Meetings and Support Group Tips
Our support group was formed informally and without the benefit of some of the ideas discussed on this page. Our group was small and yet very productive. We remain close friends to this day and are there for each other as the need arises. There is a lot of material given here, but use what feels ‘right” and dispense with the rest. Some support groups have several hundred members and need to be structured far differently than much smaller groups such as ours.
Topics covered below are:
· Job Descriptions (Of 2 Key Group Members: The Lay Leader And The Group Facilitator)
· Getting Started
· Types Of Support Groups
· Selecting a Facilitator and a Lay Leader
· Finding Participants
· Suggested Agenda For Initial Meeting
· Suggested Topics For Discussion
· Facilitating the Support Group
· Sample Confidentiality Policy
INTRODUCTION For many people peer-to-peer interaction is a positive, effective way to discuss anxiety issues and challenges. Support groups can provide a means for people affected by anxiety to meet and provide mutual support through discussions, presentations, and organized activities. Support groups create a supportive environment in which people with anxiety and their families can:
JOB DESCRIPTIONS Typically two people play key roles in the support group process: The lay leader and the facilitator.
Lay Leader The lay leader coordinates all aspects of the support group including, but not limited to, starting the group, recruiting the facilitator and participants, and promoting the group to potential participants. If a health care professional is not available, the lay leader may also fill the role of facilitator.
Facilitator The facilitator attends all meetings and leads the group meetings. Ideally, the facilitator is a health care professional with knowledge of Social Anxiety Disorder and actively working in this area of the profession. Local doctors, therapists, social workers, and other mental health professionals often will make themselves available to facilitate a group. A word of caution, however, is that any hint of conflict of interest will want to be avoided and this issue should be discussed with any potential facilitator.
GETTING STARTED Who is your target audience? What type of support group do you want to have (and what type is there a need for)? Concerns of people with social anxiety disorder are often significantly different from those with other types of stress-related maladies and the needs and concerns of people in different age groups often vary as well. Some suggested audience segments include:
1. Adult Groups (21 and older) Consider dividing this group into groups according to disorder (OCD, Phobias, Panic, PTSD, etc;) Younger and older adults; Spouses and significant others; couples and/or family
2. Youth Groups (under 21) This group should be further divided into the following age groups:
· Child (under 12)
· Teen (12-18)
· College (18-21)
3. Parent Group Designed for parents of children with GAD.
4. Ethnic Group – If you have a large ethnic population in your community, you may consider having a group that addresses that population specifically including language requirements (e.g., Spanish-speaking group).
TYPES OF SUPPORT GROUPS Consider whether the support group will be an open-ended or a closed-ended group.
An open-ended group meets on a regular basis for an indefinite period of time (no end date). For example, an open-ended group may meet once a month on a certain day at a certain time (e.g., the first Tuesday of each month). Open-ended groups should be open to anyone within your target audience who is interested in participating. The open-ended format allows individuals to join the group at any time.
A close-ended group also meets on a regular basis, but for a specified period of time. For example, a closed-ended group may meet once a month for six months. For this type of group, it is suggested that the membership be established prior to the start of the series and that no new members are added after the initial meeting. Closed membership is suggested because a closed-ended group usually goes through a certain development process in their discussions and generally arrives at a closing point at the completion of the series. The addition of new members may disrupt this process.
Special note for lay leaders:
It is advisable for the potential members of a closed-end group to be interviewed by the group facilitator prior to the
initial meeting. This will insure that the group will be appropriate for the needs and expectations of its members.
- What time will the support group meet? Time-of-day should be determined by the needs of the intended participants. Parents and young adults generally prefer evening meetings because of work and school schedules. Seniors generally prefer daytime meetings. Groups for children should not be scheduled to end later than early evening.
- What size should the group be? Optimal size for a support group is 8 to 10 people. Groups smaller than 3 or 4 or larger than 12 to14 make the group process more difficult. Ideally, the group will be large enough for the members to share a meaningful exchange of information yet small enough that each individual will be able to actively participate. When planning a support group, you should set both upper and lower limits for the size of the group.
Where will the group meet? Any location that is convenient for the target audience and provides for a comfortable setting for the group is acceptable. Be sure to consider such factors as parking, accessibility for people with disabilities, proximity to public transportation, and personal safety when selecting your location. Libraries and meeting rooms in hospitals and banks make good locations. The location should provide for the group participants to sit in a circle or living room type setting to facilitate discussion.
Special note for lay leaders: It is generally advisable to avoid holding meetings at any medical office or facility that could be associated with individual health care providers or practices. Health care providers may be reluctant to refer patients to groups under these circumstances.
- Will there be a charge? It is strongly encouraged that support groups be accessible to anyone wishing to join. Therefore, fees for participants should not be required. Underemployment and unemployment go hand-in-hand with social anxiety disorders, so remember that many who would like to participate in the support group may not be able to afford fees or dues.
- In what format will the support group interact? Each group should be given the opportunity to identify the format that would be of most interest and benefit to them. The primary purpose of a support group is to meet the needs of the participants at any given time. It is essential that members have input into format decisions. Some groups tend to be less structured with very little, if any, formal discussion or topic presentation, others begin meetings with set topics.
