Staff working with young people often ask whether it is a good, or a bad, idea to bring individuals who are battling self-harm together for group work. It’s hard to provide a stock answer as we’ve seen it work well but we’ve also seen it go very wrong. Below, we work through a few of the questions you should be asking yourself if you are considering group work; these should ensure that this intervention helps rather than hinders recovery.
There are many reasons why people consider bringing young people together to work as a group. There are good reasons and bad reasons. If the reason that first sprang to mind as you read the question had to do with promoting recovery or sharing ideas or group support then that’s great. If, however, your first through was of efficiency and making either your time or your money go further, then you might be considering this for the wrong reasons.
You are unlikely to make cost or time savings by carrying out group work as each individual will still require personally tailored support and help outside the group so, if anything, your costs are likely to go up.
Will people who wish to support their friends be welcome to attend the group or is it for sufferers only? Will there be limits on age or gender of group attendees? What is the maximum size of the group and what will you do if it becomes over subscribed?
If you have a specific group of young people in mind to attend your group, think carefully about how well this group gels. Try to ensure you don’t have too many dominant personalities or a clique of young people who might unbalance the group.
A group will only work where young people are willing to engage. Before you do too much prep and ground work, it’s well worth sounding out the young people you have in mind to see if they think that supporting each other via a group is a good idea.
Think carefully about the logistics of your group. It’s not just about having a free room. It’s about having a comfortable room with half decent furniture and enough room to set things up in a fashion that’s conducive to conversation (often sitting in a circle). Access to tea and coffee making facilities can help a lot too as people tend to calm down and relax into group work if it feels somewhat less formal.
Running a group is not to be taken lightly. The person who runs the group should be well experienced or have appropriate training. You may be able to make the case for buying in the services of a local counsellor or CAMHS worker to facilitate the group. If so, it makes sense for a lead member of staff to co-facilitate, both as a means of personal development and in order to provide additional capacity to the group. If a member of staff takes on the running of the group, it’s important to consider how they can best be supervised and supported as running a group of this type can be emotionally exhausting.
Before running a support group, you need to think carefully about the potential risks of doing so and work through your organisation’s policies in relation to these. It is well worth carrying out a formal risk assessment and considering all the worst case scenarios and how you would respond to these. This will better enable you to keep everyone safe when you are ready to get started.
Your group needs to have clear aims or a purpose and the young people being supported need a way of charting their progress against these aims, either individually or as a group. The aims will vary depending on the nature of the group but you are likely to be encouraging behaviours like:
You might choose to work with individuals outside the group on their aims and goals and just to use the group as one means of supporting these aims or you might choose to have the group work together to determine common goals or to support each other in goal setting.
Many young people really flourish when working as part of a group which is great news so long as the group is running – but how will you support young people throughout the holidays or if the group facilitator is absent? It’s important to consider these issues upfront as good work can be rapidly undone when a group cannot run unless you have clear planning in place.
Throughout these questions, the assumption has been of a physical group – but some groups can function very well online, or with an online element as part of the support. This can open up the possibility of providing support in school holidays and also provides a forum where some young people feel more comfortable opening up. It’s important to think carefully about the moderation of an online group though – it can make a lot of sense to have specific ‘opening times’ when it will be fully moderated in much the same way as a face to face group would be.
Finally, it’s important to consider the exit strategies of young people involved in the group. There can be an issue if young people grow to really value the friendship and support provided by other group members as this can mean they are reluctant to leave the group – which can make them more reluctant to move on from unhealthy behaviours. Additionally, young people can sometimes feel like they’re betraying their friends or letting them down somehow if they move on from the group.
Managing young people’s exits from the group needs to be considered carefully and, as always, we must be careful to continue to offer our support for some time after any physical signs of difficulty have dissipated. Weight may restore, or physical wounds may heal, but that doesn’t mean that emotional scars have fully healed.
Download a printable copy of this information: Running self-harm support groups