.!JNIVERS:n c, ·· .. hTHERN ' BRITISH CCWMBIA UBRAFN Prince George, B.C. SELF-ADVOCACY AND SELF-DETERMINATION FOR STUDENTS WITH DISABILITIES: AN EMPOWERMENT GROUP by Dave Barck B.A., Vancouver Island University, 2007 THIS PROJECT SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF EDUCATION IN COUNSELLING UNIVERSITY OF NORTHERN BRITISH COLUMBIA April2014 © Dave Barck, 2014 ii ABSTRACT The purpose of this project is to provide a facilitator manual for counsellors that lead psychoeducational support groups for Students With Disabilities (SWDs) in higher education. This project begins with background information regarding SWDs in higher education and rationale as to why a group focused on building self-advocacy skills and selfdetermination is a needed service for SWDs. A literature review on SWDs in higher education and the use of group therapy with SWDs in educational settings is provided, as well as a discussion of influential theories in the creation ofthe manual. An outline ofhow the project is structured is offered, which includes important information for creating the group and proposed topics. Finally, a facilitator manual for a psychoeducational empowerment group for SWDs is presented which outlines the procedures for implementing the group including suggested activities. iii Abstract TABLE OF CONTENTS 11 Table of Contents 111 Acknowledgements Vll Chapter 1 Chapter 2 Introduction 1 Purpose 4 Significance of Project 6 Personal Location 7 Overview of Proposal 10 Literature Review 12 Defining Disability 12 Medical Model 13 Functional Limitation Model 13 Ecological Model 13 Disability Definition for Project 14 Types ofDisabilities 15 Disability History and Legislation in Higher Education 16 Services for Students with Disabilities 18 Experiences for Students with Disabilities 20 Counselling and Students with Disabilities 24 Addressing Needs Through Group Therapy Disability and Group Therapy 25 28 Disability-Related Groups in Education 29 Disability-Related Groups in Higher Education 30 iv Chapter 3 Theoretical Influences 32 Person-Centred Theory 32 Integrated Elements 35 Positive Psychology 35 Expressive Arts Therapy 37 Narrative Therapy 39 Psychoeducational Group Format 40 Preventative Focus 41 An Inclusive Group Population 41 Small Institution Size 42 Weaknesses ofNot Defining Disability 42 Cultural Competence and Countertransference 43 Chapter Summary 45 Project Description 47 Goals of Manual 47 Facilitator Manual 47 Target Audience 47 Facilitator Qualities 48 Ethical Consideration 48 Proposed Group Schedule 50 Participants 51 Screening 51 Confidentiality 52 Accessibility 53 v Chapter 4 References Cultural Competence 54 Countertransference 54 Topic List 55 Session 1: Introduction and Self-Awareness 55 Session 2: Self-Awareness and Group Connection 56 Session 3: Communication and Assertiveness 56 Session 4: Self-Advocacy 57 Session 5: Self-Determination 57 Session 6: Self-Determination and Closing 58 Chapter Summary 58 Facilitator Manual 59 Table of Contents 59 Introduction 62 For the Facilitator 67 Planning the Group 73 Running the Group 80 Session 1: Introduction and Self-Awareness 81 Session 2: Self-Awareness and Group Connections 91 Session 3: Communication and Assertiveness 100 Session 4: Self-Advocacy 105 Session 5: Self-Determination 111 Session 6: Self-Determination and Closing 119 After the Group 124 125 vi Appendix A Disability Awareness 137 Appendix B Disability Rights 140 Appendix C Screening Interview 142 Appendix D Group Consent Form 143 Appendix E Group Accessibility 146 Appendix F Relaxation Exercises 148 Appendix G Fishing Exercise Handout 150 Appendix H Assertive Communication Handout 151 Appendix I Disclosing Disability 152 Appendix J Self-Advocacy Role Play Scenarios 156 Appendix K Community Resources and Links 158 Appendix L Group Evaluation Form 160 vii Acknowledgments There are many people that supported me in this process who I would like to thank. First, I would like to thank my very supportive and insightful supervisor, Dr. John Sherry, for his patience, encouragement, humour, and guidance in helping me stay positive and focused on my project. It was a pleasure and great fortune to be able to work with someone so dedicated, knowledgeable, and supportive of my work. John' s expertise in group therapy was a tremendous asset to draw from, and his guidance throughout the process was invaluable. I am also thankful for my committee members Dr. Linda O'Neill and George Dunne for their support and input as well. George's knowledge and experience counselling students with disabilities was an exceptional perspective to have in the development of my project, while his suggestions and encouragement were very valued. In addition to my committee members, I would like to thank my work supervisor, Brenda Christensen, who has been a remarkable mentor in the field of disability services in higher education. Her experience, expertise, and her student first approach working with students with disabilities at the UNBC Access Resource Centre has been vital to this project, as has her continuous encouragement. I would also like to thank my very patient, supportive, and loving wife, Sarah Henkelman, for always believing that I could do this and keeping my spirits up throughout this challenging yet rewarding process. 1 Chapter 1: Introduction The number of students with disabilities (SWDs) attending higher education institutions has been increasing in Canada (McCloy & DeClou, 2013) and in the United States (Hamblet, 2011; Kundu, Dutta, Schiro-Geist, & Crandall, 2003; Maduas, 2011; Wilson, Getzel, & Brown, 2000). In addition to this trend, many SWDs utilize more services on campus and take longer to complete their degrees compared to students without disabilities (McCloy & DeClou, 2013). Therefore, institutions should prepare for a continued increase in the enrollment of SWDs on campus and for having adequate resources to meet their needs. However, according to McCloy and Declou's (2013) study, SWDs are less likely to complete their higher education programs than students without disabilities. This finding suggests that there may be room for improvement regarding the current level of services being offered to SWDs. SWDs face several unique challenges while attending postsecondary. These challenges can include accessing education and the added stress of organizing accommodations (Holloway, 201 0), facing stigma and negative self-evaluations regarding disability (Holloway, 2010; Murray, Lombardi, Bender, & Gerdes, 2012; Stein, 2013), facing challenges regarding self-disclosure and self-advocacy (Beecher, Rabe, & Wilder, 2004; Eckes & Ochoa, 2005; Holloway, 201 0; Kundu et al., 2003), and having a lack of selfefficacy or confidence in abilities (Beecher et al., 2004). SWDs also can face additional physical or emotional stress associated with having a disability (Porter, 2011). Current levels of services for SWDs in higher education tend to primarily focus on educational access through the implementation of academic accommodations (Beecher et al., 2004). Although accommodations are considered effective for increasing access to education (Newman, Wagner, Cameto, & Knokey, 2009) and are considered valuable by SWDs (Kundu et al., 2 2003; Newman et al., 2009) there is evidence that SWDs would benefit from further support regarding self-advocacy (Eckes & Ocha, 2005; Getzel, 2008; Getzel & Thoma, 2008; Kundo et al.,2003; Roessler, Brown, & Rumrill, 1998; Test, Fowler, Wood, Brewer, & Eddy, 2005), self-determination development (Beecher et al., 2003; Getzel & Thoma, 2008), and building social supports (Murray et al., 20 12). Holloway (20 10) suggests that although institutions provide services to accommodate SWDs, SWDs still experience marginalisation and disempowerment. Supporting SWDs by providing services that focus on developing selfadvocacy and self-determination skills could potentially empower SWDs. SWDs can access other supports on campus such as counselling centres regarding development of self-advocacy and self-determination skills. Research supports that SWDs utilize counselling centres at a higher rate than students without disabilities and for longer periods of time (Porter, 2011). However, a potential problem in providing individual counselling regarding these concerns for SWDs is the limited resources available in counselling centres and that counsellors may not be educated about disability culture and issues (Beecher et al., 2003; Porter, 2011). A possible alternative to individual counselling is facilitating a counselling group specifically designed for, and sensitive to the needs of, SWDs in higher education. This project will provide a framework for a group designed to address self-advocacy, selfdetermination, and increase social support for SWDs in higher education. Murray, et al. (2012) suggest that implementing a social support intervention specifically designed for SWDs would be a helpful and cost-effective intervention for increasing self-efficacy. Not only can group counselling be more efficient than individual counselling, it also offers a greater opportunity for social connections (Gladding, 2008). The social connections facilitated through group work could be beneficial for SWDs, as research has indicated that 3 social supports, such as friendships, are an important component for success for SWDs in higher education (Gibson, 2012; Murray et al. 2012; Mytkowicz, Goss, & College, 2012; Wilson et al. , 2000). In current research there are specific disability-related groups offered at university, however I did not find groups that addressed empowerment themes for SWDs. Many groups tend to focus on populations of students with specific disabilities or specific themes. An academic support group for students with learning disabilities (LDs) in higher education was developed by Johnson (2002) and focuses primarily on academic strategies. Other counselling groups offered in higher education tend to focus on anxiety and depression when working with disabled students (Gladding, 2008). Other specific disability-related themes for groups include helping students with exam anxiety (Darner & Melendres, 2011) or social anxiety (Darner, Latimer, & Porter, 201 0). There are also groups designed and implemented in high schools to support students with LDs in the transition to higher education (McEachern & Kenny, 2007; Milsom, Akos, & Thompson, 2004). Thus the current counselling groups at many institutions have focused on academic skill building, transitioning to higher education, or providing groups for specific types of disability populations such as those with anxiety symptoms. I have created a manual for facilitators to lead a group that focuses on empowering SWDs through a focus on self-awareness, selfadvocacy, self-determination, and peer support. The theoretical orientation I use for the formation of the group is a person-centred approach that draws integrative elements from positive psychology, narrative therapy, and art therapy. The rationale as to why I chose these theories is discussed in Chapter 2. The intended users of this manual are qualified professionals at higher education institutions that provide services for SWDs. The design of this empowerment group is specifically intended for small size institutions with limited 4 resources, and where the population of SWDs may not warrant creating multiple counselling groups that focus on specific issues that those with disabilities face. Purpose The purpose of this project is to provide a facilitator manual for higher education counsellors so they have a framework for implementing a psychoeducational group for SWDs at their institution. The manual explains how to construct this group with a focus on themes of empowerment specifically for SWDs. A psychoeducational group design is used for several reasons. According to Corey, Corey, and Corey (2010), psychoeducational groups are structured according to specific topics, incorporate skill building exercises regarding these topics, and aim to provide members with increased awareness and tools to better cope with specific life issues. The aim of this group is for SWDs to develop greater self-awareness as well as self-advocacy and self-determination skills, in order to reduce disability-related challenges in higher education. A psychoeducational group can also provide a safe, respectful, and supportive environment conducive for facilitating interpersonal skills and connections between members (Corey et al. 201 0). Increasing social connections and communication skills are an important function of this group. Although some of the themes focused on in the manual could be suitable for longer term psychotherapy groups, the time restraints of the semester make the psychoeducational format more conducive for implementation in a higher education environment. The length of the group is designed to fit into the time restraints of a four month semester. As students in higher education face many time demands, the length of the group proposed is a short term group of up to six closed sessions. I have suggested a closed group format so that students have the opportunity to build relationships within the group and establish cohesion and trust with one another. In a closed group, members will be expected 5 to remain in the group until it ends and new members are not added (Corey et al. 2010). Any student with a disability, regardless if they have registered with the disability service office of their institution, can apply to join the group. Rationale for a mixed disability population of students is discussed in Chapter 2. The themes of self-determination and self-advocacy that are addressed in this group are considered important for SWDs transitioning into higher education (Eckes & Ochoa, 2005), therefore the intervention is directed primarily at first or second year undergraduate students. However, because I do not believe these themes are isolated to first year students, I suggest being flexible in considering undergraduates at any level should they be interested in the group. Members selected for group will be chosen through a screening process taking into account the personalities of potential members and their interest in the topics. The screening process is discussed in Chapter 3. Although psychoeducational groups are commonly used in higher education (Corey et al. 201 0), I did not come across any other groups designed specifically for SWDs that focus on empowerment and the themes of self-advocacy and self-determination utilizing a creative, person-centred approach. While some of the needs addressed in this group may be met through the disability support offices on campus or through counselling centres, these supports are typically implemented on an individual basis. Using a group format to address these themes can benefit a larger number of students while utilizing fewer resources when compared to providing individual counselling. Furthermore, counselling staff may lack knowledge regarding disability issues and require further training regarding working with people with disabilities (Beecher, et al. 2003). This lack of training could impact the competency of counsellors working with SWDs. The group facilitation manual can be a resource for counsellors to increase their awareness regarding disability issues. Added benefits of implementing a group for SWDs is that group work provides a greater sense of 6 community where peers can realize they may not be alone in their problems, members can learn a great deal from one another, and the group can serve as an opportunity to further develop communication skills in a safe environment (Corey, et al. 2010). The question may arise whether off campus community resources might be a better fit to provide counselling groups for specific disability types. Off campus resources in the community are not necessarily accessible to students. Many students attend higher education institutions from out of town; therefore campuses act as a centralized place for services. Referring students to services off campus may not be considered appropriate support for students that pay for student services at the institution they are attending, or they may not be eligible to receive such services. This dynamic can be particularly true if in an institution is located where community resources are limited, such as in rural communities. Furthermore, by holding a group for SWDs within the institution, greater connection with peers is anticipated. Significance of Project Providing a counselling group for SWDs at university can be beneficial for both students with SWDs and for higher education institutions. Offering a psychoeducational support group to SWDs will provide a service designed to help these students develop greater self-determination, self-advocacy, assertiveness, and social connection, all ofwhich can be important factors for academic success. By developing these skills, students can be better prepared to advocate for their needs with instructors, seek help when needed, have greater self-efficacy regarding their abilities, and form social support systems. This skill set can in tum help their chances at success in higher education. The use of groups in higher education can also increase the sense of belonging and community for those that participate (Corey et al., 201 0). 7 This group could benefit the institution by potentially increasing the recruitment of students as well as providing a service that could contribute to student retention. Providing excellent service to SWDs is very important for recruitment since many SWDs choose the school they attend based on the types of support services available to them (Hamblet, 2009). If an institution offers services for SWDs that go beyond the standard academic accommodations mandated by law, there is a possibility more SWDs will be drawn to the institution. The level of services provided to SWDs could be seen as indicative of the values held by the institution. With regards to retention, when students feel connected and engaged with their university, they are more likely to have a more fulfilling experience at school (Hadley, 2011). Porter' s (2011) research supports that there is an association between receiving personal counselling and retention rates with first year students with and without disabilities. First year students that engaged in counselling had a 7.6% higher retention rate than the first-year population as a whole (Porter, 2011), therefore, providing more counselling services for SWDs could help increase retention. Getzel (2008) emphasizes that providing supports to SWDs that increase self-determination and self-management are critical for the retention of SWDs. Wessel, Jones, Larry, and Westfall's (2009) study suggests that contributing factors to the retention of SWDs at one institution were: student involvement with activities on campus, having self-determination and purpose, and feeling a sense ofbelonging. These themes are central goals of this group, thus could lead to greater retention for SWDs. Personal Location I am presently living in Prince George, BC where I am completing a degree in the Master of Education Counselling program at the University ofNorthem British Columbia (UNBC). Concurrently, I have been working since December 2010 at the Access Resource 8 Centre (formerly the Disability Services Centre) at UNBC, where I provide assistive technology and learning strategy support to SWDs. I became interested in working with SWDs in postsecondary settings through my prior work experience. As a kindergarten teacher in Japan, I worked with several children that had suspected LDs and I recognized that a patient, child-centred manner of teaching facilitated their growth and engagement in class. This experience taught me that I liked to be involved with education, especially working with children with various learning styles and strengths. I became further interested in working with people with disabilities through my experience as a mental health worker for a supported independent living program in Surrey, BC. During this time I learnt a great deal from my clients and their worldviews. Many of the people I worked with were isolated, and it appeared that connecting clients to other peers, as well as connecting them with opportunities such as furthering their education, were important to their well-being. From my experiences, I have come to believe that education is an excellent avenue for many people to find meaning and enrichment, so I am happy to be working in a field where I can be involved in this process for others, particularly those with disabilities. Through my work at the Access Resource Centre I have become familiar with the types of supports and accommodations that UNBC puts in place for SWDs attending university. A personal interest for me in my work is getting to know the strengths and challenges of the students I work with so that I can be ofbetter support to their individual needs. However, it was through my education as a counsellor where I began to consider the emotional and social needs of SWDs due to my own personal work in these areas. It stood out to me how I primarily provided academic supports and accommodations to our students. Counselling students was not part of the mandate at our centre. From my knowledge of other institutions, focusing on academic accommodations rather than counselling is common 9 practice for disability service centres. However, I was also aware that some other institutions combined disability services with counselling. I have also noted that other institutions offer counselling groups for specific groups of SWDs. However this situation primarily occurred at larger institutions with much larger populations of SWDs. I was not aware of any smaller size institutions that provided disability group counselling, and I did not come across groups that had mixed disability populations. Furthermore, our office promotes inclusive practices for people of all abilities, so it would seem counter to our mandate to exclude people from participating in a group because of their disability. Therefore, I feel focusing on common themes that SWDs experience serves as a reasonable basis for forming the content of a group, rather than basing it on a person' s particular disability. I see the purpose of providing a counselling group as both a preventative measure for the well-being ofSWDs on campus, but more importantly, as a component of a student's education that enhances their best qualities and promotes engaging more fully in life both on and off campus. Through a focus on strength, the group may help students to better manage challenges they face in the future. I know that, from my own experience with a process group, the chance to look at what is meaningful and important to me in a supportive environment was both powerful and exciting, offering a unique environment for personal growth. For example, hearing others share vulnerabilities and personal life experiences in a safe supportive environment helped me to share my own thoughts and feeling thereby becoming better aware of my own communication habits, tendencies, strengths, and weaknesses. This insight into my own ways of being highlighted the importance of selfreflective work in facilitating my own personal growth. 10 I have provided the structure for a group with a focus on personal strengths, selfawareness, self-determination, personal growth, and relationship building. Personal growth, living better, and being happier, are at the heart of my motivation for this project and a major goal for designing this group. Although there are groups that have been designed to help certain populations ofSWDs with some of these themes, the approach I have taken differs in that it the group stems from a client-centred humanistic approach, and incorporates a positive psychology strength based focus and includes expressive and creative activities. The design of my project is also tailored to my current location. Given that UNBC is a small university in a northern community, I focused my project design on needs that I felt were significant for this environment. This notion was a factor for designing the group for a nondefined disability population of SWDs. As UNBC is a small institution, there are not enough resources to implement different groups for different disabilities. This rationale extends to implementing groups for SWDs in smaller institution sizes where resources may not permit multiple groups focused on specific disabilities. This situation may be especially true in remote and northern institutions in Canada or the United States. Overview of Proposal In Chapter 1, I provide an introduction to my project topic, discuss the purpose for providing a counselling group for SWDs, and discuss my personal location regarding the formation of this project. In Chapter 2, a literature review pertinent to my project is provided. I begin with a discussion and definition of the term disability, followed by a brief history with important legislation influential in the implementation of services for SWD in postsecondary institutions. Next I offer a review and discussion of the literature regarding supports for SWDs in higher education and explain why a psychoeducational support group is considered important for these students. Finally, I conclude Chapter 2 with a review of 11 relevant theory that is influential in the design of my project followed by Chapter 3, an overview of the group manual. Lastly, Chapter 4 consists of the facilitator manual for my proposed group. 12 Chapter 2: Literature Review Chapter 2 provides a comprehensive discussion on relevant research and theory that serves as the context for this project. I will begin by discussing definitions of the word disability, and provide background information regarding SWDs in higher education. Common services provided for SWDs will be discussed, and the need for further services and supports for self-advocacy and self-determination will be highlighted. Group therapy will be discussed as a reasonable service that can be used to help address the needs of SWDs in postsecondary institutions. A literature review of group work for people with disabilities will be provided. I then discuss influential theories used in the formation of the group, provide rationale for a mixed disability population proposed for the group, and conclude with a discussion of countertransference. Defming Disability For group facilitators working with SWDs, it is useful to be familiar with issues surrounding the definition of the word disability in order to be more culturally competent when working with those who have a disability. The definition of disability is complex. To complicate matters further, SWDs, students without disabilities, faculty, staff, administrators, medical doctors, and government policy makers that provide funding for disability services, may all have different perspectives on the term of disability (Office for Disability Issues, Human Resources Development Canada [ODIHRDC], 2003). The complexities in defining disability are reflected in Canadian law, where a comprehensive report (ODIHRDC, 2003) concluded that no single definition for disability in Canadian law is used, and the report further suggests that a singular definition of the term may not be achievable or desirable. Three general conceptual models of disability-the medical, the functional limitation, and 13 the ecological model-will be discussed. I conclude this section with a definition of disability that I used for this project. Medical model. The medical model of disability focuses on disability as a personal impairment. From the lens of this model, disability is considered a health problem or abnormality within a person's body or mind (ODIHRDC, 2003). We see the medical model of disability reflected in practices that are geared towards fixing an individual's limitation or defect (ODIHRDC, 2003). From this perspective, people with disabilities are identified as having a defect in their body or mind, and the disabled person is considered biologically or mentally inferior to those without such defects (ODIHRDC, 2003). This definition is considered the old paradigm of disability, and it does not account for environmental or external factors and their influence on individual functioning (Pledger, 2003). Functional limitation model. Another major conceptual model of disability is the functional limitation perspective. This model focuses on disability in relation to how functional restrictions impair a person's ability to engage in a life activity compared to normal standards of functionality (ODIHRDC, 2003). Therefore, disability is defined as the inability to perform an activity in a way that is considered normal because of one's impairment (ODIHRDC, 2003). From this model, the degree to which a person can perform life activities is the essential focus on what defines disability. Like the medical model, the functional model emphasizes comparisons to norms as the defining criteria for disability (ODIHRDC, 2003). Ecological model. The third major conceptual model, and also the most complex, is the ecological model, which arose out of criticisms of the medical and functional limitation models (ODIHRDC, 2003). As defined by ODIHRDC (2003) the ecological model "sees disability as resulting from the interaction of impairment, activity limitations and 14 participation restrictions in a specific social and physical environment such as work, home, or school" (p.6). According to this model, although impairments have "objective reality that [are] attached to the body or mind, disability has more to do with society' s failure to account for the needs of persons with disabilities" (ODIHRDC, 2003 , p7) than individual ability. In other words, this model can be interpreted as looking at disability arising from the failure of society to accommodate those that have different needs, rather than the individual failing to adapt to societal norms and standards. This definition is similar to the new paradigm social model of disability discussed by Pledger (2003). Pledger suggests a "person in the environment" approach to understanding disability which emphasizes the dynamic interaction between individual factors and environmental factors in shaping the experience of disability. The current trend in usage for the term disability has been towards the ecological model, which emphasizes interaction between biological or mental impairment, activity limitations, and restrictions of participation created by a dominant society that are imposed on the person, rather than viewing disability as personal deficiency (ODIHRDC, 2003 ; Pledger, 2003). However, despite the advances and changes in disability definition, the old paradigms viewing individuals with disabilities as inferior or lacking, may still be a present reality for many people with disabilities. Disability defmition for project For the purpose of this project, a definition that aligns itself with the ecological model is used. Disability is defined using a definition provided by the higher education institution ofUNBC. The definition used by the University ofNorthem British Columbia [UNBC] (2011) is very similar to definitions used by other universities in British Columbia (Simon Fraser University, 2003; University of British 15 Columbia, 1999). For the purpose ofthis project, SWDs are defined as persons who (UNBC, 2011): a) Have a significant and persistent mobility, sensory, learning or other physical or mental health impairment which may be permanent or temporary in nature; and b) Experience functional restrictions or limitations of their abilities to perform the range oflife's activities; and c) May experience attitudinal and/or environmental barriers that hamper their full and self-directed participation in life. This definition takes into account the interaction between individual factors and environment. Types of disabilities. There is a wide range of disability categories. Some general categories of disability are: persons with physical disabilities, persons with LDs, and persons with mental health disabilities (UNBC, 2011). Physical disabilities include such things as mobility issues, sensory impairments, or chronic health conditions. LDs relate to issues regarding processing of information or cognitive functions, such as difficulty processing language or controlling attention. Mental health disabilities relate to conditions such as anxiety disorders, depression, schizophrenia, bipolar or other psychological issues. Another general group of disability are developmental disabilities, such as fetal alcohol spectrum disorders, Down syndrome, or intellectual disabilities. Generally in higher education there tend to be relatively low numbers of students with developmental disabilities enrolled due to the academic enrollment criteria of institutions. For the purpose of this project, when referring to SWDs, the term implies that the student has a disability in the general term. No specific disability is being referred to unless otherwise indicated. No particular type of disability will be screened out of the group due to a disability category so long as students 16 have met the enrollment criteria specified by the higher education institution. However, prospective group members may be screened out due to other circumstances such as their attitude toward the subject of the group, or their communication skills, which will be discussed in the screening process presented in Chapter 3. Disability History and Legislation in Higher Education It is useful for counsellors to understand some history and disability legislation regarding SWDs accessing postsecondary education in order to better understand group participants. The history of SWDs in higher education was limited prior to World War One, although there were certain exceptions such as the establishment of Gallaudet College in the 19th century, an institution which specifically educated students that were deaf, or Helen Keller's attendance at Radcliffe College at the beginning of the 20th century (Madaus, 2011). After World War One and World War Two, an influx of veteran soldiers with disabilities enrolling in postsecondary education resulted in some changes in services for those with disabilities (Madaus, 2011). The programs and services implemented for SWDs during this period primarily focused on those with physical disabilities (Madaus, 2011). After the civil rights movements, resulting changes to educational legislation greatly expanded services for SWDs in higher education (Madaus, 2011). When the United States government defined LD as a category of disability in the 1960's, a large increase in the number of students with invisible disabilities was noted within education systems (Madaus, 2011 ). In 1973, The Rehabilitation Act was passed, which became a major piece of disability-related legislation that guides accessibility in postsecondary institutions to this day (Corrigan, 1998; Madaus, 2011). Section E of Section 504 ofthe Rehabilitation Act specified that postsecondary institutions were required to consider applications from qualified SWDs and to implement necessary accommodations and aids for these students 17 (Madaus, 2011). In 1990, the Americans with Disabilities Act (ADA) was passed, which has led to additional access for students in higher education and program development (Madaus, 2011 ). These historical changes in disability services and legislation, amongst other factors, have created an increase in the number of SWDs attending postsecondary institutions (Kundu, et al. , 2003 ; Madaus, 2011; Wilson, et al., 2000). Corrigan (1998) emphasizes that counsellors should be familiar with these acts when working with SWDs. Although these acts apply for American students, it is still important for Canadian counsellors to be familiar with disability services history and U.S. legislation, as these have influenced and impacted the development of disability legislation and services in Canada. In Canada, implementation of services for SWDs in higher education is influenced by several key legislative documents such as The Canadian Charter of Rights and Freedoms, and the Canadian Human Rights Act (ODIHRDC, 2003; British Columbia Ministry of Advanced Education,[BCMAE] 2011). Section 15.1 ofThe Canadian Charter ofRights and Freedoms (1982) states that: Every individual is equal before and under the law and has the right to the equal protection and equal benefit of the law without discrimination and, in particular, without discrimination based on race, national or ethnic origin, colour, religion, sex, age or mental or physical disability. (15.1) This emphasis on equality and nondiscrimination requires that higher education institutions provide equal opportunity and access for SWDs attending postsecondary schooling. The Canadian Human Rights Act (1985) declares that "all individuals should have an opportunity equal with other individuals to make for themselves the lives that they are able and wish to have and to have their needs accommodated[ ... ]without being hindered or prevented in doing so by[ ...]disability" (2). 