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Section 2. Creating and Facilitating Peer Support Groups

Portions of this section adapted from The Self-Help Leader's Handbook: Leading Effective Meetings by Adrienne Paine-Andrews, Yolanda Suarez-Balcazar, Stephen B. Fawcett, and Leslie Borck Jameson, with the collaboration of Melody G. Embree, published by the Research and Training Center on Independent Living at the University of Kansas.

  • What are peer support groups?

  • Why create and facilitate a peer support group?

  • Who can be served by peer support groups?

  • How do you create a peer support group?

  • How do you facilitate a peer support group?

  • Tips on keeping a peer support group going

  • Tips on handling difficult group members

Did you know that there are over 500,000 support groups in the United States? Because they are both inexpensive and effective ways to offer assistance to people dealing with a variety of concerns, support groups have become a common method of serving the needs of people who are experiencing problems in their lives.

Support groups can be found in big cities, small towns, and even rural areas, dealing with anything from gambling addiction to surviving domestic violence to gender issues. Perhaps the best-known support group is Alcoholics Anonymous. Founded in 1935, AA has provided a safe space for over 2 million people around the world to talk with others like themselves who have struggled with alcoholism. Other well -known support groups built on the AA model include Narcotics Anonymous and Gamblers Anonymous.

If your group or initiative does service work with people who might benefit from talking to others who have similar experiences to their own, perhaps you should consider adding a peer support group to the services you offer.

What are peer support groups?

Support groups - also often referred to as self-help groups - are groups of people who gather to share common problems and experiences associated with a particular problem, condition, illness, or personal circumstance. In a support group, people are able to talk with other folks who are like themselves - people who truly understand what they're going through and can share the type of practical insights that can only come from firsthand experience.

Some of the common characteristics of support groups include:

  • They are made up of peers - people who are all directly affected by a particular issue, illness, or circumstance
  • They usually have a professional or volunteer discussion leader or facilitator
  • They tend to be fairly small in size, to better allow everyone a chance to talk
  • Attendance is voluntary (although sometimes people are required to attend support groups by employers or the court system, especially if criminal or destructive behavior has been involved)

Why create and facilitate a peer support group?

There are many benefits to peer support groups:

  • When someone doesn't know many - or any - other people who are going through what he is coping with, he can feel isolated and stigmatized. Support groups help people with a problem or illness feel less alone and more understood.
  • Support groups don't cost much to run - advertising for the group and maybe some refreshments are all you'll probably need to pay for. Another cost might be meeting space, but you can usually get someone to donate it.
  • Support groups empower people to work to solve their own problems.
  • Members can share information, keeping one another up to date on news of interest to them.
  • Among people who are experiencing similar problems, there is a unique emotional identification that is different from the type of support that can be gotten from professionals.
  • Members act as role models for each other. Seeing others who are contending with the same adversity and making progress in their lives is inspiring and encouraging.
  • A support group is a safe place for someone who needs to talk about intensely personal issues, experiences, struggles, and thoughts.
  • Talking to a counselor or doctor can be very intimidating for some people, because those relationships tend to place more power with the professional. In a support group, members are equals; this can make people feel much more comfortable opening up about their problems.
  • Talking to others in support groups reduces anxiety, improves self-esteem, and helps members' sense of well-being overall.

Who can be served by peer support groups?

Almost anyone! At any given time, over 6.25 million Americans are using self-help groups, and about 15 million have participated in such a group at some time in their lives. Support groups are used to address a myriad of concerns, such as:

  • Diseases, injuries, or chronic medical conditions
  • Eating disorders
  • Sexual identity questions
  • Physical disabilities
  • Bad or unhealthy habits
  • Emotional problems
  • Addictions
  • Bereavement
  • Parenting

Besides serving people directly affected by a problem, support groups often welcome family members or friends of those experiencing illnesses or difficulties. Also, many independent support groups exist just for family members or friends: for example, one such group is Al-Anon, a group for families and friends of alcoholics.

How do you create a peer support group?

Think about what you want to accomplish

Decide what your group's purpose will be and who you want to reach. You might find it helpful to write vision and mission statements for your support group.

