Leading a cancer-related support group is a demanding, challenging experience. The leader plays a vital role providing support and guidance. He or she has the primary responsibility for setting the tone of the group. This begins with the family's screening interview and continues throughout group sessions.

Co-leadership of groups offers certain advantages. If one leader is unavailable, employing co-leaders can help ensure continuity and familiarity. It also enables the leaders to share and process emotionally difficult information effectively. Co-leadership with professionals from other health-care disciplines provides a blending of skills. For a population struggling with the physical and emotional impact of illness, co-leadership by a social worker and a nurse provides one such example.

The most important task for the group leader is to create a safe atmosphere in which members feel free to participate without fear of judgment or ridicule. To accomplish this, leaders must be active forces in the group and consistently demonstrate, by verbal and nonverbal behaviors, that they can be trusted. No effective work begins toward problem resolution until such an atmosphere is established.

A number of common guidelines are applicable and useful to group leaders. The group leader:

• Sets the ground rules for the group, assuring members of confidentiality
• Takes an active part in the group, particularly in creating a safe atmosphere for participation
• Initiates and stimulates discussion and allows common themes to emerge
• Provides appropriate educational materials and information on issues of concern
• Monitors the emotional pulse of the group -- when painful topics continually are avoided, the leader may attempt to introduce them as needed
• Reinforces the predictability of feelings and places problems in a universal context when possible
• Works to instill hope for change and for improved quality of life for all group members
• Encourages networking of members outside the group for additional support and socialization
• Encourages members to participate in group discussions and strives to involve the more passive members as much as possible
• Leaves sufficient time to summarize the process at the end of the meeting
• Encourages reactions to the previous session at each successive meeting

These guidelines are considered to be standard for group facilitation and can be found in Oncology Social Work -- A Clinician's Guide, Diane Blum, MSW, ACSW, American Cancer Society, Atlanta: 1993, p. 116-117.