Idiot's guide to starting a depression support group

May 18, 2011 10:04 AM

Looking to start my own in-person depression support group, but have zero background in social work or psychology. What pitfalls should I be aware of?

Okay, so there’s a guy in my neighborhood who’s trying to launch a new nonprofit foundation, one aimed at helping men who suffer from depression. His idea is a pretty simple one: basically, to raise awareness about the ways depression affects men and to encourage guys to talk to one another more about their emotional struggles. The theory is that men fear more the stigma of depression, that they often ignore or lie about their symptoms, and that even if they acknowledge their emotional struggles, they often lack a circle of buddies with whom they can talk things out. So the goal of the foundation is to weaken the stigma, to gather men together to discuss their depression, and to hopefully form a social network where guys can “check in” with one another for commiseration and support. In other words, get guys out of the depression closet and find strength in one another.

A longtime sufferer of depression myself, I thought it was a great idea. I immediately contacted this guy to get involved. Turns out, I’m not the only one who did. He told me he’s been contacted by about a dozen local guys, all of whom are still in the closet regarding their depression, who are looking for some support. He said he’d like to meet with them as a group, but he’ll be gone all summer, traveling the country to raise money and awareness for his project. Plus, he’s always envisioned an online depression management system, as opposed to an in-person support group, and most of his initial efforts will be focused on building a web community.

So he asked me if I’d be willing to step up and organize a meeting or two, just until he returns from his travels. I’d love to do it; I’ve long been frustrated by my depression treatment options and have often fantasized about starting my own support group.

But how to go about it? I have no training in social work. And my concern is that, if I called a meeting, it might just dissolve into some meandering, four-hour mope fest.

So what should I do? How should I go about planning a first meeting? Should I do it AA-style, where everyone introduces himself and gets ten minutes to tell his story? What other models might I look at? Is it acceptable to sort of make it up as I go, admitting to the group that I’m inexperienced and have only a loose agenda?

Basically, I want to avoid a blind-leading-the-blind scenario. Any tips would be hugely appreciated. If you’ve done this before—or if you’d like to get involved (I’m in Minneapolis)—please MeMail me. If you’ve been in crappy support groups before, please tell me what didn’t work. Or if you’re in one that rocks, I’d love to hear about that, too.

posted by sureshot to health & fitness (11 answers total)

Do you know anyone who is trained as a facilitator?

I think that having an agenda and/or leader might be helpful, especially in the beginning. You can always deviate from the agenda, but consider what you might say if someone contacted you looking for information about this new group: "Yeah, we'll just share our stories" vs. "We can share our stories, discuss coping strategies, settle on a topic around which to focus our discussion (like family, substance abuse, work, etc.) -- or just see what moves us."

When I'm feeling hermity (in a depressed sense), I really want to know that going out to do something will be worth my while and not another ho-hum waste of my time. An agenda, and/or the knowledge that a trusted, trained person is leading the group (and guarantees confidentiality) would go a long way.

I've been in one support group, for anxiety, and I felt like it was useless. Everyone else seemed to have problems that were much worse -- and less relatable -- than mine and dwelled on the specifics too much for me to commiserate. I felt bad, because for lack of any other way to relate, I ended up wanting to yell at some of these people for irrational things they couldn't control: "Are you kidding me? You can't go to the grocery store because you think you'll throw up -- where do you come up with this stuff???" I don't think our leader did a very good job of helping us find what we had in common.

The thing about AA is that it's a spectrum. People are at different points on their journey, and can jump from one point right back to the far end at any time. Some people will need immediate, acute support; others will just need a space to listen and the ability to nod at the appropriate time. But they're all there for the same reason. If you have a support group, people will have different stories and ways of relating, but emphasizing the commonalities between very different people can tie the group together so others can say, "Yes; I understand."

THAT'S what you want in a support group, right? Support.
posted by Madamina at 10:23 AM on May 18, 2011

Can't speak to organization much, but one thought immediately jumps to mind: If you do get this off the ground, have a backup program manager. Someone who works closely with you and can pick up the reins when YOU are depressed & can't get yourself in gear. Otherwise things will just fall apart the first time you, personally, have a de-rail.
posted by Ys at 10:23 AM on May 18, 2011

The Icarus Project - Minneapolis would be a great place to start. They address all mental health diagnoses not just depression, but use a model for support groups that does not require previous training in counseling or psychology.
posted by hworth at 10:29 AM on May 18, 2011

Before your first meeting, you should think through a few things:
1) How you will manage confidentiality in a group setting
2) What your plan will be if someone expresses intent to harm themselves or another person. Regardless of whether you intend to directly ask these questions, it is possible that these topics will arise.
3) Whether the group will be open (i.e., new people can join throughout the year, as they discover the group) or closed (i.e., no newcomers are allowed once the group has started, so that the core group is more cohesive).

Typically, a group facilitator would begin by discussing reasonable expectations that the group members should have regarding confidentiality and the extent of their duties as a group member (e.g., to keep others' information confidential, to "share the floor", to treat others with respect). You should probably let them know if you plan to report suspected child abuse (and what the cut off age would be), whether email communication or detailed phone messages are acceptable from the group leaders and whether group members are encouraged or discouraged from contacting each other outside of the group, what kind of behaviour would be grounds for expulsion from the group, etc. Depending on how informal the group is, some of these expectations may be debated/created collaboratively during the first meeting. This discussion will likely take about an hour or longer. Depending on how long you plan for each meeting to take, this discussion, plus short introductions from each participant, will probably make for a solid first meeting. It would probably also be helpful for you to ask the group members to describe any strategies (treatment or otherwise) that have helped or hindered their situation so that these introductions can give you an idea of the types of activities/readings/discussions that would fit this particular group.