Find out whether there are existing national, regional, or local groups your group can be involved with

There are several benefits to setting up your support group under the auspices of a larger organization, if you can. A larger organization can often offer resources and assistance in setting up a new support group. The name recognition that comes with affiliating with a big, well-known organization can give your group more credibility. It can also make it easier for people who need your support group services to find you. Finally, working with a larger organization keeps you from having to "reinvent the wheel" in deciding how the group will operate - you can take advantage of a tried and true model.

Using a fictional example, let's look at how someone might set up a support group with the help of a larger organization.

Yoshiko's support group

Yoshiko's sister was recently diagnosed with muscular dystrophy. Feeling frustrated and isolated, Yoshiko wanted to start a support group for the disease's sufferers and their families. After carefully studying this section of the Community Tool Box, Yoshiko decided to find out whether the Muscular Dystrophy Association, a national organization, sponsored a support group in her town.

She visited the MDA's web site and found out that they offered a group in a nearby town, but there wasn't one in her city. After Yoshiko called the organization's national office and found out the many ways that they could help her new support group, Yoshiko decided to start a local MDA support group rather than an independent one.

Consider whether the group will meet for a specific period of time or for an indefinite period of time

Support groups can be long-running, or they can be restricted for certain periods of time. For example, the local crisis center may offer a six-week support group twice yearly for people who have lost a family member to suicide, rather than a single, year-round group. This type of time-limited format is best suited to crisis situations, such as bereavement or divorce. A drawback of this format is that the group may not be available at a time that someone needs it. Problems that are more long-term in nature - a chronic disease, for example - are better served by ongoing, long-term support groups.

Decide whether the group will be open or closed

Open support groups are those in which new members are welcome to join at any time during the life of the group. This may also mean that anyone can join the group - friends, family members, etc.

In closed groups, people are only allowed to join the group at certain times (e.g., for the first three weeks only) or under certain circumstances (e.g., groups that are only for women). Some organizations offer both types of meetings - for example, Alcoholics Anonymous offers both open meetings, which anyone can attend, and closed meetings, which are only for people going through AA's program.

If you plan on working on a very specific issue and want the entire group to go through the process at the same time, you may want to consider having a closed group. However, open groups are best for most kinds of support groups.

Set a time and place for your support group to meet

Decide on a time that will make it possible for the most people to be there; for example, if your group members are likely to be church-goers, it wouldn't be a good idea to schedule meetings for Sunday mornings. Mid-afternoon on weekdays won't be good for most people who work during the day. Usually, early evenings on weekdays are the best times for the most people.

Picking a good location is far more crucial than you might think. If you work with an organization or coalition that has meeting space of its own, you might want to have your support group meet there, but don't automatically assume that this is the best space for it. You might find that a school, church, restaurant, library, or some other public building is better suited to your needs. Depending on the type of group, members may want to be discreet about their attendance, and may therefore be less likely to come if the group meets in some heavily-traveled place where they might be seen. A support group for former child molesters might want to be as nearly invisible as possible, for instance. While that's a particularly outrageous example, the same might be true for Al-Anon or a group for pregnant teens.

First and foremost, the location should be easily accessible for the people who will be coming to the support group. Is the building in an easy place to find? Is it accessible to people who use wheelchairs, canes, or service dogs? Is there adequate parking nearby?

The location should also be somewhere where people can feel comfortable enough to talk about their problems and able to offer each other support. If you're working with survivors of violent crimes, meeting in a high crime section of town or next door to the county jail might make people in your group uneasy or reluctant to even show up.

While the location you decide on should be accessible and comfortable, it also needs to fit the type of group you want yours to be. For example, meeting in a member's home can add an element of comfort, but groups are much more accessible to newcomers if held in public places; therefore, meeting in somebody's home should probably only be done if it's a closed group.

When you finally have a location picked out, make any needed room reservations or other arrangements, and you're ready to move on!

