
It’s the ‘Get to know you’ stage for members where you learn about each other and the task (Hans) at hand
•
Individual behavior is usually driven by a desire to be accepted by the others, and avoid controversy or conflict
•
This stage might include: Unclear objectives, uninvolvement, uncommitted members, confusion, low morale, hidden feelings, poor listening, etc.
Tuckman’s Stages Storming • Every group will enter the next stage in which different ideas compete for consideration. •
The storming stage is necessary for the growth of the team.
•
It can be difficult, unpleasant and even painful, especially for members of the group who are averse to conflict. Tolerance and patience are key here for the success of the group.
•
This stage might include: Lack of cohesion, subjectivity, hidden agendas, conflicts, confrontation, resentment, anger, etc.
Tuckman’s Stages Norming • In this stage, all group members take the responsibility and have the ambition to work for the success of the group's goals. •
Some team members may have to give up their own ideas and agree with others in order to make the group function, but they are now more comfortable doing so.
•
This stage includes: Questioning performance, reviewing/clarify objective, changing/confirming roles, opening risky issues, assertiveness, listening, identifying strengths and weaknesses etc.
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Tuckman’s Stages Performing • The group members are now competent, autonomous and able to handle the decision-making process with minimal outside help. •
Disagreements are expected and allowed as long as it is channeled through means acceptable to the team.
•
This stage includes: Creativity, initiative, flexibility, open relationships, pride, concern for people, learning, confidence, high morale, etc.
Tuckman’s Stages On Going • Even the highest performing groups will slip back into earlier stages every now and then • This is a normal part of a group’s growing pains
Questions?
6
Schedule for this session
Check-in 15 Minutes Slides – 20 min Six Hats Sharing Manage the risk 20 min Break + Chat 20 min First Round Sharing – 20 min Check out–15 min 2 hours
Facilitation for Groups A Group Wellness Program
HANS KAI This program brought to you by co-ops co-operating to build a better world – join us today
Original content is covered by a Creative Commons Attribution-NonCommercial-ShareAlike License CC BY-NC-SA Other work subject to the terms of its author
-
1
As Treaty Peoples, we are responsible for establishing and maintaining mutually respectful relationships.
We acknowledge with respect the Indigenous peoples on whose traditional territories we live, whose historical relationship with the land continues to this day and we apologize for our collective treatment of them
INDICATORS
BALANCE
-
SECURITY
HEALTH CARE
SELF-CARE
CHANGES
CLANS
2
HANS KAI
4 TRANS Wellness is the minimum effective dose of rest, nutrition, activity and socialization to maintain ourselves above the level of symptoms.
A wellness program balances our self-care efforts for: our bodies our minds our emotions our gender and our communities
A wellness program specifies the minimum effective dose of rest, nutrition, activity and socialization to maintain ourselves above the level of symptoms.
-
3
A wellness program monitors Health Indicators whether gender dissonance or blood pressure
A wellness program integrates self-care and shared-care
A wellness program reinforces behaviours which are low reward but necessary
-
4
A wellness program remedies Chronic conditions such as Gender Dissonance
Clans Facilitation for groups
Welcome • • • • • • •
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Thank you for coming today! Knowledge-sharing. The first training session, definitely not the last. Foundational information. Please read through the manual. There are no right or wrong answers. Feedback!
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Facilitator 101 What is a group facilitator? What does being a group facilitator mean to you? What qualities are important in a facilitator?
• • •
Responsibilities of Facilitators
What do you think are the main responsibilities of facilitators?
•
Co-Facilitation • • •
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How many people here work with a co-facilitator? How have you divided tasks between you? How do you communicate?
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Safe Spaces • •
How do you create a safe space? What is a Safe Space Agreement?
Co-Facilitation Turn to the person next to you: • Discuss some questions you feel are important to ask your cofacilitator before starting your group. • What would you like your co-facilitator to know about you?
Personal Pronouns
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•
What are personal pronouns?
•
How do you ask about someone’s personal pronouns?
•
What do you do if you forget someone’s personal pronouns?
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Safe Space Agreement Exercise •
Turn to the person next to you and practice creating a Safe Space Agreement.
Professional Boundaries • •
Why are boundaries important? What boundaries must be established?
Debriefing • • • •
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What is debriefing? What situations warrant debriefing? What are the stages of debriefing? Have you experienced situations where you wished you had debriefed them afterwards?
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Group Exercises • •
•
Why are exercises important? Does anyone have an example of an exercise they have used in their group? What should you consider when designing an exercise?
Handling Feedback
• How many people have received feedback before? •
How do we react to feedback?
•
How do we want others to react?
Peer Support
•
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What is peer support?
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Equal Status and Experience • • • •
What does equal status mean? Who feels like everyone in their group shares equal status? What is the difference between knowledge and experience? How do we support individual experiences?
Giving and Receiving Are you the only one giving support in your group? How do we balance lived experience with participant focus?
• •
Communication
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How do we best communicate with group members?
•
Do we use “I” statements or “you” statements?
•
Do we address ideas or people?
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Active Listening • •
What is active listening? How can you tell when someone is actively listening to you?
Active Listening •
Turn to the person next to you and tell them the story of how you became a facilitator. Have them repeat it back! Then switch!
Confidentiality • • •
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What does confidentiality mean? What should be kept confidential? What do you do when you run into group participants outside of the group?
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Disclosure • • •
What is disclosure? Have you had someone disclose to you before? Would you handle it differently in retrospect?
Group Goals and Guidelines • •
What are group goals? Why are group goals important?
• •
Why are guidelines important? What are some guidelines you have established in the past? What questions would you ask yourself when creating guidelines? How can you tell that it is time to revise guidelines?
• •
Healthy Groups
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•
What is a healthy group?
•
What are the signs of a healthy group?
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Unhealthy Groups • •
What is an unhealthy group? What behaviours are common in unhealthy groups?
Difficult Dynamics
• •
What difficult dynamics have you experienced? How did you handle them?
Difficult Dynamics Exercise • • •
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Think of one difficult dynamic or participant you have had in the past. Share a situation with the group. Look through your charts and match up the behaviour with a solution!
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Group Decision-Making •
Why is group decisionmaking important?
•
What are some characteristics of group decision-making.
Facilitator Checklist • • •
Included a checklist in your manual. Please take time to read through your manual. We wanted today to be a bottom-up approach. The manual is more top-down. Please read through the Code of Respect at the back.
HANS KAI Group Wellness Works
QUESTIONS?
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