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.

 

Peer support groups are widely used in communities to help people connect with others who share similar experiences, concerns, identities, health conditions, or life circumstances. They may focus on anything from substance use recovery and gambling-related concerns to surviving domestic violence, caregiving, disability, grief, parenting, or questions related to gender and sexuality.

If your group or initiative provides services to people who might benefit from connecting with others who have similar experiences, you may want to consider adding a peer support group to the services or opportunities you offer.

What are peer support groups?

Support groups -- also sometimes referred to as self-help or peer support groups -- are groups of people who gather to share experiences, concerns, information, and support related to a particular issue, health condition, identity, or life circumstance. In a support group, people can connect with others who may understand aspects of what they are experiencing and can offer practical insights based on firsthand experience.

Some of the common characteristics of support groups include:

• They are made up largely of peers -- people directly affected by a particular issue, condition, identity, or circumstance
• They may be peer-led or facilitated by a trained volunteer or professional, depending on the purpose and structure of the group
• They tend to be fairly small so that participants have meaningful opportunities to contribute
• Participation is usually voluntary, although some programs or systems may require participation in particular groups as part of employment, treatment, diversion, probation, or another formal process

Peer support groups are not necessarily the same as group therapy. Some groups are facilitated by licensed mental health professionals and may provide clinical treatment, while others are community-based or peer-led and focus primarily on mutual support, shared experience, information, and connection. Be clear with participants about what your group does and does not provide.

Why create and facilitate a peer support group?

There can be many benefits to peer support groups:

• When someone doesn't know many -- or any -- other people with similar experiences, they may feel isolated or misunderstood. Support groups can help people feel less alone and more connected.
• Support groups can sometimes operate with relatively modest resources, although costs may include meeting space, accessibility accommodations, technology, childcare, transportation support, facilitator training, refreshments, interpretation, or other needs.
• Support groups can strengthen people's sense of agency by giving participants opportunities to identify their own goals, share strategies, and make decisions about what will be useful to them.
• Members can exchange information, resources, and updates relevant to their experiences.
• People with similar experiences may offer a form of understanding and connection that is different from, and can complement, professional support.
• Members can learn from one another. Seeing how other people navigate challenges, build on their strengths, and make progress toward their goals may offer encouragement and practical ideas.
• A well-facilitated support group can provide a respectful and supportive setting for people who want to discuss personal experiences, concerns, and feelings.
• Some people may find professional relationships intimidating or may feel more comfortable first talking with peers. In a peer support group, participants can share knowledge and support in a setting designed around mutual respect and shared experience.
• Participation may help some people feel more connected, hopeful, informed, or supported. The effects will differ among individuals, and peer support should not be presented as a replacement for medical, mental health, legal, or other professional care when such care is needed.

Who can be served by peer support groups?

Peer support groups can be useful for people navigating many different experiences and circumstances, including:

• Illnesses, injuries, disabilities, or chronic health conditions
• Eating disorders or concerns related to food and body image
• Sexual orientation, gender identity, or related experiences
• Disability-related experiences and access needs
• Health-related behavior changes or personal goals
• Mental health concerns or emotional well-being
• Substance use disorders, recovery, or behavioral addictions
• Grief and bereavement
• Parenting and caregiving

Besides serving people directly affected by an issue or circumstance, support groups may also welcome family members, caregivers, partners, or friends. Other groups are designed specifically for family members and loved ones. For example, Al-Anon offers peer support for people affected by someone else's drinking.

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 hope to include. You might find it helpful to write vision and mission statements for your support group.

Be clear about what the group can provide. Is it primarily for mutual support? Education? Resource sharing? Skill building? Social connection? Recovery support? Is it peer-led, professionally facilitated, or a combination? Clear expectations can help participants decide whether the group fits what they are looking for.

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

There may be advantages to connecting your support group with a larger organization. A larger organization may offer facilitator training, educational materials, referral resources, meeting guidance, accessibility support, evaluation tools, or connections with other groups. Name recognition may also make it easier for people to find the group.