Select a group leader or facilitator

Picking the right person to lead your support group is of utmost importance. The group leader or facilitator opens and closes the meetings, sets the tone for the discussion, helps members learn how to listen and offer support to each other, and deals with any problems that come up during the meeting. The ideal facilitator will possess the following qualities:

  • Flexible schedule: He should have enough time to perform the required tasks and commit to be there for every meeting.
  • Lots of energy: He should have a positive attitude, be in generally good health, and be able to work after hours if necessary.
  • Ability: Ideally, he should have experience in facilitating such groups. He should also be responsible, articulate, fair, organized, and able to work well with others.
  • Support: Your facilitator needs to have access to needed resources to run the group (a phone, a car, etc.), and people he can rely on for assistance, if necessary.
  • The desire to do the job: He should have an interest in the topic or at least a commitment to helping others. It helps if the facilitator has some sort of affinity for the group and its topic. For example, if your support group is for survivors of breast cancer, then a good facilitator might be someone who has survived breast cancer herself, has been close to someone who experienced it, or at least has had similar experience with other types of disease. This isn't to say that people who haven't been personally touched by the topic can't be great facilitators. You might try folks who have done a lot of volunteer work or have an interest in counseling, such as a graduate student in social work or counseling psychology.

The details of the facilitator's job - running the meetings - are explained later on in this section; you may wish to refer to that when selecting somebody for the position.

Decide on any remaining details

Going back to step one, think about what you want this group to be like. This can help you make up your mind about whatever other ins and outs of the group are left, such as:

  • How often should we meet? Most support groups meet every week or two.
  • How long should meetings last? Most support groups meet for between one and two hours; you may want to have shorter meetings if you end up having a small group or if members' physical problems make sitting through a long meeting uncomfortable.
  • Should we serve refreshments? Refreshments help make everyone feel at home and encourage socializing among members; unless they aren't allowed by your location or you run a group that focuses on food issues (such as an overeaters or eating disorder groups), it's a good idea to have refreshments. If you're on a strict budget, you may have to be creative to get it set up. People can take turns providing cheap refreshments, with some discreet help if someone simply doesn't have the resources to do so. Or perhaps someone knows a merchant or restaurant who has some connection to the purpose of the group, and would be willing to donate refreshments.

Recruit members for your support group

Consider how large you want the support group to be before you start recruiting. Generally, it's best to have a group that's large enough to function well even when some of the members are absent, but small enough for all the members to feel comfortable. As a rule, 5 to 15 people is a pretty good number; anything larger too easily becomes unmanageable and impersonal.

There are many ways to get the word out about your group, and the most successful support groups usually use some combination of all of them.

Use referrals

  • Network with other groups and professionals in your area. Let local clergy, doctors, administrators, agency directors, social workers, media personnel, nurses, and other such people know about your group, and encourage them to tell people about it. Send out letters and, if you have them, brochures or flyers to the offices of local organizations that address your group's area of concern -- e.g., the local mental health agency or chapter of the American Cancer Society. You might also do presentations to some agencies and organizations
  • If your city or county has any community information and referral hotlines, be sure that they have information on your support group
  • If the support group is related to a health matter, be sure to send information to your local hospital's social services and community health education departments
  • Find out which agencies or organizations publish community or social service directories and request that your group be included in the next one

Use the media

  • Posters and flyers: These can be posted at clubs, shops, hospitals, churches, libraries, schools, post offices - just about anywhere that you think interested people might see them
  • Press releases: Sending information about your support group to the local press might interest them in doing stories on your group, which can generate interest
  • Paid advertising: Ads in the local newspaper, as well as those in publications or newsletters put out by agencies or businesses that reach the same folks you want to are a good idea, if you can afford them.
  • Letters to the editor: These can be used to tell the public about your group. They're more likely to be printed if they're in response to a story the paper has published about a related topic
  • Public service announcements: Getting these aired on local radio or television stations can get the word out to large numbers of people

Use personal invitations and word-of-mouth

  • This is the most informal method of recruiting people for support groups, but it's the most effective. The "people chain" happens when one person tells another person about a group, and then that person tells another, and so on. Tell everyone you can about the group, and ask them to tell others. When your group starts meeting, encourage members to tell others about the support group.

Once you have enough members, contact them to let them know the date and time of the first meeting. Give them a couple of weeks' advance notice so they can make any necessary adjustments in their schedule, and follow up with a postcard or telephone reminder a few days before the meeting.

How do you facilitate a peer support group?

You've put in a lot of hard work in preparing for your support group to begin, and now the day has arrived. If you are the group's facilitator, here are some helpful guidelines for running these meetings.

Prepare yourself for the meeting

Take a few minutes to think about possible topics for discussion. If this isn't your first meeting, review the topics that were talked about last time. Go over any notes you took. This can help you remember to bring up things that members might want to revisit or give updates on. If you plan to make any announcements of community events or activities that may be of interest to the group, make sure you have them ready.

