How support groups help mental health

Support groups: Make connections, get help

If you’re facing a major illness or stressful life change, you don’t have to go it alone. A support group can help. Find out how to choose the right one.

By Mayo Clinic Staff

Support groups bring together people who are going through or have gone through similar experiences. For example, this common ground might be cancer, chronic medical conditions, addiction, bereavement or caregiving.

A support group provides an opportunity for people to share personal experiences and feelings, coping strategies, or firsthand information about diseases or treatments.

For many people, a health-related support group may fill a gap between medical treatment and the need for emotional support. A person’s relationship with a doctor or other medical personnel may not provide adequate emotional support, and a person’s family and friends may not understand the impact of a disease or treatment. A support group among people with shared experiences may function as a bridge between medical and emotional needs.

Structure of support groups

Support groups may be offered by a nonprofit advocacy organization, clinic, hospital or community organization. They also may be independent of any organization and run entirely by group members.

Formats of support groups vary, including face-to-face meetings, teleconferences or online communities. A lay person — someone who shares or has shared the group’s common experience — often leads a support group, but a group also may be led by a professional facilitator, such as a nurse, social worker or psychologist.

Some support groups may offer educational opportunities, such as a guest doctor, psychologist, nurse or social worker to talk about a topic related to the group’s needs.

Support groups are not the same as group therapy sessions. Group therapy is a specific type of mental health treatment that brings together several people with similar conditions under the guidance of a licensed mental health care provider.

Benefits of support groups

The common experience among members of a support group often means they have similar feelings, worries, everyday problems, treatment decisions or treatment side effects. Participating in a group provides you with an opportunity to be with people who are likely to have a common purpose and likely to understand one another.

Benefits of participating in a support group may include:

• Feeling less lonely, isolated or judged
• Reducing distress, depression, anxiety or fatigue
• Talking openly and honestly about your feelings
• Improving skills to cope with challenges
• Staying motivated to manage chronic conditions or stick to treatment plans
• Gaining a sense of empowerment, control or hope
• Improving understanding of a disease and your own experience with it
• Getting practical feedback about treatment options
• Learning about health, economic or social resources

Possible risks

Support groups may have drawbacks, and effective groups generally depend on the facilitator to help steer away from these problems. These problems may include:

• Disruptive group members
• Conversation dominated by griping
• Lack of confidentiality
• Emotional entanglement, group tension or interpersonal conflicts
• Inappropriate or unsound medical advice
• Competitive comparisons of whose condition or experience is worse

Pros and cons of online support groups

Online support groups offer benefits and risks that are particular to that format. It’s important to consider these factors before joining an online group.

Benefits of online groups include:

• More frequent or flexible participation
• Opportunities for people who may not have local face-to-face support groups
• A degree of privacy or anonymity

Risks of online support groups include the following:

• Communication only by written text can lead to misunderstanding or confusion among group members.
• Anonymity may lead to inappropriate or disrespectful comments or behaviors.
• Participation online may result in isolation from other friends or family.
• Online communities may be particularly susceptible to misinformation or information overload.
• People may use the online environment to prey on people, promote a product or commit fraud.

How to find a support group

Information about support groups may be available from the following:

• Your doctor, clinic or hospital
• Nonprofit organizations that advocate for particular medical conditions or life changes
• National Institutes of Health websites for specific diseases and conditions

Questions to ask before joining a support group

Support groups vary in how they are organized and led. Before joining a support group, ask the following questions:

• Is the group designed for people with a specific medical condition or certain stage of a disease?
• Does the group meet for a set period of time or does it continue indefinitely?
• Where does the group meet?
• At what times and how often does the group meet?
• Is there a facilitator or moderator?
• Has the facilitator undergone training?
• Is a mental health expert involved with the group?
• What are the guidelines for confidentiality?
• Are there established ground rules for group participation?
• What is a typical meeting like?
• Is it free, and if not, what are the fees?

Red flags that might indicate a problematic support group include:

• Promises of a sure cure for your disease or condition
• High fees to attend the group
• Pressure to purchase products or services

Getting the most out of a support group

When you join a new support group, you may be nervous about sharing personal issues with people you don’t know. At first, you may benefit from simply listening. Over time, however, contributing your own ideas and experiences may help you get more out of a support group.

Try a support group for a few weeks. If it doesn’t feel like a good fit for you, consider a different support group or a different support group format.

Remember that a support group isn’t a substitute for regular medical care. Let your doctor know that you’re participating in a support group. If you don’t think a support group is appropriate for you, but you need help coping with your condition or situation, talk to your doctor about counseling or other types of therapy.

