By Tiffany Washington, MSW

A wide range of emotions are associated with the diagnosis and management of a chronic illness, including anxiety, fear, depressed mood and feelings of isolation. Kidney patients and their loved ones may not be aware of the different community services available to help deal with these emotions. As a resource, support groups provide encouragement and education as a way to cope with the disease process.

Support groups are effective interventions offering an opportunity to better manage adjustment to the illness. Support groups serve many purposes. Group services of the early 1800s served as arenas for community socialization. Later in the century, group support services evolved to a more social welfare focus. Today, groups of all types exist, including educational, problem solving, skillbuilding, self-help and therapeutic. Groups can be open to the public or closed to a specific category of people who share a common illness or struggle, and some could require membership fees. The duration and size of a group may vary depending on its purpose and location. Other specific characteristics are determined by the overall purpose for the group.

Benefits
As a kidney patient seeking services, there are other therapeutic options available, including individual counseling. While a group setting may be ideal for some, it requires careful consideration of the following benefits:

1. Goal-setting.
The demands of negotiating kidney disease are understandably overwhelming. Diet modifications, increased number of medications and functional status changes become difficult to adjust to. Support groups motivate members to set and adhere to treatment goals. Individual members contribute to the group by offering success stories about meeting treatment goals, particularly when they’ve experienced difficulties. Hearing the stories of other members with similar experiences encourages individuals to develop plans for staying on target.

2. Information, information, information.
Belonging to a support group is an excellent way to keep up with current trends of medical interventions. Information can be shared both formally and informally. Leaders of educational support groups, for example, teach and distribute information on various topics related to kidney disease. By doing so, individuals increase their understanding of treatment options and other resources. Expert speakers are available at times to answer questions and offer professional advice. Informally, members share information about their experiences and coping skills from a patient’s perspective. Knowledgeable patients become self-advocates and tend to participate more in their care.

3. Make new friends.
It is not uncommon for someone to feel isolated in their experience. The interpersonal setting of a support group helps to minimize feelings of isolation and withdrawal. Members share similar experiences and strategies on how they’ve managed to cope and effectively function at home, work and or other social venues, as well as maintain an acceptable quality of life. It is helpful for individuals to meet others with similar experiences and talk about how the disease has affected their life. As members share, a unique bond is formed, possibly leading to long term friendships.

4. Family adjustment.
Family members often experience grief and coping difficulties alongside the patient. Groups with a focus on adjustment to chronic illness often invite family members to participate. Family members who participate in support groups become advocates for their loved ones and are motivated to continue learning. This motivation becomes an overall family theme, helping patients to stay on track.

5. On-line support groups.
While it is very important to research the creditability of on-line support groups thoroughly, the increasing trend of belonging to on-line support groups are possible options for individuals and families who have access to the internet. Internet options are particularly useful for individuals and families who experience physical limitations or economic and transportation hardships and prefer to remain at home. Internet groups offer similar benefits as face-to-face meetings but in an alternative setting.

6. Locating a group.
Locating the right support group may take time. Organizations often utilize bulletins or newspaper listings to announce group availabilities. Social workers can assist patients in researching support groups in geographic areas lacking options with kidney disease as a main focus. Some dialysis and transplant centers offer short-term or on-going support groups led by patient representatives or members of the treatment team. Local and national patient organizations continue to grow offering various types of internet and face-to-face support. A group setting is not a pragmatic choice for everyone. Guidance is available to determine if the choice is right. Social workers work closely with other members of your healthcare team to make recommendations for therapeutic interventions. Once membership to a group is initiated, welltrained group leaders guide members through the phases of group work and act as a resource for participants with difficulties benefiting from the experience. The long-term benefits of support group participation for kidney patients include a decline in stress and anxiety, improved quality of life and greater hope for survival.

References
1. Zastrow, C. (1997). Social work with groups. Chicago: Nelson Hall Publishers.
2. Taylor, C.B.; Luce, K.H. Current Directions in Psychological Science, Feb2003, Vol. 12 Issue 1, p18-22, 5p

Tiffany Washington, MSW, is a social worker and doctoral student at the University of North Carolina School of Social Work. She is also the NC Council of Nephrology Social Workers (CNSW) Chair and the CNSW Region II Representative.

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