Support Group

COVID-19 - Promoting Support Group Attendance

Promoting Support Group Attendance

To provide guidance to addiction treatment providers and programs to support access and participation in support groups and recovery activities to mitigate risk of COVID-19 transmission.

According to the CDC, “the virus that causes COVID-19 seems to be spreading easily and sustainably in the community”. Since the virus can be spread before a person develops symptoms and by individuals who contract the virus but never develop symptoms, widespread social distancing is indicated to prevent the spread of this illness. Current federal guidance recommends that gatherings should be limited to no more than 10 people with adequate space to allow participants to remain 6 feet apart. Some states have prohibited all gatherings for the time being. 

Support Group Guidance

Please read our content disclaimer

Reopening

While many places across the country are starting to relax physical distancing restrictions, the COVID-19 pandemic is not over. Communities and treatment programs across the country remain at risk for increasing population prevalence over time.

To ensure the timely dissemination of this document, this resource was developed using expert consensus and was not vetted using the usual standards set by the ASAM Quality Improvement Council.

Updated: 4/14/20

Online Support Groups 

Programs and providers should provide resources for online support groups for patients who cannot or should not attend in-person groups due to risks associated with COVID-19.  Online support groups may be offered in a variety of formats including discussion groups, chat and live meetings via teleconferencing technology.  Patient preferences, recovery environment, access to technology and experience with online resources are considerations that may affect patient access and use of this resource.

12-Step Groups


Additional Recovery Support Tools and Resources

Recovery Support Apps

Sober Grid allows you to create online profiles and interact, support, and engage with other people in recovery using a platform similar to Facebook. You can also use the app to create anonymous check-ins about whether you’re sober or not, your mood, and what’s going on.

SoberTool is an easy way to track your clean and sober days. The app includes daily motivational messages and reminders to keep you on target

The WEconnect provides you with daily reminders to stay on track with your recovery plan. You can create reminders to call your sponsor, go to a group meeting, or meditate—anything you need to provide that extra push.

AA Big Book This app gives you access to the full text of the Big Book, along with a meeting finder, podcasts, prayers, and personal stories. You can use the app to bookmark meaningful passages, make notes on individual chapters in the comment section, and search for specific keywords.

12 Step Meditation Daily Reflections for AA, NA, Al-Anon This app features hundreds of easy-to-follow guided meditations, as well as soothing music, prayers, and 12-step recovery audio.

I Am Sober to track your sober days and milestones, build new habits, and enjoy ongoing motivation from a community of people who get it.

Pink Cloud find meetings near you based on your location

Meditation Apps

Headspace

Simple Habit Daily Meditation

Calm

Stop, Breath, and Think

Ten Percent Happier

Podcasts

The Bubble Hour: invites listeners to share their stories of recovery from alcohol addiction. Each week, host Jean McCarthy holds space for a guest to tell their truth, and together they explore topics relative to recovery.

Busy Living Sober: a podcast with the mission of “giving people an opportunity to listen, learn and live a sober lifestyle without shame while having fun.”

The Addicted Mind is about understanding addiction, its impact and the latest treatment options available. This podcast aims to create an environment of compassion for individuals caught in the destructive grip of the addictive process. It works to deliver real hope to people who are suffering from addiction’s painful impact.

The Sober Guy: Host Shane Ramer is in recovery from alcohol. He interviews a mix of celebrity guests and everyday people who have experienced addiction or felt the impact of drug or alcohol use. He focuses on living a positive, healthy and sober lifestyle, and uses his podcast as a platform for sharing inspiration with others who want to live the same way.

Let’s Talk Addiction and Recovery: Hear what leading addiction and recovery experts are talking about—addiction trends, topics and challenges as well as research, practices and advances that point the most promising way forward. Provoking interview series, brought to you by Hazelden Betty Ford Foundation.

The Boiled Owl Coffee Club: Casual conversations about recovery in Alcoholics Anonymous. Listen online or with any podcast management app.

Ten Percent Happier Podcast

 

Recovery Recordings

 AA History Symposium 2019 Recordings (free)

  • Why I Study  A.A. History - Newton P., U.S. Trustee-at-Large
  • A.A. on North American Reservations - Don C. (Colorado Springs, CO), Rod B. (Salt Lake City, UT) & Greg M. (Henderson, NV)
  • The Untold Story of A.A. in San Quentin Prison - Jackie B. (San Francisco, CA)
  • The Debate over Special Purpose Groups - Joe C. (Toronto, ONT)
  • Bill's "Spook" Sessions - Dan Carracino, Co-Director of the PBS documentary Bill W.: The Creative Force Behind Alcoholics Anonymous
  • Early Group Problems - Kevin Hanlon, Co-Director of the PBS documentary Bill W.: The Creative Force Behind Alcoholics Anonymous
  • Dr. Bob’s Letters - Michelle Mirza, GSO Archivist
  • “Varieties of Spiritual Experience” - Jay S. (Sedona, AZ)
  • “Alcohólicos Anónimos” Carrying the Message to the Spanish-Speaking World - Juan R. (Holister, CA)

https://www.aahistorysymposium.org/2019-album

Password: thebroadhighway

Recovery Readings

12 Step

Alcoholics Anonymous: https://www.aa.org/pages/en_US/alcoholics-anonymous
Twelve Steps and Twelve Traditions: https://www.aa.org/pages/en_US/twelve-steps-and-twelve-traditions