At the same time, affiliation is not always necessary or appropriate. Consider whether the larger organization's philosophy, practices, accessibility, and expectations fit the people you hope to involve.

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. Yoshiko wanted to connect with other people living with muscular dystrophy and with family members and caregivers who had similar experiences. After carefully studying this section of the Community Tool Box, she decided to find out whether the Muscular Dystrophy Association, a national organization, had support resources or groups in her area.

She visited the organization's website and learned that there was a group in a nearby town but not in her city. After contacting the organization and learning what support was available, Yoshiko decided to explore creating a local group connected with the larger organization.

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

Support groups can be ongoing or can meet for a defined number of sessions. For example, a local crisis center might offer a six-week grief support group several times a year for people who have lost someone to suicide. A time-limited format may work well when the group has a focused curriculum or purpose. An ongoing group may work better for people seeking long-term peer connection around a chronic condition, caregiving role, recovery, or another continuing experience.

Consider what participants need rather than assuming one format works best for a particular issue. Some organizations offer both ongoing groups and shorter-term groups.

Decide whether the group will be open or closed

Open support groups allow new members to join throughout the life of the group. Depending on the purpose, friends, family members, caregivers, or other supporters may also be welcome.

In closed groups, people join during a particular enrollment period, or participation may be limited to people who share a particular experience or meet specific eligibility criteria. Some organizations offer both open meetings and closed meetings for people directly participating in a program.

If your group will work through a structured process or discuss especially sensitive material, a closed group may help participants develop continuity and trust. Open groups may be more appropriate when ongoing access is important. Neither format is automatically better; choose the structure that fits the group's purpose and participants.

Set a time and place for your support group to meet

Choose meeting times based on the schedules and needs of the people you hope to involve rather than assuming one time will work for everyone. Consider work schedules, caregiving, religious observances, school, transportation, and other responsibilities. Offering virtual or hybrid participation may also increase access for some groups.

Picking an appropriate location is important. If your organization has meeting space, it may be convenient, but don't automatically assume it is the best option. A library, community center, health facility, faith community, school, or another location may be more accessible or comfortable.

Privacy can also matter. Participants in groups related to recovery, mental health, reproductive health, experiences of violence, LGBTQ+ identity, legal involvement, or other sensitive topics may reasonably want discretion about their participation. Choose a location that respects privacy without treating participants or their experiences as something shameful that needs to be hidden.

First and foremost, the location should be accessible to the people who will attend. Consider public transportation, parking, wheelchair access, accessible restrooms, lighting, hearing or communication access, service animals, language access, and other accommodations.

The location should also support comfort and psychological safety. For example, survivors of violence may have concerns about meeting in places closely associated with traumatic experiences or law enforcement. Ask potential participants what kinds of spaces would feel comfortable and appropriate rather than making assumptions.

Meeting in a member's home can sometimes feel welcoming, but it may create concerns about privacy, accessibility, transportation, boundaries, or safety. Public or community-based spaces are often easier for newcomers to access. Online meetings may also be an option when privacy and technology needs can be addressed appropriately.

When you have chosen a location, make any necessary reservations and accessibility arrangements.

Select a group leader or facilitator

Choosing the right facilitator is important. The facilitator opens and closes meetings, helps create respectful discussion, supports participation, reinforces group agreements, and responds when challenging situations arise.

Helpful facilitator qualities may include:

• Availability and reliability: The facilitator should have enough time to prepare for meetings, attend consistently, and follow through on responsibilities.
• Capacity and support: Facilitating emotionally meaningful conversations can take energy. The facilitator should have appropriate support, backup, and opportunities for rest rather than being expected to handle everything alone.
• Facilitation skills: Ideally, the facilitator has experience or training in listening, group facilitation, communication, managing conflict, setting boundaries, and responding appropriately when concerns fall outside the group's scope.
• Access to resources: The facilitator should know how to connect participants with appropriate community, health, mental health, crisis, legal, or other resources when needed.
• Commitment to the group: The facilitator should respect the people involved and understand the purpose of the group. Lived experience may be valuable, but it should not be treated as a requirement. A person can be an effective facilitator because of training, community knowledge, empathy, or other relevant experience.

