2018 Hans Kai Facilitator Resources

2018 HANS KAI FACILITATOR 

RESOURCES 

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2 0 1 8 H A N S K A I F A C I L I T A T O R R E S O U R C E S 

HANS KAI 4 

Trans 

FACILITATOR MANUAL 

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Section One ................................................................................................................................................................................. 1 

Introduction ................................................................................................................................................................................ 1 

We are a Treaty People 2 

So, you are starting a group! 4 

Section Two ................................................................................................................................................................................. 7 

Facilitation and Presentation ....................................................................................................................................................... 7 

Workshop Objectives 8 

1: Process vs. Content 9 

2: Understanding Facilitation 11 

3: Laying the Groundwork 13 

4: Verbal Communication Skills 16 

5: Non-Verbal Communication Skills 19 

6: Overcoming Nervousness 21 

7: Hacking Hans Kai 23 

8: Choosing Your Delivery Methods 25 

Section Three ............................................................................................................................................................................. 29 

Tips and Tools ........................................................................................................................................................................... 29 

1: Creating Fantastic Flip Charts 30 

2: Creating Compelling PowerPoint Presentations 32 

3: Wow ‘Em with the Whiteboard 34 

4: Vibrant Videos and Amazing Audio 36 

5: Pumping it Up a Notch 38 

Section Four Working with a group............................................................................................................................................ 40 

1: Group Development Dynamics 41 

2: Group Thinking 44 

3: Group Decisions 49 

Creating a Short List 49 

4: Dealing with Difficult People 51 

5: Addressing Group Dysfunction 53 

6: Getting a Group Back on Track 56 

Section Five Hans Kai Content ................................................................................................................................................... 60 

1 – Indicators 62 

2 – Security 64 

3 – Self-Care 66 

4 – Balance 68 

5 – Healthcare 70 

6 – Changes 72 

7 – Clans 74 

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Section One 

Introduction 

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We are a Treaty People 

All Canadians, as Treaty peoples, share responsibility for establishing and maintaining mutually respectful 

relationships. The Truth and Reconciliation Commission states this is the basis of reconciliation. A critical part of this 

process involves repairing damaged trust by making apologies, providing individual and collective reparations, and 

following through with concrete actions that demonstrate real societal change. They stated these 10 principles as 

underlying the work we are called to do, and the resilience of Indigenous people shows that is possible for us to do 

the work that needs to be done. 

From “What We Have Learned”, the report of the Truth and Reconciliation Commission 

1. The United Nations Declaration on the Rights of Indigenous Peoples is the framework for 

reconciliation at all levels and across all sectors of Canadian society. 

2. First Nations, Inuit, and Métis peoples, as the original peoples of this country and as selfdetermining 

peoples, have Treaty, constitutional, and human rights that must be recognized and 

respected. 

3. Reconciliation is a process of healing of relationships that requires public truth sharing, apology, 

and commemoration that acknowledge and redress past harms. 

4. Reconciliation requires constructive action on addressing the ongoing legacies of colonialism that 

have had destructive impacts on Aboriginal peoples’ education, cultures and languages, health, 

child welfare, the administration of justice, and economic opportunities and prosperity. 

5. Reconciliation must create a more equitable and inclusive society by closing the gaps in social, 

health, and economic outcomes that exist between Aboriginal and non-Aboriginal Canadians. 

6. All Canadians, as Treaty peoples, share responsibility for establishing and maintaining mutually 

respectful relationships. 

7. The perspectives and understandings of Aboriginal Elders and Traditional Knowledge Keepers of 

the ethics, concepts, and practices of reconciliation are vital to long-term reconciliation. 

8. Supporting Aboriginal peoples’ cultural revitalization and integrating Indigenous knowledge 

systems, oral histories, laws, protocols, and connections to the land into the reconciliation process 

are essential. 

9. Reconciliation requires political will, joint leadership, trust building, accountability, and 

transparency, as well as a substantial investment of resources. 

10. Reconciliation requires sustained public education and dialogue, including youth engagement, 

about the history and legacy of residential schools, Treaties, and Aboriginal rights, as well as the 

historical and contemporary contributions of Aboriginal peoples to Canadian society. 

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Kairos Blanket Exercise 

The KAIROS Blanket Exercise is an interactive 

learning experience that teaches the Indigenous 

rights history we’re rarely taught. Developed in 

response to the 1996 Report of the Royal 

Commission on Aboriginal Peoples—which 

recommended education on Canadian- 

Indigenous history as one of the key steps to 

reconciliation, the Blanket Exercise covers over 

500 years of history in a one and a half hour 

participatory workshop. 

Blanket Exercise participants take on the roles of Indigenous peoples in Canada. Standing on blankets that 

represent the land, they walk through pre-contact, treaty-making, colonization and resistance. They are 

directed by facilitators representing a narrator (or narrators) and the European colonizers. Participants 

are drawn into the experience by reading scrolls and carrying cards which ultimately determine their 

outcomes. By engaging on an emotional and intellectual level, the Blanket Exercise effectively educates 

and increases empathy. Ideally, the exercise is followed by a debriefing session in which participants have 

the opportunity to discuss the experience as a group. This often takes the form of a talking circle. 

Terms of Use 

Please do your best to work in partnership with Indigenous people when delivering this workshop, paying 

special attention to the protocols of the traditional territory you are on. 

Be mindful that the Blanket Exercise may cause strong emotions and act as a potential trigger for 

participants, particularly those who are Indigenous (but who may not have self-identified). Please offer 

support during and after the workshop to ensure that the Blanket Exercise is as safe an experience as 

possible. See the Health Support page for more information. 

We encourage widespread use of the KAIROS Blanket Exercise; however, we ask that you always 

acknowledge KAIROS as the creator of this teaching tool, including in all promotional materials, and that 

you use the term “KAIROS Blanket Exercise” and the acronym “KBE.” If people want more information, 

please refer them to www.kairosblanketexercise.org. 

If you are charging participants a fee, please talk to us first. KAIROS would like to see a portion of the 

proceeds go towards supporting the Blanket Exercise program. In addition, we want to ensure it is not a 

profit-making endeavor. If your organization is interested in using the Blanket Exercise as a regular 

workshop or training tool, please contact us at blanketexercise@kairoscanada.org. The first step will be 

to negotiate a Memorandum of Understanding that outlines and clarifies expectations, roles and 

responsibilities. 

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So, you are starting a group! 

Who are we? 

Rainbow Health Co-operative is BC's largest trans owned organization. We support individuals and families living 

with transition related to gender. We are a 100% volunteer not-for-profit community services co-operative 

incorporated in British Columbia. Our federal charitable status is pending. Our Membership is open to all, but our 

focus is the transgender community. We assist existing groups and establish new ones through the Hans Kai 4 Trans 

(HK4T) , Canada's most comprehensive gender wellness program. HK4T is part of the Hans Kai family of programs 

which are provided across Canada through partnership with Norwest Community Health of Winnipeg, the 

originators of the Hans Kai program. 

We help you get started 

Getting a group underway is a lot of work. Deciding on a format; developing materials, inviting guests, promoting 

your event, everything together adds up to a big list, especially for a volunteer. We help by sitting in as one of your 

co-hosts while your group gets settled in. 

We help with the scheduling, promotion and registration of the group. We post meeting information in one of our 

regional Meet-up Pages, list your meeting on the XQQ calendar and register your group into the various directories 

where people search for support including 211BC. 

There will always be a time when you have a conflict in your schedule and need someone to step in and host when 

you can’t. Your co-facilitator can be the most important member of your group. How you divide up duties is 

between the two of you, but the co-facilitator often takes care of the business side of the meeting; helping with 

promotion, getting the notices out, attending the monthly meeting for facilitators and the simple things like 

opening and closing the space. 

Help build group continuity. 

It takes a lot to get any group going, and once you do, it is rewarding to see it keep going. Sometimes other things 

in life need attention and you just need someone to fill in for a while. Sometimes it is time to hand off the torch to 

others in the group. Whatever happens, we help you through the transition. One way we assist is by helping the 

groups determine its purpose, define a charter, and keep copies of what has been decided. 

Help make your group, sharing, safe, inclusive and self-sustaining 

If people wanted to go to a show, they would be at the Odeon watching Bruce Willis, not sitting in a room with 

others who share similar interests and challenges. It is important that each group develop its own guidelines that 

encourage participation from everyone. We call this a framework of robust inclusion and each group needs to 

develop its agreement that incorporates it as a component. We cover $10 / month in expenses, (we suggest the 

healthy snack), but groups need to be self-supporting for their other direct costs. 

Help by supporting YOU. 

Many people want to start groups because they themselves feel a similar need, but it is important to remember 

your role as facilitator is different than that of a participant. Sometimes you may need to vent yourself – and it may 

be due to things going on within your group. We maintain a monthly meeting where group facilitators can get 

together themselves and share. An ongoing support forum for group facilitators is available to you anywhere, 

anytime (or at least where there is internet service). We are also available for one on one ‘debriefing’ when you 

really need to talk something over, or brainstorm on promoting group interaction. 

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Help you manage your group. 

After a group has met for a while – the group members can end up in a bit of a rut. They can feel like there is 

nothing new or of interest that motivates them to return to the next meeting. We help with this in a couple of ways 

– first organizing special events, mainly through our Hans Kai for Trans program, but we also provide a monthly 

handout that has a new icebreaker and a suggested topic for the month, usually with a group exercise. 

Help organize special events and resources. 

Sharing is an important aspect of any group – but so is developing activities that maintain group interest or attracts 

new members to your group. These can be part of your group’s activities or a bigger event your group can 

participate in. The occasional special guest is often a good motivator to get people to show up. We help you find 

external resources for your group. 

Add content and guest speakers to your groups meeting. 

Groups who participate in Hans Kai for Trans can request workshops. Workshops are designed to last about 45 

minutes, or about half of a regular meeting – but a group can always extend their discussion around the topic if 

they choose. We add new workshops proposed by our members, so enquire if there is a workshop you would like 

to see. We provide a monthly bulletin – The Rainbow Connector, which provides a new ice breaker and group 

exercise each month. It also provides the login sheet and deposit slips if needed. One of the responsibilities is for 

the group host to see that this is completed and returned in the postage paid envelope we provide. 

Help you promote your group. 

We maintain a master list of all groups and group members across BC. We maintain a master list of all groups on 

the XQQ website and include that list in the print copy which is published four times a year. We send out a weekly 

email that includes a link to groups and lists special events coming up. 

Meetup Link - We maintain a Meetup page for each region where we post all events and meetings. We post your 

meeting / event there. 

Local press / Craigslist - We maintain posting for each region where for all events and meetings. We post your 

meeting / event there. 

Facebook Page – On our Rainbow Health Coop Facebook page, we maintain a separate page for each region where 

we post all events and meetings. We post your meeting / event there. We share that posting through other 

Facebook groups and pages that are used by folks in each region. You should promote your meeting on your pages 

as well. 

XQQ.ca – XQQ is our primary communications tool for all group activities. Our strategy is to attract attention to the 

various support groups by maintain fresh and relevant content for the community. We would love to do a story 

about you or your group. We also appreciate any contribution. We divide the content up into several streams: 

News, (current issues of interest) Stories, (fiction, poetry, biographies), Thoughts, (Opinion blogs or single pieces), 

and calendar events. 

Help find a sponsor for your group. 

Some sponsors are organizations, and some are individuals. A sponsor can engage in a number of ways from being a 

part of the group directly to being the keepers of the group’s mission statement. Some sponsors help in other ways. 

We think every group is stronger if they have a sponsor, and we try and find a sponsor for your group if you don’t 

have one. While it never hurts to get a bit of financial support where ever you can, your sponsor should be more 

than that. Your sponsor should understand the purpose of your group and help you fulfill that purpose. Your 

sponsor should also be there when you need support and a first person to turn to if you have a matter you cannot 

resolve yourself, especially if it is with your co-facilitator. 

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Help you find a place to meet. 

We share space at the YES Centre, which is at 107- 1208 Wharf Street. This location is at the base of the building, 

facing out on the inner harbor. Access is good by transit or car from any part of the greater Victoria area. Both 

spaces are fully accessible but still offer a discrete and secure way to meet. The building shares restrooms which are 

gendered and chair accessible. The space includes a meeting room that easily accommodates 10 to 12 people 

seated casually in a group or up to 25 in presentation mode. The room has a modular conference table that can be 

configured in several ways or moved out of the way for group seating. The YES Centre another meeting room that is 

a bit smaller. It is set up with a conference table suitable for 8. 

So, let’s get started 

Peer-Facilitated Groups are organized by community volunteers. Each group is asked to maintain QMUNITY’s Code 

of Respect. One facilitator in each group needs to participate Are You Experienced? – Celebrating Rainbows Safely. 

We include these training sessions in an extended session of the peer facilitator support meeting four times a year. 

Our Rainbow Polishing Tips are help tips for group organizers. This is also attached. Please read through it, you will 

find it covers many of the things you need to consider to make sure your group gets off to a good start. We fill this 

requirement as co-host until someone completes the training. 

Write the group announcement 

You need a group name – it should be 80 characters or less. You need a description. Let everyone know what your 

group is about. We try to make all our meetings open to all – and let the topics attract those who are interested. 

You might say something like “of special interest to trans men”. You can list the things the group will do or talk 

about. What is your group about? Is it a support group that socializes? Or is it a social group that provides a bit of 

support, but mainly gets together to do things? Is it for people in active transition or concerned about a particular 

area of being queer. Keep the description fairly short, less than 1,000 words but make sure the reader gets a sense 

of what you will be doing. Send us the Group Name and Description when you have it ready and we will get it 

posted. 

Tell people about the group 

We help – but it is up to you to promote the group. It is your biggest job when starting a group. Post it on Facebook, 

add links in blogs, tell people you know. Postering in coffee shops and similar is a bit more work but catches people 

you might miss otherwise. We post in all the coffee shops right around the center. We will inform other partner 

organizations, post on Craigslist, our website and social media pages, and include in our general press release for 

local media. 

Think about how to be self-supporting 

There are many ways in which people can help, and instilling an understanding of these needs in the group from 

the beginning is the right time. Many people have access to resources they can contribute besides their time and 

money. Ask them. Alcoholics anonymous has run itself for almost a century on the dollar or two each member 

tosses into the hat at each meeting. This seems a reasonable standard for each group to meet and it is up to you 

how to handle it. Our guideline is $2/month/person. 

Finally – Please promote membership in Rainbow Health 

As a co-op we depend on our members. Membership is simple to sign up for and a regular membership is $5.00 for 

life. We include membership cards with each monthly package, please help us promote the cooperative. There is 

much to be done to improve community health, and we do get better together. 

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SUPPLEMENTAL RESOURCES FOR THIS TOPIC 

Here are some links to online resources about creating a group 

statement step by step 

http://nonprofithub.org/wp-content/themes/nonprofithub/img/landingpages/mission/nonprofithub-missionstatement.pdf 

https://www.extension.iastate.edu/agdm/wholefarm/html/c5-09.html 

CHECK IN AND ICEBREAKER 

Topic 

Where 

When 

Who 

Terms 

What are the colours 

of our flag? 

http://www.diycommitteeguide.org/article/vision-mission-and-values 

Check in 

Notices 

Territorial Avowal 

Icebreaker 

MATERIALS 

PREPARATION 

ACTIVITY 

Head 

Count 

Phones 

Away 

Time 

Check 

Include short notices here 

Access 

Needs 

Parking 

Lots 

Ask someone to share, use your own or one from suggestion box 

Who is like this? – an exercise to move people around 

Index cards for names 

Markers 

Have participants fill out their name card. Then, ask 

participants to stand in a circle, shoulder to shoulder. They 

should place their name card at their feet. Then they can 

take a step back. You as the facilitator should take the place 

in the center of the circle. 

Explain that there is one less place than people in the group, 

as you are in the middle and will be participating. You will 

call out a statement that applies to you, and anyone to 

whom that statement applies must step forward then find 

another place in the circle. Examples: 

• Who has a cat at home? Who is wearing blue? 

Odd person out stands in the center and make a new 

statement. 

Repeat until everyone has changed place from where they 

startedThe rules: 

You cannot move immediately to your left or right, or back 

to your starting place – No kicking, biting or shoving! 

Rainbow Health Co-op materials are licensed for noncommercial 

use through a Creative Commons 4.0 

License 

web: rainbowhealth.coop phone: (888) 241-9992 

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TODAYS TOPIC 

EXAMPLE GROUP FLAG – THIRD BAND NOT YET COMPLETED 

Introduction We come together to take care of each other, but with us in the 

room is something else we need to take care of – the group 

itself. A group that is properly cared for becomes selfsustaining. 

That’s our goal. 

We start with four steps – 1, Finding what we have and what 

we need, 2, Learning how to think together, 3, Deciding how we 

make decisions, 4, Deciding how we shares responsibilities. 

Materials Small US and Canadian Flags, Pride or trans flag 

3x3 post it notes – three colours 

One large sheet of paper, pens, markers, tape 

The four images attached with this guide. 

PREPARATION 

Activity 

Draw an outline of a flag on the piece of paper or whiteboard 

separating it into three bands – like the French flag 

Hand out post it notes of each colour to each person. 

Take the small Canadian flag. Get people to say the first thing 

they think of. Repeat for the US flag. Finish discussion by asking 

If this group had a flag – what would it look like? Take out the 

trans and pride flag. We will discuss several questions to get 

started in deciding what our group flag will look like. 

First Question- What am I bringing to the group? Write 

answers. Go around the circle and have each person share and 

put their note on the flag within one band. 

Second Question - What do I need from this group? Repeat the 

sharing and posting. You the leader go last. You post the 

symbols you prepared and explain each one briefly. At this 

point the group flag should look like the picture. 

Third Question – What do I want this group to do / be? 

Complete the flag and set stage for second exercise 

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Section Two 

Facilitation and Presentation 

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Workshop Objectives 

Research has consistently demonstrated that when clear goals are associated with learning, the learning occurs 

more easily and rapidly. With that in mind, let’s review our goals for today. 

By the end of this workshop, you should be able to: 

• Define facilitation and identify its purpose and benefits. 

• Clarify the role and focus of a facilitator. 

• Differentiate between process and content in the context of a group discussion. 

• Provide tips in choosing and preparing for facilitation. 

• Identify a facilitator’s role when managing groups in each stage of group development 

• Identify ways to help a group reach a consensus: from encouraging participation to choosing a solution. 

• Provide guidelines in dealing with disruptions, dysfunctions, and difficult people in groups. 

• Define what interventions are, when they are appropriate, and how to implement them. 

• Perform a needs analysis and prepare an outline 

• Select presentation delivery methods 

• Practice verbal and non-verbal communication skills 

• Knock down nervousness 

• Develop and use flip charts with color 

• Create targeted PowerPoint presentations 

• Utilize white boarding for reinforcement 

• Describe how video and audio enhance a presentation and list criteria for determining what types to use 

• Enrich the learning experience with humor, questions, and discussion. 

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1: Process vs. Content 

Facilitators are process experts; they are as interested in the “how?” as much as the “what?” To produce quality 

output, you must arrive at it functionally. In this module, we will discuss the difference between process and 

content, and which among the two should be a facilitator’s focus. 

situational elements. 

About Process 

Process refers to the way a discussion is happening, independent of the 

subject matter or issue being talked about. Basically, process talks about how 

a group works together. It includes how members talk to each other, how they 

identify and solve problems, how they make decisions, and how they handle 

conflict. It takes into account group dynamics, non-verbal messages, and 

Process elements include: 

• Meeting Flow. How does the meeting begin? How do they transition to another item 

in the agenda? Who keeps the ball rolling? Are there topic jumps? How does the 

meeting end? 

• Participation. How many people contribute to the discussion? What is the quality of 

their contribution? Are there highs, lows, and shifts in group participation? How are 

silent people treated? 

• Communication. How do group members communicate with one another? Is the verbal communication 

congruent with the non-verbal communication? Who talks with whom? Who interrupts whom? 

• Roles. What roles do each member of the group play? Are these roles self-assigned or assigned by others? 

Are the roles productive? How do the members of the group respond to these roles? 

• Power/ Influence. Who has high influence? Who can move the group into a particular action whether 

positive or negative? How do they exert this power? Is the group democratic, authoritarian, or permissive 

when it comes to discussions? Are there shifts in power/influence? Are there rivalries? Do there seem to be 

coalitions and alliances? 

• Problem-Solving Process. Is the problem stated in clear workable terms? Does it seem clear to everyone 

what the issue is? How does the group arrive at solution? Is this method acceptable and fair to all 

members? 

• Decision-Making Process. How are the best interests of all participants represented in the decision making 

process? Are there self-authorized decision-makers? Does the group arrive at a consensus? Is the way of 

deciding acceptable to all members of the group? How are people who disagree with the majority treated? 

• Group Atmosphere. What is the general feeling in the group? How are feelings handled? Are they 

encouraged and validated? Is this group capable of care? Are there significant emotional attachments 

between members? 

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About Content 

Content refers to the subject matter of a discussion: the actual words or ideas that were 

spoken independent of contextual variables like non-verbal cues and procedural variables. 

It refers mainly to the literal meaning of words and makes no reference to connotations, 

subtexts, and insinuations behind messages. 

In a meeting, content are the agenda topic, the suggestions put forward by the staff members, the solutions they 

arrive at. Content in a facilitated discussion should all come from the group and not the facilitator. 

Example: The content of the meeting may be “how to change the company’s image to that it will appeal to a 

younger market.” In contrast the process element in the same meeting is brainstorming to solicit as many options 

as possible. 

A Facilitator’s Focus 

Which between process and content should a group facilitator attend to? 

Ideally, a facilitator should attend to both process and content. After all, process and content feed one another. 

Good meeting processes create better content; keeping to relevant content makes for a great discussion process. A 

productive discussion can only happen when the content is on track and the meeting flows in a functional way. 

However, facilitators are primarily process experts; they manage information flow and treatment. They are not 

encouraged to provide content input in any way. While some knowledge of a meeting’s topic can help a facilitator 

manage a meeting better, a facilitator should not put forward personal opinions and suggestions, or make 

judgments and decisions for the group. They’re also content neutral; they should never take sides in a debate. 

When a facilitator adds to the content of a discussion, the facilitator’s role is confused from neutral guide to biased 

participant or a trainer/ coach. If a content expert is needed (one whose task is to clarify technical issues in a 

discussion e.g. a lawyer for union issues, or an Organizational Development consultant), they can be included as 

participant in the group for expert reference. 

Here is an example of a facilitator focusing primarily on process instead of content: 

Imagine that a group discussion is stuck. The group can’t seem to generate a good, viable idea for their project. A 

content expert in this situation can provide a range of alternatives they can try--- after all he or she has specialized 

knowledge in this area. But a facilitator is a process expert. Instead of giving suggestions, a facilitator would seek to 

identify why idea generation is not proceeding well. Maybe the group is tired? Maybe the problem needs to be redefined? 

In these cases, a facilitator can encourage a working break to get the thinking juices flowing, or ask the 

group to re-define the problem to encourage a different perspective, respectively. 

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Managers who fail to learn facilitation skills 

are getting buried. Their traditional “direct 

control” approach to managing just does not 

work when there is so much to do and so 

little time to do it 

Richard Weaver & John Farrell 

2: Understanding Facilitation 

Groups are powerful resources in any organization. When you tap into groups, 

you don’t just get the best of individual members, you also get the best of 

group interaction. The result is a more dynamic, creative and empowered 

team. 

To get the most of groups, you need facilitation skills. In this module, we will 

discuss what is facilitation, what is a facilitator and when is facilitation 

appropriate. 

What is Facilitation? 

Facilitation is a manner of handling group meetings in a way that takes the focus away from just one leader, and 

instead distributes leadership to all members of the group. There is premium on democracy, group involvement, 

and cooperation. The focus is not just on getting things done, but also in feeling good about it. 

Consultant Dave Sibbet defines facilitation as “the art of leading people through processes towards agreed-upon 

objectives in a manner that encourages participation, ownership, and creativity from all involved.” 

Facilitation is often contrasted with presentation, which is delivering information or decisions to a group. 

Facilitation is group-centered while presentation is leader-centered. For this reason, facilitation is incompatible with 

an autocratic management style. 

Example of the difference between facilitation and presentation: 

FACILITATION: “How do you think the company can solve this problem? Does anyone have any ideas?” 

PRESENTATION: “This is how we will solve the problem…” 

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What is a Facilitator? 

Group-centered meetings require an individual or individuals in the case of larger 

groups to manage the process. This person(s) is a facilitator. 

A facilitator is a person who helps groups to arrive at their objective by ensuring that 

everyone’s contribution is heard and the processes being used are both productive 

and empowering to all. Facilitators work primarily through leading and blocking 

techniques, basically directing traffic within a group discussion. Facilitation can also 

involve managing group member’s emotions, defusing tensions and encouraging team cohesiveness. In some cases, 

facilitators help in setting and revising meeting structure, and managing conflicts. 

To be effective, facilitators have to be neutral to the discussion, not partial to any members, and acceptable to 

everyone involved. They should not take a position in any of the issues raised, nor should they advocate a solution - 

-- or attempt to directly solve the problem. Having an objective “third party” facilitator ensures that group 

members would feel safe about voicing out their opinions. 

Knowledge of group process and an appreciation of democratic management are pre-requisites to becoming an 

effective facilitator. Sensitivity and keen observation skills are also non-negotiable. 

What about Co-Facilitators 

Responsibilities as Facilitators 

Facilitators set clear boundaries in regards to: no dating group members, no initiating contact, or accepting 

invitations for contact outside of the roles as facilitator. Facilitators need to be seen by 

participants as safe, non-partial people the members can go to if they are having 

problems in the group. Along with this goes creating a non-sexualized environment. 

These boundaries are the same for all QMUNITY volunteers, regardless of their program. 

These boundaries exist to protect participants 

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It’s amazing what you can accomplish when it 

doesn’t matter who gets the credit. 

Anonymous 

3: Laying the Groundwork 

A facilitated approach is not just a technique; it’s an attitude and disposition to 

doing things that should be shared by the whole organization. To best benefit 

from group facilitation, you need to set the stage for it. In this module, we will 

discuss choosing a facilitated approach, planning for a facilitated meeting and 

collecting data. 

Choosing a Facilitated Approach 

In an earlier module, we discussed about the situations where facilitation is appropriate and 

situations when facilitation is not appropriate. These factors can be a guide if facilitation is 

the best approach to managing a meeting in your organization. 

If your organization has decided that facilitation is appropriate, the following are some steps 

you should take: 

• Orient the participants about what facilitation is, and what it can do for them. If a team is new to the 

facilitated approach, they might find difficulty with the process. For example, individuals from a hierarchal 

organization might feel uneasy contributing when there are senior members in the group. In situations 

where there’s conflict, the group might even expect the facilitator to adjudicate the issue or at least offer 

an opinion. It’s important then to level everyone off with what facilitation is (and what it isn’t) before you 

start implementing it in your group. If there are significant reservations about changing to a facilitated 

approach, surface them so that they may be addressed. 

• Make sure that facilitation has the administration’s support. The incentive to make the most out of a 

facilitated discussion can be nullified if the people who make decisions still prefer a top-down, autocratic 

approach. While it’s not guaranteed that ideas and proposal produced by facilitated teams will get 

approved, administration should at the very least communicate their openness to the team’s efforts. 

• Choose the right facilitator. Facilitators can be from within the organization or a freelance professional. 

It is important that you pick a facilitator who is not part of the problem-context or the solution, and is 

generally perceived as unbiased with no conflict of interest. They must also possess the right attitude and 

disposition in handling people’s contribution. 

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Planning for a Facilitated Meeting 

The following are some things you can do in preparation for a facilitated meeting: 

• Set the venue. Facilitation works best if the venue is conducive to a comfortable discussion. Chairs 

arranged in a circle are always better than a classroom set-up, to emphasize equality among all members. 

Privacy is a must. If you need to use materials like flip chart paper, markers, and nametags, prepare them 

beforehand. 

It also helps to prepare not just the venue of the meeting proper, but the surrounding areas as well. It’s not 

unusual for facilitators to invite meeting participants to break out in smaller discussion groups, or even 

“take a walk” to blow off steam. As such, preparations for these activities should be made before the 

meeting. 

• Set aside time. Facilitated meetings should not be rushed; minding process is 

the reason why it works well. The length of a facilitated meeting 

depends on 

the agenda and the number of participants, but the recommended 

duration is 

30 minutes to one hour. 

• Prepare a Facilitation Plan. As a facilitator, never go blindly into a meeting. 

While an experienced facilitator would likely have enough skills enough 

to “wing 

it”, it always pay to be prepared. 

Make sure you know what the objective of the meeting is, expectations of the group and/or the 

organization from you, and the profile of your participants. Decide ahead how you are going to begin and 

end the meeting, and how you plan to manage the meeting itself. For this process, it helps if you research 

and gather relevant information beforehand (more on this later), and prepare a Facilitation Plan (see the 

next page). 

• Make plans for documentation. To better be able to follow up, and identify process issues in a group, it 

always helps if a meeting is documented. Typically, groups assign a secretary to take minutes of a meeting. 

However, traditional minutes usually deal with just content. For best results, consider assigning a process 

observer: someone to document process elements in a group. 

• Prepare Psychologically. Lastly, it’s important that you take the time to prepare internally if you’re going to 

facilitate a meeting. Being a facilitator can be a mentally, sometimes even emotionally, demanding job. You 

want to make sure that you are in a relaxed frame of mind before you facilitate. Deal with personal issues 

that can interfere with the process, and note your biases and assumptions about the group or the subject of 

the meeting. 

Below are samples of meeting guides provided to Hans Kai 4 Tran facilitators each month: 

15


Collecting Data 

The more information a facilitator has about the group she will be facilitating, 

effective he or she can be. 

The following are some tips in collecting data as preparation for facilitating a 

the more 

meeting: 

• Communicate ahead with the person who invited you to facilitate the meeting to 

understand what is expected from the meeting and what is expected 

from you 

as a facilitator. If there are presenters and content experts in the 

meeting, 

it’s also best to meet with them beforehand to ensure that you are both on the same page. 

• Ideally, you should also be able to interview or survey participants ahead of time. This can give you time to 

understand the dynamics of the situation, as well as establish rapport. Ask about the group’s history, their 

view of the meeting subject, and how the group normally accomplishes things. It also helps to know ahead 

if there are reservations about inviting a facilitator. 

• Request documentation about the group’s previous meetings e.g. minutes or progress reports. They will 

give you an idea of where the group is at the moment. 

• If there’s a sensitive issue involved, know as much as you can about the situation – and even the 

personalities involved. For instance, knowing that there’s underlying tension about a specific topic will tell 

you to approach it cautiously. Similarly, knowing who the participants in conflict are can guide you when 

dividing participants into working groups. Note though: always triangulate your information gathering 

method so that you don’t get just one side of the story. 

• Understand the subject matter of the meeting. While facilitators are not content experts, you must know 

enough about the topic to be able to track the discussion. For example, familiarize yourself with the terms 

and language of the group. You lose precious time by having to ask the group to explain terms to you. 

16


Good communication is as stimulating as 

black coffee, and just as hard to sleep after. 

Anne Morrow Lindbergh 

4: Verbal Communication Skills 

Communication skills are needed to be able to provide an excellent presentation. 

Without being able to verbalize your ideas and opinions there is very little chance 

of having a successful presentation. We will begin by looking at listening and 

hearing skills, asking the correct questions and finish with communicating with 

more power. 

Listening and Hearing: They Aren’t the Same Thing 

Hearing is the act of perceiving sound by the ear. Assuming an individual is not 

hearing-impaired, hearing simply happens. Listening, however, is something that one 

consciously chooses to do. Listening requires concentration so that the brain 

processes meaning from words and sentences. Listening leads to learning. 

This is not always an easy task. The normal adult rate of speech is 100-150 words per minute, but the brain can 

think at a rate of 400-500 words per minute, leaving extra time for daydreaming, or anticipating the speaker’s or 

the recipient’s next words. Listening skills, however, can be learned and refined. 

17


Asking Questions 

Three types of questions are useful in a presentation; open questions, clarifying 

questions, and closed questions. 

Open Questions: Open questions stimulate thinking and discussion or responses 

opinions or feelings. They pass control of the conversation to the respondent. Leading 

open questions include: Why, what, or how. A statement such as “describe the 

characteristics of the car” is really an open question. Examples of open questions 

including 

words in 

include: 

• Describe the style of the leader of the meeting. 

• How do you feel when you hit a home run? 

Asking questions is both an art and a science. Your questions in a presentation should be: 

• Clear and concise, covering a single issue 

• Reasonable, based on what participants are expected to know 

• Challenging, to provoke thought 

• Honest and relevant, eliciting logical answers 

Clarifying Questions: A clarifying question helps to remove ambiguity, elicits additional detail, and guides you as 

you answer a question. Below are some examples: 

• You said you liked apples more than oranges, why is that? 

• What sort of savings are you looking to achieve? 

Closed Questions: Closed questions usually require a one-word answer, and shut off discussion. Closed questions 

provide facts, allow the questioner to maintain control of the conversation, and are easy to answer. Typical leading 

words are: Is, can, how many, or does. Below are several examples of closed questions: 

• Who will lead the meeting? 

• Do you know how to open the emergency exit door on this aircraft? 

Phrasing: To evoke an answer, your question should use phrasing that is: 

• Clear and concise, covering a single issue 

• Reasonable, based on what participants are expected to know 

• Challenging, to provoke thought 

• Honest and relevant, directing participants to logical answers. 

Directing Questions appropriately: Should you direct your questions to individuals or to an entire group? When 

you direct a question to an individual, you: 

• Stimulate one participant to think and respond 

• Tap the known resources of an “expert” in the room 

If you choose to direct your question to the group instead, you: 

• Stimulate the thinking of all participants 

• Provide participants the opportunity to respond voluntarily 

• Avoid putting any one person on the spot. 

18


Communicating with Power 

It’s been said that you have between thirty seconds and two minutes to capture your participants’ attention. It’s 

critical to engage people from the beginning. 

Voice: 38% of the message received by a listener is governed by the tone and quality of 

your voice. The pitch, volume, and control of your voice all make a difference in audience 

perception. 

Characteristics Description Tips 

Pitch How high or low your voice is Avoid a high-pitched sound. 

Speak from your stomach, the 

location of your diaphragm. 

Volume 

Quality 

The loudness of your voice 

must be governed by your 

diaphragm 

The color, warmth, and 

meaning given to your voice 

Speak through your diaphragm, 

not your throat 

Add emotion to your voice. 

Smile as much as possible when 

you are speaking 

Command: Selecting a good opener is an important way to take command of an audience. Making judicious use of 

certain types of remarks will endear you to the audience from the moment the program starts. 

• A dramatic story 

• A reference to a current or well-known news story 

• A personal experience 

• A rhetorical question 

• A historical event 

• Adventure, either past or present. 

More Tips 

• Did we say practice? And practice again? 

• Smile 

• Stand up straight and tall 

• Rivet your participants with eye contact 

• Dress like your audience, or one level above it. 

19


The most important thing in 

communication is hearing what isn't said. 

Peter F. Drucker 

5: Non-Verbal Communication Skills 

Understanding your body language and other physical queues is very important 

when you are presenting material in front of an audience. Your non-verbal 

communication skills are just as important as your verbal skills. Combined they 

make up the complete communication package that you use when you are 

presenting your material. 

Body Language 

Non-verbal communication is the process of communication through sending and receiving wordless messages. It is 

the single most powerful form of communication. Nonverbal communication cues you in to 

what is on another person’s mind, even more than voice or words can do. 

One study at UCLA found that up to 93 percent of communication effectiveness is determined 

by nonverbal cues. Another study indicated that the impact of a performance was determined 7 

percent by the words used, 38 percent by voice quality, and 55 percent by non-verbal 

communication. 

Body language is a form of non-verbal communication involving the use of stylized gestures, postures, and 

physiologic signs which act as cues to other people. Humans unconsciously send and receive non-verbal signals 

through body language all the time. 

Your words represent only 7% of the message that is received. Your body language represents 55%. But your body 

language must match the words used. If a conflict arises between your words and your body language, your body 

language governs. 

20


Gestures 

Gestures are an important tool for a presenter. The challenge is make 

gestures support the speaking, reinforcing ideas. Below are several basic rules 

for the use of gestures: 

• Make most gestures above the waist. (Those below the waist suggest 

failure, defeat, and despair.) 

• Hold your forearms parallel to the waist, with your elbows about 3 inches from the side. 

• Make your hands part of your forearm, opening them, with your fingers slightly curved. (Limp hands may 

indicate a lack of leadership.) 

• Use both hands to convey power. 

Gestures of direction, size, shape, description, feeling, and intensity are all effective when speaking. 

The Signals You Send to Others 

Signals are movements used to communicate needs, desires, and feelings to others. They are a form of expressive 

communication. More than 75% of the signals you send to others are non-verbal. People who are excellent 

communicators are sensitive to the power of the emotions and thoughts communicated non-verbally through 

signals. 

Types of Non-Verbal Signals: Other than gestures already discussed, signals include: 

• Eye contact 

• Posture 

• Body movements. 

They all convey important information that isn't put into words. By paying closer attention to other people's 

nonverbal behaviors, you will improve your own ability to communicate nonverbally. Intervals of four to five 

seconds of eye contact are recommended. It is also important to use a tone of voice to reinforce the words in your 

presentation. For example, using an animated tone of voice emphasizes your enthusiasm for a participant’s 

contribution in a debrief session. As a presenter, your words should match your non-verbal behaviors. If they do 

not, people will tend to pay less attention to what you said, and focus instead on your nonverbal signals. 

It’s Not What You Say, It’s How You Say It 

Tone of Voice: We are all born with a particular tone of voice. While most people are not gifted with a radio 

announcer’s voice, we can learn to improve our tone of voice. The idea is have your voice sound upbeat, warm, 

under control, and clear. Here are some tips to help you begin the process. 

• Make sure you are breathing from the diaphragm. 

• Stay hydrated by drinking lots of water and avoid caffeine due to its diuretic effects 

• Stand up tall; posture affects breathing, which affects tone. 

• Smile; it warms up the tone of your voice. 

• If your voice is particularly high or low, exercise the range of your voice by doing a sliding scale. 

• Record your voice and analyze the playback. 

• Practice speaking in a slightly lower octave. Deeper voices have more credibility than higher pitched voices. 

It will take getting used to pitching your voice down an octave, but it will be worth the effort. 

• Get feedback from a colleague or family member about the tone of your voice. 

21


The If I ever new completely leader is a facilitator, lost my nervousness not an order I 

giver. would be frightened half to death. 

6: Overcoming Nervousness 

Nervousness is normal when giving a presentation. After all, public 

speaking is the top fear in the top ten lists of fears. Nervousness can strike 

at different points in a presentation: 

• At the beginning 

Paul John Lynde Naisbitt 

• If you feel the audience has slipped away from you 

• If your memory betrays you. 

This module will provide you with concrete strategies for overcoming 

presentation jitters. 

Preparing Mentally 

Visualization is the formation of mental visual images. It is an excellent way to prepare your 

mind before a presentation. There are several types of visualization: 

• Receptive visualization: Relax, clear your mind, sketch a vague scene, ask a question, 

and wait for a response. You might imagine you are on the beach, hearing and smelling the sea. You might 

ask, “Why can’t I relax?”, and the answer may flow into your consciousness. 

• Programmed Visualization: Create an image, giving it sight, taste, sound, and smell. Imagine a goal you 

want to reach, or a healing you wish to accelerate. Jane used visualization when she took up running, 

feeling the push of running the hills, the sweat, and the press to the finish line. 

• Guided Visualization: Visualize again a scene in detail, but this time leave out important elements. Wait for 

your subconscious to supply missing pieces to your puzzle. Your scene could be something pleasant from 

the past. 

The process for Effective Visualization 

• Loosen your clothing, sit or lie down in a quiet place, and close your eyes softly. 

• Scan your body, seeking tension in specific muscles. Relax those muscles as much as you can. 

• Form mental sense impressions. Involve all your senses; sight, hearing, smell, touch and taste. 

• Use affirmations. Repeat short, positive statements and avoid negatives such as “I am not tense”; rather, 

say “I am letting go of tension.” 

• Use affirmations. Repeat short, positive statements that affirm your ability to relax now. Use present tense 

and positive language. As an example: 

o Tension flows from my body 

o I can relax at will. 

o I am in harmony with life. 

o Peace is within me. 

22


Visualize three times a day. It’s easiest if you visualize in the morning and at night while lying in bed. Soon, you will 

be able to visualize just about anywhere, especially before a presentation. 

Physical Relaxation Techniques 

People who are nervous tend to breathe many short, shallow breaths in their upper chest. 

Breathing exercises can alleviate this. You can do most breathing exercises anywhere. Below are some exercises 

that will assist you in relaxing. 

• Breathing Exercises: Deliberately controlling your breathing can help a person calm down. Ways to do this 

include: breathing through one’s nose and exhaling through one’s mouth, breathing from one’s diagram, 

and breathing rhythmically. 

• Meditation: Meditation is a way of exercising mental discipline. Most meditation techniques involve 

increasing self-awareness, monitoring thoughts, and focusing. Meditation techniques include prayer, the 

repetition of a mantra, and relaxing movement or postures. 

• Progressive Muscle Relaxation (PMR): PMR is a technique of stress management that involves mentally 

inducing your muscles to tense and relax. PMR usually focuses on areas of the body where tension is 

commonly felt, such as the head, shoulders, and chest area. It’s a way to exercise the power of the mind 

over the body. 

• Visualization: Visualization is the use of mental imagery to induce 

relaxation. Some visualization exercise involves picturing a place of serenity 

comfort, such as a beach or a garden. Other visualization exercises involve 

imagining the release of anger in a metaphorical form. An example of this 

kind of visualization is imagining one’s anger as a ball to be released to 

and 

latter 

space. 

Appearing Confident in Front of the Crowd 

In addition to everything we’ve discussed, below are some tips for maintaining your confidence when you’re “on”. 

• Get a good night’s sleep 

• Practice your words along with your visuals 

• Have a full “dress rehearsal” 

• If you are traveling to a new site out of town, try to arrive early in the evening and locate the site. That way 

you won’t be frazzled in the morning, trying to locate the venue. 

23


7: Hacking Hans Kai 

It takes three weeks to prepare a good 

impromptu speech. 

Mark Twain 

We will look at the beginning steps to follow when creating a plan to improve your 

Presentation Skills. The first thing to look at is to perform a Needs Analysis. This will 

help you to understand your audience and provide you with the answers to a few 

basic questions. A basic outline and some minor research would then be utilized to 

help create the basic program that will assist you in developing greater 

Presentation Skills. 

Performing a Needs Analysis 

A needs analysis measures what skills employees have -- and what they need. It indicates how to deliver the right 

training at the right time. The results answer the following questions: 

1. What is the audience with the problem or need for change? 

2. What tasks and subtasks does an expert perform to complete a work process? 

3. What gaps exist between experts, average, and poor performers of a work process? 

4. How do we translate the needs into objectives to promote a strong learning outcome? 

The method can be simple; observation, careful note taking, and asking questions work. 

Question 

Methods 

Audience? 

Interview key stakeholders and listen to their concerns about the problem. 

Define who needs help to overcome the problem. 

Identify and describe the audience and the work. 

Tasks? 

Observe the work being done by recognized experts. 

Take careful notes and ask questions where needed. 

Document the proper performance of the work tasks. 

Gaps? 

Observe other workers doing the tasks. 

Compare results with the performance of experts. Document identified skill 

gaps. 

Outcome? 

Develop a complete list of tasks for performing the work completely and 

correctly. 

24


Writing the Basic Outline 

To develop the outline, group the tasks that fit together logically, and create 

that reflect the goal of the subtasks. 

headings 

• Handling a Call 

o 

o 

o 

o 

o 

Answer call 

Listen to customer’s problem 

Express empathy for the trouble 

Open a new support ticket 

Resolve the complaint per the list of allowable resolutions 

• Documenting Call Resolution 

o Document the resolution in the call notes 

o Close support ticket 

Add headings for an introduction and workshop objectives at the beginning -- and a wrap-up and evaluation at the 

end, and your basic outline is complete. 

Researching, Writing, and Editing 

Researching: The needs analysis has likely produced much of the supporting content required to build the program. 

However, if information gaps exist, return to your expert performers (also termed subject matter experts) and ask 

questions. 

Writing: If you’re using a word processor, create a template so your material is consistent from the beginning. 

Assign a preliminary time length to each module based on the total time available for the presentation. (You’ll 

validate it later.) When writing, aim for brevity. The more you say, the less the audience remembers. 

Make sure to validate your finalized content before you move on to editing. 

Editing: As you edit, write for the ear, not for the eyes. Make sure sentences are 

words or less and only convey one thought. Use simple, familiar words. Make sure 

have provided the definitions of any terms important to the learning experience. Try 

up your module titles. 

twenty 

that you 

to spice 

25


I never teach my pupils; I only attempt to 

provide the conditions in which they can 

learn. 

Albert Einstein 

8: Choosing Your Delivery Methods 

Now it's time to determine what methods you will use to deliver your 

presentation. We will be beginning by covering basic delivery methods. 

Once we have a good foundation and grasp on the basic methods we 

will delve into more advanced methods. 

Basic Methods 

Lecture: If you must lecture occasionally, use strategies to make the delivery more interactive. 

Discussion: A discussion facilitated by the presenter can be rich in interactivity. 

Small Group learning experiences: A small group experience provides direction toward 

specific learning goals, and provides a high degree of participant involvement. 

• Dyads (Groups of 2). Using pairs provides unlimited options for simple interactive 

experiences. You can say, “Turn to the person on your right and…” Using dyads 

manages the attention span, the extent of influence, and the focus of the goal. The 

learning experience is relatively intimate. 

• Triads (Groups of 3). Trios expand the focus and experience opportunities. A measure of intimacy is still 

retained, but multiple viewpoints can be contributed. Triads are useful for producing definitions, 

establishing priorities, or providing an ongoing support system. 

Case Study: The case study method is the presentation of detailed information about a particular situation, often 

problem solving. Case studies can be very creative exercises, and they are well-suited for small groups. Here are six 

guidelines for developing a case study: 

1. Determine the principle you wish to have the case emphasize 

2. Establish a situation that demonstrates the principle 

3. Develop appropriate symptoms 

4. Develop the characters 

5. Write the case 

6. Provide questions to guide the learners as they process the case study to solve a problem. 

26


Advanced Methods 

After you feel comfortable with basic delivery methods, you can begin to explore some of the more challenging 

ways to present and facilitate learning experiences. 

Role play: Role playing allows participants to act out a behavioral role. This exercise -- done with small groups or 

the large group -- allows members to expand their awareness of varying points of view, and provides an 

experiential learning opportunity. A role play can be used in several ways; to solve a participant problem, clarify or 

sharpen an issue, or demonstrate a skill approach to a task. Importantly, it gives people an opportunity to practice a 

skill or approach in a safe environment and use the experience later on the job. 

Here are several tips for managing a role play exercises: 

• Obtain volunteers, rather than making assignments 

• Use role play later in the training session, when participants know each other better 

• Select low-threat situations, such as a work group holding a staff meeting. 

27


Problem solving: Problem solving experiences are increasingly popular in training presentations because they allow 

participants to gain “real world” experience that often provides direct transfer back to the job. 

There are three phases to a problem solving exercise: 

1. Defining the problem and generating data about it 

2. Generating potential solutions 

3. Selecting an implementing a solution. 

Below are several of the many proven methods that are available to help participants with each phase. 

Phase Method Description 

Defining the problem and 

generating data about it 

Generating potential 

solutions 

Selecting and 

implementing a solution 

Pareto Analysis 

Force Field Analysis 

Brainstorming 

The Delphi Technique 

Ranking 

The Journalist’s Six 

Questions 

Vilfredo Pareto, a mathematician and 

economist coined the “80/20” rule. A Pareto 

Analysis allows you to group and analyze data 

for a problem such as defects in a model of 

kitchen faucet. 

Kurt Lewin defined driving forces and 

restraining forces that influence the solution to 

a problem. 

Brainstorming allows a group to generate a 

large volume of ideas about a problem, or 

potential solutions. Later, the results must be 

condensed to a workable number of ideas, 

typically through grouping, and then voted on. 

Originally used by the RAND corporation, the 

Delphi technique allows the anonymous 

generating of ideas which are then filtered. 

Participants rank options on a given scale, with 

or without criteria. 

Use “who, what, when, where, why and how” 

questions to generate data. 

28


Basic Criteria to Consider 

A training presentation may use any combination of delivery methods as long as the 

result is to achieve learning outcomes -- and consider organizational requirements 

constraints. The four-step process below will help you select the best training 

options to meet your training needs. 

net 

and 

delivery 

1. List all possible learning methodologies that could be used to achieve the session 

objectives 

2. Identify possible delivery options for the learning methodologies 

3. Identify the organizational, presenter, facility, and resource parameters and their impact on the delivery 

options. 

4. Recommend your delivery strategies. 

At a bank, the outcome of the process might look like this: 

Objective Delivery Strategy Expansion/Notes 

List the five key customer 

support principles at the bank 

Demonstrate a performance 

problem with a customer 

support team in a bank 

Generate ideas for improving 

customer support service 

Lecture only the principles, using 

the flip chart or PowerPoint for 

emphasis, and then add 

interactivity 

Role play 

Brainstorming 

Find a lead-off story 

Develop a group problem-solving 

exercise to provide follow-up 

practice 

Use triads 

Find extra space 

Procure additional flip charts for 

groups 

29


Section Three 

Tips and Tools 

30


It's a visual world and people respond to 

visuals. 

Joe Sacco 

1: Creating Fantastic Flip Charts 

Information written on flip charts enhances the learning process. 

During a presentation, the use of flip charts serves to inform 

participants, record information, and focus attention on a topic. They 

represent a simple, low-cost learning aid -- with no requirements for power or technology, and no worries about 

burned-out bulbs or darkened rooms. Flip charts add versatility to a presentation, and allow the presenter to use 

creativity to enhance the learning process. 

Required Tools 

At a minimum, you will need a flip chart easel, several pads of flip chart paper, a few sets of 

colored markers, and masking tape for posting the results of exercises. Also handy are 

several packages of sticky notes to flag specific pages, and a straight edge. You may want to plan to cover up 

information that you will reveal at a given time during the presentation and then have some pre-cut paper 

available, sized appropriately for the text. 

If you are bringing pre-written charts to an off-site presentation, you will also need some type of container to 

protect the pages. 

The Advantages of Pre-Writing 

There are many good reasons to pre-write your flip chart content. 

• Confidence: You are in control of the material for your presentation – design, 

organization, and appearance. This also helps reduce nervousness. 

• Appearance: Your material has a specific “look and feel” that is not necessarily easy to achieve when 

prepared during a session. 

• Time: With your charts ready ahead of the presentation, the time during a presentation is used for learning 

activities, not writing, which keeps your back to the participants. 

Tips: 

• Always print; never use handwriting 

• Consider using a straight edge to stem tendency to write “downhill” 

• If you are using charts in a sequence, number them. 

31


Using Colors Appropriately 

Good use of color can make the difference in the dynamics of a presentation -- and participants’ acceptance of the 

content. Conversely, the effect of a great chart can suffer from the poor use of color. According to the Optical 

Society of America, blue, black, and green offer the greatest visibility, and blue is the most pleasing color. Avoid 

purple, brown, pink, and yellow for any type of general printing. 

The use of two or three color combinations can be very effective. Here are several rules. 

• Red and orange should only be used as accent colors for bullets, underlines, or arrows, 

or for key words when everything else is in black or blue 

• Avoid orange and blue together 

• Never use yellow. 

When creating your charts, take some time to think about the colors you are using, and how they can enhance the 

understanding of your topic. 

Creating a Plan B 

Paper is not permanent, even if you are presenting at your own location. And if you’re flying with your materials or 

shipping them, packages do occasionally get lost or damaged. You will need a backup plan in case 

something happens. Below are some tasks for creating your Plan B. 

• Keep documents on your computer organized by course, reflecting the content and order 

sequence of each flip chart. 

• Make paper handouts of the most critical information on the charts. 

• Take pictures of the chart pages, and have the camera or images with you on site. 

• If you have time to re-create some of your charts, enlist a volunteer to help you reconstruct the most 

critical ones. 

• If you will be returning to the site, consider leaving a set of your charts with a trusted colleague until you 

return. 

• As time permits, duplicate your charts in PowerPoint. Although you will probably continue to use flip charts, 

having them available in PowerPoint becomes a backup. 

32


Ask yourself, ''If I had only sixty seconds on 

the stage, what would I absolutely have to 

say to get my message across?" 

2: Creating Compelling PowerPoint 

Presentations 

Microsoft PowerPoint is a commanding tool for creating visual screens for a 

presentation. Visuals created in PowerPoint and projected on a screen are 

often easier to see in a large room than information displayed on a flip chart. 

Using PowerPoint offers the following benefits: 

• Allows you to add emphasis to important concepts, helping to increase 

retention of information 

• Adds variety to your presentation 

Jeff Dewar 

• Makes it easier to display images, charts, or graphs possibly too complex for a flip chart. 

Also, PowerPoint files can easily be shared with participants or others after the session. 


To create and use a Microsoft PowerPoint file to support your presentation outline, you will 

need: 

• Microsoft Office PowerPoint software for Microsoft Windows or Macintosh OS 

• A Windows or a MAC computer equipped with the minimum hardware and software 

specifications for your version of PowerPoint 

• An LCD or DLP projector 

• A projection screen 

Optionally, you may wish to add the following to your toolkit: 

• Storage media such as a USB memory stick or CD-R disc 

• An extension cord 

• A laser pointer for emphasis during the discussion of a PowerPoint slide. 

Tips and Tricks 

Use the following suggestions to enhance the benefit of your PowerPoint presentation. 

Overall Appearance 

• Display only one major concept on each slide 

33


• Use short phrases or bullet points rather than paragraphs 

• Limit each line of text to no more than 7-8 words 

• Allow only 7-8 lines of text per slide 

• Use images sparingly; one or two per slide 

• Leave a good amount of blank space in your presentation 

• Create a title for each slide 

• Use effects, transitions animation, and sound very sparingly. 

Fonts and Color 

• Use simple sans serif fonts such as Helvetica or Arial for readability 

• Select a point size of 32 or larger for titles, and 20 points for body text 

• Use colors that work well together, such as yellow or white on a dark blue background. 

• Check the readability and visibility of your fonts and color choices with the lighting in the room in which you 

will present. 

Preparation 

• Make sure to match your slides to the purpose of the presentation 

• Develop a template and stick to it for a consistent look and feel 

Computer 

• Check your equipment, computer settings, and room lighting in advance 

• Before your presentation, turn off screensavers, instant messaging, and email notifications 

• Make sure that your computer’s power management console will not automatically shut the system down 

after a set amount of time. 


While technology allows you to make great enhancements to a presentation, it also offers more opportunities for 

technical trouble. Here are some suggestions to keep your presentation moving along, even if the technology isn’t. 

• Make one or more backup copies of your PowerPoint file on the computer on which you plan to show the 

presentation. 

• Before the presentation, download and install the free Microsoft PowerPoint Viewer available at 

www.microsoft.com. In the event that your PowerPoint software won’t run, you will still be able to use the 

viewer to show your PowerPoint slides. 

• Copy your PowerPoint file onto a USB Drive. That way, if you have a computer problem, you can move the 

file to another one, if available. 

• Bring sufficient printed copies of your presentation for participants. If logistics prevent that, plan to have at 

least one copy available for photocopying on site. 

• If all else fails, write your key points on a flip chart. 

34


Technology makes it possible for people to 

gain control over everything, except over 

technology. 

John Tudor 

3: Wow ‘Em with the Whiteboard 

A whiteboard is the name for any glossy-surfaced writing board 

where non-permanent markings can be made. Unlike the 

predecessor chalkboard, there is no chalk dust, and markings remain longer than they would on a chalkboard. 

Whiteboards have been around since the 1970’s, and are now vastly improved and more affordable compared to 

early models. The use of a whiteboard helps to promote interactivity during a presentation. 

Traditional and Electronic Whiteboards 

Traditional Whiteboards: Traditional whiteboards are attached to the wall, or are available in 

free-standing frames. Unlike pre-written flip chart paper sheets, whiteboards cannot easily be 

moved from site to site. However, they are usually larger, and are useful for recording the results of small group 

exercises or spontaneous information arising in a discussion. Traditional whiteboards cost less than $100, or up to 

$1,000. A traditional whiteboard requires a set of wet or dry erase whiteboard markers, a whiteboard eraser, and 

whiteboard cleaning solution. 

Electronic Whiteboards: An electronic whiteboard looks like a traditional whiteboard, but is a unique combination 

of hardware and software. The surface is connected to a computer and a projector. A projector beams the 

computer's desktop onto the board's surface, where users control the computer using a pen, finger, or other 

device. Uses include: 

• Operating any software that is loaded onto the connected PC, including web browsers and proprietary 

software 

• Using software to electronically capture text or marks written on the whiteboard 

• Translating cursive writing to text 

• Controlling the PC. 

Because the markings on the whiteboard are digitized, the resulting electronic information can be stored, printed, 

or shared in real time with participants in other locations. Electronic whiteboards cost more than $1,000. 

35


Using Colors Appropriately 

Colors on a whiteboard are often more vivid than those on a flip chart. Otherwise, most of the same rules apply: 

• Blue, black, and green offer the greatest visibility, with blue the most pleasing color. 

• Avoid purple, brown, pink, and yellow for any type of general printing. 

• The use of two or three color combinations can be very effective; however orange should only be used with 

red as an accent color. Never use yellow, and avoid orange and blue together. 


Traditional Whiteboards: When using a traditional whiteboard, have extra markers on hand, because they tend to 

dry up easily. 

If your presentation is longer than one day, plan to make a backup of your work from the computer to a USB flash 

drive in the event that they are erased overnight. 

Electronic Whiteboards: If you are working with an electronic whiteboard and encounter technical issues, you can 

show a previously created PowerPoint presentation through a projector. Plan to carry at least one copy of the 

PowerPoint handouts for duplication if needed. You can always quickly jot down key 

points 

on a flip chart. 

Regardless of which type of whiteboard is used, key content should be available in a 

master or on flip chart pages as a backup. 

handout 

36


4: Vibrant Videos and Amazing Audio 

Audio and video are very much a part of our everyday lives, so they are accepted 

--and even expected media in a presentation. They are attractive options for a 

presentation because they provide learners with more dimensions by which to 

receive information. While video and audio both represent a one-way 

communication to participants, the opportunity to use them as part of learning 

exercises or in the ensuing discussions adds value to the presentation. 

Video 

There are three main ways to obtain video material: 

• Creating your own media using a small personal video camera 

• Purchasing off-the-shelf video designed for training presentations 

• Hiring a professional video production company. 

Your media budget, the amount of available preparation time, your comfort and skill level with video, and the type 

of presentation will all influence the direction. 

Audio 

A good video can make all the difference. 

Brian May 

Audio can be used as a standalone option, as part of the video, or even created by the participants, such as an 

exercise to write and sign a song. 


For video with audio you will need some type of player, depending upon the media type: 

• A DVD-ROM or Blu-ray player if you are using a video disc 

• A laptop or PC with software to play digital video 

You will also need a projector and a projection screen. Speakers are optional, but 

recommended for more than the smallest room and group. 

Although today's cameras are light-sensitive, you may also need some simple lighting, such as a 

handyman light from a hardware store. If you want more than the onboard audio built into the camera, get a 

simple lavaliere or handheld microphone. 

Finally, especially if budget is an issue, consider using one or more personal video devices -- such as iPods with 

iTunes software. You'll also need a handful of inexpensive ear buds. You can pass the iPods around the room at 

certain times, or have participants up to view and listen to the material. While perhaps less formal than the others, 

this solution, is much more portable if your presentation is delivering off-site. 

37


Tips and Tricks 

Purchased Off-The-Shelf Video 

• Check reviews of the media online 

• Shop around for the best prices 

• Preview the work before you purchase 

• Test the video in conjunction with the exercise with a colleague before the presentation. 

Personally created video 

• Plan by creating a simple outline that matches your presentation content 

• Create a storyboard using PowerPoint, a word processor, or paper before you record 

• Check your equipment thoroughly 

• Do a practice run before your final recording. 

• Transfer the recording immediately to a computer for backup. 

Professionally produced video from a production company 

• Create an outline. (The storyboard may be provided by the production company.) 

• Carefully create a request for proposal, and interview several companies 

• Preview finished samples of each company's work 

• Ask for a client list, and check with several of them 

• Plan to dedicate an in-house resource person to work with the production company 

• Manage costs through a preproduction meeting, trimming, if necessary, where it makes sense 

• Maintain frequent two-way communication during the project 

• If all proposals come in nearly equal, trust your instincts based on the relationships you have formed with 

the prospective companies 


Regardless of the method you use for your audio and video, it is essential to have a backup plan in the event that 

something goes awry with the technology. 

• Have one or two backup copies of your media, perhaps on a USB flash drive and a DVD 

• Test everything before the presentation 

• For higher-end productions, have a technician on standby if possible 

• Record and back up the audio track separately; if the video fails you will still have the audio 

• Create a handout with the key concepts contained in your video 

• Capture screen shots directly from the video (if permissible by copyright) and add them to a PowerPoint file 

• If sequence isn't an issue, and you have access to a technician later, adjust your agenda to utilize the video 

later in the program. 

If, for any reason, none of the above is feasible, consider substituting a role play between you and the selected 

participants. Above all, today's participants understand the “gotchas” when technology is involved, and will 

probably be empathetic as you carry on your presentation as if it was no big deal. 

38


A sense of humor is a major defense 

against minor troubles. 

Mignon McLaughlin 

5: Pumping it Up a Notch 

Bringing it to the next level is something you can accomplish after 

feeling comfortable with all of the previous topics discussed. You can 

add the little touches that will produce a lot of value during your 

presentation. 

Make Them Laugh a Little 

Humor is a popular way to liven up a presentation. It makes the audience align with you, and 

sends a signal that you are in charge. Handled properly, humor enriches a presentation. 

When considering humor, make sure that whatever content you choose meets four criteria: 

• You think the joke or lines are funny 

• You can repeat the piece confidently and comfortably 

• Your choice is not offensive to anyone (gender, race, age, disability, politics) 

• Your audience will understand and appreciate what you are saying. 

• A joke should have a punch line, delivered with all you’ve got. 

Here are some tips for collecting and using humor: 

• Jot down jokes as you hear them in everyday life; classify them as your collection grows 

• Deliver any humor verbally only, and keep things light 

• Match your humor to the demographics of the audience 

• Research and consider using local humor if you’re working off-site 

• Don’t be afraid to poke fun at yourself. 

If a joke or delivering humor with words isn't within your comfort level, consider sharing a lighthearted cartoon, 

doing a simple magic trick, or doing something else that is unexpected and evokes a reaction and some emotion 

from the participants. 

39


Ask Them a Question 

Questions can be used in many ways, and at just about any time during your 

presentation. 

• As an opener 

• To check whether the desired learning is occurring, or to extend the learning 

experience 

• To diffuse a difficult or uncomfortable situation 

• To fill a long pause 

• To get a feel about the mood in the room. 

As we learned in module four, Verbal Communication Skills, you can use open, clarifying, or closed, questions, 

depending upon your needs. 

Encouraging Discussion 

Much of the discussion during your presentation will be structured to fit with the learning 

exercises. If a remark or question is made during a discussion that is off topic or something that 

should not be dealt with at the time, you can always add it to the parking lot, and return to it 

during the wrap-up to bring closure. 

As an adjunct, the exercise below provides participants with a different method for fielding a discussion in 

conjunction with a learning topic. 

Dealing with Questions 

Q&A Sessions: If time permits in your presentation, you may choose to hold a general question-and-answer 

session. Since as the presenter you are in control, you can decide when to stop the discussion. In a large 

room, be prepared to repeat each question. If no questions arise, be prepared to ask one yourself. 

You can use an open question to begin the session: “What questions do you have?” 

Restating Negative Questions: If a question is phrased negatively, restate it. For example, "Why have so many of 

his staff displayed chronic absenteeism?" can be restated as "Let's explore what we can do to reduce absenteeism 

in the team." 

Off-topic: Don't forget about the parking lot if you receive an off-topic question. 

Leveraging experience in the room: There may be situations when you wish to redirect a question to one of the 

participants. Again, you are in charge, so call upon someone and keep the discussion moving on afterward. 

The following exercise is a fun, light way to prompt a group to ask questions to tackle a project or a problem. 

40


41


Section Four 

Working with a group 

42


Every company has two organizational 

structures: the formal one is written on the 

charts; the other is the everyday 

relationship of the men and women in the 

organization. 

Harold H. Geneen 

1: Group Development Dynamics 

Groups are not stagnant entities; they change. Initial uncertainty and 

ambiguity give way to stable patterns of interaction, while relationship 

between members wax and wane. To be an effective facilitator, you must be 

sensitive to the changes happening within groups. 

stage of development they are in. 

In this module, we will discuss one of the most widely-used theories of group 

development: Tuckman and Jensen’s Model of Team Development. We will 

also discuss how a facilitator can best respond to groups depending on what 

Stage One: Forming 

The initial stage of group development is the forming stage. It is commonly referred to as the 

orientation stage or the “getting-to-know-you” stage, as group members still don’t know much 

about each other or about the organization. If the organization itself is new, then there might not 

be any existing structure or rules in the group yet. 

During the forming stage, members tend to feel tensions and uncertainties. After all, group 

members are dealing with people they hardly know, and this initial unfamiliarity may leave them feeling 

uncomfortable and constrained. Often, members are on guard, carefully monitoring their behavior to make certain 

they avoid any embarrassing lapses of social poise. 

Without the benefit of a long and solid relationship with the group, involvement and commitment to the 

organization may be low. There may also be extreme dependence on leaders, dominant personalities and other 

group members. 

The forming stage is characterized by many tentative and testing behaviors: explorations of the boundaries of both 

rules and tasks. During the forming stage, it is important for the facilitator to: 

• Establish rapport among group members 

• Encourage members to be comfortable with one another 

• Make everyone feel accepted in the group 

• Establish rules and guidelines for both task and relational behavior 

• Encourage the group to be comfortable with the organization 

43


Stage Two: Storming 

A natural offshoot of uncertainty and ambiguity is the need to clarify expectations, establish 

patterns, and put a structure into place. Clarity, patterns, and structure are what make a group 

stable. However with many different personalities and perspectives to reconcile, these things 

don’t always evolve smoothly. The natural formation of sub-relationships within the group can 

also add to the pressure. Enter the second stage of group development: the storming stage. 

The storming stage of group development is characterized by conflict, whether overt fighting or subtle tensions. 

This happens when at least two people disagree on a way of doing things or a way of relating. Conflicts in groups 

also occur when particular members assert control or dominance in some form, and other members resist. 

Coalition-building and fractionalization of the group can happen as members take sides on an issue. 

The emotional atmosphere in groups during the storming stage can be characterized by tension, anger, frustration, 

and discounting of other people’s responses. 

A facilitator guiding a team in the storming stage should remember that conflict is normal, even necessary element, 

in group development. Conflicts are signs that there are processes that need streamlining, or issues that require a 

definite response. When conflicts surface within groups, facilitators can help the group see an opportunity to set a 

structure (which is the next stage.) During the storming stage, it is important for the facilitator to: 

• Defuse tensions 

• Promote positive communication in the group 

• Identify problems areas 

• Facilitate conflict resolution processes 

Stage Three: Norming 

The third stage of group development is the norming stage. 

If the conflict areas during the storming stage are addressed properly, the result should be the 

establishment of norms. 

Norms are rules or standards of behavior within a group. They can be explicit (such as a company 

policy) or implicit (unspoken expectations). Norms help groups to meet their goals. At the very least, norms help 

the group maintain some degree of stability so that tasks can be done. 

During the norming stage, group members develop greater cohesiveness and possibly intimacy. There is greater 

security in opening up to others and suggesting new ways of doing things. The norming stage is a period of clarity in 

terms of the group’s identity, dynamics, and direction. 

If you’re a facilitator handling a group in the norming stage, it helps to: 

• Practice skills in identifying possible solutions 

• Define roles and expectations 

• Manage change 

• Help the group to reach a consensus 

Evaluating new systems and protocols and making revisions if necessary are also part of the norming stage. 

44


Stage Four: Performing 

When groups are able to successfully implement a new rule or system, they can begin a period of optimum 

productivity. With stability in place, there is room for creativity, initiative, stability, open relationships, pride, 

learning and high morale. Group energy is no longer taken up by set-up matters, and can be 

channeled fully to the work. The group goes into the height of task success: the performing stage. 

The relationships among group members also become more relaxed and involved. Because the 

task details are already clearly defined, and there is no need for vicious power struggles, there is 

more room for closeness and deeper relationships among members. 

To get to the performing stage is the goal of all organizations. As a facilitator, your task is to guide the group 

towards this stage. One important thing to remember though is that optimal productivity often occurs later in a 

group’s life, and a period of storming and norming are pre-requisites to it. 

At this stage, the role of the facilitator is to help maintain the group in the performing stage. Tasks include 

providing support and motivation in each task, and reinforcing best practices. 

What happens if the group gets new members or encounters new tasks? What if a new issue comes about 

threatening peak performance? In these cases, the group can go back to earlier stages. For example, if new groups 

members make pre-existing rules obsolete, or a new conflict area is spotted, then the group returns to the storming 

stage to hash out a new system. It is said that in the life course of a group, it will return to the storming stage 

regularly. See figure in the next page. 

An effective facilitator can point out that that re-accomplishing developmental tasks characteristic of earlier stages 

(e.g. establishing rapport) may be needed to adapt to new changes. 

An Illustration of Tuckman and Jensen’s Stages of Team Development: 

Forming 

Performing 

Storming 

Norming 

45


A genuine leader is not a searcher for 

consensus but a molder of consensus. 

2: Group Thinking 

Martin Luther King, Jr. 

The aim of facilitated discussions is to create participatory groups: one 

where the goal is cooperative rather than competitive decision-making. All 

members should have equal input in the process, and equal opportunity to 

voice opposition to an idea or conclusion. In this module, we will discuss 

the key facilitation skills needed to build consensus: encouraging 

participation, gathering information, presenting information, synthesizing 

and summarizing. 

Encouraging Participation 

Consensus is more likely to happen if members feel encouraged to contribute. The following are some of the ways a 

facilitator can encourage participation in small groups: 

• Provide preparation guidelines in the meeting agenda. Participants are more 

likely to contribute, if they feel confident that they have something to add to the 

discussion. It’s helpful then to send out a meeting invitation with guidelines what to 

review and study in preparation for the meeting. It is also better if you can also send out 

guide questions ahead of time. 

• Before starting a group meeting, check on everyone’s comfort level. Some people are at ease being in 

meetings; others have difficulty. There are also situational factors, such as an uncomfortable seat or a 

poorly ventilated room, which can hamper group participation. Inquiring if group members are comfortable 

before starting a meeting can help a facilitator establish rapport with the group, and address hindrances to 

group participation. 

• State at the start of the meeting that members’ participation is not just welcome, but is integral to the 

process. Sometimes, all it takes is for the facilitator to explicitly say that members are allowed and 

encouraged to participate for the discussion to be a lively one. These guidelines can be made part of the 

orientation process. 

• Acknowledge responses. Show that you have heard and understood a contribution. You can do this in nonverbal 

and verbal ways. Non-verbal ways include eye contact, nodding, and leaning forward towards the 

speaker. Verbal ways include praising (“I’m glad you brought that up.”, “That’s a good point.”), clarifying (If I 

may reiterate what you just said, you suggested that, is this correct?), and requesting for more information 

(“Tell us more.”, “Please go on.”). 

46


• Avoid discounting responses. Similar, make sure that you’re careful not to give a response that might be 

interpreted as devaluing a contribution, or even ignoring it. Examples of discounting responses are “That 

was said already.” , “That’s irrelevant.” , “That’s it? Is there anything else?” 

• Solicit group members’ responses. You can encourage participation by directly 

asking everyone their opinion on a subject matter. Example: “Can I get everyone’s 

opinion about this proposal?” or “Let’s share all our ideas. We won’t react until 

we’ve heard them all.” 

• Build on responses. A good way to encourage participation is to integrate each member’s response with 

that of other members or with the whole group. Similarities and differences are surfaced, and the way each 

point relates to another is verbalized. This way, the discussion is moving and the individual contributions 

are seen as relevant to the whole. 

Ways to do this include: 

o 

o 

o 

Universalizing – Helping the group see that their concerns are shared. Example: “Who else has felt 

this way?” 

Linking – Making verbal connections to what individual members say and feel. Example: “Bill thinks 

that there should be another meeting to prepare for the conference. This seems to be similar to 

what April was saying a while ago.” Or “Michael believes that the group should outsource all 

customer communication. Jonathan, on the other hand, feels that an in-house customer care staff 

will serve the company better. It seems we have two different but equally valid approaches to this 

problem.” 

Redirecting – To promote the involvement of all in the discussion. Example: “What do you think 

about that?” or “What do you think about Mark’s idea?” 

• Intentionally keep silent. Intentional silence can also be a way to encourage participation, especially if a 

group is eager to contribute and needs no prompting. 

• Thanking the Group. Lastly, affirming the group for their participation, and each member for their 

contribution, can encourage greater involvement in the succeeding meetings. 

Gathering Information 

The following are some of the ways a facilitator can gather information during a discussion. 

• Go-round. In this technique, each member of the group gets a turn to speak without getting interrupted. 

Sometimes, the amount of time each member is allowed to speak is limited to encourage fairness. In gorounds, 

each member gets to speak. Note that this method may not be applicable if you have many 

participants. 

• Break Out Groups. In this technique, the facilitator divides the participants into smaller groups (anywhere 

from dyads up, depending on the size of the group and the subject to be discussed) and then later allots 

time for a representative from each group to share their point of view. This method is applicable when 

there are too many participants to do an efficient go round, or some discussion is necessary, but that 

discussion is more effective in smaller teams. 

47


• BRAINSTORMING. Brainstorming is a method of gathering information that involves getting as many ideas 

from the group in limited time. During brainstorming, participants can verbalize any idea they have, good or 

bad, and a documenter logs it in a flip chart. Only when all the ideas have been exhausted, or there are 

already enough ideas for consideration, does the group check out each idea one by one. For best results the 

time for brainstorming is limited. 

• FISHBOWL Method. This method is best when an intense discussion of a subject is needed, but the group is 

too large for the time allotted. In the fishbowl method, a sample of the group discusses the topic, while the 

rest function as observers. Ideally, the discussion sample should represent the diversity in the group. 

Presenting Information 

In order for a discussion group to reach a consensus, it is important that they are well-informed of the facts of the 

issue, as well as the positions of the different parties concerned. In this sense, an effective facilitator is one that can 

guide group members in presenting important information to the plenary. 

The following are some tips in presenting information in groups. 

• Separate presentation from discussion time. Assign a time particularly for presentation of information. 

Going back and forth between discussion and presentation can disrupt group process and may 

even make for ineffective decision-making. For best results, place the presentation time on the 

agenda, and assign presenters before the meeting proper. 

• If there are more than one side to an issue, or more than one option in consideration, 

make sure you assign equal time for each. Process can be helped if each party feels that they are being 

treated fairly. Being given equal time as another party can facilitate this. And even if there are no conflicting 

parties in the group, giving each subject or each proposal the same time as the others can ensure that 

decisions that would be made at the end of the meeting are not biased in any way. 

• Use a multi-media guide if possible. When presenting information, it helps to know that information can 

be presented in visual (the use of colorful presentations, hand-outs, demonstrations, flipcharts, videos, 

etc.), auditory (descriptive narratives and reports) and bodily/kinesthetic (activities to learn key points) 

ways. Use the method that fits the learning style of the group and the subject of 

the presentation. 

Note that the use of projected visual aids may require a darkened room, making 

the meeting less conducive for group interaction. 

Synthesizing and Summarizing 

A synthesis is an integration of key points or key process movements in the discussion. 

An example of synthesizing is listing issues that have been resolved and issues that are still up for discussion. A 

summary, on the other hand is a short recap of what has been discussed or what has happened. Syntheses and 

summaries are not just conducted at the end of each meeting, but also during the discussion proper. 

Synthesizing and summarizing key discussion points is facilitative during a meeting. There are many reasons for this. 

First, synthesis and summaries show that the discussion is on track and following the agenda. It can also clear 

confusing discussions, and help members see where the group is at any moment. These processes also give the 

group a sense of accomplishment --- the synthesis and the summary is usually an indication of movement in the 

discussion. 

The following are some ways a facilitator can synthesize or summarize during a group discussion: 

48


• Let the group summarize or synthesize for themselves. Example: Ask group members “What have we 

discussed so far?”, “What did you learn from this discussion?” or “What have we decided about this 

situation?” 

• Ask a group member/ group members to provide a synthesis or summary. 

• Offer your tentative synthesis/ summary and seek for the group’s clarification. For example: “This is what 

we have discussed so far….Did I miss anything out?” 

• Refer to the agenda or published documentation in a flip chart paper. “So far, we have discussed Topic A 

and B. These are our resolutions…” 

49


Identifying the Options 

The following are some ways groups can identify options during decision-making. Some of these ways are also the 

ways of gathering information discussed earlier. 

• Brainstorm. Brainstorming is the process of coming up with as many ideas as you can in the shortest time 

possible. It makes use of diversity of personalities in a group, so that one can come up with the widest 

range of fresh ideas. Quantity of ideas is more important than 

quality of ideas in the initial stage of brainstorming; you can 

filter out the bad ones later on with an in-depth review of their 

pros and cons. 

• Facilitated SWOT Analysis. Some teams create each 

option as a group, and they do so by conducting a facilitated 

analysis of the organization’s strengths, weaknesses, 

opportunities and threats, as they relate to the problem. 

Parallel Thinking. Six Thinking Hats is a system designed by 

Edward de Bono which describes a tool for group discussion and 

individual thinking involving six colored hats. "Six Thinking Hats" 

and the associated idea parallel thinking provide a means for 

groups to plan thinking processes in a detailed and cohesive 

way, and in doing so to think together more effectively. 

The most import thing about these 

processes is that they are conducted in a 

consultative fashion. 

50


Choose always the way that seems the best, 

however rough it may be. Custom will soon 

render it easy and agreeable. 

3: Group Decisions 

Pythagoras 

The steps outlined in the previous module are just ways to set the stage towards 

consensus-building. When it comes to the actual decision point, it helps that a 

facilitator knows ways to guide a group towards optimal decision-making. In this 

module, we will discuss ways to identify options, create a short list, and choose a 

shortlist. We will also use a way of deciding not often considered by many, called 

the multi-option technique. 

Creating a Short List 

There are many criteria a facilitator use to help a group create a shortlist. The following are just some of these 

ways: 

• Costs and benefits. An ideal solution is one that has the least costs and most benefits. 

• Disagreeing parties’ interests. An ideal solution has factored in the impact on all parties concerned and has 

made adjustments accordingly. 

• Foresight. An ideal solution doesn’t have just short-term gains bit long term ones as well. 

• Obstacles. An ideal solution has anticipated all possible obstacles in its implementation and has made plans 

accordingly. 

• Values. An ideal solution is one that is consistent with the mission-vision of the organization and or its 

individual members. 

51


Choosing a Solution 

• Decide on a criterion (or criteria). Ask the group 

to come up with the criteria to be used to 

evaluate each option. These criteria could be 

costs and benefits, consistency with the values 

of the organization, feasibility, etc. Once criteria 

are set, the facilitator can guide the group into 

weighing each option according the criteria. 

