Resources for starting a meditation and behavioral health support group?

I’m interested in starting a local, in-person meditation and behavioral health support group. As part of this effort, I’m trying to assemble resources that can help to ensure that the group is run in a manner that is ethical, safe and protects privacy. I wanted to reach out to the Discuss and Discover community to ask if you have any suggestions for guides, instructional material, etc.? I come from a healthcare background, so I am very comfortable working in this space (I’ve taken care of patients who have severe, active mental health issues including suicide attempts, hallucination, significant cognitive impairments, etc.), but I know that a lot has already been prepared by others.

Goal: To discuss applied meditation practice and share lived experiences while finding support in a safe and tolerant space. We’ll begin with a 20 minute sitting meditation, then transition to a discussion/support group for 40-60 minutes. Participants can share challenges they’ve experienced, offer advice, and discuss application of mindfulness strategies, with an emphasis on incorporating practical guidance from the suttas.

Resources:

  1. Code of conduct for attendees: Is anyone aware of a code of conduct for a support group like this? Core principles would include respect for privacy, and non-judgemental comments. I’ll likely ask everyone to turn off their smartphones, and we can’t do this by Zoom since it is not privacy-compliant. We will likely need to include a legal disclaimer and links to mental health support options as well.

  2. Practice Guide for Participants/Group Leader: I searched Discuss&Discover and found a helpful post about running a meditation group (Running a meditation group | Sujato’s Blog ) It mentions having a practice guide and I was wondering if one was ever created.

  3. Group leader certification: This same website mentions that there is a risk that untrained individuals could run these groups. I see that there are several fee-for-service mindfulness training programs, typically costing $3000-$8000 and I know of a hospice chaplain at my hospital who has signed up for one. Are there any options for training that are not cost-prohibitive? Most likely not, but I thought I would ask in case someone else knows.

  4. Books: There is a growing interest in recognizing the negative side-effects of meditation, including handling distressing thoughts from past trauma (e.g. Trauma-Sensitive Mindfulness: Practices for Safe and Transformative Healing by David A. Treleaven and Willoughby Britton). I think that a practice emphasis on mindfulness of breathing (MN118) and metta meditation can help to mitigate some of these concerns, but it is important to be aware that issues may arise and a support group that meets regularly could help to provide a safe environment to discuss them on an ongoing basis. There is also a very large literature on Buddhist Psychology and I’m planning to read “Buddhist Psychology and Cognitive-Behavioral Therapy: A Clinician’s Guide” by Dennis Tirch, Laura R. Silberstein-Tirch as a start.

  5. Recommended suttas: I was hoping to assemble a collection of short, practical suttas as a reference. I think that MN19 (Two Kinds of Thought), MN20 (How to Stop Thinking) and MN118 (Mindfulness of Breathing) would be helpful as a start. Do you have any other suggestions?

I hope that I can assemble something and then post it to Discuss&Discover after having had a chance to iterate it and get feedback. Thank you for any suggestions you may have.

5 Likes

Hi @ngoonera .

For now I just have a quick possible resource for you re: #1 on your list of questions. Here’s a zen group that lists their guidelines which you may be able to adapt for your purpose. I know of some other Buddhist centers/groups that have adapted these. Also at the end there is a list of other resources, ones that they’ve used which might also be useful.

All good wishes for developing your group; a valuable thing to offer!

2 Likes

Hi @ngoonera, thank you for posting your idea.

Just some reflections.

There are two or three types of groups I’ve seen run from my university Buddhist society days.

  1. The type of group that is run by mental health or other professional. These are typically advertised via a mental health support service and have an inclusive, secular outlook (although the people who run them are frequently but not necessarily Buddhist). The aim is to help with mental health support in a professional or paraprofessional context (i.e. people have degrees and stuff and possibly expensive additional training in something with an acronym).

  2. The type of group that is run by Insight Meditation or Zen people. These have a more secular/lay outlook and lay tradition and might be run with a teacher within these groups or from tapes.