The facilitator should also understand the limits of the role. A peer support facilitator should not present themselves as a therapist, medical professional, attorney, or crisis responder unless they actually hold that role and the group has been structured accordingly.

The details of the facilitator's job -- running the meetings -- are explained later in this section; you may wish to refer to that when selecting someone 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 decisions about details such as:

• How often should we meet? Many groups meet weekly, every other week, or monthly. Choose a schedule that fits the group's needs and resources.
• How long should meetings last? Many groups meet for about one to two hours, but shorter meetings may work better depending on participants' schedules, health, energy, accessibility needs, or the size of the group.
• Should we serve refreshments? Food and beverages can help create a welcoming environment, but consider allergies, dietary needs, eating-disorder recovery, cultural preferences, cost, and facility rules. If members are asked to contribute, make sure no one feels pressured to spend money they cannot afford.

Recruit members for your support group

Consider how large you want the support group to be before you start recruiting. The group should be large enough to continue functioning when some people are absent but small enough for participants to have meaningful opportunities to contribute. Groups of roughly 5 to 15 people often work well, although the right size depends on the purpose and format.

There are many ways to let people know about your group, and you may want to use several approaches.

Use referrals

• Network with organizations, professionals, and community partners related to the group's focus. These might include health professionals, social workers, educators, faith leaders, peer specialists, community health workers, advocacy organizations, or others who may know people interested in the group.
• If your city or county has community information, referral, or 211 services, ask how your support group can be included.
• If the group is related to a health issue, provide information to relevant hospitals, clinics, public health programs, community health organizations, and patient or caregiver networks.
• Find out which organizations maintain community resource directories and request that your group be included.

Use communication channels

• Posters and flyers: Place these in locations that people you hope to reach actually use, such as libraries, health centers, community organizations, schools, workplaces, faith communities, recreation centers, or local businesses.
• Press releases: Local news outlets or community newsletters may be interested in a new support resource, especially when it addresses a current community concern.
• Digital outreach: Use websites, email lists, social media, community apps, online calendars, and partner organizations' digital networks when appropriate.
• Letters to the editor or opinion pieces may also help raise awareness when a related issue is receiving public attention.
• Public service announcements: Local radio, television, podcasts, or community media may provide space for public-service information.

Use personal invitations and word-of-mouth

• Personal invitations and recommendations can be especially effective because people may be more comfortable attending when they hear about the group from someone they trust. Ask partners and current members to share information while respecting other people's privacy.

Once you have enough interest, contact participants with the date, time, location, accessibility information, and any other details they need. Use the communication method people prefer -- email, text, phone, or another option -- and send a reminder shortly before the meeting when appropriate.

How do you facilitate a peer support group?

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

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 themes members wanted to revisit. Be cautious about keeping unnecessary personal notes. Any information you do retain should be limited, securely stored, and handled according to your organization's privacy policies.

Have referral information available in case someone needs support beyond what the group can provide. Depending on the group, this might include health care, mental health services, crisis resources, domestic violence services, substance use treatment, housing assistance, or other community resources.

Prepare the room for the meeting

Arrive early enough to prepare the space. Arrange seating so that people can see and hear one another while leaving room for wheelchairs, mobility devices, service animals, interpreters, or other access needs. Avoid assuming everyone will be comfortable sitting in a tight circle or maintaining direct eye contact.

If you're serving refreshments, set them up in an accessible location. If you're using name tags, consider allowing participants to write the name and pronouns they want others to use rather than making assumptions.

