DBSA recommends that we begin each group by reviewing these facilitator support meeting protocols and guidelines to help participants learn and commit to the group standards.
- Share the air.
- Everyone who wishes to share has an opportunity to do so. No one person should monopolize the group time.
- One person speaks at a time.
- Each person should be allowed to speak free from interruption and side conversations.
- What is said here stays here.
This is the essential principle of confidentiality, and MUST be respected by all.
- Differences of opinion are OK.
We are ALL entitled to our own point of view.
- We are all equal.
Accept cultural, linguistic, social, and racial differences and promote their acceptance.
- Use “I” language.
Because we do not participate in support groups as credentialed professionals, we do not INSTRUCT or ADVISE. We do, however, share from our personal experiences. We are unique individuals and only we know what is best for our own health (along with our doctor’s recommendations.) Example: “In my experience, I have found …”
- It’s OK not to share.
- People do not have to share if they do not wish to.
- It’s everyone’s responsibility to make the discussion group a safe place to share.
- We respect confidentiality, treat each other with respect and kindness, and show compassion.
What are DBSA Support Groups?
DBSA support groups are gatherings of peers who are there to help each other help themselves. It is important to remember that everyone follows their own unique path to wellness and recovery, using different tools and different tactics of their own choice. For many people, DBSA support groups are an important part of their wellness plan.
Core Elements of a Recovery-Oriented DBSA Support Group
As you think about what the DBSA support group offers to people, think about these statements and consider how you can encourage these elements in your support groups.
- Provide hope in every interaction.
- Empower others in simple ways.
- Use person-first language.
- Focus on strengths.
- Promote personal choice.
- Help everyone leave committed to action.
The Facilitator’s Personal Commitment
It can be helpful to review the following commitment prior to support group meetings to remind yourself of your role and th needs of the group. Take some time to think about what else you would like to include in your personal commitment.
As the facilitator for this DBSA support group, I commit to:
- Share as a group participant.
- Empower participants to support each other.
- Support others as an equal, not a leader.
- Use the DBSA guidelines.
- Be compassionate and understanding.
- Work towards a hopeful and positive environment.
- Ask for help when I need it.
- Leave medical talk to medical professionals.
- Empower the group to focus on recovery-oriented discussions.
- Begin and end the meeting on time.
What is the goal of DBSA Support Groups?
Most of us would agree that the purpose of DBSA support groups is to help improve the lives of people living with mood disorders.
It’s important to state this purpose in our support groups to set the right expectations. Here’s a sample purpose that you could use: “We are people living with depression or bipolar disorder who come together to learn from each other and encourage one another as we work towards wellness.”
What is recovery?
Recovery from mental illness is a new concept for some people, and for others it is something with which they are very familiar. Recovery means different things to different people.
DBSA uses the following definition when talking about recovery: A full and meaningful life in the community. Whatever your definition, the premise of recovery is the same. Recovery is more than a reduction of symptoms or being “stable.” It’s about attaining the life you want.
Discussion Starters
If you’re having a hard time getting conversation going during the open group discussion or if you have a consistent group of attendees and they seem to talk about the same topics each time the group gathers, consider asking participants to share their thoughts on a particular topic when it is their turn. The group should direct discussion but introducing possible topics at the beginning of the meeting is a great facilitator tactic. Some potential topics are:
- Wellness tips
- Talking to a therapist or doctor
- Effects of the illness on family and friends
- Fears members share
- Stigma members face
- Doing things that make you feel good
- Celebrating recent successes
- Adhering to your treatment plan
- Relationships
Additional discussion starters:
Flow Tips for Facilitators
During discussion, facilitators do only what their position calls for: facilitating smooth discussion. To do this:
- Restate — Participants need to know that others have been listening. Restating what others say in other words is the simplest way to let them know you are paying attention.
- Question – Ask questions that seek more information or clarify what a member has said: “Maurice, can you tell us more about . . . ?”
- Redirect – Ask other group members to respond to what has been said: “I wonder if anyone has some thoughts about what Jennifer has just shared.” This can be a good technique for drawing out quieter group members and involving them in the discussion.
- Reflect — Identify the feelings that underlie what is being said. This is done in an intentionally tentative way: “It sounds as though …”
- Validate – If you have experienced some of the feelings being expressed by a member, say so and tell them you understand why they feel that way. You can do this without agreeing with someone or condoning unacceptable behavior.
- Summarize – Review what the conversation has been about up to the present. This puts things in perspective, refocuses discussion, and shows where discussion can go.
- Share — Facilitators shouldn’t forget that they are also group members. They should share feelings and experiences when it is their turn.
There is nothing wrong with silence at any time during the discussion. A break in conversation allows people to reflect on what was said and collect their thoughts. Silence sometimes encourages people who haven’t talked to speak up.