  3. The type that is run by the Buddhist student association or chaplaincy. These groups often prioritise monastic speakers, regularly inviting monks and nuns. These groups are likely to be open to sutta based material & sometimes invite people with extensive training in Buddhist texts.

The issue I see with using suttas for reference is that it’s conflating group 3 with group 1. What tends to be acceptable to group 1 is the Buddhism that has already been filtered via a middleman who has digested it for a wider audience…you might get less favourable reactions to the raw material.

Additionally, the accreditation process is different for each stream. Group 1 is via the normal professional channels with money and diplomas and things. I have less experience with group 2, but there are a number of lay traditions. Group 3 is more traditional monastery system.

Noting that just because group 3 is traditional doesn’t mean the institutions, lineages, and cultures around sutta teaching should be underestimated.

From your post, I’m having trouble working out where your group would fit, as it includes elements of group 1 and groups 2-3. It’s ok to have a personal life that spans both, but in a group setting, it might be helpful to know which aspects will dominate. This will in turn decide the type of credentialling required.

If it’s hosted in a more secular setting, it might be better to keep it in a group 1 type track and get your teachers from a professional pool. If you want to do something like group 2 or 3, good to find a tradition and raise the idea with the gatekeepers of that tradition. Working with experienced people means they can let you know what they have done previously. They can also be the people you talk to if you need advice or encounter unexpected issues.(:

2 Likes

This one - AN 3.65 (Buddha’s advice to Kalāmas of Kesaputta)

1 Like

You could ask potential members of the group for their opinions. They might be able to tell you what areas they struggle with, etc. I would try to cater to the needs of the group, rather than preach at them. (not trying to be offensive, but I’m not sure how else to word it)

1 Like

Thank you for your helpful comments summarizing the different kinds of support groups. It makes sense that one type initially comes from healthcare, another comes initially from a religious foundation and a third may be from a University background (with students, invited speakers, etc.). A few thoughts:

  1. One way to blend the groups is to present the support group as coming from the perspective of psychology informed by an eastern spiritual perspective. Key elements of this eastern psychology emphasis include concepts such as non-self, dependent origination, and a focus on meditative practices. While there are schools of western psychology that embrace some of these elements, such as Attention and Commitment Therapy, they generally do not include all of them. In this context, because the group may not be receptive to directly quoting the suttas, it may be more helpful to focus on themes that Buddha emphasized (such as non-self) while making sure to include the actual suttas themselves in the supplemental reading material. Perhaps the concept of “eastern psychology” is too broad and it may be better to use the term “Buddhist psychology”.

  2. The issue of credentialing is a complex one. There are “credentialing” bodies for bare mindfulness approaches, but I believe that bare mindfulness is not the safest approach for indivinduals with possible behavioral health issues. There are religious-based programs, but since I have a family and associated financial obligations, I cannot put aside a few years to complete those practices. My approach primarily emphasizes a limited pool of early texts that have high concordance parallels (so I generally do not use the Satipathana Sutta because Sujato and others have noted that likely it may have been written 200-300 years after the Buddha (Sujato, A History of Mindfulness, 2012)). The excommunication of Ajahn Brahm is another example of the challenges of “credentialing”. Perhaps the best approach is transparency and to acknowledge to the group that the activity is not being performed under any specific credentialing body.

With metta

Thanks for explaining your idea further.

I said, “raise the idea with the gatekeepers of that tradition,” it’s a different concept to becoming a monk, I meant to just be open to hearing what they have to say, (which could be yes, no or later). If you are teaching sutta, to me, it would be the first consideration that you yourself have actually learned sutta (likely to be a very positive growth experience!)

For example, as someone who currently teaches material from the Satipatthana Sutta, I think it would be a misunderstanding to say that the whole sutta is late and shouldn’t be taught. Some of the key points relate especially to the dhammanupassana section, of which there several unexpended versions available focusing on the 5 hindrances and 7 bojjhangas.

P.S. AFAIK the only action ever taken against Ajahn Brahm within the WPP group was to delist Bodhinyana as a branch monastery, no-one has ever said he can’t teach meditation. This group is quite large and has enough people and resources to function independently anyway.

