The group approach can be most effective in dealing with life's big strains even when it comes to matters of anger, sexuality and assertiveness. Padraig O'Morain reports.
Every now and then people write to Jacky Jones to tell her one of the courses she manages has changed their lives.
This is not the sort of response most of us would expect from people attending courses run by the Health Promotion Services of a health board.
But in the Western Health Board (Galway, Mayo and Roscommon), health promotion workers have been developing, since the late 1980s, courses which have, indeed, changed people's lives.
According to Jacky Jones, regional manager of the Health Promotion Services, she learned a long time ago that simply telling people what's good for them and what's bad for them achieves little. "I mean, do you know anybody who doesn't know smoking is bad for you?" she asks.
What counts in bringing about positive change, she says, "is your thinking process, your mental health and your communication skills and not whether you know whether something is good for you or bad for you."
For instance, "You can know all you want about stress but if you're not able to say no to your boss or say no to anybody else who says take on another job, well, you're not going to get anywhere."
Armed with this insight she and Colm Byrne, now health promotion training officer in Co Mayo, set about creating what has become an extraordinary range of courses on issues affecting mental and physical health.
Last week, the WHB published a 350-page manual, Wellbeing Through Groupwork, giving details on how to run courses on everything from understanding sexuality to time management, bullying, anger management, conflict with teenagers and living with fear. A greatly expanded version from previous issues, it also covers more traditional topics such as food hygiene, becoming more active and alcohol abuse.
The most popular courses are on the theme of communications and assertiveness, she says. "That's the big issue. That's the bottom line when it comes to health."
Bernie Howley, from Shunnaughmoyle, near Knock, has derived enormous benefits from the Communications and Assertiveness course.
"I am communicating better with my husband rather than assuming he knows what I mean," she says. "I am different with my children. I don't criticise them."
She now draws a clear distinction between the child and the child's behaviour. "I don't need to wrap my car around a tree anymore because I am angry. Now I take it back to the source. If you insult me I take it back to you. Today I wouldn't be afraid of saying, I don't like what you said to me. That's coming from being comfortable with myself."
Improvements in quality of life come from many sources. Esther Mary D'Arcy, now president of the Irish Society of Chartered Physiotherapists, designed the course on pelvic floor exercises for women with urinary incontinence. The treatment offered by the course "is successful and very rewarding", she says, yet there are women who, perhaps through embarrassment, have put off doing anything about it for up to 21 years.
Many of the women affected are in their early 20s and upwards. "There is a feeling that this is something that happens to older women. That is not necessarily so. Even a small improvement can make a great difference to a person's quality of life."
Generally speaking, the health promotion courses are run by part-time facilitators in premises provided by local groups, such as women's groups, who have asked for particular courses to be run.
The cost to the Western Health Board is 65,000 a year for up to 50 courses. The benefits derived from that spending have not been measured - but it seems fair to say they are many, many times greater than the cost.
The Wellbeing Through Groupwork manual comes complete with handouts and can be bought for 10 from the Health Promotions Services Western Health Board, West City Centre, Seamus Quirke Road, Galway.