Teach Confidentiality with the Loss Game
The Mount Rogers Health District of Bristol, VA, found that a good way to teach aides the importance of patient confidentiality, especially in the cases of AIDS patients, was through a sensitivity exercise created by the Virginia Department of Health.
Here’s the game:
This exercise, in which feelings are key, takes about 35 minutes. Identifying the feelings and helping participants to manage them are the facilitator’s primary goals of this exercise. Ask participants to list on a piece of paper:
1. A material possession that they value dearly.
2. A physical attribute of which they are proud.
3. A favorite physical activity.
4. A personal secret that they share with few or no one. Have them draw a circle around the secret to signal that it is "hidden."
5. The one or two friends or loved one whose support has been critical to them.
Now ask participants to consider each of the following developments. With the exception of item four, ask them to X-out the item as you move through each.
1. An unforeseen financial reversal causes them to lose/sell the material possessions.
2. An accident causes the physical attribute to be lost or severely marred.
3. That renders it impossible for them to engage in their favorite activity.
4. Through a combination of circumstances, their secret is "out." Have them erase the circle "hiding" the secret.
5. Because they have discovered your secret, their most important support person(s) abandons them.
Ask participants how they feel at these losses. List their responses on a flip chart. Be sure all the following are covered as reactions of persons in transition:
• self-devaluation;
• anger/rage;
• fear;
• depression;
• loss of control;
• withdrawal;
• suicidal tendencies.
Ask participants if they recognize the connection between their feelings and the reactions of HIV-infected people. Note that during transition, people infected with HIV may also experience:
• social rejection, real and imagined;
• mental deterioration, possibly dementia.
Intervention strategies during this phase should be selected to help participants accept responsibility (not blame) for his or her state. Develop a strategy by redirecting participants’ attention to the loss exercise. Ask them to identify ways in which they have dealt or might deal with the loss of their valued material possession and/or favorite activity.
List responses on a flip chart, being sure to cover:
• rationalization;
• replacement;
• financial assistance;
• AIDS-related support groups;
• increased spirituality;
• finding/developing alternate sources of support/new friends;
• increased interest in other existing possessions/activities;
• "will power" (deciding to live without).
Before moving on, restore each of the lost items to participants. Whether through an "accident or fate" or "case of mistaken identity," they have regained everything. Allow a few moments for relief taking.
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