By Prudence Hopkins, MA, BCC
Two afternoons a week I am assigned to provide pastoral care at the freestanding psychiatric hospital that is part of the Mary Washington Healthcare System. The psychiatric facility is divided into units based on acuity and age. I see patients both in group settings and one on one.
Feedback is mostly positive. Overall, the patients like group time with the chaplain, saying it’s surprisingly different than they assumed it might be. There also have been times when the dynamic is not ideal and generating interest and discussion can be difficult at best. Fortunately these times are infrequent.
Structure for this group is extremely important as participants seek stabilization and a sense of inner well-being. This article shares what I have found to be a successful framework for holding group support, simply called “Chaplain Group.” Chaplain Group support meets with the less severely ill adults in the non-acute unit.
I begin with open eyes, open ears, open mind and open heart. I remain curious about what I will learn, and how the dynamic will unfold. When sharing is going on there is no judgment, no praise, no critique, as if focusing with the lens of a camera. We follow rules of respect and confidentiality as is expected in these settings. I am mindful of times when I might be a little closed-off or distracted and find it’s important to check myself and return to a place of openness. Then the dynamic flows better.
We begin with introductions. I introduce myself and make sure that I know the names of everyone before we proceed. This intentional getting-to-know-names witnesses to the importance of who we are and our narrative. Usually, the members of the group know one another. However, this cannot be assumed as there are times when this might be the first group for someone newly admitted. Routine introductions ease the newcomer into the mix.
The next endeavor is for each person to say in one word what they are feeling at that moment. Here we honor each feeling by remaining silent, witnessing with respectful presence. I request that each one remember the feeling words so that at the end of group they can reflect back to see if they notice any changes from within.
Next, I ask if there are any topics of a spiritual nature that could be brought up for discussion. When someone brings something to light I make an assessment. To prevent a monologue, if this is something that would be better talked about one on one, I invite that person to set a time to talk with me individually. There are times when the group decides to take on an item brought forth by a peer, and we run with it. As with any group process, as long as most of the group engages we have success. When someone comes to the group and does not share, that is also acceptable.
When there aren’t any spiritual issues brought forth from within the group, I have a theme or a themed activity to engender discussion. For example, throwing out the word “faith,” I may ask: What does this word mean to you today? When has faith kept you centered? Have you ever felt a loss of faith? What happened? What feelings arise when you hear the word ‘faith’? Frequently the group latches on to the topic and conversation ensues. My role at this time is to ensure that no one person dominates the group or hijacks the group off topic. This continues for about 45 minutes and then, “Unfortunately, we have to conclude,” denoting entry into wrap-up mode.
Wrap-up mode is the last part, and perhaps the most important part of this format. Participants are invited to verbalize a take-away thought or feeling that they now claim by virtue of the fact they showed up. Often, persons with social anxiety, depression and other mental disorders find that it takes great effort to participate. Now is the time for insight and affirmation as peers validate each other’s contributions to the discussion. This way they deepen connections with each other and in some cases “normalize” feelings that may not have been normalized before. Mutual support, understanding, and respect among peers become evident. It is a transformative time to behold. There is a different tenor in the room.
The importance of showing up becomes evident when discovery takes place. There are times when individuals who did not participate but only observed, now, speak to the others for the first time. This demonstrates that even though they are not engaging verbally, they are listening in and internalizing. Being there has made a difference. Simply being.
Some theological insights brought forth, perspectives of the holy, are quite unique. The beauty of chaplain group is that it can create a redemptive time through which the group witnesses a transformation toward a renewed sense of dignity and hope.
“It’s time for Chaplain Group! All are welcome.”
Prudence Hopkins, MA, BCC, is staff chaplain at Mary Washington Healthcare in Fredericksburg, VA.