18 Based on these and other key legislative documents, postsecondary institutions in British Columbia, as well as other Canadian institutions, have a legal obligation to accommodate the needs of SWDs attending university or college. Providing services to SWDs in higher education is considered a shared responsibility between government and postsecondary institutions (BCMAE, 2011). Generally institutions provide assistance and accommodations to SWDs, while the government provides funding to assist in meeting accessibility requirements (BCMAE, 2011). It is important for facilitators to have some knowledge and awareness of the legal duty to accommodate SWDs. Services for Students with Disabilities Current levels of services for SWDs in higher education tend to primarily focus on educational access through the implementation of academic accommodations, which is in accordance with the legal obligations for public postsecondary institutions. Many SWDs will request academic accommodations to help reduce functional impacts associated with their disability (Corrigan, 1998). Most institutions have a designated disability or accessibility service office that specializes in coordinating and implementing academic accommodations for SWDs in order to create accessible learning environments. Academic accommodations are intended to remove disability-related barriers to education and learning. A common definition of reasonable accommodation for SWDs is: Any adaptation, modification or alteration to the environment, instructional or evaluation methodology necessary to assist in access to the University. Accommodation may also include alternate formats and methods of communication, physical renovations to the University, and the use of assistive technology or the provision of special services through third party service providers. (UNBC, 2011 , p 2) 19 This UNBC definition of reasonable accommodations is a common definition shared by other institutions such as University of British Columbia (1999) and Simon Fraser University (2003). Academic accommodations can include supports such as extra time on exams, class note takers, alternate format textbooks and class materials, and the use of assistive technology. How accommodations are implemented is based on many factors such as documentation, resources available at the institution, and individual student need. Facilitators should note that any service provided by an institution, such as a counselling group, should provide reasonable accommodations so that no member of the group is excluded from accessing the group as a result of their disability. In Chapter 3, I discuss some potential accommodations facilitators should be aware of when implementing a psychoeducational counselling group. Other services specifically designed for SWDs might include mentoring programs, academic strategy training, coaching, or funding opportunities. Many campuses will have student created support groups for SWDs. Although these groups can be very effective and helpful, they do not provide the same level of structure and safety that can be implemented through a qualified and trained group facilitator. Although public higher education institutions in North America are required by law to implement accommodations and supports to qualified SWDs, the extent to which any postsecondary institution provide services and support for SWDs can vary widely (Kundu et al., 2003; Wilson et al., 2000). Services can range from being minimally compliant with accessibility legislation, to being extensively designed to facilitate not only academic success but also psychosocial adjustment (Kundu et al., 2003; Wilson et al., 2000). The extent to which an institution implements services for SWDs can be argued to be a reflection of an institutions beliefs and values (Gibson, 2012). 20 The following project is geared toward facilitating personal empowerment for SWDs through creative group work focused on themes of self-awareness, self-advocacy, selfdetermination, interpersonal communication, and social connection. According to Hadley (2011), SWDs in postsecondary institutions should be in an environment that encourages learning and growth so that such students can engage more fully with their campus. Services that focus on self-esteem and self-advocacy development through peer group work are in accordance with Hadley's position, fostering growth and engagement for SWDs on campus. Therefore this project is partially designed for institutions seeking to provide specific services for SWDs that go beyond academic accessibility requirements. The trend in services for SWDs on campus has continued to focus on providing services for accessibility issues, while also looking at more extensive supports for an increasing variety and number of SWDs (Madaus, 2011). Although these services and accommodations are considered very important for SWDs (Kundu et al., 2003), there is evidence that SWDs would benefit from supports regarding other challenges they face in higher education. I discuss these challenges and the gaps that exist with current services in the following two sections. Experiences for Students with Disabilities Several researchers have studied the experiences of SWDs in postsecondary to evaluate current service levels and elucidate areas of need (Gibson, 2012; Mytkowicz et al., 2012; Stein, 2013; Wilson et al., 2000). Although research indicates that academic services may be meeting the needs of the students, there appears to be a gap in services geared toward social and personal support specifically for this group of students. The following section highlights areas of social and personal needs for SWDs identified in research that could be supported through the implementation of a psychoeducational counselling group for SWDs. 21 In a study of student satisfaction of the disability-related services provided by four institutions, Kundu et al. (2003) found that, although the overall majority of students in the four universities were satisfied with the services provided by the disability service office, a common theme emerging from this research was a reported lack of training to advocate for personal needs regarding disability. The majority of students from the institutions indicated that they did not receive enough self-advocacy training (Kundu et al., 2003). This study suggests that support regarding self-advocacy is an area that SWDs identify as an area of need. The need for further self-advocacy training is also supported by other authors (Beecher et al. , 2004; Eckes & Ochoa, 2005; Holloway, 2010; Lynch & Gussel, 1996; Roessler et al., 1998). Using a psychoeducational group to help SWDs develop their abilities to self-advocate could help address this need. Obtaining academic accommodations can of itself present challenges, as it requires a student to self-identify as a SWD to the disability support office of an institution, as well as to self-advocate with faculty in order to receive accommodations (Beecher et al., 2004; Murray et al. , 20 12). Another challenge for SWDs is that may have lower levels of selfefficacy regarding academic abilities (Beecher et al., 2004). Getzel and Thoma (2008) suggest that self-determination is an important factor for the success of SWDs in higher education, and that more support in developing self-determination skills could be beneficial. A qualitative study by Stein (2013) explored how college students with psychological disabilities used and perceived the services provided by disability support offices. Using a grounded theory method, Stein interviewed 16 participants about their experiences with the disability service office on campus. Generally students felt the accommodations implemented by the disability support office were integral to their success and even allowed them to stay in school (Stein, 2013). Participants in Stein's (2013) study also indicated it 22 was significant to know that disability support staff cared about them, and that they did not need to feel alone with their challenges. Another major theme brought up in Stein' s study was stigma and concerns associated with disclosing disability. Participants felt stigma was a pervasive problem, and that there were more negative attitudes towards people with psychological disabilities than other types of disabilities (Stein, 2013). According to Stein (2013) most participants would not disclose their disability because of fear of stigma unless it was absolutely necessary to do so. One participant discussed the difficulty in disclosing because "people don 't see it as a real thing" (Stein, 2013 , p.156). This study highlights that having a support system, a caring environment, and not feeling alone with one' s disability were considered important for some students with psychiatric disabilities, and that further support regarding disclosure and education on campus were seen as important. It also reveals the poignancy that stigma has for those with invisible mental health disabilities. Some of these concerns could potentially be supported by focusing on themes of selfdisclosure and stigma in the caring environment of a properly facilitated psychoeducational group. Wilson et al. (2000) sent a survey to students who had registered with the disability service office at the Virginia Commonwealth University in order to get the students' perspective on the level of services provided, and to identify areas for improvement. One of the areas highlighted by students was the need for specialized services such as support groups and personal skills training (Wilson et al. , 2000). This study suggests that a counselling group for SWDs that focuses on personal skill development is considered important to these students. Gibson (2012) looked at narrative accounts of five SWDs and an analysis of their stories supported the conclusion that social connection and support beyond academic assistance are centrally valuable. In Gibson's study, four students with 23 LDs and one student with cerebral palsy were asked to participate in semi-structured interviews as well as complete an art-based tool prior to the interview regarding their first year university experiences. Gibson notes that several of the participants discussed the importance of peer relationships and the crucial role they play in their self-image and experience in education. Respondents felt that close friendships at university where important because they could have a dependable person to help with their work, learning, and socializing (Gibson, 2012). Relationships and friendships have been identified as important components for the academic world, as well as for the social worlds, of young students with LDs (Male, 2007). A psychoeducational group for SWD could help foster these positive peer relationships. In a study by Mytkowicz et al. (2012) qualitative data was gathered from the stories of 14 students with LDs or attention deficit hyperactivity (ADHD) disorder to get a better understanding of how these students experienced and evaluated a fee-based support program at a college. The support program was built around four themes for student with LDs: it focused on creating a culture of care by having an empathic and approachable instructor that acted as a facilitator; there was a focus on transformative learning, focusing on the change processes oflearners; self-authorship, self-agency, self-esteem, and self-determination were goals oftransformative learning; and lastly the program focused on development of effective learning strategies (Mytkowicz et al., 2012). According to Mytkowicz et al. (2012) the sense of safety and caring in the support program helped participants feel comfortable and experiencing positive regard was considered very important to them. Mytkowicz et al. also highlighted how participants felt that relationships, metacognition development, and communication through dialogue were valuable components of the program. This study points to the importance of integrating both cognitive and emotional processes into support 24 programs for students with LDs or ADHD disabilities, and for creating a positive, safe, and caring environment for these students. The students that participated in this study where in good academic standing, so these findings may not be indicative of students with low academic standing (Mytkowicz et al., 2012), which some SWDs may have. Similar emphasis on the importance of a supportive and safe environment for SWDs is supported by Stein (2013). This research on the experiences of SWDs in higher education highlights that although SWDs with various disabilities report satisfaction with many supports on campus, there is still room for improvement of services in meeting the needs of these students. Specifically, guidance regarding self-advocacy, self-determination, and social support are suggested as areas of need by these studies. Counselling and Students with Disabilities From this research on the experience of SWDs, it is clear that academic accommodations are not the only service SWDs will benefit from in higher education. One possible way to address concerns regarding self-disclosure, advocacy, and self-esteem is for SWD to work on these issues through counselling. SWDs can access counselling services, career counselling, and other students services commonly provided at higher education institutions to receive personal, social, and emotional support. In fact, SWDs may seek counselling at a higher rate than students without disabilities. In a study by Porter (2011), students with confirmed disabilities at an institution comprised 30.5% of clients attending counselling services, although they made up only 11% of the population. Furthermore, the author suggests that students with confirmed disabilities and students with probable (undisclosed) disabilities accounted for 60% of counselling hours (Porter, 2011 ). This study highlights that SWDs utilize counselling services at a high rate. It follows that this large 25 number of students using these services could put a great deal of pressure on campus counselling centers. Although counselling is sought out by SWDs, some literature suggests counselling centres could be better prepared for working with these students and their needs. Many student service offices and counselling centres are not always aware of, or sensitive to, the unique needs of SWDs (Beecher et al., 2004) such as their need to self-advocate, selfdisclose, and access accommodations. Beecher et al. (2004) discuss that SWDs face new stressors when they go to university, have unique emotional concerns, and face career concerns that students without disabilities do not encounter. Beecher et al. suggest that postsecondary counsellors would benefit from training in disability themes in order to help better support these students. Although disability service offices may be more aware of the needs of SWDs than counselling offices, Beecher et al. point out that these centres may not necessarily have resources or funding to provide appropriate personal supports that meet these types of needs for SWDs. Therefore counselling centres may need to support more and more SWDs, which would require further awareness of disability culture and services specifically designed for their needs. Addressing needs through group therapy. A psychoeducational counselling group for SWDs would address many of the needs identified in the studies discussed, and also place less demand on individual counselling resources. Murray et al. (2012) suggest that implementing a social support intervention specifically designed for students with disabilities could be a helpful and cost-effective support for SWDs. A psychoeducational group is often used in higher educational settings because it allows students to discuss relevant topics within a safe environment (Gladding, 2008). Although there are several types of groups, the type of group proposed for this project is based on a psychoeducational group model that 26 focuses on the conditions and challenges SWDs attending higher education may face. Nontraditional postsecondary students benefit from psychoeducational groups because they can be a good source for resources and information about academic life, emotional support from peers, social interaction, and support for other developmental needs (Gladding, 2008). SWDs are a non-traditional student group, so they certainly could benefit from these positive aspects of group counselling. Murray et al. ' s (2012) research supports that social peer support can improve the self-efficacy of SWDs in higher education. Therefore, the themes of self-awareness, self-advocacy, self-determination, and relationship building could be addressed through activities in a structured and supportive environment provided through a psychoeducational group setting. A psychoeducational group is also fitting due to the time frame of the semester and for the limited number of sessions proposed by this manual. Six sessions are suggested due to the length of a standard four month semester, and because there are many other demands SWDs face in terms of their academic course load and personal life. Because of the relatively brief duration of the group, a psychoeducational group is appropriate because it will provide enough structure to make the sessions meaningful and therapeutic, while also keeping the focus of the group away from deeper personal or interpersonal work better suited for longer term counselling. Furthermore, psychoeducational group counselling can offer benefits not available in individual counselling. Groups provide an environment where students can receive peer support and foster interpersonal connections and skills. Support networks can form through group work, individuals have an opportunity to work on interpersonal skills, and individuals can develop a greater sense of normalcy by sharing their feelings and experiences with others who may have similar challenges (Gladding, 2008; Yalom & Leszcz, 2005). Geisthardt and 27 Munsch (1996) propose that social skills training for adolescent students with LDs can be beneficial in their ability to develop positive peer relationships and sources of support during stressful times. Through group work, "social skills training may benefit adolescents with LDs by providing skills necessary to develop positive peer relationships as well as to be more effective at mobilizing peers as sources of support in times of stress" (Gesithardt & Munsch, 1996, p.294). The idea of relationship building and friendships as important components of academic success for SWDs in higher education provides rationale for the formation of a counselling group for SWDs at university. Counselling groups can help students foster relationship building and friendships both within and outside of group. Gibson (2012) further emphasized that we do not exist in isolation, and that learning involves growth and awareness of self, others, and an ability to learn together from one another. A counselling group could be a venue through which such growth and education can be facilitated. People in counselling groups can also develop insight into their own strengths, and use the group as a venue for change and working on weaknesses (Gladding, 2008). These benefits of group work make implementing a psychoeducational group for SWDs in postsecondary a potentially great source of support for this group of learners and their unique needs. Themes of self-awareness, self-advocacy, and self-determination can be supported through group work that focuses on building insight, knowledge, and skills regarding these themes. By creating a facilitated counselling group for SWDs, there is potential for greater educational and personal development for SWDs, and it may be a better use oflimited institutional resources. 28 Disability and Group Therapy In this section a general review of the use of groups with people with disabilities will be provided. The review will discuss some of the use of groups in educational setting, and address the lack of framework offered in the literature for a psychoeducational support group for SWDs in higher education. Group work for people with disabilities has been well utilized and has been effective in many situations. Feigin (2002) discusses using group therapy for individuals and families coping with illness and disability. Group counselling can provide people living with disability an opportunity to alleviate the problems that are associated with disability (Feigin, 2002). Groups for people with disabilities also enable members to examine the impact of their disability amongst others that have similar experiences, and can help to facilitate skill development and actualizing self-potential (Feigin, 2002). These groups can be extremely helpful in providing a space to discuss issues and concerns those without disabilities may not understand or may be uncomfortable talking about. Mayers (1978) discusses using a group counseling approach for people with disabilities to discuss sexuality and reported that individuals felt the group was a very good opportunity for them to improve their social and sexual self-images, improve their social skills, share experiences, and encourage positive risk taking in their lives. Salmon and Abell (1996) ran a group for adults with LDs. They emphasized active methods such as psychodrama and role play as suitable for LDs since they encourage participation and facilitate self-expression (Salmon & Abell, 1996). A study by Braithwaite, Waldron, and Finn (1999) looked at people with disabilities using computer support groups. This study involved coding 1400+ messages from the online support groups. The researchers found that the largest percentage of messages were supportive (Braithwaite et al., 1999). This study suggests that messages through online support groups can be a good 29 source of encouragement and aid from peers. It is thus probable that an in-person group for SWDs would also provide social encouragement and support regarding the challenges associated with postsecondary. These studies are just several examples of how group work has been utilized for people with disabilities. Disability-related groups in education. Group work has been widely used in the education system to support students with a wide range of disabilities. Sartini, Knight, and Collins (2013) emphasize developing social skills training and peer interactions for students with complex disabilities, such as Asperger's Syndrome, by utilizing peer social groups. Groups for students with LDs were one of the most common types of groups found in the literature reviewed. A transition group for students with LDs going into higher education or for students going into the work force was developed by McEachern and Kenny (2007). McEachern and Kenny (2007) discussed the importance of a psycho educational group for high school students with LDs as a useful intervention to help students with LDs transition from high school to a postsecondary setting. Students with LDs face different challenges at postsecondary than while at high school, and often are not adequately prepared for this transition (McEachern & Kenny, 2007). There group was structured around themes for students with LDs to help them prepare for the transition to higher education. In addition, the same authors created a structure for students with LDs in high school that would be transitioning into the workplace. Milsom et al. (2004) also provided a framework for a psychoeducational transition group for students with LDs transitioning to postsecondary. However, students with LDs are not the only SWDs that face challenges transitioning into postsecondary. Hadley (2011) suggests that these themes are felt by other SWDs as well. It also follows that if such a group is considered important prior to transition, for those students that were not able to access such a service in their high school, a group at their institution 30 could be beneficial for helping their adjustment to the postsecondary setting. Group therapy for middle school SWDs can be helpful for helping build resiliency and personal empowerment (Arman, 2002). Bowen (1998) suggests that imaginative and creative art projects can be effective interventions for developing self-determination for SWDs in lower levels of education. The group proposed in this project aims to build on using group work for SWDs in higher education to facilitate empowerment and self-determination for SWDs in higher education using creative approaches. Disability-related groups in higher education. At a higher educational level, many universities do offer counselling groups for students through their counselling offices. However, not many are specifically designed for SWDs. Many groups in higher education focus on themes such as test anxiety (Darner & Melendres, 2011 ; Katahn, Strenger, & Cherry, 1966). Test anxiety itself is experienced by a great deal of students with or without disability, and therefore the group is not specifically designed for the needs of SWDs. However the social benefits of such groups are important. Katahn et al. (1966) found that students who participated in a test anxiety group reduced their anxiety and did better academically. What was interesting was that the researchers attributed the success of the students to the discussion with and advice received from peers, rather than relaxation techniques taught in the group (Katahn et al., 1966). This finding underscores the significance of process in group therapy, and the significance of building relationships with members and facilitators in group, as being the central components of group counseling (Corey et al., 2010). Some specific groups in the literature that focus on disability are groups for social phobia and groups focused on academic skill development for students with LDs. Darner et al. (201 0) designed a group for those who experience high amounts of social anxiety. This 31 group focused on building assertiveness and social skills, and in increasing self-confidence (Darner, et al. , 201 0). Johnson (2002) developed a framework for a psychoeducational group for students with LDs. Although the group did offer an opportunity for personal and social development, its focus was on academic skill development and was intended specifically for students with LDs. This group provides a suitable model for a psychoeducational group, and could be modified to address a broader range of topics to include the personal and social needs of SWDs. Other counselling groups offered at many institutions are specific to a particular disability population, such as those who experience clinical levels of anxiety or depression (Gladding, 2008). Some institutions have support groups for health issues or long term illness, such as groups for students who are HIV positive (Gladding, 2008). Gladding (2008) points out that personal growth groups are used in colleges for many different populations. However personal growth and development groups are not mentioned as being used specifically for SWDs. The psychoeducational group proposed in this project could be considered as a personal growth group due to the emphasis on personal empowerment and social connections for SWDs. By reviewing the literature, we can see that there are groups used on different campuses designed for specific disability populations or particular topics. However there were no groups specifically for SWDs that are tailored towards empowerment, self-advocacy and self-determination. Many of the current groups focus on a specific disability population. Creating a separate group for each disability population is likely not feasible for smaller sized institutions due to both limitations in resources and the smaller amount of students within individual disability categories. Thus there is a gap in the current literature on how to 32 design a psychoeducational group for SWDs that focuses on themes of empowerment using a person-centred, creative approach. This manual is intended to fill this gap. Theoretical Influences The theories that influence the construction of my group are provided in this section. The foundational theory upon which this group is designed is person-centred theory. From this basis, I will discuss the reasons a psychoeducational approach is