Ending well

There are a variety of reasons peers might stop coming to sessions. Often peers feel the group is no longer meeting their needs. In some cases, there are improvements that could be made with the group so that it runs better, which will keep attendance up. In others, perhaps the group runs well, but the peer has got all they needed out of it and leaves.  This is to be expected.

From a practical point of the view, the question becomes “what should happen when a peer wants to leave the group, or simply stops coming?”

First, find out why the peer wants to leave. Note that sometimes people might not be comfortable enough to suggest the group is not run well, if that’s what they think – they might not want to offend you! You could perhaps prompt them and ask whether they think anything about the group could be improved.

Second, decide whether you can use what they have told you to improve the group. You might feed it back to the other members. Alternatively, they might be leaving because they feel they have got all they need from the group, which is fine, or there might be some external circumstance (e.g. illness or change in circumstances) that forces them to leave.  At this point you could advise the peer that they are welcome back if they feel like joining again.

It is also possible that a peer is very disruptive to the sessions.  In this case you might have a quiet word with them after the session. There is probably a reason for their behaviour that can be addressed. If they continue to be disruptive, you might suggest that the group is not right for them.

Facilitators leaving the group

The same reasons for leaving groups apply to facilitators as they do peers. Of course, with facilitators it is more problematic as without facilitators there is no group. We have also found that, understandably, facilitators can be concerned about leaving peers in a dependent state. If the group is to end without you, a priority should be to try and make sure that the peers are thoroughly connected with clinical services, and go to see a health professional if they have pressing concerns. Beyond that, you could refer them to other support groups in the local area – see ‘Local facilities’ page here.

If there is more than one facilitator, the other/s can take over whilst new facilitators are recruited, if appropriate. The first obvious source of new recruits is the existing peers. As a facilitator, you might make suggestions for who could take over and see if they feel comfortable with the idea. If you are a facilitator and are thinking of leaving the group, if possible it would be good to provide some notice so that the group can make efforts to find a new facilitator.

Finally, one alternative to leaving the facilitator role completely is to carry on support via telephone or internet. For example, we had one facilitator in our study who had to move abroad, but was happy to stay in e-mail contact with her peers. Whether this an option or not will of course depend on the individual facilitator(and their peers).

As with disruptive peers, other facilitators can also be similarly disruptive. Hopefully this will be less likely with facilitators who have trained for the role. If this situation arises, we suggest that you speak to healthcare organisers for advice.

Dealing with the emotional aspect of groups ending

When groups have run their course and all participants feel like there is not much else to be gained from it, naturally they will end. Many peers and facilitators are surprised at the emotion involved when this happens. It can be quite upsetting if you happen to have got close to others in the group and suddenly the group no longer exists. When a significant source of social support disappears from your life, there is a need to fill that with other support. Immediately you may want seek support from friends and family. In the longer term you may want to find other support groups. Of course, the people in the group can always stay in contact with each other! If this is not possible and you or your peers feel like you need someone to talk to, we would advise that you talk to a healthcare professional.

The seasons as natural end points

When thinking about ending groups, taking into account how the seasons and their holidays structure people’s lives is useful. Over Christmas and the summer holidays for example, people are probably going to be less engaged with attending support groups. They may then decide to re-engage afterwards or end their participation. ‘Anchoring’ people’s endpoints to natural seasonal breaks will allow for a less abrupt way to end things, if indeed people want to leave the group. Of course, these points also apply to recruiting new members. It is probably a good idea to try recruiting new people just after the Christmas and summer holiday seasons.

Information for organisers
When people leave groups or groups come to an end altogether, you will probably want to try to make sure that its members feel like they can turn to other sources of support should they need it.
Another thing to consider is that there needs to be a mechanism to intervene when recruited facilitators are being disruptive to a group or otherwise not following the programme. This might involve letting the facilitators know that the process is not right for them, following a warning of some kind. In this case, monitoring will be necessary. To learn about such facilitators in the first place, it would be good to have a peer reporting system. This might be assurance given out to peers that they can contact you if they feel the facilitator is not fulfilling their duties correctly.