Some possible format options are:
Open Discussion: This format enables participants to share
feelings, ideas, concerns, or other information that is
important to them. There are no predetermined topics or
speakers. This is the format that we followed in our support
Topic-Oriented: This format starts with a specific topic that
is announced in advance. The members then discuss the
topic and related issues during the meeting. Topic oriented
groups may also feature outside speakers.
Speaker-Oriented: This format is similar to the topic-
oriented group, however, the focus of each meeting is a
specific speaker and the information that the speaker may
cover. The group should be able to actively participate in the
meeting through question and answers or a discussion
following the speaker’s presentation. This should not become
simply a lecture program.
SELECTING A FACILITATOR/ LAY LEADER It is generally recommended that support groups be led or facilitated by health care professionals. Facilitators may be therapists, counselors social workers, doctors or other trained health professional.
Special note: All health care professionals serving as facilitators must carry their own malpractice insurance.
A knowledgeable lay leader also may lead support groups if a health care professional is not available. With a couple of exceptions, we lead our own group, but we did invite a local Psychologist to facilitate a few of our meetings. We preferred facilitating our own group. Either way, facilitators/group leaders should agree to the following guidelines:
The facilitator should not release the names of participants to outside sources. Also, for participants to feel comfortable sharing their feelings, the discussions of the group must remain confidential in all regards. Confidentiality should only be breached in instances of suspected child abuse, when participants express
suicidal tendencies or when necessary to comply with specific legal requirements.
The purpose of these groups is to provide mutual support, not to serve as a part of the person’s medical treatment. Therefore, participants and facilitators must not provide specific medical advice to members of the group. The facilitator must insure that participants are not exchanging specific medical advice or critiquing specific medical professionals within the context of the group meeting. Remember that anxiety affects people in different ways and what works for one person is not always a wise choice for the next person.
Distribute a news release Finding people to attend and persons to help with a support group can be a challenge. One way to raise awareness of a support group is to circulate a news release to local media. The release should include information about the support group (who, what, when, where and why). Distribute the release to the calendar desk of your local newspaper and community calendar contact at your local radio and television stations. Be sure to provide local health care providers, senior centers and local churches the news release for publication in their newsletters/bulletins. We have a couple of sample press releases on a separate page that you can tailor to your needs or follow for ideas.
Special note: Be sure to inform any local mental health office about your group so it can be added to their support group referral listings.
Flyers Create a flyer to distribute throughout the area. Don’t forget local hospitals, clinics, grocery stores, coin laundries, health food stores, and pharmacies.
Referrals Distribute a letter along with a flyer to area health care professionals (especially anxiety educators, doctors, social workers, and counselors) asking them to refer their patients to the program.
For open-ended groups, you may find that the needs of participants have been met so well that they no longer feel they need the ongoing support, information, etc. that first brought them to the group. You should interpret this as SUCCESS! After all, the intention of a support group is often to address a short-lived need for support, not to foster a long-term dependence on the group. Dwindling participation in close-ended groups should be viewed differently. Since completing the group process is important for this type of group and an up-front stated expectation, leaders should assess whether the process is providing what participants expected and whether the interview process for screening members was adequate.
SUGGESTED AGENDA FOR INITIAL MEETING
1. Welcome and Introductions
2. Define Group Format (i.e., open discussion vs. structured topics or speakers)
· Medical Advice – group members should be reminded that the support group is not an opportunity to receive medical advice. The individual’s doctor should give medical advice and seeing the doctor should be encouraged.
· Smoking Policy – due to the health-related nature of an anxiety support group, it is strongly encouraged to enforce a non-smoking policy.
· Refreshments – encourage participants to bring their own snack. Soft drinks can be provided, but other food items should be discouraged at most of the general meetings. Potlucks or other refreshments should be pre-planned as special meetings and appropriate to the occasion.
· Location of Telephone and Bathroom
· Contact Person (Optional) – provide participants with the name and contact information for the lay leader or other designated group member who can be contacted by prospective support group members.
· Notification of Absence (Optional) – determine ahead of time if participants should be required to notify the lay leader or facilitator if they will not be attending a support group meeting. This is an option that not all groups will want to adopt.
· Call Pools (Optional) – the facilitator may choose to encourage participants to car pool to the support group meetings or ask if there are any members who need assistance with getting to the meeting.
· Exchange of Names and Phone Numbers (Telephone Tree) – participants call and remind other members of meetings or to be available to one another during bad weather or illness. Anxiety and panic attack sufferers often find it helpful to have someone to call “in a pinch.”
· Confidentiality – all participants need to feel comfortable sharing their feelings, so it is important that the discussions of the group remain confidential in all regards. Members and facilitators should not discuss the information shared within the group with anyone. (I have included a sample policy as an example for your consideration.)
· Mutual Respect – includes not interrupting each other. Only one person should be speaking at any one time.
· Discussion of Potential Support Group Topics – Provide participants with a forum to discuss what they would like to see happen within their support group. You can have those who attend write down some topics and turn them into the facilitator at the meeting or provide an email address for this purpose.