the suggested for this group. Building on a person-centred foundation, I will integrate several other theoretical influences and elements into the formation of this group: positive therapy, art expression therapy, and narrative therapy. I will then discuss the inclusiveness approach I propose for this group. Lastly, I will discuss potential issues of countertransference that facilitators should be aware of. Person-Centred Theory The overarching approach to the formation of this group is founded on a personcentred methodology. Person-centred theory is based on several premises. A fundamental premise of this theory is that each person has vast inner resources "for self-understanding and altering their self-concepts, basic attitudes, and self-directed behavior; these resources can be tapped if a definable climate of facilitative psychological attitudes can be provided" (Rogers as cited by Gladding, 2008, p. 3 79). Another important premise of this theory is that the group will help members develop their potential and what they want to work on without needing to be directed a certain way by the facilitator (Rogers, 1970). However, for the proposed group, facilitators will play a more directive role compared to a person-centred encounter group. Facilitators will present activities and themes to be explored in group, but will maintain a person-centred approach in that they provide the group with options and allow the members to determine the best approach for the theme. The facilitator views the 33 group as being capable and having inner resources to direct and develop themselves as individuals and as a group (Gladding, 2008). However, in order for these premises to occur, the conditions in the group must be created to maximize the full potential of its members (Rogers, 1970). Facilitators and group members expressing genuiness, empathy, and acceptance in communication will allow for maximizing inner growth and self-direction (Gladding, 2008). Building genuine relationship is also very important in person-centred approaches and should be a central component ofthe group (Rogers, 1970). For the purpose of this project, the elements from person-centred theory that are most influential are providing a safe, accepting environment for participants, focusing on building trusting relationships with the facilitator and group members, and trusting in each participant's ability to recognize their own potential and needs. The reason I use personcentred theory to influence my creation of this psychoeducational group is because the approach does not make the facilitator an expert on a SWD's life, but rather honours each person' s ability and puts faith in their self-efficacy and ability to decide what is best for them. Rogers (1965) also supports that learning can be facilitated through student-centred approaches. Rogers (1965) suggests that the educational situation that "most effectively promotes significant learning is one in which (1) threat to the self of the learner is reduced to a minimum, and (2) differentiated perception of field experience is facilitated" (p.391). Therefore a psychoeducational group can have congruent elements with person-centred theory by promoting a safe and accepting environment where people's different experiences are honoured and validated. In my literature review, students identified feeling a sense of acceptance and feeling a supportive environment as important to their academic success (Mytkowicz et al., 2012). This research supports creating a client-centred atmosphere for a group as a suitable basis for working with SWDs. For this group, I offer suggestions and 34 interventions that can be utilized, but ultimately leave it to the group and individuals to decide what they feel is important to work on during the sessions. A person-centred approach is congruent with the client-based approach the American Group ofPsychotherapy Association [AGPA] (2007) supports in their guidelines for group psychotherapy. According to the AGPA, a client-based approach differs from group practices that are based on evidenced-based practices. Evidence-based practices emphasize implementing group treatment interventions based upon empirical data obtained through randomized controlled studies of specific treatments on specific conditions and populations (AGPA, 2007). Alternately, a client-based approach integrates best available research with practitioner expertise in the context of the client's specific world and culture (American Psychological Association [APA], 2005). Such an approach is person-centred, and allows for facilitators to respect and learn from the culture of the group and in tum co-create interventions based on the group's needs. This approach fosters the creation of a group environment that believes in each person's own abilities and respects their worldview and meaning of disability. For the purpose of this project, the structure and interventions suggested for the group are guided by my own experience working within the disability service field in higher education, my education and research with counselling practices and disability issues, and by utilizing a person-centred approach upon implementation. This project's structure and the proposed interventions are intended to be guided and influenced primarily by the needs and concerns of the members of the group in a way that best serves them. Therefore the structure in this project is intended to act as a suggestive guide for facilitators. 35 Integrated Elements This project also integrates positive psychology, narrative therapy, and art therapy into the design and operation of the group. This integrative approach has been used in working with SWDs in lower levels of education. A group by Bowen (1998) founded on a person-centred basis has utilized integrating different theory and techniques in a group for students with mild disabilities in the K-12 system. Students with mild disabilities were identified as those with LDS, cognitive impairments, or emotional or behavioral disorders (Bowen, 1998). Bowen ( 1998) emphasized that whatever counselling strategy was deployed, the group must employ the values of acceptance and appreciation for individual differences. Such an environment will be beneficial for a mixed disability population because it emphasizes accepting people of all types of abilities. Bowen' s emphasis on acceptance as a central structure from which other therapeutic approaches and techniques can be implemented is congruent with the person-centred approach that is central to my project. Positive psychology. Positive psychology theory views people as having inherent developmental tendencies toward growth and fulfilment (Linley, Joseph, Maltby, Harrington, & Wood, 2009), which suggests positive therapy techniques have a good fit with the person- centred approach of this group. Positive theory focuses on questions of what it means to be human and to live well (Linley et al. , 2009). Pursuing fulfillment and living well are embodied within the ideal purpose ofhigher education. Schreiner, Hulme, Hetzel, and Lopez (2009) discuss how employing positive psychology values on campus offers the opportunity for institutions to further students learning beyond academics and into what it means to be positive leaders in community and work, and to explore what makes a life worth living. Schreiner et al. (2009) argue that numerous philosophers have emphasized the importance of educators being committed to enhancing the best qualities of students. The 36 proposed psychoeducational group shares the sentiment of enhancing the best qualities of the students through the group process. The emphasis on personal growth, exploring strengths, finding personal meaning, and developing self-advocacy and determination are, from my perspective, worthwhile areas of focus in a group for SWDs and are a refreshing contrast to the limitation and deficiency themes of disability that are prevalent in the medical model of disability. Positive therapy can work well with a person-centred theoretical orientation because it focuses on positive aspects of human experience and values the therapeutic relationship. Positive therapy has also been used in working with people with disabilities (Dunn, Uswatte, and Elliot, 2009; Hartley, 2010; Wehmeyer & Palmer, 2009). As a result of positive psychology' s similar underpinnings to person-centred therapy, I use some ofthe constructs from positive therapy in the foundation of my group. Selfdetermination, resiliency, and strength based approaches are some positive therapy constructs (Shogren, Lopez, Wehmeyer, Little, & Pressgrove, 2006) that influence the interventions used in the group because these concepts can be beneficial for self-esteem and empowerment. The positive therapy concept of self-determinism in humans can be viewed as a person' s active contributions, or "authoring", of their own behaviour which is selfregulated and self-motivated (Wehmeyer, Little, & Sergeant, 2009). Wehmeyer and Palmer (2003) studied levels of self-determination in high school students with intellectual disabilities or LDs. The study supports that having higher levels of self-determination contribute to positive life outcomes for SWDs (Wehmeyer & Palmer, 2003). The researchers followed up with participants one and three years postgraduation, and found those students that had been more self-determined fared better in terms of employment, finances, and living independently (Wehmeyer & Palmer, 2003). Therefore incorporating techniques and building relationships within the group that foster self-determination is vital to the process. 37 Resiliency is another construct used in positive therapy that is influential in the structure and process of the group. Defined broadly, resiliency is an ability to adapt positively under the context of adversity, risk, or other negative conditions (Masten, Cutuli, Herbers, & Reed, 2009). Research has linked resiliency to improved academic performance at postsecondary for students with psychological disabilities (Hartley, 2010). Dunn, et al. (2009) reviewed resiliency in people who acquired a disability, and suggest that one of the most powerful sources for resiliency and growth for people is to maintain their individuality identity, rather than focus on their disability. From this perspective, "[d]isability is but one aspect of a person's life; it does not define a person or his or her self- or social worth" (Dunn et al., 2009, p. 657). In facilitating a group for SWDs, group leaders should incorporate the concept of resiliency and treat members as complex individuals. Another important focus of the group is to concentrate on the strengths of students rather than weaknesses. Smith (2006) defines strengths as "that which helps a person to cope with life or that which makes life more fulfilling for oneself and others" (p.25). Smith also emphasizes that strengths are not fixed traits; they are culturally and contextually defmed. Therefore, the facilitator should be aware that their interpretation of strength may or may not be the same as the definition of strength of the SWDs in the group. Some strengths that can be built through therapy include courage, personal responsibly, interpersonal skills, perseverance, and purpose (Smith, 2006). The development of such strengths is an important area of growth for SWDs. Expressive arts therapy. Person-centred expressive arts therapy was developed by Carl Roger's daughter Natalie Rogers (Corey, 2009). Through the use of expressive arts therapy, clients have an opportunity to use a variety of mediums and creative outlets- such as music, sculpting, writing, painting, and improvisation-to express feelings and gain 38 insights from these activities (Corey, 2009). This approach is based on person-centred theory, where group facilitators help create supportive, genuine, and safe environments that help allow for open and honest creativity (Corey, 2009). By a facilitator providing psychological safety and freedom through a person-centred approach during therapy, clients can become more receptive to stimulating and challenging experiences through expressive and artistic interventions (Corey, 2009). Creative techniques such as role play and psychodrama have been suggested as useful for participation and self-expression for adults with LDs (Salmon & Abell , 1996) and creative art projects have been used for developing self-determinism for SWD in educational settings (Bowen, 1998). Incorporating creative elements in a safe supportive environment could aid SWDs in developing self-awareness, personal identity, and self-determination. Art therapy has been used in education systems for social skill building and empowering SWDs. Epp (2008) studied a social skills group designed for children who had an autism spectrum disorder. The group implemented art therapy and cognitive behaviour techniques with the students, and the researcher found that there were significant improvements for the students assertiveness scores, as well as a reduction in disruptive behaviour after participating in the group (Epp, 2008). Isis, Bush, Siegel, and Ventura (20 10) reviewed an art therapy program that focuses on providing support for students with emotional or behavioural disabilities. The art therapy program began in 1979 and continues to operate, helping SWDs adjust to their academic environment and maximize their own social and emotional potential (Isis et al. , 2010). The positive effects of these programs highlight that incorporating some art therapy elements into the psychoeducational group for SWDs in higher education can be an empowering and creative intervention. 39 Art therapy has previously been utilized with people in hospitals with cancer or Parkinson' s disease. Luzzatto and Gabriel (20 11) discuss the format and success of an art therapy program for cancer patients at a hospital. Art therapy is used to strengthen the concept of the inner self for patients, as many cancer patients are in need of a readjustment of self-identity within the context of the potentially traumatic experience of developing cancer (Luzzatto & Gabriel, 2011). For patients with Parkinson' s, working with clay has been found to reduce the levels of emotional distress (Elkis-Abuhoff, Goldblatt, Gaydos, & Corrato, 2008). This research suggests that art therapy can be useful in activities for exploring self-identity, building self-confidence, and relieving emotional distress for people facing distressful health conditions. Although the above studies indicated benefits to art therapy, other research by Reynolds, Nabors, and Quinlan (2000) points out that the effectiveness of art therapy is not empirically conclusive. However, for the purpose of this group, my intent is to use elements of art therapy interventions in a safe and competent manner that could allow members of the group a creative opportunity for self-exploration, expression, identity formation, selfdetermination, and socialization. Narrative therapy. Narrative techniques are incorporated in the manual because disability narratives have been highlighted by some researchers as a powerful method for understanding personal identity. Narrative therapy emphasises listening to clients' stories and treating these stories as representations of an individual ' s truth and interpretation of meaning in life (Gladding, 2008). Regarding disability, narrative therapy can be a useful theoretical construct to consider as the dominant cultural narratives defining disability may have had a large impact on what the personal meaning is for those living with disability. Helping participants author their own story of disability can be a useful and empowering 40 intervention for group. Dunn and Burcaw (2013) researched personal narrative accounts of disability that people created regarding their own experience of their disability. The authors believe narrative accounts of disability can inform both those with and without disability about what it is like to live with disability and thereby get to know more about a person' s life and lens. Such narratives can help the individual and therapist to recognize important themes which can increase awareness, and can be used to help explore areas of strength and limitation. The authors further suggest a coherent disability identity can help individuals adapt to their disability (Dunn & Burcaw, 2013 ). In the manual, consideration of activities that explore disability identity through personal narratives can be used as an intervention for increasing self-awareness, forming connections with others, and recognizing strengths. This approach shifts focus away from the definitions and labels of disability suggested by others towards reauthoring what disability means to an individual through their own words and life story. Psychoeducational Group Format The structure of the group is founded on creating a safe supportive environment for participants that can help facilitate self-directive exploration towards personal development. From this basis, some structure should be offered by the facilitator because the intent of the group is to help participants develop personal insight, knowledge, and skill development regarding self-advocacy and self-determination. For SWDs, this approach can be particularly empowering as the facilitator is not considered the expert on their lives, nor the person that is there to "fix" or "treat" them. Rather, this position espouses each students' own strengths and puts trust in their ability to grow and develop from their own resources when a fostering environment and space are provided. 41 From this basis, some structure will be offered through the psychoeducational components of the group. This structure includes providing specific themes and topics for sessions such as self-awareness, assertive communication, self-advocacy, and selfdetermination, as well providing some education regarding these themes. The structural element of a psychoeducational group is fitting since purely person-centred approaches can be problematic in their lack of structure. A lack of structure can result in members feeling like they are going nowhere in the group, or feeling unprepared for the openness required in nondirective groups and thereby withdrawing from participation in the group (Gladding, 2008). Because students are often dealing with a great deal of other stressors and changes in their lives as they attend a postsecondary institution, I believe a lack of structure could be detrimental to meeting their needs within the group. Preventative focus. A premise behind the formation of this group and its psychoeducational structure is its preventative focus. Rather than being a group whose focus is on fixing problems or concerns already developed, the group is designed to help foster personal awareness and skill development, relationship skills and connections, and to help strengthen personal resources for academic success. A preventative focus can help students identify strengths and learn skills to facilitate greater achievement of academic and life goals (Schreiner et al., 2009). This focus on elements to enhance a good life in higher education for SWDs, is in line with the tenants of positive psychology (Lopez & Gallager, 2009). An Inclusive Group Population This manual takes an inclusive group approach in defining the population of SWDs who are the intended audience. There is no specific disability criteria involved in order for participants to be considered eligible to join the group. It is my belief that students with different disabilities are not to be included or excluded from the group based on their 42 disability. Those who want to join the group may do so based on their decision to engage with the content of the group, not based on my choice to exclude or include based on a disability category. Rather than emphasizing a certain disability, I emphasize selecting participants through a screening process that identifies a fit for the group based on other factors such as whether participants are unable to participate in the primary task of the group for logistical, psychological, or interpersonal reasons (Yalom & Leszcz, 2005). The screening process will be discussed in more detail in Chapter 3. Thus the group will be heterogeneous in terms of disability. A heterogeneous group will allow participants to experiment with interpersonal skills with a rich variety of people with varying abilities. It can also be considered to be more representative of outside social structure and act as a microcosm of the outside world (Corey et al. , 2010). As the group manual is designed to prepare SWDs for self-advocating and determining their own academic and life paths, a heterogeneous population is appropriate to prepare for real world scenarios. Participants can benefit by developing interpersonal skills amongst members that do not necessarily have the same disability, which could be beneficial in bringing these skills into a real world environment. The group is homogenous to the extent that the themes of self-advocacy and self-determination share commonalities for most SWDs in higher education. Small institution size. Another reason this project proposes a nondefined disability group for SWDs is because there are not enough campus resources to serve separate categories of disabilities in a small institution. This factor may be especially true in remote and northern institutions in Canada. Weaknesses of not defming disability. A concern that arises from not using a specific disability to define the population of the group is that there may not be enough commonality between group members of differing abilities, or that the experiences of 43 members are too diverse for effective work to occur. Although there certainly may be instances that a more specified and tailored group to specific disability counselling is warranted, that is not the purpose of this project. My belief is that there will be enough commonality between students with various disabilities, such as the need to self-advocate and to develop self-determination skills, that the group will be beneficial to participants provided they have been screened for appropriate motivation. In addition, the following group manual could be implemented for specific disability populations if that is deemed appropriate by the facilitator and resources permit it. Cultural Competence and Countertransference In order to ethically work with people from different cultural backgrounds, counsellors should have certain levels of competency regarding different cultural groups. People with disabilities are considered a minority group with similar history to other minority groups: they have faced subjugation, intolerance, and discrimination (Artman & Daniels, 201 0). Many psychotherapists are not familiar with working with this cultural group (Artman & Daniels, 2010). Grothaus, McAulife, & Craign (2012) discuss three competency domains counsellors can consider in order to develop greater cultural competence. The first domain to consider is one's self-awareness, which involves knowing one's own culture, acknowledging privileges, and examining one' s own biases in worldview and counselling theory. The second component to work on is developing knowledge regarding a culture (Grothaus et al., 2012). Counsellors need to be active in learning about diverse cultures and experiences of people from those cultures. Lastly Grothaus et al. (2012) suggest that counsellors should work on developing skills and counselling approaches that are appropriate for the client's culture. I believe that using strength based and humanistic 44 approaches are fitting for the culturally diverse group of SWDs because these theories emphasize and respect the worldview of the client. Bias against people with disabilities in the general public, and even with professionals, is pervasive. People with disabilities may be regarded as lacking autonomy and agency, and people tend to talk to people with disabilities in a childlike manner (Wang & Dovidio, 2011) or perceive them as being defective or abnormal (Smith, Foley, & Chaney, 2008). According to Prince (2009), " [a]s a social issue and policy area, the prevailing distribution of sentiment in Canada of disability is one of ambivalence, with an odd mixture of positive and negative attitudes, beliefs, perceptions, experiences and behaviours" (p.18). Because people with disabilities may have faced discrimination and prejudice throughout their lives, it is important that counsellors reflect on their own biases in order to try and keep them from interfering with facilitating the counselling group. To effectively and ethically practice counselling with SWDs, facilitators need to think critically about their own experiences regarding disability, work to overcome biases that they may have about people with disabilities (Hays, 1996) and be aware of countertransference during sessions. Countertransference occurs when the therapist begins to respond in irrational or emotional ways to the client as a result of something that the therapist is triggered by in the client (Corey, 2009). The A.D.R.E.S.S.I.N.G. model proposed by Hays (1996) is one way a counsellor can reflect and work on their own biases when working with people from a minority culture which they are not part of. Using this model, a counsellor would ask questions such as "How do my age and generation-specific experiences, my disability (or lack of experience with disability), my religion or religious upbringing (and so on) affect my view of people, my beliefs about the world, where I live, who my friends are, and the kind ofwork I do?" (Hays, 1996, p. 334). Asking oneself such 45 questions specifically regarding disability can be enlightening and is important to do when working with SWDs. Facilitators and clients may be at different stages of acceptance regarding disability, and this will influence transference and countertransference. One's beliefs may not be static so it is important to continually reflect on how one perceives people with disabilities. Working on one' s self-awareness ofbeliefs and biases regarding disabilities is important in order to minimize countertransference during sessions. Through self-reflection, clinical supervision, and increasing knowledge about disability-related issues and through knowing people with disabilities, a facilitator can work on minimizing countertransference. It is important that the therapist be aware of what may trigger them regarding working with people with disabilities. Through increased awareness of personal reactions and biases brought into session, the facilitator can become more conscious of their actions and replace those that are detrimental with balanced client-centred practices. Chapter Summary This chapter has offered an extensive review of literature relevant to this project. Having an understanding of the complexities in defining disability, and understanding some history and legislation regarding disability, is important for working with SWDs in postsecondary settings. SWDs do utilize academic supports in postsecondary institutions, but there is a lack of specific support for SWDs regarding personal, emotional, and social adjustment. The use of a psychoeducational support group could be an intervention that meets some of these needs for students. Group work has been used in many instances for people with disabilities and for SWDs in lower levels of education. However, the use of group for SWDs in higher education appears to be underutilized. My project aims to fill this gap by creating the structure for a psychoeducational group for SWDs in higher education. 46 Person-centred theory serves as the basis ofthe group, integrating elements of positive psychology, art therapy, and narrative therapy into group activities. The person-centred basis is appropriate as it emphasises a safe, accepting group environment that promotes the strengths of group members. From this basis, empowering elements and techniques from positive psychology, narrative therapy, and art therapy are drawn upon in the creation of the manual. 47 Chapter 3: Project Description The format of my project is the development of a facilitator manual that can be used by counsellors to implement a psychoeducational group for SWDs in a higher education setting. In this section, I discuss how the manual has been designed and structured. The manual provides a suggested structure for the group including a list of topics and activities that can be used. Goals of Manual The goal of the manual is to provide facilitators with guidance in forming their own support group for SWDs in their higher education institution. With the aid of this manual, appropriately trained counsellors with group experience may implement the group within their own school. Through the implementation of this group, it is hoped that SWDs will receive support in developing self-awareness, self-advocacy, self-determination, and build social connections with peers. The manual also provides the facilitator with some resources for developing cultural competency in working with SWDs, and for addressing countertransference. Facilitator Manual The facilitator manual covers the rationale and goal behind the group, target audience, recruitment processes, screening processes, facilitator skills required, suggested structure, proposed schedule, potential topics, possible interventions appropriate for each topic, and how to end the group. Different elements of the manual are briefly discussed in this chapter. Target Audience The target audience for this manual is for higher education staff involved with the implementation of services for SWDs such as disability service professionals and counselling 48 centre professionals. The user of the manual should be someone with a professional skill set to be able to provide counselling services, such as counsellors, social workers, or other appropriately trained individuals. Others who can benefit from the manual are administrators involved in the implementation of services for SWDs. Facilitator Qualities The facilitator of the group should maintain professional responsibility in line with the Canadian Counselling and Psychotherapy Association [CCPA] (2007) ethical standards outlined in Section A. Professional Responsibility. The facilitator should possess high standards of professional competence and ethical behaviour, practice in ways that are respectful of legal, civic, and moral rights of participants, and recognize their boundaries of competence (CCP A, 2007). If the needs of the group exceed the level of competence of the facilitator they should refer to other professionals (CCPA, 2007). In accordance with the standards of professional responsibility, the facilitator should have knowledge and capability in group work. Specific facilitator skills are discussed in the manual. Ethical Considerations Ethical considerations for this project are that the manual needs to be implemented by appropriately trained staff who are competent in group counselling practice, and who are sensitive to needs of people with disabilities. These considerations are in accordance with CCPA (2007) Code of Ethics section A3. Boundaries of Competence. Facilitators should also follow the CCPA (2007) code Bl5. Group Work, ensuring that they screen members, and "inform clients of group member rights, issues of confidentiality, and group techniques typically used. They [will also] take reasonable precautions to protect group members from physical and/or psychological harm resulting from interaction within the group, both during and following the group experience" (p. 10). The facilitator must be cautious when ending 49 the group to do so in a safe manner, and refer members requiring further counselling to appropriate resources to obtain additional support, such as individual counselling. Ethically, confidentiality among group members needs to be discussed by the facilitator and informed consent must be given by participants prior to commencing group therapy. Limits of confidentiality are in accordance with CCPA (2007) section B2 which requires the facilitator to break confidentiality during the conditions where disclosure would prevent imminent danger to a client or other person; where legal requirements mandate a release of information; or when a child requires protection or is at risk. Further concerns with confidentiality in a group setting need to be discussed. Due to the group setting, confidentiality by group members cannot be guaranteed, although facilitators should stress the importance of maintaining confidentiality. Informed consent will follow the CCP A (2007) code b4: "When counselling is initiated, and throughout the counselling process as necessary, counsellors inform clients of the purposes, goals, techniques, procedures, limitations, potential risks and benefits of services to be performed, and other such pertinent information" (p.7). Because the group may be involved with difficult discussions that could produce strong feelings, vulnerable sharing of information, and other common risks that pertain to group counselling, providing informed consent would be a vital component to the process. Participants need to be aware of the risks involved. Facilitators will also be required to follow CCPA (2007) guideline B8. Dual Relationships, which states that: Counsellors make every effort to avoid dual relationships with clients that could impair professional judgment or increase the risk of harm to clients. Examples of dual relationships include, but are not limited to, familial, social, financial, business, or close personal relationships. When a dual relationship cannot be avoided, counsellors so take appropriate professional precautions such as role clarification, informed consent, consultation, and documentation to ensure that judgment is not impaired and no exploitation occurs. (p.8) Facilitators need to maintain professional boundaries with group members within and outside of the group, taking care not to develop friendships or other types of relationships with group members that can impact their ability to effectively work with the group. Proposed Group Schedule The proposed length of the group is six sessions, starting in the second month of the semester. It is suggested that four weeks at the beginning of the semester be available for recruitment and screening of interested members. The six sessions should be held weekly at a consistent time and location, preferably during times where the least amount of classes are occurring. The duration of sessions is suggested at 90 minutes. The group ends in the middle of the third month of the semester to allow time for students to focus on assignments and exams. This can also allow students time to complete an evaluative component for the group if desired. Running the group for six sessions is only a suggestion because students may be more likely to commit to six sessions as opposed to eight. Some facilitators may want to change the length of the group to eight sessions, as this can allow for greater group cohesion and depth in work. The activities in the manual and structure of the group can be altered to allow for eight weeks of activity by focusing on certain themes for a longer period. Depending on the flexibility of the facilitator and the needs of the group, extra sessions could also be added on to the group if desired. 