What a Good Support Group Should Look Like
Needing support for our challenges
Sometimes people need a little help in life when they're faced with difficult battles and challenges. They may feel isolated and disconnected, or they may lack understanding and knowledge of their issues. They may need advice and encouragement, especially from people who are living through the same struggle. There's something powerful about a shared journey.
Support groups aren't for everyone. Sometimes you might have to try more than one until you find the right fit. I offer here a look at some elements and qualities to consider as you begin your journey of finding support. I will also share some of my own personal experiences in support groups—including pitfalls and examples of positive and negative outcomes.
The importance of a good facilitator
It can't be stressed enough how important it is to have a good facilitator. It will make or break the group. They should have good training and be equipped to provide and maintain a safe environment for members.
A facilitator should state clearly what the group is about, what they will be working on, the format, guidelines, rules, and boundaries so the group functions in a healthy way. A poorly run support group can create unnecessary, added stress, be counterproductive, and sometimes even be detrimental. I know from personal experience.
Following are some strong characteristics of a good support group facilitator:
- Well trained
- Good organization skills
- Good communication skills
- Knowledge and experience with the issue of the support group
- Lover of people
- Able to create a safe environment through rules and guidelines
- Willing and able to keep the group within the bounds of those rules and guidelines
- Foster and model trust, encouragement, and empathy and compassion
- Keep the good of the whole group first
- Able to handle unplanned, sensitive situations (will cover below) or conflict
Time limits for sharing
Time limits for individual sharing is a must. One of the most common problems with support groups is people monopolizing the share time. Allowing a few to monopolize the time is grossly unfair and sabotages the whole purpose of the group. People get hurt and discouraged by it. A support group leader should be willing to follow the protocol they learned in training to prevent this from happening. I have been in support groups with poor facilitators where I ended up feeling defeated, that no one cared about me, and having wasted my time. Others also felt cheated and quickly quit coming.
Personal experience with monopolizers
Experience #1: Negative outcome
The very first support group I attended was for depression. There were fifteen people. The format was to go around the circle, give our name and personal, emotional weather report in thirty seconds. Then we'd go to the "sharing" portion. The group was one hour and fifteen minutes long.
We opened with Harry who began with "I'm Harry and I'm in a tornado right now. You wouldn't believe what my wife did..." He was off and running for a good four minutes until someone cleared their throat loud - a hint to Harry to shut up, or a hint to the leader to make Harry shut up. It worked.
There were several who followed the rules, but there were still a few more Harry's. All the facilitator did the whole time was smile and give an occasional "Uh huh," or "Oh my goodness." We didn't have enough time for everyone to talk in the sharing portion. I talked with her afterwards about my disappointment and asked about the rules. She gave me the right answers, she just didn't do what she was supposed to. I went the next week and it was the same way. I dropped out, as did some others.
Experience #2: Positive outcome
One time I took a coping skills group through my Group Health clinic. It was part support and part education and there was lots of discussion. It was expertly facilitated until one day a woman decided it was all about her. She rambled on and on and for some reason the group leaders couldn't rein her in. This went on two more times, so I sent an email to the group leaders expressing my feelings of disappointment and frustration. I was very polite and they were on it right away. They had a private conversation with the woman and there were no more problems. The group was very helpful to me and I very much appreciated the wonderful ladies who facilitated, and let them know.
A safe sharing environment
- Healthy sharing - Members need to feel safe. In support groups people are often vulnerable, and carry deep hurts and fears. It takes a tremendous amount of trust to be involved. A group leader should explain what types of responses are allowed and not allowed. For example, the leader might instruct the members not to cross talk, interrupt someone, make inappropriate comments that could hurt or offend someone. Some of these everyone should already know and practice; unfortunately, not everyone does. I feel more comfortable when these imperatives are given. I don't want to be hurt nor do I wish to hurt others. There are many formats around, so the leader can lay out the guidelines according to the format and what is healthy and safe for all.
- Safe sharing format for trauma groups - Members of support groups on mental health and grief and loss are the most vulnerable to triggers. People who have trauma in their past can be triggered by someone else's trauma story. A safe and effective trauma support group should not have a format in which members share and process their trauma. That should be done in private therapy. It opens up all kinds of problems in a group setting, most significantly triggering others. This is my opinion based on personal experience, and in speaking with clinicians and therapists.
