PATIENT SKILLS
PROGRAMME
Facilitator Manual
Module A
1
About this Manual
This manual contains materials to support the delivery of the Patient Skills Programme. It
includes:
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 overview of the Programme
 standard programme for each session
 materials for the delivery of all Module A activities
 explanation of the icons and charts used in the materials
Additional materials to support the programme are:
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materials for the delivery of all Module B activities
materials for the delivery of all Module C activities
participant Workbook and Handouts
guide for Facilitators
guide to Facilitator Training, Skills and Assessment
guide to Quality Assurance
guide for Programme Leads
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2
Overview of the programme
2.1
The purpose of the Patient Skills Programme
The core focus of the programme is to enable people to better manage their own health,
through increasing their self confidence, increasing their skills and supporting positive
changes in health related behaviour, leading to activated patients who feel in control of their
health choices.
2.2
How this programme relates to wider health services
The Patient Skills Programme does not, and should not, exist in isolation from the wider
health services that people use. The Health Foundation, through its Co-Creating Health
programme, believes that people with long term conditions are best able to manage their
own condition when:
 they have the necessary skills, knowledge and confidence
 they are being supported by clinicians proactively using self management support skills
and techniques
 the systems and processes of the healthcare service are designed to support self
management
2.3
Course structure
The Patient Skills Programme is normally run over six weeks, with a workshop a week. Each
workshop consists of a series of activities, each lasting 20 minutes, which are put together to
create a single session lasting 2 hours 40 minutes.
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However, the programme is designed to be adaptable, and may, for example, be spread over
longer by running (particularly the last two or three sessions) at fortnightly, rather than
weekly, intervals, or by creating new workshops.
2.4
Course delivery: co-facilitation
What makes the programme unique is that it is co-delivered by a health professional and a
person with experience of living with a long term condition working in partnership. This
collaboration between the professional and lay tutors is a model for the collaborative
relationship the programme is promoting between health professionals and patients.
Feedback from previous participants has shown that they find the different perspectives,
experience, knowledge and skills that the tutors from different backgrounds bring extremely
valuable.
2.5
Course content
The programme is made up of three sets (Modules) of activities, containing a range of
different components and activities:
 Module A: Core Repeated Activities: Goal-setting, Goal Follow-up and Problem solving
– These activities are core to health related behaviour change and should be included
and repeated in every workshop.
 Module B: Core Generic Self-management skills
– These activities are also considered core self management activities or core to the
group process. Each activity should be covered at least once in the course of Patient
Skills Programme.
 Module C: Optional Self-management skills and topics
– These activities are optional and may be included as needed. Additional module 3
activities may be created for specific diseases and communities.
3
Standard programme
All the modules are designed to be delivered flexibly, in the order and at the pace that best
suits the group, however, we have set out below a standard programme for each of the six
workshops.
Programme for workshop 1
Module
Activity
B
B
B
A
A
B1
B2
B3
A1
A2
Getting to know one another
Understanding self-management
Recognising and accepting change
Introducing goal-setting
Setting the agenda and close
Time
(minutes)
40
20
20
40
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Programme for workshop 2
Module
Activity
A
B
C
A
A
A
A3
B4
C1
A4
A5
A2
Welcome
Follow-up
Challenging unhelpful beliefs
Helpful breathing (optional)
Sharing and agreeing agenda
Working on a self-management goal
Setting the agenda and Close
Programme for workshop 3
Module
Activity
A
B
A
C
A
A
A3
B5
A6
C2
A7
A2
Welcome
Follow-up
Working together in partnership
Problem-solving
Eating Well (optional)
Weekly goal setting
Setting the agenda and close
Programme for workshop 4
Module
Activity
A
B
B
C
A
A
A3
B6
B7
C3
A7
A2
Welcome
Follow-up
What happens next? Follow-up options
Anxiety, relaxation and your health condition
Managing fatigue, helpful rest and sleep(optional)
Weekly goal setting
Setting the agenda and close
Programme for workshop 5
Module
Activity
A
B
B
C
A
A
A3
B8
B9
C4
A7
A2
Welcome
Follow-up
Planning
Communicating our needs and feelings
Being thankful for what’s going well (optional)
Weekly goal setting
Setting the agenda and close
Time
(minutes)
5
30
20
20
20
30
10
Time
(minutes)
30
20
20
20
30
10
Time
(minutes)
30
20
20
20
30
10
Time
(minutes)
30
20
20
20
30
10
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Programme for workshop 6
Module
Activity
A
B
B
C
A3
B10
B11
C10
A
A8
Welcome
Follow-up
Becoming a resourceful self-manager
Recognising and managing set-backs
Accepting and asking for support from others
(optional)
Setting Longer term goals
Close and evaluation
Time
(minutes)
30
20
20
20
30
10
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4
Using the Module C Activities
Module C contains a library of optional activities which may be generic or condition-specific.
There is time allocated in each workshop, with the exception of Workshop 1, for one or two of
these activities to be included. At the end of workshops 1-5 there is an opportunity for the
participants and facilitators to negotiate the agenda for the next workshop. Further conditionspecific activities may be developed by individual organisations delivering the programme.
These can be added to the Module Three library.
This list of the Module Three options and a brief description can be used by facilitators to
help them during this Agenda-setting process.
Activity Name
Fatigue, rest and sleep
Module C Options
Activity Description
Helps us to recognise and identify ways that fatigue can be
managed by effective planning, rest, relaxation and sleep.
Eating well-making
choices, making changes
Allows us to identify some small changes in the food and drink
choices we make and to consider and find solutions to the
barriers to making these changes.
Helpful breathing
Introduces and practices helpful breathing and explains how it
may help to regain control of symptoms and reduce anxiety.
Mixed feelings about
Explore our own ideas about the importance and benefits to us
being active
of becoming more active and allows us to consider our own
mixed feelings about it.
Acknowledging and
Recognises and acknowledges that negative emotions (fear,
managing unhelpful
anxiety, worry, and guilt) frequently accompany a health
emotions
condition, reflects on your experience and to consider ways
that these emotions can be handled positively.
Making a self-care plan in Introduce the Care-planning process which can be done with a
partnership
member of the health care team and considers how it is being
introduced locally.
NB check local relevance.
Making and sharing plans Considers the subject of planning for future, when we may be
for future health care
more unwell and unable to make our own decisions, and how
to communicate these plans with family, friends and the health
care team.
Using our minds as a
Introduce the concept of the mind as a self-management tool,
self-management tool
the mind body connection and some helpful techniques to
manage symptoms leading to more optimal self-management.
Being Thankful for what’s Enables us to feel less anxious and more relaxed by allowing
going well
us the opportunity to show gratitude for, and share with others
simple events and experiences which have made us feel
good.
Accepting and asking for Explores reasons why asking for help can be difficult and
help and support from
considers ways to access varying types of support from family,
others
friends and colleagues.
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5
Layout of the materials
