Support groups offer people many things - the ability to meet others in similar circumstances, to share methods of coping and develop new relationships at a time of isolation. Groups have also been shown to improve adjustment, mood, coping and quality of life for people dealing with bereavement

• You have a number of people who want to belong to the group

• At your first meeting - establish group goals that meet the expressed needs for mutual help, information or discussion of concerns. Ground rules need to be worked out and discussed

• Establish if you need funds for the group. This may include funding for refreshments, mail and phone calls, duplication of materials and transportation for group members.

• Resolve the obvious questions before the group begins. Where will the group meet and when? How often will the group meet and how long will each meeting last? How will people travel to and from the group?

• Decide on how the group will work - ie will people be made welcome to join after the group has started? Group dynamics very often work against incomers ie people within the group resist others breaking up the circle. You will need to make sure that this is addressed

The Group Leader
The group leader plays a vital role in guiding the group, setting the tone, creating an atmosphere of trust and providing support. These strategies are useful for the group leader:

• Ensure that the ground rules for confidentiality, listening and mutual respect for group members are established. Try to do this at the first meeting and perhaps write it down and give copies to the group members - make sure that people who join later are aware of the ground rules and are happy with them.

• Begin where the group members are, rather than imposing your own preconceived agenda

• Initiate and stimulate discussion and allow common themes to emerge

• Take an active part in the group process, especially in creating a safe atmosphere for participation

• Monitor the emotional pulse of the group. When painful topics are being avoided, you may have to introduce them or at least gently point out that they are being avoided

• Acknowledge the predictability of feelings, ie anger, denial, withdrawal and hopelessness and help the group to discuss feelings and accept that there is a process which may need to be gone through. Not everyone goes through a classic process and each have their own way of dealing with fear and loss and may not behave as expected

• Positively encourage networking of group members outside the formal group for additional support and socialization

• Help members join in the group discussion and involve the more passive members as much as possible while also respecting that some people find exposure in a group situation difficult - there are often echoes of ridicule at school

• Leave sufficient time to sum up and close properly at the end of each group meeting. Warn members (a minimum of ten minutes) before the end of the meeting that there is only such-and-such time left

• Provide articles and information on issues of concern to the group if that is what is wanted in your group

• Allow for the fact that you may need third party insurance and make enquiries about necessity and cost

Dealing with setbacks 
It is important to acknowledge that not all groups are successful. Groups may fail to work as shown by absenteeism, dropouts or lots of internal wrangling, personality types such as monopolisers or silent members may disrupt the flow of discussion or groups may focus on "safe" topics such as treatment and anger at the medical system to avoid discussion about their feelings. No matter how difficult or doomed, each new group should be seen as a learning experience. It's often helpful to discuss meetings and what happened with a colleague to keep things in perspective.