Personal experiences with support groups involving trauma
Experience # 1 Disastrous outcome
I went to a Celebrate Recovery meeting once. I went to an introductory session before being assigned a group for my issue. We had to go around the table, give our name, and a brief statement on why we were there. One woman after another said they were there for a specific trauma I had experienced, and described their experiences in detail. I was wedged up against the wall and couldn't get out without climbing over people, so I stood up and shouted stop. I explained I was being triggered and wasn't there for abuse recovery. The leader said their rule was they weren't supposed to share details. Why hadn't she told us at the beginning? Why hadn't she stopped it? It started all over. I crawled over a bunch of women, went out to the parking lot and threw up. I went back inside when it was over, and being distraught and traumatized, let her have it. She referred me to a program elsewhere. I reported it to the director. He was bored by my remarks. I never returned.
Experience #2 Positive outcome
I went to a trauma group at my mental health clinic. The format was educational, discussion, and tools on how to deal with symptoms like flash backs, nightmares, etc. It was recovery based, not processing our traumas. The facilitator explained the format, the purpose of the group, and told us why we don't share our stories - triggering. It was really great. When someone forgot and started with their story, he redirected them skillfully and it was a very positive experience.
Respect for everyone and the rules
- Respect - There should be respect by everyone, including the facilitator. You probably think that's a given with the group leader, but every once in awhile you get one that's flaky and ought not to be running a support group (examples below). Members should respect one another at every level. Their comments and observance of all the rules will make the group more beneficial. Here is a sampling of rules on respect:
- Silence devices
- No texting
- All sharing is confidential
- Don't interrupt
- No cross talk
- No critisism or judgmental remarks
- Wait your turn
- Stick to the format and guidelines
- Be encouraging and positive
- If you have an objection to someone's bad behavior, speak to the facilitator privately afterward, or if allowed in group, let your words be without hostility and respectful
- No profanity or inappropriate talk
Personal experience with an insensitive, disrespectful facilitator
Experience # 1 Negative outcome. Years ago I went to a day treatment program in a town far away to get treatment for my PTSD and depression. It was an intense two weeks of groups throughout the day. Unfortunately, there simply wasn't enough staff to cover everything. This created a huge problem - BEEPERS. Because they had to discuss our cases with our doctors and therapists back home, they used beepers to notify them that a call had come in. They felt this necessary due to tight schedules of our practitioners. It was always a juggling act.
One day a person was sharing something very intimate and emotionally charged. The beeper went off and the counselor just got up and left. The girl looked shocked, humiliated, and betrayed. I took the therapist's chair and encouraged the girl to carry on and we all encouraged her. We had all been given an evaluation questionnaire about the staff. I expressed my outrage that they allowed beepers in sessions and how this counselor devastated this poor woman. They worked something out but a lot of damage had been done.
Experience # 2 - Disastrous outcome. The same setting and clinician as above. A seventeen year old girl was close to her discharge date. She had done no sharing the entire time. The group leader above chewed her out one day in front of our large group and made her cry and run out. The next day she came back with her sister in tow and was able to share her story, a very difficult story to tell for one so young. She then promptly quit the program.
Never have I seen such insensitivity and disrespect from a clinician.
Facilitators must know how to handle sensitive moments
- Handling sensitive moments - Sometimes members can get very emotional and break down or become very anxious and overwhelmed. The person may need a little extra time and not pushed to pull it together. Each case is individual. The facilitator should handle those moments with sensitivity and encourage sensitivity from the others. There are other situations that are sensitive, like someone who is unwilling or feels they are unable to participate week after week. I will share a personal experience below on this, but there are many sensitive issues that will come up and the facilitator needs to know how to handle them.
- Group leaders should be sensitive people - Group members want to know the leader sincerely cares and is compassionate. It's terrible to have a leader who is wooden, distant, short, dismissive, and as rude and flaky as the one I shared above. You can always tell when someone is just there for the paycheck. In my opinion, they need a support group more than the members. People have different personalities and styles in working with others as group leaders. They might show care and compassion differently. That's fine, just so it shows.
Facilitators should be accessible, accountable and open to concerns
Facilitators should be accessible to support group members individually in private should they have a concern or complaint. If that is not possible, the supervisor of the leader should handle it. They must also have an attitude of openness when a member has a concern or conflict. I shared such an experience above where the group leaders responded to my concerns and took care of the problem.