Scripted and Unscripted Facilitator Instructions
There are two pages which cover exactly the same workshop content:
 Upper page provides structured but unscripted notes which an experienced facilitator
can use to deliver the programme content. The clouds which can provide suggestions
for free-thinks and discussions can be completed by facilitator beforehand
 Lower page provides structured and scripted text which an inexperienced facilitator can
use to deliver the programme content. The clouds which offer suggestions for free-thinks
and discussions are provided.
It is expected that, over time and with greater experience, facilitators will confidently move
from a scripted to an unscripted delivery style. When a facilitator uses the unscripted notes
they should take care to ensure that the materials are delivered in a suitably non-directive
style with careful attention to the use of language which supports self-determination.
Fonts
 The activities for each workshop use Arial 11 black, this is chosen as it is clear and easy
on the eyes.
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Comic Sans 13 Blue is used to identify discussions as it denotes a more informal
tone.
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Module A
Activity A1: Goal Setting
6
Guide to Icons
Icons are used throughout this manual as a visual reminder to facilitators and to back-up the Facilitator Instructions
Icon Name
Icon
What it means
Self-Management Circles
When the Optimal Self-management circles are shown, the facilitator
should refer to the fact that self-management requires attention to all three
areas of the Bio-psychosocial model of health.
Small Group Discussion
This should be for groups of three or four individuals. The facilitators can
and should circulate amongst the small groups to offer support and
clarification.
Whole Group Discussion
This is an opportunity to discuss issues as a whole group. There are open
questions in the notes which can be used to stimulate the discussion.
However these may or may not be required. There are also ideas in the
clouds which may be helpful to guide the discussion. If any discussion
becomes negatively focussed the facilitator should initiate a problemsolving approach and ensure that solutions are identified before the
discussion ends.
Problem Solving
Opportunities for problem-solving occur throughout the workshops; during
Goal-setting, Goal Follow-up and during individual activities. Any
opportunity to problem-solve should be seized when time allows. Problemsolving can use either a formal process where ideas are captured on a flipchart, or an informal process where the facilitator verbally collects ideas
from the group and offers them back to the participant who voiced the
problem to enable them to choose a solution which is helpful to them.
PS
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Module A
Activity A1: Goal Setting
Pair and Share
This is an opportunity for individuals to briefly ‘pair-up’ with another
participant, so they can share their experiences safely. Should there be an
uneven number of participants, it works best if one of the facilitators makes
up a pair. Do not allow these ‘pair and share’ conversations to last more
than 2 or 3 minutes.
Freethinking
It can be helpful to head the Group free-think chart beforehand. Both
facilitators are involved in a free-think, one acts as a scribe whilst the other
generates and manages the ideas from the group and feeds them to the
scribe at a pace they can write. Ask the questions and allow the group time
to come up with their ideas. Be prepared to rephrase the question if you
feel this will help the group to generate more ideas. The clouds provide
other ideas. With permission from the group you could add a few of these if
they are finding it difficult. Scribe the ideas from the group, using the words
of the participant. If the idea is rather long-winded, ask “How would you like
me to write this down?”
There are many opportunities to role-model your own experience of selfmanagement. Prepare these beforehand and identify examples which will
be relevant and helpful to the group, and which you feel comfortable to
share. When talking about your own experience you should be brief,
approximately 30 seconds, and always finish by describing the solution
which worked for you.
Role Modelling Box
Role Play
During a role-play, both facilitators act out a short interaction between two
people. Briefly explain beforehand that this is what you are doing. It can be
useful to tell the group when you are starting the role-play and again when
the role-play has stopped.
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Module A
Refer to / complete
Workbook
Activity A1: Goal Setting
In many activities reference is made to completion of materials which is in
the work book that accompanies the workshops. Some of these, like Goalsetting, are for completion during the session; others are for use at home,
like Guided Imagery, whilst others are for reference only.
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Module A
Activity A1: Goal Setting
7
Guide to Charts
These Charts are used through the workshops.
Self-management circles
Group Ground-rules
We agree to:
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treat each other with respect
arrive in good time and aim to attend every session
let everyone’s viewpoint be heard
maintain confidentiality
identify achievable goals and work towards them
help others find solutions to problems they encounter
join in discussions
gather and share information and resources with others
be open-minded about new ideas and give them a try
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Module A
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Activity A1: Goal Setting
Questions to help you set your Goals
What is your Goal?
How important is your Goal to you? What makes it important?
What do you need to achieve it?
Which bits will you do this week?
How much? How often? When?
If you visualise yourself doing this bit of your Goal this week,
how confident do you feel, on a scale of 0-10?
Our Goal Needs To:
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be our choice
be important to us
be a little difficult to achieve
allow us to feel more confident once we have achieved
it
 let us show other people and ourselves that we can
overcome problems
 let us feel in control
Agenda Setting Questions
 What am I going to this meeting for and what do I hope to get
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from it?
How have I been feeling since my last visit?
What have I been finding difficult?
What else in my life might be affecting my health?
What have I been doing to look after my health?
Is there anything I might find difficult to talk about?
What is my goal?
What do I need to know about treatments?
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Problem Solving
identify the problem
explore it
think of some ideas
choose one to try
try the idea out in a real life situation
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Module A
Specific
Measurable
Achievable
Realistic
Time based
Activity A1: Goal Setting
SMART Goals
What you will do?
How much...how often?
How confident are you that you can do it?
How confident are you that you will do it?
When will you do it?
Accept problem isn’t
solvable now
Identify the real
problem
Get more
ideas
Explore the
problem
Choose
another
idea
Problem Solve
Suggest
Ideas
Try the
idea out
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Questions to help you with Goal Follow-Up
What was your goal for the past week?
How much? How often? When?
Was it the whole goal or a step towards your goal you
wanted to reach?
Tell us how you did with that goal?
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Choose an idea
Questions Chart
What am I going to this meeting for and what do I hope
to get from it?
How have I been feeling since my last visit?
What have I been finding difficult?
What else in my life might be affecting my health?
What have I been doing to look after my health?
Is there anything I might find difficult to talk about?
What is my goal?
What do I need to know about treatments?
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Module A
The Journey towards Optimal Self-Management
My role in
I am
I can
managing
confident
identify
my health
that I know
and solve
condition is
how to
problems
important
manage my
when they
health
arise
condition
Beginning
x
x
x
the journey
Finding the
x
x