Prepare the room for the meeting

Arrive 20 to 30 minutes early to arrange the room. Put the chairs in a circle large enough for latecomers to fit in, with enough room for folks who use wheelchairs to easily join. If you're going to have refreshments, set them up on a table to the side or back of the room. If you're going to use name tags, have them ready. Have a pen and paper to take notes.

Start the meeting

As people begin arriving, be sure to make eye contact and say hello, greeting them by name if you've met them before. Call the meeting to order on time, or at least within five minutes of the designated time. This encourages other members to be prompt. It also rewards those who are punctual; if you always start the meeting late because you're waiting for that one person who shows up 15 minutes late every time, you risk alienating those who made the effort to be there on time. A simple "Let's get started," or "Well, it's five minutes after seven o'clock, why don't we begin the meeting," is adequate.

Give preliminary introductions and information

Introduce yourself briefly; if you have some experience with the group topic, be sure to mention it. Make any announcements and ask the group if they have anything to add.

Opening a support group meeting

At the first meeting for Yoshiko's MD support group, she was pleasantly surprised to see that 15 people showed up. Opening the meeting, Yoshiko introduced herself: "Hello everyone. My name is Yoshiko Hatori and my sister Miho has been living with muscular dystrophy for over a year now. I'm happy to see so many of you came tonight."

She had only one announcement: "By the way, there'll be a car wash fundraiser for the local chapter of the MDA next Saturday from noon to four p.m. at First Baptist Church, so tell as many people as you can about it."

If this is a new group or there are new members present for the first time, explain the ground rules. The most common ground rule for support groups is that everything discussed in the group must be kept confidential. Reminding the group of this from time to time is very important. Explain whether the group is open or closed and what that means. Be sure that everyone understands the rules.

Have everyone introduce themselves, stating their names and a little bit about why they were interested in the group. Then begin the discussion, either by touching on something that was mentioned by one of the members or by bringing up a prepared topic.

Starting a discussion

When members of Yoshiko's group were introducing themselves, one young man named Brian mentioned that his family was planning a trip to the Rockies and that he was concerned about his ability to withstand the higher altitudes. She had planned to talk about family issues in general, but Brian's comment gave Yoshiko an idea. When introductions were finished, she began the discussion this way:

"Brian, you mentioned your apprehension about this upcoming family trip. Could you tell us more about your concerns?" After the group discussed Brian's trip for a while, Yoshiko said, "I found that Christmas with my family was overshadowed by Miho's MD diagnosis. We were all worried about her, and it really made it hard to just enjoy being together as a family. Would anyone like to talk about what effect MD has had on their own family gatherings?" This prompted several members to jump into the discussion.

Encourage members to listen to each other

Being a good listener - and acting as an example to group members in this regard - means being an active listener, one who is obviously listening and understanding what is being said. How do you let people know that you're listening?

  • Body language (leaning slightly towards the speaker, not fidgeting)
  • Eye contact (looking in the speaker's eyes, not looking around the room)
  • Brief encouraging statements, also sometimes called nonverbal encouragers ("Uh-huh" or "Mmm-hmm")
  • Nodding
  • Repeating or rephrasing the speaker's last phrase to let him know you understood. ("I can't believe my mother was so cold about it," could be responded to with, "So you were really hurt by what your mother did," for example)

Encourage members to offer support to one another

While being supportive yourself, you must also help others in the group learn how to be so as well. Demonstrate the active listening skills listed above while the member is speaking. Wait 10 seconds or so and then, if no other members have done so, offer support. Group members will usually pick up on this and start offering support themselves. If they don't you may have to ask them questions about how they are affected by the discloser's experience.

For example, Yoshiko might say the following things in her group:

  • "Shawna, what can you say to Brian that might help?"
  • "How can we give Brian some support now?"
  • "What do you think about what Brian is going through, Annie?"

Encourage members to talk about themselves

One advantage of support groups is that they can create an atmosphere in which members feel comfortable talking about and working through very personal issues and experiences. Disclosure - the act of revealing personal information - gives other members a chance to offer support, ideas, and assistance. It also encourages other members to share their own experiences and fosters an atmosphere of trust in the group. To maintain that trust, facilitators may find that they also need to disclose information from time to time.

