Combining Practice and Classroom: I Don't Want to Miss the Miracles
BPD Update Online, Winter 2003
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I Don't Want to Miss the Miracles:
Ten Years Leading a Men's Group

by Bob Vernon, Indiana University School of Social Work

I hold a men's group in an adult day care facility called "A Caring Place". I have been doing this Wednesday afternoons for about ten years. This is volunteer work. The group is not clinical in any way and ther is no therapeutic agenda. I don't get paid although the rewards are considerable. Let me tell you about our group.

The men who participate range from their early sixties to well into their late eighties. Our oldest member died at ninety four. These men have made the transition from work to retirement, have lost family members and friends, can no longer get around without considerable help, and now need close supervision due to deteriorating health. All have "got" something, such as Alzheimer's, serious impairments from strokes, advancing Parkinson's disease, or other problems we'll all face if we live long enough. I suspect adult day care services are as much for family respite as for the participants.

Our group varies from about five individuals to as many as twelve depending on how many men are in the program at any given time and who is physically able to participate. Any male can join us and most do. We are near "the end of the line". People in our group eventually deteriorate and go to a skilled nursing facility. Or they die. In the last ten years I have seen about thirty continue on to nursing homes and a few less at their funerals. The longest anyone has been in the group has been nine years. The shortest has been three weeks. Most are with the group for perhaps two years. No one has ever improved to the point where they can resume independent living.

Death is ambiguous in our group: you die and that's not good, or you get worse, and that's clearly not good either. This means that what you do in the meantime is far more important. As far as we are concerned, it is not what you've got. It is what you've got left.

Affirmation is the important outcome in our group. Three rules are repeated at every session: Anything goes, everything stays, and take all the time you need. Everyone in the group is physically disabled, and cogitative abilities range from quite normal to very poor. If you are barely capable of articulate speech, we'll wait for you to make you point even if it takes you several minutes to compose a simple sentence. If you have trouble crafting logical thoughts, we'll guess with you until we all understand what you are probably trying to say. We'll laugh at the same joke you tell over and over as if we've never heard it before. We'll discuss recent events or hear your stories from long past that are important for you. We can speak Great Depression, World War II and Korea when needed. We hold occasional seminars on immediate concerns like Depends.

Why Do I Do It?

I'm not a person of faith, but I really enjoy the miracles. These come occasionally as gentle surprises. For example, one of our current members suffered a severe stroke several years ago and lost his ability to speak. In the last few months though, he has become more and more articulate, largely due to his work with a speech therapist and his sheer will. Another member, "John" is quite confused most of the time. A new member, far more disoriented, joined the group but continually got up to wander around the room. Old guys do this. John got up, gently guided him back into the group and sat next to him, comforting him. The group generally is about half African Americans and half European Americans, the most segregated generation ever. Yet race has absolutely no meaning: Survivorship is what counts. The inexplicable occasionally happens too: a man with very severe dementia will briefly become aware, articulate, and tuned in. Watching them care for each other is a privilege, and perhaps a promise.

I also enjoy what they teach me. Self esteem and esteem for others actually grows with disability. Family is everything. People without families do not survive long.

Feeds Back Into Classroom....

I suspect that my practice lends legitimacy to my teaching. Students have hardwired b.s. detectors, and having a small collateral practice helps establish credibility. But this is marginal and unintended on my part. I take very little from the men's group directly back into the classroom. I may occasionally tell a story to illustrate a policy or community issue but rarely discuss anything more. Remember: The second rule for the group is "everything stays." I do occasionally share small miracles.

I also chair the executive board for Community Addictions Services of Indiana (CASI). CASI is a substance abuse agency with about five programs and twenty five employees. I use CASI-related issues far more in the classroom, largely because I teach policy, macro HBSE, and macro practice. What I do take back from the men's group is an awareness of the limitations in my own interests in technology. I'm a major advocate for using tech in social work practice and administration. The men's group helps me keep this in perspective. None of the things we talk about in this group could be done online, in a chat room, on a listserv, or through a website. They remind me that I am a social worker first, and that while technology certainly has its promises, it also has its limitations. Online support groups, information and referral nets, and shared case management systems are emerging as excellent ways to deliver services, but there will always be the need for direct hands-on contact. And I don't want to miss any miracles.

There's more Combining Practice and Classroom on the next page...

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