1. Hench, Christine MSW

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Q I am providing care to a patient who lives in a group home where they practice "gentle teaching." I have never heard of this and I am not sure what is expected of me.


Gentle Teaching is a way of interacting with others based on the knowledge that we cannot change anyone else; we can only change ourselves. Important principles are also compassion, a rejection of authoritarianism, and the acceptance of people for who they are. Being surrounded by gentleness is what we all want. It is especially important for people who have been marginalized, such as those with disabilities, nursing home residents, the homeless, and victims of abuse and neglect. By virtue of their current or past circumstances, they may be prone to depression, self-abuse, aggression, addiction, and other unhealthy ways of expressing feelings.


Everyone has the tools to help create a Culture of Gentleness:


* EYES should be soft. When our eyes are soft, the corners of our mouth automatically form a smile.


* WORDS should be uplifting and undemanding.


* TOUCH is a powerful human need. Many disenfranchised people do not get touched except in a clinical way. A touch on the hands or shoulder, or a hug can be an effective way of communicating that you care.


* PRESENCE is another way of thinking about body language. Our posture should be open and welcoming.



When we practice a Culture of Gentleness, we stop thinking about "behavior problems." Instead, we see the "behavior" as a symptom of a problem. When someone is struggling, we look at the following to see how we can help:


SAFE-Does the person feel physically and emotionally safe? Is there anything in the person's life that would cause the person to feel something bad may happen? Sometimes, the current environment is safe but the person has powerful memories of past events that cause him or her to feel unsafe.


LOVED-Someone who does not feel cared about, valued, or loved is a deeply unhappy person. We can use the tools listed above to convey that she or he is safe and loved.


PRAISE-Vulnerable people cannot get enough praise.


DEMANDS-Do people around the person tell him or her what to do or when to do it? Gentleness requires giving people choices and doing things on their timetable, not ours.


TRANSITIONS-Transitions are difficult for all of us, but especially for people who have them imposed by others. For example, it is not unusual for people in group homes or nursing homes to have no choice in moving there. They may be moved from room to room, or experience other changes with no say in the matter or even any understanding about why the change is occurring. Even small transitions, such as going to bed, going from one place to another, can be unnerving for some people. We need to plan ahead to make each transition smooth.


SCHEDULE-Just imagine if you got up in the morning and had no idea what was going to happen, or when. Vulnerable people need to know what the day has in store-who will be working with them, what will happen after breakfast, or when a visitor is to arrive. Those who cannot read should have a visual schedule to help them navigate the day. The schedule should include choice. Does the person want to take a bath or a shower? When does the person want to take it? Does the person want to go to the store today or for a walk?


Your patient is very lucky to live in a place that practices these principles. All of us can use the tools of Gentle Teaching to help our patients feel safe and cared about, at least for the time we are with them.