Recovery Dharma

https://recoverydharma.org/book

Refuge Recovery

https:refuge recovery.org/refuge-recovery-book

Etiquette for online-support groups 

Participants in online support groups should conduct themselves in a manner that comports with the norms and expectations of the group and basic rules of etiquette that apply to in- person meetings

Similar to in-person support group meetings, online meetings may have varied expectations about etiquette and norms that are specific to the particular group or meeting.  For new participants, it may be helpful to review supporting materials made available online by the meeting organizer prior to attending the first meeting.  In addition, spending time observing the group format and interactions of members can be beneficial for new members. 

In general, basic rules of etiquette that promote a safe, respectful and supportive group environment during in-person meetings apply equally in online settings.  These include:

  • Punctuality

  • Civility and avoidance of profanity

  • Contribute by sharing while being mindful of time and others’ need to share

  • Not giving advice or “cross-talking” (speaking directly to an individual member of the group vs sharing with the group itself)

Some considerations specific to the online setting include:

  • Avoid distractions and interruptions:  Try and find a quiet, private space free from distractions. If attending by video, dress as you would for an in-person meeting. Checking email, texts or having other screens, windows or browsers open while engaged in live online support groups decreases the benefit to all.  Silence mobile devices.

  • Text-based forums such as discussion, chat, or list-serves can result in communication failures and misunderstandings.  Be aware of the limitations of these modalities and the challenges of interpreting meaning in the absence of non-verbal cues.

  • Unfamiliarity with online communities:  Most have FAQ’s and other resources that can help familiarize new users.

  • Poorly-run groups:  Well-run groups have a moderator or otherwise identified group leader to keep the meeting on track and consistent with the group’s expectations.  A poorly run support group can be worse than no group at all.  Fortunately, it is easier to quietly exit a poorly run online group than an in-person group and you should not hesitate to do so if the experience is not a good fit for your needs.

   

Resources

Zoom instructions about meeting recording notifications: https://support.zoom.us/hc/en-us/articles/360000486746-Recording-Notifications

Protecting online Zoom meetings from harassment and unwanted participation

As zoom use have been growing to accommodate the current situation, we are hearing of multiple instances of “Zoom Bombings” – intruders are joining meetings uninvited and disrupting them. These instances could be especially troubling for support group meetings. To avoid “zoom bombings”, there are a few steps that could be considered to help provide groups with a safer environment:

  1. Mute audio and disable video and screensharing for attendees
    As the host, you can disable video and screen sharing as well as mute all attendees upon entry. Set “screen sharing” to “Host Only”. This will protect the meeting from any unwanted content. During the meeting, you can enable all these options for individuals or the group, if you need to.

    Additional information: https://support.zoom.us/hc/en-us/articles/203435537-Mute-All-And-Unmute-All
  2. Protect your meetings with a password
    A password will protect you from hackers, but will not necessarily protect from unwanted attendees. Be careful with who you share the password with and instruct the group to not share the password with strangers.

    Additional information: https://support.zoom.us/hc/en-us/articles/360033559832-Meeting-and-Webinar-Passwords-
  3. Never use your personal meeting ID when scheduling a meeting
    When creating a meeting, you should always choose the "generate a random meeting ID" option. If you use your personal meeting ID instead of generating a new one, that ID could get leaked and Zoom bombers can use that to join your future meetings.

    Additional information: https://support.zoom.us/hc/en-us/articles/201362373-What-is-a-Meeting-ID-
  4. Modifying the name you log in with as a participant
    Encourage your group to review instructions for using the platform your using, and make sure they pay attention to the option of modifying their name when they log in.

    Additional information: https://support.zoom.us/hc/en-us/articles/201362193-Joining-a-Meeting
  5. Use a virtual background
    You can also encourage the group to consider using a virtual background. This can be used to cover up anything behind them that could be used to identify who, or where, they are.

    Additional information: https://support.zoom.us/hc/en-us/articles/210707503-Virtual-Background
  6. Enable waiting rooms as a host
    As a host, you have an option of creating a waiting room. When a participant logs in, they will be sent to a waiting room, where you can review attendance and admit individuals into the session.