• Survey which options members like. A 

facilitator can also conduct a quick survey of 

what each group members like in the list. You 

can select the solution either by strict consensus 

or by majority vote. 

• Survey which options members don’t like. 

Similarly, a facilitator can ask the group which 

options from the short list are no-no’s and 

eliminate them from the list. 

Using the Multi-Option Technique 

When coming up with solutions to an issue, you are not limited to choosing one best one. 

You can also pick several solutions to a problem, and follow through on these many solutions 

simultaneously. This is process called the multi-option technique. 

For instance, in addressing a problem about lagging sales, approaches can be related to poor advertising, poor 

market selection, or a problem in the product itself. A group following the multi-option technique will assign a 

person or team to follow through on each option. One team can create a better advertising campaign; another 

team can look for a better market; while another team can improve the product. In succeeding meetings, each 

team will report their results as separate teams. 

The solutions followed through in a multi-option technique are not necessarily complimentary to one another, 

although groups have the option to follow through on only complimentary ideas. But if the group wants to see two 

opposing scenarios with different assumptions, they can do so. 

How can a facilitator conduct the multi-option technique? The group can brainstorm several options, and the 

facilitator can help the group select which of the many options they want to pursue further. 

52

SUPPLEMENTAL RESOURCES FOR THIS TOPIC 

Two Heads Better Than One 

Topic 

Where 

When 

Who 

Group Decision Making 

Check in 

Notices 

Territorial Avowal 

Icebreaker 

MATERIALS 

PREPARATION 

ACTIVITY 

Head 

Count 

Phones 

Away 

Time 

Check 

Include short notices here 

Access 

Needs 

Parking 

Lots 

Ask someone to share, use your own or one from suggestion 

box 

House of Cards – set goals for this meeting 

Deck of playing Cards 

Markers, flip chart paper 

Pass out one playing card to each participant, facedown. 

Tell them not to look at the card. 

Ask participants to look at their playing cards. They 

are to find others with their suit, but they are not 

allowed to talk or show their card. For example, if a 

person had a spade, they may illustrate that by 

pretending to dig a hole. 

Once participants are in their groups, they are to 

introduce themselves and come up with a list of five 

things that they would like to learn during the 

workshop. 

Once groups have created their list, have each 

group present their list and combine topics on the 

flip chart. Use this as a guide during the workshop. If 

there are any topics that will not be covered, list 

these in the parking lot. 

Rainbow Health Co-op materials are licensed for 

non-commercial use through a Creative Commons 

4.0 License 

53

Exercise 

Introduction We come together to take care of each other, but with us in the 

room is something else we need to take care of – the group 

itself. A group that is properly cared for becomes selfsustaining. 

That’s our goal. 

We start with four steps – 

1, Finding what we have and what we need 

2, Learning how to think together 

3, Deciding how we make decisions 

4, Deciding how we shares responsibilities 

Materials Lost at Sea Exercise ranking chart for each group member 

Lost at Sea Ranking Chart 

Items Step 1 Step 2 Step 3 Step 4 Step 5 

Your 

Rank 

Team 

Rank 

Coast 

Guard 

Differ 

1 & 3 

Differ 

2 & 3 

A sextant 

A shaving Mirror 

Mosquito netting 

25 litres of water 

Case of army rations 

Activity 

Lost at Sea 

You have chartered a yacht with three friends, for the holiday trip of a lifetime 

across the Atlantic Ocean. Because none of you have any previous sailing 

experience, you have hired an experienced skipper and two-person crew. 

Unfortunately in mid Atlantic a fierce fire breaks out in the ships galley and 

the skipper and crew have been lost whilst trying to fight the blaze. Much of 

the yacht is destroyed and is slowly sinking. Your location is unclear because 

vital navigational and radio equipment have been damaged in the fire. Your 

best estimate is that you are many hundreds of miles from the nearest 

landfall. 

You and your friends have managed to save 15 items, undamaged and intact 

after the fire. In addition, you have salvaged a four man rubber life craft and a 

box of matches. 

Your task is to rank the 15 items in terms of their importance for you, as you 

wait to be rescued. Place the number 1 by the most important item, the 

number 2 by the second most important and so forth until you have ranked all 

15 items. 

Atlantic Ocean Map 

Floating seat cushion 

10 litres of oil/gas mix 

Transistor Radio 

20 sf of black plastic 

1 can shark repellent 

1 litre of 160 proof rum 

15 feet of rope 

2 cases of chocolate bars 

Ocean fishing pole 

54

Facilitator Guide – Exercise answers 

Break Suggestions 

The US Coastguard says that the basic supplies needed when a person is 

stranded in the middle of the ocean are things you can use to attract 

attention and aid in survival until rescue arrives. The trans-Atlantic trip takes 

about 20 days, more or less depending on winds. Articles of navigation are 

useless because it is impossible to store the food and water needed in the 

scenario described. Without the signalling devices there is little to no chance 

of being spotted and rescued. 

Five Minute Break – 

Activities 

Hand Dancing 

https://youtu.be/gJ 

NyLgS56-8 

Sharing Circle 

Hacky Sack 

Koosh Ball 

Resistance tubes 

Talking stick 

Trigger Warnings 

Healthy Snacks 

Oranges 

Veggies and Dip 

Rice crisps and 

Humus 

Pita bread / dip 

Grapes 

Yoghurt 

Chicken Wraps 

Bran muffins 

ITEMS 

Coast 

Guard 

Team 

Rank 

Coast 

Guard 

Differ 

1 & 3 

A sextant 15 Useless without chronometer and 

tables 

A shaving Mirror 1 The most powerful tool to 

communicate your presence 

Mosquito netting 14 No mosquitos in the middle of the 

ocean – useless 

25 litres of water 3 This is several days of rations is 

carefully used 

Case of army rations 4 Basic food intake 

Atlantic Ocean Map 13 Worthless without the navigation 

equipment 

Floating seat cushion 9 Useful if someone falls overboard 

10 litres of oil/gas mix 2 Ignited and used for signalling 

Transistor Radio 12 Useless in the middle of the ocean 

Differ 

2 & 3 

20 sf of black plastic 5 Collect rainwater and provides shelter 

1 can shark repellent 10 To repel sharks of course! 

1 litre of 160 proof 11 Useful to clean injuries – otherwise 

rum 

useless except to add to the gas 

15 feet of rope 8 A variety of uses – but none high on the 

list for survival 

2 cases of chocolate 6 Reserve food supply 

bars 

Ocean fishing pole 7 No guarantee you can catch fish – 

RETURNING MEMBERS 

PLESE JOT IN YOUR NAME 

NEW MEMBERS 

PLEASE FILL IN YOUR NAME AND EMAIL ADDRESS 

Y O U R 

Y O U R 

N A M E 

E M A I L @ A D D R E S S . C O M 

INLCUDE $5 IF YOU WANT TO BE RAINBOW HEALTH MEMBER 

RAINBOW 

YES NO 

YES 

NO 

55


I think you have to work with people, and 

when I talk about managing relationships, 

don’t think about the derogatory 

“managed relationships. 

4: Dealing with Difficult People 

Anil Ambani 

Group process can get hampered by the presence of difficult members. A skilled 

facilitator should know how to deal with difficult people, so that the discussion 

will remain on track and the group atmosphere will remain pleasant and 

conducive to participation. In this module, we will discuss how to address 

disruptions, common types of difficult people in groups and how to handle them, 

and how to let the group resolve issues on their own. 

Addressing Disruptions 

Disruptions in groups can be in any form. They can be from the members, or from the 

environmental factors. 

The following are ways to deal with disruptions in groups: 

• Refocus the discussion on the agenda. This intervention is similar to the intervention on keeping the 

discussion on track. If a disruption occurs, gently remind the group of the topic. 

• Identify the intention behind the disruption and address it. Don’t focus on what was said. Instead, focus 

on why the person said it. Example: repeated interjections can mean that a member does not feel like he or 

she is being listened to. 

• Reiterate rules. You may refer to ground rules set at the beginning of the session. 

• If no rule against the disruption exists, then take it as an opportunity to set one. 

56


Common Types of Difficult People and How to Handle Them 

The following are some of the common types of difficult people in groups and how to 

handle them. 

Type of Difficult 

Person 

Dominating 

Description 

These are 

members who 

monopolize the 

conversation and 

even overtly block 

other members 

from making a 

contribution. 

Typical 

Behavior 

“I am the only 

one with 

experience in 

this matter. Let 

me tell you what 

to do.” 

Ways to Deal 

with Them 

• Solicit other members’ 

opinion. “We 

appreciate your 

experience and we’ll 

take what you said into 

account. But let’s see 

what others think too.” 

Aggressive 

Quiet and Non- 

Participative 

Overly Talkative 

Members who 

resort to personal 

attacks. 

Group members 

can be quiet for a 

variety of reasons: 

they can be shy, 

intimidated, or 

uncomfortable 

joining in the topic. 

Members talk too 

much. 

“You just don’t 

know what 

you’re doing!” 

• Reiterate the ground 

rules. “We have agreed 

that there will be no 

personal attacks.” 

• Get back on topic. 

“Remember all 

comments are useful as 

long as they relate to 

the topic. 

• Re-state their position 

in objective terms 

• Establish eye contact 

and invite them to join 

in. 

“We’d like to hear 

from people we 

haven’t heard from 

before. Could you give 

us your take on this 

issue?” 

• Remind them of the 

time limit. 

• Tell them you can only 

discuss one point at a 

time. 

• Ask them for key 

summary points. 

Helping the Group Resolve Issues on Their Own 

The following are two ways a facilitator can help groups resolve issues on their own: 

Ignore. For cooperative teams, natural facilitators will emerge if the facilitator doesn’t make immediate 

interventions. 

Promote direct feedback. Ask the group members what they think about the situation or a particular person’s 

behavior. Example: “Mike, can you tell Bob the effect on you when he interrupts you?” 

57


The key elements in the art of working 

together are how to deal with change, how 

to deal with conflict, and how to reach our 

potential. 

Max DePree 

5: Addressing Group Dysfunction 

All groups have the potential to be dysfunctional: incapable of achieving goals. 

This is because each person is different, and each group has their own unique 

history. A facilitator must know how to recognize signs of group dysfunction, and 

skilled to address them. In this module, we will discuss three ways to address 

group dysfunction: setting ground rules, restatement and reframing issues and 

keeping the discussion on track. 

Using Ground Rules to Prevent Dysfunction 

One of the best ways a facilitator can anticipate problems in a group discussion is to set ground 

rules. Ground rules orient participants with what is expected from them. Moreover, they set 

boundaries of acceptable and unacceptable behavior during the discussion. For best results, 

ground rules must be set in a consultative fashion, with the rules, and sometimes the 

consequences of violation of rules, negotiated among members of the group and agreed upon by 

consensus. 

When setting ground rules, it is important to both verify if the rules are understood, and if they are acceptable. 

Make sure too that a documentation of the ground rules is available for everyone, either as a hand-out or posted in 

a flipchart paper for everyone to see. 

Ground rules in a group meeting can relate to: 

• How to make the most of the meeting. For example: practice timely attendance, participate fully. 

• How to make a contribution to the discussion. For example: do the members raise their hands and ask the 

facilitator for permission to speak; use I-messages. 

• How members should treat other members. For example: “don’t interrupt whoever is speaking, listen 

actively to whoever has the floor, accept that everyone has a right to their own opinion, no swearing or any 

aggressive behavior. 

58


• Issues relating to confidentiality. Example: all matters discussed in the group shall remain within the group. 

This is also the moment for the facilitator to reveal if the minutes of the meeting will remain solely for his or 

her reference, or will it be given to an authority in the organization. 

• How violations of ground rules would be addressed. Example: the use of graduated interventions from 

warning to expulsion from the group. 

Restating and Reframing Issues 

The way an issue or problem is phrased can influence group members’ attitudes towards it. After all, different 

words have different meanings and connotations. A simple example is the difference between the words 

“problem” and “challenge” in reference to a situation, or “victim” and “survivor” in reference to a person. 

Restatement is similar to paraphrasing; it is changing the wording of an issue, but the main idea is the same. For 

example: simply changing “this suggestion seems to have made some members of the group angry”, to “there 

seems to be a strong concerns about the suggestion” can lessen the antagonistic nature of the statement. 

Reframing is similar to restatement, except reframing goes deeper. In reframing, a facilitator changes the way a 

problem is conceptualized in order to facilitate a consensus or support a conflict resolution. 

In some cases, the problem is reframed in order to support the position of two parties in 

contention. The meaning may or may not change, but the spirit of the statement remains the 

same. For example, instead of saying “we’re here to talk about how to approach salary cuts,” 

a facilitator can say “we’re here to talk about how the company can provide employee 

security despite limited funds.” 

In group facilitation, simply restating or reframing an issue can lessen the adversarial nature 

of a position, or invite a fresh way of looking at things. When the issue is phrased in neutral or workable terms, it 

becomes conducive to a reasonable discussion. 

How can a facilitator successfully re-state or reframe an issue? The main skill necessary for these processes is active 

listening. An effective facilitator must be sensitive to what each party needs and be able to incorporate these 

interests when phrasing an issue. Having an appreciation of the language of the group, and their unique 

perspective, are also important in this process. 

Some of the ways of restating and reframing includes: 

• Changing “hot buttons” or value-laden words into neutral ones. 

• Reminding the group of larger goals/ smaller goals the entire group is working on. 

• Changing a problem into workable terms. 

• Approaching an issue from another perspective. 

59


Getting People Back on Track 

A group discussion can go off-topic for many reasons. Sometimes, the purpose of the meeting wasn’t really clear. In 

other times, the discussion naturally led to an interesting issue not part of the agenda. And in other times, there are 

individuals who initiate and maintain off-topic discussions. 

Regardless of the reason, the following are ways to get a discussion back on track: 

• Review the agenda. A facilitator can create check points in the agenda and constantly refer to it as the 

discussion progresses. For example: “Let’s take a moment to take a process check. Are we still following our 

agreed upon agenda?” 

• Reflect to the group what is happening, and reintroduce the correct topic. Example: “I appreciate the 

participation and enthusiasm. But it seems that we have gone off the agreed upon agenda. I 

believe the topic under discussion is…” 

• Offer to put the off-topic on a “parking lot” for possible later discussion. For 

example: “You raised a good point Mary. Maybe we can look at that later it today, or set a 

separate meeting for it.” 

• Ask the group if they are finding the discussion helpful to the goal. This 

intervention is recommended for unstructured meetings, where a foray into an off-topic is not necessarily a 

negative thing. For example: “I noticed that there has been a long debate in the group about this idea. Is 

this discussion helpful for everyone?” 

• Ignore the off-topic discussion and reintroduce the correct topic. If you feel that acknowledging a topic 

detour will just result in more dysfunction (e.g. it will provoke a long, defensive response), then it may be 

best to just ignore it. Instead, summarize the last thing that was said related to the topic, and ask a question 

that continues from it. For example: “If I may get back to what Louis was saying earlier. He said….Does 

anyone agree with his observation?” 

60


It is always possible to argue against an 

interpretation, to confront interpretations, 

to arbitrate between them and to seek for 

an agreement, even if this agreement 

remains beyond our reach. 

Paul Ricoeur 

6: Getting a Group Back on Track 

In general, facilitators neither inject themselves in issues nor direct the flow of 

discussion; they merely go where the group wants to go. There are occasions, 

however, when stronger responses are needed to make the group more 

functional and productive. In this module, we will discuss what these stronger 

responses are, why they are necessary, and when is it appropriate to use 

them. 

Why Intervention May Be Necessary 

Facilitators are part of a group for a reason: to help the group achieve their goals in the most democratic and 

cooperative way possible. Ideally, groups should have cooperative members with knowledge, skill, and personality 

to assist this process. However, in the real world, groups are much more complicated. 

Indeed, even well-meaning group members can create dysfunctional teams. For this reason, 

intervention may be necessary. 

An intervention is an injection of one’s self in the process in pursuit of a specific goal. 

Interventions are what separate a facilitator from a mere participant--- the participant’s 

statements are contributions, whereas a facilitators’ statements are interventions. 

Technically, anything that a facilitator does, both verbally and non-verbally, in the course of his or her role in a 

group is an “intervention.” However, the term intervention is usually reserved to relatively stronger interference in 

a group’s natural way of doing things. 

The following are some of the reasons why intervention may be necessary: 

• To help the group achieve their goals. If an on-going dynamic in the group is keeping the entire team from 

reaching their objective, then it’s time to intervene. For example: if a coalition exists in members, decisionmaking 

might get skewed to one side of the issue. 

• To protect group process. If the integrity of the chosen methodology in getting results is being 

compromised, then a facilitator must intervene. 

61


• To prevent the escalation of an issue. Generally, facilitators should let the group handle things on their 

own. But some hot issues are better nipped in the bud, or they might blow up into a larger issue can create 

serious damage. 

• To sample “skills” to the group. In some occasions, group members lack the skills to deal with a group 

issue, e.g. two conflicting issues. In these cases, intervention may be necessary to expose the group on 

more functional processes. 

When to Intervene 

The following are some situations when intervention may be necessary: 

• The group is stuck. This means that the process is not producing results, or the process is not progressing to 

the next level. 

• The group is about to move on to the next agenda without realizing that an important aspect of the 

discussion is unresolved or unaddressed. 

• The group continues to follow a negative pattern despite soft 

interventions. (We will discuss levels of interventions in the next 

section.) 

• Something unethical is going on in the group, like a personal attack or 

subtle/blatant intimidation. 

• Group process is being hampered by a dominant person or clique. 

• Group members are misunderstanding each other. 

• The facilitator perceives tension and suspiciousness in the group. 

62


Levels of Intervention 

There is a guiding principle in medicine that goes: don’t prescribe strong medicine when a 

milder one will do. Similarly, interventions in facilitation range from non-directive to 

directive, subtle to explicit, non-intrusive to very intrusive. It helps to know what the levels 

of intervention are in order to decide what response to give to different situations in a 

group. 

The following are the different levels of intervention: 

• No intervention. Unless there is a pressing concern that requires a facilitator’s intervention, the first level 

of response is to do nothing. By not responding to a concern, a facilitator is effectively letting the group 

take care of the problem, and implement their own solution. Note though that even if a facilitator is not 

directly responding to the problem, he or she may be actively gathering information about the group and 

how they process their own issues. 

• Reflective Technique. The first few levels of intervention are geared towards increasing awareness within 

the group that a problematic situation is in place. One way to do this is to objectively state what you notice 

is going on. Note that you are not supposed to voice out your opinions or evaluations of the group dynamic; 

merely bring to awareness something that the group may not have noticed. The group is left to confirm or 

refute the facilitator’s observations. Either way, the result may be further clarification. 

Example: “I noticed that four of you had been very quiet since we started.” 

• Solicit the Group’s Observations. As much as possible, let the group members identify themselves what is 

happening within the group. One way to do this is to solicit feedback through general leads. Example: 

“Jane. What can you say about what is happening right now?” 

• Interpret observations. This becomes necessary when the group has difficulty seeing the implications of 

what is going on in the process. NOTE: always phrase your interpretations in tentative fashion, as if seeking 

confirmation from the group if your observations are correct or incorrect. 

Example: “I’m noticing that the energy is low? Are we focusing on the right issue? Or is there something 

else that we have more energy for?” 

• Suggest solutions. If the group seems to be stuck, suggest a way to deal with the problem. Note: suggest 

only process changes. And always get the approval of the group. Example: “We seem to be stuck, would 

you like to try a different approach?” 

• Restructure the process or an aspect of it. Change the group process by re-organizing the structure of 

dialogue (dyads, small groups, etc.), using problem solving processes, inserting a “process break” or 

changing the original agenda. 

• Confront. This is directly mentioning the problem, or the difficult individual. Note that confrontation is a 

very strong intervention, and must be used only as a last resort, when all other softer interventions have 

been exhausted. Example: “I noticed that you are always encouraging the other members of the group to 

leave the meeting prematurely. And twice now it has disrupted the process. May I know what the reason 

why you’re doing this is?” 