Start the meeting

Welcome people as they arrive. Use people's names when you know them and follow their preferences about handshakes, hugs, or other physical greetings.

Start reasonably close to the agreed-upon time while allowing some flexibility for transportation, caregiving, disability, work schedules, or other barriers that may affect arrival.

Give preliminary introductions and information

Introduce yourself briefly and explain your role. If you have lived, professional, or community experience relevant to the group's topic and are comfortable sharing it, you may choose to mention it. Make any announcements and invite participants to share relevant updates.

Opening a support group meeting

At the first meeting for Yoshiko's muscular dystrophy support group, 15 people attended. Yoshiko introduced herself: "Hello everyone. My name is Yoshiko Hatori. My sister Miho has been living with muscular dystrophy for a little over a year. I'm glad you're here, and I hope this can be a place where we learn from and support one another."

She also mentioned an upcoming community fundraiser and shared information about local resources.

If this is a new group or new members are present, explain the group agreements. Confidentiality is often one of the most important agreements, but avoid promising that the facilitator can absolutely guarantee what other members will do outside the group.

You might say that members are expected not to share other people's personal stories or identifying information outside the group. Also explain any legal or organizational limits on confidentiality that apply to facilitators, such as mandated reporting requirements or situations involving immediate safety concerns.

Explain whether the group is open or closed, whether participation is voluntary, and any other expectations related to respectful communication, privacy, accessibility, and safety.

Invite participants to introduce themselves in whatever way feels appropriate. Do not require people to disclose personal information simply because they are attending the group.

Encourage members to listen to each other

Active listening helps people feel heard and understood. There is no single correct way to show that you are listening, and communication styles vary across cultures, personalities, disabilities, and neurotypes.

Helpful approaches can include:

• Giving the speaker your attention in a way that is comfortable and respectful
• Using eye contact when it is comfortable for both people, without treating eye contact as a requirement
• Using brief verbal responses such as "I hear you," "Mm-hmm," or "That makes sense"
• Using appropriate facial expressions or gestures
• Rephrasing what someone has said to check your understanding. For example: "It sounds like you felt really hurt by what happened. Is that right?"

Encourage members to offer support to one another

Part of the facilitator's role is to help members learn how to respond supportively to one another. Model listening, validation, and respectful curiosity.

Avoid putting a participant on the spot by demanding that they respond to someone else's disclosure. Instead, invite the group generally:

• "Would anyone like to share something that has helped them in a similar situation?"
• "What kinds of support might feel useful here?"
• "Has anyone had an experience they would like to share that connects with what Brian described?"

Encourage members to talk about themselves

One advantage of support groups is that they can create an environment where participants feel able to discuss experiences that matter to them. Sharing personal information can help people connect and offer support, but disclosure should always be voluntary.

Facilitators should not pressure people to reveal personal experiences, trauma, diagnoses, family information, or other sensitive details. People can participate by listening, sharing general reflections, or speaking only when they feel ready.

Open-ended questions can help a person explore an experience without directing them toward a particular answer.

Asking open-ended questions

Camilla, a parent in Yoshiko's support group, talked about how difficult it had been to balance her health needs with caring for her children.

Yoshiko invited her to say more with questions such as:

• "What parts of your routine have been especially difficult lately?"
• "What kinds of support would make things easier for you and your family?"

Yoshiko then invited other members to share only if they wanted to:

• "Has anyone had a similar experience they'd be comfortable talking about?"
• "What has helped you when you've been balancing your own health with caregiving responsibilities?"

You can also plan topics ahead of time. Some support groups use readings, reflection prompts, optional journaling, guest speakers, or activities to begin discussion.

Offer support

Support is one of the main reasons people participate in peer groups. Support can include listening, validating feelings, recognizing strengths, sharing relevant experiences, helping someone identify resources, or simply letting them know they are not alone.

Support should generally emphasize empathy rather than pity. Instead of assuming you know exactly how someone feels, acknowledge what they have shared and allow them to define their own experience.

