How to facilitate Group AR sessions

A facilitator’s role is to plan and prepare for each session, set ground rules, encourage group members to contribute, and occasionally offer expert knowledge as a hearing care professional.

The power of Group AR comes from the group members sharing their experiences and suggestions with each other. They are experts in their needs, what it is like to live with a hearing loss, and what strategies have or have not worked for them. 

You must therefore make sure that the participants do the majority of the talking. It is tempting to simply provide information, but people may have just as great a need to tell their story and be heard by people that truly understand their experience.

If information is needed, see if other group members can provide answers, if not, make your input a short part of the discussion. As a rule of thumb, the facilitator should speak no more than 30 percent of the time.

Setting the agenda

Ask the group what they want to discuss and list all topics on the flipchart. If more than one person suggests the same topic, put a checkmark next to it. Prioritize the most popular topics.

Once you’ve have had a chance to plan using this input, provide an agenda of what each session will focus on. Use our session plans as inspiration. 

Set and maintain ground rules

Ground rules help everyone get the most out of Group AR. Introduce them in the first session and remind the group as needed:

1. The person speaking must use the microphone
This helps everyone hear and prevents us from interrupting one another.

2.  Let the group know if you cannot hear the person speaking
This communication tactic lets us practice asserting our needs and telling someone immediately when we cannot understand. Establish a hand signal to indicate when someone is having difficulty hearing.

3.  Let everyone have a voice
Listening to each other and not dominating the conversation or interrupting when someone is talking is essential for the group to work well.

4.  Use the expertise in the room and be supportive 
One of the goals of Group AR is to help each other by sharing our personal experiences, lessons learned, strategies, and ideas for living well with hearing loss. Please be generous with your comments and feel free to ask the group for input.

5.  Integrity 
Respect each other and agree that personal stories stay in the room.

Dealing with difficult emotions

As you get the group engaged in activities and sharing experiences, difficult emotions may come up. Encourage participants to name and discuss these emotions. Doing so will help people understand themselves better and empathize with their partner. 

These are some common emotions that you may encounter as a facilitator:


It is common to become frustrated when struggling to understand what others are saying in person, on the phone, or when communication partners ignore requests to repeat or clarify speech. 

Anxiety and social anxiety

When sensory information of any kind is weakened or missing, a person goes into a heightened state of awareness to compensate. Inability to hear or locate the source of important environmental sounds such as alarms, doorbells, or phones, is especially anxiety provoking.

Emotionally painful events, such as being seen as foolish or incompetent due to an embarrassing communication error, become deeply etched in a person’s memory. Future situations can cue the old memory, causing similar emotional reactions.

If this happens, the person can experience anxiety in a new, non-threatening situation and may not even be aware of what is causing the disturbing feeling. Some people develop feelings ranging from apprehension to dread about going to certain events. 

This type of fear and anxiety can lead to a debilitating condition known as social anxiety. This causes the person to react with moderate to extreme discomfort in social situations.

It is common in people with hearing loss to stop engaging in activities they used to enjoy but now have difficulty communicating in, such as going to restaurants, playing cards with friends, or attending family gatherings. In a serious case, the person may avoid social interactions altogether and isolate themselves. Social isolation itself produces a variety of negative consequences such as loneliness and depression.

Sam Trychin listens to a participant who has been excluded from activities throughout her life. Be prepared to listen as participants describe the emotional affects of hearing loss and offer words of encouragement.


When people are depressed they are prone to see events from a pessimistic perspective, selecting and remembering negative aspects of a situation and disregarding the positive aspects. Depression often robs a person of the energy necessary to take steps to improve their quality of life. 

Grief and loss

Some people have lost something of great value to them due to their hearing loss. For example, a music lover may be devastated that they cannot hear in the same way as before. Others have lost careers and even valued relationships. Note that grief sometimes presents as anger.

Embarrassment, shame, and guilt

Some people feel embarrassed or ashamed when they have said or done things that are considered socially awkward because they couldn’t hear well. Shame may also result from the self-perception that one is damaged or unworthy. Guilt arises when an individual becomes aware that their hearing loss has caused harm in some way to another individual and they feel remorseful. 

Leverage silence

Don’t be afraid of silence. Silence allows group members to absorb what has been said. Not filling the silence reinforces that the group belongs to the participants. It can also motivate group members to really consider a statement or question for themselves and may help them provide a thoughtful contribution.

Program evaluation

Before you begin your Group AR program, decide how you will collect feedback from the participants. Input on what topics are interesting, what works well, and what does not, is valuable information that can help you improve the group sessions and your facilitation skills. 

Louise Hickson describes three simple and effective ways to evaluate the success of your Group AR program.

Here are three easy ways to collect feedback from your group:

Simple feedback form

After each session or at the conclusion of a series, give group members a simple questionnaire with three questions.

  • What did you like about the sessions?
  • How could the sessions be improved?
  • What actions have you taken as a result of participating in the Group AR program?

After collecting the questionnaires, read over the answers and consider what changes you will make to your program. Remember that it is not possible to please everyone all of the time. All you can do is strive to make a positive impact on as many participants as possible. 
Download simple form

Goal-setting measure

In the first session of your program, have participants write down five goals of what they would like to learn or achieve during the Group AR program. Collect their feedback and use this information to shape your plans for the program.

During the final session, hand the questionnaires back to each participant. Ask them to rank each goal on a scale from 1 to 5, with 1 being “goal not met” and 5 being “goal achieved.” 

This evaluation method is based on the Client Oriented Scale of Improvement (COSI)

International Outcome Inventory

At the end of your Group AR program, give group members the International Outcome Inventory (IOI) for Alternative Interventions. It consists of seven questions related to the impact of the program on their lives. 
Download International Outcome Inventory form