Working with peer support groups
A group agreement or ground rules can help manage many difficulties in a peer support group. Find out how to create a group agreement, and things you should consider, on this page.
How to create a group agreement or ground rules
As a group, you should spend a session drawing up your agreement. The whole group should be involved, and everyone should feel like they have ownership of it.
We recommend that you review it on a regular basis to keep it ‘alive’ and relevant, and to make sure that new members understand it. You can use the opportunity to ask if people would like to make changes.
Here are a few things you might want to consider:
- Finding a space for everyone to speak
- Giving advice or being too directive
- Breaches of confidentiality
- Aggressive behaviour
- Responsibility for decision-making in groups
- Lack of understanding around some difficulties or experiences
- Critical, judgmental or insensitive comments and lack of respect for differences
Things to consider when making a group agreement
Confidentiality
- Only share what you personally feel comfortable sharing.
- Don’t share personal information about others discussed within the group without permission.
Respect
- Challenge the view, not the person.
- Respect individual boundaries.
- Promote a relaxed feeling in the group.
- Allow individuality and value diversity.
Conduct
- Take time out if you need it – allow people to leave the group.
- Challenge discriminatory or oppressive behaviour.
- Come up with a way to challenge disruptive behaviour.
- Resolve disagreements within the group.
- Timekeeping – be punctual when joining online meetings.
Communication
- Actively work to understand the perspective and experiences of others in the group.
- Allow for everyone to have their say.
- Humour – as long as it doesn’t offend others.
- Try not to monopolise the discussion. Stay focused.
- Listen carefully to what others have to say.
- Everyone should be able to express how they feel without judgement.
- Respect other viewpoints and avoid dismissive and negative language.
- Be careful in the words that you choose. Avoid making personal attacks and using disrespectful language.
- Bounce and share ideas with each other.
- Don’t use acronyms or abbreviations without explaining them.
- Take time to make sure you have the means and time for online communications.
With thanks to NSUN (National Survivor User Network).
Finding a space for everyone to speak
There should be an opportunity for everyone to feel they are heard or listened to.
You can achieve some aspects of this by providing activities designed to give everyone an opportunity to speak. You can use icebreakers or you could start or finish a group with an opportunity for everyone to say how they’re feeling. Other methods which allow people to feel that they are being listened to are the use of a comments box, or a meeting feedback form.
If someone is silent in a group, it may be that they are simply listening and learning, waiting for a time when they feel safe enough to speak.
Where there are group members who tend to dominate conversations, it can be useful to remind them to allow others to have an opportunity to speak, referring to the group agreement to reinforce the request. There are other simple tactics for a facilitator to adopt in this situation, such as making no eye contact with the person who is dominating the group and moving the conversation on to another person or topic.
However, if it becomes very difficult to change this behaviour within the group, it may be helpful to take the person to one side outside of the group to find out what is troubling them and encourage them to listen to others.
Another method is to use a kind of game: introduce an item such as a shell into the group, with the rule that only the person holding the shell can speak. This can be fun if introduced occasionally and can alter the dynamics in a group.
Giving advice or being too directive
On occasion, people may become too directive with their peers and imply that they know what their peers should do in a particular situation.
Suggesting and sharing strategies is an important element of peer support, but it can cross a boundary and become too directive. This should be discouraged as it may not be welcomed and is not in line with the ethos of peer support.
You can point to the values of peer support and encourage people to understand the need for everyone to retain choice and control and to reach their own decisions.
Breaches of confidentiality
Confidentiality is one of the most common ground rules for group work. It is also one that is often unintentionally broken by people who know each other and talk outside of the group. The use of a comment or suggestion box can help to identify this problem (and others).
Dealing with it is not so easy. You can of course point to the group agreement and remind people periodically of what they’ve all agreed to. It may also be useful to have a specific group discussion about what confidentiality means to everyone. People may have different understandings of what it means and how to make it work.
Aggressive behaviour
Some people may become aggressive during group discussions, perhaps when they are expressing strong feelings or in disagreement with another group member. Expressing anger can be entirely understandable and appropriate in some circumstances, but it is not acceptable for someone to become aggressive towards others as it could destroy the safety of the group.
Aggressive behaviour needs to be challenged in the right way. If it isn’t, people may not feel safe to return to that peer support space. This is where it’s really helpful to be able to refer to the group agreement and see if it covers this situation. If it doesn’t, then it’s time for the group to talk about what they consider to be appropriate behaviour and come to an agreement about what will happen if someone breaks the ground rules. It’s important to be clear with everyone about what is not acceptable behaviour and agree to the sanctions together.
You can find de-escalation training online. Some simple de-escalation techniques include the following:
- Appear calm: adopt a neutral facial expression, avoid eye contact.
- Allow space around the person who is being aggressive: do not get too close.
- Control your breathing, lower your voice and keep an even tone.
- Try distraction strategies: engage the person in thinking about a solution.
- Acknowledge their feelings.
- Use words and phrases that de-escalate, such as:
- “I wonder if...”
- “Let’s try...”
- “It seems like...”
- “Maybe we can...”
- Tell the person what you want them to do (making a positive statement), rather than what you don’t want them to do. For example, “Please sit down” rather than “Stop arguing with me”.
- Avoid backing them into a corner, either verbally or physically.
Remember: in order to maintain the safety of the peer support space, it’s more important that you are seen to address the situation than to ‘win’ an argument.
Responsibility for decision-making in groups
It can be difficult to encourage peers to participate in the shared decision-making of the group. Some people may feel they have something important to contribute, but find it difficult to do so. Others may feel reluctant to take responsibility for the decisions of the group. This may make it difficult to make and implement important decisions.
If this becomes a problem, it may be helpful to discuss with peers how they would like decisions to be made (for example, voting or delegating different things to different people). As with most things, this should be reviewed from time to time as the group itself changes.
Lack of understanding around some difficulties or experiences
There are limits to how well people will understand each other’s difficulties. The fact that people share similar experiences does not mean they share the same experiences.
There will be a diversity of experience within a single group, even a group aimed at one particular mental health diagnosis. This may lead to people unintentionally saying things that are insensitive or demonstrate that they have not understood, which can be upsetting.
One way of addressing this is to run a discussion session around a particular topic, and invite a member of the group to contribute to this. This will help peers learn about issues they may not be familiar with.
Critical, judgmental or insensitive comments and lack of respect for differences
On occasion, peers may say things that are directly offensive, insensitive, critical or which demonstrate a lack of respect for other people in that peer support space. People may express racist, homophobic or other discriminatory views. This runs directly counter to several of the important values of peer support and is likely to severely compromise the safety of the peer support environment, particularly for members of marginalised communities.
It is vital that offensive or discriminatory views are challenged – and it may be that other members of the group will take part in challenging them. Your group agreement should refer to some of the values that will help with this such as: the need to be inclusive and non-discriminatory.
If this does not work, try talking to individuals outside the group to establish if their remarks are a result of a misunderstanding of the purpose of the group or of certain issues. You may need to consider whether this peer support is right for this individual if they continue to do this.