Route
Travelling
x


Staying on



Track
Activity A1: Goal Setting
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Becoming Resourceful
How else might I get what I need?
Who else has information that might help me?
What is something very similar which might also work?
Who else has expertise in this field?
What is another thing I can try?
What would I suggest someone else could do in a
similar situation?
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Module A
Activity A1: Goal Setting
Tips for Preparing an Active Declaration
 plan a meeting with doctor to discuss what you might
Why is it helpful to have a setback plan?
 you feel you are doing something to manage the
want to happen
 choose the best person to act for you and talk about it
with them
 decide what you would want to happen
 prepare any documents, with professional advice (e.g.
GP, CAB)
 sign the documents and get them witnessed
 make sure right people know you have the documents
 have several copies in useful places (e.g. medical notes,
with medicines)
The 3 Circles
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change
you feel more in control
to speed up recovery
helps to regain lost function
can give other people a helpful role
provides a sense of direction
provides small goals to work towards
Questions to help us plan
 How long it will take?
 When is the best time to do it?
 What help do I need to do it?
medical
social
emotional
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Module A
Activity A1: Goal Setting
Materials to support activities
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Module A
Activity A1: Goal Setting
Activity: Introducing Goal Setting
Time: 40 minutes
Requirements: Self-Management Circles chart, Our Goal Needs To chart, Prepared modelling boxes, Questions to help your
Goals chart.
Module A: core, repeated
No of Pages: 10
Aim:
 Introduce the concept of goal-setting within self-management as a positive, helpful tool for people to use to help them become active,
confident self-managers and so manage the impact of their long-term condition on their everyday lives.
Objectives:
 consider some of the benefits to them of goal-setting as a positive tool in their self-management
 understand how goal-setting works within the patient skills programme
 feel they are in a safe and secure environment in which to set goals
 set a Goal which they feel they can confidently achieve this week
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Module A
Activity A1: Goal Setting
UNSCRIPTED GUIDANCE
Unscripted Instructions
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Display the SelfManagement Circles
chart.
Explain why setting achievable goals is an important and useful self-management tool which
helps us:
– Feel more able to make the changes necessary to manage our health in a positive way
– Work out what is important to us and allow us to focus on this
explain that goals which are both slightly challenging and yet achievable seem to work best
explain that because goal-setting is so important we spend time in each session on this
The goal can relate to any area of our self-management; the medical, the emotional and the social.
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Module A
Activity A1: Goal Setting
SCRIPTED GUIDANCE
Scripted Instructions
An important part of self-management is ‘Setting Goals’. There is a great deal of evidence that shows
that goal-setting is a useful tool which can be used by people living with a health condition. People who
set and work towards goals are more positive and confident about making useful changes in their lives they achieve more and any problems seem more manageable.
Let’s think about what we mean by goal-setting.
Goals focus our attention on something we want. If that something is important to us, we are more likely
to put our efforts into achieving it. If it is something we have chosen, rather than something someone else
tells us we have to do, we are more likely to succeed.
Display the SelfManagement Circles
chart.
Achieving a goal we have chosen, which we feel is important and worthwhile to us, demonstrates to
ourselves and to other people that we have the confidence to overcome problems and obstacles
successfully. Setting goals which we choose is a key self-management tool and we spend some time in
every workshop focussing on this.
A goal which is slightly challenging but which is achievable if we are willing to put in the effort is likely to
bring the most benefit, both in what we achieve and in how we feel about ourselves when we succeed.
We might choose to work on some goals around the medical side of the condition – for example
managing our medication well. However as we talked about earlier self-management is more than
managing the medical aspect, it is also about how the rest of life and the health condition impact on each
other.
The goals we set can be around any of the three areas of self-management; the medical, the emotional,
the social.
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Module A
Activity A1: Goal Setting
UNSCRIPTED GUIDANCE
Unscripted Instructions
Display Our Goal needs
to chart.
One facilitator models a
goal they have
succeeded with that fits
the above criteria.
When we decide on a self-management goal for ourselves it needs to:
Our Goal Needs To:
be our choice
be important to us
be a little difficult to achieve
allow us to feel more confident once we have achieved it
let us show other people and ourselves that we can overcome
problems
 let us feel in control
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Module A
Activity A1: Goal Setting
SCRIPTED GUIDANCE
Scripted Instructions
Display Our Goal needs
to chart.
One facilitator models a
goal they have
succeeded with that fits
the above criteria.
When we decide on a self-management goal it needs to:
Our Goal Needs To:
be our choice
be important to us
be a little difficult to achieve
allow us to feel more confident once we have achieved it
let us show other people and ourselves that we can overcome
problems
 let us feel in control
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Module A
Activity A1: Goal Setting
UNSCRIPTED GUIDANCE
Unscripted Instructions
Display the Questions to
help you set your Goals
chart.
Explain that goals need to be definitely stated and slightly challenging. We can use the next chart to
help us.
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Questions to help you set your Goals
What is your Goal?
How important is your Goal to you? What makes it important?
What do you need to achieve it?
Which bits will you do this week?
How much? How often? When?
If you visualise yourself doing this bit of your Goal this week, how
confident do you feel, on a scale of 0-10?
Each week we set a small, achievable goal. The charts are in your workbook. (Co-Facilitator) is going to
set their goal now.
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Module A
Activity A1: Goal Setting
SCRIPTED GUIDANCE
Scripted Instructions
It isn’t always easy to identify a goal which is important to us and achievable but with practice it does get
easier.
Some of the goals we might want to achieve might be quite large. These goals will be more achievable if
they are broken down into smaller bits. Even quite small goals sometimes need to be broken down into
still smaller ones.
Goals which are clear, definitely stated and slightly challenging lead to better results than goals which
are vague and easy - easy goals are easy to ignore and this is where this next chart can be helpful.
Display the Questions to
help you set your Goals
chart.
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Questions to help you set your Goals
What is your Goal?
How important is your Goal to you? What makes it important?
What do you need to achieve it?
Which bits will you do this week?
How much? How often? When?
If you visualise yourself doing this bit of your Goal this week, how
confident do you feel, on a scale of 0-10?
Every week we are all going to set a small, achievable goal, including us.
As facilitators we are here to support you as a group support each other. The charts are in your
workbook.
It may be helpful to see how this is done so (Co-Facilitator) is going to set a goal for the next week.
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Module A
Activity A1: Goal Setting
UNSCRIPTED GUIDANCE
Unscripted Instructions
Co-Facilitator asks the
questions from the
Questions to help you
set your Goals chart.
Prepare beforehand a
small achievable goal
which illustrates these
questions well.

Allow about 5 minutes for
this discussion. Circulate
around the group offering
support where needed.
Invite participants to
share their goal with the
group starting with a
volunteer then move
round the group from this
point. Use these
questions as a guide if
needed.
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–
–
–
–
–
Invite group to work in pairs to support each other to set a goal, using the
question as a prompt. These goals can be recorded in their workbook.
explain that you will invite them to share these goals with the group shortly
Invite each person to share their goal, using the questions below if required.
What is your goal?
How important is the goal to you? What makes it important?
What do you need to do to achieve it?
Which bits will you do this week?
How much? How often? When?
If you visualise yourself doing this bit of your goal this week, how confident do you feel on a scale
of 0-10?
When facilitator 1 is
reached they should
share their goal for the
week.
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Module A
Activity A1: Goal Setting
SCRIPTED GUIDANCE
Scripted Instructions
Co-Facilitator asks the
questions from the
Questions to help you
set your Goals chart.
Prepare beforehand a
small achievable goal
which illustrates these
questions well.
Allow about 5 minutes for
this discussion. Circulate
around the group offering
support where needed.
Invite participants to
share their goal with the
group starting with a
volunteer then move
round the group from this
point. Use these
questions as a guide if
needed.
When facilitator 1 is
reached they should
share their goal for the
week.
We would like you to work in your pairs, to support each other by using the Questions to
help you set your Goals chart to identify which bit of your goal you will work on this
week. You can record this in your workbook. We will then invite you to share your goal
with the group.
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–
–
–
–
–
We would now really like you to share your goal with the group.
What is your goal?
How important is the goal to you? What makes it important?
What do you need to do to achieve it?
Which bits will you do this week?
How much? How often? When?
If you visualise yourself doing this bit of your goal this week, how confident do you feel on a scale
of 0-10?
We look forward to sharing our progress with you next time and hearing how you got on with your goals.
We wish you all well with your goals.
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Module A
Activity A1: Goal Setting
Appendix References and Notes
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Module A
Activity A2: Setting the agenda
Activity: Setting the Agenda for the next workshop and Close.
To be used: At the end of every workshop.
Time: 10 minutes.
Requirements: List of Module C Activities available.
Module A: core, repeated
Number of Pages: 2
Aim:
 For the group to decide on the optional module for the next workshop.
Objectives:
 the group will have come to a consensus decision about the optional module for next week
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Module A
Activity A2: Setting the agenda
Instructions
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Go through agenda for
workshop one.
Make sure you know in
advance what activities
are included in the next
workshop.
Choose the optional
module that most of the
group want to cover.
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remind the group what has been covered in this workshop
remind the group that working collaboratively with their clinician is an important selfmanagement skill, that we can now practice by considering the agenda for the next workshop:
– show the group the planned agenda on the chart
– share with the group the Module 3 options which are available in this PSMSP
– negotiate and agree with them their choice for the next session
remind them about any changes to any arrangements for the next workshop, times, facilitators,
visitors etc
thank group for their attendance and participation
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Module A
Activity A3: Goal follow-up
Activity: Goal follow-up.
To be used: At the start of every workshop after week 1.
Time: 30 minutes
Requirements: Questions to help you with Goal Follow-Up chart, Problem Solving chart.
Module A: core, repeated
Number of Pages: 4
Aim:
 To support participants to share their experience of working towards their identified goals and to enable the group to be used as a
resource for problem-solving.
Objectives:
 share their experience of working towards a goal this week
 receive encouragement and acclaim from peers
 reflect on any problems encountered and identify solutions they might try in the future
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Module A
Activity A3: Goal follow-up
Tell the group that we are now going to follow-up on the goals we set in the last workshop.
Instructions
Use the chart as a prompt.
Be brief and concise.
Remember, you are
modelling successful SelfManagement.
Ask for a volunteer to followup on their goal and move
round from there.

–
–
–
–

Explain that following-up on goals is just as important as setting them in first place:
allows the sharing of success
offers opportunity for reflection
offers opportunity for problem-solving
offers opportunity to consider further goals
one facilitator models first
Questions to help you with Goal Follow-Up
 What was your goal for the past week?
 Was it the whole goal or a step towards your goal you wanted to
reach?
 Tell us how you did with that goal?
– How much?
– How often?
– When?
Using questions from the
chart appropriately, make
sure everyone is specific in
their follow-up.
If successful, compliment
their good Self-Management.
OR
If despite problems someone
adjusted their plan to reach
their goal, compliment their
good Self-Management.



