AN EXAMINATION OF A BLIND VETERANS PEER SUPPORT GROUP AT THE DENVER VA MEDICAL CENTER Presented by: Brian M. Polovoy, MS, MSW, LCSW & Pamela Newton, MA,

AN EXAMINATION OF A BLIND VETERANS PEER SUPPORT GROUP AT THE DENVER VA MEDICAL CENTER

Presented by:

Brian M. Polovoy, MS, MSW, LCSW & Pamela Newton, MA, VHA-CM

DISCLAIMER

The following presentation is not affiliated with the Veterans Administration

All views and opinions expressed are solely those of the presenters and in no ways are representative of the Veterans Administration, U.S. Government or any other entity

SUPPORT GROUP BACKGROUND

BACKGROUND

• The support group was first conceived by Pamela Newton the VIST Coordinator for the Denver VA Medical Center. After working in this position for a number of years, Pamela recognized the need for some form of peer support among the Veterans she was serving

• After conducting some preliminary research, Pamela realized that the emotions one feels when losing a loved one are similar to those which are experienced by individuals who lose their sight

• As a result, Pamela came to the understanding that many of the peer support techniques which are commonplace in grief and loss groups could potentially be helpful for many of the blind and visually impaired veterans with whom she was working

• Pamela then consulted social workers and other mental health professionals on group process; as well as attended a retreat on group process at the Lighthouse in New York City; culminating in the creation of a peer support group for blind and visually impaired Veterans

• The main goal of this support group was for Veterans to have a network of trusted individuals outside of professionals with whom they can share their struggles

• This group was created 17 years ago as a forum for blind Veterans to address the following:

• The processing of vision loss

• The idea of “I am not alone”

• Redefining thoughts of helplessness or uselessness

• Coming to grips with the idea that vision loss is an all-encompassing lifelong journey.

• The initial format of the group became more of a psychoeducational design. This consisted of mostly guest speakers and lectures. Although this provided a great deal of information for the Veterans, it failed to provide the empowerment piece which was central to the initial goal of the group’s formation

• This format continued for approximately the first 10 years of the group. This in turn lent itself to continued reliance on the VIST coordinator, and stunted growth in many of the key areas which were first envisioned.

• Within the past five years the group has evolved towards its intended goal with its focus now being placed on peer support rather than psychoeducation

The purpose of this qualitative study was to:

• Examine the perceptions and values of the Veterans related to the

effectiveness of group support

• Examine the group’s effectiveness in addressing core values

relating to an increase in the quality of life for group members

• What improvements can be made to increase the overall benefit

and satisfaction of the group

METHODS

PARTICIPANTS

• The data for this qualitative study were collected from individual face-to-face interviews with members of the Blind and Visually Impaired Veterans Support Group

• Males ages 65-90

• The Veterans in this group spanned through three different wartime eras; these being World War II, Korea and Vietnam

• The Veterans fell on a visual impairment spectrum from legally to complete and total blindness

STUDY FORMAT

A semi-structured interview guide designed to explore the following core areas:

(1) Reasons for continued participation in the group

(2) Feelings and attitudes toward peer support

(3) Changes that may have occurred as a result of continued participation in the group

(4) Improvements needed for the betterment of the group as a whole

RESULTS

A thorough analysis of the data, several major themes had emerged. These included:

(1) Camradery and brotherhood

(2) ‘All in the same boat’ phenomenon

(3) Ability to cope with difficulties associated with vision loss/blindness

(4) Widening the scope of what is possible regarding vision loss/blindness

(5) Empowering group members to become the greatest source of support and knowledge for one another

CAMRADERY AND BROTHERHOOD

• “The comradery is more important now than a lot of other things [...] it allows me to lean on them as much as they lean on me. Everybody leads everybody else through the darkness.”

• “Comradeship of the members is an extremely important idea. It’s the brotherhood that allows me to get through.”

• “Being with the group has allowed me to see the importance of having people who support you as you go along in your journey.”

ALL IN THE SAME BOAT PHENOMENON

• “We all have the same problem […] our limitations are focused in the same area.”

• “It’s good to know that we’re not the only ones in the world dealing with this situation, that there are others in the same boat.”

• “It humbles me a great deal […] [being] around other Veterans in a similar situation allows me to go on through their inspiration.”

• “It’s good being around people who understand who you are and where you come from.”

• “I like being around Veterans with the same problem I have. Being around sighted people is not comfortable for me and when I’m in the group I’m always comfortable.”

• “Having people from similar backgrounds dealing with similar issues allows me to deal with my limitations and issues surrounding visual impairment and blindness more easily.”

• “I’m willing to stumble through situations that I wouldn’t have attempted before due to the support of other Veterans.”

ABILITY TO COPE WITH DIFFICULTIES ASSOCIATED WITH VISION LOSS/BLINDNESS

• “Seeing other people in worse condition than I am and how they cope with their vision loss and leading productive lives and not hibernating allows me to know that a real life is possible.”