 

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1. Delisle VC, et al. Effect of support group peer facilitator training programmes on peer facilitator and support group member outcomes: A systematic review. BMJ Open. 2016;6:e013325.
2. Pomery A, et al. Skills, knowledge and attributes of support group leaders: A systematic review. Patient Education and Counseling. 2016;99:672.
3. Skirbekk H, et al. To support and to be supported. A qualitative study of peer support centres in cancer care in Norway. Patient Education and Counseling. 2018;101:711.
4. Embuldeniya G, et al. The experience and impact of chronic disease peer support interventions: A qualitative synthesis. Patient Education and Counseling. 2013;92:3.
5. Hughes S, et al. The experience of facilitators and participants of long term condition self-management group programmes: A qualitative synthesis. Patient Education and Counseling. 2017;100:2244.
6. Bender JL, et al. What is the role of online support from the perspective of facilitators of face-to-face support groups? A multi-method study of the use of breast cancer online communities. Patient Education and Counseling. 2013;93:472.
7. Mo PK, et al. Are online support groups always beneficial? A qualitative exploration of the empowering and disempowering processes of participation within HIV/AIDS-related online support groups. International Journal of Nursing Studies. 2014;51:983.
8. Understanding psychosocial support services: Types of support services. American Cancer Society. https://www.cancer.org/treatment/treatments-and-side-effects/emotional-side-effects/understanding-psychosocial-support-services/types-of-support-services.html. Accessed June 9, 2018.

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therapy & medication

Support Groups: Types, Benefits, and What to Expect

Whether you’re seeking support for caregiving, addiction, depression, anxiety, or another mental health issue, overcoming your unease and attending a support group can be a valuable step toward healing.

What is a support group?

A support group is a gathering of people facing common issues to share what’s troubling them. Through the sharing of experiences, they’re able to offer support, encouragement, and comfort to the other group members, and receive the same in return.

When you’re going through a challenging or traumatic time, family members and friends may sympathize, but they don’t always know what to say or the best ways to help. Doctors and health professionals may sometimes offer minor emotional support, but their primary focus is always medical.

Support groups developed to join people together who are dealing with similar difficult circumstances. That may be coping with a specific medical condition, such as cancer or dementia, a mental health issue like depression, anxiety, bereavement, or addiction, for example, or caring for a family member or friend facing such a problem. Whatever issues you or a loved one are facing, though, the best medicine can often be the voice of people who have walked in your shoes.

A support group offers a safe place where you can get information that’s practical, constructive, and helpful. You’ll have the benefit of encouragement, and you’ll learn more about coping with your problems through shared experiences. Hearing from others facing similar challenges can also make you feel less alone in your troubles.

While it’s perfectly normal to feel reticent, anxious, or apprehensive about joining a support group, it can help to dispel some of the common myths and misconceptions about these groups and how they operate.

Myths and misperceptions about support groups

In some circles, there’s still a stigma associated with mental health problems, which extends to attending support groups for those problems. Some people see reaching out to others as a sign of weakness, while others believe confiding in others is a waste of time and won’t achieve anything.

Other commonly held myths and misperceptions about support groups include:

Myths and misperceptionsMyth: There aren’t any support groups in my area.Fact: There are tens of thousands of support groups nationally and globally, in-person and online. There’s one available for nearly every problem and condition.Myth: Support groups don’t have any answers.Fact: While it’s true they’re not a magic bullet for all your problems, you will get some answers—and a lot of support while working through a tough or sensitive issue.Myth: I will be required to share my story.Fact: In most groups, you can choose to speak (or not) as you feel comfortable.Myth: Other participants may attack or criticize me.Fact: A well-run support group sets boundaries and requires participants to show empathy and respect to each other.Myth: I’ll feel even more depressed after attending a support group.Fact: The simple act of sharing your problems can be extremely cathartic. So, most people feel uplifted and encouraged after attending a support group.

Types of support groups

Depending on your needs, you may decide to join one of three types of support groups—a mutual support group, a 12-step help group, or a therapy group. Just remember that whatever support group you choose, it’s not a substitute for medical care.

Mutual support groups

Mutual support groups are peer-led groups. Facilitators receive training, but they don’t give advice or act as professionals. Participants in a mutual support group can be people dealing with a certain condition or circumstance, whether it’s a medical issue, domestic abuse, grief, or a mood disorder. Other support groups are designed to provide support for family members or friends of someone who is living with a difficult situation.

Group members share what’s working for them, and they inspire others to do the same. There’s usually no cost for mutual support groups.

12-step self-help groups

12-step programs are typically geared toward those with an addiction, such as alcohol, drugs, gambling, or sex. During group meetings, participants work through the 12 steps to recovery created by Alcoholics Anonymous.

