Charting Your Course : Teach Charting Your Course : Seminar I - Facilitator's Guide

Participant Material for Seminar I
Evaluation Form for Seminar I

It would be helpful for an oncology nurse to be present for the first hour to explain common symptoms and symptom management strategies.

Materials

flip chart and markers
several sheets of paper for each participant
pens

Objectives

Have the opportunity of sharing experience with others
Learn approaches to pain and symptom management.
Understand what contributes to establishing a personal sense of control.

Opening

Introduce yourself
List the objectives of this session
Explain logistics - time, rest rooms
Explain the confidentiality policy: everything that is shared in the group should stay here.
Discuss acceptance: there are no good or bad emotions or questions. We are here to listen and grow without fear of judgment. Each person's process of coping is different. There is no right way to feel. Honor your own tempo. It is your choice to speak or to be silent.

Introductions

Ask each participant to introduce him or herself and say briefly what he or she hopes to gain from this series. Caregivers are encouraged to take these seminars as well as patients. Both patients and caregivers can benefit from the information presented.

Symptoms of Disease/Treatment and Their Management

Discuss with the group:
What symptoms have participants experienced?
List symptoms on a flip chart.
It would be helpful for a nurse specialist to discuss symptoms and symptom management at this point. If a specialist is not available to make a presentation, refer to the materials in Seminar I for general information on these topics:

Assessment of pain and symptoms
Record-keeping and reporting pain and symptoms
Cancer and pain
Issues of fatigue
Stress Management
Normalcy of Anxiety and Depression
Sexuality

A Sense of Control

One aspect of facing a serious illness is that we feel we have lost control over our own life. We forget that we, with our values and our circumstances, are in the driver's seat. What has helped people to regain your balance, to take hold of a situation and make good choices?
Exercise:
Have each participant make a list of things that help them feel in control.
This list was compiled in a pilot workshop:

Faith and spirituality
Sense of survivorship - feeling that I can beat it
Able to express emotion
Support
Having information
Confidence in making choices
Given permission to make decisions
Respect
Keep normal life style
Keep working
Not be isolated - be with people
Laughter - sense of humor
Financial resource - but also blood, sweat & tears
Quiet time
Knowledge
Feeling people are being honest & forthright
Having time to ask questions
Faith in caregivers
Having confidence
Be with people who can be human
Be flexible
Accept fact that you can't control
Being able to help
Ability to talk - communicate
Taking a pro-active approach
Doctors/administrators

Have individuals read their lists aloud and compile a group list on a flip chart.
Discussion points:
In what ways do you feel in control of things now?
What can you do to feel more in control?
What resources inside yourself and outside can you call on to make a difference in your present situation, if you want to?
Exercise:
Now have everyone make another list of actions they can take to feel more in charge of their lives.

A Relaxation Exercise

Have everyone practice the following relaxation exercise:
Try to picture a place in your mind that you find very appealing. It can be a meadow, a beach, a mountain, or another location that is special just to you.
Close your eyes and picture yourself in that place.
Look around in your mental picture and note the beauty of that place. Take in the colors that you see. Take time to look closely at details that are appealing to you.
Imagine that you can smell special smells of this place: maybe salt air, or the freshness of a meadow. Breathe in deeply and slowly. As you exhale. Imagine that the tension you have been feeling is flowing out.
Feel the warmth of the sunshine or the coolness of a gentle breeze. Run your hand along the sand or grass. Feel the inner peace that comes from being in a place where you are in control.
Recognize that you can return to this image, this special place in your mind whenever you want.
When you are ready, slowly focus your attention on your current surroundings. Return to the here-and-now renewed and refreshed.

Problem Solving

Everyone has problems, worries and concerns. If a problem seems impossible to solve, we may be using up all our energy in worrying about it.
Here is a framework for addressing problems:

Clearly define the uppermost problem.
Recognize how you feel about that problem.
Relax and try not to think about solutions for a while.
Consider all possible solutions, even "bad" ones.
Try to imagine how other people might solve the problem.
Evaluate the pros and cons of each solution.
Arrange the various solutions into a list, starting with the least desirable or least practical ones and working up to the most desirable or practical ones. Talk about your list of solutions with family, friends, or advisors.
Make a choice. Remember that not all choices are final. Be flexible.
Consider some favorable or positive aspect of the original problem. Can you think about it differently?

Discuss: would using this system help the group members address and resolve some of their concerns?

Closing

Are there any questions or comments on today's session?

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This content is derived from the "Charting Your Course Seminars: A Whole Person Approach To Living With Cancer", provided by Norris Cotton Cancer Center.