63


Intervention Techniques 

In the previous module, we introduced intervention and the different levels of intervention. In this module, we will 

focus on particular intervention techniques: use of processes, boomerang it back, and ICE it. 

Using Your Processes 

As process experts, the best way a facilitator can intervene in an unproductive or dysfunctional 

group is by introducing a process that would directly address the problem or issue. For example, 

if a group’s problem is the monopoly of the floor by certain members, a facilitator can introduce 

the round robin discussion to ensure that everyone gets their turn to speak. 

If the problem is the lack of information about the issue in contention, the facilitator can make 

presentation part of the agenda. If the problem is a lack of understanding between management 

and staff, the facilitator can break the group into pairs of management and staff. 

Boomerang it Back 

To “boomerang” an issue back is to present an issue back to the group for them to resolve. The 

reflective technique (discussed in the previous module) is one of the basic ways of mirroring an 

issue to a group. 

Another way to do this is to rephrase a group’s concern into a question addressed to the group. 

For example, when a group member says “maybe we are just too tired to think of a new idea for 

this project”, a facilitator can simply say “do you think you are too tired?” 

Or if a group member asks a facilitator a question, the facilitator can just bounce the question back. Example: if a 

group member asks “should we continue this project?” the facilitator can simply reply “What do you think? Should 

you?” 

ICE It: Identify, Check for Agreement, Evaluate How to Resolve 

Another way to intervene is to use the ICE technique. ICE stands for: 

• Identify 

• Check for Agreement 

• Evaluate How to Resolve. 

When you ICE it, you surface what the problem is, verify with the group its accuracy (or at least their agreement), 

and then start the process of looking for solutions. Example: “What do you think is going on in the group right now? 

So, if I understand correctly, this is what is happening? Is this correct? How do we go about addressing this 

problem?” 

64


Section Five 

Hans Kai Content

2 0 1 8 H A N S K A I F A C I L I T A T O R R E S O U R C E S


1 – Indicators 

Blood Pressure – Blood Sugar 

Your Hormones – The minimum effective dose


Schedule for this session 

Check-in 

15 Minutes 

Slides – 

20 min 

Six Hats Sharing 

Manage the risk 

20 min 

Break + Chat 

20 min 

First Round Sharing – 

20 min 

Check out–15 min 

2 hours 

Group Wellness Works 

A Group Wellness 

Program 

H A N S K A I 

This program brought to you by 

co-ops co-operating to build a better 

world – join us today 

Original content is covered by a Creative Commons Attribution-NonCommercial-ShareAlike License CC BY-NC-SA 

Other work subject to the terms of its author 

- 1

As Treaty Peoples, we are responsible 

for establishing and maintaining 

mutually respectful relationships. 

We acknowledge with respect the Indigenous 

peoples on whose traditional territories we live, 

whose historical relationship with the land 

continues to this day and we apologize for our 

collective treatment of them 

INDICATORS 

SECURITY 

SELF-CARE 

BALANCE 

HEALTH 

CARE 

CHANGES 

CLANS 

- 2

INDICATORS 

H A N S K A I 

What we hope to explain today 

SOME DEFINITIONS 

WHAT IS WELLNESS? 

WHAT IS A PROGRAM? 

WHAT IS Gender Dissonance vs Dysphoria? 

A short break 

The common risks of medical transition 

Tracking personal health indicators 

What is wellness? 

(Fill in the blanks) 

- 

- 3

Wellness is…. 

"A state of complete 

physical, mental, and 

social well-being, and 

not merely the 

absence of disease or 

infirmity." 

 

World Health Organization 

"A conscious, selfdirected 

and evolving 

process of achieving 

full potential." 

National Wellness Institute 

- 

Social Determinants of Health 

Six Dimensions of Wellness 

Copyright 

1976 

- 

This is what we say…. 

Wellness is the minimum 

effective dose of rest, 

nutrition, activity and 

socialization to maintain 

ourselves above the 

level of symptoms. 

 

Wellness integrates our 

bodies, our gender, our 

minds, our selves and our 

communities”. 

 

Rainbow Health Co-operative 

- 

- 4

HOW DO WE ASSESS WELLNESS? 

SOCIAL 

- 

PERSONAL 

Health 

refers 

to the 

entire 

range 

of our 

well 

being 

HEALTH 

WELLNESS 

Wellness refers 

to the range 

above the level 

where negative 

indicators are 

present 

- 

- 

- 5

Minimum Effective Dose 

The MED is simply the smallest dose that will 

produce a desired outcome and anything beyond 

the MED is wasteful. 

- 

A wellness 

program 

focuses our 

time and effort 

in self-care by 

providing 

information, 

tracking health 

indicators, and 

providing 

feedback to 

keep ourselves 

above the 

level of 

negative 

indicators 

- 

PARETO’S PRINCIPLE 

- 

- 6

THE OTHER SIDE OF THE COIN 

- 

It goes away 

I have a backache 

It does not go away for a week 

I go to my chiropractor 

They do an adjustment 

I take aspirin 

STIMULUS, HIGH 

RESPONSE 

- 

One day I notice I have less pain 

I go to the gym for a fourth week 

I go to the gym for a third week 

I go to the gym for a second week 

I go to the gym for a week 

I have a backache 

It does not go away for a week 

I learn about the condition 

STIMULUS, LOW 

RESPONSE 

- 

- 7

AUTONOMOUS BEHAVIOUR 

COMPLIANCE BEHAVIOUR 

- 

A group 

wellness 

program 

leverages our 

self-care efforts 

by utilizing our 

programming 

as social 

animals 

- 

H A N S K A I 

Summary 

Maintains habits that enhance wellness 

Informs about self-care 

Applies the minimum effective dose 

Maintains awareness of symptom indicators 

States when and how to seek help 

Develops capacity for long term effort 

Provides individual feedback on results 

- 8

H A N S K A I 


QUESTIONS? 

- 9

Blood Pressure 

People taking control of their health. 

What is blood pressure? 


• The force of the blood pushing against the 

walls of the blood vessels as it flows through 

them 

• The amount of blood your 

heart pumps and the amount 

of resistance in the arteries 

affects your blood pressure 

What are the two numbers about? 

• The systolic, or high number, measures the 

pressure in the vessels as your heart is 

pumping – during a beat 

• The diastolic, the low number, measures the 

pressure in the vessels as your heart is 

relaxed – between beats 

1

What is normal blood pressure? 

• Average person Person with diabetes 

below 135/85 (home) below 130/80 

• Consistent, 3 to 4 readings in a row, that are 

higher should be reported to health care 

provider 

Abnormal Blood Pressure 

• 130-179/85-109 is high and should be 

passed on to health provider at next visit 

• >180-199/110 -119 should call their health 

care provider to arrange appointment 

• >200/120 would indicate an emergency – 

immediate appointment or go to ER 

immediately 

What are the symptoms of high blood 

pressure? 

• None for most people 

• Pressure in the head, light headedness, 

blurred vision, nausea and vomiting, chest 

pain, shortness of breath 

2

Why is blood pressure important? 

• High blood pressure means that the heart 

has to work harder 

• High blood pressure increases risk for heart 

disease 

• High blood pressure + blocked arteries 

increases your risk for heart attack or stroke 

Lifestyle management of blood pressure: 

– Increased physical activity 

– Stress Management (for some) 

– Moderate alcohol consumed 

– Healthy body weight 

– Smoking cessation 

– Healthy eating – DASH 

– Less sodium 

Which meal is higher in 

sodium (salt)? 

A. Kentucky fried chicken dinner 

3100 mg 

B. Baked lemon chicken breast, herbed 

potatoes and green beans 160 mg 

C. Baked salmon, steamed rice and broccoli 

200 mg 

D. Bowl of cream of mushroom soup and a 

reuben sandwich with sauerkraut 4460 mg 

3

Healthy Habits for Blood 

Pressure 

• Limit canned and processed foods 

• Limit salted snack foods and fast foods 

• Use less salt in cooking and at the 

table 

• Use garlic, lemon, herbs and spices 

• Salt substitutes - check with your 

doctor 

Demonstration 

• Sitting comfortably 

• Feet flat on the floor 

• Arm relaxed and 

supported at heart 

level 

• On the bare arm (not 

on top of sleeves) 

• Do not talk or read 

while taking blood 

pressure 

• Wear loose non-restrictive 

clothing 

• Heavy physical activity 2-3 

hours prior can raise the 

numbers 

• Be well rested and relaxed 

• Remember that smoking 

and caffeine intake within 

30 minutes of blood 

pressure reading can raise 

the numbers 

Demonstration 

4

• Metabolic syndrome is not a specific 

illness but a series of risk factors: 

1. Increased Waist Circumference 

Men: Equal to or over 102 

centimetres (40 inches) 

Women: Equal to or over 88 

centimetres (35 inches) 

2. Elevated Blood Pressure 

Equal to or over 135/85 

Metabolic Syndrome 

3. Elevated Triglyceride Level 

Equal to or over 1.7 

4. Low HDL “good” Cholesterol 

Men :Less than 1.04 

Women: Less than 1.29 

5. High Fasting Blood Sugar 

Equal to or over 5.6 

3 or more of the above risk factors = metabolic syndrome 

Metabolic Syndrome 

Why should I be concerned? 

• Associated with increased risk of developing diabetes 

or having a heart attack or stroke 

• Early screening of these risk factors can make a 

difference 

• Treatment of these risk factors can prevent 

complications down the road (adopting healthy 

lifestyle can minimize all of these risk factors) 

Questions? 

5

Diabetes 


What is diabetes? 

• To use glucose (sugar) for energy, the body 

needs insulin 

• With diabetes, body makes too little 

or no insulin, or cannot properly 

use the insulin it makes 

• Not enough insulin = blood glucose 

levels increase 

• Over time, high blood glucose levels 

can lead to serious complications 

1

Type 1 Diabetes 

•Pancreas produces little or no insulin 

• Affects about 10% of people diagnosed 

with diabetes 

• Diagnosed most often in children and 

young adults 

• Insulin injections are needed 

• Caused by genetic and environmental 

factors 


• Affects about 90% of people with 

diabetes 

• Diagnosed most often in adults 

• Cells in the body do not use insulin 

properly (insulin resistance) and/or body 

does not make enough insulin 

• Managed with meal planning, physical 

activity, blood glucose testing, medication 

and sometimes insulin 

Gestational Diabetes 

• Increases risk of developing diabetes later 

in life 

• All pregnant women should be tested 

2

Prediabetes 

• Blood sugar levels are higher than what is 

considered normal but below what is 

considered the level for a diagnosis of 

diabetes (fasting blood sugar between 

6.1 – 6.9) 

• Increased risk for developing type 2 

diabetes and heart disease 

Risk Factors for Diabetes 

• Parent, brother or 

sister with diabetes 

• Age (> 40 years old) 

• Certain ethnicities 

(South Asian, Asian, 

Latin American, 

African, Aboriginal) 

• High blood pressure, 

high cholesterol 

• Obesity (especially 

higher waist 

circumference) 

• Having a baby over 

9 lbs 

• Having gestational 

diabetes 

Q & A 

What is the most effective test to diagnose 

diabetes? 

a) Fasting blood glucose test 

b) Urine test 

c) Vision test 

d) Non-fasting blood glucose test 

3

Q & A 

Which is not a sign / symptom of type 2 

diabetes? 

a) Weight loss 

b) Energetic 

c) Blurred vision 

d) Having to pee very often 

Q & A 

Type 2 diabetes is when: 

a) The body is allergic to insulin 

b) You have low blood sugar 

c) The body does not use insulin properly 

d) The body does not produce insulin 

True or False 

Eating too much sugar in the form of candy, 

soft drinks and other sweets can cause 

diabetes? 

4

For people who don’t 

have diabetes: 

• Before meals/fasting 

4-6 

• 2 hours after a meal 

5-8 

HbA1C < 6.0% 

Blood Sugar Targets 

For people who do 


• Before meals/fasting 

4-7 

• 2 hours after a meal 

5-10 

HbA1C < 7.0% 

LDL cholesterol < 2.0 

Checking Your Blood Sugar 

You will need: Glucometer (blood sugar tester), drummet 

(contains the strips), one-time use lancets (purple and white), 

sharps container (yellow) 

1. Wash hands with soap and water or hand sanitizer 

2. Clean the glucometer with an alcohol swab before use 

each time. 

3. Press the middle button on the glucometer down, then let go 

(a strip will pop out of the bottom). The glucometer will turn 

on. 


4. Turn then pull off the purple head of the lancet, hold up to 

finger and press the purple button until you hear a click (you 

should feel a small poke). If you don’t see any blood, gently 

squeeze your finger to increase the blood flow. 

5. Hold blood sample up to the strip (the strip should soak up a 

small blood sample) 

6. Glucometer will show your blood sugar reading within 5 

seconds 

7. Write down your reading in your logbook 

5

Checking your Blood Sugar 

8. Hold the glucometer above the sharps container. The strip 

should be over the opening of the container. Press the 

middle button down, then let go to get rid of the used strip. 

• Let your Hans support person know if you need more supplies 

(lancets, drummets, alcohol wipes) 

• When your sharps container is full, drop it off at your pharmacy 

and get a new one from them (this is free of charge). Be sure 

to close the sharps container before placing it back in your 

toolkit. The lid should snap shut but not be closed so tightly 

that it will not reopen. 

Questions? 

6

Questions? 

Healthy Waists 

• According to the National Institutes of Health, 

increased waist circumference is a measure of 

increased risk for: 

• Type 2 Diabetes 

• Heart Disease (heart attack, stroke) 

• High Blood Pressure 

• “Apple” and “Pear” Shapes 

Waist Circumference 

• Women 

– Goal: Less than 35 inches (88 cm) 

• Men 

– Goal: Less than 40 inches (102 cm) 

• Some people depending on their culture 

may need to have even lower goals for their 

waist circumference 

7

Demonstration 

• Place the tape measure half way between your hip 

bone and your lowest rib. This will likely be just 

above your belly button. Wrap the tape measure 

around you in a circle. Make sure the tape 

measure is level all the way around. The tape 

measure should not push in or indent the 

skin. Relax, exhale and measure. 

• It is best to measure your waist circumference on 

bare skin. If you are wearing clothes, be sure to 

measure the same way each time. 

8


Check-in 

15 Minutes 

Slides – 

20 min 



20 min 

Break + Chat 

20 min 


20 min 


2 hours 

Hormones, 

The Minimum Effective Dose 


Program 

H A N S K A I 






- 1









INDICATORS 

SECURITY 

SELF-CARE 

BALANCE 

HEALTH 

CARE 

CHANGES 

CLANS 

- 2

H A N S K A I 4 T R A N S 

Wellness is the 

minimum effective 

dose of rest, 

nutrition, activity 

and socialization to 

maintain ourselves 

above the level of 

symptoms. 

A wellness program balances 

our self-care efforts 

for: 

our bodies 

our minds 

our emotions 

our gender 

and 

our communities 

A wellness program specifies 

the minimum effective dose 

of rest, nutrition, activity 

and socialization 

to maintain ourselves 

above the 


- 3

A wellness program monitors 

Health Indicators 

whether 

gender dissonance 

or 

blood pressure 

A wellness program integrates 

self-care 

and 

shared-care 

A wellness program reinforces 

behaviours 

which are low reward but necessary 

- 4

A wellness program remedies 

Chronic conditions 

such as 

Gender Dissonance 



Hormones 

Blood Sugar 

Hormone Readiness 

Hormone Therapy Risks 

Risk Management 

INDICATORS 

Hormones, The minimum 

effective dose 

- 5

What are Hormones? 

Hormones are 

chemical messengers 

that are secreted 

directly into the blood, 

which carries them to 

organs and tissues of 

the body to activate 

target cells. 

What body parts produce hormones? 

How many 

of the 

endocrine 

glands can 

you name? 

How many of the 

endocrine glands 

can you name 

Name one 

hormone produced 

by each 

- 6

What body parts produce hormones? 

1. Pineal gland 

2. Pituitary gland 

3. Thyroid gland 

4. Thymus 

5. Adrenal gland 

6. Pancreas 

7. Ovary 

8. Testes 

1. Melatonin 

2. ADH, Oxytocin, 

LH, FSH 

3. T4, T3 

4. Thymosin 

5. Testosterone, 

Epinephrine 

6. Insulin 

7. Estrogen 

8. Testosterone 

Insulin 

• To use glucose for energy, the body 

needs insulin 

• 

• With diabetes, body makes too little 

or no insulin, or cannot properly 

use the insulin it makes 

• 

• Not enough insulin = blood glucose 

levels increase 

Now for the OTHER hormones 

Testosterone 

 

Estrogen 

Progesterone 

Other chemicals that 

affect blood levels of 

hormones; such as 

Anti- androgens 

Hormone therapy—the administration of exogenous 

endocrine agents to induce feminizing or masculinizing 

changes 

- 7

The Standards of Care 

VERSION 7 

World Professional Association for Transgender Health 

Hormone therapy is a medically 

necessary intervention for many 

transsexual, transgender, and 

gender-nonconforming individuals 

with gender dysphoria 

The Standards of Care 

World Professional Association for Transgender Health 

The criteria for hormone therapy are as follows: 

1. Persistent, well-documented gender dysphoria; 

2. Capacity to make a fully informed decision and to 

consent for treatment; 

3. Age of majority in a given country 

4. If significant medical or mental health concerns are 

present, they must be reasonably well-controlled 

THiP Hormone Readiness Assessment 

VCH - Transgender Health Information Program 

Who provides assessments? 

Any general practitioner, nurse practioner or family physician 

with some basic training can assess for and prescribe 

hormone therapy to adults. 

Do I need counselling to start on hormone therapy? 

Counselling is not typically required to get a prescription for 

hormones. 

How long does a hormone assessment take? 

It generally takes a few visits to your health care provider, 

over the course of 2-6 months, before starting on hormone 

therapy. 

- 8

Oral Estrogen 

(e.g. Estrace) 

Premarin 

(PRegnant MARes urINe) 

Sublingual 

Estrogen Patch 

(e.g. Estradot, Estraderm, Oesclim) 

Injectable Estrogen 

(e.g. estradiol valerate) 

Medroxyprogesterone 

(e.g. Provera) 

Micronized Progesterone 

(e.g.Prometrium) 

Prediabetes 

Blood sugar levels are 

higher than what is 

considered normal 

but below what is 

considered the level 

for a diagnosis of 

diabetes 

(fasting blood sugar 

between 6.1 – 6.9) 

Risk Factors 

Relative with diabetes 

Age (> 40 years old) 

Certain ethnicities 

(South Asian, Asian, 

Latin American, 

African, Aboriginal) 

High blood pressure, 

high cholesterol 

Obesity (especially 

higher waist 

circumference) 

Having a baby 9 lbs + 

Ovary based feminizing hormone cycle 

Follicular 

Injectable Testosterone 

(e.g.testosterone cypionate or testosterone enanthate) 

Testosterone Patch 

(e.g.Androderm) 

Testosterone Gel 

(e.g.Androgel, or compounded testosterone gel/cream) 

Oral Testosterone 

(e.g. testosterone undecanoate) 

 

Likely increased risk 

Weight gain 

Venous thromboembolic disease (leg clots) 

Gallstones 

Elevated liver enzymes 

Hypertriglyceridemia 

Likely increased risk with presence of additional risk factors 

Cardiovascular disease 

Possible increased risk 

Possible increased risk with presence of 

additional risk factors 

No increased risk or inconclusive research 

High Blood Pressure (Hypertension) 

Hyperprolactinemia or 

prolactinoma 


Breast cancer 

Likely increased risk 

 

Weight gain 

Androgenic alopecia (balding) 

Polycythemia (blood disorder) 

Acne 

Sleep apnea 

Possible increased risk with presence of 

additional risk factors 

No increased risk or inconclusive research 

Hypertension (high blood pressure) 


Cardiovascular disease 

Elevated liver enzymes 

Hyperlipidemia 

Destabilization of bipolar disorder, psychotic 

disorder 

Loss of bone density 

Breast cancer 

Cervical cancer 

Ovarian cancer 

Uterine cancer 

- 10

How to perform 

a breast self 

exam – Trans 

Women 

How to perform a breast self exam – Trans 

Women Video 

 

How to perform 

a breast self 

exam – Trans 

Men 

Abnormal Blood Pressure 

• 130/85 -139/89 is high and 

should be passed on to 

health provider at next visit 

• >140/90-199/110 should call 

their health care provider to 

arrange appointment 

• >200/120 would indicate an 

emergency – immediate 

appointment or go to ER 

immediately 

What are the symptoms of 

high blood pressure? 