51 Participants The number of participants suggested for the group is between six to ten group members. Participants may be students registered with the disability service office of the institution as a SWD, or other self-identifying SWDs on campus. Possible disabilities by participants are unknown but could include mental health, mobility, chronic health problems, LDs, ADHD, or sensory disabilities. Participants will be selected for group based upon the screening criteria. Screening Students that are registered with the disability service office of their institutions, or students that self-identify as having a disability, are eligible to sign up for the group. However, screening of potential members needs to occur in order to determine if a student is suitable for the group. In selecting group members, two things should be considered: who is likely to benefit from the group, and what mixture of clients will produce the most effective group (AGP A, 2007). One method of selection proposed by AGP A (2007) is to discuss the goals of the group, the tasks, and the quality of the relationships within the group with the client to determine if these criteria are fitting with his or her goals and motivation. If the goals ofthe group fit with the client' s goals, then the client will generally be more motivated and involved with the group (AGP A, 2007). The AGP A (2007) suggests ideal clients are highly motivated and self-reflective, and have a reasonable level of interpersonal skills. Thus, when selecting students for the group, the facilitator should discuss the format of the group, goals, and expectations of the group with each interested member. The second selection criteria suggested by AGP A (2007) is to determine whether the composition of the group members will work together. Facilitators will need to assess the level of motivation ofpotential members, and take into account their social abilities. A 52 client's motivation and ability to commit to the group is recommended as an important component to assess member compatibility (AGP A, 2007). Because the group proposed is psycho educational in structure, the levels of motivation and interest in the proposed topics could be viewed as indicators that the group members will or will not be compatible. Facilitators should also consider if personality factors of a member mesh well within the group. Members whose interactions may not mesh well based on the facilitators judgment, for example highly anxious individuals or those with anger-management concerns, may need to be screened out and referred to another resource. According to Y alom and Leszcz (2005) the screening process should identify a fit for a group based on members' ability to participate in the primary task of the group for logistical, psychological, or interpersonal reasons. Therefore, those who may be triggered by confrontation or certain topics that will be covered in the group, those who are not respectful to others, or those that are experiencing psychosis would be screened out. The requirement that potential members will need to be assessed for suitability to the group should be clearly explained to applicants and the process should be handled carefully should a member not be considered a good fit. If screening indicates that a student may not be a good fit for the group, then the facilitator needs to be able to refer the student to another resource. The AGP A (2007) suggests that if clients cannot engage in the primary activities of the group for whatever reason, they should be matched with a group whose activities are more inline and homogenous with the individual ' s ability level. If no other groups seem fitting for the student, the student could be referred to individual counselling. Confidentiality Procedures and guidelines for discussing group confidentiality are provided to facilitators in the manual. All statements made by participants in counselling must be treated 53 with utmost respect and confidentiality (Yalom & Leszcz, 2005). Limits of confidentiality will need to be discussed with each participant and each member must provide informed consent to join the group. Except for the limits of confidentiality, the facilitator is required to maintain complete confidentiality regarding group participants (Yalom & Leszcz, 2005). Because of the nature of group settings, facilitators need to be explicit that complete confidentiality is expected by all group members in order to create a safe and trusting environment (Yalom & Leszcz, 2005). Facilitators should emphasize that if members want to speak about the group outside of session with others, they may only make reference to their own experience, and not anything that could identify other members (Y alom & Leszcz, 2005). Facilitators should also be explicit in telling the participants that, although they are bound by ethical standards to not break confidentiality outside oflimits, group members are not bound by the same standard as the facilitator and he or she cannot guarantee other members will not break confidentiality. Although facilitators can discuss the detrimental effects that breaking confidentiality will have on the group, such as harming members or creating mistrust, ultimately each participant will be responsible to play their part in maintaining confidentiality. Accessibility The manual offers information on practices that help create an accessible group environment for people of various disabilities. Because this service is intended to be provided by the school, institutions have a legal duty to ensure that the service is accessible. Facilitators need to be familiar with what accessibility entails. For example, ifthere are wheelchair users in the group, the location of the group will need to be checked for accessibility. Good practice would be choosing a room that is accessible for wheelchairs regardless if any member uses one. Facilitators should be aware that not all materials in a 54 group may be accessible to people depending on their disability. If there are visually impaired members of the group, printed materials should be provided to these members in an alternate format that they can use. Being flexible in the type of materials that members work with can be a way to make the group more accessible. For example, if an activity involves drawing, those who cannot see could sculpt something, or alternately create something musical. The manual provides checklists for accessibility and strategies on making the group accessible for SWDs. Facilitators should discuss the accessibility needs of each participant in advance of the group in order to put in accommodations as needed. Cultural Competence The manual provides a discussion on the need for facilitators to develop cultural competence when working with participants with disabilities. There is an extremely wide range of disabilities; therefore, facilitators can never be expected to be experts on the different characteristics of each type of disability. However, facilitators can familiarize themselves with general challenges SWDs may face at school, be aware of the rights of people with disabilities, and follow general interaction guidelines when interacting with people with disabilities. Some general guidance on working with SWDs and resources are provided in the manual. Countertransference Yalom and Leszcz (2005) describe countertransference broadly as a therapist' s reaction to a client. Countertransference says something about the therapist rather than the client and is reflective of the facilitator' s own idiosyncratic reactions (Yalom & Leszcz, 2005). This occurrence can be problematic because the therapist is having a reaction to the client that is based on their own background, and is not based on what is happening in session. Facilitators should be aware of their own reactions when working with people with 55 disabilities. The manual provides suggestions for facilitators on how to address personal biases or reactions towards people with disabilities in order to help manage their countertransference. Topics List The following is a suggested schedule and topic list for the group. In general, the flow of sessions will consist of an opening ritual and check in activity to set the stage for the group, followed by a general ice breaker activity for building rapport and trust between members, followed by a creative empowering activity, discussion of the activity or theme, and a session wrap up. Although the themes of self-identity, self-advocacy, and selfdetermination will be interlaced throughout the group, certain sessions will focus specifically on understanding these concepts through the implementation of creative activities and interventions. Insight and skill development around these themes is anticipated to occur throughout the process of the group. Session 1: Introduction and self-awareness. The purpose of the first meeting is for group members to be introduced to other members, for group rules to be agreed upon, for safety and trust to begin to be established within the group, and for members to participate in an activity regarding self-awareness regarding identity and personal strengths. Participants will be encouraged to give a brief introduction of themselves, what their interests are in attending university, and what their interests are in attending the group. A brief description of what themes are addressed and a discussion of the theoretical influences behind the group are suggested for the first session. This discussion can include how a person-centred approach emphasizes the intrinsic abilities of each person, how positive psychology influences focus on a person's strength, how narrative therapy is associated with identity and our life story, and how art therapy brings a creative approach to the group in order to 56 facilitate self-awareness and empowerment. Participants are involved in developing the rules for the group, and facilitators can address any important issues that may be overlooked, such as confidentiality limits and communicating respectfully. In keeping with the person-centred approach, participants will be encouraged to share thoughts and feelings with the group, but are not required to say anything they do not want to. Starting with a focus on self-awareness allows participants to explore personal meaning regarding disability. This can include exploring benefits associated with disability, as well as personal acceptance ofself(Dunn & Burcaw, 2013). Through creative art based activities, participants can be encouraged to increase their self-awareness and discover a positive self-core (Luzzatto & Gabriel, 2000). Suggested activities that could be used to facilitate exploration of self-identity are provided in the manual. Session 2: Self-awareness and group connection. The purpose of the second meeting is to continue to build on the theme of self-awareness from session one, as well as to build deeper connections and relationships between group members. Disability selfawareness is important for increasing the ability to self-advocate (Milsom et al. , 2004), which is an important component in higher education and employment. Students are encouraged to identify strengths and limitations that they have and how they believe their disability impacts them. Connections within the group are important as well because as participants learn how to be authentic and empowered in the small community of the group, they may be inspired to move to the larger circle of community outside of the group (Rogers, 2011). Therefore activities that facilitate self-awareness and encourage authentic group interaction and connections are offered in the manual. Session 3: Communication and assertiveness. Assertiveness skills are considered important for students to self-advocate (McEachern & Kenny, 2007 ; Milsom et al. , 2004), for 57 improving social interaction skills, and building self-confidence (Darner et al., 201 0). Therefore this session will focus on building assertive communication skills. Students will be provided psychoeducational material on assertiveness, and given an opportunity to reflect on their own communication styles. Activities are geared toward understanding personal communication styles and practicing assertiveness skills. The goals of the session are for members to strengthen assertiveness skills and gain insight about their personal communication style. Possible activities include creating art work that represents a person' s assertive self or role playing. Session 4: Self-advocacy. This session focuses on the role of self-advocacy and why it is important. Psychoeducational material will be provided on legal rights of students, and on issues of disclosing disability. McEachern and Kenny (2007) emphasize that understanding legal rights is important for SWDs to self-advocate. Roessler et al. (1998) provide suggestions on how to prepare SWDs to self-advocate by walking through the procedure of requesting accommodations in higher education. Issues such as knowing what services one needs, and how to talk to instructors, staff, and other students are covered. Role playing may be suggested as a way to practice assertiveness and self-advocacy. Pairing members up to take turns role playing as a student and as a faculty member is a way to make the exercise more interesting for participants. Further suggestions are provided in the manual. Session 5: Self-determination. While self-advocacy is important for SWDs in order to ensure they can obtain the supports they need, self-determination is essential for persisting in higher education (Getzel & Thoma, 2008). Self-determination involves having determination to overcome obstacles that arise (Getzel & Thoma, 2008). It also involves setting goals and authoring one' s own behaviour. SWDs may have challenges in setting their 58 own goals that they wish to pursue (McEachern & Kenny, 2007). The suggested activities can help students identify fears and challenges that they face, and discuss what strengths and supports they need to overcome them. Session 6: Self-determination and closing: The purpose of the last session is to provide closure to the group experience and allow participants to reflect on the progress they have made during their time in the group. Potential activities are listed in the manual. The session is structured to allow for discussion and activities focused on what students can take from the group and implement in the future. Other resources available in the community are shared, and participants are given an opportunity to conclude any unfinished business from . . pnor sesswns. Chapter Summary In this chapter, the structure of the proposed psychoeducational group for SWDs was provided. The target audience, goals of the manual, ethical considerations, an outline of sections that are covered in the manual, and a list of proposed topics were provided. Chapter 4 provides the comprehensive manual, which includes a table of contents, rationale for the group, facilitator information, suggestions for starting the group, suggested topics, suggested activities, and reference materials so that facilitators can implement the group in a format they see fitting. 59 Chapter 4: Facilitator Manual Table of Contents Introduction 62 Why Create a Group for Students with Disabilities in Higher Education? 62 Self-Advocacy 63 Self-Determination 63 Overview of Group Format 63 Goals of Group 64 Who Might Use this Manual 64 Theoretical Orientation 64 Rationale for Selecting an Inclusive Population 66 For the Facilitator 67 Counselling Relationship 67 Basic Counselling Skills 67 Group Counselling Skills 68 Art Therapy Considerations 68 Boundaries 69 Working with Students with Disabilities 70 Countertransference 71 Planning the Group 73 Psychoeducational Group Structure 73 Suggested Timeline 73 When and Where to Meet 74 Group Membership 74 60 Recruitment 75 Screening 76 Preparing an Accessible and Accommodating Environment 77 Confidentiality 78 Potential Challenges 79 Running the Group 80 Session 1: Introduction and Self-Awareness 81 Activity: Mixed Media Collage 85 Activity: Disability Video Discussion 87 Activity: Fishing Exercise 89 Session 2: Self-Awareness and Group Connection 91 Activity: School as We Experience it 93 Activity: School Puzzle 95 Activity: Construction of a Self-Box 97 Activity: Self Portrait of Me Inside and Out 99 Session 3: Communication and Assertiveness 100 Activity: Annoying Behaviours 102 Activity: Expressing Opinions 103 Activity: Assertive Conceptualization Through Art 104 Session 4: Self-Advocacy 105 Activity: Self-Advocacy Role Play 107 Activity: Group Experience of Self-Advocacy 109 Session 5: Self-Determination Activity: Intentionality in Action 111 113 61 Activity: Knowing our Strengths and Limits 115 Activity: Resiliency Drawing 117 Activity: Tank of Gas 118 Session 6: Self-Determination and Closing 119 Activity: Taking What I Like, Leaving What I do not Like 121 Activity: Imagine Us in the Future 122 Activity: Treasure Map Activity 123 After the Group 124 Evaluation of the Group 124 Staying Connected After group 124 Referrals 124 62 Introduction The following manual provides a structure for implementing a psychoeducational group utilizing creative activities in order to empower students with disabilities (SWDs) attending postsecondary school. The group is designed to promote the development of selfawareness, self-advocacy, self-determination, and social support through group work and creative engaging activities. I have developed the format and style of this group based on the following: a review of current literature in this area, my personal experience and knowledge working in the disability service field in higher education, and my educational background in psychology and counselling. Why Create a Group for Students with Disabilities in Higher Education? The group has been designed to meet the needs of SWDs attending a higher education institution. There is a need for this group of learners to be able to self-advocate and be self-determined in their educational pursuits. SWDs face several unique challenges while attending postsecondary. These challenges can include barriers to accessing education, the added stress of organizing accommodations, stigma related to disability, and issues regarding self-advocacy or self-disclosure (Beecher et al. , 2004; Eckes & Ochoa, 2005; Holloway, 2010; Kundu et al. , 2003). SWDs can also be challenged with physical or emotional stress associated with having a disability. The aim of this group is to provide support for SWDs regarding some of these challenges. Although institutions have supports on campus for SWDs, current services tend to focus on the implementation of academic accommodations to help ensure educational access. Even though accommodations are considered effective for increasing access to education and are considered valuable by SWDs there is evidence that SWDs would benefit from further support regarding self-advocacy, self-determination development and building social supports (Getzel & Thoma, 2008; Murray et al. , 2012; Newman et al., 2009). Supporting SWDs by providing services that focus on developing self-advocacy and self-determination skills could potentially empower SWDs. Therefore, the purpose of this facilitator manual is to provide a structure for a group that addresses these areas of need for SWDs. This manual is designed so facilitators can lead a group centring on empowering SWDs through a focus on self-awareness, self-advocacy, self-determination, and peer support. By developing these skills, students can be better prepared to advocate for their needs with instructors, seek help when needed, have greater self-efficacy regarding their abilities, and form social support systems. These skill sets can in tum help their chances at success in higher education, as well as with future endeavors such as employment. 63 Self-Advocacy Although there are many definitions of what self-advocacy means, for this manual self-advocating is defined as the ability to speak up for oneself and one' s own needs (Furney, Carlson, Lisi, & Yuan, as cited in Test et al., 2005). Fundamental components of selfadvocacy involve having knowledge of self and knowledge of personal rights, as well as the capability to communicate effectively (Test et al., 2005). Knowing what an individual wants is essential in l)eing able to tell others what is desired or needed. Thus the following group begins with a focus on self-awareness and insight, and builds on this knowledge through an emphasis on personal rights and communication skill development. Self-advocating requires communication skills of negotiation, assertiveness, and problem solving, and one goal of this group is for students to practice and develop such communication skills. A student that is able to self-advocate will have a strong understanding of their strengths and needs, and be prepared to ask for accommodations and assistance as needed. Self-Determination In general, self-determination can be defined as the ability to take charge of one's life, which can involve developing abilities and attitudes that help individuals define goals for themselves and take action in achieving these goals (Browder, Mood, Test, Karvonen, & Algozzine, 2001 ). Self-understanding, decision making, problem solving, self-awareness, goal setting, and internal locus of control are considered important components of selfdetermination (Sands & Wehmeyer, 1996). These concepts are central themes in many of the activities suggested in this group. Building self-determination in students can help them to make choices and decisions based on their own interests and increase their resourcefulness when confronted by challenges. Overview of Group Format The group is structured to be psychoeducational in format, utilizing a person-centred approach and creative activities. The group begins with a focus on increasing self-awareness and self-identity for the first several sessions. From there, the group builds on these areas while shifting focus to communication skills and self-advocacy. Lastly, the group moves towards an emphasis on working on self-determination through goal setting and a focus on taking control of one's life. Developing self-awareness, the ability to advocate, and selfdetermination could be very helpful for the success of SWDs in higher education. A closed group format is suggested so that students have the opportunity to build relationships within the group and establish cohesion and trust with one another. In a closed group, members will be expected to remain in the group until it ends and new members are not added (Corey et al. 201 0). 64 Goals of Group The goals of the group are for students to develop insight and awareness about their own strengths and self-identity, to develop self-advocacy skills, to develop selfdetermination, and to apply this personal learning to their academic pursuits (and beyond). It is also a goal of the group for students to practice assertive communication skills and develop peer relationships. Who Might Use this Manual? The target audience for this manual are higher education staff involved with the implementation of services for SWDs such as disability service professionals and counselling centre professionals. The group facilitator should be someone who is a member of a professional college or association, who also has professional competence regarding group facilitation. Others who may potentially benefit from this manual are administrators that may be involved in the organizing of the proposed group. Furthermore, the design of this empowerment group is specifically intended for small size institutions were there are limited resources available, and where the population of SWDs may not warrant creating multiple counselling groups that focus on specific disability populations. Theoretical Orientation The theoretical orientation used in the formation of the group is a person-centred approach that draws integrative elements from positive psychology, narrative therapy, and art therapy. The person-centred basis is appropriate as it emphasizes a safe, accepting group environment that upholds the strengths of each group member. From this basis, empowering activities adapted from elements of positive psychology, narrative therapy, and art therapy are suggested. • Person-centred theory o A fundamental premise of this theory is that each person has vast inner resources and capacity for self-direction, and should be treated with dignity and worth (Rogers, 1993). o The facilitator views the group as being capable and having inner resources to direct and develop themselves as individuals and as a group (Gladding, 2008). o Facilitators and group members expressing genuiness, empathy, and selfdirection allows for maximizing inner growth and self-direction (Gladding, 2008). 65 o • • Providing a safe, accepting environment for participants, building trusting relationships with group members, and trusting in each participant' s ability to recognize their own potential and needs are central principles for the implementation of this group. Positive psychology o Positive psychology theory views people as having inherent developmental tendencies toward growth and fulfilment(Linley et al. , 2009), which suggests positive therapy techniques have a good fit with the person-centred approach ofthis group. o Positive theory focuses on questions of what it means to be human and to live well (Linley et al. , 2009). o Self-determination, resiliency, and strength based approaches are some positive therapy constructs that have influenced the interventions used in this group. Expressive arts therapy o Through the use of expressive arts therapy, clients have an opportunity to use a variety of mediums and creative outlets- such as sculpting, writing, painting, and improvisation- to express feelings and gain insights from these activities (Corey, 2009). o This approach is based on person-centred theory, where group facilitators help create supportive, genuine, and safe environments that help allow for open and honest creativity (Corey, 2009). o • For the purpose of this group, my intent is for facilitators to use elements of art therapy interventions in a safe and competent manner that could allow members of the group a creative opportunity for self-exploration, expression, identity formation, empowerment and socialization. Narrative therapy o Narrative therapy emphasises listening to clients' stories and treating these stories as representations of an individual ' s truth and interpretation of meaning in life (Gladding, 2008). o Narrative therapy can be a useful theoretical model for understanding dominant cultural narratives defining disability which may have a large impact on what personal meaning is for those living with a disability. 66 o Helping participants author their own story of disability can be a useful intervention for group members. Rationale for Selecting an Inclusive Population The proposed project takes an inclusive group approach in defining the population of SWDs which the group is designed for. There is no specific disability criteria involved in order for participants to be considered eligible to join the group. This approach is taken because there are common themes that SWDs face in higher education, such as facing environmental and attitudinal barriers, and needing to request and organize their accommodations. Also, this group is designed for a mixed disability population because it is intended for use by small institutions where resources may be limited and population size may not warrant the creation of multiple groups addressing specific disability populations. Therefore, I suggest that students with different disabilities are not to be included or excluded from the group based on their disability. Those who want to join the group may do so based on their decision to engage with the content of the group, and on their fit with the group members based on the screening process. - - - - - - - - - - - - - - - - - - - - - - - - ---- --. 67 For the Facilitator This section outlines the suggested role and basic skills facilitators should have when running this group. It also provides general guidelines regarding communicating with people with disabilities, as well as discusses the facilitator' s need to understand their own countertransference reactions when working with people with disabilities. Counselling Relationship Yalom and Leszcz (2005) emphasize that underlying any task or technique used by the therapist is the need for a positive relationship between the facilitator and the client. The therapist should display genuineness, acceptance, concern, and empathy, in order to build therapeutic relationships with participants, which is considered much more important for effective group work than technique. To establish caring and supportive relationships with group members, a personcentred approach is suggested. From this approach, the facilitator should view each individual in the group with dignity, worth, and capacity for self-direction. In other words, the facilitator views each member in the group as a person with an innate ability to grow and reach their full potential. The facilitator should act as a guide for the group, rather than taking control of the group process (Rice, Renooy, Zitzelsberger, Aubin, & Odette, 2003). In this approach, the facilitator is not expected to be an expert dictating what the group should learn or achieve. Facilitators should also interact with group members in a congruent, authentic, and genuine way. Through this person-centred stance, participants will be encouraged to come up with insights and strategies that are supportive and fitting to their own way of being in their daily lives and in higher education. Basic Counselling Skills In order to allow the individuals and the group to pursue their own needs and interests, the facilitator should be competent in fundamental counselling skills. These include the abilities to practice active listening and empathy, ask open ended questions, and show acceptance to members. When members feel welcome, accepted, respected, and understood, self-directed growth can occur (Rogers, 1993). For more information on counselling skills such as immediacy, probing, open ended questions, and reflections, please see the following resources: • Adler, R. B., Rolls, J. A., Proctor III, R.F., & Towne, N. (2009) . Looking out looking in (Canadian ed.). Toronto, ON: Nelson. 