When a member discloses information, the facilitator may have to guide the discussion to make the member comfortable or encourage others to join the discussion. Asking open-ended questions - those which cannot be answered with a simple "yes" or "no" - is very useful at this point.

Asking open ended questions

Camilla, a single mother in Yoshiko's support group, talked about how hard it's been for her to take care of her three children over the past few months. She was having a hard time expressing herself, so Yoshiko coaxed her with these open ended questions:

  • "What's it like for you when you're trying to get your kids ready for school in the morning?"
  • "What have you told your children about what's going on with your health right now?"

Yoshiko wanted to get other members to offer support, and she wanted to use Camilla's disclosure to encourage further disclosure from other members.

She asked the following open-ended questions:

  • "What sorts of things in your own lives make you feel the way Camilla feels about this?"
  • "How do you all manage it when you have to be a caretaker for others while dealing with your own illness?"

You can also plan topics ahead of time. Some support groups do things like have their members do reading or keep journals of their experiences to help spark discussion.

Offer support

This is the main reason your group exists! Fortunately, offering support is one of the simplest things to do in the course of running a support group. Giving members support can help them realize that reaching their goals is possible, give them hope, or just let them know that you empathize with what they're going through.

Support consists of making statements that show your understanding, sympathy, and concern. Listen for the feelings expressed by the member, and address those feelings. Support can also be expressed through body language (such as making eye contact or smiling) or touch (hugging, patting the member's arm). Care should be taken in using touch as a form of support - in some circumstances, such as a support group for survivors of child sexual abuse, touch may be threatening and uncomfortable instead of comforting.

Usually, members will offer support to each other on their own, or they will quickly pick up on how to do so by following your example. However, you may have to ask questions to coax them into offering support by asking questions.

Providing support

When Brian said, "I feel bad because I think I'm becoming a burden to my family," Yoshiko could have offered support by saying:

  • "I know things are really tough for you, but I hope you can take some comfort from how much your family obviously loves you," or
  • "I'm sorry to hear that. But I know that I don't mind the extra time I put into taking care of my sister since she's gotten sick - as a matter of fact, I really cherish that we've been able to spend more time together. You might find that the same is true for your family.

Yoshiko could also encourage other members to offer support by saying:

  • "How can we support Brian now?"
  • "Has anyone been through similar experiences with their families?"

Help members solve problems

While solving problems shouldn't be the only goal of a support group, it is something that many members hope for and expect. All members should take part in the problem -solving process so that no single person is seen as the solution to their difficulties. It's the facilitator's job to help members learn how to help each other with problem solving.

Here are the steps to problem solving:

  • Clarifying the problem: Make sure everyone fully understands the problem. If you aren't sure what the problem is, ask questions to get more information.
  • Talking about the alternatives: Bring up possible solutions to the problem, but be very careful to word them in a way that doesn't give advice. For example, instead of "You should do this," a better wording could be "I wonder what it would be like for you to try this" or "Maybe you could do this." Telling people what to do is not the purpose or responsibility of a support group. It takes away a person's feeling that he can handle his own problems and can make people feel attacked and uncomfortable. Try asking members to tell what's worked well for them in similar situations. You can also ask the person with the problem what he thinks might work.
  • Choosing which option(s) to take: Have the group discuss the pros and cons of each suggestion. You can then let the person with the problem come to a decision, or he may want to take some time on his own to consider the possibilities. Let him know that the group cares and wants to know how things turn out.
  • Offering help: Sometimes members may offer to assist each other. For example, if the problem being discussed is a member's problems with transportation to the meetings, other members might offer to give that person a ride.

Problem-solving

Clarifying the problem:

Yoshiko asked some questions to find out more about Camilla's problem:

  • "What parenting duties do you find to be the hardest to keep up with?"
  • "Do you find that these things are consistently hard to get done, or is it more difficult at particular times?"

Talking about the alternatives:

Yoshiko used open ended questions to gently make suggestions and get members to offer them as well:

  • "What would it be like to ask your kids to help out with chores around the house?"
  • "What has helped you get through hectic times with your kids in the past? "
  • "Would any of you like to suggest things Camilla could do to make things run more smoothly around her house?"