• None for most people 

• Pressure in the head, 

light headedness, 

blurred vision, nausea 

and vomiting, chest 

pain, shortness of 

breath 

What is normal blood pressure? 

• Average person Person with diabetes 

below 120/80 (home) below 130/80 

• Consistent, 3 to 4 readings in a row, that are higher should be 

reported to health care provider http://www.heartandstroke.com 

- 11

Blood Sugar Targets 

For people who don’t 


Before meals/fasting 

4-6 

2 hours after a meal 

5-8 

HbA1C < 6.0% 

For people who do 


Before meals/fasting 

4-7 

2 hours after a meal 

5-10 

HbA1C < 7.0% 

LDL cholesterol < 2.0 


1.Wash hands with soap and water or hand sanitizer. 

2.Clean the entire glucometer with an alcohol wipe before use 

each time. 

3.Have your own bottle of strips ready. 

4.Insert one strip into the glucometer (it will automatically turn on). 

5.Turn then pull off the purple head of the lancet, hold up to finger 

and press the purple button until you hear a click. Gently 

squeeze your finger to increase the blood flow. Place used 

lancet into sharps container. 

6.Hold finger with blood sample up to the side of the strip 

7.Glucometer will show your blood sugar reading within 5 seconds 

8.Wrap a band aid around your finger. 

9.Remove the strip from the glucometer and place into sharps 

container. 

10.Clean the glucometer with an alcohol wipe. 

Getting Your Lab Results 

- 12

How to Register for Lab Results 

Risk reduction 


Summary 

Hormones, the minimum effective dose 

Diabetes is the hormone related illness affecting the most 

Canadians 

WPATH 7 outlines the requirements for hormone therapy (HT) 

Trans Health Information Program has guidelines for the 

different types of hormones 

There are significant “Likely Increased Risks” from HT 

You should develop a personal risk reduction plan 

- 13

H A N S K A I 


QUESTIONS? 

- 14


2 – Security 

Eating for Health 

Living Good and Cheap


Eating for Health 

Test your nutrition IQ 

Q. Sunny Delight and Frutopia are examples of real juice? 

True or false 

Q. Instant packaged noodles (Mr. Noodle) are a healthy fast lunch? 

True or false 

Q. Fruit roll-up snacks belong to the Vegetables and Fruit food group? 

True or false 

Q. How many teaspoons of sugar are in a can of regular pop? 

a) 2 

b) 6 

c) 9 

d) 14 

Guiding Principles 

• Achieve Balance 

• Familiarize yourself with portion sizes 

• Eat more fruits and vegetables 

• Eat more whole grains 

• Get Active! 

1

Healthy Eating Tips 

• Follow “Eating Well with Canada’s Food Guide” 

• Eat regularly spaced meals and don’t skip breakfast 

• Eat a variety of foods 

• Try to include fish and meat alternatives into your meals 

• Limit foods high in calories, sugar, fat and salt 

• Stay hydrated with unsweetened beverages 

• Be active everyday 

Canada’s Food Guide 

• Guidance is given for males and 

females, 2 years and older: 

• Children, teens and adults 

Guidance on the quantity of food 

• A small amount of unsaturated 

fats is recommended 

• For intake of essential fatty 

acids 

2

What is one food guide serving? 

A “Food Guide Serving” is: 

– A reference amount 

– Not necessarily intended to represent what would be 

eaten in one sitting 

• Illustrations and different 

measures are used to help 

communicate what is one 

Food Guide Serving 

Guidance on the quality of food choices: 

Vegetables & Fruit 

• Eat at least one dark green and one orange 

vegetable each day 

– For folate and vitamin A intake 

• Have vegetables and 

fruit more often than 

juice 

– For fibre intake 

Guidance on the quality of food choices: 

Grain Products 

• Make at least half your grain products 

whole grain each day 

– For fibre 

– To reduce risk of heart 

disease 

3

Increase your fibre intake 

• Women: 25 g fibre per day 

• Men: 35 g fibre per day 

– Have one high-fibre source daily 

• 2 tbsp ground flax 

• 2 tbsp All Bran Buds 

• Metamucil 

– Eat a meat alternative 3x/week 

• Legumes: lentils, split peas, chickpeas 

• Beans 

Advice for women of childbearing 

years 

• Extra calories are needed during: 

• The 2 nd and 3 rd trimesters of pregnancy 

• Breastfeeding 

• Including an extra 2 or 3 Food Guide Servings is 

expected to meet these additional needs 

Advice for those over 50 

• Health benefits are associated with adequate vitamin D intake 

• Vitamin D requirements increase with age: 

• 600 IU (15 micrograms) for 1 – 70 years old 

• 800 IU (10 micrograms) for people over 70 years old 

• It is difficult to meet these vitamin D levels without 

recommending unrealistic amounts of some foods 

• A supplement containing 400 IU vitamin D, 

is recommended for people over age 50 

4

Food Safety 

• Wash hands often, especially before and after food 

preparation 

• Food should not be kept at room temperature longer than 2 

hours 

• Air dry dishes or use paper towel 

• Look for expiry dates 

• Keep hot foods hot and cold foods cold 

• Ask people in your group if they have any food allergies 

• When in doubt throw it out! 

Increase physical activity 

“F I T T” Principle 

• Aim for 30 minutes 5x/week (150 minutes of moderate to 

vigorous activity per week) 

– Does not have to be all in one session 

Frequency 

Intensity 

Time 

Type 

• Muscle and bone strengthening exercises 2x/week 

Fats: The Good, Bad and the Ugly 

• Good Fats:”unsaturated” fats 

- heart healthy: soft margarine, oils, nuts, salmon 

• Bad Fats: “saturated” fats 

- animal fats: butter, cheese, meat, dairy, tropical oils 

• Ugly Fats: “trans” fats 

- artery clogging: hard margarine, processed baked goods and 

other foods, shortening, “partially hydrogenated” 

5

Cholesterol 

• What foods have cholesterol 

– Shrimp, liver, egg yolks 

• Did you know?? 

– High cholesterol foods are not the only foods that will raise 

cholesterol 

Ways to decrease total fat intake 

Instead of: 

• Cream 

• Oil 

• Salad dressing 

• Sour cream 

• Mayonnaise 

• Butter 

• Fat in baking 

Choose: 

• Half and Half /No fat 

• Non-stick spray/pan 

• Calorie-wise, fat-free 

• Light, fat-free 

• Light, fat-free 

• Soft margarine 

• Applesauce 

Shake the Salt Habit 

High salt foods: canned soups, deli/processed meats, 

condiments, pickles, pre-packaged foods, vegetable juices 

Ways to decrease salt: 

- use herbs and seasonings, powders (garlic/onion) 

- rinse canned foods first – gets rid of about 1/3 the salt! 

- limit salt at the table and cooking 

What are some of your ideas? 

6

Sugar Shock 

“Liquid Candy” 

Drink 

• 1 – 355 ml cola can 

• 1 – 591 ml sport drink plastic bottle 

• 1 – 710 ml cola plastic bottle 

• 1 – 473 ml glass bottle fruit beverage 

• 1 – 1L slush drink container 

• 1 – 1.25 L slush drink container 

• 1 - 500 ml plastic water bottle 

• 1 – 250 ml cup of Tang 

• 1 – cup ice cream sundae 

Teaspoons of added sugar 

9 

12 

18 

15 

31 

38 

0 

14 

19 

• Look at the amount of food 

• Read the % DV 

(5% and 15%) 

• Choose: 

Less of: 

More of: 

Fat 

Fibre 

Saturated and Vitamin A 

Trans fat 

Calcium 

Sodium 

Iron 

Label Reading 

Portion Distortion 

20 years ago vs. now 

7

Portion Distortion 

20 years ago vs. now 

Eat Better Together 

• Healthier meals with less fat, salt, sugar and 

more whole grains and vegetables 

• More control over ingredients 

• Increased communication among family 

members 

• Children less likely to engage in risky behaviors 

Time Saving Tips 

• Use thinner slices of meat, thin pasta (spaghettini) 

• Assign family members tasks 

• Use a crockpot (soups, stews, roasts) 

• Make bulk meals over the weekend to use 

throughout the rest of the week 

• Use pre-cut veggies, bagged salads, pre-grated 

cheese 

8

Remember . . . 

• Achieve Balance 

• Watch portion sizes 

• Eat more fruits and vegetables 

• Eat more whole grains 

• Get active! 

Questions? 

9


3 – Self-Care 

Let’s Get Active 

Exercise, Rest, Water & Poop 

Gender – Dissonance vs Dysphoria 

Sexuality – Healthy & Affirming


Let’s Get Active 


Physical Activity 

Where do you get your info? 

1

Barriers 

Pain? 

Stretching 

• No preworkout 

static 

stretching 

• Will not help 

with muscle 

soreness 

• Will not reduce 

your risk of 

injury 

• Helps with 

circulation 

2

Flexibility & Mobility 

• Flexibility - the capacity of a 

joint or muscle to move 

through its full range of 

motion. 

• Mobility - The ability to 

produce a desired movement. 

• Stability - The ability to resist 

an undesired movement. 

Cardio 

Cardiovascular exercise also called 

cardiorespiratory exercise, or just 

'cardio' involves movement that gets 

your heart rate up to improve oxygen 

consumption by the body. 

Anaerobic exercise is short-lasting, high-intensity activity, where 

your body’s demand for oxygen exceeds the oxygen supply 

available. Anaerobic exercise relies on energy sources that are 

stored in the muscles and, unlike aerobic exercise, is not 

dependent on oxygen from (breathing) the air. 

Muscular Strength & Endurance 

‘Generally’ -Muscular strength is 

the amount of force a muscle or 

muscle group can put out or the 

amount of weight you can control. 

Muscular endurance is the ability 

of a muscle or group of muscles to 

sustain repeated contractions 

against a resistance for an 

extended period of time. 

3

Muscular strength and endurance are 

important for many reasons: 

• Increase your ability to do activities like opening doors, lifting 

boxes or chopping wood without getting tired. 

• Reduce the risk of injury. 

• Help you keep a healthy body weight. 

• Improve confidence and how you feel about yourself. 

• Lead to healthier, stronger muscles and bones. 

• Give you a sense of accomplishment. 

• Allow you to add new and different activities to your exercise 

program. 

Body Composition 

• Note the space 5lbs takes 

up on a body 

• Weight Loss vs Fat Loss 

• More calories to feed 

muscles 

• Weight scale may show 

you gained weight when 

you begin resistance 

training 

Posture is EVERYTHING! 

• Neutral Spine 

• Hips 

• Sitting 

• Rotation 

4

Recovery 

• 300-400 g, 10-20 min. 

• Relax muscles 

• Decrease inflammation 

• Increase perspiration, 

helping to get rid of toxins 

and impurities 

• Stimulates vasodilatation, 

facilitating blood flow to 

the muscles 

• Lower excessive CNS excitation or 

increase it 

• No need for more than 2x per week full 

body 

Fear the ‘Wellness’ Pitch 

Statistics show that most acute Low 

Back Pain begins to improve after 2 

to 5 days and typically resolves itself 

in less than 1 month with nonsteroidal 

anti-inflammatories 

(NSAIDs) and (tolerable) activities.” 

So, to say that a given intervention 

gave you relief from low back pain 

in 4 weeks time, going 3x per week 

for treatment, isn’t impressive as 

that’s likely to happen by simply 

resting at home. 

Exercise 

5

How to use a pedometer 

• Put your pedometer on as soon as possible each day as every step counts 

towards your daily total. 

• Reset your pedometer each morning. 

• The pedometer can be attached to your belt, 

• skirt or jogging clothes, and should be lined up above your knee. 

• The pedometer should be parallel to the ground (not tilted). 

Activity Goal Setting 

• To determine your current level or baseline, wear your pedometer for a 

week and divide your totals steps by seven. To safely progress to higher 

activity levels, you should try to increase your daily steps once per week 

by 10-15% from your current level 

• Aim for 7,500 steps per day if you are looking to maintain your health and 

weight. 

• Aim for 10,000 steps or more per day if trying to lose weight, improve your 

health or increase your fitness. 

• 2000 steps is the equivalent of walking approximately 1 mile and the 

equivalent of expending approximately 100 calories. 

• It takes approximately 5 minutes of walking to accumulate 500 steps. 

6

Canadian Physical Activity Guidelines (18-64 years) 

To achieve health benefits, adults aged 18-64 years should accumulate at least 

150 minutes of moderate- to vigorous-intensity aerobic physical activity per 

week, in bouts of 10 minutes or more. 

It is also beneficial to add muscle and bone strengthening activities using major 

muscle groups, at least 2 days per week. 

More daily physical activity provides greater health benefits. 

Guidelines for Older Adults (65 years and older) 

To achieve health benefits and improve functional abilities, adults aged 65 

years and older should accumulate at least 150 minutes of moderate- to 

vigorous-intensity aerobic physical activity per week, in bouts of 10 minutes or 

more. 

It is also beneficial to add muscle and bone strengthening activities using major 

muscle groups, at least 2 days per week. 

Those with poor mobility should perform physical activities to enhance balance 

and prevent falls. 

More daily physical activity provides greater health benefits. 

Gatherer 9-15km/day 

Hunter 20-50 km/week 

> 8 hr/day 

< 4hr/day sedentary 

Canadians 20-79 reporting vigorous 

physical activity (150 min) = 52% 

Reality 

150 minutes = 15% 

30min/day = 5% 

7

To be healthy, you 

need to adopt an 

ABNORMAL BEHAVIOR 

Questions? 

8


Check-in 

15 Minutes 

Slides – 

20 min 



20 min 

Break + Chat 

20 min 


20 min 


2 hours 

Gender Wellness 

Dissonance vs Dysphoria 


Program 

H A N S K A I 






- 1









INDICATORS 

SECURITY 

SELF-CARE 

BALANCE 

HEALTH 

CARE 

CHANGES 

CLANS 

- 2

Self-Care 

Gender Wellness 

H A N S K A I 


WHAT IS GENDER DYSPHORIA? 

WHAT IS GENDER DISSONANCE? 

WHAT IS COGNITIVE DISSONANCE? 

WHAT IS WELLNESS? 

WHAT IS A PROGRAM? 


- 3

CD-10-CM Diagnosis Codes > Mental, Behavioral and 

Schedule Neurodevelopmental for this session 

disorders F01-F99 > 

Disorders of adult personality and behavior F60-F69 > 

F64 Gender identity disorders 

2017 ICD-10-CM Diagnosis Code F64.0 

Transsexualism 

Clinical Information 

Severe gender dysphoria, coupled with a 

persistent desire for the physical characteristics and 

social roles that connote the opposite biological 

sex. 

The urge to belong to the opposite sex that may 

include surgical procedures to modify the sex 

organs in order to appear as the opposite sex. 


In adolescents and adults 

gender dysphoria diagnosis 

involves a difference between 

one’s experienced/expressed 

gender and assigned gender, 

and significant distress or 

problems functioning. 


A form of cognitive dissonance experienced by 

trans people due to a misalignment of their 

subconscious and physical sexes. 

Gender dissonance differs from the psychiatric 

term “gender dysphoria,” which typically conflates 

this cognitive dissonance regarding one’s sex with 

the mental stresses that arise from societal pressure 

to conform to gender norms. 

A subconscious, intrinsic, self-understanding that all people experience 

regarding their own sex embodiment. Cissexuals tend not to notice or 

appreciate their own subconscious sex because it is concordant with their 

physical sex. In contrast, trans people tend to be excruciatingly aware of their 

subconscious sex (as it is at odds with their physical sex). 

- 4

Schedule Cognitionfor the this act session of knowing; 

perception 

Gender Schedule for this session 

Dissonance 

Ineffable 

ideas that 

cannot be 

expressed 

in spoken 

words 

- 5

(Fill in the blanks) 

How do we 

describe the 

in·de·scrib·a·ble 

Six Dimensions of Wellness 

we are more basic…. 

“Wellness is the integration of our bodies, 

genders, minds, selves and communities into 

the minimum effective dose of rest, nutrition, 

activity and socialization to maintain 

ourselves above the level of symptoms. 

 

Rainbow Health Co-operative 

- 6

Where Does Self-Care Fit into Health? 

Social Heath Indicators 

Personal Heath Indicators 

Example: 


- 7

Gender 

Dissonance 

Gender 

Dysphoria 

Anxiety 

Depression 

Develop Capacity for long term effort 

Time for self-care 

Reward for 

behaviour change 

H A N S K A I 

A Wellness Program: 

Summary 

Develops habits that enhance wellness 

Informs about self-care 

Applies the minimum effective dose 

Maintains awareness of health indicators 

States when and how to seek help 

Develops capacity for long term effort 

Tailored to the individual and provides 

feedback on results 

- 8


4 – Balance 

Achieving Balance 

Emotional and Mental Wellness


Achieving Balance 

Stress 

What is stress? 

•Body’s way of responding to demand 

•Chemicals released give us energy and strength 

How do we know we’re stressed? 

Fight or flight 

Environment 

Internal 

Fatigue 

Types of stress – episodic, chronic 

Thoughts about Stress 

While stress does involve events and our response to 

them, these are NOT the most important factors. 

It is our thoughts about the situations in which we find 

ourselves that is the critical factor. 

1

3 Stages of Stress 

•Stage 1 - Body activity is increased – heart rate, rapid 

breathing, sweating, butterflies 

•Stage 2 – body uses up its resources (feel tired, 

fatigue, memory loss, cold/flu, increased consumption 

of coffee, smoking, alcohol 

•Stage 3 – Energy stores are drained. Serious illness 

can develop – heart disease, mental illness, insomnia, 

personality changes 

Coping Mechanisms 

Short Term: 

• ? 

Long Term: 

• ? 


Mingling 

Walking Backwards 

2

Mental Health 

Mental health is defined as a state of well-being in which every 

individual realizes her own potential, can cope with the normal 

stresses of life, can feel productive and fruitful and make a 

contribution. 

Taking care of yourself and asking for help when you need it are 

signs of health and strength. 

Older adults may experience depression more than others due 

to so many changes in roles and social networks. 

Non-REM Sleep – 75% 

• Stage 1: Light sleep, between being awake and 

falling asleep 

• Stage 2: Onset of sleep, disengaged from 

surroundings, body temperature drops, 

regular breathing & heart rate 

• Stages 3: Restorative sleep – Breath slower, 

Blood Pressure drops 

REM Sleep – 25% 

Rapid-Eye-Movement Sleep 

• Electrical activation of the brain 

• Very relaxed muscles 

• Body immobile 

• Eyes dart back and form 

• Provides energy to the brain and supports mental 

function 

3

Effects of Poor Sleep 

• Hand/eye coordination 

• Hormonal function – fat regulation 

• Memory, poor attention 

• Impaired judgment 

• Mood 

• Carb craving 

• Weakened immune system 

What gets in the way? 

Pain 

4

Recognize what you can change 

Strategies 

Meditation 

Progressive Muscle Relaxation 

Emotional Support 


Questions? 

