FORUM: An Innovative New Model of Peer Support Group That Merits Watching

A Peer Support Group, also described as a “self-help group” or a “mutual aid” or “mutual help” group, refers to a group of people who gather together to talk about shared problems or experiences and to provide informal support to each other.  The network of available peer support groups is huge!  There are more visits each year to peer support groups than to mental health clinicians.  There are as many as 120,000 AA groups alone. 

 One of the reasons for their success is that they are developed and facilitated by people in recovery and virtually all are free. The agenda of these groups is clearly focused on the recovery of people who attend.  It is not to make money.  This lay model of leadership does create some challenges.  The quality of facilitators can vary widely between groups, which means that meetings that are poorly facilitated can be less than helpful.  I have certainly been to meetings that were not helpful, in part because the facilitator did a poor job.

 Forum is a new for-profit organization that takes a different approach to providing peer support.  Forum clearly promotes the value and desirability of peer support for people facing many different challenges. The organization works with facilitators to develop small virtual peer support groups (6-15 people) that focus on very specific topics. 

 At the time I am writing this, there are 118 groups advertised on the Forum Website (https://app.joinforum.com/support-groups).  These groups are organized by the following categories:

1.     Career and Business (one example is a group called ‘Calm Through Change: For Entrepreneurs Facing Uncertainty’)

 2.     Family and Relationships (e.g. Confident Parenting for Managing the Anxieties of Raising Young Kids)

 3.     Health and Wellness (e.g. Navigating Cancer: Peer Support for Men)

 4.     Life Transitions (e.g. Grief 2 Growth: Coping with the Sudden Loss of an Adult Child)

 5.     Clinical (e.g. Beauty In The In Between Group- Post-Traumatic Growth for Women)

Unlike most peer support groups, FORUM groups have the following characteristics:

·        Attendance is not open – participants apply to attend, but are screened and then invited to the group.

·        Participants pay a fee to attend.  This is typically in the form of a monthly fee from $25-$50.

·        The facilitators are paid for their work. They receive a portion of the participants’ fees in compensation for their work.  This compensation is tied to the number of people who attend, and so creates an incentive for the facilitator to encourage members to attend.

·        Forum employees help recruit for the group.  Using online tools, they publicize the groups to people identified as likely to be participants. 

This is a very big change in how peer support groups have been organized, resulting in several key advantages:

1.     The groups are small and focused.  The conversations are likely more specific and people are likely to connect more quickly because of the greater degree of similarity.

 2.     The active recruitment work by FORUM staff helps ensure membership, and takes some of the burden of promotion off of facilitators.  The use of sophisticated online marketing tools suggests that recruitment is likely to be successful – which is not always the case for many self-help group startups.

 3.     The fact that facilitators are trained, and there are quality assurance measures to ensure that facilitators do a good job, addresses a long-standing weakness of many self-help organizations that rely on untrained volunteers.  The quality of supports in organizations like AA vary widely.  If a group is well-facilitated, it is likely to grow.  If it is poorly facilitated, the group is likely to shrink.  The result is that you can’t be sure of the quality of any specific AA group without attending it first to see what it is like.  By training facilitators and evaluating quality, it seems likely that FORUM groups will have greater consistency in the quality of the group experience they offer.

 4.     The fact that the facilitators are paid creates an additional incentive for them to provide good facilitation.  Volunteer facilitators are typically motivated internally to be helpful.  The addition of an external monetary incentive has the potential to improve their work as facilitators.

Unintended consequences:

1.     The required fee for participants will limit who can participate to those with financial means.

 2.     The financial incentive for the facilitators can have a negative impact on the group.  I have a colleague who was interested in joining a FORUM group.  She met with the facilitator to talk about the group.  She ultimately decided not to join, stating that the facilitator seemed highly motivated to have her attend, which made her uncomfortable.  In most self-help groups, the decision to attend a meeting is based solely on whether the person wants to attend.  There are no additional incentives of any sort.  When additional incentives are present, like people who attend AA or NA because of the requirement of their probation officer, those incentives often result in problems. 

 3.     The financial incentive for the FORUM organization may have a broader negative impact.  It is possible that only certain types of groups result in financial benefits to the organization, and so “profitable’ groups will be developed instead of groups that may be needed but are less profitable.  Financial incentives often lead to a range of unintended consequences.

Forum support groups represent a major development in the way peer support is provided.  The way Forum is approaching this challenge is likely to send ripples through the field.  To the degree that their efforts encourage all self-help organizations to reconsider how they train and support facilitators, and monitor the quality of their groups, I think FORUM will have a positive impact.  To the degree that financially motivated organizations move into the huge area of peer support groups, I am less confident that we can tell whether there will be clear benefits or not. Money changes things.  The current network of peer support groups has developed without financial incentives.  The introduction of a profit motive may have a destructive impact on something that is currently quite wonderful.

Whatever you think of financial incentives in peer support groups, I think you’ll agree that Forum is an innovative approach that merits watching to see what lessons we all can learn from their experience. 

DISCLOSURE: I have no financial relationship with FORUM and not conflict of interest to report.

KEY WORDS: Peer Support Groups, FORUM, Innovation