    Additional information: https://support.zoom.us/hc/en-us/articles/115000332726-Waiting-Room
  7. Encourage your group to communicate with you if they become suspicious of anybody
    Inform your group of potential issues with unwanted visitors. Let them know they can send you a private message through the chat if they have concerns regarding a certain individual in the meeting.

    Additional information: https://support.zoom.us/hc/en-us/articles/203650445-In-Meeting-Chat
  8. Do not record the meeting
    Zoom does not automatically record meetings, but the host can choose to record and save the video to their computer or upload it to Zoom’s servers. Participants are alerted through the Zoom platform when the meeting is being recorded, and can choose not to participate. Hosts should also ensure that participant recording is disabled:

    Additional information: https://support.zoom.us/hc/en-us/articles/201362473-Local-Recording
    Hosts should consider not recording unless there is a compelling reason to do so. If you do record:
    • The default name of the video can make it easy to predict what it contains. The host should rename the file so it is less easy to identify.
    • Be careful where you store or post the video (e.g. Amazon, Dropbox, Google, YouTube, Vimeo). Make sure your accounts are set to private and protected by a strong password.
    • https://support.zoom.us/hc/en-us/categories/201137166-Audio-Video-Sharing

Confidentiality

Support group leaders and participants should be aware of the risks and benefits to anonymity and confidentiality in online environments and take measures to promote online privacy.  Online environments offer unique opportunities for enhanced privacy but also can present special challenges.

Privacy considerations: 

  • Register with an anonymous username and email account.  Turn off the video setting for live teleconference meetings if you do not want video to be captured and/or verify that the meeting is not being recorded. 
  • Video teleconference support groups:  Be aware of what is visible in the background of your webcam and that it does not inadvertently reveal information about your or others.
  • Features of teleconferencing apps that promote privacy:

Screen capture disabling: screen captures are disabled on participant’s device while logged into the meeting

Images cannot be sent by participants logged into the meeting

Device /user information is removed from logging and reporting

Meeting recording is disabled. 

  • Anonymity and hoaxes:  Anonymity is, for some people, a key benefit of online support groups.  However, this anonymity can also be exploited by those who seek to misrepresent themselves or carry out hoaxes.  False representations are a risk with any internet social activity.  Support groups are not immune and participants should be aware that the intimacy and vulnerability that promotes healing can also lead to a misplaced sense of security.   Remember to exercise the same level of care you would with anyone unfamiliar to you.  

Resources

Washington Physician Health Program Teleservices Agreement:  Example document contains instructions for using Zoom teleconferencing interface, decorum and expectations for Zoom support meeting attendance, and security features such as disabled recording, screen capture, and end to end encryption:  https://wphp.ellucid.com/documents/view/376/security=6f43a766c0233d4405f174687733c532e631ec01

How can I be sure recording is disabled on Zoom calls?  https://support.zoom.us/hc/en-us/articles/360000486746-Recording-Notifications

Considerations for small group meetings with proper social distancing

Infection control is a shared responsibility among support group leaders/planners and participants who should work collaboratively to decrease the transmission of COVID-19 per public health recommendations and orders.  Under conditions of active community spread of COVID-19, social distancing is one of the most effective public health strategies for reducing transmission of the illness.  During community spread of COVID-19, decreasing the rate of new cases is critical to controlling the illness and supporting the integrity of the health care infrastructure.  Social distancing requires us to minimize our contact with others to the greatest extent possible.  This means working remotely when possible, school and restaurant closures and bans on gatherings and events. 

When social distancing recommendations are in effect, it is prudent to cancel most non-essential events and gatherings, including support group meetings.  However, in some circumstances, such as residential or intensive treatment settings, a risk-benefit analysis may favor continuing limited, smaller group meetings.  The availability and practicality of implementing proper precautions may influence decisions about canceling or continuing such meetings. 

Policies or practices to consider

  • Limit meetings to 10 or fewer participants
  • Individuals at high risk for complications of COVID-19 infection, who are feeling sick or have been exposed to a suspected or confirmed case of COVID-19 should self-quarantine and not attend group meetings of any size
  • Participants (including staff or volunteers) should be screened for symptoms of COVID-19 prior to group attendance
  • Make arrangements such that participants are outside of close contact and can maintain a distance of 6 feet from other participants in a well-ventilated space for the duration of the meeting
  • Educate and practice respiratory hygiene (cover coughs, wash hands, dispose of tissues)
  • Do not share food or drinks
  • Infection control practices including hand hygiene and environmental sanitation (as described in section 3 above) should be implemented

Resources

https://www.whitehouse.gov/wp-content/uploads/2020/03/03.16.20_coronavirus-guidance_8.5x11_315PM.pdf

https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/index.html