What was the problem that prevented you from reaching your goal?
What might you have been able to do to give you greater success?
Would it be helpful to ask the group, about any ideas they may have?
OR
Only, if goal was not reached,
ask:
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Activity A3: Goal follow-up
Instructions
Problem Solving
Identify the problem.
explore it
think of some ideas
choose one to try
try the idea out in a real life situation




Using the Problem Solving
chart go through the problem
solving steps:
Identify the problem.
Explore the problem with
participant to ensure the real
problem has been identified
Collect ideas offered by
group:


If there are two or three
ideas, summarise these
verbally and repeat them
back.
Remind the group that Problem Solving is a useful tool to help us to achieve optimal SelfManagement and will be used in every workshop.
Suggest they may want to consider in what way it could be helpful to follow-up on a goal they
have set with a health professional.
Thank them for sharing their success and the actions they took when things did not go according to
plan.
If there seem to be more
than three ideas, suggest it
may be helpful to write these
down on a flipchart. Once the
ideas are exhausted, read
these back.
Invite person with problem to
select an idea to try. They
may wish to use this as their
goal for the next week.
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Activity A3: Goal follow-up
Appendix, References and Notes
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Module A
Activity A4: Sharing and agreeing an agenda
Activity: Sharing and agreeing an agenda
Time: 20 minutes
Requirements: Flipchart: What topics might we want to add to the agenda for our consultation? Questions chart.
Module A: core, repeated
Number of Pages: 14
Aim:
 To introduce collaborative agenda-setting as a tool, which can help to establish an equal partnership between patient and clinician.
Objectives:
 understand what is meant by setting a collaborative agenda for a consultation
 consider what may be included
 reflect on agenda setting situations between a Health Professional and patient
 discuss the benefits of agenda setting
 identify the questions which could be asked in a consultation
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Activity A4: Sharing and agreeing an agenda
UNSCRIPTED GUIDANCE

Remind the group that you will be agreeing an agenda for the next workshop at the end of this
one. Some of these topics are fixed and others are agreed by the group

Describe how we can use this method of agenda-setting when we attend a health-related
meeting and that it allows the health professional and patient to agree the key issues for them
both.

Explain that agenda-setting is a tool which can help us feel in control
Unscripted Instructions
Allow the group time to
come up with ideas.
Be prepared to rephrase
the question if you feel
this will help the group
generate more ideas.
What topics might we want to add to the agenda for our consultation?

Explain the importance of an agenda being shared and agreed, so that both parties get their
most important issues covered and the priority for the patient is identified and shared.
Invite the group to listen to two short role-plays and explain we will discuss these.
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Activity A4: Sharing and agreeing an agenda
SCRIPTED GUIDANCE
Scripted Instructions
Allow the group time to
come up with their ideas.
Be prepared to rephrase
the question if you feel
this will help the group to
generate more ideas.
With permission from the
group you could add a
few ideas from this list if
they are finding it difficult.
At the end of each workshop we will be considering the topics to be covered in the next one. Some of
these have already been identified in the programme; other topics are decided by the group and become
part of the agenda for the next session.
We can use a similar agenda-setting technique during our health care appointments to enable us to get
the most from these meetings. Agenda setting is a tool we can use to help us agree collaboratively with
any health professional the key issues which need to be discussed in this particular consultation. Some
of these issues may be identified by the health professional; whilst we identify those, which are a priority
for us.
Agenda-setting during a health care appointment can help us feel in control and demonstrates to the
health professional that having a role in managing our health is important to us.
What topics might we want to add to the agenda for our consultation?
Medication, New symptoms, New treatment options,
Results of tests / further tests, Smoking, Alcohol,
Eating, Exercise, Lifestyle, Getting pregnant, Travel,
Effect on a relationship, How can I self-manage well?,
My goals, What the future holds, What happens if…?
Support available from others.
It is important that the agenda is shared and agreed, so that both parties collaborate to get their most
important issues covered.
You will now see two short demonstrations of a routine consultation between a GP and Lesley, a patient
living with a health condition. After we’ve finished we will consider the differences between the two
conversations.
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Module A
Activity A4: Sharing and agreeing an agenda
Unscripted Instructions
Situation One
Both tutors read the
following script.
GP: Hello Lesley, thanks for coming in to see me. I thought we might start by having a look at your
medication. You are still taking Bupimide 5mgs every day?
Lesley: Yes that’s right.
GP: You’ve been taking them for over three years now. Any trouble with them?
Lesley: Er… I don’t know really......... I don’t think so.
GP: OK that’s good. So you had some tests last month?
Lesley: Mmm.... was the result alright?
GP: Well, a little on the high side, but then that’s not unusual for you....very similar to the last one.
Lesley: Oh...right.
GP: Perhaps we had better do some more in three months just to keep an eye on it.
Lesley: Oh dear....I really don’t like blood tests.
GP: Well that’s fine then.... If you make an appointment to see me in three months once you’ve had your
blood test taken?
Lesley: Oh right (gets up to leave) erm...... by the way.... I’ve been thinking, doctor... I’m finding working
full-time really hard, I just get terribly tired....

Introduce the second example.
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Module A
Activity A4: Sharing and agreeing an agenda
Scripted Instructions
Situation One
Both tutors read the
following script.
GP: Hello Lesley, thanks for coming in to see me. I thought we might start by having a look at your
medication. You are still taking Bupimide 5mgs every day?
Lesley: Yes that’s right.
GP: You’ve been taking them for over three years now. Any trouble with them?
Lesley: Er..... I don’t know really......... I don’t think so.
GP: OK that’s good. So you had some tests last month?
Lesley: Mmm.... was the result alright?
GP: Well, a little on the high side, but then that’s not unusual for you....very similar to the last one.
Lesley: Oh...right.
GP: Perhaps we had better do some more in three months just to keep an eye on it.
Lesley: Oh dear....I really don’t like blood tests.
GP: Well that’s fine then.... If you make an appointment to see me in three months once you’ve had your
blood test taken?
Lesley: Oh right (gets up to leave) erm...... by the way.... I’ve been thinking, doctor... I’m finding working
full-time really hard, I just get terribly tired....
Now let’s listen to the second example.
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Unscripted Instructions
Both tutors read the
following script.
Activity A4: Sharing and agreeing an agenda
Situation Two
GP: Thanks for coming in to see me Lesley, I’m hoping we can talk about your blood
test results and your medication today, but before we do I wondered what thoughts
you might have had about what you want to talk about.
Lesley: Well, I would like to know about my blood test results, although that’s not the priority for me….
there are some other things I would like to talk about. I’ve been feeling terribly tired recently, so much so
that I am wondering about reducing my working hours a bit. But...as well....me and my partner are
struggling financially, so I’m not sure it’s right to do so.
GP: OK, I can see that both of those are important to you, is there anything else you hoped to talk about
today?
Lesley: Well, my sister wonders if the reason I’m so tired could just be because I’m carrying so much
weight. I wanted to talk about that too really.
GP: OK, is there anything else you hoped to talk about today?
Lesley: No....no....I don’t think so.
GP: So shall we start by talking about the tiredness and the extra weight that is bothering you, as these
could be important when we look at your medication afterwards. How does that sound?
Lesley: That would be ever so helpful, thank you.
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Scripted Instructions
Both tutors read the
following script.
Activity A4: Sharing and agreeing an agenda
Situation Two
GP: Thanks for coming in to see me Lesley, I’m hoping we can talk about your blood test results and
your medication today, but before we do I wondered what thoughts you might have had about what you
want to talk about.
Lesley: Well, I would like to know about my blood test results, although that’s not the priority for me….
there are some other things I would like to talk about. I’ve been feeling terribly tired recently, so much so
that I am wondering about reducing my working hours a bit. But...as well, me and my partner are
struggling financially, so I’m not sure it’s right to do so.
GP: OK, I can see that both of those are important to you, is there anything else you hoped to talk about
today?
Lesley: Well, my sister wonders if the reason I’m so tired could just be because I’m carrying so much
weight. I wanted to talk about that too really.
GP: OK, is there anything else you hoped to talk about today?
Lesley: No....no....I don’t think so.
GP: So shall we start by talking about the tiredness and the extra weight that is bothering you, as these
could be important when we look at your medication afterwards. How does that sound?
Lesley: That would be ever so helpful, thank you.
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Module A
Activity A4: Sharing and agreeing an agenda
Briefly summarise the difference between the two role-plays.
Scripted Instructions
How did agenda setting help the doctor and Lesley?
Use suitable examples
from your own experience
or practice.
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Module A
Scripted Instructions
Activity A4: Sharing and agreeing an agenda
In the first role-play the agenda was set by the GP without consulting Lesley. In the second, the agenda
was negotiated and agreed between them.
How did agenda setting help the doctor and Lesley?
Tutors facilitate a
discussion, bringing out
the following points:
Patient could voice concerns right from the
start, GP could manage the time, Patient and
clinician were equal in the process, and
Patient’s feelings were valued, more like a
discussion where ideas were shared, more
useful and relevant for both.
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Unscripted Instructions
Activity A4: Sharing and agreeing an agenda