Like mutual support groups, 12-step self-help groups are peer-led, free, and frequently offer separate groups for the loved ones of those with the addiction.

Therapy groups

Unlike mutual support groups and 12-step programs, mental health providers lead therapy groups. A professional therapist brings several people together who are living with similar conditions and provides treatment to them as a group.

Therapy groups are available for a wide variety of mental health conditions. There may be a cost for a therapy group, although it may be covered by health insurance.

[Read: Finding a Therapist Who Can Help You Heal]

Online support groups

Online support groups can be useful when it’s not possible to meet in person. They’re a great alternative if the distance is too far, transportation isn’t available, or your work or family schedule prevents you from attending an in-person support group. Online support groups can also work well for those who are dealing with a rare condition where your peers are spread out across a wide area.

Of course, the online support group format has some disadvantages. It can be more difficult for participants to interpret the facial expressions and body language of other participants. What’s more, the lack of in-person contact can diminish communication which is so vital to support group participation. An online forum may also limit the extent that participants are able to express warmth to others in the group.

[Read: Online Therapy: Is it Right for You?]

As with any online meeting, there’s always the risk of encountering technical problems or participants being distracted, which can be particularly troublesome if someone is sharing a sensitive story.

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Benefits of support groups

A support group is a safe place where you can talk about your emotions and circumstances with others who know how you feel and won’t judge or criticize you. It can also help you to:

Learn better coping strategies. As you go through challenging circumstances, you may need to learn new ways to cope. At a support group, you’ll learn coping skills from people who’ve found success using them first-hand. You might learn tips on meditating, journaling, or things you wouldn’t have otherwise considered. You might also pick up new ways to set healthy boundaries and function better.

Grow through shared experiences. A support group gives you opportunities to get things off your chest. Sharing your own experiences with the group can help ease your emotional burden and feelings of isolation. As others in the group share their stories, you can gain valuable insight about how others deal with similar situations.

Focus on self-care. Support group participants may offer up innovative ideas for how to care for yourself, manage stress, combat fatigue, and feel mentally and physically stronger.

Maintain a sense of hope. Being around your fellow support group members can help boost your mood and sense of optimism, giving you the emotional reserves to realistically envision a better future.

What to expect from a support group

Every support group functions a little differently, so it’s not always easy to tell if a particular group will be a good fit for you. But there are some things to look for when evaluating your choices:

The support group has clear rules about who can attend. Depending on the group, it could be limited only to a specific gender, adults over 18, people dealing with a specific challenge, or the friends and family members of those living with a certain condition. Relatively few support groups are open to just anyone.

The facilitator puts you at ease. Experienced facilitators expect newcomers to be nervous about attending a group. They’ll do their best to ease your fears by welcoming you, ensuring you’re in the right group, and telling you what to expect.

The support group has some kind of structure. Typically, the group should have a clear agenda with four basic elements: the facilitator welcoming everyone, each participant given the opportunity to introduce themselves, a group discussion, and the facilitator formally announcing the end of the group meeting.

There are clear guidelines. Rules and expectations are important to help everyone feel safe in the group. It’s common for groups to enforce a time limit of 1-2 minutes per participant to prevent anyone monopolizing the conversation. Support groups often have a “pass rule” if someone doesn’t feel up to sharing. Group members should be reminded to be respectful, empathetic, and to maintain complete confidentiality.

The facilitator helps the group stay on track. Whether the facilitator is a professional or a layperson, you should expect them to be trained and capable. Capable facilitators know how to enforce boundaries and stick to the schedule while giving each participant a chance to speak. They’re instrumental in pulling together common themes within the group to inspire the most productive discussions. Emergencies can and do come up during group time, and facilitators should know how to handle them appropriately.

Some peer-led support groups occasionally bring in guest speakers. These are opportunities for group members to get education from doctors, therapists, specialists, or other professionals to help educate the group on a certain topic.

Mandatory reporting and confidentiality

In general, everything shared within the group should stay within the group. However, some facilitators or group members may be mandated reporters. This means they are legally required to report crimes they learn about—such as abuse—even during a confidential group discussion. Some licensed professionals are also required to report suicide threats and threats of imminent physical harm to others.

Rules for some support groups require those who are mandated reporters to announce this fact to the group before the meeting starts, but this may not always be the case.

Red flags for an unproductive support group

The discussion portion of a support group should be helpful and productive. If something feels “off”, it probably is. Some red flags that signal the support group may not be right for you include:

The facilitator lacks skills and training. It’s essential for facilitators to control their meetings. They shouldn’t allow anyone in the group to take over or monopolize the group’s time. They should be clear on the group guidelines and be willing to enforce them. For example, they should not allow disrespect or the sharing of medical advice. Also, they shouldn’t take the entire group time to share their own problems, leaving little or no time for others to share.