Remember that everyone in the group, including you, has experienced difficulty in their lives. The facilitator should be prepared to deal firmly but kindly with individuals who are hypomanic, hostile, antagonistic, discouraged, and depressed. Strive to be patient, kind, and empathetic, but remember that the purpose of the meeting is to provide productive support for everyone. If one individual is dominating discussion, for example, it is appropriate for the facilitator or other group participants to intervene and move on in the discussion. In this situation you may want to try some of the following statements:
“It sounds like there’s a lot going on in your life right now. Let’s hear from a few other people and then if we have time at the end of the discussion we’ll come back to you.”
“I think we’re clear now about your ideas, John. Who else would like to respond?”
“It seems we’ve moved from the original topic. Is that what we want to do?”
“Do you have an opinion about that, Jane?”
“Let’s share the air to make sure everyone’s getting a chance to participate.”
What are some other things you might say?
Empowering Others through Facilitation
If someone appears to be unable to participate productively in discussion, is in crisis, or is suicidal, be prepared to summon assistance or make sure that the individual in question gets the help they need from another resource. See the Handling Challenges section for more information.
Many of us who get involved in leadership roles have a tendency to be problem-solvers and like to offer advice in order to help people. As a facilitator, our role is to assist the group in supporting one another— not to solve their problems or even offer advice. This can be very difficult for many of us—especially if people seem to be asking for our advice. Here are some statements you may want to try using to make sure you’re facilitating conversation rather than giving advice.
“What experiences have other people here had that Sean might find helpful as he deals with this?”
“Out of all the problems you’ve talked about tonight, which one is most important?”
“What are some things you think would help? Does anyone else have additional ideas?”
What are some other things you might say?
As you continue to put questions back to the group and the individual you will likely be surprised at how many possible solutions they can come up with. And, as an added bonus, everyone leaves feeling like they hold the power to change their lives in their own hands!
Handling Challenges
We are peers. We are not professional counselors. While we encourage you to be prepared, don’t expect to be able to deal effectively with every difficult situation that arises.
The following information is designed to help you handle common challenges within support groups. For more detailed information, please see the DBSA Conflict Management Guide and Support Group Crisis Response Guide which are available on the Chapter Management section of DBSA’s website.
- If you become overwhelmed or things get out of hand, get help. Quietly ask another person in the group to go get one of the chapter leaders or another facilitator. Because you are a peer, and not a professional, it is responsible to ask the group to determine how to handle a situation that has gotten out of hand.
- Jot down problems and share them with other facilitators. Bring them up when meeting with the Professional Adviser.
- Reference DBSA conflict management tools, crisis intervention tools, etc. for assistance with challenging situations.
- Be prepared with chapter policies for common challenges.
Some challenging situations are best processed by the entire group (as opposed to something that should be addressed in a one-on-one setting). Here are some suggestions to help you facilitate the discussion:
- Clarify the issue. What exactly is each person upset about? Can each person state clearly his or her own viewpoint and how it differs from the other person’s? Sometimes a simple misinterpretation is at the root of the problem.
- Ensure group back-up support If each party in an argument feels some degree of support or understanding from some people in the group the intensity of their anger may be reduced somewhat, as they don’t feel so alone.
10 Tips for Preventing Conflict
The first step in successfully managing conflict is working to prevent it altogether. Here are ten tips to help you and other support group participants prevent the challenges of conflict before they arise.
1. Gossip: Just say no
2. Praise: Always in short supply
3. Don’t burn bridges
4. Communicate
5. Forego public shame and blame
6. Talk to everyone
7. Include the group in group decisions
8. Give constructive feedback often
9. Intentionally seek participants outside the “inner circle”
10. Have agreed upon policies for conflict management in place
Encourage “I” statements. Speaking from one’s own experience and feelings is more conducive to productive conversation in a conflict situation than making statements about “you” and “your” behavior. Help the group avoid passing judgment on one another. Allow people to finish statements. People should be able to complete their thoughts. Often conflicts are resolved simply by letting everyone be heard.
Keep discussion focused. Try not to allow side issues to be brought in unnecessarily, and thereby complicate matters. Try to keep people talking about one issue at a time. Encourage and model active listening. Occasionally restate what each party is saying, or ask them to do it. People, more than anything else, want to know they’re being listened to.
Take a short break. When things feel out of control, it may be useful to ask for a moment or two of silence, or perhaps to encourage a stretch or a coffee break. A cool-down period can be very helpful.
Invite others to help out. Peer-led support groups are, by definition, led by equal peers. Sometimes it can be helpful to ask another peer to step in for a while and guide the discussion. Often, this change of voice can change the group’s attitude as well. End the meeting with a round-robin. Whether or not there is still tension in the air, it might be useful to give people in the group a chance to have a last word or two about what happened during the meeting, and about what they might want to see happen next time.
Be sure to visit the DBSA Chapter Management Website at http://www.dbsalliance.org/chaptermgmt for more resources, such as:
- DBSA Support Group Facilitation Guide
- DBSA Conflict Management Tool
- Articles on support group facilitation
- Support Group Crisis Management Guide
- Online DBSA facilitator trainings
- Printable copies of the DBSA Support Group Guidelines
- Role-playing scenarios
And much more!