If a member has a complaint about the facilitator, the facilitator should listen and not get defensive, annoyed or angry. It may happen that there was a misunderstanding, or talking it through they come up with a solution. Sometimes supervisors handle such matters and they talk to the leader. There are times when group members can behave badly toward the leader in private and she needs to know how to handle those times in the best way possible. Good training should offer ways to do so and supervisors should be available to the leaders for support. Sometimes, a supervisor needs to field the complaint.
There are also times where a member goes to the leader to tell her that something another person is doing or saying is causing them a lot of discomfort or fear. The facilitator will need to deal with the other member and not expect the person to take care of it on their own.
Facilitators need accountability, but also support for themselves. I've led some groups and I can attest to the need for support.
Tools and suggestions for application
A good support group will provide tools (part of the solution) to manage symptoms or life situations that members may be struggling with. Knowledge and information can do that as well as offering suggestions from the leader or members, or assignments where members can apply what they're learning or dealing with. Below is an example of a very effective tool I received in my Group Health coping skills group.
Tool I received in a support group
Self-soothing first aid kit: In the coping skills support group I mentioned earlier, I received many tools to manage anxiety and coping. This particular one was one of the best. A self-soothing first aid kit is a means to soothe anxiety. It won't work, however, if you wait until you are in a critical state. The idea is to catch it early and find some things that you find very soothing, for all the senses if possible. Get a box or some other container (I actually used a literal tool box). Here are some ideas of what to put in your kit:
- Sight: A photo of someone or something that brings you pleasure, or perhaps a video of nature. You could put up Scriptures, quotes, or affirmations around the house that speak to you. I used a photo of my grandson and another family photo. I also drew the picture below to hang on my wall.
- Hearing: Soothing instrumental music, nature sounds, a calm soothing song that makes you feel peaceful and hopeful. I used an instrumental CD of hymns, and a song about God's care while we sleep, and an audio of the reading of the Bible. Stay away from sad or stimulating music.
- Touch: A stuffed animal, a soft blanket, a smooth stone or some other smooth item. An essential oil or lotion. A bubble bath (showers are too stimulating). Pets count. If you find it soothing to pet your cat, dog, or other member of the animal kingdom, that's perfect. I used a smooth stone I put in my pocket if I was out and about, or just held it when home. I also used my wonderful collie, Nellie. Nellie exuded love and was an unofficial service dog.
- Taste: A favorite herbal tea, a banana, hot chocolate, jello or pudding. I used herbal teas and bananas. Bananas are a comfort food for me and Chamomile tea is very calming to me. You don't want here to eat junk food or to gorge on something fatty. It's not about sating your appetite.
- Smell: The herbal tea of course is a double whammy because you get two senses covered. You can also use a scented candle, potpourri, or essential oil. I used the tea and sometimes simmered a spice on the stove. I heard of someone baking bread or pop up biscuits.
These are just a few examples. There are a few activities one can do that are soothing. I'm not sure what category they'd fall into. Coloring in one of those adult coloring books is very soothing to me, and I make cards. Knitting or crocheting is very soothing for some. Just be careful not to do or use something stimulating. When I would start feeling a little anxious or agitated (I learned to recognize the early stages) I would get into my kit and use one, or several items leisurely. Now that I'm sharing this with you, I can see I need to return to my kit at this season of life.
The power of encouragement
Encouragement and hope should be a staple of every support group. Encouragement is such a powerful gift. Here are ways encouragement can be offered:
- Sharing like experiences and challenges
- Listening carefully
- Expressing empathy and compassion
- Showing understanding of the other person's struggle
- Offering helpful suggestions
- Words of affirmation and reassurance
- Offering assurance and hope
Receiving encouragement can rejuvinate, motivate and inspire someone to move forward, take a little risk and a step of faith, try something new. There is nothing, no nothing like a good dose of encouragement. If a support group can do only one thing, encouragement would be best.
The importance of physical boundaries
No touching: People seeking help in a support group can be vulnerable - some more than others. That's why boundaries and rules and guidelines are so important. In some support groups no touching boundaries are very important to protect vulnerable members.
Lets look at a possible touching boundary scenario that can create a problem.
Cynthia is in an anxiety and depression support group. Her social anxiety keeps her isolated a lot. She feels alone, lonely and worthless.
Todd is a fellow group member. His issue is depression that has hung on for over a year and continues to worsen. He too feels isolated and worthless.
