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. Author manuscript; available in PMC: 2010 May 25.
Published in final edited form as: J Acquir Immune Defic Syndr. 2008 Sep 1;49(Suppl 1):S59–S67. doi: 10.1097/QAI.0b013e3181844807

TABLE 1.

Handling Challenging Behaviors and Situations Within the Sessions General responses

General responses

  • Ignore inappropriate behavior

  • Redirect participant toward appropriate behavior

  • Reward even the slightest movement toward appropriate behavior

Challenging participant behaviors: Disruptive, rambles, overly talkative, complaining frequently
Possible reasons for the behavior

  • Desire for attention

  • Angry about something and does not know another way to express it

  • Hides feelings of insecurity/avoidance of sensitive material

  • Looking for partner or facilitator respect

  • Is in a lot of pain

  • Under the influence of alcohol or drugs

  • Is bothered by disorganized thoughts

Facilitator’s responses

  • Keep temper in check

  • Reinforce appropriate behavior: “You know, John, I think it is really great the way you are focusing on what Diane has to say right now.”

  • Summarize, reframe, and move on: “You make some interesting points, I wonder though, if we can go back to a point that was made earlier, _________.” or “I am sorry that I interrupted you, unfortunately we only have a brief period of time and I really want to get to ___________.”

  • Actively involve participant in constructive participation, for example, ask the person to role-play with their partner: “Wow, you are really full of energy today. Maybe we can harness that and have you act out a role play with [partner’s name].”

  • Ask the other participants for any comments that lead back to the topic: “That’s great, you’ve really given the group a lot to think about, let’s see if anyone else wants to respond. ”

  • If participant is unable to participate constructively, take the person aside and suggest that he/she leave and come back later in the session (in extreme situations only). Check in with person at the end of the session: “Alex, it seems as if it is difficult for you to participate in the session in a way that feels calm and constructive. Are you okay? I’d like to take a minute to help you explore what might be bothering you. Let’s step outside for a few minutes and we’ll rejoin the session later.”