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Diabetes Support at School
I am a firm believer that groups can make all things fun, not just bearable. In almost 20 years of school guidance counseling, I’ve had kids in support groups laughing even when dealing with such heavy topics as grief and divorce. Over the last three years I have developed and led a support group of middle school students who have Type 1 diabetes. And they have been grinning, snickering, and laughing out loud!
If your school or community does not offer a support group for teens with diabetes, perhaps you need only to ask for one. That’s what happened in my case. A parent of a recently diagnosed child commented to the school nurse, in my presence, that she wished there were a support group somewhere for such kids. Knowing next to nothing about Type 1 diabetes, I stepped up.
How do you initiate such a group at your child’s school? First, you need to contact a guidance counselor or the school nurse to find out if there are enough students with Type 1 diabetes to form a group; an effective group needs at least four members. (The same general approach would likely work well for a group of students with Type 2 diabetes, although you might need to alter some of the activities suggested here.) Then you need to ask the counselor to consider becoming its leader. Emphasize the emotional and social benefits of having such a group. Point out that a group will help students realize they are not alone in coping with this condition, and that group members will form a close bond with each other as they express feelings that only others with diabetes can fully understand. In a group setting, they can learn from each other’s mistakes, discuss uncomfortable situations that arise, and buoy one another with hope. It should be hard for the counselor to ignore your plea, especially if you come equipped with a suggested group agenda (such as a copy of this article)!
No meetings should be conducted with the students before parents are contacted. Some families may have reservations about a counselor talking with their children about a private health condition, but most will be pleased that someone is recognizing their special concerns. So far I have had 100% participation. Parents have been not merely agreeable, but enthusiastic.
Though my focus is middle school, these group sessions could easily be adapted for elementary school. The nature of this kind of group calls for a yearlong schedule: It’s not as if the students’ diabetes will disappear for part of the year. Also, since the group will most likely be composed of students from several grade levels, practical scheduling may limit meeting times to the first or last period of the day. For this reason, I meet with my group on a monthly rather than weekly basis throughout the school year. With meetings spaced far apart, the first- and last-period teachers rarely complain about the students missing their classes.
A group leader will most likely find that the months don’t roll around fast enough for students in the group. Most kids with Type 1 diabetes have never before had the opportunity to be in such a setting, and they are elated to have their situation acknowledged. Add to that the opportunity to miss class once a month, and the diagnosis has suddenly taken on a positive aura.
I invited the school nurse to be a part of our group, and she joins us when no “emergencies” are parked at her door. The relationship of a child with diabetes (or another chronic condition) with the school nurse — if there is one — is of paramount importance. In a support group, the nurse can learn about the multifaceted lives of these students, something beyond the daily accounting of numbers.
After the leader has covered the basics, the group can move on to a great conversation starter: a sentence-completion activity. Before the meeting, the leader should write unfinished sentences about diabetes on a piece of paper, cut the paper into strips so there’s one sentence per strip, and place the strips in a basket. When the group is ready, pass the basket and have each child draw a strip. Students should be allowed to pass or redraw if they do not feel comfortable finishing the sentence on their slip. Here are some examples of what to write:
It is important to take as much time as needed for this activity, allowing students to elaborate on their own statements and those of others. They may be new to each other and a bit timid at this first session. At first the older students may tend to dominate the younger ones, and the leader will need to take over the reins if this happens.
Challenge of the day
Other possible “challenge of the day” topics are field trips, swimming pool events, sleepovers, and even something as general as the amount of time spent each day checking blood glucose levels.
Jonathan’s chess club always has snacks during the meeting. Students take turns providing refreshments, and most bring regular sodas and high-calorie sweets. Jonathan should (A) eat nothing and sulk, (B) eat some of it if he’s hungry and cover the carbohydrate he consumes with insulin, (C) bring his own snacks, or (D) when it’s his turn, bring in healthy snacks.
To raise the chances that all the different topics will get discussed, the leader should not tell students during the first round that the colors of the strips mean anything. After the first round, however, students can be told that all yellow strips are about money, all blue ones are about food, etc. Then in subsequent rounds they can exercise choice in selecting the area they want to discuss. With the strip labeled “food,” students may talk about not always being able to eat what everyone else in the family is having for dinner, or about the trouble their mothers go to just to cook something special for them. With the strip labeled “activities,” there may be responses about the whole family canceling plans when the student has an episode of low blood glucose. The strip labeled “siblings” can be expected to stir up some anger: Students may report on siblings who taunt them while snacking on candy bars or who scream in jealousy over all the attention the sibling with diabetes gets. This activity sparks both laughter and shared frustration, and helps bond the students even closer.
Since January is a time of beginnings, this session will emphasize the value of focusing on the many other aspects of life. The students can do this by making a collage. For this, the group leader should cut out magazine pictures ahead of time and lay them out on a table. Students can then select pictures that they think represent them both now and how they’d like to be in the future. Once they have completed their collages, each should share the reasons for his choice of pictures. At the end of the year, when the students complete evaluation forms, many may choose this session as their favorite — they are given permission to see themselves, and encourage others to see them, as someone other than “that diabetic kid.”
Advances in medicine
It’s wise to prepare some questions together at the previous meeting that group members can ask in case they suddenly freeze up. As usual, the leader can write the questions, cut them into strips, and throw them into that faithful basket for group members to draw from. Here are some examples of questions students may wish to ask:
There won’t be a pause of two seconds before discussion erupts! Some members of the group will recognize themselves in these scenarios and openly admit to exhibiting negative attitudes at times. It’s all right for the students to freely express themselves and to chide one another, but the leader should keep it from becoming vindictive.
Life-size board game
Each student then takes a turn by drawing a slip from the basket. Once everyone has had a turn, the same order is cycled through again until someone reaches the finish line.
Here are some examples of instructions to write on the slips:
There can also be a number of “free space” strips; this means a free step forward. If the group uses up all the strips before someone has reached the final space, the strips can simply be put back into the basket and recycled.
End of the school year
Finally, at this meeting the group leader should distribute an evaluation form. It should ask the students what they liked about the group, what they would change, what their favorite session was, and other pertinent information. This input can then be used to tailor sessions for the next year, so that when the students come back, they continue to be motivated by fun, thoughtful activities. This is only fair, given the humor, sincerity, and love that they will bring to the group.
If you are a school counselor who has been asked to start such a group, consider the immense benefit that a support group will give to students with diabetes. You have been provided with a plan in this article, and of course you can use your imagination to expand upon the activities or create new ones. Start a group and watch it take off! You’ll have no regrets.
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