Support can also be expressed through body language, tone, or physical gestures. Physical touch -- including hugs or touching someone's arm -- should never be assumed to be welcome. Ask first or let participants initiate. This is particularly important in groups involving trauma, disability, cultural differences, or experiences of violence.

Providing support

When Brian says, "I feel bad because I think I'm becoming a burden to my family," Yoshiko might respond:

• "That sounds really hard. I'm glad you felt comfortable telling us."
• "Would it be helpful to talk about what makes you feel like a burden, or about what support from your family feels like right now?"

She could also invite peer support by asking:

• "Would anyone like to offer Brian some support?"
• "Has anyone had a similar experience they'd be comfortable sharing?"

Help members solve problems

Problem-solving can be one useful part of a support group, but not every person who shares a concern is asking for advice or solutions. Before brainstorming, ask what the person wants from the group: listening, emotional support, information, ideas, or practical help.

If the person does want to explore options, the group can work through steps such as:

• Clarifying the concern: Make sure the person has had a chance to describe what is happening in their own words.
• Exploring possible options: Rather than telling the person what they "should" do, participants can share what has worked for them or ask whether the person would like to hear ideas. The person affected remains in control of their own decisions.
• Considering the options: Discuss possible advantages, drawbacks, resources, barriers, and consequences. The person can decide what, if anything, they want to try.
• Offering practical support: Members may sometimes be able to help one another with transportation, information, referrals, meals, childcare, or other needs, as long as the support is voluntary and appropriate boundaries are maintained.

Problem-solving

Clarifying the concern:

Yoshiko asks Camilla:

• "Which parts of the week feel hardest to manage right now?"
• "Are there particular times when transportation or household responsibilities become especially difficult?"

Exploring options:

After asking Camilla whether she wants ideas from the group, Yoshiko might ask:

• "What kinds of help would feel realistic for your household?"
• "What has helped during especially busy weeks in the past?"
• "Would you like to hear some ideas from other members?"

Choosing what to try:

Camilla decides that transportation and household tasks are the two areas where additional support would make the biggest difference.

• Another member whose children attend the same sports program offers to coordinate rides when schedules allow
• A member shares information about a local school transportation and family-support resource
• Another parent shares strategies that have helped their family divide household responsibilities in age-appropriate ways

Offering help:

The group has provided several possibilities, but Camilla decides which options make sense for her family.

Close the meeting

Many support group meetings last about one to two hours. Try to honor the agreed-upon ending time so participants can plan around work, caregiving, transportation, medications, energy levels, and other responsibilities.

Here are some ways you can close the meeting:

• Summarize themes rather than personal details: Briefly review the main topics, resources, or ideas discussed without unnecessarily repeating private disclosures.
• Ask for additional comments or questions: Check whether anyone has something important to add.
• Remind members about the next meeting: Share the date, time, location, virtual link, or other important information.
• Invite volunteers if needed: Members may choose to help with refreshments, communication, transportation, meeting setup, or other group needs. Participation in these tasks should remain voluntary.
• Thank participants: Acknowledge the time, care, and perspectives people contributed.
• Document only what is necessary: If the facilitator needs notes for planning or organizational purposes, keep them brief and avoid unnecessary identifying or sensitive details. Store records securely and follow applicable privacy policies.

Closing the meeting

As the agreed-upon ending time approaches, Yoshiko says:

"We're getting close to the time we agreed to finish, so let's wrap up for tonight."

She asks:

"We've talked about family relationships, caregiving, and transportation tonight. Is there anything important anyone would like to add before we close?"

She reminds the group of the next meeting and asks whether anyone wants to volunteer to send a reminder to participants.

Afterward, Yoshiko notes only the general themes the group may want to revisit: family relationships, caregiving support, transportation, and resources for people who have limited family support. She avoids recording unnecessary personal details about individual members.

