Things to watch out for in groups
Peers will have differing experiences of living with diabetes and diverse personalities.
Initial introductions and conversations will give you some idea about the more talkative/shy members of the group. If it seems appropriate you may want to ask a quieter member of the group a question to encourage them to participate, if other peers appear to be contributing more than others.
The outcome of the group meetings depend on how the individuals relate to each other. If you have any thoughts on how your group is working, it would probably be useful to write these down and reflect on them to give you ideas on how to run future groups.
It may become clear that some group members have a negative approach to a topic. They may also encourage others to agree. If this happens, there are a number of things you could do.
One of these might be to begin to look for solutions to the issue under discussion. But do not jump straight into this – make sure the peer has the chance to express the reasons and experiences that the negative approach is based on. Once they have told their story, try to respond, or encourage other peers to respond, with ideas for helping the peer deal with their negative feelings.
Another possibility is to ask a more positive member of the group to contribute their approach to the issue. They too will encourage others to agree with them, and with your reinforcement, it may help to bring the entire group to unite in a more constructive way.
Below, we have included additional information to support you in managing more challenging situations with your peers.
As a peer supporter, it is necessary be aware of the issue of bereavement, which may be experienced both by your peers and yourself if someone else in your group passes away.
In the first case, although you can of course offer comfort – mainly by being a good listener (see here) you will not be qualified to deal with peers’ bereavement – unless the peer support group is specifically set up around the issue. Rather, you will want to suggest that those dealing with the issue seek professional help. In general, it is important to be aware that bereavement is a reason why people may not come to sessions or may be emotionally distressed during them.
It is of course possible that someone in the group passes away, especially if you dealing with a terminal or chronic condition. Training for people running these groups needs to pay thorough attention to bereavement issues, and advice on when to refer to a healthcare professional.[not sure what else to put here. We originally included this section because a facilitator phoned up a peer and found out they had died from their spouse – but I’m not sure what advice we could give to help counter that].
In running peer support sessions you are likely to come across a number of challenging situations. To get an idea of some of these issues, take a look at the following video:
We have suggested some of the most common situations below, but people are of course unpredictable, and others might come up! We hope that in thinking to some possible solutions to these, common themes emerge, and a certain way of dealing with challenging situations will become apparent. This should equip you to deal with an approach to tackle any situation that arises. Another point is that how you handle some of these situations will depend on the group size, as with a peer who is very quiet, for example. After this exercise, we have suggested some principles for managing challenging situations.
Challening situations exercise
It would work well to go through these challenging situations in pairs or groups, and then compare your answers to some of our suggestions further down.[note we could have boxes that people fill in here. We could even ask them to submit their responses – a source of data perhaps? Again we could link to a word file so that people could download the exercise].
- A peer calling you everydayAlthough it may be difficult to do, it is probably best to approach the peer and suggest that you are busy with other commitments outside of the time you spend volunteering to be a peer supporter. You could emphasise that you are volunteering, and are not paid for the role. It might be useful to suggest certain times where you can answer your phone e.g. one morning or evening a week. You could then suggest that the peer could phone other people for support. To facilitate this, you could have a list of support services available, including services for people in crisis like the Samaritans. If you are working with other peer supporters, you could ask them whether they have more time to speak to peers on the phone.
- A peer dominates your sessions for long periods of time making it hard for other peers to talkThere are various ways to try to tackle this problem. One solution would be to be say something like “I am conscious that a few people in the room haven’t had the chance to share their thoughts yet… John [quiet member], have you ever experienced this?”. You could also ask the group to do ‘rounds’, where you go round each member in turn and ask them to say something. Asking the peer if you can talk about it with them later might be another solution. If the situation continues, you could approach the peer after the session, and thank them for their input, but note that others are not really getting a chance to speak, and ask him to help you to try and ensure that happens.
- A peer want you to give them medical advice (e.g. looking at feet, change in medications etc.)It is best to remind the peer that you are not a health professional and are not qualified to give medical advice. You can talk about your experiences with checking feet, changing medications, and how you used health services to do this. That way, you can help the peer to do the same in order to help with their problems. You can refer the peer to clinical services – see the page here.
- A peer doesn’t speak at all during the sessionsYou could ask the peer what they think (if you sense that it wouldn’t make them uncomfortable), or engage in rounds so that everyone gets a chance to speak. If you have a large group, you could break off into two smaller groups so that the peer is in a group they find more comfortable. It may be that the peer is not speaking for a variety of reasons – they cannot hear properly, maybe they cannot understand people’s accents, they might not be interested in the material, or they might be shy. If the peer continues not to speak, you probably want to try to ascertain why, so they you can help more effectively. Ask them about it after and not during the session.
- You think a peer is having a hypo
Below we have provided some general principles to follow in challenging situations.
Principles for managing challenging situations
- Find the right time to approach the person.
- Acknowledge the person’s beliefs/opinions (this doesn’t mean you have to agree with them)
- Deal with the situation as soon as possible; waiting may cause more problems.
- Find something positive to say to the person (they attend regularly, are cheerful, etc.).
- Stay positive and avoid condemning words or behaviour. Even bad situations can be approached positively.
- Be honest, specific, and straightforward – in a tactful manner – about what attitudes or behaviours are causing difficulties.
- Don’t be afraid to say you do not know the answers and be honest about this.
- Ask for change. Help the person determine what they must do to think or behave in a more acceptable manner.
- Be patient. Allow the person time to tackle their attitudes and behaviour.
- Support their positive response and efforts to make the necessary adjustments.
- Consider asking the individual to leave if he or she refuses to co-operate. This is a last resort move after every other alternative is exhausted.
Other possible challenging situations are :
- Peer talking too much
- Peer talking too little
- Peers chatting amongst themselves
- A disruptive peer, subversive of the process
- Background noise/venue problems
- Run out of things to talk about
- Everyone seems set in their routine
- People won’t ‘open up’ in sessions