Make sure that this
question list is available in
their resource pack.
explain the importance of preparing for a health meeting beforehand by identifying points we
want to discuss
suggest the following questions may be useful prompts for us
Questions Chart
 What am I going to this meeting for and what do I hope to










get from it?
How have I been feeling since my last visit?
What have I been finding difficult?
What else in my life might be affecting my health?
What have I been doing to look after my health?
Is there anything I might find difficult to talk about?
What is my goal?
What do I need to know about treatments?
explain that there are occasions when there is insufficient time to do justice to all of the concerns
of health professionals and patients and that a further appointment may be needed
suggest that using an agenda-setting sheet may be useful and point out example in workbook
invite them to look at the agenda-setting sheet with a partner and consider whether they would
find it helpful
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Scripted Instructions
Activity A4: Sharing and agreeing an agenda
To help us to take part in the agenda-setting process we may need to give some thought beforehand to
what we might wish to talk about.
We may want to use these questions to guide us.
Make sure that this
question list is available in
their resource pack.








Questions Chart
What am I going to this meeting for and what do I hope to
get from it?
How have I been feeling since my last visit?
What have I been finding difficult?
What else in my life might be affecting my health?
What have I been doing to look after my health?
Is there anything I might find difficult to talk about?
What is my goal?
What do I need to know about treatments?
There are times when both the health professional and the patient are not able to do justice to all issues
in just one appointment. If this is the case you may need a follow-up appointment where other topics can
be discussed.
Some people find an agenda setting sheet useful in these situations. There is an example of one of
these in your workbook.
Perhaps you would like to have a look at this sheet and think about how you would feel about using it.
You might want to share your thoughts with a partner.
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Module A
Activity A4: Sharing and agreeing an agenda
How would you feel about using one of these agenda-setting sheets? What topics
might you want to discuss? What subjects might you want to have on the agenda
which aren’t on the sheet?
Unscripted Instructions
The prompt questions are
there as a guide. You can
use these, or any other
appropriate questions, to
stimulate the discussion.

summarise by saying that we are likely to find our health meetings more satisfying and helpful if
we use agenda- setting

explain that some local clinicians may also be undergoing similar training to this to enable them to
share and agree an agenda with patients

explain that to self-manage optimally we need to work in partnership with the members of the
health care team and that agreeing a shared agenda is one way to do this
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Scripted Instructions
The prompt questions are
there as a guide. You can
use these, or any other
appropriate questions, to
stimulate the discussion.
Activity A4: Sharing and agreeing an agenda
How would you feel about using one of these agenda-setting sheets? What topics
might you want to discuss? What subjects might you want to have on the agenda
which aren’t on the sheet?
If you prepare beforehand for your meetings, you will be able to contribute to setting the agenda. This is
likely to make your meetings with health professionals more helpful and satisfying. It will also enable you
to feel that you are working with them in a more equal way. It may be that your health professional is also
taking part in similar training and will also be learning more about sharing and agreeing the agenda with
patients.
Optimal self-mangers work in partnership with health care professionals - sharing and agreeing an
agenda is one way to do this.
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Activity A4: Sharing and agreeing an agenda
Appendix, References and Notes
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Module A
Activity A5: Working on a self management goal
Activity: Working on a self-management goal.
Time: 20 minutes
Requirements: SMART Goals chart, Questions to Help You Set Your Goals chart, prepared modelling boxes.
Number of Pages: 8
Aim:
 To enable participants to identify and plan the activity required to take a step towards achieving a self-identified health related goal.
Objectives:
 considered whether the identified goal remains relevant, realistic and important to them
 identified an achievable step/s towards their goal which can be achieved by the next session
 identified any barriers or problems to success
 planned the step/s in a way which allows them to feel confident to achieve
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Unscripted Instructions
Activity A5: Working on a self management goal
Remind the group that earlier we followed-up on last week’s goals and that some of these goals were
short term and simple while others were longer-term and more complex.




explain that if they are setting goals with clinicians they may use SMART goals
invite them to share any experience they have of using SMART goals
explain that SMART goals help us to create a robust plan which is more likely to be successful
use the chart to explain SMART goals
Draw attention to this
chart by explaining it.
Invite the group to
discuss.
Explain that this is in their
booklet/pack.
S
M
A
R
T
Specific
Measurable
Achievable
Realistic
Time based
SMART Goals
What you will do?
How much...how often?
How confident are you that you can do it?
How confident are you that you will do it?
When will you do it?
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Scripted Instructions
Activity A5: Working on a self management goal
Earlier we followed-up on our goals and you were able to share with the group the progress you made in
working on your goals. Some of those goals were simple and short term goals - goals that you have now
reached. Others were more complex goals with many steps that you are still working towards.
We can now continue this work. When we work in partnership with our health professionals on goals to
improve the management of our health condition we may come across something they use called
SMART goals. Perhaps some of you have heard about these?
Draw attention to this
chart by explaining it.
Invite the group to
discuss.
Explain that this is in their
booklet/pack.
If we set a goal, or a step towards it with a SMART plan, it means our plan is robust and workable and
we give ourselves the best chance of success. To remind us of what is meant by SMART goals, here is
a chart.
S
M
A
R
T
Specific
Measurable
Achievable
Realistic
Time based
SMART Goals
What you will do?
How much...how often?
How confident are you that you can do it?
How confident are you that you will do it?
When will you do it?
By making sure we know exactly what we plan to do, we have a much greater chance of success. Using
these questions can really help us.
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Module A
Activity A5: Working on a self management goal

Unscripted Instructions
Invite the participants to
share if they are planning
to change/modify their
goal and why.
right one for you to work on just now?


invite the group to take a few minutes, alone or with a partner, to consider a goal they want to
work towards and the step/s they want to take this week
explain that some people like to use the following questions as a guide
•
•
•
•
•
•
Invite your co-facilitator to
share their plan for their
goal this week using the
Questions to help you set
Goals as a guide.
Facilitator 2 prepares
beforehand a small
achievable goal which
illustrates these questions
well.
invite the group to consider modifying their goal if necessary to make it more relevant, more
achievable or become something which is more important to them
What thoughts do you have about this? Do you feel the goal you set is still the

Questions to Help You Set Your Goals
What is your goal?
How important is your goal? What makes it important to you?
What do you need to do to achieve it?
Which bits will you do this week?
How much? How often? When?
If you visualise yourself doing this bit of your goal this week how
confident do you felon a scale of 0-10?
explain that you as facilitators also set and work on goals and that you are going to invite your cofacilitator to share theirs now
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Scripted Instructions
Invite the participants to
share if they are planning
to change/modify their
goal and why.
Activity A5: Working on a self management goal
It may be that in light of the experience over the last week you might want to modify the goal you set
yourself slightly; or because you now know a little bit more about Self-Management, you may want to set
a completely different goal.
What thoughts do you have about this? Do you feel the goal you set is still the
right one for you to work on just now?
You could take a few minutes now to think about the step(s) you are going to take
towards your goal before the next session. You may find the SMART chart helpful now or you could also
use the Questions to Help You Set Your Goals chart. You can work with a partner if you want to.
Invite your co-facilitator to
share their plan for their
goal this week using the
Questions to help you set
Goals as a guide
Facilitator 2 prepares
beforehand a small
achievable goal which
illustrates these questions
well.






