Section 3: ACT intervention to reduce stigma of mental illness

Activity 1.5 The Inclusion/Exclusion Circle Game

ACT Processes:

  • Defusion
  • Values

Objectives:

  • To promote empathy and connection among participants
  • To illustrate the power of arbitrary rules
  • To encourage committed action guided by chosen values

Participation Format:

  • Participants will gather in the centre of the room and walk around and then be sent outside the circle.

Number of Facilitators:

  • 2

Time Required:

  • 45 mins

Materials Required:

  • A set of different colour cards. The number of cards should correspond with the number of participants in the group learning session. The idea is to have half of the cards be white (representing privileged statuses) and the other half of the cards be different colours (representing different marginalized statuses). Do not inform the participants about the significance of the different colour cards.
  • A facilitator guide with descriptions of the different colour-coded case scenarios of social identities, statuses, privileges, and marginalization. See Appendix 1.5b.
  • A bell to capture participants’ attention during the game.
  • Signs labeled “Station #__” to be placed on the walls. The number of signs required depends on the number of marginalized statuses used in the game. A minimum of 6 and a maximum of 8 marginalized identities/statuses is recommended in this game to achieve optimal effectiveness.

Activities & Instructions


Setup
  • Arrange all the chairs in a large circle and ensure that there is sufficient space in the centre for participants to move around and interact safely and comfortably; also to have sufficient space for participants to stand at the assigned stations outside of the circle (see Appendix 1.5a).
Instructions for participants
  1. Facilitator #1 shuffles the different colour-cards and randomly distributes one card to each participant, without disclosing the significance of the different colours. The number of cards should correspond with the number of participants in the group learning session. The idea is to have half of the cards be white (representing privileged statuses) and the other half of the cards be different colours (representing different marginalized statuses).
  2. Facilitator #1 invites all participants to enter the circle in the centre of the room and mingle. Explain to participants that at the sound of the bell, everyone will stop and listen for further instructions.
  3. After participants have mingled for 10 to 15 seconds, Facilitator #1 rings the bell to capture participants’ attention.
  4. Facilitator #1 reads the description of colour-coded description #1. The game starts with the description of the marginalized identities/statuses; the purpose is to illustrate that only members with privileged statuses will be left in the centre of the circle.
  5. Facilitator #1 states: “If you are holding a [e.g., blue] colour card, this is about you.” Facilitator then reads the description of the [e.g., blue] colour identity/status, and finishes by saying, “If you have a [e.g., blue] card, leave the circle and go to Station #[e.g., 1] and stay there. Do not allow anyone else into your station.”
  6. Instruct the participants inside the circle to mingle between the facilitator’s narration of each colour-coded identity/status. Repeat the above process until the descriptions of all the colour-coded marginalized identities/ statuses cards have been read out and all the participants representing these marginalized identities/statuses have been sent to the different stations around the room.
  7. Read out the description of the privileged identities/statuses represented by the white colour cards, and instruct the participants holding these cards to stay and mingle within the circle.
  8. When all the cards have been read, ask the participants to return to their original seats and go over the exercise.
Debriefing Points
  1. Ask the participants to share their experience in doing this exercise.
    Probes:

    1. What was it like taking part in this exercise? How did you feel?
    2. What came to your mind when you were sent away from the circle?
    3. What came to your mind when others were sent away from the circle?
    4. What came to your mind when you were kept in the circle?
  2. Questions to promote critical reflection and emancipation dialogue:
    Probes:

    1. Why did you leave the circle when you were asked to?
    2. How many of you wanted to resist the instructions? What happened?
    3. What did you notice about the people outside the circle? What could have been done about the situation?
    4. If you engage in this exercise again, would you play the game differently? How?
Notes to Facilitators

This exercise has been well tested with many groups. Common reflections that have been generated by participants include (prompt as necessary):

  • The voice of authority made participants feel they need to obey;
  • The fear of being ‘kicked out’ of the circle kept participant docile and silent instead of speaking out;
  • Participants who were instructed to leave the circle, upon reflection, felt they could have and should have reached out to each other at the different station to become a collective force;
  • Participants through this experiential learning developed empathy for each other, including those left inside the circle;
  • Participants left inside the circle did not enjoy their ‘privileges’ any more; they did not like the arbitrary unfairness associated with social exclusion.
  • The reported outcomes of this exercise suggest that compassion is a human quality and value that we can tap into to promote collective committed action towards social change and justice.
  • With more mindful awareness and attunement to our values, we can stop the automatic following of arbitrary rules that discriminates and marginalizes people.

References & Sources

  • Wong, J. P. & Li, A. T. (in press). The Exclusionary Circle Game: A tool to promote critical dialogue about HIV stigma and social justice. Progress in Community Health Partnerships: Research, Education, and Action.