68 • Corey, G. (2009). Theory and practice of counselling and psychotherapy (8th ed.) Belmont, CA: Thompson Brooks/Cole. Group Counselling Skills The facilitator's basic tasks are to create and maintain the group, build group culture and connections, and be mindful of the here and now (Y alom & Leszcz, 2005). In building group culture, the facilitator functions as a leader in helping set the norms of a group that will be conducive to the growth and well-being of members. The facilitator should model respectful, caring communication and look for ways in which group members can connect and learn from one another. The facilitator should focus on process in the group, that is, focus on the here and now occurring within the group during session (Y alom & Leszcz, 2005). Because the proposed group has psychoeducational components, process may not be as heavily emphasized as it is in other types of experiential or encounter groups, but can still be a very effective and powerful phenomenon that facilitators should be aware of. Facilitators should also focus on validating the experience of the participants in the group. They can encourage members to speak about their own experiences by acknowledging and validating what is shared. Participants can also learn a great deal from one another. Group members can be validated by other participants who witness, affirm, aspire, or motivate (Rice et al., 2003). This approach to having members learn from and validate one another is based on their own life experiences and is considered more effective than having the facilitator as the source of knowledge and skills. For more regarding group facilitation skills see: • Gladding, S.T. (2008). Groups A Counseling Specialty (5th Ed). Upper Saddle River, NJ: Pearson. • Yalom, I., & Leszcz, M. (2005). The theory and practice ofgroup psychotherapy (5th ed). New York, NY: Perseus. Art Therapy Considerations Regarding the skills required for facilitating creative work proposed by this group, the facilitator should once again approach teaching and viewing art from a person-centred approach. The facilitator does not need to be gifted in art, but should be open to the process of sharing and exploring thoughts and feelings through creative mediums. The facilitator has a responsibility in modelling how to respectfully and sensitively help group members discover meaning in their art (Rogers, 1993). To show respect facilitators should ask participants to explain what the process was like and what meaning a 69 creative work has for them (Rogers, 1993). It is important for facilitators to talk to group members about withholding judgment or analysis of someone else's art, and to establish that members only provide input after asking if a participant would welcome it (Rogers, 1993). The facilitator should tell members to concentrate on their own feelings about someone else's work and focus on their own personal reaction, rather than interpreting what the work means to the artist (Rogers, 1993 ). These practices can help others feel safe in showing creative work, and should be modelled by the facilitator and practiced by group members. For more information on facilitating art therapy refer to: • • • • Anderson, F. (1992). Art for all the children: Approaches to art therapy for children with disabilities. Springfield, IL: Charles C Thomas. Rogers, N. (1993). The creative connection: Expressive arts as healing. Palo Alto, CA: Science and Behaviour. Rogers, N. (2011). The creative connection for groups: Person-centred expressive arts for healing and social change. Palo Alto, CA: Science and Behaviour. Wadeson, H. (2000). Art therapy practice: Innovative approaches with diverse populations. New York, NY: Wiley. Boundaries Although the nature of this group is psychoeducational, it is still intended to be therapeutic and may involve the development of complex relationships between facilitators and members. It is important that the facilitator establish boundaries around what their role is as the facilitator and what can be suggested regarding the development of relationships between members. Regarding the latter, given that the group is held at university and the population of members consists of students, it is likely that members will know each other outside of group. This, in fact, could be positive. However, the facilitator should be mindful that member-to-member contact outside of the group can result in formation of sub-groups that could be detrimental during sessions (Gladding, 2008). The facilitator can discuss what the groups ' thoughts are on the formation of relationships outside of group, but emphasize that within the group the setting is one of openness and acceptance towards all members, not just one ' s friends. If members pair up too much, the risk is that other members may feel left out. The facilitator should also be cautious about what type of relationship they have with participants. It is important that facilitators do not form friendships or personal relationships outside of the group setting. Thus outside of session, facilitators should take care not to befriend members. 70 Another important thing to consider is the amount of personal information that one self-discloses. Self-disclosure by facilitators can be an effective therapeutic tool, however it should only be done with the best interests of the group in mind. If the facilitator begins to use the group as a platform to do their own therapeutic work, or to discuss their own personal disability, it is likely not appropriate for the well-being of the group. For more information regarding boundaries, duel relationships, and confidentiality, refer to: • Canadian Counselling and Psychotherapy Association. (2007). Code of ethics. Retrieved from http://www .ccpa-accp.ca/_ documents/CodeofEthics_en_new .pdf Working with Students with Disabilities It is essential that facilitators have some awareness and familiarity interacting with people who have disabilities in order to be culturally competent. There is an extremely wide range of disabilities and facilitators can never be expected to be experts on the different characteristics of each type of disability. However, facilitators can familiarize themselves with general challenges SWDs may face at school, be aware of the rights of people with disabilities, and follow general interaction guidelines when interacting with people with disabilities (see Appendix A). However, the most important part of working with a person with a disability, just like with any other person, is to respect each person as a unique individual with different strengths and abilities. Treating each person as an individual, rather than focusing on treating each person according to their disability type, is a respectful and humanistic approach that shifts focus away from what makes a person disabled, to what makes a person a person. Facilitators can use client-centred approaches to understanding what a person's disability means to them, and let the participant teach the facilitator about their life. The facilitator should not position themselves as an expert on disability, instead viewing the participant as the expert on their own life. For more general information on working with people with disabilities please refer to the following resources : • General interaction guidelines when communicating with people with disabilities are provided in Appendix A. • Information on disability rights are provided in Appendix B. • For a brief history of disability services in higher education refer to Mad aus (20 11 ). • For general counselling guidelines for working with SWDs in higher education, refer to Beecher et al. (2004) or Artman and Daniel (2010). • For information on artwork with people with disabilities refer to Wadeson (2000) or Anderson (1992). 71 Countertransference Facilitators should be aware of their own reactions when working with people with disabilities. To effectively and ethically practice counselling with SWDs facilitators need to think critically about their own experiences regarding disability and work as necessary to overcome biases that they may have about people with disabilities as well as be aware of countertransference during sessions. Yalom and Leszcz (2005) describe countertransference broadly as a therapist's reaction to a client, which can occur in two ways: objective and subjective. Objective countertransference An objective countertransference reaction reflects the participant's interpersonal impact on the facilitator and other group members, and indicates a source of interpersonal data about the client (Yalom & Leszcz, 2005). For example, the facilitator may feel tense with a particular client if the client is quick to criticize the facilitator and others in the group. This feeling and reaction to the client might be indicative of something actual in the way the client communicates. This type of transference can be potentially therapeutic and insightful for members to know about if shared in an appropriate and caring fashion. Subjective countertransference Subjective countertransference says something about the therapist rather than the client and is reflective of the facilitators own idiosyncratic reactions (Y alom & Leszcz, 2005). This occurrence can be problematic as the therapist is having a reaction to the client that is based on the facilitator's background. This subjective countertransference occurs when the therapist begins to respond in session to the clients in irrational or emotional ways as a result of something that has been triggered in the therapist (Corey, 2009). For example, if the facilitator begins to feel criticized by a participant and this triggers the facilitator's memories of being critiqued by their father, the facilitator is reacting to their past experience rather than what is occurring in the session. This type of countertransference can be problematic as it takes the therapist away from what is occurring in the moment and draws focus internally, rather than on the participant they are there to help. Working on one's self-awareness ofbeliefs and biases regarding people with disabilities is important in order to minimize countertransference during sessions. Through self-reflection, clinical supervision, increasing knowledge about disability-related issues, and through knowing people with disabilities, a facilitator can work on minimizing countertransference. Facilitators should consider seeking their own therapy regarding these responses (Y alom & Leszcz, 2005). It is important that the therapist be aware of what may trigger them regarding working with people with disabilities. Through increased awareness of what may trigger a 72 facilitator and what biases they bring into session, the facilitator can be more conscious of their actions in session and replace those that are detrimental with balanced person-centred practices. 73 Planning the Group Psychoeducational Group Structure The structure of the group is founded on creating a safe and supportive environment for participants that can help facilitate self-directive exploration towards personal development. From this basis, some structure should be offered by the facilitator because the intent of the group is to help participants develop personal insight, knowledge, and skill development regarding self-advocacy and self-determination. For SWDs, this approach can be particularly empowering as the facilitator is not considered the expert on their lives, nor the person that is there to "fix" or "treat" them. Rather, this position espouses each students own strengths and puts trust in their ability to grow and develop from their own resources when a fostering environment and space are provided. The structural element of a psychoeducational group is fitting since purely personcentred approaches can be problematic in their lack of structure especially in the short time frame of an academic semester. A lack of structure can lead to members feeling like they are going nowhere in the group, or they may not be ready for the openness required for pure encounter groups to be effective, and thereby regress in their interactions and participation (Gladding, 2008). Because students are dealing with a great deal of other stressors and changes in their lives, having too little structure is believed to be detrimental to meeting their current needs within the group. Therefore a balance between creating a safe, explorative, and person-centred environment, and the guidance provided by the suggested activities and themes brought forward by the facilitator, must be maintained. Suggested Timeline Due to the nature of the academic year, it is suggested that the timeline of the group be based on the length of the semester. The following suggested timeline of the group is based on a four month academic semester beginning in September: • Recruitment and screening in September • Group starts first or second week of October • Six weekly sessions are held • Group ends in the middle of November before final exams and assignments begin to accumulate for students The same pattern can be suggested for the winter semester: • Recruitment and screening in January • Group starts first or second week of February 74 • Six weekly sessions are held • Group ends in the middle of March before final exams and assignments begin to accumulate for students I suggest running the group for six sessions because students may be more willing to commit to this length of time compared to a longer running group. However some facilitators may want to change the length of the group to eight sessions, as this can allow for greater group cohesion and depth in work. The activities in the manual and structure of the group could easily be altered to allow for eight weeks of activity by focusing on certain themes for more time. Also, depending on the flexibility of the facilitator and the needs of the group, extra sessions could be added on to the group if desired and logistically practical. Therefore the suggested structure, although designed for six sessions, has enough depth in material to allow for longer implementation if desired. When and Where to Meet There are many factors to consider when deciding on a time and place to hold the group sessions. Meeting times should be consistently held at the same time once a week if possible, and, as best as possible, be at a time when class conflicts are minimized. Choosing a time when no classes are held may not be possible, therefore consider contacting the room booking coordinator to find out times of the day, or days of the week, when the least amount of classes are held. Another important consideration when choosing meeting times is to take into account the different cultural events that may occur during the semester. Contact the institution' s interfaith chaplaincy, international student centre, or first nations centre to inquire about upcoming spiritual, ceremonial or religious events during the semester. Compare the calendar of such events with the group schedule and try to reduce scheduling conflicts. With respect to choosing a location, it is important to emphasize that the location needs to be accessible to people with mobility concerns. Other factors to consider are that the location is pleasant, comfortable, quiet, and private (Johnson, 2002). Group Membership The group is designed primarily for undergraduate students who are attending a higher education institution that identify themselves as a person with a disability. Participants may be students registered with the disability service office of the institution as a SWD, or other self-identifying SWDs on campus. Possible disabilities by participants are unknown but could include mental health disabilities, mobility, chronic health problems, LDs, ADHD, or sensory disabilities. Specific participants will be selected for group based upon the screening criteria. The number of participants suggested for the group is between six and eight if possible. A closed group format is suggested so that students have the opportunity to build relationships within the group and establish cohesion and trust with one 75 another. In a closed group, members are expected to remain in the group until it ends and new members are not added once the group has begun. Because the group will be working with people across a spectrum of diverse disabilities, it is important that participants don't focus on comparisons of disabilities, such as "your disability is not so bad" or "I am not as disabled as other group members" (Rice et al., 2003). To address these types of comparisons, have participants focus on similarities and connections (Rice et al. , 2003), for example asking "have you ever been compared to anyone else with a disability?", "what happened in that situation and what was that like for you?" Rice et al. (2003) also suggest that rather than making positive or negative judgments about the abilities of members, each group member should focus on validating their own expenences. Some group members may require different accommodations, such as using communicative devices, or having extra time to speak or process information. When implementing a group for people with mixed disabilities, members should develop a general consensus on respecting the uniqueness of each individual in the group at the beginning of the group process (Rice et al., 2003) Recruitment Advertising for the group can be done in a number of ways. It is a good idea to try and disseminate information about the group early in the semester or even before the semester begins. It is also important that different mediums be used to advertise, as some forms of advertisement such as posters may not be accessible for all students. • Create a poster with key information about the workshop such as topics covered, who it is for, when it will be held, the screening process, and contact information on how to find out more. • Posters can be placed throughout campus in high traffic areas as well as on different department bulletin boards. • Email would be an effective way to advertise for the group. If the group is being run through the accessibility or disability service office of the institution, a generic email could be sent out to all students registered with the office announcing the group. Make sure that the email would be accessible for visually impaired students that use screen readers. • Email announcements could be emailed to the student body at large. • The announcement of the group and important information could also be placed on the department website. 76 • Get creative and advertise on the campus radio station or other types of media if possible. • It is important to network with disability and counselling office staff about the group. Personal suggestions from student service provider staff or faculty could be helpful. Screening Potential participants need to be aware that they will be involved in a screening process for the group and that this is standard procedure for group work. Screening allows for the facilitator to explain in detail the expectations and requirements of the group, and to determine if potential members are suitable for the group. • One method of selection proposed by AGP A (2007) is to discuss the goals, tasks, and quality of the relationships within the group with each applicant in order to determine if these are fitting with the client's goals and motivation. Ifthe goals ofthe group fit with the client's goals, then the client will generally be more motivated and involved with the group. As the group proposed is psychoeducational in structure, the levels of motivation and interest in the proposed topics could be viewed as indicators if the group members will be compatible. • The second component to consider suggested by AGP A (2007) is whether the composition of the group members will work. Members whose interactions may not mesh well based on the facilitators judgment, for example highly anxious individuals or those with anger-management concerns, may need to be asked to attend another group in which the interaction styles of members are more similar to their own. • The screening process should identify a fit for a group based on a participants' ability or inability to participate in the primary task of the group for logistical, psychological, or interpersonal reasons (Yalom & Leszcz, 2005). Therefore, those who may be triggered by confrontation or certain topics that will be covered in the group, those who are not respectful to others, or those that are experiencing psychosis should be screened out. • The requirement that potential members will need to be assessed for suitability for the group should be clearly explained to potential applicants and the process should be handled carefully should a member not be considered a good fit. If screening indicates that a student may not be a good fit for the group then the facilitator must refer the student to another resource. Alternate resources could be another group more compatible with the student' s abilities or interests, or individual counselling. • When members agree to join the group and are considered a good fit through the screening process, it is important to discuss with them their accommodation needs. 77 For example, will they require alternate formats for written materials? Keep in mind that accessibility to the group is a legal right of students; therefore students need to be accommodated unless the accommodation request is unreasonable and poses undue hardship to the institution. I strongly recommend facilitators discuss the duty to accommodate with a disability advisor if they have are any questions regarding accommodations. • See Appendix C for an example of an introductory screening interview. • Members who are selected as a good fit for the group will need to also review the informed consent form and sign that they understand the limits of confidentiality of the group. See Appendix D for an example. Preparing an Accessible and Accommodating Environment In this section, I offer general suggestions and practices on how to create an accommodating environment for people with differing abilities. However, specific accommodations may need to be very individualized depending on what a person's needs are. Therefore, make sure to find out what the accommodation needs of each participant are well in advance of the group commencing, as some accommodations will require more preparation and planning than others. • I suggest it is good practice to select a room and create a group environment that is accommodating to people of all abilities. • One place to begin when considering an accommodating environment is to choose a meeting room that is accessible for wheelchair users or those with mobility impairments. Consider the layout of the room: can a person using a wheelchair get to the room in the first place? Is there an elevator students can use to get to the room if need be? Other questions to consider are the layout of the room: is there enough space for a person using a wheelchair to navigate? If there is a need for the use of a table for artwork, is the table at a proper height or adjustable so that a wheelchair will fit? For blind students, keeping the layout of a room and supplies they may need to use consistent is important so that they can learn where things are and not need to rely on another person to guide them (Anderson, 1992). • For people with ADHD or autism, certain environments can be very distracting. Try to remove unnecessary stimuli that are not relevant to the group and activities (Anderson, 1992). Choose a room that has a quiet location, and if possible, few windows and adjustable lighting. • For more information on accessible environments, refer to Appendix E. 78 • Alternate formats for handouts may need to be created for students with visual disabilities. Any handouts provided to the group must also be provided in an accessible alternate format. Students with visual disabilities may use assistive technology to access print materials, so handouts could be provided in a WORD format, or other file format, that is compatible with the student' s assistive technology. • Adaptions to art material need to be considered as well. What range of mobility or dexterity do participants have? Some students may not have as wide a range of hand functions as others; some students may be blind. Consider making individual adaptations for each member in accordance to their needs as best as possible. If members are asked to paint, discuss with a visually impaired student whether they would like to create a tactile creation instead. Could they create something musical? Could a person with limited mobility use modified tools to paint? Facilitators should discuss potential activities with participants in the screening session and identify what preparations and alternate materials could be used for different activities. Some students will use assistive technology or have an aide accompany them if required. • Attendants or interpreters may need to be arranged to assist participants. The attendants or interpreters do not actively participate in the group, and need to be experienced staff that can be trusted to keep the group confidential. The use of such aides can take advanced preparation, and facilitators should liaise with the disability service office to help coordinate such services. Confidentiality All statements made by participants in counselling must be treated with utmost respect and confidentiality (Yalom & Leszcz, 2005). Limits of confidentiality must be discussed with each member prior to the group, and members should sign an informed consent form indicating that they understand (see Appendix D). Outside of these limitations, the facilitator is required to maintain complete confidentiality regarding what happens in the group. Because ofthe nature of group settings, facilitators need to be explicit that complete confidentiality is expected by all group members in order to create a safe and trusting environment. Facilitators' should emphasize that if members want to speak about the group outside of session with others, they may only make reference to their own experience, and not to anything that could identify other members (Yalom & Leszcz, 2005). Facilitator' s should also provide informed consent that, although they are bound by ethical standards to not break confidentiality outside oflimits, group members are not bound by the same standard as the facilitator and the he or she cannot guarantee other members will not break confidentiality. They can discuss the detrimental effects breaking confidentiality will have, such as harming members, but ultimately each participant will need to agree to confidentiality and maintain it. 79 Potential Challenges Accessibility Creating an accessible environment for the needs of all students can lead to some creative problem solving. The biggest challenge regarding accessibility is having enough time and resources to implement accommodations needed. Therefore, it is important that the accommodation needs of students are known in advance of the group commencing. Facilitators are strongly encouraged to seek the help of the disability or accessibility support offices on campus if they have questions about accommodations. Mixed disabilities Because the group is intended to involve students with a variety of disabilities, there may be a great deal of variety of personalities in the room. People with different disabilities may compare their own disabilities to others. It is important that the facilitator model an emphasis on focusing on each individual's feelings and thoughts, and to look at other group members as people, not a disability category. Conflict Although some group conflict is a normal and productive group dynamic, sometimes different members may clash. As with any other group, the facilitator should address conflict openly in the group to try and sort out the issues within the group. However, should a particular member or members behaviour become disruptive to the functioning of the group, the facilitator may need to address this outside of group sessions with these individuals. If the individuals continue to be disruptive to the functioning of the group, the facilitator may need to ask the disruptive members to withdraw from the group, and take care to refer them to another service. 