Questions to Help You Set Your Goals
What is your goal?
How important is your goal? What makes it important to you?
What do you need to do to achieve it?
Which bits will you do this week?
How much? How often? When?
If you visualise yourself doing this bit of your goal this week how
confident do you felon a scale of 0-10?
As you know we also enjoy setting and working towards goals ourselves. I’m keen to hear about the goal
(co-facilitator) has set.
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Unscripted Instructions
Invite participants to share their
goal with the group using the
standard ‘sharing’ process, always
asking for a volunteer and then
moving round the group from this
point. Use these questions as a
guide if someone needs help to
voice their goal clearly.
Activity A5: Working on a self management goal
NB If both facilitators are confident you can divide a large (i.e. greater than 8) group into
two halves with one facilitator per group. Otherwise both facilitators work together to
support participants to set goals.

–
–
–
–
–
–
Invite each person to share their goal, using the questions below if required:
What is your goal?
How important is the goal to you? What makes it important?
What do you need to do to achieve it?
Which bits will you do this week?
How much? How often? When?
If you visualise yourself doing this bit of your goal this week how confident do you feel
on a scale of 0-10?
If a participant has a low
importance level, you can use the
Facilitator Guidance in the
appendix that follows this activity.
When second facilitator is reached
they should share their goal for the
week.
If problems or barriers arise, or a
confidence level is low, you can
offer to help using a formal or
informal problem-solving model.

Explain that we will be following-up on their progress during the next session and wish
them well.
Once everyone has shared their
goal.....
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Activity A5: Working on a self management goal
Scripted Instructions
Invite participants to share their
goal with the group using the
standard ‘sharing’ process, always
asking for a volunteer and then
moving round the group from this
point. Use these questions as a
guide if someone needs help to
voice their goal clearly.
If a participant has a low
importance level, you can use the
Facilitator Guidance in the
appendix that follows this activity.
NB If both facilitators are confident you can divide a large (greater than 8) group into
two halves with one facilitator per group. Otherwise both facilitators work together to
support participants to set goals
Now we are all going to share our goals.

The following questions can help us be really specific about what we are going to do:
– What is your goal?
– How important is the goal to you? What makes it important?
– What do you need to do to achieve it?
– Which bits will you do this week?
– How much? How often? When?
– If you visualise yourself doing this bit of your goal how confident do you feel on a scale
of 0-10?
When second facilitator is reached
they should share their goal for the
week.
If problems/barriers arise, or
confidence level is low, you can
offer to help using a formal or
informal problem-solving model.
Once everyone has shared their
goal.....

We are looking forward to hearing how you get on with your goals in the next workshop
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Activity A5: Working on a self management goal
Appendix, References and Notes
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Module A
Activity A5: Working on a self management goal
Facilitator Guidance for Supporting Individuals with Low Importance
During Goal-Setting we use a set of questions which allow us to support people to set goals which are both important to them and ones
they are confident they will achieve.






What is your goal?
How important is the goal to you? What makes it important to you?
What do you need to do to achieve it?
Which bits will you do this week?
How much? How often? When?
If you visualise yourself doing this bit of your goal this week, how confident do you feel on a scale of 0-10?
We use the questions: How important is the goal to you? What makes it important to you? to enable participants to consider for themselves
why, and if, their goal really matters to them. By working out, and hearing themselves say, that something is very important to them and
why it is, makes them more likely to be motivated to achieve it.
Once you become more confident as a Self-Management coach you may wish to extend this technique by asking the person some further
questions if they state that their goal is not important to them. NB Use of this in-depth technique is not an essential competence for SelfManagement facilitators.
The technique uses scaling 0-10, similar to that used in measuring confidence.
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Activity A5: Working on a self management goal
How might the conversation go?
Participant: My goal isn’t that important.
Facilitator: So, on a scale of 0-10, where 0 is “you don’t care about eating crisps whilst watching TV” and 10 is “not eating crisps
whilst you watch TV, is the most important thing to you”, where would you be on the scale?
Participant: I suppose 4 or 5.
Facilitator: OK, I’m interested in what makes it 5 rather than 3?”
At this point the participant has to think about why they have said 5:
Participant: Well, once I have opened the packet, I realise I’m not that hungry, I feel guilty because they are opened… and I still
eat them anyway so I feel even more guilty. I don’t like feeling like that”.
Facilitator: So, it sounds as though you like the idea of the crisps but then you feel guilty about opening them?
Participant: Yes, often I do, I don’t need them, it’s just habit......I suppose it is quite important to me really, to get out of the habit
and I won’t feel guilty then.
Facilitator: So it’s important to you to be able to watch the TV and not feel guilty about eating crisps.
At this point facilitator returns to the set of Questions to help you set your Goals chart.
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Module A
Activity A6: Problem solving
Activity: Problem solving.
Time: 20 minutes
Requirements: Problem Solving Cycle chart, prepared problem.
Number of Pages 8
Aim:
 To demonstrate and practice the problem-solving process.
Objectives:
 consider the role of problem-solving as a Self-Management tool
 identify the steps of the problem-solving process
 consider situations where problem-solving would be helpful
 practice the use of the problem-solving steps to solve a ‘real’ problem
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Unscripted Instructions
Activity A6: Problem solving
Explain that problem-solving is used frequently during these workshops because it is an important tool
which allows other self-management skills to be used effectively.



describe how we might do this whilst working to identify and set a goal or during follow-up and
how we have also used the rest of the group as a resource
acknowledge that problem-solving is a skill used by many people in their home and work lives
explain the importance of the first step of Identifying the real problem
Use the Problem-Solving
Cycle chart to illustrate
the steps as you describe
them.
Accept problem isn’t
solvable now
Identify the real
problem
Get more
ideas
Explore the
problem
Choose
another
idea
Try the
idea out
Problem Solve
Suggest
Ideas
Choose an idea
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Module A
Scripted Instructions
Activity A6: Problem solving
During these workshops we frequently spend time looking to find solutions to the problems and
difficulties we experience in managing life with a health condition. We might do this while working to
identify and set a goal or perhaps during follow-up, when we have looked at some of the challenges we
met as we worked on our goals. We might also have used others in the group as a resource to help us
do this.
Many of us are already good problem solvers - in the past we have regularly used our problem solving
skills in our work and home lives. Problem-solving is a helpful Self-Management skill and allows us to
use other skills and techniques to best effect.
Use the Problem-Solving
Cycle chart to illustrate
the steps as you describe
them.
The first step is to identify the real problem - it may seem like an obvious step but it is not always as
simple as it sounds. Sometimes we might identify the wrong source of the problem and this will divert
our efforts and energy in the wrong direction.
Accept problem isn’t
solvable now
Identify the real
problem
Get more
ideas
Explore the
problem
Choose
another
idea
Try the
idea out
Problem Solve
Suggest
Ideas
Choose an idea
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Module A
Activity A6: Problem solving

Unscripted Instruction
Continue to use the
Problem-solving cycle
chart to illustrate the
steps as you describe
them.
–
–
–
–
–
–
–
Explain each stage in the process:
exploring the problem to find out when or why it happens
suggesting as many ideas as possible and suggest writing down these possible solutions
trying out an idea, to see if it works
going back to the list and think again
asking other people for their ideas
accepting that the problem may not be solvable just now, or
going back the problem and making sure it had been identified correctly in the beginning
In what situations might problem-solving be useful?
.
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Module A
Scripted Instruction
Continue to use the
Problem-solving cycle
chart to illustrate the
steps as you describe
them.
The prompt questions are
there as a guide. You can
use these, or any other
appropriate questions, to
stimulate the discussion.
Activity A6: Problem solving
You may need to spend time exploring the problem, to find out when or why it happens. Then come up
with as many solutions as you can; the best problem-solvers come up with the most ideas not
necessarily the best ideas. Sometimes it can help to write the ideas down before you decide on one to
try out.
Next, you need to try out your idea. If your idea works, the problem is solved, but if it doesn’t you can go
back to the list, pick another idea and try that one out. If the problem hasn’t been solved and you have
used up all the ideas on your list, you could ask other people for their ideas; it is surprising just how
many different ideas there can be to solve one problem.
If the problem isn’t solvable at the moment then we may need to accept this - or it might help to go back
to the first step, re-explore the problem and make sure we were trying to solve the real problem in the
first place.
In what situations might problem-solving be useful?
Setting goals, Modifying goals, during a
setback, Medical visits, getting help from
other people, when stressed or anxious,
when we want to make changes, managing
medication, facing a new challenge, when
our symptoms are worse.
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Module A
Unscripted Instruction
You can use a problem
which a group member
has already identified
during the workshop or a
problem modelled by cofacilitator.
Activity A6: Problem solving
Explain that problem-solving is a particularly useful tool when goal-setting. It can help to identify barriers
to successful achievement if confidence level is low.



