Running Groups Online: The Virtual Therapeutic Community

group online.jpg

The past few weeks have introduced a lot of novelty into my life.  I’ve gone from someone who went to work every day to someone who is trying to work out how a way of working based on relationships can continue in a world where people can’t be physically together.  Some sacred cows of Mental Health work are being slaughtered.  Early last year I was in a meeting where people argued passionately that it was unthinkable for patients to occasionally meet their therapists in different rooms.  Now we are learning that it is contact that is essential, while the medium and environment come in a distant second.

Keir offers therapy, consultation and training around complex mental health issues via Beamconsultancy.co.uk

I love working in our day therapeutic community.  This is a group that runs for five and a half hours where the members share power with staff.  All our decisions are made by agreement, consensus and if required, by voting.  As the members always outnumber the staff this means that they hold the decision making ability in the group.  This level of empowerment/coproduction isn’t common in services and while it is cherished by its members, it can make organisations feel anxious.

Last week the group was cancelled as a response to the government advice to self isolate.  A lot of my weekend was spent trying to find a way to run a group without anyone actually being present.  One of the most useful things I found was this:

https://www.nhsx.nhs.uk/key-information-and-tools/information-governance-guidance

This gave out advice encouraging the use of video conferencing endorsed by the Information Commissioner’s Office, the National Data Guardian and NHS Digital. 

I went into work (the living room) on Monday hoping to work out a way to set up a meeting on Zoom.  To my knowledge, Central and Northwest London, Leeds and Northwest Boroughs are using this for video calls with patients.  

After speaking with managers in work I was encouraged to use Accurx.  I set this up and the test version (3 images of me on different devices and a guest appearance from @hoppypelican) seemed to work well.  When I tried it today it soon became apparent that on our version we could only have 4 people in a meeting at once. 

I spoke with IT who suggested Webex.  This is something I’d never used before but it wasn’t too bad.  You go to the website and sign up.  This eventually takes you to a place where you have the option to START A MEETING.  You’re then given the option to download the app or you can do it through your browser.  I downloaded the app.  You then end up in a meeting with a screen full of your own face.  Clicking on … lets you invite participants and there’s an option to COPY MEETING LINK.  I chose this and then emailed and text the link to everyone who was due in group.  Some people opted to join using the app on their phones, most people preferred to use their laptop. 

For the next 2 1/2 hours we help a group when we thought that it wouldn’t be possible.  We spoke of how different things would be. The uncertainty about privacy. The greater need for confidentiality. At one point we had 9 participants with everyone talking about how good it was to hold on to each other during these difficult times.  It wasn’t perfect, people had some issues with sound, some of us found it weird to be sharing the background of our living rooms and it took some of us longer than others to log in but we learned that it could happen.  On the positive side, eye contact seemed easier over the computer.  People who sometimes disappeared in group were more present than ever. 

Losing the physical contact with people will be very difficult to get used to.  We might all be learning some lessons about how we connect with people that we can’t be with.  What I’m often told is that it’s that connection that allows people to hang on. We need to keep people connected in these difficult times, particularly those who feel unworthy of care and compassion.

What I hope people can take from this example is that in the current emergency, groups do not have to stop.  Not only is it possible to do groups, people are doing them.  If I can help you to keep your groups going drop me a message Keir Harding OT on facebook, @keirwales on twitter or through the website.  

#StayAtHome (and run groups)