One day in group, Cynthia breaks down sobbing. Without even thinking about the no touch rule, out of compassion and empathy, Todd spontaneously puts his hand on Cynthia's shoulder and gives it few rubs and tells her it's going to be okay. It is innocent as far as intentions. Todd is not hitting on poor Cynthia. But there is a spark. A man has shown kindness and compassion to lonely Cynthia and she thinks about his touch after she pulls it together and the group proceeds. He is drawn to her now as well. They meet after group and have coffee and one thing leads to another. Long story short, it ends badly because neither is stable enough to carry on a healthy relationship and it turns out Cynthia has childhood sexual trauma issues and Todd has an addiction to benzodiazapines he's been hiding. Cynthia is deeply wounded by Todd and the relationship sets her back. This may be a more extreme case, but it's an example of how far things can go. It was Cynthia and Todd's choice to enter into that relationship, but certainly touching in the group can create an open door or spark something that may otherwise not have happened.
Another example would be someone touches another to comfort or greet them and they have trauma in their past and such forms of touching create a serious trigger or other negative reaction. Some people just don't like to be touched.
A personal experience with boundary issues in a group
Sometimes in support groups, members can misconstrue someone's encouraging words or helpful suggestions. It can become a very difficult situation and in much the same way as the physical boundary. I learned this the hard way.
- A very nice young man was in a group I attended. This young man began to sit with me every time group met. Soon, the way he spoke to me indicated he felt a little too fond and attached to me because I offered a lot of support when he shared a few times, as I did with everyone. He was young enough to be my son. He began saying nice things about me to the group. My eyes connected once with the facilitator and I knew she saw my discomfort. I went to her afterward and asked for her help. She talked to the young man. He reassured her he would stop, but it continued. I began to wait until everyone was seated before I entered so I could find a seat away from him but he always saved my seat and there were none left. I should have spoken to him myself, not just leave it entirely to the leader, but at that time of my life I didn't have the confidence to handle it.
One day it was announced that he would be moving on in a week so members could say something encouraging to him if they wanted, and he likewise. I said nothing. Much to my chagrin, he stood up and said a bunch of nice things about me and pulled out a military badge belonging to his best friend who died in combat. He wanted to give it to me as a thank you gift and remembrance of him. Everyone was saying "Aw, that is so sweet." I was extremely uncomfortable and put on the spot. Again, my eyes met with the leader and she didn't quite know what to do. I told him no way could I accept anything so sacred. He insisted and looked hurt and I didn't want to humiliate him so I took it. After group I tried to give it back to him more assertively. He reached out to hug me. The leader was unsure how to handle it and left it to me. I understood her side. It was such a personal, awkward and bizarre thing. I don't fault her. I wish I'd been equipped to handle it on my own, but my life was a mess and I wasn't.
Appreciate and encourage your group facilitator
When significant things go wrong in a group, I feel the need and responsibility to speak up, for my own good, and that of others. I've always been respectful and friendly, but sometimes very vulnerable and upset, like in the story just above. Many times I took valuable time and resources to get there and participate. I live in a rural area and if I have to pay a hefty bridge toll and gas money to get there, or pay money to take a support type of class or group, I want to get what I paid for.
After I got my peer support certificate, I did an internship at an organization that provides support groups of all kinds. I co-facilitated a few groups and came to appreciate some of the challenges group leaders face. In one group, two very toxic people did nothing but emotionally vomit on the group. No matter which positive way we tried to direct them, they continued their diatribe. My supervisor and I would be completely drained and frazzled. We'd go back to her office and debrief by talking about it, trying to see how we could handle it differently. Then we sat in silence. This took a toll on my own emotional vulnerabilities. I approached the director about doing my own workshop that involved expression through writing. It was a wonderful format and very successful.
Complaining trumps thanking too often. Helping professionals work very, very hard. Tell them you appreciate them, because after all, it is you they're serving to give you a better life. Their work goes way beyond what you see when you're with them. Sadly, they take a lot of guff from rude people. As I said, encouragement is a powerful gift, but gratitude can move mountains, clear up storms, and set us free from the bondage of misery, and everyone involved is blessed. Living a life of gratitude will bring so many blessings to you, you may not have need for a support group or other services. Who wouldn't want that? I do. Sign me up!.
Gratitude helps you to grow and expand; gratitude brings joy and laughter into your life and into the lives of all those around you."— Eileen Caddy
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
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© 2017 Lori Colbo