Books on effective facilitation:
- Effective Support Groups. James E. Miller
- The Zen of Groups. Hunter, Bailey & Taylor
- The Art of Facilitation. Hunter, Bailey & Taylor
- Self Help and Support Groups. Linda Farris Kurtz
Recovery Resources
If you’re looking for additional ways to make your support group more recovery focused, you may want to consider incorporating some of the following materials into your meetings.
- DBSA brochures, website, calendar, FacingUs.org, etc.
- Pathways to Recovery by Priscilla Ridgwav, et. al.
- Wellness Recovery Action Plan by Maty Ellen Copeland
- Participants or other community members’ personal stories of recovery
- Participant-chosen motivational readings, CD’s, excerpts, etc.
- Articles about recovery from mental illness
Sample DBSA Support Group Meeting Outline
DBSA support groups are not required to operate according to a rigidly prescribed formula. The sample meeting format shown here incorporates the elements used by many of our groups and is intended to guide you. Try using this as a starting point for the group’s discussion of participant needs and how the group can be structured to meet those needs.
- Gathering time
- Welcome
- Review what will happen at the meeting
- Review discussion guidelines
- Check-In-
- Discussion
- Close the meeting
Detailed Meeting Agenda
Gathering or social time
- Welcomes people . . . breaks the ice
Have one or more of your volunteers greet people as they arrive and thank them for coming. Encourage newcomers to sign in on the list provided, including telephone and e-mail address, if available. Volunteers can invite guests to have refreshments if these are available and help introduce newcomers to others in the room.
Special note: Keep track of how many people have arrived so that you can quickly and easily decide how many groups you will need to split into. DBSA recommends that you have no more than 10-12 participants in each support group.
Welcome
- Brings people together and gets their attention . . . provides a focus point
What you might say:
“Hello, everyone, and thank you for coming to the DBSA support group tonight. We know that it may not have been easy for you to make the decision to attend. My name is Katie, and I’d like to welcome you.”
Be sure to set the stage by stating the purpose of the support group and add any needed “housekeeping” announcements: where people can pick up materials, location of restrooms and water fountains, when the meeting is scheduled to end, etc. Even if the same people attend the support group regularly, it is important to offer a formal welcome to everyone.
Review what will happen at the meeting
- Moves the group to the business part of the meeting . has the same information and knows what to expect everyone
Check-in
- A chance for each person to find out who else is at the meeting and what their issues are . . . to know that they’re not alone
What you might say:
“Now it’s time to review the format and schedule for the meeting. Tonight we will follow a procedure recommended by DBSA and designed to give everyone an opportunity to participate as they are comfortable. First we will check in: each of us will have an opportunity to introduce ourselves by first name and tell us if you have a topic you’d like to discuss at tonight’s meeting.
“After the check-in, we will have a talk about our mood disorders and share experiences, personal feelings, information, and strategies for living successfully with these illnesses. The discussion will last until [time] when the meeting will end.
“Before we begin to talk with each other, I’d like to review the guidelines for our discussion.”
Read aloud the DBSA support group guidelines, which are provided at the beginning of this guide. Stating guidelines at each meeting is valuable for many reasons. It ensures that everyone is responsible for following the same guidelines and helps people learn and commit to the group standards.
This is also the time for the facilitator to outline her/his role. To facilitate means to assist or make easier. Facilitators, therefore, assist the group by making easier the conversations and sharing that goes on at self-help meetings.
Each person has an opportunity to introduce themselves by their first name and tell the group if there’s a topic they wish to discuss.
Open group discussion
The heart of why a DBSA support group exists. Sometimes a topic of common concern has been identified during the check-in, and the facilitator can begin discussion using this topic. For example, if several participants have expressed frustration about communicating with their family, the facilitator might say, “It sounds as if a number of us are having challenges in working with our families. As we go around the circle tonight, you are all welcome to address the challenges or successes you have had in communicating with your family along with anything else you’d like to discuss. Perhaps we can determine a number of possible approaches for ourselves in dealing with this concern.”
The facilitator can also begin discussion by asking if anyone would like to be the first to share or just ask the person to their left or right to begin.
Close the meeting
- Brings closure to the session
How to do it:
- Give a 10- or 15-minute notification before discussion is scheduled to end.
- Ask members to make any final comments or summaries.
- Briefly summarize what has happened at the meeting.
Ask people how they feel the group has helped them and how they will move forward on their recovery journeys before the next meeting. Some sample questions include:
- What will we take away from the meeting that will help us?
- What will we commit to doing as we move forward into the week?
- What new strengths will we explore?
- What part of our recovery or wellness plan will we work on this week?
- Announce next meeting date/time/place OR (if this is your first meeting) get commitment from attendees to meet again and determine date/time/place.
- Encourage new attendees to attend 3 or 4 times before deciding whether a support group is right for them or not.
- Encourage attendees to tell others about the group, including their doctor/other mental health professional.
- Ask for volunteers to help with the next meeting.
- Refer to fact sheets or other information/materials that are provide to participants.
- Thank everyone for coming