SUGGESTED TOPICS FOR DISCUSSION
Using the following list of possible topics, have the participants work in small groups for 20 minutes to decide on topics of greatest interest (encourage them to add additional topics not listed.) If six meetings are being planned, ask each group to submit nine suggestions, etc. List suggestions on a flip chart and have the entire group prioritize the list.
· Anxiety and the family
· How to talk to friends and others about anxiety
· Anxiety in the workplace/career choices
· Spouses and significant others
· Complications of anxiety
· Special problems associated with travel
· Exercise issues
· Breathing techniques for relaxation
· Relationships with health care providers/health care system
· Sexuality and sexual problems
· Obsessive-compulsive behaviors
· Medications and their complications
· Insurance and Finance issues
· Natural remedies
· School issues
· Relaxation techniques
· Making lifestyle
FACILITATING THE SUPPORT GROUP
The facilitator’s primary responsibility is to keep discussion smooth and flowing, with as much member participation as possible and hopefully without too much intrusion from the facilitator.
1. Keep eye contact with all participants. Simply looking at someone and (smiling!) while you’re speaking or listening helps that person feel part of the discussion, even if he/she has not contributed vocally for some time.
2. Address people by name. This connects people to you and to the group and also helps others remember names in case they missed it during the introductions.
3. Notice who talks and who doesn’t. Do not press newcomers. If someone who has been silent speaks up – encourage more discussion on that point. If someone tends to dominate the discussion, find gentle ways to involve others. This is known as “gate keeping” – you tend the “gate” and encourage silent ones and try to divert the conversation away from chatty ones.
4. Be aware of “group energy” and individual reactions. Use peripheral vision, and glance around the room frequently to check out facial expressions and body language. Watch for those who fidget and those who appear bored, and don’t be afraid to call on these people. Keep an eye on unusually quiet people and use your judgment about drawing them into the discussion.
5. Let one person talk at a time. If someone does not get to finish a point – go back to that person. If someone tries to contribute but can’t get into the conversation, give that person the floor. If a side conversation develops, wait to see if it ends on its own accord, if it doesn’t – try to silence it discreetly. If it becomes distracting, interrupt the main discussion and make a general announcement that there is to be one person talking at a time.
6. Keep discussions on a personal and feeling level. Challenge generalizations such as “All men are . . .” or “All women want is . . .” by asking those present if the statement just made pertains to them. Encourage “I” statements about feeling and experience. If you’re not getting them, ask for them. You may feel that you need to share some of your own t o pave the way (“Has anyone else felt that way?”)
7. Listen so that you can:
a. give positive feedback to good points
b. extend support (“That must have been hard on you” or “How great you could do that”)
c. call attention to similar or conflicting points of view
8. Let members speak first. Before YOU ask a question, give the group every opportunity to question each other.
9. Avoid teaching. Instead, ask leading questions that guide the group to make important decisions on the agenda. Only “teach” when you have to in order to move on and after sufficient questions.
10. Throw questions directed to you back to the group (“That’s a good question – what do all of you think?”)
11. Pick up on comments that are natural transitions to the next item on the agenda and use them to move there if the time is right.
12. Stick to the agenda . . . but not with glue. Notice when the discussion gets off the track and pull it back by saying so. However, if good energy is being generated, then let it flow until it gets too far a field or seems to be a way of avoiding the topic at hand. Be prepared to chuck the agenda entirely, with or without the group’s consent, should someone present an issue of overriding importance (most obviously if someone cries).
13. Avoid making judgments and discourage them from others. The craziest statement has yet to be heard, If you feel strongly, express yourself in ‘I” statements (I needed this, so I did that or I couldn’t have done that because…”) If you feel compelled to give advice tell only what you would do, and emphasize that …. or throw it out to the group … or phrase it in a question “Have you considered doing A or B?” If a member of the group appears to be rendering judgments, point out that he/she is expressing one person’s opinion and that certainly there are many ways to view a situation.
14. If discussion lags, it may be a difficult topic, you may have a lot of newcomers, there may be another issue of more importance, or it may just be a bad night.
15. Silence is okay. Participants often need to consider a point just made or phrase their responses, and a group member will usually break the silence. Count to ten before you break the silence.
16. Rely on your intuition and instincts. Be open. Convey warmth and acceptance.
17. Enjoy yourself. You are not an expert with all the answers. The group has the answers, and you are simply guiding the discussion. Do not feel that you have to do all the work (you shouldn’t do all the work!). Feel free to participate and to ask your own questions. Your sincere interest and involvement can be contagious.
SAMPLE CONFIDENTIALITY POLICY
Anxiety Support Group
In a support group environment, it is necessary to keep all information shared within the group environment confidential. Facilitators, lay leaders, and participants should not discuss conversations, situations, or participants with individuals outside of the support group. The lay leader or facilitator must not breach confidentiality except in extreme circumstances (such as instances of suspected child abuse, expressed suicidal tendencies, or when it is necessary to comply with specific legal requirements.)
Page last updated February 26, 2017