Choosing which option(s) to take:

Camilla's problem centered around transportation (getting her kids to and from school and soccer practice) and household chores. Camilla decided on the following solutions:

  • Another member's children were part of the same soccer team, so she offered to let Camilla's children ride with them to and from practice
  • One member's sister had children at the same school as Camilla's children. She offered to call her sister and arrange for Camilla's children to carpool with them to school in exchange for help with gas money.
  • Another single mother in the group shared some ideas on using incentives to get her children to help out more with household chores that Camilla decided to try

Offering help:

As you can see above, two of the three solutions that Camilla decided on involved help from other members.

Close the meeting

Most support group meetings last between an hour and two hours. If the group is caught up in a particularly intense discussion or in helping a member solve a problem, you might go a few extra minutes, but generally it's best to stop before everyone is tired and eager to leave. When the discussion is winding down or when a previously agreed-upon ending time has arrived, wrap things up. Here are some ways you can close the meeting:

  • Make a summary statement: Summarize the topics that were discussed and alternatives that were chosen. Highlight any positive observations or solutions that came up.
  • Ask for additional comments or questions: Check to see if anyone in the group has anything to add.
  • Remind members about the next meeting: Let everyone know the time and place for next time.
  • Request volunteers, if necessary: If you need help with donations, refreshments, transportation, or other group needs, this is the best time to ask for it. Asking for help from members encourages them to take leadership responsibilities and fosters a sense of personal investment in the group's success.
  • Give a final greeting: Thank everyone for coming, say goodbye, and encourage them to come again.
  • Make final notes: Shortly after the meeting, make some brief notes about what was discussed while it's fresh in your mind. This information can be used to jump-start the next meeting. Keep any notes on the group in a safe place to insure confidentiality.

 Closing the meeting

After the discussion had wound down, Yoshiko followed the above steps in this way:

Making a summary statement:

"I see it's getting to be about the time we'd agreed that we'd stop, and I know many of you would like to get home, so I think we'd better wrap up for the evening."

Asking for additional comments or questions:

"We talked a lot about our families tonight. Are there any last thoughts anyone would like to add?"

Reminding members about the next meeting:

"Our next meeting will be on Wednesday the 23rd at 7:00 p.m. I hope you can all be there."

Requesting volunteers:

"Can someone volunteer to call everyone on the phone list a couple of days before the meeting to remind them about it?"

Giving a final greeting:

"I'm so glad you all came, and I think we got into some really interesting subjects tonight. I hope to see you on the 23rd!"

Making final notes:

After she got home, Yoshiko sat down with a cup of coffee and wrote some notes on the meeting: "Brian talked about his concerns about how MD will affect his upcoming family trip; Camilla talked about how tough it is to be a single mom with MD. Next time maybe we should focus more on issues that affect the people who are single or not close to their families."

Tips on Keeping a Support Group Going

  • Keep track of your group's progress. From time to time, ask members for their feedback on how the group is going. Find out how useful they find it, how comfortable they feel, and their likes and dislikes about the group. Use this information to make adjustments.
  • Share responsibility for the group. Letting others take leadership roles helps them feel more committed to and invested in the group. Make sure members know their help is appreciated. Since you may find it's often easier to do things yourself, asking others in the group to take over some responsibilities can be trying. However, no one person should have to do everything, and sharing responsibilities will help you avoid burnout.
  • Be sure everyone has a chance to talk. Some people are naturally more talkative than others. Asking questions to get quiet members to speak up is important. It's also crucial to keep the more vocal members on-topic and gently remind them to let others have a turn at times.
  • Emphasize the importance of confidentiality. In order for your members to feel safe enough in your support group to self-disclose and work through problems, they need to feel sure that nobody is going to be telling people outside of the group about the group's discussions. Make sure this is well understood by everyone.
  • Encourage outside contact among members. Members can offer support to each other outside of meetings. The "buddy" system, used by groups like AA, encourages members to take interest in one another's well-being and form relationships outside the group.
  • Keep recruiting. If you have an open group, make sure you continue to get the word out. Groups can stagnate when the membership remains the same all the time, and if members who leave are never replaced your group will not survive.
  • Share rewards and failures. Let members know that you appreciate their contributions. When people make mistakes, don't place blame. Don't heap all of the praise when something goes well on any one person - or all of the guilt when things go badly.
  • Keep a realistic perspective. Don't idealize the support group. There may sometimes be people that your group won't be able to help; this doesn't mean your efforts are futile. Also, when members leave, it doesn't mean you've failed them. Usually it means that they have used the group as much as they think is useful and moved on with their lives.
  • Remember that this is a support group. The dynamics of a group may change over time - for example, it could become more social in function, or it could change focus in terms of topic. No matter how the group changes, your group's primary purpose is to provide support and understanding to its individual members.

