Group Aural Rehabilitation session five

In this session we aim to get group members talking about emotions brought out by hearing loss, their experiences of stigma,, and discuss stress reduction techniques. 


  • Discuss how stigma can affect your experience of hearing loss
  • Introduce stress reduction techniques
  • Group activity: Guided imagery exercise

Discuss how stigma can affect your experience of hearing loss

People with hearing loss often experience a stigma from others, or even feel stigma toward themselves because of their condition. Stigma can potentially compromise their confidence, self-efficacy, and overall quality of life. Wallhagen, 2010 found that stigma influences a person at multiple points on their journey including initial acceptance of hearing loss, deciding to have their hearing tested, choosing what steps to take, selecting a type of hearing aid, and deciding when and where to use assistive technology. 

In order to live well with hearing loss a person needs to overcome embarrassment and the damage to self-esteem that stigma creates. This is an ongoing personal process. This session’s conversation is a starting point for participants to think and talk about the topic of stigma and how it affects their lives. 

Introduce the topics of stigma and self-stigma, and define these two terms as a group. You might use this article from Gagné, Southall, and Jennings to support your conversation. Write down people’s contributions on a flip chart. 

Ask the group members whether they have experienced stigma. Ask for volunteers to share an instance of when they have faced it. Remind the group that we are not here to problem solve or critique, but to simply listen. Make sure everyone gets a chance to share if they would like to. Do not rush the group.

Discuss stress reduction

Research shows that group aural rehabilitation participants who are taught relaxation strategies have more positive outcomes and can cope better with their hearing loss. 

Explain that hearing loss can increase stress and anxiety. In addition to its impact on relationships and the experience of stigma, individuals with hearing loss must use more effort to understand speech than individuals with normal hearing. This is because they have to use additional cognitive resources to make sense of an incomplete auditory signal. A full day of effortful listening can be stressful.

On top of that, stress may make it more difficult for people with hearing loss to take the necessary steps to improve their situation and employ communication strategies. 

Ask the group what they are already doing to cope with stress. 

It is useful to distinguish between positive and negative ways that we all deal with stress. For example, positive methods may be exercising or engaging in a hobby. Negative methods may include drinking excessive amounts of alcohol or isolating oneself. Making this distinction will help group members identify negative patterns they may be falling into, and encourage them to employ more positive methods to deal with stress.

Group activity: Guided imagery exercise

Lead the group in the following guided imagery exercise for relaxation:

  1. Please get into a comfortable position where you can remain for a couple minutes without having to move. If you chose to remain in your chair you can sit toward the edge of the chair so that your back is not slouching, plant both feet on the floor, and let your hands rest on your legs. 
  2. Close your eyes. Start breathing deeply. Soon you should notice that your belly is expanding and contracting with your breath. Let your shoulders drop and relax. You might visualize breathing stress and tension out, and breathing peace and calm in.  
  3. Once you get to a relaxed state, begin to envision yourself in the midst of the most relaxing environment you can imagine. For some, this might be floating in the cool, clear waters off a remote tropical island. For others, this might be sitting by a fire in a secluded cabin, deep in the woods, while the snow is falling. 
  4. As you imagine this environment involve all of your senses. What do you see? What do you hear? What do you smell? How does it feel? 

Allow group members to spend a few minutes enjoying this. When it’s time, invite them to gradually return their attention to the room. Encourage the group to try using this exercise at home or work before your next meeting. 

This activity was adapted from Elizabeth Scott’s article “Use Guided Imagery for Relaxation.”

There are numerous websites, apps, videos, books, and classes to help people practice relaxation. Ask group members to look into one new activity or tool they would like to incorporate in their daily lives. Have them report back to the group what they found next time you meet.