The group is too large. The time goes quickly during a support group. If it’s too large, not all participants will have a chance to share and get the benefit of what the others share. Generally, ten or fewer members works best in a support group.

The confidentiality rule isn’t enforced consistently or at all. Group members often share many sensitive issues at a support meeting. It’s essential for facilitators to enforce confidentiality at group meetings so that every participant feels safe. Participants should be discouraged from getting involved in group texts, chats, and social media outside the group where unmoderated discussions can become disrespectful. Students or other observers shouldn’t be allowed to observe or record the group for educational or other purposes.

The primary focus is promoting a product or service. It’s common for nonprofits or other groups to sponsor support groups. If they ask for high fees to register, or they’re promoting products or services (such as medications or therapeutic services), the sponsor may have the wrong motivation and the group may not be as effective.

The group always ends on a bleak note. Discussions in a support group can get heavy at times and drag down the group’s energy. A skilled facilitator develops ways to bring the group’s energy up before the meeting closes, leaving everyone feeling hopeful and optimistic.

Overcoming the psychological obstacles to joining a support group

It’s hard and emotionally draining to deal with a serious issue such as addiction, bereavement, burnout, depression, or another mental health problem. For some people, it’s even harder to ask for help and be willing to receive it. Half the battle of attending a support group is just getting through the door for the very first time.

It’s common to feel nervous, frightened, or even ashamed. By joining a support group, it means you’re acknowledging and accepting the fact that the issue you’re facing is real, you can no longer avoid dealing with it, and you need help. These can be hard things to accept, but there are ways to overcome the obstacles to taking that first step.

• You have nothing to lose by giving a support group a fair try. The people sitting on the other side of the door once felt the very same way you do.
• You’ll likely make new friends who will be more sympathetic than some of your closest friends and family members are able to be about your current circumstances.
• If you’re afraid to go alone, consider asking a trusted friend to tag along for moral support. After the first few meetings, you’re sure to feel more at ease.

Getting the most from a support group

There are a few things you can do to get the most from joining a support group.

Attend on a regular basis. You’ll get the most out of a support group if you attend regularly. It will help you get acquainted with other group members and increase your comfort level.

Participate in the discussions. Participating in a group keeps the discussion flowing and everyone engaged. Other participants will look forward to hearing your updates and any words of wisdom you have to share with them.

Be sensitive to others in the group. There’s always a chance that something could come up during the group that upsets you or rubs you the wrong way. Be cognizant that people who come to support groups are dealing with serious, sensitive, and emotionally-charged issues. If you can’t look past it, bring the issue to the facilitator’s attention, and give them a chance to resolve it.

Recognize when a group isn’t the right fit. A productive support group depends a lot on group dynamics. With different people joining and leaving the group, group dynamics can change. If things aren’t working out, you might consider switching to a different support group.

Remember your reasons for joining

When you feel like things couldn’t possibly be worse, a support group can help you reframe your issues and view them in a more positive light. One of the best steps you can take toward feeling better is mustering up the courage to identify an appropriate support group and start attending.

You’ll know you’ve taken the right step when you feel you have something in common with others in the group, and you’ve contributed something to them as well. Most importantly, you can call your experience a success when you leave the group thinking, “I feel better now than when I first arrived.”

Author: Toni Hoy

• References

  Pfeiffer, P. N., Heisler, M., Piette, J. D., Rogers, M. A. M., & Valenstein, M. (2011). Efficacy of Peer Support Interventions for Depression: A Meta-Analysis. General Hospital Psychiatry, 33(1), 29–36. https://doi.org/10.1016/j.genhosppsych.2010.10.002

  Strozier, A. L. (2012). The effectiveness of support groups in increasing social support for kinship caregivers. Children and Youth Services Review, 34(5), 876–881. https://doi.org/10.1016/j.childyouth.2012.01.007

  Worrall, H., Schweizer, R., Marks, E., Yuan, L., Lloyd, C., & Ramjan, R. (2018). The effectiveness of support groups: A literature review. Mental Health and Social Inclusion, 22(2), 85–93. https://doi.org/10.1108/MHSI-12-2017-0055

  Steadman, J., & Pretorius, C. (2014). The impact of an online Facebook support group for people with multiple sclerosis on non-active users. African Journal of Disability, 3(1), 132. https://doi.org/10.4102/ajod.v3i1.132

Get more help

NAMI Support Groups: What to Expect (PDF) – Guide to support groups from the National Alliance on Mental Illness. (NAMI Seattle)

Find Support Groups – Resources to find support groups in the U.S. (Mental Health America)

Support Groups – Directory of support groups in the UK. (Mental Health UK)