• “It’s given me confidence to know that other people are struggling […] It’s good to know that other blind guys are struggling the same way you are.”

• “You always have someone a little worse than you are from whom you can learn things.”

• “Being with the group allows you to realize that other people are handling their impairments and triumphing over them […] other members of the group are examples of success in spite of their condition rather than failures […] if they can do it, so can I.”

WIDENING THE SCOPE OF WHAT IS POSSIBLE REGARDING VISION LOSS/BLINDNESS

• “When you have a disability, it makes you want to feel sorry for yourself or depressed like your lacking something other people have.”

• When asked the question, “Has attending the group changed the way you look at the world? If so, how?” A number of the Veterans expressed the following sentiments:

• “It stopped me from feeling sorry for myself, it gets me out and gets me going, it opened my eyes towards freedom I thought was no longer possible.”

• “Hearing the stories of different Veterans inspires you and allows you to set goals for yourself based on what they have achieved for themselves.”

• “Attending the group has allowed me to see different ways of doing things that I may not have thought of.”

• “It’s allowed me to see what is possible through listening to the stories of other guys.”

• “Finding out how other people have overcome different obstacles gives me hope.”

EMPOWERING GROUP MEMBERS TO BECOME THE GREATEST SOURCE OF SUPPORT AND KNOWLEDGE FOR ONE ANOTHER

• “We’ve gone through the speaker stage. It’s time we started speaking out on our own experiences; it’s time to start exchanging knowledge amongst ourselves.”

• “We need to start utilizing the group as a resource of information to help with individual problems.”

• “The discussion sessions are important so that we can share our experiences. It’s good to hear the comments of others.”

• “The peer support element is the most important.” “I feel the group members accomplish more as they learn to talk about themselves freely and discuss their problems and how they overcome their problems. You realize that the group members already know more than any speaker you could bring in.”

• “The conversation between the Veterans opens the door for those who may have otherwise remained silent and allows them to share their experiences and difficulties.” “It’s time for us to be a true support to one another. It may even help us with problems we didn’t realize we had.”

REALIZATIONS BROUGHT ON BY ATTENDING THE GROUP

ACCEPTANCE OF MORTALITY

•“I’ve come to understand that I’m not going to live forever, and that’s okay. I don’t know how much longer I have, but I know now that the time I do have left can still be meaningful.”

BENEFITS BEYOND THE SCOPE OF THE GROUP

INTIMATE PARTNER COMMUNICATION & ACCEPTANCE

• “Listening in on the group and socializing with other spouses and caregivers has allowed my wife to open up and understand that she’s not alone. A direct result of having attended the group has been an increase in our patience with one another and a greater ability to tolerate one another’s shortcomings.”

DISCUSSION

DISCUSSION

• Overwhelming majority feel it’s time to empower the group members to be the

greatest source of knowledge

• Major themes presented themselves are at the core of what Veterans view to be

essential in dealing with their vision loss/blindness

• Ideas are building blocks for a thriving existence

• Network of support, a “pseudo-family”

• Remain vibrant and vital contributors to the world

STRENGTHS & WEAKNESSES

STRENGTHS

• This study provided a platform where the Veterans could freely express their opinions on a variety of topics related to the group’s dynamics and life with visual impairment/blindness

• The Veterans were also given an opportunity to speak openly and candidly without fear of judgment or the possibility of offending their fellow group members

• The trust that existed between the investigator and study participants allowed for a much more in-depth, insightful set of interviews to be conducted

• The complex group dynamics that have formed over time seemed to have allowed for a greater level of introspection on the part of the Veterans during the interview process

• seemed to have allowed for a greater level of introspection on the part of the Veterans during the interview process

WEAKNESSES

• Small Sample Size

• Sample Method

• Potential For Subjective Interpretation

 POSSIBILITIES FOR FURTHER STUDY

POSSIBILITIES FOR FURTHER STUDY

• Due to the open-ended nature of this support group and the lifelong membership of its participants, no prior attempt had been made to examine the group processes and their effectiveness in increasing the quality of life of these Veterans living with their visual impairments/blindness. Hence, there could be benefit in conducting a similar qualitative study in the next few years

• Research of this type may also benefit from the creation and psychometric testing of an adapted quantitative instrument. Such an instrument could include numerous other sites and significant sampling that, in turn, could make the study results more generalizable

• Given the numerous injuries suffered by Veterans as a result of recent campaigns such as Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn it is reasonable to suggest that expanding a study such as this to include significant sampling has the potential to yield a great deal of benefit for the blind and visually impaired Veteran population as a whole

PRACTICE IMPLICATIONS

PRACTICE IMPLICATIONS

• Multifaceted cultural components which are at play

• Empower the group members to take control

• NOT allow them to take yet another passive role

• Develop the bonds of comradeship

• True acceptance and growth

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