80 Running the Group This section provides suggested procedure, topics, and activities for running a creative group for SWDs that focuses on themes of self-awareness, self-advocacy, selfdetermination, and peer connections. Each session is broken down into purpose, goals, timeline, procedure, and suggested activities. Facilitators can use this section to help guide their own group facilitation in a way that works best for their participants and their facilitation style. The proposed group is broken into six sessions according to the following topics: Session 1: Introduction and Self-Awareness Session 2: Self-Awareness and Group Connections Session 3: Communication and Assertiveness Session 4: Self-Advocacy Session 5: Self-Determination Session 6: Self-Determination and Closing For facilitators that would prefer to run a group for more than six sessions, the suggested topics and sessions could be modified according to the facilitator or group needs. See the suggested example below for the format of an eight session group: Session 1: Introduction Session 2: Self-Awareness Session 3: Self-Awareness and Group Connections Session 4: Communication and Assertiveness Session 5: Self-Advocacy Session 6: Self-Determination Session 7: Self-Determination Session 8: Closing 81 Session 1: Introduction and Self-Awareness Purpose: The purpose of the first meeting is for group members to be introduced to other members; for group rules to be discussed and agreed upon; to begin to establish the group as a safe place; and for members to participate in an activity regarding self-awareness. Goals: • Welcome and introductions • Establish group rules • Build group safety and trust • Begin self-awareness work • Connect with group members Suggested Order of Session: • Opening ritual (5 minutes) • Introduction (5-1 0 minutes) • Group overview (5 minutes) • Group rules (10-15 minutes) • Self-awareness activity and discussion (45-60 minutes) • Wrap up (5-10 minutes) Procedure: Opening ritual A good way to begin each group session is to start with an opening ritual. Welcome each member and have the group sit in a circle facing one another. You can do a short relaxation exercise (see Appendix F) to help group members focus on the present and immediate experience, helping to get their mind set into the group session. Part of this opening ritual could be to do a short check in as well, having each member state how they are feeling at that moment, or describing something positive that happened to them that week. 82 A talking circle is another opening ritual that could be used. For a talking circle, an object such as a rock is passed around the circle to each member. Only members holding the rock are permitted to speak, while others give their full focus and attention to the speaker. The speaker may share what they like, or nothing at all if they want. The object is passed around in a circle ensuring each participant gets a chance to share something. Let members know that each meeting will begin in a similar format to help focus the group ' s attention and engagement, and to let them know they are entering into a safe and caring environment. Introductions Following the focusing activity to open the group, participants will be encouraged to give a brief introduction of themselves, what their interests are in attending university, and what their interests are in attending the group. Group overview After the introduction, the facilitator can go over some of the basic themes and goals of the group. This step is intended as a summary of what the group is about, which should have already been covered in more detail during the pre-group interviewing and screening process. This summary should be a brief description of the themes that will be addressed in the group which will include: building self-awareness and insight of one' s personal identity, learning about personal strengths and challenges, learning about disability rights and resources, learning about the importance of self-advocacy, assertiveness, self-determination, and resiliency in higher education and how to develop these traits. The summary should also briefly cover the theoretical influences behind the group and the facilitator' s counselling approach. This summary could include how a personcentred approach emphasizes the intrinsic abilities of each person, whereby the facilitator views each individual as an expert on their own life with innate values and resources that can be tapped into. The facilitator acts as a guide, balancing direction and exploration, while working to help create a safe, supportive environment. However, the direction of the group, and the safety and support of the environment, is a shared responsibility between all members. If appropriate, the facilitator can discuss other theoretical views behind the group, such as how a positive psychology influence emphasizes a focus on a person's strength; how narrative therapy is associated with building personal identity through our life stories; and how art therapy will be used to bring a creative approach to the group in order to foster selfawareness and empowerment. Discussion of group rules and norms Participants will be involved in developing the rules of the group, while the facilitator should address any important issues that may be overlooked. It is essential that issues such 83 as confidentiality limits and communicating respectfully are discussed during this first session. In keeping with the person-centred approach, participants will be encouraged to share thoughts and feelings with the group, but are not required to say anything they do not want to. Make sure to cover the rules for respectful sharing and viewing of art work. Emphasis should be placed on withholding opinions or judgements about the artwork of others, on asking participants if they would like feedback, and focusing on personal reactions to another's work rather than interpreting it for them. Self-awareness activity The first suggested activities for the group are designed to focus on developing selfawareness and helping establish self-identity. Several activities are suggested and the facilitator can incorporate one that is deemed appropriate for the group. Having a strong sense of self-identity is important for participants so that they can focus on finding personal meaning regarding their own perception and understanding of disability. This can include finding benefits associated with having a disability, as well as finding personal acceptance of one' s abilities (Dunn & Burcaw, 2013). Through creative art based activities, participants can be encouraged to increase their self-awareness and uncover a positive self-core (Luzzatto & Gabriel, 2000). By doing an activity about self-awareness, the tone of the group is being set as one of self-directed personal growth and reflection. Rather than focusing on instructive materials at this stage of the group, the emphasis is on each individual's process of learning about their own identity. Because this is the first session, participants may be reluctant to express themselves or feel uncertain about the group; therefore other less art based activities are also suggested. Before beginning any creative activity, the facilitator should remind participants that there is no right or wrong way to do an activity in the group, that participants only share as much as they are comfortable with, that everything done in the group is considered confidential, and that people focus on what is going on for them and not be judgmental of others. Wrap up The facilitator should take time to close each session. This step typically could involve a summary of what occurred during session. Asking participants to share one thought that carne up for them from the session, or asking participants to set one goal for the week related to what they learnt from the session, can be good ways to wrap up. Suggested Activity Options: • Mixed Media Collage • Disability Video Discussion 84 • Fishing Exercise 85 Activity: Mixed Media Collage (adapted from Wadeson, 2000) Purpose: Starting with a collage can be a useful activity for exploring self-awareness in a group setting and may be considered less threatening then other art activities (Wadeson, 2000). A collage involves assembling and arranging different materials to create an image or shape (Wadeson, 2000). A mixed-media collage can accommodate a potential wide range of abilities in the group. It could consist of things such as magazine clippings, construction paper, tissuepaper, photographs, and markers. It should also include such things as tactile objects, particularly for students who may have visual impairments. For example objects such as rocks, leaves, bark, beads, string, clay, blocks, construction paper that can be cut, etc. A hot glue gun could be used if students feel comfortable using one. Time: 45-60 minutes Procedure: Introduce the activity as a personal-awareness collage and present materials. Ask participants to spontaneously cut out or arrange objects they find interesting or meaningful that are in some way connected to their sense of self. Then ask the group to choose about 10-12 items and instruct the group not to put too much thought into what they choose but rather emphasize selecting things intuitively. The items in the collage can be objects or images that participants like or dislike, or ones that relate to their life in some way. Then the images or objects can be arranged and glued together in way that makes sense to the participant. Allow group 30-40 minutes for construction of their collage. When participants have finished or when time is up, ask participants to reconvene in a circle. Members are invited to share their collage with the group. Some participants may prefer to be silent, or have others comment on what they see in their collage if they wish. Materials needed: • Assortment of Magazines • Photos • Tactile Objects (leaves, beads, string, felt, rocks, twigs etc.) • Glue • Glue gun • scissors 86 • Coloured Markers • Construction paper Resources: Anderson, F. (1992). Art for all the children: Approaches to art therapy for children with disabilities. Springfield, IL: Charles C Thomas. Rogers, N. (1993). The creative connection: Expressive arts as healing. Palo Alto, CA: Science and Behaviour. Rogers, N. (2011). The creative connection for groups: Person-centred expressive arts for healing and social change. Palo Alto, CA: Science and Behaviour. Wadeson, H. (2000). Art therapy practice: Innovative approaches with diverse populations. New York, NY: Wiley. 87 Activity: Disability Video Discussion Purpose: Videos can be a useful tool to facilitate discussions and personal reflection for participants regarding disability-related themes. Participants can watch selected films that are relevant to disability-related issues and then have an opportunity to discuss their reactions. Time: Varies depending on length of film. 20 minutes suggested for discussion of film. Procedure: For this activity, let the group know that they will be watching a video clip this session focusing on people with disabilities. Participants are instructed to think of their own reflections and reactions to the video clip. Provide some probing questions that they could reflect on during the clip. Some suggested questions to have in mind could be: What came up for you while you watched this video? How were people with disabilities portrayed in this film? What stood out for you about this video? Why was that? In what way can you identify with the characters in the film? Suggested video clips that can be used: Friesen, T. (Producer), & Klein, B.S. (Director). (2006). SHAMELESS: The ART of disability. Available from https://www.nfb.ca/film/shameless_the_art_of_disability/ • This documentary focuses on art, activism and disability, following the stories of five individuals. Rosen, P. (Producer). (2013). How difficult can this be? The F.A .T city workshop [DVD]. Available from http://www.shoppbs.org/ • This film features LD expert Richard Lavoie, who gives a presentation on the frustrating and stressful experience students with LDs face in the classroom. Hernandez, K. P. (Director). (2010). Disability stereotypes. Retrieved from http://www.youtube.com/watch?v=qWwJ7ku8UrY#aid=P-YwcH3yNsE • This short film depicts how people with disabilities may face exclusion and prejudice Materials: • Video to view • TV or projector, DVD player or computer 88 Resources: Schwartz, D., Blue, E., McDonald, M. , Giuliani, G. , Seirup, H., Rose, S., ... Perkins, A. (2010). Dispelling stereotypes: promoting disability equality through film. Disability & Society, 25 (7), 841-848. doi:10.1080/09687599.2010.520898 Wadeson, H. (2000). Art therapy practice: Innovative approaches with diverse populations. New York, NY: Wiley. 89 Activity: Fishing Exercise (adapted from Fishing Exercise, n. d.) Purpose: This is a good exercise for students to get to know themselves better by identifying what they value. Increased self-awareness is an important component for self-advocacy and selfdetermination. This activity gives members a chance to reflect on their own self and personal values, and then share something about what they learnt in a group setting. Time: 20-30 minutes Procedure: Announce the activity to the group. For example, "This is an exercise about getting to know yourself and what you value better. We are going to pretend to go fishing and the potential catch are listed on this sheet" Provide each group member with the "Fishing Exercise" (n. d.) hand out sheet (see Appendix G). The sheet will list the following values: wisdom happiness faith popularity health fame honesty courage love power friends skill creativity excitement beauty wealth Read the following script: "It's been a good day out fishing and you have caught the five fish you hoped to catch. Circle these." Once each member has circled five fish, read the next line: "You lean back on the bank of a river and suddenly doze off. Two fish get away. Cross those out from your catch." Next, say: "Your best friend comes along, and they are hungry, so you give them one of your fish. Cross that one off as well." Lastly, say: "As you talk with your friend, a cat sneaks up and runs away with another fish. Cross it off. You are left with one." 90 Ask the participants to write down what value is left on the back of the sheet. The remaining value can be a good source of discussion for participants. "This value is probably something you value most. What are some things that you are doing to provide you with this value?" Let members write down answers to this question. After they have filled out the worksheet, have a discussion about the exercise. Leave it optional for members to share what value they ended up with. It may be too early in the group to share core values to members. Focus on asking open-ended questions about what the process was like for members, and emphasize that they should only share what they are comfortable with sharing. Optional: ask participants to draw or create a representation of this fish. What would the fish look like? What would it be doing? Discussion questions: Some questions to ask could be, "did anything come up for you doing this exercise?"; "Did you know that this was an important value for you?"; "How has this value influenced you as a person in your life?"; "What does this value mean to you regarding your education?" Materials needed: • Fishing exercise handouts for each member (Appendix G) • Writing materials • Paper (optional) • Pens, pencils, paints (optional) 91 Session 2: Self-Awareness and Group Connection Purpose: The purpose of the second meeting is for group members to continue to build trust with one another in the group, to strengthen their connection to members, and to continue to develop greater self-awareness. Goals: • Strengthen relationships and trust within group • Develop interpersonal skills • Strengthen self-identity • Focus on understanding personal strengths and limits Suggested Order of Session: • Opening ritual (5 minutes) • Ice breaker (5-10 minutes) • Self-awareness activity and group-awareness activity (45-60 minutes) • Wrap up (5-10 minutes) Procedure: Opening ritual Have the group take a moment to become grounded. Ask if anything came up for anyone in the group from the last session. Ice breaker activity (adapted from Rice et al., 2003) An ice breaker activity can help participants become involved in the session and is a chance to get to know one another better. A suggested activity for this session is to have each member of the group use the first letter of their name and think of a word that starts with the same letter that is an aspect of themselves that they like. For example, "My letter is D, and my word is drawing. I have always enjoying making silly drawings." 92 Self-awareness and group awareness activity Natalie Rogers (2011) discusses how through a creative connection process, we first journey inward to tap into our unconscious and became more self-aware, gaining personal insight and empowerment. As group members learn how to be authentic with themselves, they can also learn ways to relate and connect with others within the safety and community of the group. This connection within the group is important, because as participants learn how to be authentic and empowered in the small community, they may be inspired to move to the larger circle of community outside of the group in a similar manner (Rogers, 2011 ). Facilitators can emphasize using the connections and empowerment built within the group to help build similar connections and self-empowerment in their outside lives and communities. Next, introduce the activity for the day which centres on further selfawareness and follow with a discussion of the activity. Check out Allow members to discuss what the session was like for them. Did anything stand out? Did they learn something about themselves? Challenge members to take one thing they have learnt so far and implement it this week. Suggested Activity Options: • School as We Experience It • School Puzzle Group Activity • Construction of a Self-Box • Self Portrait of Me Inside and Out 93 Activity: School as We Experience it (adapted from Rogers, 2011) Purpose: This activity is designed to summon collaboration in the group. It allows for participants to openly discuss what they create as well as see how their actions affect others in the group (Rogers, 2011). This activity can help build awareness ofhow one's interactions affect others and also provide insight into group communication skills and building community through shared experiences in school. Time: 45-60 minutes Procedure: Begin the session by providing a large circle of paper that is large enough for all members to sit around the perimeter. Offer chalk, writing materials, tactile materials, etc. Explain to participants that the circle in front is meant to be "school as you experience it." Announce that "We will spend the next 30-40 minutes creating our world at university/college." Emphasize that participants think of their personal life and their experience so far in higher education. "What are your thoughts, feelings, fears, excitements? Do as you wish with the blank paper in front of you." People may have their own section to work on, go right to the middle, or partner up with others. Once the group has finished creating their school experience, have members reconvene to discuss what they created. Discussion questions: Now is a good chance to reflect on the process of expressing their school experience. Did they work together? Did they stay focused on their own image or creation? What was that like for them? Material needed: • Large circular paper large enough for group • Alternately individually cut circular posters • Pens, pencils, crayons, paints, tactile objects, etc. • Possibly desks and chairs Resources: Anderson, F. (1992). Art for all the children: Approaches to art therapy for children with disabilities. Springfield, IL: Charles C Thomas. 94 Rogers, N. (1993). The creative connection: Expressive arts as healing. Palo Alto, CA: Science and Behaviour. Rogers, N. (2011). The creative connection for groups: Person-centred expressive arts for healing and social change. Palo Alto, CA: Science and Behaviour. 95 Activity: School Puzzle (adapted from Rogers, 2011). Purpose: This activity aims to create some unity within the group and strengthen connections between participants. Time: 45-60 minutes Procedure: Take a large circle of white paper which will be cut into abstract puzzle pieces. To do so, use the backside of the paper to pencil out puzzle shapes and number them. There should be enough pieces for each member to get a piece. Rogers (20 11) suggests that participants should not be aware that the pieces are for a puzzle. Cut the shapes out and put them randomly in a pile. Instructions for participants: "I have made some abstract shapes for the group to use. Pick a shape and use the materials provided to create an image of how you feel about being in university right now. What does your higher education experience mean to you?" Indicate the amount of time they have to create this (30 minutes is suggested). After the time is up, announce that it is now time to work together to find out how the pieces fit. Participants will need to work together to find out how the puzzle fits. When the puzzle is completed, allow time for discussion of the completed picture. The complete picture is composed of each individuals experiences, which come together to make up the community that is in the group and at the school. Materials needed: • Large paper • Drawing materials, crafting materials • Scissors • Glue Resources: Anderson, F. (1992). Art for all the children: Approaches to art therapy for children with disabilities. Springfield, IL: Charles C Thomas. 96 Rogers, N. (1993). The creative connection: Expressive arts as healing. Palo Alto, CA: Science and Behaviour. Rogers, N. {2011). The creative connection/or groups: Person-centred expressive arts for healing and social change. Palo Alto, CA: Science and Behaviour. 97 Activity: Construction of a Self-Box (adapted from Wadeson, 2000) Purpose: For this activity, participants will be asked to decorate a small shoe box which represents what is seen by others on the outside and what is private on the inside (Wadeson, 2000). The boxes can be painted or collaged, and decorated with objects both outside and inside. A selfbox collage has been used with a high school student diagnosed with ADHD, LDs, and Bipolar disorder (Wadeson, 2000). Time: 45-60 minutes Procedure: Have a small cardboard box, such as shoe box, for each member of the group. Say that the activity for today is designed for group members to develop greater awareness of their inner private self, as well as the self we believe others see. The outside of the box is meant to represent our self as it is perceived by others. The inside of the box is meant to represent our inner self. Create these selves using the materials provided and be as creative as you want. Some questions to think about are: how similar is the self we see and the self we think others see? How different are they? Are there parts of our inner self that we want others to see more of? Are there parts of our outer self that we do not want others to see? After 30 minutes, allow the group to share what they have created with the group. Discuss. Have the group consider what aspect of the inner self is most central to their experience at university. Materials: • Cardboard boxes • Collage materials • Magazines • Drawing, painting supplies • Glue • Tactile materials • Objects to put in the box 98 Resources: Rogers, N. (1993). The creative connection: Expressive arts as healing. Palo Alto, CA: Science and Behaviour. Rogers, N. (2011). The creative connection/or groups: Person-centred expressive arts for healing and social change. Palo Alto, CA: Science and Behaviour. Wadeson, H. (2000). Art therapy practice: Innovative approaches with diverse populations. New York, NY: Wiley. 99 Activity: Self Portrait of Me Inside and Out (adapted from Rice et al., 2003) Purpose: This activity is designed to create a visual or tactile representation of the differences and similarities between a student's self-perceptions and how others perceive them. Time: 45-60 minutes Procedure: Ask participants to take a large piece of paper and fold it into three sections, creating a double door that opens to the central part of the paper. On the outside "doors" have members create a picture or write words that represent how participants feel others perceive them. Next have students unfold doors and create a representation of how they perceive themselves on this section of paper. Next allow students to share and witness other peoples work. Some examples of witnessing others' art include: Identify what aspects of someone's art interests you or caught your attention? What was significant about what someone said to you about their art? What does it suggest about their beliefs, dreams, desires, intentions, values etc. Don't give opinions or judgments about others art work. Materials: • Paper • Creative materials Resources: Rice,C., Renooy, L., Zitzelsberger, H., Aubin,A., & Odette, F. (2003). Talking about body image, identity, disability, and difference: A facilitator 's manual. Toronto, ON: Building Bridges. Rogers, N. (1993). The creative connection: Expressive arts as healing. Palo Alto, CA: Science and Behaviour. Rogers, N. (2011). The creative connection for groups: Person-centred expressive arts for healing and social change. Palo Alto, CA: Science and Behaviour. Wadeson, H. (2000). Art therapy practice: Innovative approaches with diverse populations. New York, NY: Wiley. 100 Session 3: Communication and Assertiveness Purpose: In the third session, the emphasis on self-awareness begins to shift towards communication skill development. Although it is expected that the theme of building selfawareness continues throughout the remainder of the sessions, the format ofthe group shifts toward activities and discussions focusing on self-advocating and developing selfdetermination in higher education. Goals: • Understand different communication styles • Develop awareness of own personal communication style • Communication skill development • Assertiveness skill development Suggested Order of Session: • Opening ritual (5 minutes) • Ice breaker (5-10 minutes) • Assertiveness handout and group discussion (1 0 minutes) • Assertiveness and communication activity (45-60 minutes) • Wrap up (5-10 minutes) Procedure: Opening ritual Have the group take a moment to become grounded. Ask if anything came up for anyone in the group from the last session. Ice breaker: yarn ball For this activity, bring a ball of yam. One person starts offholding the string, and can tell the group one thing they learnt about someone in the group from last week. They then throw the ball to someone else in the group, while still holding onto the string. Each member takes a tum talking about something they learnt last week about a member in the group and then they throw the yam to someone else until each person has had a tum. Then at 101 the end all members are connected by the string, visually representing connection in the group. Assertiveness discussion Begin by providing the group with handouts on assertiveness (Appendix H) and have a group discussion regarding different communication styles and what their experience of them has been like. Ask group members to reflect on what type of communicator they think they are. Communication activity Assertive communication is a key component of self-advocating, for improving social interaction skills, and for self-confidence (Darner et al., 201 0). Therefore, in preparation of focusing further on self-advocacy and self-determination, the suggested activity will focus on building assertive communication skills and understanding what assertiveness means for members. Wrap up Chance to discuss final thoughts, and share one assertive act they could try that week. Suggested Activity Options: • Annoying Behaviours • Expressing Opinions • Assertive Conceptualization Through Art 102 Activity: Annoying Behaviours (adapted from Darner et al., 2010) Purpose: For this activity each member of the group is assigned an annoying behaviour to act out to practice assertiveness skills and learn about their own communication styles. Time: 45-60 minutes Procedure: Different annoying behaviours are listed on separate pieces of paper and placed in a hat/jar. Each member draws one behaviour. Some examples include: talking on a cell phone at the back of class, tapping, watching videos in class and laughing, chatting, etc. The behaviours can be created by the group. Each member takes a turn asking the annoying member to stop their annoying behaviour using assertive strategies. Group members will have a handout on assertive communication to refer to (Appendix H). Another option is for the entire group to be engaged in annoying behaviours, and one member of the group to take a turn asking all the other members to stop their annoying activity. Several members could be instructed to resume their annoying behaviour once again even after they have been asked to stop. This can create a real life scenario and opportunity for practicing assertive communication in multiple cases. Follow up activity with a group discussion. Material needed: • Paper • Writing instruments • Hat or jar • Assertive communication handout (Appendix H) Resources: Darner, D. E., Latimer, K. M. , & Porter, S. H. (2010). "Build your social confidence": A social group for college students. The Journal for Specialists in Group Work, 35(1), 7-22. doi:l 0.1080/01933920903463510 Dawley, H. H. Jr., & Wenrich, W. W. (1976). Achieving assertive behaviour: A guide to assertive training. Monterey, CA: Wadsworth. 103 Activity: Expressing Opinions (adapted from Darner et al., 2010) Purpose: This activity provides members with an opportunity to express differing opinions, and provides participants with an opportunity to handle conflict within the safety of the group. Time: 45-60 minutes Procedure: For this activity, one member is assigned the role where they must express an opinion on a topic of their choice (or on a suggested topic by the facilitator). One member is assigned the role to disagree with the opinion, and the remaining group members are asked to agree with the original opinion. The person assigned to express their opinion should discuss their opinion on a selected topic. Some suggested topics could be opinions on services offered at the school, best or worst instructors, etc. All but one member of the group agrees. The person expressing their opinion has a chance to discuss their opinion and disagree with someone about it in an assertive way. Each participant should then get a chance to try each role. Discussion Questions: Group discussions after can centre on exploring what the experience was like be the only one who disagreed? What was it like to have others agree with you? What do you think this means about your own communication style? Material needed: • none Resources: Darner, D. E., Latimer, K. M., & Porter, S. H. (2010). "Build your social confidence": A social group for college students. The Journal for Specialists in Group Work, 35(1), 7-22. doi: 10.1080/01933920903463510 Dawley, H. H. Jr., & Wenrich, W. W. (1976). Achieving assertive behaviour: A guide to assertive training. Monterey, CA: Wadsworth. 104 Activity: Assertive Conceptualization Through Art Purpose: This activity is intended for participants to reflect on their own ways of communicating, and identify what helps them to act assertively. It involves the creation of artistic representations of oneself communicating in an aggressive or passive way, compared with an artistic representation of oneself communicating in an assertive way. Time: 30-45 minutes Procedure: Provide each participant with a piece of large paper and ask that they divide it in two. On one side, instruct the group to create an image of their non-assertive self. Take a moment to discuss what non-assertiveness can look like. It can be passive, aggressive, and passiveaggressive. Ask the group to reflect on a time at school or elsewhere in their lives when they acted in one ofthese ways. What did that feel like? Ask the group to draw this image on one side of the paper. After the group has created their non-assertive image, ask them to reflect on times in their life when they have been assertive. What was that like for them? How did they feel? Ask the group to create an image of their self being assertive. When the drawings are complete, ask the group to reflect on how they ended up being assertive in those situations? What do they need to be assertive? Encourage people to share their stories and pictures in the group. Materials needed: • • • Construction paper Pens, pencils, paints Tactile objects if required Resources: Carlisle, J. S., & Donald, K. M. (1985). The use of art exercises in assertiveness training. Journal of Counselling and Development, 64, 149- 150. Retrieved from http://library.unbc.ca:2048/login?url=http://search.ebscohost.com/login.aspx?direct=true&db =aph&AN=4964352&site=ehost-live&scope=site Dawley, H. H. Jr., & Wenrich, W. W. (1976). Achieving assertive behaviour: A guide to assertive training. Monterey, CA: Wadsworth. 