Appendix 1.5a – Diagram for space arrangement (Exclusionary Circle)

Appendix 1.5b – Case scenario cards

Descriptions of Marginalized and Privileged Identities
    1. COLOUR: RED
      If you are holding a red card, this is about you. You were trained as an engineer in your country of origin. You had ten years of professional experience before you immigrated to Canada two years ago. You tried to find work in the engineering field in Toronto and you have not been successful. You are currently working as a part-time sales representative. You feel discouraged and worried about your future. If you are holding a red card, leave the circle and go to Station #1. Stay there and do not accept anyone else into the station.
    2. COLOUR: BLUE
      If you are holding a blue card, this is about you. Your father has frequent outbursts of anger. Whenever he is angry, he beats your mother and yells at you. Last week your father went into a rage again. Your mother took you and your little sister to a shelter. You now have to attend a different school near the shelter. You feel embarrassed about telling your new classmates where you are living. If you are holding a blue card, leave the circle and go to Station #2. Stay there and do not accept anyone else into the station.
    3. COLOUR: PINK
      If you are holding a pink card, this is about you. You are 15 years old. You are gay. You have been bullied at school since Grade 4 for being different. You have tried to talk to your parents about your sexuality but they always change the topic. You feel anxious when you go to school; you cannot stand how other students have been making fun of you. You have decided to drop out of school. If you are holding a pink card, leave the circle and go to Station #3. Stay there and do not accept anyone else into the station.
    4. COLOUR: ORANGE
      If you are holding an orange card, this is about you. You are a 12-year-old of East Asian background. When you watch TV or movies, it really bugs you that most East Asian characters are portrayed either as “nerds” or “Asian gangsters.” Although your parents were born in Canada, people always ask you where your parents were from. Your teachers at school expect you to do well in math and ignore you when you try to make it on the football team. If you are holding an orange card, leave the circle and go to Station #4. Stay there and do not accept anyone else into the station.
    5. COLOUR: PURPLE
      If you are holding a purple card, this is about you. You are a transgender Asian person. Your family disowned you when you came out to them about your gender identity. When your employers and co-workers found out that you are a trans-man, they used different excuses to prevent you from getting a permanent job. You moved to downtown Toronto because you feel unsafe on the streets in suburban areas. One time, you ran out of money and had to stay at a men’s shelter, but the fellow residents harassed you; they called you names and wanted to send you away. If you are holding a purple card, leave the circle, go to Station #1, and ask – “Can I join you?” Once you are rejected, move on and go to the next station to ask if you can join. Again, you will be rejected. Keep moving to the next station until you get to Station #5 where you will stay. This is a reminder that all those in Stations #1, 2, 3, and 4 are not to accept anyone else into your own station.
    6. COLOUR: YELLOW
      If you are holding a yellow card, this is about you. You are a new immigrant. Your spouse is seven months pregnant. You arrived in Toronto with your spouse last week. You found out that there is a three-month waiting period before you are able to access the Ontario Health Insurance Plan. You cannot afford to pay for an appointment with an obstetrician. If you are holding an orange card, leave the circle and go to Station #6. Stay there and do not accept anyone else into the station.
    7. COLOUR: GREEN
      If you are holding a green card, this is about you. You are a 16-year-old of South Asian background. When you entered high school, everyone at school told you to join the cricket team, even though you were really interested in football. Every time there is a news story on the so-called honour killing, other students would ask if you know the victim. Some of your classmates also wanted to know if you would have an arranged marriage once you finish school. If you are holding a green card, leave the circle and go to Station #7. Stay there and do not accept anyone else into the station.
    8. COLOUR: BROWN
      If you are holding a brown card, this is about you. You grew up with strong religious beliefs and affiliation. After you immigrated to Canada two years ago, you have continued to be an active member in your church. Being a new immigrant, you rely on the social network and support at church. However, you are not able to disclose to your church leaders or other church members that you have depression and an addiction problem. The strong doctrine of purity and moral living makes you feel judged and ashamed. If you are holding a brown card, leave the circle and go to Station #8. Stay there and do not accept anyone else into the station.
    9. COLOUR: WHITE #1
      If you are holding a white card, this is about you. You are 16-years-old. You have many friends at school. In the last two weeks, you noticed that one of the boys in your class stopped coming to school. He was a quiet guy; he seemed nervous whenever he had to speak in class, and he could not stop shaking his legs when he sat in class. But he seemed to be a kind person. You wonder if he dropped out because your classmates were calling him a ‘freak’. You also wish you had stood up for him when other students were bullying him. Since you are holding a white card, you get to stay in the circle. You can continue to mingle.
    10. COLOUR: WHITE#2
      If you are holding a white card, this is about you. You live in an affluent neighborhood with your wife and two sons. You seldom worry about your sons being stopped and searched by the police. You also do not have to worry about being shot in your own neighborhood. You are pleased that your oldest son has been accepted to study law at the University of Toronto. Since you are holding a white card, you get to stay in the circle. You can continue to mingle.

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Acceptance and Commitment Training (ACT) for Mental Health Promotion Copyright © 2024 by Kenneth Po-Lun Fung, Josephine Pui-Hing Wong is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, except where otherwise noted.

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