Tips on Keeping a Support Group Going

• Keep track of your group's progress. Ask participants periodically how useful, welcoming, accessible, and respectful they find the group. Use their feedback to make improvements.
• Share responsibility for the group. People may want to help facilitate, welcome new members, organize activities, coordinate resources, or take on other roles. Shared leadership can strengthen the group and reduce burnout.
• Create opportunities for everyone to participate. Some people talk more than others, and some prefer to listen. Don't assume quieter members are disengaged. Invite participation without putting people on the spot, and help make sure no one person consistently dominates the conversation.
• Emphasize privacy and confidentiality expectations. Remind members not to share other people's personal stories or identifying information outside the group. Be transparent that a peer group cannot absolutely guarantee what every participant will do after the meeting.
• Support voluntary connections outside the group. Members may choose to keep in touch, provide mutual support, or develop peer partnerships. Make sure people understand that no one is required to share contact information or maintain relationships outside meetings.
• Continue outreach if the group is open. Let people know the group exists and make sure new members receive a welcoming orientation to its purpose and agreements.
• Share credit and learn from challenges. Recognize people's contributions and avoid assigning blame when something does not work as planned.
• Keep a realistic perspective. A support group will not meet every person's needs, and people may leave for many reasons. Departure does not automatically mean the group failed them. Someone may have found another resource, achieved what they wanted from the group, changed schedules, or simply decided that a different form of support fits them better.
• Remember the group's purpose. The group may change over time, but continue checking whether it is providing the kind of peer support, connection, information, or mutual assistance members want.

Tips on Handling Challenging Group Dynamics

Facilitators sometimes need to respond when a behavior makes it harder for other members to participate, feel respected, or stay focused. Rather than labeling someone a "difficult member," focus on the specific behavior and its effect on the group.

A useful approach is supportive limit-setting: acknowledge the person's needs or perspective, explain the effect of the behavior, clarify the group expectation, and identify a more constructive alternative.

Times when supportive limit-setting may be useful:

• When repeated late arrivals disrupt the group and the person may need help identifying a workable solution
• When one participant regularly takes so much discussion time that others have little opportunity to speak
• When a member repeatedly dismisses or argues with every idea in ways that prevent productive discussion
• When someone has health, mental health, substance use, safety, or other needs that appear to go beyond what a peer support group can reasonably provide
• When someone repeatedly interrupts, makes discriminatory or harmful comments, violates group agreements, or moves the discussion far away from the group's purpose
• When it becomes clear that the group's purpose does not match the kind of support a participant is looking for

If someone appears to be in immediate danger or experiencing a medical or mental health emergency, follow your organization's emergency procedures and connect the person with appropriate professional or emergency support rather than expecting the group to manage the situation alone.

Steps for supportive limit-setting:

• Acknowledge the person's perspective: "I can tell this is really important to you."
• Describe the effect on the group and clarify the limit: "I want to make sure everyone gets a chance to finish speaking, so I'm going to ask that we not interrupt one another."
• Offer an alternative: "Let's finish talking about Camilla's concern, and then we'll make sure there's time to come back to what you wanted to raise."
• Check understanding: "Does that work for you?" or "Is there another way we can make sure your concern gets addressed without interrupting someone else's turn?"

In Summary

Peer support groups can provide connection, shared understanding, practical information, encouragement, and opportunities for people to learn from others with similar experiences. They can be relatively simple to organize, but effective groups still require thoughtful planning, accessible meeting options, clear expectations, appropriate facilitation, privacy protections, and realistic boundaries about what peer support can provide.

The strongest groups treat members as people with knowledge, agency, strengths, and choices -- not simply as people defined by a diagnosis or problem. Participants should be able to decide what they share, how they participate, and what kinds of support they want from the group.

Peer support works best when it complements, rather than attempts to replace, other resources people may need. By creating respectful spaces for mutual support while recognizing the limits of the group, organizations can help participants build connection, exchange knowledge, and support one another through difficult experiences and meaningful life changes.