The Young Survival Coalition (YSC) has hosted virtual groups for the past five years. The groups started as pilots to see if they would “take” and then became regular programmatic offerings. The virtual groups were based on particular topics or stage in treatment or survivorship. Some of them dwindled just like other support groups, while others remain robust. The technology used was Adobe Connect. It wasn’t the best because it required users to access the meeting with an internet connection to see screens as well as dial in on a phone. Those who wanted to participate were sent a series of email reminders before each meeting and a follow-up message after the meeting.

During 2019, YSC switched from Adobe Connect to Zoom, which prompted a look at guidelines and processes. Here’s where we are: I send reminders to those who are in our Salesforce database. Salesforce is a constituent management system that allows us to see who registers for an event. We use an email platform called Pardot, which allows us to track who has received and opened the email. During our first year using Pardot, we noticed that sometimes those emails go straight to junk/spam.

Zoom allows users to click one link and access both video and audio and does not require a separate dial-in number, but the option to just dial in for audio access is also available. We are not bound by HIPAA, but we do have a confidentiality policy. We don’t share constituents’ information. If they want to exchange it themselves (similar to in-person groups), that is their choice.

For professional facilitators, we have a contract that has been vetted. There are support group guidelines attached to that agreement. For our professional facilitators, we ask for a copy of their license and proof of liability insurance. If the group is peer-led, there is no contract. If you are someone whose reaction is “Oh, I’m covered through my hospital/agency,” I strongly encourage you to obtain professional liability insurance on your own. I recommend having a plan in place to ensure you have appropriate liability coverage and have made good faith efforts to ensure the safety of anyone who participates in a virtual group.

When an individual registers for one of our virtual groups, there is a mandatory agreement of confidentiality. I tend to err on the side of being conservative when it comes to rules and protecting clients. In this scenario, the clients are (a) YSC, (b) the facilitators and (c) the constituents. Even if someone expresses that they don’t care about their information being shared, you should.

Facilitators are reminded (even if they are world-class therapists) that their role is to be a shepherd. They are to share at the meetings that if someone finds themselves in distress or crisis in between meetings, they should either (a) refer back to YSC, (b) call their health care provider, (c) call 9-1-1 or (d) call the National Suicide Prevention Lifeline. This topic surfaced on SWON recently, and I held a Zoom meeting with those who responded with interest. A question came up about what to do if someone on the call expressed suicidal ideation. We all agreed that the facilitator would need to try to contract with that person right away. It is important to note that this would be the exception rather than the norm. There are no guarantees that the person in distress will stay on the line or agree to any additional contact with the facilitator. This is part of the stickiness of virtual meetings. The person expressing suicidal ideation could be in Idaho, while the facilitator is licensed in California. His/her license is  not going to cover that person. Having that understanding up front about who to call is important.

If a facilitator decides to connect 1:1 with an attendee of the group, it is made clear that they are doing so not as a representative of YSC. For those in the hospital setting, this will be a more stringent process. You may need to meet with Risk Management to determine what is or is not allowed or possible. It could be that offering virtual meetings is brand new territory. Having attendees sign something in advance that doesn’t hold the hospital liable or responsible may be needed. I don’t know what that is. You may be breaking new ground here.

If you are considering an online support group I would definitely give thought to:

• What platform will you use for the group? Will it be a phone call or also include a video element?
• How will you manage registrations for the group and how will you send reminders or confirm registration?
• What is your plan for emergencies that may develop while a group is live?
• What kind of liability coverage do you have?

I hope this is helpful and wish you well in your endeavors to further connect and help support your clients.