Safer space

Online group therapy through conversation

Safer space is designed to be therapeutic. To encourage curiosity about our experience in groups and to build a community of mutually helpful relationships.

What is Safer space?

I provide a consistent space for people with problems to talk together. Spontaneous conversation within a time limited and commonly understood framework. The content determined by the participants at each group.

Safer space is a seventy minute group with a ten minute break in the middle (30:10:30) mins. The number of participants is limited to eight. It happens each Thursday 6pm - 7.10pm through ZOOM video conferencing. We operate a donation model so you can decide what monetary value the group has to you.  Book today


I have devised, supervised, facilitated, clinically governed and been a member of therapeutic groups across my twenty year career in mental health. These have been in high secure settings, open forensic wards, CMHT's, charitable organisations and in the community. The group structures have included anger management, anxiety management, self advocacy, intensive outpatient addiction rehabilitation, open addiction groups, ward talking groups, therapeutic music groups and community talking groups.

What are the boundairies?

The group process has a consistent boundaried structure. Boundaries are an agreement on how we communicate with each other in the group.
The group content is determined by the participants at each group.
Please respect other people's roles in the group and the topics they raise.
People can come and go from the group during its operation.
People do not have to speak if they do not want to, it is fine to just listen.
Confidentiality - what is said in the room stays in the room. Unless people are put at risk by this rule. Also please note the facilitators will receive supervision where group content will be discussed nb. A detailed description of confidentiality in online therapy groups can be found below.
Please communicate to the facilitators if you feel there are significant risks for individuals subsequent to the group.
Please do not bully others, or yourself, with words, emotions or actions.
If you need to use a phone please take yourself, and the phone, outside the group.
Being under the influence of illicit drugs or alcohol will prevent you being able to consent to being in the group.
The facilitators may keep written notes of your participation. In collecting and storing this data they are all registered as data controllers under GDPR and have privacy policies. Each facilitator also has their own supervisor, professional indemnity insurance and professional body who governs their practice. For Andy this is the Health and Care Professions Council (HCPC.)

What will the facilitators do?

Hold the group boundaries
The primary effort of facilitation will be to maintain a conversation.
The group’s therapeutic potential lies in the opportunities conversations provide for therapeutic human interactions.
Simply put how things are talked about is more important than what is talked about.
Facilitators are encouraged to talk about their own experience of a topic if it was viewed to be in their and the group’s best interest. In this way the facilitators will make themselves vulnerable to help the group. Deliberately practising new ways of communicating, understanding, and feeling to help the group.
Facilitators will make introductions at the start of each group. Welcome latecomers and thank early leavers.
Individuals should not be targeted rather ideas and facts should be the main focus of discussions.
Participants are invited, but not pressured, to comment on each other's suggestions and there is an assumption that expertise is shared amongst people in the meeting.
There is an expectation of curiosity, rather than judgement, about your own and others' experiences in the meeting.
Acceptability of conflict in a group is communicated – this being tolerated and accepted within the limit of not causing others significant distress.
Silences are OK but we would not expect them to be lengthy i.e. more than one minute.
The facilitators as professionals have safeguarding responsibilities towards the group. If any member has significant concerns about the health and/or safety of another individual. This may need to be taken outside the group to other responsible agencies. if this is the case those involved will be informed prior to notification.
Examples of necessity for further enquiry: presentation under the influence, unusual cognition or memory, speech or interactions

The detailed framework and how I manage Risk

The group is a stepping stone between closed group therapy and a peer support group. The group is based on the facilitators clinical experience of, and evidence for, therapeutic groups.


Entry criteria:

Adults (16+).

Adults who want to help themselves and others in a group setting.

Participants must be assumed to have capacity to participate unless it is established that they lack capacity. If we feel the need to investigate if someone has the capacity to make decisions about their participation. We note that participants need to be able to understand, retain and use the information about their participation and communicate their decision.


Exclusion criteria:

People for whom the intervention seems detrimental in terms of risk to self or others.

Repeated breaches of group boundaries

Group risk assessment and management processes

Two guiding principles a) I will take all reasonable steps to reduce the risk of harm to service users, carers and colleagues as far as possible. b) I will not do anything, or allow someone else to do anything, which could put the health or safety of a service user, carer or colleague at unacceptable risk.

Risk assessment in the group principles: I aim to balance the seriousness of the possible outcome with the possibility it may occur based on specific risk factors. In questions of risk we will attempt to use multiple sources of information, collaborate with the participant, communicate with each other and if necessary other agencies in making decisions.

Risk management: Participants will be provided with the contact details and availability of facilitators outside the group. In addition participants will be provided with a crisis information leaflet details emergency helping resources if they suffer an adverse reaction to the group.

Limits of confidentiality in online group therapy

I work within the codes of ethics of the Health and Care Professions Council (HCPC) and the British Psychological Society (BPS.) These include a duty of confidentiality, unless there is a significant risk of harm occurring by that confidentiality being maintained. I am also compliant with the General Data Protection Regulation (GDPR.) As such I am a registered data controller with the Information Commissioner's Office (ICO.) 

There are additional potential breaches of confidentiality in an online therapy group. Participants need to be aware of and accept the risks involved. Groups will not be recorded.  Potential breaches to confidentiality may include, but are not limited to: 

  • A group member attending group in a non-secure location where a nonmember (such as a family member or roommate) can see or hear the group.

  • A member recording or taking a screenshot of the group members.

  • A member using recorded material to share the identity of the group or a specific member.  

How does it work?

In terms of motivational interviewing, cognitive and behavioural (CBT) models

The group process works by participants practising a variety of ‘good habits’. These ‘good habits’ are the, evidenced based, psychological means to recover from a variety of other mental health problems. They are the change mechanisms of motivational interviewing, cognitive, and behavioural psychotherapies:

Increasing our self-awareness by communicating our experience, reflecting upon it, and being open to other people's experience.

Practising constructive emotional expression with others.

Identifying and evaluating the helpfulness of our thoughts, feelings and behaviours.

Evaluating and practising alternative ways of being.

Reducing the strength of, and choice of response to, our distress related triggers.

Rewarding ourselves, and each other, for working on our problems.

Learning through observing other people.

Increasing our self-confidence through successes in the group

Practising decision making about our participation in, and the content of each group.

Increasing our sense of connection by asking for help, receiving help, offering help and helping.

References

Colon Y., Friedman B. (2003) Conducting group therapy online. In: Technology in Counselling and Psychotherapy. Palgrave, London

Gentry, M. T., Lapid, M. I., Clark, M. M., & Rummans, T. A. (2019). Evidence for telehealth group-based treatment: A systematic review. Journal of telemedicine and telecare, 25(6), 327-342.

Hayhoe Benedict, Verma Anju, Kumar Sonia. Shared medical appointments BMJ 2017; 358 :j4034

Richards, D., & Viganó, N. (2013). Online counseling: A narrative and critical review of the literature. Journal of clinical psychology, 69(9), 994-1011.

 

07503316840 / 01870 603701

©2020 Dr Andrew Perry, Linlithgow, Scotland