If the guy that you are organizing it with does have a background in social work or psychology, there will be guidelines for his professional conduct that could help you avoid legal pitfalls. But keep in mind that, even if neither of you is bound by professional standards of conduct, it would probably be a good idea to find out your legal liability, and make a list of your local emergency and mental health resources, should something go awry.
posted by monkeys with typewriters at 10:48 AM on May 18, 2011 [1 favorite]

One of my friends is part of a group like this, inspired by Icarus Project. Her biggest problem with the group is one member who talks too long and dominates the group. Having someone in a facilitator role and/or setting group norms would probably help with this. Perhaps the first meeting could be focused on what you each want to bring to and get out of the group?
posted by momus_window at 10:52 AM on May 18, 2011

Forgot to mention - yes, it is completely acceptable (and probably important for establishing trust) for you to discuss your own background, inexperience and motivation for leading the group. This is not therapy, and you don't have to be an expert for it to be helpful.
posted by monkeys with typewriters at 10:53 AM on May 18, 2011

One last thought - think about whether there are any conditions under which you would not let someone join the group without having some empirically supported treatment first or at least concurrently (active substance abuse? hallucinations? recent history of suicide attempts and risky and impulsive behaviour?).
posted by monkeys with typewriters at 11:01 AM on May 18, 2011

Hey, OP here. Just thought I'd chime in to say thanks for the tips and to clarify a few things.

First off, I would never presume to form a full-fledged, therapeutic support group. No way I'm qualified for that. I'm envisioning something much more in line with the Icarus Project (thanks, hworth!): a casual meet-up where depressed guys can meet other depressed guys and discuss coping strategies, treatment frustrations, etc. Again, the idea is simply to get a small community going while this foundation founder is out of town. Presumably, I can hand things off to him when he gets back. And this guy IS an expert. He’s got a master’s degree in social work and adjuncts at the local university.

So again, just wondering if I can make something like this useful—even just in the short-term. Keep the ideas coming!
posted by sureshot at 11:06 AM on May 18, 2011

I've gone to a few meetings at the Mood Disorders Support Group in New York, and they were really well-run and organized. I haven't had a chance to look at the website in a while, but they might have tips on how they put together the groups. Good luck - it sounds like a great idea!
posted by Neely O'Hara at 11:37 AM on May 18, 2011

I too have attended a few MDSG depression support groups here in NYC and second the idea of having a gander at their site. From what I gleaned, the moderators were not all or even mostly mental health professionals, just fellow sufferers who had been attending the group long term, knew the drill, and wanted to take a more active role. Meetings always opened with a discussion of confidentiality and respect for other participants and their different opinions and outlooks. The most workable format I encountered included an initial 'intro' of going about the room to each participant, who would BRIEFLY relate what's weighing on his or her mind that particular week. Following this, the organizer would often then echo back 'hot spot' topics that came up more than once among all the participants and ask if anyone wanted to start off talking about those particular issues, while simultaneously offering the floor to anyone with something pressing to say, regardless of topic. From there, you just see where it goes, and tie threads of issues together when you catch them dangling loose in natural lulls. Nearing the end of the group's time, another bounce around the room to each participant was made, with special emphasis on people who may have been silent or issues that may have been brought up at the beginning but neglected in conversation. Sometimes the moderator would ask participants to state one proactive or positive thing they could do that week. That part usually felt like someone putting a threadbare, cheery spin at the last minute on a terribly sad movie. It's perfectly ok to let people just be sad. It's probably the only place they're allowed to let their 'everything's fine here!" mask drop; I couldn't see the need to trot it out at the last minute.

I personally found that the moderator and the level of control they evince can really make or break a meeting. Madamina's mention of people "dwell[ing] on the specifics too much for me to commiserate..." was quite common in my experience, and led to a bunch of glazed-eyes and shifty, bored-looking participants who never showed up again. There is almost always someone who mistakes 'support group' for 'private therapy session' and thereby neatly co-opts vast, unbroken swaths of alloted time delving into the delicate intricacies of his or her nasty divorce or terrible sibling dynamics. Touching on specific events or issues is of course necessary, but focusing at length one person's highly specific issue or scenario means the thing you all have in common - in this case, depression - is lost in search of a solution for one person's specific problem. But hey, you're probably in a support group because there ISN'T any magic, one-shot solution to be found no matter how many brains you put to the task - it's about coping and feeling understood and accepted and not quite so powerfully isolated in your suffering. The sole thing everyone there suffers in common is depression; a good support group needs to walk that line between the myriad individual manifestations of it and the overarching themes of the disorder that bind what may be radically different individual persons, with absolutely nothing in common, together. And while that sounds like a terribly common sensical thing, it's clearly far easier said than done, and seems to rely heavily on the moderator steering the ship right through everyone's private deep wells of misery and on into more international waters, so to speak.
posted by involution at 5:31 PM on May 18, 2011

I've been to a group which is part of the Depression and Bipolar Support Alliance. It was well-run and there are rules the members commit to in order to help things run smoothly. DBSA's website has a page about starting a DBSA chapter. You can request that they send you a start-up guide, which might give you some of the guidance you are looking for. There is also a facilitator guide (PDF) you can look at right away - this includes the rules I mentioned above.
posted by hijol at 5:34 PM on May 18, 2011 [1 favorite]