Tips on Handling Difficult Group Members

In dealing with difficult group members, support group facilitators must learn a delicate combination of control mixed with kindness. This sort of assertive caring directly addresses problems with the group without insulting or offending members. You may use assertive caring during a meeting to get the discussion back on track, or you may wish to speak to the member in private after the meeting.

Times to use assertive caring:

  • When a member is often late to meetings
  • When a member talks too much, monopolizing the discussion
  • When a member rejects every suggestion that others make - the "yes, but" phenomenon
  • When a member appears to have problems that are more than the group can handle - such as someone who's had a change in health and should seek medical attention, or someone who may have psychological problems needing professional attention
  • When a member interrupts others or brings up inappropriate or irrelevant subjects
  • When a member's problem doesn't match up with what the group is meant to address

The steps to assertive caring:

  • Show that you understand the member's position or dilemma: State that you understand the reason(s) behind the member's negative behavior. Use "I" or "we" statements, which show how his behavior affects you and the group. For example, "I know things are difficult for you, but right now we're trying to figure out what Camilla can do about child care."
  • Set limits: Gently but firmly correct the behavior. Explain your reasons; letting the member know why you need to change the situation will make him more likely to cooperate. For example, "I know things are difficult for you, but right now we're trying to figure out what Camilla can do about child care, and it's hard to do when you keep interrupting."
  • Suggest an alternative: Explain what you'd like to see the member do instead of the negative behavior. For example, "I know things are difficult for you, but right now we're trying to figure out what Camilla can do about child care, and it's hard to do when you keep interrupting. I wonder if we could wait to talk about your problem until after we've come to some conclusions about what Camilla can do."
  • Get the member's agreement on the alternative: Make sure the member understands what is being asked of him and agrees to do it. For example, "I know things are difficult for you right now, but we're trying to figure out what Camilla can do about child care right now, and it's hard to do when you keep interrupting. I wonder if we could wait to talk about your problem until after we've come to some conclusions about what Camilla can do. Is that okay with you?"

In Summary

Support groups are a great way to provide a service to the people your organization or initiative works with, without a huge investment of time or money. Moreover, running a support group is a good way to reach out and get people interested in the other things your organization or initiative does. It's also a way to give back to the community - improving or supporting a good public image for your group. Finally, it's just a good thing to do. With relatively little effort and cost, a support group can make a significant impact in the lives of people dealing with a problem. What better reason can there be?

Contributor 
Chris Hampton

Print Resources

Boyd-Franklin, N., Morris, T. S., and Bry, B. H. (1997). Parent and family support groups with African American families: The process of family and community empowerment. Cultural diversity and mental health. Vol. 3, No. 2, pp. 63-92.

Developmental Research and Programs, Inc. and Roberts, Fitzmahan & Associates. (1988). Preparing for the drug free years: A family activity book. Seattle, WA: Comprehensive Health Education Foundation.

Jacobs, M. K., and Goodman, G. (1989). Psychology and self-help groups: Predictions on a partnership. American psychologist, Vol. 44, No. 3, pp. 536-545.

Paine, A. I., Suarez-Balcazar, Y., Fawcett, S. B., and Jameson, L. B., with Embree, M. G. (1990). Self-help leader's handbook: Leading effective meetings. Lawrence, Kansas: Research and Training Center on Independent Living.

Online Resources

Center for Community Support and Research. (1995). Helpful hints for a successful first meeting.

Center for Community Support and Research. (1995). Keeping a support group going: Five things you should remember.

Center for Community Support and Research. (1995). Self-help groups: Are they effective?

Center for Community Support and Research. (1995). Starting a support group: Important Decisions.

Organizations

National Self-Help Clearinghouse
Graduate School and University Center
City University of New York
33 West 42nd Street, Room 1227
New York, NY 10036
(212) 840-7606

Online Resources

Self-help Sourcebook Online

American Self-Help Group Clearinghouse