acknowledge that barriers can come from both within us and from outside sources
being able to solve problems allows us to feel more confident on our self-management journey in
the future
explore the Problem solving process with the help of the Problem Solving Cycle
If using a facilitatorgenerated problem, allow
co-facilitator to explore it
with you.
Once problem identified,
write on chart, invite
group to suggest ideas.
Person with problem
chooses an idea to try.
PS
Invite to set this as goal.
Refer back to Problem
Solve cycle to revise
process.

suggest that they may need to use the Problem-solving process later as they set goals
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Module A
Scripted Instruction
You can use a problem
which a group member
has already identified
during the workshop or a
problem modelled by cofacilitator.
Activity A6: Problem solving
Problem-solving can be used at any time, but it is especially useful when working towards goals.
If our confidence level is below 7, it may be that there are barriers to our success. Sometimes the
barriers come from other people or external sources and sometimes the barriers come from within us. By
identifying and exploring the problem and suggesting solutions we will begin to feel more confident in our
journey to optimal self-management.
Let’s look at the process in action now.
If using a facilitatorgenerated problem, allow
co-facilitator to explore it
with you.
Once problem identified,
write on chart, invite
group to suggest ideas.
Person with problem
chooses an idea to try.
PS
Invite to set this as goal.
Refer back to Problem
Solving Cycle to revise
process.
You may see problem-solving used again when we each set our goals later in the session.
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Module A
Activity A6: Problem solving
Appendix, References and Notes
64/83
Module A
Activity A7: Weekly goal setting
Activity: Weekly goal-setting workshops 3, 4, 5
Time: 20 minutes
Requirements: Self management Circles chart, Our Goal needs to: chart, Prepared Goal, Questions to help you set your Goals chart.
Number of Pages: 8
Aim:
 Introduce the concept of goal-setting within Self-Management as a positive, helpful tool for people to use to help them become active
self-managers and so manage the impact of their long-term condition on their everyday lives.
Objectives:
 identify a goal which is important to them
 break their goal into do-able ‘bits’
 explore their ability to achieve this ‘bit’ before the next workshop
 feel they are in a safe and secure environment in which to set goals
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Module A
Activity A7: Weekly goal setting
Unscripted Instructions



Draw attention to this
chart by explaining it.
Invite the group to
discuss.
Explain that this chart is
in their workbook.
remind the group that earlier you followed up on goals set during the last workshop and that you
will now set goals for this week
explain that a goal can be a step towards a larger goal or be a small goal towards greater selfmanagement
explain that all goals do not need to be medical and that goals can be around any aspect of selfmanagement. Use the SM Circles chart to explain this:
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Module A
Scripted Instructions
Activity A7: Weekly goal setting
Earlier we followed-up on the goals we set in the last workshop.
Now, we can work together to help us identify a goal which is important to us and which we feel
confident that we can achieve before the next workshop.
The goal we work on this week can be a single step towards a larger goal or it can be any goal related to
the self-management of our health condition.
Draw attention to this
chart by explaining it.
Invite the group to
discuss.
Explain that this chart is
in their workbook.
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Module A
Activity A7: Weekly goal setting

Use chart to remind group that goals need to be:
Unscripted Instructions
Our Goal needs to:
Draw attention to this
chart by explaining it.
Invite the group to
discuss.





be our choice
be important to us
be a little difficult to achieve
allow us to feel more confident once we have achieved it
let us show other people and ourselves that we can overcome
problems
 let us feel in control
Explain that this is in their
workbook.
Facilitator 1 asks
facilitator 2 the questions
from the Questions to
help you set your Goals
chart.
Make sure you have
given some thought to
this in advance of the
session.

explain that to be most effective goals should be at least a little challenging

acknowledge that identifying goals which are important to us can be difficult at times

invite co-facilitator to model the goal they have set themselves for the following week
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Module A
Activity A7: Weekly goal setting
In choosing our Self-Management goal for ourselves it should:
Scripted Instructions
Draw attention to this
chart by explaining it.
Invite the group to
discuss.
Explain that this is in their
workbook.
Facilitator 1 asks
facilitator 2 the questions
from the Questions to
help you set your Goals
chart.
Our Goal needs to:
be our choice
be important to us
be a little difficult to achieve
allow us to feel more confident once we have achieved it
let us show other people and ourselves that we can overcome
problems
 let us feel in control





Goals which are clear, definitely stated and slightly challenging lead to better results than goals which
are vague and easy.
It isn’t always easy to identify a goal which is important to us and achievable so we will demonstrate the
process first. Then you can spend a little time identifying your own goal. (Co-facilitator) is now going to
set a goal for the following week.
Make sure you have
given some thought to
this in advance of the
session.
NB If both facilitators are confident you can divide a large (greater than 8) group into two halves
with one facilitator per group. Otherwise both facilitators work together to support participants to
set goals.
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Module A
Unscripted Instructions
Invite participants to share their
goal with the group using the
standard ‘sharing’ process,
always asking for a volunteer
and then moving round the
group from this point. Use these
questions as a guide if someone
needs help to voice their goal
clearly.
Activity A7: Weekly goal setting

Invite each person to share their goal, using the questions below if required:
–
–
–
–
–
What is your goal?
How important is the goal to you? What makes it important?
What do you need to do to achieve it?
Which bits will you do this week?
How much? How often? When?
If you visualise yourself doing this bit of your goal his week how confident do you feel on a scale
of 0-10?
If participant has low importance
or confidence level, and you
need more ideas, see the
guidance notes in the appendix.
When second facilitator is
reached they should share their
goal for the week.
If problems/barriers arise you
can offer to help using a formal
or informal problem-solving
model.
Explain that we will be following-up on their progress during the next session and wish them well.
Once everyone has shared their
goal:
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Module A
Scripted Instructions
Invite participants to share their
goal with the group using the
standard ‘sharing’ process,
always asking for a volunteer
and then moving round the
group from this point. Use these
questions as a guide if
someone needs help to voice
their goal clearly.
If participant has low
importance or confidence level,
and you need more ideas, see
the guidance notes in the
appendix.
Activity A7: Weekly goal setting
NB If both facilitators are confident you can divide a large (greater than 8) group into two
halves with one facilitator per group. Otherwise both facilitators work together to support
participants to set goals

Now we are all going to share our goals. The following questions can help us be really
specific about what we are going to do:
–
–
–
–
–
What is your goal?
How important is the goal to you? What makes it important?
What do you need to do to achieve it?
Which bits will you do this week?
How much? How often? When?
If you visualise yourself doing this bit of your goal his week how confident do you feel on a scale
of 0-10?
When second facilitator is
reached they should share their
goal for the week.
If problems/barriers arise you
can offer to help using a formal
or informal problem-solving
model.
Explain that we will be following-up on their progress during the next session and wish them well.
Once everyone has shared their
goal:
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Module A
Activity A7: Weekly goal setting
Appendix, References and Notes
72/83
Module A
Activity A8: Setting self management goals
Activity: Setting Self-management Goals in the future
Time: 30 minutes
Requirements: Sharing Our Success Chart, The Journey towards Optimal
Self-Management chart, Questions to help you set your Goals chart, Prepared
Modelling Boxes
Number of Pages: 8
Aim:
 Introduce the idea of continued Self-management goal-setting as a helpful tool to enable people to become activated and
optimal self-managers.
Objectives:
 consider the benefits to them of goal-setting as a positive tool in their self-management
 reflect on their progress towards activation and some of the changes they have made
 consider and explore their need for follow-up
 identify any long-term goal they choose to set
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Module A
Activity A8: Setting self management goals

Unscripted Instructions
Allow 5 minutes for this
sharing and then ask for
feedback.
Remind participants that
we want to allow time for
everyone to be able to
share something here.
Invite participants to
share something they
have achieved with the
group using the standard
‘sharing’ process, always
asking for a volunteer and
then moving round the
group from this point.
Remind the group that the workshops have been about change, about recognising and accepting
the importance of the role they play in managing their health condition and also about trying out
new skills and making changes.

