Training facilitates good support group leadership

Experience to lead comes in many forms

In a true support group, people interact and discuss their condition in a structured way, says Kate Lorig, RN, DrPH, director of the Stanford Patient Education Research Center in Palo Alto, CA. Therefore, leaders must have good group skills. "The leader would have to have training. That’s why people that have been trained in group skills, such as social workers or psychologists, make good support group leaders," she says.

Knowledge of facilitation skills is key to leading a support group effectively, says Sandra S. Johnson, MSW, oncology social worker for cancer support services at Evergreen Healthcare in Kirkland, WA. "Practice is the best," she says.

She acts as consultant for a group of volunteer leaders and oversees the meetings. Support group volunteer leaders are cancer survivors who have attended a support group for at least a year and have completed treatment. They also must attend training sessions, quarterly meetings, and education events. All are encouraged to attend local hospice and bereavement training as well.

"My volunteers have from one to nine years experience in group facilitation. I make a point to inform them of any pertinent educational offering in the area that might strengthen and support their skills," says Johnson.

Facilitation skills can be gained through guidance, reading, supervision, participation, and experience, says Melissa D. Hartley, MSW, social worker and therapist at Seattle Cancer Treatment and Wellness Center.

Hartley, who facilitates groups at the clinic, says that her job description is to facilitate discussion regarding people’s shared and individual experiences regarding cancer and provide relevant information for members as appropriate. She must maintain balance among group members and provide opportunity for all to share. It’s up to the facilitator to create a safe environment where members can trust that their experience will be kept confidential and where they will be treated respectfully, she says.

A support group leader must ensure the group members feel heard, understood, and validated. He or she also is a reliable and stable person with whom they can share their fears and emotions, says Hartley.

Support group leaders must have the ability to be genuine and professional while facilitating a sometimes-challenging discussion. They also must be perceptive regarding members’ group experiences and take appropriate measures to meet their needs, she says.

Keeping problems under control

It’s important to correct any misinformation that is given during a support group meeting, says Hartley. The policy at Seattle Cancer Treatment and Wellness Center is for the leader to state that he or she has a different understanding of the subject and qualify the statement with the fact that he or she is not a medical professional.

Although there are no written guidelines, the volunteers and Johnson at Evergreen Healthcare are quick to correct what is said or bring in a knowledgeable person to address or correct any misinformation.

Medically incorrect advice is not the only problem that can occur. There can be difficulty with participants. Support group leaders must make sure that discussion goes smoothly and manage people in groups who may be taking too much time or exuding inappropriate behavior, she says.

"I attend every meeting, and I am the consultant for the leaders. Our quarterly meetings are for the purpose of reviewing what has worked and what hasn’t worked. Sometimes, after group [meeting], we will debrief, particularly if there is a death or a problem’ participant," explains Johnson.

While discussion time is important, all the groups that she facilitates like to have educational meetings where specialists are invited to provide more in-depth educational information. Some favorite topics are health care insurance advocacy, discussion of the latest treatments led by a medical oncologist, Social Security disability, naturopathic care, and nutrition.

Educational programs should not be held too frequently, says Johnson. "Last year, we offered educational programs once a month. The group decided this was too much, and we now offer them once a quarter," she says.

When a speaker is invited to every meeting and there is no time for personal discussion, the activity is not a support group but a lecture series, warns Lorig.

The groups at the Seattle Cancer Treatment and Wellness Center are not centered on a particular curriculum, but members may request specific information or discussion. "I work at providing that information through handouts, guests, discussion, or other resources. Our naturopaths, oncologists, massage therapist, and acupuncturists are very happy to offer their expertise as requested," says Hartley.


For more information about selecting and training support group leaders, contact:

  • Melissa D. Hartley, MSW, Social Worker & Therapist, Seattle Cancer Treatment and Wellness Center, 122 16th Ave. E., Seattle, WA 98112. Telephone: (206) 292-2277. E-mail: Web site:
  • Sandra S. Johnson, MSW, Cancer Support Services, Evergreen Healthcare, 12040 N.E. 128th St., MS #63, Kirkland, WA 98034. Telephone: (425) 899-2265. E-mail:
  • Kate Lorig, RN, DrPH, Director, Stanford Patient Education Research Center, 1000 Welch Road, Suite 204, Palo Alto, CA 94304. Telephone: (650) 723-7935. Web site: