Cancer type: Some support groups are organized according to the type of cancer a person has. For example, women with breast cancer may not be as comfortable in a mixed diagnosis group with men who have prostate cancer or other types of cancer. In some circumstances, this type of grouping seems more natural and enables people to address common issues more effectively.

Stage of cancer experience: The stage of the cancer experience is another way to organize a support group. The issues that arise for a person with a new diagnosis are different than for those who have recurrent cancer. Some would say this is the most important distinction in choosing a support group.

Open membership: Open membership in a group means that members may come and go within the group freely. There is often no requirement to sign up for the group ahead of time and no expectation that you will stay in a group over the group's time course. If you want to attend 2 meetings in the beginning of the group and are unable to attend the next 3, but want to return for the remainder, you are welcome to do so. This means the group's membership will change with each group meeting. Therefore, if you are interested in consistent or intimate relationships or friendships, this might not be your first choice for a group. However, if you are unable to commit regularly to a group, this type of group might be perfect for your current life situation.

Closed membership: In a closed group, the group members usually pre-register for the group. The group achieves a certain number or mix and is then closed to new members. In a closed group, the members are usually expected to commit to a certain number of sessions in attendance. The advantage of this type of group is the consistency of the group members and the ability to get to know one another well and therefore support each other more fully. Sometimes this is just not feasible for cancer patients or their families given the demands of the illness.

Therapy group: This type of group is different from the typical cancer support group. Therapy groups offer actual "group therapy," a type of psychological therapy similar to individual counseling but in a group setting. The therapy group is led by a mental health professional trained in group therapy practice. Members of the group are asked to participate as part of therapy and will be challenged by other group members about their input. The person in a therapy group will be challenged to actually change something within him or herself. Therapy groups are for those who have particular issues within their cancer experience that they need help with. This might include women with a history of abuse or men who experience depression. People who have problems relating to others socially often benefit from a group therapy setting. The average cancer patient or family member will not find this type of group essential.

Peer support group: This defines most of the existing cancer support groups. As the title implies, this type of group consists of those who have similar experiences. A lay person or health professional may lead this group. The leader may be a cancer survivor. Some would say this type of group provides the best experts — others that have been through the cancer experience. Shared experiences and information is glue that bonds people quickly. It can provide comfort, companionship, and a safe place to go with fear, guilt, pain, and depression. Not only is the peer network supportive, but it can also be fun and empowering. Laughing about the "weird" experiences one has as a cancer survivor is best done with others who have walked in your shoes.

Educational intervention group: An educational intervention group is a group that meets to share information on topics related to cancer. This type of group might include having a medical expert speak on a specific topic like infertility. Following the presentation, the group has a question and answer discussion with the expert. This type of group focuses more on medical information, but often provides some emotional support in the process of sharing. Sometimes having a concrete topic makes it easier to move into personal discussion with people who find it hard to talk about their feelings otherwise. Also having more information about your disease or treatment helps you feel more in control.

Coping skill intervention group: In this type of group, certain skills for dealing with cancer are taught. One example is relaxation training. Since having cancer and its treatment can be so stressful, it is helpful to learn how to help yourself relax. Another example might be to discuss how patterns of negative thinking interfere with your ability to cope effectively with cancer. Mental health professionals skilled in teaching these types of interventions generally lead these groups. The group learns the exercises, practices them at home, and talks about how they are working. In the context of easing one's stress by learning new skills, participants also get a chance to share their problems and experiences.

Telephone support groups: Telesupport groups are groups that communicate by telephone, often by conference call. This is helpful for people who are unable or unwilling to participate face-to-face. These groups can take any form. Some may be educational, while others may be focused on stress management. Some may have open membership, and others may be closed to new members. They can be time limited or ongoing. Sometimes participants contact each other in between group sessions and provide individual support. This type of group can be challenging since members are not able to see each other's facial expressions. Careful listening and concentration are required. This may be a good option for someone who is physically immobile yet desires more contact with people. It is important that these groups are affiliated with a reputable organization and hosted by a trained professional.

Children with cancer in the family support groups: Sometimes children try to behave like adults so life will be easier for their parents. A support group for children gives them a safe place to air their frustrations and ask questions (for example, "Did your mom or dad's hair fall out?"). There is a growing awareness that children of adult patients can benefit from support groups and in fact, have many of the same needs as adults. The primary need is to meet other children whose parents have cancer. Children can feel very isolated if a parent is sick and think that no one else has the same feelings and worries. Cancer is different from other problems that children experience. For example, most children know other children whose parents are divorced, but they are less likely to know other children whose parents have cancer. This can make them feel very alone and different from their peers. When children meet other children in this situation, it is comforting to realize that others have the same worries, such as:

• Why does my parent have cancer?
• Is it something I did that made it happen?
• Did my parent "catch" cancer from someone else?
• Will my other parent get sick?
• Can I get cancer?
• How will my life change?
• Will my parent still be able to take care of me?
• Will my friends at school know about Mom or Dad's cancer?
• Should I talk to my friends about it?
• Will people treat me differently?
• Will my parent die from cancer?
• Who would take care of me if that happens?
• Will I still be able to do things I enjoy?
• Will Mom or Dad still do "fun things" with me?
• Will I have to take care of Mom or Dad?

Support groups for children should be lead by professionals. People like schoolteachers or guidance counselors, art therapists, music therapists, oncology social workers, or nurses who have experience with children are examples of possible group leaders. The professional should be knowledgeable about cancer and the issues it raises for families. Parents can check with resources in their community to find support groups for children whose parents have cancer. Hospital social workers, nurses, psychologists, clergy members, and school counselors are good resources to ask about support groups in your area. Some cancer treatment centers offer support groups for children, although they are less available than groups for adults. The success of a group for children will depend on the professional's use of play therapy or activities to involve children and address tough issues. Adults receive help by talking about a problem, whereas children are less able to verbalize their feelings and worries. The professional should be experienced in getting children to open up through play, drawing, and games. A cancer survivor sometimes is able to do this if he or she has had experience or training in working with children in groups and knows how to safely talk about uncomfortable feelings.

The best kind of support program for children is one that offers a corresponding group for parents. Parents are a child's best teachers and you will learn from other parents about ways to deal with your children. Parents should expect feedback from the group facilitator about their child's participation in the group and what the professional thinks about the family's needs.

At first, your child may not be excited about the idea of attending a support group. People usually resist doing something new, and children are no exception. Once your child experiences the support and fun a group offers, he or she will probably be quite eager to participate.

Support groups for children with cancer: Children with cancer have support groups too. In these groups, kids can talk about things that are specific to their age group. Young adults or adolescents may particularly benefit from groups since they are mature enough to share verbally their concerns. Being independent, dating, planning for the future, and dealing with friends and family are some of the topics that young people discuss. If children are younger, groups engage in art and play activities that relate to their illness, rather than sitting around talking about it. Some are offered in hospitals and clinics, and others through local and national organizations. Camps are a way that children with cancer can have fun and be with others in a similar situation.

What Are Some Advantages to Being in a Support Group?

• Provides a connection in an experience that can feel isolating
• Provides support in hard times
• Provides information and coping skills
• Makes people feel less helpless about themselves and others because they are able to help others
• Offers tips that only cancer survivors can provide
• Allows powerful emotions to be shared

Revised: 02/24/2005