5


Check-in 

15 Minutes 

Slides – 

20 min 



20 min 

Break + Chat 

20 min 


20 min 


2 hours 

Mental & Emotional Wellness 


Program 

H A N S K A I 






- 1









INDICATORS 

SECURITY 

SELF-CARE 

BALANCE 

HEALTH 

CARE 

CHANGES 

CLANS 

- 2




dose of rest, 





symptoms. 



for: 

our bodies 

our minds 

our emotions 

our gender 

and 







above the 


- 3



whether 


or 



self-care 

and 

shared-care 


behaviours 


- 4



such as 


BALANCE 

Mental & Emotional 

Wellness 

Anxiety and Depression 

Anxiety: 

• Generalized fear without a focus that you are aware of 

• Can come from distance in an attachment relationship 

• a fragmented sense of self, future worry 

• fear of future events but unsure of what to be fearful of 

Depression: 

• Sadness that last longer than two weeks 

• Can become chronic from self-condemnation 

• We turn anger on ourselves to create an illusion we have control 

• Can be simply caused by brain chemicals. See your Doctor 

- 5

Anxiety and Stress are not the same 

Stress is a response to a threat in a situation 

Anxiety is a reaction to the stress 

Managing stress reduces anxiety 

What is Stress? 

Different for 

everyone 

Individual 

meanings 

Strain or 

tension 

What causes 

N – anything that is new or a novelty. 

U – unpredictability or unpredicted. 

T- any threat to the personality. 

S – feeling a poor sense of control; 

either real or imagined. 

- 6

The Triple A Approach To Stress 

Alter 

The 

situation 

Avoid 

Accept 

The First A - Acceptance 

We have the capacity for normal stress 

Accept 

Be as 

positive 

as 

possible 

Needs 

to be 

done 

Going 

to the 

dentist 

Stress Activates Thoughts and Feelings 

It’s supposed to 

Come and go in your mind and body. 

You cannot control them. 

You are not them; they are a part of you. 

You can develop a relationship of acceptance and 

acknowledgement with them. 

They can be your friends, allies, and radar to navigate 

relationships. 

We have a great capacity to feel so we always have 

more space for them. 

Feelings cannot kill us. So calm down. 

- 7

Six Core Emotions: 

Come from deep within your consciousness 

Six Core Emotions: 

Using them effectively vs ineffectively 

Happiness – things are optimal; keep moving in that 

direction 

Sadness – you have suffered a loss; slow down and 

take care of yourself 

Fear – be cautious, protect yourself of the danger it 

tells you is there 

Anger – you’ve suffered injustice; use the energy to 

solve the problem 

Surprise – used a lot in humour; we don’t tense up so it 

goes away quickly 

Disgust – way past dislike perhaps as far as repulsive 

Capacity to accept comes from 

The flip side of stress is not relaxation; it is 

resilience. 

The healthful ability to come up with a 

Plan B in the face of a stress full 

situation 

- 8

The Second A - Avoidance 

Identify stressors 

Remove them 

Avoid 

Take care in using avoidance 

Not appropriate when… 

Just to please others 

Avoiding or altering it would reduce your stress more 

Feel like you have no choice 

The Third A – Alter 

Think positively and 

having a positive attitude 

Improving specific skills 

Doing something 

differently 

- 9

1 Be Proactive 

2 - Begin with the End in Mind 

3 - Put First Things First 

4 - Think Win-Win 

5 - Seek First to Understand, Then 

to be Understood 

6 – Synergize 

7 - Sharpen the Saw 

Mindfulness Exercise 

Would you like to take part in an exercise to become 

more aware of thoughts and feeling? 

Would you like to get better at feeling instead of 

rejecting, avoiding, or suppressing them? 

H A N S K A I 

Summary 

- 10

H A N S K A I 


QUESTIONS? 

- 11


5 – Healthcare 

Primary Care Through the Years 

Get What You Pay For


Primary Care Through the Years 


Outline 

1. Introduction 

2. Annual Check-up 

3. Pediatrics – What is involved in a health 

review 

4. Adults – What is involved in a health review 

5. Fall Prevention/Senior Concerns 

6. Who to see when 

Introduction 

• Everyone should have a primary health care 

provider 

• M.D. vs N.P 

• It pays to prepare – list of concerns and 

questions 

- have your medication list with you 

1

What is an annual check-up? 

• A time to touch base with your health 

provider 

• Will check-in to see generally how you are 

doing with your health 

• May also include recommended screens 

• May not include a head-to-toe exam 

Pediatrics 

Each annual visit could include: 

• Body measurements – ht, wt, head circumference, BP 

• Developmental markers 

• Lifestyle assessment and education 

• Physical assessment 

• Immunizations 

• Parental Concerns/Safety issues 

Development 

• Gross motor 

• Fine motor 

• Language 

• Independence 

• Socialization 

For adolescents also include: 

• Puberty changes 

2

Lifestyle Assessment 

• Nutrition 

• Exercise 

• Dental Care 

• Safety issues 

For Adolescents also include: 

• Substance Use 

• Reproductive Health 

Immunizations 

2 month – Diphtheria, Tetanus, Pertussis, Polio, Haemophilus influenzae, 

Pneumococcal – total 2 injections 

4 month – same as 2 month - boosters 


12-15 month – Varicella, Measles, Mumps, Rubella, Meningococcal – 

total 2 injections 


4-6 year – Diphtheria, Tetanus, Pertussis, Polio, Measles, Mumps, Rubella 

Grade 4 - Hepatitis B, Meningococcal 

Grade 6 – Girls only – Human Papilloma Virus 

Grade 9 – Tetanus, Diphtheria 

Adults 

Each visit could include: 

• Body Measurements – weight, BP 

• Lifestyle Assessment and Education 

• Health Screenings 

• Appropriate Immunizations 

• Address Concerns 

• Medication Review – Herbal, OTC, Prescribed 

• Health History Review 

3

Lifestyle Assessment 

• Nutrition 

• Exercise Pattern 

• Use of Nicotine, Alcohol, Recreational Drugs 

• Stress Management 

Health Screens 

• Cholesterol 

• Diabetes 

• Blood Pressure 

• Stool for Occult Blood 

• Cervical 

• Mammogram – 50 – 69 years old, every 2 years 

• Vision – every 3-5 years 

• Hearing – T.V. turned louder? Miss conversations? 

Fall Prevention 

• Balance, muscle tone and bone strength 

• Vision and hearing 

• Unsafe conditions 

- in the home 

- outside 

• Proper nutrition 

• Appropriate footwear 

4

Vaccines - Adults 

Tetanus – every 10 years 

Flu vaccine – annually – especially 

recommended with young children, elderly 

and people with chronic disease 

Pneumonia vaccine – at age 65 or earlier if you 

have a chronic disease 

Health Care Provider 

Who? What? Where? 

Health Links – ph: 204 -788-8200 

24/7 phone line 

Quick Care Clinic – 363 McGregor Ave. 

Mon- Fri 1-8:30 Sat/Sun/Holidays 9-4:30 

ER 

Questions 

?? 

5


6 – Changes 

Surgical Choices and Care



Check-in 

15 Minutes 

Slides – 

20 min 



20 min 

Break + Chat 

20 min 


20 min 


2 hours 

Your Body 

Surgical Choices and Care 


Program 

H A N S K A I 






- 1









INDICATORS 

SECURITY 

SELF-CARE 

BALANCE 

HEALTH 

CARE 

CHANGES 

CLANS 

- 2



for: 

our bodies 

our minds 

our emotions 

our gender 

and 







above the 




whether 


or 


- 3


self-care 

and 

shared-care 


behaviours 




such as 


- 4

H A N S K A I 


Review how a wellness program works 

Surgical choices and care 

CHANGES 

Surgical Choices and Care 

WPATH 7 Standards of care 

- 5

ACCESSING SURGERY 

IN BC 

Top Surgeries 

Breast 

Augmentation 

Chest Contouring 

Hysterectomy 

6 months 

Orchiectomy 

6 months 

A number of 

surgeons do these 

surgeries 

ACCESSING 

SUGERIES IN 

CANADA 

Phalloplasty 

Metoidioplasty 

Vaginoplasty 

Vulvoplasty 

Labiaplasty ? 

Primary care – 

responsible for surgical 

readiness 

Post – surgical 

Montreal regime 

TCBC Nurse support for 

trans post surgery is 

optional 

ACCESSING SURGERY OUTSIDE OF 

CANADA 

Any surgery outside of Canada is typically 

private 

MSP decision – not common – go to website 

Out of country option for masculinizing bottom 

surgeries may be available 

United States – Expensive with exchange 

Thailand – Affordable, but travel is major factor 

Serbia - Affordable, but travel is major factor 

http://www.transhealthcare.org/ 

- 6

What costs associated with gender-affirming surgery will not be 

covered by MSP? 

While MSP pays for the cost of the above surgeries, there are some 

costs that are not covered. These include: 

1. Travel costs to and from Montreal for lower surgeries and surgical 

revisions. Please note that masculinizing bottom surgeries, erectile 

and/or testicular implants require at least two trips to Montreal. 

2. Supportive garments (for breast construction and chest surgery) 

I can’t afford the cost of my flight(s) to Montreal for gender-affirming 

surgery. What are my options? 

You can apply to Hope Air, a Canadian charity that arranges free 

flights with commercial carriers, for Canadians who must travel to 

health care. 


Program 

EXPLICIT IMAGES 

OF GENITALIA AND 

SURGERY 

- 7

Bottom surgeries 

Trans masculine 

Hysterectomy 


Phalloplasty 

Scrotoplasty 

Testicular implants 

Other surgeries 


Top Surgery 

Body Sculpting 

SURGICAL PREPARATION & REQUIREMENTS 


Electrolysis 

Required for phalloplasty 

Must start 1 year prior to surgery 

Weight 

Primary care determines surgical readiness 

Other pre-conditions 

Diabetes 

Smoking 

SLIDE NEEDS COMPLETION 

METOIDIOPLASTY 

Clitoris is released from 

its surrounding tissue 

and urethra 

lengthened using 

clitoral hood or vaginal 

mucosa 

Flap of skin from the 

labia minora is then 

wrapped around to 

create a small 

phallus 

- 8

METOIDIOPLASTY RESULTS 


Metoidioplasty, scrotoplasty, 

testicular implants 

Phalloplasty 

Phalloplasty 

- 9


Program 

Bottom surgeries 

Trans feminine 

Penectomy 

Orchiectomy 

Vaginoplasty - inversion 

Vaginoplasty - other 

Vulvoplasty 

Labiaplasty 

Clitoroplasty 

Other surgeries 


Augmentation 

Saline / Silicone 

Facial Feminization 

Trachea Shaves 

Body Contouring 

Liposuction 

SURGICAL PREPARATION & REQUIREMENTS 


Electrolysis 

US – Required by most 

Canada – Optional 

Best started 1 year prior to surgery and stopped 2 months 

before surgical date 

Weight 

Primary care determines surgical readiness 

Other pre-conditions 

Diabetes 

Smoking 

- 10

Vaginoplasty – penile inversion 

7 Labias formed 

8 Post surgical 

5 Cavity created 

6 Neo vagina drawn in 

3 Cavernosa removed 

4 Neo vagina formed 

1 Testes removed 

2 Glans released 

- 11

Vulvoplasty 

Labiaplasty - Clitoroplasty 

Before 

labiaplasty 

After 

labiaplasty 

Orchiectomy 

- 12

Post surgical aftercare – 

trans feminine trans masculine 

Separate 

BOTH 

Wound Care 

Pain Management 

Mobility 

Swelling 

Sex 

Separate 

Dilation 

Douching 

H A N S K A I 

Summary 

Surgery 

ACCESS 

PREPARATION 

COSTS 

TRAVEL 

AFTER CARE PLAN 

RECOVERY 

SCHEDULING 

H A N S K A I 


QUESTIONS? 

- 13


7 – Clans 

Families of Origin and Choice


3

Working Together 

Respecting boundaries and working 

without a leader 

Check-Ins 

• Check-ins are a great way to start off every meeting. 

• They give everyone a chance to give an update about how 

they’re feeling 

• It also gives the group a better understanding of people’s 

actions for the rest of the meeting 

• With a check-in you only have to share what you want 

Boundaries 

• There are many ways of thinking about boundaries 

– Borders between countries 

– Fences around a playground 

– Personal boundaries 

– Personal values 

• Our boundaries are defined by our experiences, our beliefs 

and our culture. 

1

Boundaries 

• In Hans it’s natural for some people to 

open up about personal health 

information or life experiences. 

• It’s also natural for some people to not 

be as comfortable opening up. 

Boundaries 

• If one person feels comfortable 

enough to share information it doesn’t 

mean you or anyone else must. 

• Everyone has the right to set their own 

boundaries 

Boundaries 

• Hans groups should be a safe space 

for everyone. 

• Respecting people’s privacy, beliefs 

and boundaries is key to a successful 

group. 

2

Consensus 

• Consensus means that decisions are made 

in a way that everyone has had an equal 

say 

• A group using consensus requires a culture 

of cooperation, openness and involvement 

• It only takes one ‘no’ to block the decision 

Consensus 

With consensus everyone brings a piece of 

the puzzle. You can’t finish the puzzle unless 

everyone has a say. 

Consensus 

• If someone says ‘no’ you must work together to 

reach a compromise where everyone is 

comfortable enough to say ‘yes’ OR at least not say 

‘no’ 

• Remember, just because you can block (say no) 

doesn’t mean you always should. 

• Ask yourself “Is this something I can live with?” 

3

Consensus 

• When someone says ‘no’ then the group 

needs to have a conversation. 

• It helps the conversations move smoothly if 

one person becomes a facilitator. 

• A facilitator should be chosen prior to the 

meeting and the same person should not 

always be the facilitator. 

Topic 

E.g.: What should we eat next meeting? 

No 

Suggestions 

E.g. Let’s have red pepper hummus 

No 

Block 

Someone says no to the idea 

Discussion 

Chat about why someone said no 

E.g. Charlie is allergic to red peppers 

Consensus 

Everyone agrees 

Adjusted Suggestion 

Make new suggestions that respect and include everyone's thoughts 

E.g. Let’s have regular hummus 

Tuckman’s Stages 

• When people get together in a group they don’t usually jump 

right into things perfectly 

• There are always some growing pains along the way 

• In 1965, Dr. Bruce Tuckman developed a model with four 

phases that every group goes through when developing. 

1. Forming 

2. Storming 

3. Norming 

4. Performing 

4

Forming 

• This is where all groups start out 


• It’s the ‘Get to know you’ stage for members where you learn 

about each other and the task (Hans) at hand 

• Individual behavior is usually driven by a desire to be 

accepted by the others, and avoid controversy or conflict 

• This stage might include: Unclear objectives, uninvolvement, 

uncommitted members, confusion, low morale, hidden 

feelings, poor listening, etc. 


Storming 

• Every group will enter the next stage in which different ideas 

compete for consideration. 

• The storming stage is necessary for the growth of the team. 

• It can be difficult, unpleasant and even painful, especially for 

members of the group who are averse to conflict. Tolerance 

and patience are key here for the success of the group. 

• This stage might include: Lack of cohesion, subjectivity, hidden 

agendas, conflicts, confrontation, resentment, anger, etc. 


Norming 

• In this stage, all group members take the responsibility and 

have the ambition to work for the success of the group's goals. 

• Some team members may have to give up their own ideas 

and agree with others in order to make the group function, 

but they are now more comfortable doing so. 

• This stage includes: Questioning performance, 

reviewing/clarify objective, changing/confirming roles, 

opening risky issues, assertiveness, listening, identifying 

strengths and weaknesses etc. 

5


Performing 

• The group members are now competent, autonomous and 

able to handle the decision-making process with minimal 

outside help. 

• Disagreements are expected and allowed as long as it is 

channeled through means acceptable to the team. 

• This stage includes: Creativity, initiative, flexibility, open 

relationships, pride, concern for people, learning, confidence, 

high morale, etc. 


On Going 

• Even the highest performing groups will slip 

back into earlier stages every now and then 

• This is a normal part of a group’s growing 

pains 

Questions? 

6


Check-in 

15 Minutes 

Slides – 

20 min 



20 min 

Break + Chat 

20 min 


20 min 


2 hours 

Facilitation for Groups 


Program 

H A N S K A I 






- 1









INDICATORS 

SECURITY 

SELF-CARE 

BALANCE 

HEALTH 

CARE 

CHANGES 

CLANS 

- 2




dose of rest, 





symptoms. 



for: 

our bodies 

our minds 

our emotions 

our gender 

and 







above the 


- 3



whether 


or 



self-care 

and 

shared-care 


behaviours 


- 4



such as 


Clans 

Facilitation for groups 

Welcome 

• Thank you for coming today! 

• Knowledge-sharing. 

• The first training session, definitely not the last. 

• Foundational information. 

• Please read through the manual. 

• There are no right or wrong answers. 

• Feedback! 

- 5

Facilitator 101 

• What is a group facilitator? 

• What does being a group facilitator mean to you? 

• What qualities are important in a facilitator? 

Responsibilities of Facilitators 

• What do you think 

are the main 

responsibilities of 

facilitators? 

Co-Facilitation 

• How many people here work with a co-facilitator? 

• How have you divided tasks between you? 

• How do you communicate? 

- 6

Safe Spaces 

• How do you create a safe space? 

• What is a Safe Space Agreement? 

Co-Facilitation 

Turn to the person next to you: 

• Discuss some questions you feel are important to ask your cofacilitator 

before starting your group. 

• What would you like your co-facilitator to know about you? 

Personal Pronouns 

• What are personal pronouns? 

• How do you ask about someone’s 

personal pronouns? 

• What do you do if you forget 

someone’s personal pronouns? 

- 7

Safe Space Agreement Exercise 

• Turn to the person next to you and practice creating a 

Safe Space Agreement. 

Professional Boundaries 

• Why are boundaries important? 

• What boundaries must be established? 

Debriefing 

• What is debriefing? 

• What situations warrant 

debriefing? 

• What are the stages of 

debriefing? 

• Have you experienced 

situations where you wished 

you had debriefed them 

afterwards? 

- 8

Group Exercises 

• Why are exercises 

important? 

• Does anyone have an 

example of an exercise 

they have used in their 

group? 

• What should you 

consider when designing 

an exercise? 

Handling Feedback 

• How many people have 

received feedback before? 

• How do we react to 

feedback? 

• How do we want others 

to react? 

Peer Support 

• What is peer support? 

- 9

Equal Status and Experience 

• What does equal status mean? 

• Who feels like everyone in their group shares 

equal status? 

• What is the difference between knowledge and 

experience? 

• How do we support individual experiences? 

Giving and Receiving 

• Are you the only one giving support in your group? 

• How do we balance lived experience with participant 

focus? 

Communication 

• How do we best 

communicate with group 

members? 

• Do we use “I” 

statements or “you” 

statements? 

• Do we address ideas or 

people? 

- 10

Active Listening 

• What is active 

listening? 

• How can you tell 

when someone is 

actively listening 

to you? 

Active Listening 

• Turn to the person 

next to you and tell 

them the story of 

how you became a 

facilitator. Have 

them repeat it back! 

Then switch! 

Confidentiality 

• What does confidentiality mean? 

• What should be kept confidential? 

• What do you do when you run into group 

participants outside of the group? 

- 11

Disclosure 

• What is disclosure? 

• Have you had someone disclose to you before? 

• Would you handle it differently in retrospect? 

Group Goals and Guidelines 

• What are group goals? 

• Why are group goals important? 

• Why are guidelines important? 

• What are some guidelines you have established in the 

past? 

• What questions would you ask yourself when creating 

guidelines? 

• How can you tell that it is time to revise guidelines? 

Healthy Groups 

• What is a healthy 

group? 

• What are the 

signs of a healthy 

group? 

- 12

Unhealthy Groups 

• What is an unhealthy group? 

• What behaviours are common in unhealthy groups? 

Difficult Dynamics 

• What difficult 

dynamics have you 

experienced? 

• How did you handle 

them? 

Difficult Dynamics Exercise 

• Think of one difficult dynamic or participant you 

have had in the past. 

• Share a situation with the group. 

• Look through your charts and match up the 

behaviour with a solution! 

- 13

Group Decision-Making 

• Why is group decisionmaking 

important? 

• What are some 

characteristics of group 

decision-making. 

Facilitator Checklist 

• Included a checklist in your manual. 

• Please take time to read through your manual. We 

wanted today to be a bottom-up approach. The 

manual is more top-down. 

• Please read through the Code of Respect at the 

back. 

H A N S K A I 


QUESTIONS? 

- 14

2018 Hans Kai Facilitator Resources

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