105 Session 4: Self-Advocacy Purpose: This session will focus on the role of self-advocacy and why it is important for SWDs in higher education, and give participants an opportunity to role play scenarios where they can self-advocate. Goals: • Understand legal rights and school rights • Understand pros and cons of disclosure • Practice self-advocating scenarios required in higher education Suggested Order of Session: • Opening ritual (5 minutes) • Ice breaker (5-10 minutes) • Personal rights handout and group discussion on self-advocacy (10 minutes) • Self-advocating activity (45-60 minutes) • Wrap up (5-10 minutes) Procedure: Opening ritual Ice breaker: round robin poem (adapted from W adeson, 2000) This activity involves creating a group poem through the creative contributions of each member. Start the activity by writing a beginning line for a poem on a piece of paper, for example: The sun beamed down. Then pass the paper to the next participant, and ask them to contribute a line or word. The paper is passed around the group until each member has had a chance to contribute something to the poem. If the group desires, the poem can go around the group multiple times. When it is finished, have someone read the poem that the group has created. Personal rights handout and group discussion on self-advocacy In this session, psychoeducational material will be provided on legal rights of students (Appendix B), and on issues of disclosing disability (Appendix 1). McEachern and Kenny (2007) emphasize that understanding legal rights is important for SWDs for self- 106 advocacy. In addition to self-awareness and effective communication, self-advocating also requires an understanding of ones rights which include a student's rights as a citizen, as an individual with a disability, and as a student (Test et al. , 2005). A good way to start discussion on self-advocacy is to have a quick group discussion where individuals can share what the concept means to them. Discuss the concept of selfadvocacy, followed by legal rights, and disclosing disability. Self-advocating activity In this session, the activities are intended to increase understanding of personal rights and to offer opportunities to build self-advocating skills. Wrap up Ask the group to share one thing they learnt about someone else this week. Suggested Activity Options: • Self-Advocacy Role Play • Group Experience of Self-Advocacy 107 Activity: Self-Advocacy Role Play {adapted from Johnson, 1996, and Rice et al., 2003) A good way to learn skills and how to handle situations is through acting out scenarios through role play (Rice et al. 2003). Drama allows members to try different approaches and to explore strategies for action within the safe space of the group. Acting can help participants to reaffirm skills and learn new ways to interact (Rice et al. 2003). It can also be insightful in allowing us to explore different roles with other people in interactions. This activity is designed to help group members to identify social interactions in higher education that they have found difficult or challenging. The goal of this exercise is for members to identify strategies for dealing with challenging social situations at school and to practice being assertive and advocating for their needs. Time: 45-60 minutes Procedure: Let participants now that the following activity is meant to help them identify their own current methods of responding in difficult scenarios and to confront a variety of situations they may encounter in higher education (Johnson, 2002). For this activity, participants are paired up and given a scenario. See Appendix I for two suggested scenarios adapted from Johnson (2002). Participants could also create their own scenarios if they prefer. Allow members to discuss the scenario in pairs for 10 minutes. Participants should identify what is happening, generate possible strategies to deal with the problem, consider consequences of these strategies, and decide a best approach for themselves. Next have a group discussion on what came up for participants. Following this, let members have a chance to role-play an assertive response to the scenarios. One person can pretend to be the instructor, another, the student. Encourage them to have fun and be spontaneous in their responses. If members are uncomfortable, let them pass. Allow for 10 minutes for each person to play a role. Get back together as a group and have a group discussion on the activity. Discussion Questions: Some questions suggested by Rice et al. (2003) that could be useful in generating discussion are: "have you been in similar situation as this? What did you do? Was it a problem? When was it not a problem? What worked? What didn't? What would you have done differently? What would you have done the same?'' 108 Material needed: • Self-Advocacy Scenario handouts (Appendix J) • Handouts on assertiveness (Appendix H) Resources: Johnson, J. (2002). Facilitating an academic support group for students with learning disabilities: A manual for professionals. Boston, MA: AHEAD. Lynch, R. T., & Gussel, L. (1996). Disclosure and self-advocacy regarding disability-related needs: Strategies to maximize integration in postsecondary education. Journal of Counseling and Development, 74, 352-357. doi: 10.1002/j.l556-6676.1996.tb01879. Pocock, A., Lambros, S., Karvonen, M., Test, D., Algozzine, B., Wood, W., & Martin, J. (2002). Successful strategies for promoting self-advocacy among students with LD: The LEAD group. Intervention in School and Clinic, 3 7, 209-216. doi: 10.1177/105345120203 700403 Rice,C., Renooy, L., Zitzelsberger, H., Aubin,A., & Odette, F. (2003). Talking about body image, identity, disability, and difference: A facilitator 's manual. Toronto, ON: Building Bridges. Roessler, R., & Brown, P ., Rumrill, P. (1998). Self-advocacy training: Preparing students with disabilities to request classroom accommodations. Journal on Postsecondary Education & Disability, 13(3), 20-31. Retrieved from https :/ /www. ahead.org/uploads/ docs/ .. ./jped 13 3roesslerselfadvocacy.doc Test, D. W., Fowler, C. H., Wood, W. M., Brewer, D. M., & Eddy, S. (2005). A conceptual framework of self-advocacy for students with disabilities. Remedial and Special Education, 2(43), 45-54. doi:: 10.1177/07419325050260010601 109 Activity: Group Experience of Self-Advocacy Purpose: This activity allows participants to reflect on their own classroom experiences, and share with the group strategies and approaches they have taken to self-advocate with instructors, staff, and other students. Time: 30-45 minutes Procedure: Begin with a group discussion on what self-advocacy means to the group. Use a flip chart to record what the group comes up with. Ask members what is needed in order to selfadvocate. Important components for self-advocacy involve knowing what services one needs and how to talk to instructors, staff, and other students (Roessler et al. (1998)). After this discussion, ask the class to come up with examples of situations at university where an instructor, student, or staff member has acted in a way that has challenged them, and perhaps even gone against their rights. For example, an instructor not thinking a student needs to have an accommodation, another student saying it's unfair that someone gets extra time to write an exam, or a staff member setting up an event which blocks wheelchair access in the hallway. Have participants come up with various scenarios, imagined or real, that occur for them. Discuss with the group how many students relate to some of these challenges. What would it be like to be in a situation like that? How did you handle it? What did you want to happen? How could it have been handled differently? (10 minutes). As a group, discuss strategies and ways to assertively deal with some of these scenarios (10 minutes). If time permits, ask for a few volunteers to role play one of the scenarios in front of the class. For participants watching, encourage them to reflect on aspects of the situation that interest them. What was the significance of the situation? Ask the viewers to acknowledge where the role play moves or doesn't move them (10 minutes). Stress that group members reflect on their own feelings and thoughts that come up from the role play, and that they should not make judgments about how the other group members acted out the scenario. Materials: • Flip board chart 110 • Markers Resources: Lynch, R.T., & Gussel, L. (1996). Disclosure and self-advocacy regarding disability-related needs: Strategies to maximize integration in postsecondary education. Journal of Counseling and Development, 74, 352-357. doi: 10.1002/j.1556-6676.1996.tb01879. Pocock, A., Lambros, S., Karvonen, M., Test, D., Algozzine, B., Wood, W., & Martin, J. (2002). Successful strategies for promoting self-advocacy among students with LD: The LEAD group. Intervention in School and Clinic, 37, 209-216. doi: 10.1177/ 105345120203 700403 Roessler, R., & Brown, P ., Rumrill, P. (1998). Self-advocacy training: Preparing students with disabilities to request classroom accommodations. Journal on Postsecondary Education & Disability, 13(3), 20-31. Retrieved from https://www .ahead.org/uploads/docs/ .. ./jped 133roesslerselfadvocacy.doc Test, D. W., Fowler, C. H., Wood, W. M., Brewer, D. M., & Eddy, S. (2005). A conceptual framework of self-advocacy for students with disabilities. Remedial and Special Education, 26( 43), 45-54. doi:: 10.1177/07419325050260010601 111 Session 5: Self-Determination Purpose: The emphasis in session five builds on the themes of self-awareness, communication skills, and advocacy by turning to the concept of self-determination, which involves the ability to take direction in one' s life, build persistence during adversity, recognize strengths and limits, and draw upon resources when needed. Objective (goals): • Continue to build on self-awareness • Communication and assertive skill practice • Developing sense of self-agency • Identify strategies for persistence • Explore personal strengths and limits, sources of support Suggested Order of Session: • Opening ritual (5 minutes) • Ice breaker (5-10 minutes) • Self-determination group discussion (10 minutes) • Self-determination activity (45-60 minutes • Wrap up (5-10 minutes) Procedure: Opening ritual Ice breaker: scribble drawings (adapted from Wadeson, 2000) For this activity, first ask participants to reflect on something that is going on for them that day, whether it is how they are feeling, something they are thinking about, or something that has recently happened. Provide each participant with a sheet of paper and pen. Next ask participants to close their eyes and draw what is on their mind. Encourage participants to scribble and be spontaneous with their drawing. When they have finished, ask members to open their eyes and reflect on what they see. Encourage participants to share how they feel with the group. 112 Self-determination group discussion A good way to start the session is to have a quick group discussion on selfdetermination where individuals can share what the concept means to them. According to Serna as cited by Sands and Wehmeyer (1996), self-determination involves a person' s awareness of their strengths and weaknesses, their ability to set goals and make choices, to be assertive at the appropriate time, and to interact with others in a socially competent manner. A self-determined person can make independent choices based on their own ability to use resources, which includes collaborating with others when needed (Sands & Wehmeyer, 1996), which is a very important skill in higher education. The outcome of a self-determined person is to realize their own potential and obtain their goal without infringing on the rights of others (Serna as cited by Sands & Wehmeyer, 1996). In addition to understanding one' s strengths and weaknesses, self-determination requires a belief in self as capable and effective (Field, Martin, Miller, Ward, & Wehmeyer as cited by Pocock et al., 2002). The use of a person-centred approach fits especially well with empowering group members through affirmations and the facilitator' s belief in the members ' inherent ability to recognize their strengths and capabilities. Self-determination activity Introduce the self-determination activity to the group and allow time for discussion. Wrap up Ask members to share one positive source of strength they draw upon when they are faced with a challenge. Remind group that the next session is the last session, and if there is anything they want to happen or cover in the last session they will have a chance to bring it up during that time. Suggested Activity Options: • Intentionality in Action • Knowing our Strengths and Limits • Resiliency Drawing • Tank of Gas 113 Activity: Intentionality in Action (adapted from Rice et al., 2003) Purpose: This activity adapted from Rice et al. (2003) is focused on building personal agency. It focuses on discussions about how the choices we make in our daily lives can move us toward feeling more positive, or alternatively, negative, about ourselves. For some members, the activity will validate actions they already take, while for others it may help them to develop strategies to develop greater self-agency. Time: 45-60 minutes Procedure: For this activity, a group discussion will be facilitated regarding challenging situations students have experienced in their everyday lives. Ask group members to pair up or journal individually about challenging experiences at school and how they handle them. Invite members to not censor or judge themselves about how they dealt with the situations. Some questions Rice et al.(2003) suggest are: what do you do to deal with situations where people are hurtful? When something negative happens, what is one thing you do to take care of yourself? According to Rice et al. the responses by the members are often strategies they use to handle difficult situations. When the group comes back, have a brainstorm session on strategies to handle stress. Which are positive and negative strategies that people use? Some strategies suggested by Rice et al.(2003) used to deal with difficult situations could be withdrawing, getting angry, using drugs, isolating, etc. Or there could be positive strategies, such as focusing on what you like about yourself, doing one small thing for yourself that day, saying no, surrounding yourself with positive image, and valuing yourself and who you are (Rice et al., 2003). Help the group share and come up with their own strategies and record the group 's answers on a flip chart. Following this discussion, introduce the idea of self-direction to the group by brainstorming what this means members. According to Rice et al. (2003) self-direction is the capacity to recognize choices, discover one ' s own values, beliefs, and intentions, an ability to influence and impact others, and a capacity to make change and take action in the world. In reference to the challenging situation they just discussed, ask the group how their personal agency impacts these situations. What personal choices did they make regarding the situation? What value did or didn't they use in making these choices? Lastly, discuss as a group what types of experiences or messages increase a person' s selfagency. Some suggested group questions include: what experiences or messages diminish 114 your personal self-agency? Self-agency involves both internal and external resources. In a difficult situation, what are some internal resources a person can draw from to increase a sense of agency? Internal resources can include thinking through situations, affirming beliefs and perspectives, etc. What are some external resources that be drawn from to increase self-agency? External resources could include getting help from others, including social supports and institutional supports. Self-agency is a process where new and unexpected situations will arise. One semester your instructor may be very accommodating. The next semester you face attitudinal barriers. Rice et al. (2003) suggest that defining oneself is an important part of empowerment, as opposed to having others define who we are. This can be particularly poignant for people with disabilities, who may have had the label of disability defined by others more than by their own self. For this session, the facilitator can emphasis that we do not have power to define how another person will perceive or define us, but we do have the power to decide how we will respond (Rice et al., 2003). Materials: • Pens • Writing paper • Markers • Flip chart Resources: Arman, J. (2002). A brief group counseling model to increase resiliency of students with mild disabilities. Journal ofHumanistic Counseling, Education and Development, 41, 120128. doi: 10.1002/j.2164-490X.2002.tb00136.x Getzel, E., & Thoma, C.(2008). Experiences of college students with disabilities and the importance of self-determination in higher education settings. Career Development for Exceptional Individuals, 31 (77), 77-84. doi: 10:1177/0885728808317658 Johnson, J. (2002). Facilitating an academic support group for students with learning disabilities: A manual for professionals. Boston, MA: AHEAD. Rice,C., Renooy, L., Zitzelsberger, H., Aubin,A., & Odette, F. (2003). Talking about body image, identity, disability, and difference : Afacilitator 's manual. Toronto, ON: Building Bridges. Sands, D. J. , & Wehmeyer, M. L. (1996). Self-determination across the life span: Independence and choice for people with disabilities. Toronto, ON: Paul.H. Brooks. 115 Activity: Knowing our Strengths and Limits (adapted from Rice et al., 2003) Purpose: This activity is meant to highlight the personal strengths and skills group members have generated throughout their lives, to acknowledge challenges they face, and to facilitate problem solving skills and resources for handling difficult situations at university. Time: 20-30 minutes Procedure: Have a group discussion and mark answers on a flip chart regarding the following questions adapted from Rice et al. (2003). When have you felt really good about yourself? How do you get that feeling back? What actions can you take to get back in that direction? What are you already doing to get there? What skills and strengths do you have to get there? What impedes you getting there? How do others in your life identify these strengths? What would you be like if you maintain these strengths? Following this discussion on strengths, ask members to imagine themselves in a difficult scenario at university. How would you apply the strategies of the strong self? Optional: have members create an image expressing their strong self and how they see themselves managing a difficult scenario at university or in their life. Discussion questions: Materials: • Flip chart • Markers • Paints, pens, etc. (optional) • Paper (optional) Resources: Rice,C ., Renooy, L., Zitzelsberger, H., Aubin,A., & Odette, F. (2003). Talking about body image, identity, disability, and difference: A facilitator's manual. Toronto, ON: Building Bridges. Sands, D. J., & Wehmeyer, M. L. (1996). Self-determination across the life span: Independence and choice for people with disabilities. Toronto, ON: Paul.H. Brooks. 116 Smith, E. J. (2006). The strength-based counseling model. The Counseling Psychologist, 34(13), 13-79. doi: 10.1177/0011000005277018 White, V. E.(2002). Developing counseling objectives and empowering clients: A strengthbased intervention. Journal ofMental Health Counseling, 24(3), 270-279. Retrieved from http://www .amhca.org/joumal.html 117 Activity: Resilience Drawing (adapted from Mahin, n. d.) Purpose: This activity is designed so participants can identify personal sources of strength and resilience and to highlight them through creative expression. Suggested time: 30-45 minutes Procedure: Begin the session with a group discussion on what the concept of resiliency means to the group. What does it take to be resilient? Can you think of a time when you were resilient? What happened during those times? Next, provide paper, paints, textured objects, etc. to the group. Tell the group to imagine a being in nature that survives in harsh environments such as a flower in a sidewalk crack, a tree at a top of a mountain, a lizard in the desert, a moose in the snow. Instruct the group to create an image of resourcefulness on the paper. Give the group around 30 minutes to work on their image of resilience. When all are fmished or time is up, ask the group to discuss and share. Materials: • Paints, pencils, pens, tactile materials • Paper Resources: Arman, J. (2002). A brief group counseling model to increase resiliency of students with mild disabilities. Journal ofHumanistic Counseling, Education and Development, 41. 120128. doi: 10.1002/j.2164-490X.2002.tb00136.x Mahin, G. (n. d.). Group activities. Retrieved from http://www.expressi vetherapist. corn/group-activities.html Sands, D. J., & Wehmeyer, M. L. (1996). Self-determination across the life span: Independence and choice for people with disabilities. Toronto, ON: Paul.H. Brooks. White, V. E.(2002). Developing counseling objectives and empowering clients: A strengthbased intervention. Journal ofMental Health Counseling, 24(3), 270-279. Retrieved from http://www .arnhca.org/joumal.html 118 Activity: Tank of Gas (adapted from Mahin, n. d.) Purpose: This activity is designed for participants to reflect on their own inner resources and sources of strength when facing school and life challenges. New sources of support, coping, and resilience may be highlighted through the activity. Procedure: For this activity, participants are asked to draw two columns on a piece of paper. On one column, ask participants to list areas in school or life that they are confident about. This could be writing tests, or a specific subject, or a hobby. On the other column, list areas of school or life that they are insecure about. This could be something like writing tests, making friends in class, talking to instructors, finding a romantic partner, etc. Once the lists are composed, ask the group to count and total each column. Subtract the insecure total from the confident column. The remaining amount is how much gas is left in their tank. Now ask participants to come up with a third column on the back of the page listing ways they can fill up their tank. What activities help them to fill up the tank? Once they have created the third column, in a fourth ask members to creatively express something affirming their ability to improve their confidence and self-acceptance of areas in their life they are insecure about. Discuss as a group and share. Discussion questions: What would be it like to try and do something you are not confident about with an empty tank of gas? What about with a full tank? Materials required: • paper • pens • Paints, creative materials, tactile materials Resources: Mahin, G. (n.d.). Group activities. Retrieved from http://www.expressivetherapist.com/group-activities.html 119 Session 6: Self-Determination and Closing Purpose: The purpose of the last session is to provide members an opportunity to reflect on their development in and experience of the group, consider future goals and implementing something they have learnt from the group, and to provide closure to the group experience. Other resources in the community should be discussed and provided. Goals: • Consider on future goals • Continue to develop awareness, advocacy, and self-determination skills • Provide closure to the group • Provide resources for participants for after the group Suggested Order of Session: • Ritual opening (5 minutes) • Ice breaker (5-l 0 minutes) • Community resources handout (5 minutes) • Group closing activity (45-60 minutes) • Wrap up (5-10 minutes) Procedure: Ritual opening Ice breaker: museum exhibit (adapted from Rogers, 2011) First ask the group to move around the room to loosen up. Split the group into two groups and ask them to reflect on how they are feeling with themselves that day. Next, ask everyone to close their eyes. One half of the room is asked to imagine they are in a museum looking at their self in an exhibit; the other half should stand still with their eyes remaining closed. Ask those who are pretending to be in a museum to pose in a way that reflects how they feel, keeping their eyes closed. Next, ask them to consider if this is the way they want to be feeling today. If it is not, members should pose in the way they would like to be feeling. Ask them to hold their poses. Now the entire group can open their eyes. Instruct the half that did not pose to go and "view" the exhibit and to ask each person about their 120 pose. Some questions participants could ask are: Did you change your pose? What was it that needed to change? If they did not change poses, what was it about the day that kept them in their current pose? Now switch and have the other half pose in the exhibit and the other half view and ask questions. Community resources handout Provide group with handout for resources they could use after the group finished and discuss what other supports they can access (Appendix K). Some participants may experience negative feelings towards the end of group such as anxiety, so ensure that such members are aware of resources that they can access after the group (Corey et al., 2010). Lead a discussion on what members expected at the beginning of the group and where they are at now. What have members learnt about themselves or others? Allow some time and space to discuss unfinished business, such as things participants have wanted to address earlier in the group but did not have a chance to do so (Corey et al., 201 0). Closing activity Review and summarize some of the themes and topics addressed in the group. Discuss how in the final phase of the group it is important to think about a plan of action for continuing to apply what was learnt in the group into life in postsecondary and beyond (Corey et al. , 201 0). Thus the last group activity is one that is meant to reflective on what has occurred, and also to look ahead at how to implement what was learnt in the group in the future. Wrap up End on a positive note, ask the group to share one happy memory they created from the group. Also ask group if they would be willing to fill out a group evaluation form (see Appendix L). Remind members about the importance ofkeeping confidentiality, even though the group is ending. Suggested Activity Options: • Taking What I Like, Leaving What I don't Like • Imagine Us in the Future • Treasure Map Activity 121 Activity: Taking What I Like, Leaving What I do not Like (adapted from Rogers, 2011). Purpose: This activity is designed to help participants further develop self-awareness and focus on positive aspects oftheir self. Time: 45-60 minutes Procedure: For this activity, get participants to begin with a meditative journey around the room (music or drumming could be used). Ask members to focus on three things as they move around the room: • A quality they have developed in their self that they like • A quality they would like to leave behind • Who and what they will go home to after school today. Allow about 5-1 0 minutes. When the group returns, as them to write the quality they like on a piece of paper with their name on it and put in envelope. They may keep it. With another piece of paper, write qualities they do not like. Place under chair. Meet as small groups and discuss what they are going home to and the good quality. Come together as large group and in full circle share good quality. Put the envelope in the circle centre. The quality they do not like can be ripped up and thrown in a garbage basket. Materials: • pen • paper • waste basket • envelopes Resources: Smith, E. J. (2006). The strength-based counseling model. The Counseling Psychologist, 34(13), 13-79. doi:10.1177/0011 000005277018 Rogers, N. (2011). The creative connectionfor groups: Person-centred expressive arts for healing and social change. Palo Alto, CA: Science and Behaviour. 122 Activity: Imagine Us in the Future (adapted from Rice et al., 2003) Purpose: This activity is designed to help bring closure to the group. Time: 45-60 minutes Procedure: Begin activity with asking the group to imagine that we all come together in one year from now. This can help members reflect on what they have learnt from the group and each other and how they might incorporate some of the skills and insights into their daily lives after the group ends. Now each member is asked to write their name on a piece of paper and pass it to the person to their right. The person who receives the paper answers a question about the person (examples provided below), and then they pass the paper to the next person on their right. The next person then answers another question about the person whose name is on the paper. Continue this process until everyone receives their paper once again. Make sure there are enough questions for each member of the group as well as facilitator(s). Allow the members to share any thoughts or feelings coming up from them or any comments that were written. Some examples of questions that could be included adapted from Rice et al (2003) are: What strengths and values have helped this person through the challenges of school last year? What have others admired in this person? What is one thing you learnt from this person? What is one thing you want to tell this person that you didn't during the group? What is the next positive thing this person is going to accomplish? Etc. Materials: • pen • paper Resources: Rice,C., Renooy, L., Zitzelsberger, H., Aubin,A., & Odette, F. (2003). Talking about body image, identity, disability, and difference: Afacilitator 's manual. Toronto, ON: Building Bridges. 123 Activity: Treasure Map (adapted from Mahin, n. d.) Purpose: This activity can be used to visualize personal goals and identify both challenges and resources to help meet the goal. Time: 45-60 minutes Procedure: Discuss with the group that today' s activity involves thinking about the future. Talk to the group about what success in higher education might mean to them. Now, provide each member with a piece of paper and label one comer as "the beginning" and the other as "success" in education. Instruct the group to draw a squiggly curving line between the points. Next, using collage materials create objects, events, strengths, challenges, resources, etc. that they think they might face along the way to success. What are the obstacles? Are there physical or social barriers? What are the supports? Participants should be feel free to put whatever they feel is important to them on their journey. These can be both positive and negative, such as "failing an exam", "feeling left out", or "support from friends", "self-respect", "being genuine", etc. Allow the group to share what they have created with the group. Materials: • Paper • Collage materials Resources: Mahin, G. (n.d.). Group activities. Retrieved from http://www. expressivetherapist.corn/group-activi ties.html 124 After the Group Evaluation of the Group Throughout the group sessions, invite members to provide ongoing feedback if something about the group is not working for them. That way as a facilitator you can listen to those needs and adapt the group accordingly. During the last group session, invite participants to provide some feedback about the group by filling out anonymous evaluation forms (see Appendix L). Evaluation forms should not include the participant's name and can be placed in a drop box when completed. These evaluations can be helpful for shaping future groups and for providing justification for this service (Rice et al. , 2003). Staying Connected After Group During the last group, take a moment to discuss that members may want to become friends and carry on relationships after. It' s important to emphasize that the work done in group is confidential and must remain so after the group has finished. However each member is free to disclose personally what the group was like for them and what they talked about. In maintaining relationships after the group, emphasize to members that they need to continue to respect each person' s confidentiality. Referrals During or after the group, it may become evident to the facilitator that concerns or issues are arising for members that are beyond the scope of the group. It is important for facilitators to be familiar with other resources on campus and in the community which they can refer members to. 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Ten guidelines to facilitate social groups for students with complex special needs. Teaching Exceptional Children, 45(3), 54-62. Retrieved from cec.metapress.com Schreiner, L.A., Hulme, E., Hetzel, R., & Lopez, S. J. (2009). Positive psychology on campus. In Lopez, S. J., & Synder, C. R. (Eds.), Oxford handbook ofpositive psychology (2nd ed., pp. 569-578). New York, NY: Oxford University Press. Schwartz, D., Blue, E., McDonald, M., Giuliani, G., Seirup, H., Rose, S., ... Perkins, A. (2010). Dispelling stereotypes: promoting disability equality through film. Disability & Society, 25(7), 841-848. doi:10.1080/09687599.2010.520898 Shogren, K. A., Lopez, S. J., Wehmeyer, M.L., Little, T. D., & Pressgrove, C. L. (2006). The role of positive psychology constructs in predicting life satisfaction in adolescents with and without cognitive disabilities: An exploratory study. The Journal of Positive Psychology, 1(1): 37-52. doi: 10.1080117439760500373174 Simon Fraser University. (2003). Accessibility for students with disabilities policy. Retrieved from http://www.sfu.ca/policies/gazette/general/gp26.html 135 Smith, E. J. (2006). The strength-based counseling model. The Counseling Psychologist, 34(1), 13-79. doi:10.1177/0011000005277018 Smith, L., Foley, P. F., & Chaney, M. P. (2008). Addressing classism, ableism, and heterosexism in counselor education. Journal of Counseling and Development, 86, 303-309. doi: 10.1002/j.1556-6678.2008.tb00513.x Stein, K. F. (2013). DSS and accommodations in higher education: Perceptions of students with psychological disabilities. Journal of Postsecondary Education and Disability, 26(2), 145-161. Retrieved from http://www.ahead.org/publications/jped Test, D. W., Fowler, C. H., Wood, W. M., Brewer, D. M., & Eddy, S. (2005). A conceptual framework of self-advocacy for students with disabilities. Remedial and Special Education, 26 (1 ), 45-54. doi: 10.1177/07419325050260010601 United Cerebral Palsy. (n. d.). Disability etiquette. 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Rehabilitation Psychology, 56(2), 123-127. doi:l0.1037/a0023039 Wehmeyer, M . L. , Little, T. D., & Sergeant, J. (2009). Self-determination. In Lopez, S. J., & Synder, C. R. (Eds.), Oxford handbook ofpositive psychology (2"d ed., pp. 357-366). New York, NY: Oxford University Press. Wehmeyer, M. L., & Palmer, S. (2003). Adult outcomes for students with cognitive disabilities three-years after high school: The impact of self-determination. Education and Training in Developmental Disabilities, 38, 131-144. Retrieved from http:/ /hdl.handle.net/1808/6217 Wessel, R. D., Jones, J. A., Larry, M., & Westfall, C. (2009). Retention and graduation of students with disabilities: Facilitating students success. Journal of Postsecondary Education and Disability, 21 (3 ), 116-125. Retrieved from: http://www.ahead.org/publications/jped White, V. E. (2002). Developing counseling objectives and empowering clients: A strengthbased intervention. Journal ofMental Health Counseling, 24(3), 270-279. Retrieved from http ://www.amhca.org/joumal.html Wilson, K., Getzel, E., & Brown, T. (2000). Enhancing the post-secondary climate for students with disabilities. Journal of Vocational Rehabilitation, 14, 37-50. Retrieved from http://www.iospress.nl/ Yalom, I., & Leszcz, M. (2005). The theory and practice ofgroup psychotherapy (5 1h ed.). New York, NY: Perseus. 