Ingredients Of A Good Support Group


The question came up in another thread. I was asked, what is involved in creating a support group?

I think this is a very important question to ask. That is why i decided to deal with it in a separate thread. I would also add to that question, what makes for a good support group?

The following is just my opinion. However, bear in mind that I have had extensive experience over years with various types of groups. I have learned a thing or two about what works and what doesn't. I have primarily been a participant, but was also asked to temporarily lead 3 different groups at different times, so have experience on both sides.

1) First, a good support group does not have to be modeled on a 12-step format.

I personally do not care much for 12-step formats. Why? Because there is a de-emphasis on personal sharing and interaction. I have attended two 12-step groups in the past. 12-step groups are based primarily on a standard procedural format which is designed to create stability for the participants. They will typically start with the reading of a standard intro script. Then there are the opening comments, announcements, welcoming of new members, and introductions (first name only). Then there is a recitation of the group rules for sharing. These are often very restrictive and allow for no questions, suggestions, or 'cross talk' to the one sharing. The sharing is also limited typically to 3-5 minutes per person. When sharing is done, there is a group recitation of a prayer or other mantra.

I do believe that there are some benefits in having a regular format that is followed each time. Keeping things disciplined and focused allows for a feeling of safety and continuity for participants. However, I believe that allowing more room for personal sharing and interaction among group members is also important because it is largely why some people are there. Some members (who are less shy) will interact with each other after the group. But for some, a more restrictive sharing format can make some feel a bit isolated and not very connected while the group is in session.

2) A good group will have a leader who is skilled at keeping discussions on track.

It is VERY easy to lose control of a group. There will always be someone in the group whose needs or wants can end up monopolizing all the focus, or derailing the group. Even the leader can monopolize a group if he is still too needy for attention! I have seen this many times. A good leader will be more selfless in this regard. He will keep the conversations moving, will encourage interaction and sharing among members, and will not allow the group to constantly get bogged down in the needs of one member (especially his own) over all the others. A little bit of focus on one member - especially if his immediate needs are great - is sometimes going to be necessary. But if the group is spending a lot of time on one person, and if that becomes a regular occurrence, it will prevent others in the group from feeling heard and valued.

3) A good group will have a leader who has worked on his own issues and has something positive to share about his own recovery.

A leader does not have to be perfect by any means. However, he should be fairly stable emotionally, not easily triggered, and able to deal with various situations and stories. If he is still all over the place emotionally, or is overly negative, pessimistic about recovery in general, or just very confused, that will not inspire confidence or hope among the group members. If a leader is using the group only to work out his own issues, that is NOT the right place for that. He should not be the leader.

The leader should ideally be in counseling himself, or in other support groups, and be learning and growing outside of the group.

4) A good group will encourage members to do their own healing work outside of the group.

I have seen this way, way too many times. Many people become "professional group attenders" and think that just by coming to a group meeting, they are doing all they need to do to pursue their healing. It doesn't work like that. You have to do your own soul-searching, reflection, seeking answers, working through emotions, and especially grieving. In short, you have to face your own pain and work through it in order to grow past it.

A support group is not there to spoon-feed anyone emotions, i.e. tell you how to think, how to feel, or magically erase your pain. It is there to support your own healing efforts.

I have seen people who have attended the same group for over a decade and wondered why they never seemed to get much benefit out of it. I know it is true that different people heal at a different pace. But they truly seemed like the were just going through the motions. When I would ask them if they do any of their own writing, counseling, etc. they would usually say something like "Yeah, I tried that once, but gave up because it was too hard."

Maybe that is all they can do during that time, and I can respect that. I have been there myself. But I also can't help but wonder if like me, they might need some extra encouragement or push to break out of what might be a rut.

The point is, we can't make the mistake in thinking that attending a group is a substitute for putting in the personal work of pursuing healing. If you approach a group with that mindset, you will be there a long time, wondering why you still feel the same way after years.

5) It is fine to host a group or be the administrator, but not be the discussion leader.

Play to your strengths. That will benefit everyone involved,. including yourself. You might have an idea for a group, be able to line up meeting places and times, and be willing to manage the contact list - but not so much the rest. That is perfectly fine. Just find someone to work with who is willing and able to put in the time and attention to leading discussions, managing the flow of conversation, etc. The best groups I've been seen had divisions of labor, and their operation did not rest solely on one person. Groups are more sustainable over time if there are more people involved in running them.

...I have lots more to say but have to stop here for now. Feel free to post comments or questions in the meantime.

- Chris
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Chris that was spot on. I once attended a new 12 step start up and didn't care for the format. I did attend a mixed support group for a year and a half that was quasi professionally run that was more like you stated it should be with the emphasis on each having their time to share and even some cross talking. There was a rule where the only one who had the floor to talk was the one one holding the stuffed animal, once the talker was done and the animal was passed if they wanted feedback others were free to talk about what they felt about what they heard. Some used it to just vent and didn't want feedback and that was ok. I learned a lot from that group. This wasn't a "CSA" group, but most were survivors of CSA and that and the sequelae from that were the main issues talked about.

A good leader has to be strong enough to keep control of the meeting, to be strong enough to hold others accountable if problems arise between members or if someone becomes a danger to themselves or others. The leader of the group I attended was a little woman who was a marshal artist with some kind of fancy belt degree, but when a sketchy guy showed up, she told me that she appreciated me being part of the group and asked me to back her up in case of any problems with asking the guy not to come back. Thankfully there was no drama in dis-inviting him, she handled it as good as she could I think. You have to be willing to get out of your comfort zone to keep things safe and orderly.
I'm actually thinking about going back to Sex Addicts Anonymous or try Sex Love Addicts. I stopped going in April. I probably need to attend an establish fellowship rather than starting a new one. Although there doesn't seem to be any Male Survivor's of sexual abuse groups here.
I used to lead a male survivor group. One word of caution is that it needs to stay focused on healing and discussion. Too many groups get hijacked by people with unrelated issues that the group is not equipped to deal with. We also prohibited perpetrators even if the were victims first. There were some very good reasons for that.
I've been disappointed in my efforts to find a group dealing with CSA. I've attended two ASCA meetings recently but the format is too restrictive for me. I certainly understand the benefit of such structure for folks who are especially vulnerable and close to being triggered, but that is not where I am in my process. I attended a support group offered by Parents United years ago that was excellent. There was a trained therapist leading the conversation. I also attended a Survivors of Incest meeting but I was so new to exploring CSA issues I couldn't get much out of the experience. At the time I didn't believe my abuse was "incest" but now I understand part of it was.

I have gotten a great deal out of Overeaters Anonymous, a 12 Step fellowship. The structure is enough to offer safety and the sharing invites intimacy. As Chris notes, a great deal of the fellowship and deep sharing happens after the formal meeting ends. I love that there is no cross talk during sharing. It feels respectful and doubtless makes it possible to share difficult material. Feedback can happen after the meeting ends IF the person who shared is open to receiving it.

My therapist has two groups for men who've been sexually abused but neither has an opening at the moment. I'm content to do my individual therapy for the moment but would eventually like to move from individual to group therapy. Perhaps at some point I'll feel ready to organize a group.