Suggest that most people will feel they have made progress by:
– Setting a weekly goal.
– Working on it between workshops.
– Following-up with the group.

Explain that it would be helpful to hear from them about their successes – the goals worked on
and changes made in the way they manage their health conditions.

Suggest they might also want to share what you have learnt about yourself and the management
of your health condition. The chart is there to help them with this.

Invite them to share with a partner (or small group) first, and explain we will then follow-up as a
whole group.




Sharing Our Success Chart
a success you have had
a goal you have worked on
a change you have made in the way you manage your health
conditions
something you may have learnt about yourself or about the
management of your health condition
Affirm any success and
learning you hear.
Thank the group for sharing and commend them on their self-management and remind them that goalsetting is one of best ways to achieve optimal self-management.
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Module A
Scripted Instructions
Allow 5 minutes for this
sharing and then ask for
feedback.
Remind participants that
we want to allow time for
everyone to be able to
share something here.
Invite participants to
share something they
have achieved with the
group using the standard
‘sharing’ process, always
asking for a volunteer and
then moving round the
group from this point.
Affirm any success and
learning you hear.
Activity A8: Setting self management goals
These self-management workshops have been about change, about recognising and accepting the
importance of the role we play in managing our health condition and about trying out new skills and
making changes which have increased our confidence.
Most of us feel we have made some progress. One way we have done this is by setting a weekly goal,
working on it between workshops and then following-up with the group. It would be helpful to hear from
you about the successes you have had; the goals you have worked on and the changes you have made
in the way you manage your health conditions. You might also want to share some of what you have
learnt about yourself and the management of your health condition.




Sharing Our Success Chart
a success you have had
a goal you have worked on
a change you have made in the way you manage your health
conditions
something you may have learnt about yourself or about the
management of your health condition
Perhaps you would find it helpful to share with a partner (or small group) first and then we will follow-up
as a whole group. The chart is here to help you.
It is really good to hear from you about the successes you have had and the learning you have gained.
Setting and working on achievable and challenging goals is one of the best ways to become an optimal
self-manager.
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Module A
Unscripted Instructions
Activity A8: Setting self management goals
Remind the group about the chart they looked at in workshop 1. It looked at where they were on their
journey to becoming an optimal self-manager.
The Journey towards Optimal Self-Management
My role in
I am confident
I can identify
managing my
that I know
and solve
health
how to
problems
condition is
manage my
when they
important
health
arise
condition
Beginning the
x
x
x
journey
Finding the
x
x

Route
Travelling
x


Staying on



Track
Allow 1 minute for people
to consider this and share
with their partner or small
group.
NB if Follow-up
sessions are planned
these can be discussed
here:
NB if Follow-up
sessions are not
planned continues with:

invite them to consider where they are now on the self-management journey
Either: remind them of the discussion from an earlier workshop about what support to set future goals is
available after these workshops end,
Or: invite them to set a goal for the future, and suggest they might need to consider how they can
receive support to set and follow-up on goals.
Suggest that we add an extra question to our list: How will you follow up on your goals?
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Module A
Scripted Instructions
Allow 1 minute for people
to consider this and share
with their partner or small
group.
NB if Follow-up
sessions are planned
these can be discussed
here:
NB if Follow-up
sessions are not
planned, continue with:
Activity A8: Setting self management goals
You might remember in the first workshop you looked at where you were on your journey towards
Optimal Selfmanagement:
The Journey towards Optimal Self-Management
My role in
I am confident
I can identify
managing my
that I know
and solve
health
how to
problems
condition is
manage my
when they
important
health
arise
condition
Beginning the
x
x
x
journey
Finding the
x
x

Route
Travelling
x


Staying on



Track
Perhaps you would like to think about this again to consider what progress you have made towards
being an active optimal self-manager.
Either: In an earlier workshop you considered whether or how you would continue to work together to
support one another to set goals and make progress. So we can talk about this again now.
Or: You may need to think about how you might be able to continue to get support to set goals in the
future.
We can now set a goal for the future, although we may not be together as this group to follow-up.
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Module A
Activity A8: Setting self management goals
We can add an extra question to the chart we used earlier: How will you follow up on your goals?
Unscripted Instructions






Write the question: How
will you follow up on your
goals? On the flip chart.
Facilitators share their
goal with the group.
Invite participants to
share their goal with the
group using the standard
‘sharing’ process, always
asking for a volunteer and
then moving round the
group from this point.

Questions to help you set your Goals
What is your Goal?
How important is your Goal to you? What make it important?
What do you need to achieve it?
Which bits will you do this week?
How much? How often? When?
If you visualise yourself doing this bit of your Goal this week, how
confident do you feel, on a scale of 0-10?
Invite them to work in pairs; to support each other by using the Questions to help you set your
Goals chart to identify the goal they will set. Suggest they record this in their work-book.

Remind them that if they are struggling to manage their condition at times, they now have a range
of tools to help. They:
– can identify and find solutions to problems
– put these solutions into action by setting them as a goal
– follow-up and get encouragement to succeed from other people
– work in partnership with a health professional, by setting the agenda for health meetings and by
having them as a resource for problem-solving and for setting and following up on goals
Wish them well with their goals and their onward journey to optimal self-management.
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Module A
Activity A8: Setting self management goals
Scripted Instructions
Write the question: How
will you follow up on your
goals? on another flip
chart.
Facilitators share their goal
with the group.
Invite participants to share
their goal with the group
using the standard
‘sharing’ process, always
asking for a volunteer and
then moving round the
group from this point.






Questions to help you set your Goals
What is your Goal?
How important is your Goal to you? What makes it important?
What do you need to achieve it?
Which bits will you do this week?
How much? How often? When?
If you visualise yourself doing this bit of your Goal this week, how
confident do you feel, on a scale of 0-10?
We would like you to work in pairs; to support each other by using the Questions to help you set your
Goals chart to identify the goal you will set yourself. You can record this in your work-book.
If we find we are struggling to manage our condition at times we now have a range of tools to help us.
We can identify and find solutions to problems; we can put these solutions into action by setting them
as a goal. We can follow-up and get encouragement to succeed from other people. We can also work in
partnership with our health professional, by setting the agenda for our meetings, and also by having
them as a resource for problem-solving and perhaps for setting-goals and following- up on these goals
with them. We wish you well with your goals and on your onward journey to optimal self-management.
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Module A
Activity A8: Setting self management goals
Appendix, References and Notes
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Module A
Activity A9: Close and evaluation
Activity: Close and evaluation
Time: 10 minutes
Requirements: Dates, times, venue for follow-on, Evaluations, Certificates (if
used locally)
Number of Pages: 2
Aim:
 To encourage and support follow-on, complete evaluation and close the programme.
Objectives:
 been given the opportunity to say farewell to one another and to facilitators
 be reminded of follow-on arrangements
 completed the programme evaluation (if applicable)
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Module A
Activity A9: Close and evaluation
Instructions
Go through agenda for
workshop six.
Support the group to
complete evaluations
according to local
instructions.
Make sure you the
arrangement for follow-on
sessions/events/activities.

remind the group what has been covered in this workshop

ask the group to complete the short evaluation of the workshops

issue certificates (if used locally)

remind the group of arrangements- dates, times, venues etc for follow-on
sessions/events/activities

thank the group for their participation and the support they have offered to one another, and to
you as facilitators
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Module A
Activity A9: Close and evaluation
For further information:
Tel: 0207 257 800
www.health.org.uk
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