137 Appendix A: Disability Awareness (adopted from United Cerebral Palsy, n. d.) Communicating with People with Disabilities General rules and suggestions for interacting with people with disabilities are essentially the same as interacting with anyone: treat people with respect and good manners. However, there are some specific issues that can arise depending on a person' s ability, and the following list provides some guidelines to consider when communicating with people who have disabilities. These are only guidelines and do not hold true for all individuals. 1. Speak directly to a person with a disability, not to their companion or interpreter. 2. Offer to shake hands when introduced to a person with a disability. Those with artificial limbs or limited hand use are often able to shake hands. It is also acceptable to shake a person' s left hand if required. 3. Always identify yourself and others who are around you when meeting a visually impaired person. In a group setting, practice identifying the person who you are speaking to. 4. Only provide assistance to a person with a disability if you have offered and the person accepts. Listen to what they require or ask for instructions. Do not assume they need help. 5. Treat adults as adults and do not patronize people with disabilities by speaking down to them or by using child-like language, or by patting them on the shoulder or head. 6. A person' s wheelchair or assistive device is considering part of their personal space. Do not hang onto a wheelchair or lean on it. 7. Listen attentively. If you are talking with a person with a speech difficulty, be patient and wait for them to finish speaking before you speak. If necessary, ask for clarification by asking short questions. Do not pretend to understand what they say if you are having difficulty understanding. Instead, repeat what you have understood and allow them to respond. Their response will help guide your understanding. 8. Place yourself at eye level when speaking to a person in a wheelchair. 9. Lightly tap the shoulder or wave your hand to get the attention of a deaf person. Speak directly and clearly to the person while looking at them to determine if they can read your lips. Not all deaf people can read lips. 10. Be relaxed. Do not be embarrassed about using terms like "see you" or "did you hear what happened?" if they relate to a person' s disability. Ask questions if you are unsure about what to do. Other resources for disability awareness: The following article provides some strategies and common themes counsellors can draw upon when working with students with disabilities in higher education: 138 • Beecher, M. E. , Rabe, R. A., & Wilder, L. K. (2004). Practical guidelines for counseling students with disabilitites. Journal of College Counseling, 7, 83-89. doi: 10.1 002/j.2161-1882.2004.tb00262.x • Artman, L. K., & Daniels, J. A. (2010). Disability and psychotherapy practice: Cultural competence and practical tips. Professional Psychology: Research and Practice, 41(5), 442-448. doi :10.1037/a0020864 For a history on disability services in higher education, refer to: • Madaus, J .W. (2011). The history of disability services in higher education. New Directions for Higher Education, 154, 5-15 .doi: 10.1 002/he.429 The following resources can help facilitators understand experiences of people with disabilities: • Dunn, D. S., & Burcaw, S. (2013). Disability identity: Exploring narrative accounts of disability. Rehabilitation Psychology, 1-10. doi: 10.1 037/a0031691 • Getzel, E., & Thoma, C.(2008). Experiences of college students with disabilities and the importance of self-determination in higher education settings. Career Development for Exceptional Individuals, 31(77), 77-84. doi: 10:1177/0885728808317658 • Gibson, S. (2012). Narrative accounts ofuniversity education: socio-cultural perspectives of SWDs. Disability and Society, 27(3), 353-369. doi: 10.1080/09687599.2012.654987 Videos Friesen, T. (Producer), & Klein, B. S. (Director). (2006). SHAMELESS: The ART of disability. Available from https://www .nfb.ca/film/shameless_the_art_of_disability/ • This documentary focuses on art, activism and disability, following the stories of five individuals. Hernandez, K. P. (Director). (2010). Disability stereotypes. Retrieved from http://www.youtube.com/watch?v=qWwJ7ku8UrY#aid=P-YwcH3yNsE • This short film depicts how people with disabilities may face exclusion and prejudice 139 Rosen, P. (Producer). (2013). How difficult can this be? The F.A.T city workshop DVD. Available from http://www.shoppbs.org/ • This film features learning disability expert Richard Lavoie, who gives a presentation on the frustrating and stressful experience students with learning disabilities face in the classroom. 140 Appendix B: Disability Rights (adapted from BCMAE, 2011) The following documents influence the implementation of services for students with disabilities in higher education. Federal Canadian Charter of Rights and Freedoms This charter guarantees people with disabilities equal benefit and protection under the law without discrimination based on race, national or ethnic origin, colour, religion sex, age, or mental or physical disability. Canadian Human Rights Act This act prohibits discrimination against people with disabilities. According to this act: All individuals should have an opportunity equal with other individuals to make for themselves the lives that they are able and wish to have and to have their needs accommodated, ·consistent with their duties and obligations as members of society, without being hindered in or prevented from doing so by discriminatory practices based on race, national or ethnic origin, colour, religion, age, sex, sexual orientation, marital status, family status, disability or conviction for an offence for which a pardon has been granted. (2) For a request for accommodation to be considered unreasonable ... it must be established that accommodation of the needs of an individual or a class of individuals affected would impose undue hardship on the person who would have to accommodate those needs, considering health, safety and cost. (15.2) A person who proposes to implement a plan for adapting any services, facilities, premises, equipment or operations to meet the needs of persons arising from a disability may apply to the Canadian Human Rights Commission for approval of the plan. (17.1) http://www.efc.ca/pages/law/canada/canada.H-6.head.html Provincial British Columbia Human Rights Code According to this Code, a person must not, without a bona fide and reasonable justification, a) Deny to a person or class of persons any accommodation, service or facility customarily available to the public, or b) Discriminate against a person or class of persons regarding any accommodation, service or facility customarily available to the public Because of race, colour, ancestry, place of origin, religion, marital status, family status, physical or mental disability, sex or sexual orientation of that person or class of persons. (8 .1) 141 http://www.bclaws.ca/EPLibraries/bclaws_ new/document/ID/freeside/00_9621 0_ 01 The Workers Compensation Board ofBC's Occupational Health and Safety Regulation A worker must not be assigned to activities where a reported or observed impairment may create an undue risk to the worker or anyone else. (1.4.19) http://regulation.heal thandsafetycentre.orgl s/Part4.asp The British Columbia Building Code Clause 3.8.2.17 is intended to ensure that school buildings are accessible. http://www.bccodes.ca/bccode_ building.htm 142 Appendix C: Screening Interview (adapted from Rice et al., 2003) Introduction: I'm meeting with people interested in a self-determination group for students with disabilities attending this institution. This is a chance to get to know you better and for you to know more about the group and if it is something that will be a good fit for you. How did you hear about this group and what made you want to find out more? About the group: The group is designed to focus on themes of self-awareness, self-advocacy, selfdetermination, and social communication. These themes will be addresses in a supportive group environment. The group environment will be a non-judgmental atmosphere were we will explore these themes through activities, share our own thoughts and feelings about university, and discuss what it is like to have disability and what it may mean to us. We will focus on identifying personal strengths and developing skills to self-advocate and be self-deterministic. The themes of the group will be explored through various means including group discussions, art work, role play, and other activities. There will also be some information provided and guidance from the facilitator on these themes, but it will involve self-directed exploration and learning from group members. The group will be held on the following days of the week at this time. We expect group members to be able to attend all meetings. Questions about group process and accommodation: This group will work best when members are comfortable participating in small groups. What is your experience in group settings? How do you feel about being in a group? What do you think makes for a successful group? If a group was helpful for you, what would it look like? Have you been in a group with people with different disabilities before? If one group member talked a lot and didn't allow others to speak, what would you do? Can you commit to the entire group session? Do you have any concerns about the group or who might be in the group? Is there anything you need for this group to be comfortable and accessible for you? 143 Appendix D: Group Consent Form Self-Advocacy and Self-determination Group Welcome to the self-advocacy and self-determination group for students with disabilities at (institution name) . This group is designed to promote the development of selfawareness, self-advocacy, self-determination, and social support through group work and creative engaging activities. Overview of Group Format The group is structured to be psychoeducational in format, utilizing a person-centred focus and creative activities. The group begins with a focus on increasing self-awareness and selfidentity for the first several sessions. From there, the group builds on these areas while shifting focus towards communication skills and self-advocacy. Lastly, the group moves towards an emphasis on self-determination through goal setting and a focus on taking control of one's life. Developing self-awareness, the ability to advocate, and self-determination skills can be very helpful for the success of students in higher education. Goals of Group The goals of the group are for participants to develop insight and awareness about their own strengths and self-identity, to develop self-advocacy skills, to develop self-determination, and to apply this personal learning to their academic pursuits (and beyond). It is also a goal of the group for students to practice assertive communication skills and develop peer relationships. Consent to group counselling The group counselling setting will give you an opportunity to explore your own behaviour, feelings, thoughts, relationships, and other areas that may be of interest or concern for you. You will be able to do so in an environment that is safe, accepting, and caring. As a participant you will be partially responsible for creating such an environment for all members by bringing to the group an accepting and non-judgemental attitude. The facilitator, you, and the other group members will form relationships from which you all will learn through each other. This can be helpful for personal growth, skill development, problem solving, and improving relationships. The group counselling environment can also be challenging as topics or things in your life may come up for you, or for others, that you find difficult or uncomfortable. Although you only need to share and participate so far as you are comfortable, it is important that you are aware that this can happen in counselling. 144 Personal Information and confidentiality The use of any personal information collected in operating the group will not be shared with any other person or organization outside of the counselling and or accessibility/disability service offices without your written permission to do so. All members are expected to maintain confidentiality about what occurs during group sessions, as well as regarding who is a member of the group. However, you should be aware that, although confidentiality is required and expected by all participants and the facilitator, only the facilitator is bound by legal obligations to maintain this confidentiality. Therefore, although the facilitator will require confidentiality of all members, the facilitator cannot monitor the extent to which confidentiality is practiced by other members. There are also legal limits to confidentiality for the facilitator. Personal information may be shared under the following circumstances: 1. If a child is being abused or neglected, or is at risk of such and requires protection 2. If the facilitator believes that another person is in clear and imminent danger 3. If a release of information is required and authorized by the law Your Rights In this group, at any time, you may: • • • • End your relationship with the group and facilitator at any time by notifying the facilitator Withdraw consent for your disclosure of personal information if provided Request a referral to another service if possible Access or retain a copy of any personal information in your records of the group If you have a concern about any aspect of the group and are unable to resolve the issue or uncomfortable doing so with the facilitator, you may contact their supervisor at _ _ _ _ _ _ (supervisor contact). Your responsibilities In choosing to join this group, it is expected that you will: • • • • Attend all group sessions. If you are not able to make a session, please provide notice to your facilitator Treat all participants with dignity, respect, and non-judgment Reflect on your own thoughts and feelings Refrain from interpreting or commenting on artistic work of others without asking permission from the person who made it 145 Signature My signature confirms I have read the above. I am aware of the limits of confidentiality, and my rights and responsibilities in participating in this group. Name of Participant: __________________________ Signature of Participant: _________________________ Date signed: _________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ___ Name of Facilitator: --------------------------- Signature of facilitator: -------------------------- 146 Appendix E: Group Accessibility (adapted from U.S. Department of Transportation Disability Resource Centre, 2012) Choosing the Meeting Location: • • • • • Host the meeting at a location near public transportation/subway with a working elevator Accessible parking is available to participants Facility's entryways are 38" or wider, and have ramp or elevator access to all meeting areas for participants who use wheelchairs or scooters Wheelchair accessible bathroom is located near the meeting room Meeting room is in a quiet location without background noise and/or poor acoustics Room SetUp • • • Tables are high enough for people who use wheelchairs (36" high) Remove clutter and space chairs to ensure dispersed seating and room for wheel chair users Keep meeting set up consistent for those with visual disabilities. Do not change layout of room each meeting Materials • • • • • • Consider using a variety of art materials for users of different abilities For students with visual impairments, provide tactile materials which can be used to create art For those with limited mobility or dexterity, consider adapting art tools to their needs For handouts, ensure that students with visual impairments receive alternate format of the materials. For example, a WORD format file of handouts so that they could use them with assistive technology For students with hearing impairments, captioned videos should be used For students with visual impairments, try to get videos with described video if possible For more information on implementing accommodations, the following resources may also be helpful: Simon Fraser University. (2003). Accessibility for students with disabilities policy . Retrieved from http://www. sfu. ca/policies/ gazette/general/ gp26 .html University of British Columbia. (1999). Academic accommodations for students with disabilities. Retrieved from http://www.students.ubc.ca/access/disabilityservices/portfolio/policy-73/ 147 University ofNorthern British Columbia. (2011). Subject: Access and accommodation for SWDs. Retrieved from http: //www .unbc.ca/sites/default/files/assets/access _resource_centre/student_services_access _and_accomodation_for_students_with_disabilities_pee_sept_22 _11.pdf Association of Higher Education and Disability http://www.ahead.org/ For more information on creating accessible art refer to: Anderson, F. (1992). Art for all the children: Approaches to art therapy for children with disabilities. Springfield, IL: Charles C Thomas 148 Appendix F: Relaxation Exercises (adapted from Davis, Eshelman, & McKay, 1995) At the start of each group session, take time to focus the group through a relaxation or check in activity. The following are some exercises adapted from Davis et al. (1995) that can be used to help focus the group. After doing such an activity, the participants are expected to be more focused on the present session. Suggested time for activities is 5 minutes. Internal and external awareness 1. Ask members to focus their attention on the outside world using thoughts such as "I am aware of the clock on the wall, the group sitting together, the noises in the hallway etc." 2. After taking time to be aware of what is going on around you, shift your focus inward to your body and physical sensations. For example, "I'm feeling tense, or happy, my muscles are sore, my stomach is growling, etc." 3. Ask participants to go back and forth between focusing on internal and external awareness. For example, "I am aware of my buttocks pressing into the chair, the bright light from the lamp, my toes wiggling, the ticking of the clock, etc." 4. This activity can help participants focus on separating and appreciating what is going on in both inner and outer worlds. Body Scanning For this exercise, ask participants to close their eyes. Starting with a focus on toes and moving up through the body, ask participants to identify what they are feeling in different parts of their body. Where are they tense? Be aware of the muscles in your body, and which are tense and which are relaxed. Ask members to think of any life situation that is causing the muscles to be tense. Letting Go of Tension Have participants sit comfortably in their chairs with feet on the floor. Instruct the group to breathe deeply into their abdomen, saying "breathe in relaxation". Tell participants to pause before exhaling. Breathe out from the abdomen and say "breathe out the tension". Pause before inhaling. With each breath, take a moment to be aware of any tension in the body. Use each exhalation to let go of the tension. Participants can use their imagination to visualize relaxation entering into their body and tension leaving. 149 Grounding Ask participants to close eyes and focus on the area where their body touches the chair they are sitting on. What are the sensations? Ask participants to notice other things their bodies are doing: are there arms or legs crossed? Pay attention to the places where there is contact. Now ask the group to focus on how their body is taking up space: how much space is the body taking up? Can you feel the boundary between yourself and space? What does that feel like? Notice these feelings. Members can also focus on breath, paying attention to the speed of their breathing. Where does your breath rest in your body? Is it up high in your chest? In the midsection of your stomach? Down low in your belly? Ask participants to try to move their breath around their body from one area to another, from upper to middle to low. For further ideas for relaxation the following book is a good resource: Davis, M., Eshelman, E. R., McKay, M. (1995). The Relaxation and Stress Reduction Workbook (4th ed). Oakland, CA: New Harbinger. 150 Appendix G: Fishing Exercise Handout (Fishing Exercise, n. d.) This is an exercise about getting to know yourself better and what you value. You are going to pretend to go fishing and the potential catch is listed below: wisdom happiness faith popularity health fame honesty courage love power friends skill creativity excitement beauty wealth It's been a good day out fishing and you have caught the five fish you hoped to catch. Circle these. You lean back on the bank of a river and suddenly doze off. Two fish get away. Cross those out from your catch. Your best friend comes along, and they are hungry, so you give them one of your fish. Cross that one off as well. As you talk with your friend, a cat sneaks up and runs away with another fish. Cross it off. You are left with one. Your catch of the day is: _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ This value is probably something you value most. What are some things that you are doing to provide you with this? 151 Appendix H: Assertive Communication Handout (adapted from Johnson, 2002) Passive, Aggressive, and Assertive Communication What is Passive Communication? • • • • • Not expressing self Avoid conflict Give into others Overlook own wants and needs Negative consequences: self-denial, low self-esteem, helplessness, anxiety, pent-up anger What is Aggressive Communication? • • • • • • Threat, demand, judgment Is about personal gain Does not account for other person's feelings Typically causes harm (physical, emotional, social) Direct or Indirect (Passive Aggressiveness) Negative consequences What is Assertive Communication? • Standing up for personal rights and expressing thought, feelings, and beliefs o I statements: • This is what I think • This is what I feel • This is how I see the situation • This is what I want • • • Being direct, honest, and appropriate in the expression of these beliefs Respecting and not violating other people' s rights Everyone is entitled to act assertively and express honest thoughts, feelings, and beliefs Being assertive enriches life Developing assertive system increases likelihood of continuing to be assertive • • 152 Appendix I: Disclosing Disability Disclosure is a decision that is up to you to make regarding both academic and work life. It's a complex and important decision each individual must make. Disclosure in higher education While pursuing your education at a postsecondary institution, you do not need to disclose your disability to anyone at your institution, the choice is yours. However, in order to receive academic accommodations, you will need to disclose your disability limitations to the accessibility or disability services office at your institution. To get academic accommodations, you will also need to notify your instructor that you have registered as a student with a disability. You do not need to discuss the nature ofyour disability with your instructor. It is up to you if you want to disclose information about your disability. You can think about the following questions regarding disclosing your disability to instructors. • • • • • Is there ever a need to disclose your disability to your instructor? What are your thoughts about disclosing your disability to your instructor? Would it help the instructor understand your needs better if you discussed your disability? What would you need in order to feel comfortable to disclose your disability? What are the disadvantages? Disclosure in the work place Source: Government of Alberta, Alberta Learning Information Service. (n. d.). Disclosure: What to say about your disability - and when. Retrieved from http://alis.alberta.ca/ep/eps/tips/tips.html?EK= 163 It's up to you Disclosure is an important and complex decision that is entirely yours to make. What' s right for one person may not be right for another, and what works in one situation may not be successful in another. Whether you mention your disability in your cover letter or resume, during the interview or at the time of the job offer depends on you and the situation. If you're dealing with a service provider or agency that works specifically with persons with disabilities, you will still have some say in how much is disclosed. Disclosure is entirely your choice. 153 To disclose or not to disclose Before deciding if, when and how to disclose your disability, think about the following questions: • Is your disability visible? • How do most people react when they learn about your disability? How do you deal with their reactions? • When do you feel most comfortable and confident disclosing your disability? • Does not disclosing put your safety or the safety of others at risk? • Will the employer think you' re dishonest? How would you deal with that reaction? • What misconceptions might the employer have about your disability? • If you disclose, will you be able to reassure your employer that your disability will not affect your ability to do the work? • Asking for accommodations will almost certainly require you to disclose. Do you need accommodations for the interview? Or if you get the job? • What do you know about this employer's policies and experiences regarding people with disabilities? (Adapted from University of Alberta, Career and Placement Services Tips) Options for Disclosure: Advantages and Disadvantages Use the chart to help you decide if and when to disclose: joption !Advantages !Disadvantages !Recommendations Third party referral recommended by someone the employer knows little control over what is said about you good option if the person recommending you is supportive employer is aware of your situation you could be screened out follow up with a call to the employer demonstrates openness could be used to screen you out use if employer has equity program limited space to describe abilities, accommodations focus on your skills and abilities Application, resume or cover letter employer may be recruiting for diversity can't address 154 !employer' s concerns When interview is scheduled employer is interested allows employer to prepare provides opportunity to discuss your disability After interview [same as above is scheduled employer may react negatively if you require accommodations for the interview, disclose at this you may not receive time serious consideration call employer to disclose if someone else booked the interview same as above same as above gives time to prepare When you reduces risk of employer employer might react use this method if you are confident you can keep the meet employer forming preconceived negatively to . . employer focused on your opmwns surpnse abilities During the interview you can reassure employer same as above you can answer questions After receiving if your disability won't possible strong a job offer adversely affect your negative reaction ability to do the work, from employer employer can't withdraw offer if your disability is not visible, use this option and focus on your abilities in this situation, ifyour disability is invisible, you may choose not to disclose at all (Adapted from University of Alberta, Career and Placement Services Tips) Tips for disclosing • If you've had little success in disclosure situations or feel uncomfortable, try role playing the disclosure process with supportive friends or family members. • Be positive. Focus on your skills and qualifications and don't present your disability as a weakness. • Be prepared to address any concerns employers express, even if they're not expressed directly. • Know what workplace accommodations you may need, including their availability, cost and funding programs the employer can access. • Anticipate the employer's questions about your disclosure and know how you' ll answer them. Use examples. 155 Telling employers about your disability may be the biggest uncertainty in your work search. How, when and whether or not you disclose is entirely up to you. Once you' ve reached a decision about disclosure, ask yourself one last question: will disclosing my disability at this time and in this way help me reach my goal of getting work? 156 Appendix J: Self-Advocacy Role Play Scenarios (adapted from Johnson, 2002) Scenario One: What's so frightening about your instructor? Doug is a first year student enrolled in an English course. One assignment for the class was an eight page research paper. Doug started to work on the paper three weeks before it was due. Doug worked hard to get the paper finished on time, and even met with his instructor to get feedback on what he had done before handing it in. When Doug got his paper back, he was shocked to learn he had received a D. He felt he should have got a much better grade and was used to getting B' s for all of his other assignments. He wondered why he got such a low grade. He looked over his work and the instructors comments but still does not understand why he got the grade he did. He considered talking to the instructor but suspects the instructor may not like him. He tells his classmates that he thinks he got the low grade because his instructor does not like him may be because he has cerebral palsy. He decides to not talk to the instructor and begrudgingly studies for the final. Questions to consider: • • • • Is Doug being assertive, passive, or aggressive? What is the problem? How did he handle it? What else could he have done? Role play how Doug could assertively approach this situation with the instructor. Scenario Two: How can I get others to understand my disability? Janet is in her second semester at university. She was diagnosed with a learning disability and received accommodations and assistance in high school. However at university, she heard an instructor talking about how he did not think another student that was requesting accommodations really needed them to succeed. Also, she was self-conscious about having a learning disability and did not want to come across as different from her peers. Rather than seeking accommodations and support from the disability service offices at her school and having to talk to instructors about needed accommodations, she chose not to get supports and tough it out. After failing two out of her first four courses and barely passing the other two, she is considering dropping out of school. Questions to consider: • • • Is Janet being assertive, passive, or aggressive? What is the problem? How did she handle it? 157 • What else could she have done? Discuss and role play how Janet could assertively approach talking to other students or instructors about her disability. 158 Appendix K: Community Resources and Links Disability-related Resources: BC Coalition of People with Disabilities http://www.bccpd.bc.ca/ Canadian Human Rights Commission http://www .chrc-ccdp. gc. ca/index.html Ministry of Social Development and Social Innovation Information for persons with disabilities _http://www. sdsi.gov.be. ca/pwd.htm Human Rights in British Columbia Handout http://www. ag. gov. be. ca/human-rights-protection/pdfs/DisabilityDiscrimination. pdf Student Aid BC disability service framework https://studentaidbc.ca/sites/alVfiles/school-officials/disability_services_framework. pdf National Educational Association of Disabled Students http://www.neads.ca/ Association of Higher Education and Disability http://www.ahead.org/ Counselling Resources: Northern Health Mental Health Services http://www .northernhealth. ca/Y ourHealth/MentalHealthAddictions.aspx Canadian Mental Health Chapter Prince George http://www. princegeorge. cmha. be. cal UNBC Wellness Centre http://www. unbc. calwellness-centre Community Care Centre 159 http://www. unbc.ca/community-care-centre Crisis or Emergency Contact Information: University Hospital of Northern BC 250-565-2000 24 hour Crisis and Information Line 1-888-562-1214 Community Response Unit (CRU) 1-866-565-2966 24-hour Suicide Support Line 1-800-SUICIDE or 1-800-784-2433 24-hour Youth Support Line (age 13-21) 1-888-564-8336 160 Appendix L: Group Evaluation Form (adapted from Rice et al., 2003) What was your general experience of this group? What was valuable for you about this group? What was not helpful for you about the group? What did you learn in this group? Did you achieve what you had hoped in participating in this group? Where there any barriers that impacted your ability to attend or participate in sessions? What changes would you recommend for future groups? Would you recommend this group? Why or why not? Do you have any other comments about the group?