1 Like

My advice is that if you are going to use the Anapanasutta in a group setting then use it as a means of removing distracting thoughts;

He should develop mindfulness of in-&-out breathing so as to cut off distractive thinking. An9.1

Use thinking about the breath as to shut out the thinking about distracting things and simply train for calming in general.

"[1] Breathing in long, he discerns, ‘I am breathing in long’; or breathing out long, he discerns, ‘I am breathing out long.’ [2] Or breathing in short, he discerns, ‘I am breathing in short’; or breathing out short, he discerns, ‘I am breathing out short.’

If there are no distracting thoughts then there is no need to think about the breath neither.

It’s rather straight forward, will go well with the mn19 & 20 and is completely fine for beginners.

Also, I have been thinking about this “need” and I think it is inevitable that is happening. I vouch for the sacred space and the sovereignty of the Individual. Let’s investigate some methods that are upholding these principles already. For example: https://npcassoc.org/

I think this is a wonderful idea. Two ideas, one is, that the Buddhist chaplaincy program at UWest could be interested in a Buddhist counseling/therapy system. My question is, The Buddha’s teaching dynamic is the person is always striving for Nirvana, without that asperation, the entire system falls apart. How does one, deal with so many that do not believe in this and would consider it an infringement on their free thought to insist on this?
Finally, I do not this the word " tortured" is the best translation. I prefer " subdue of subjugate". What do you think? Do you know Pali? I don’t . “with teeth clenched and tongue pressed against the roof of the mouth, should squeeze, squash, and torture mind with mind. [7.8]”(SuttaCentral)

Thanks for explaining that. I think it is very helpful to get the input of different practitioners/schools. In this way, the forum at Discuss&Discover is quite valuable and I appreciate the input you and others have provided. In regards to the Satipatthana Sutta, I’m glad that you are able to incorporate it into your teachings. I’ve found it a bit challenging primarily because there is so much in there. It sounds as if you focus on the dhammanupassana section, so I’ll take another look at that. I’m increasingly interested in the bojjhangas and their relationship to the jhanas, so perhaps that will be helpful as you mention. Thank you for also clarifying that Ajahn Brahm was not excommunicated per se, just “de-listed”.

I personally think that APS is a great tool for beginners especially because it emphasizes joy/happiness in the 5th and 6th contemplation. This helps make the meditation experience a pleasant abiding, as the Buddha frequently mentioned. Furthermore, it helps to serve as a natural salve to the stress and suffering that many with behavioral health issues experience. In this context, I prefer it to “bare mindfulness” because I worry that a practitioner, without access to joy/happiness, may be overwhelmed as past traumas surface during the quiet of bare mindfulness. Research done at Brown University suggests that as many as 40-60% of meditation practitioners have negative experiences at some point during meditation.

Learning all 16 steps can be a bit much, but it is not that hard, and learning at least the first 6 contemplations is a great start. I’m also thinking of recommending to the attendees the book “Talk to yourself like a Buddhist” which discusses self-compassion practices that one can use off the cushion.

How fascinating–thank you for sharing that link to the Philosophical/Logic-Based Therapy group. I see that they offer a certificate program (Training | Logic-Based Therapy & Consultation Institute). Their approach, one which emphasizes logic, may be a good parallel for the Early Buddhist Texts, one which appeals to me because of its rigor and simplicity.

I meant using thinking about the breath to shut out the traumas or whatever distracting thoughts as to attain seclusion by means of not giving them attention.

When seclusion is attained the joy arises and unwholesome states do not enter.

For most beginners merely experiencing a quietude of the mind is plenty pleasant.

Another circumatance is that attaining this spiritual joy is relatively difficult by means of anapanasati especially in a secular setting whilst being troubled & stressed.

In many circumstances it would be easier to give people an inspiring talk in order to make them feel joy & happiness rather than having them try attaining pleasure born of seclusion by Anapanasati because hindrances are very difficult to overcome for a beginner.

Walking and standing meditations are also a great tool for group sessions. These are great to incorportate for a setup going into the sitting posture.

Contemplation of one’s own virtues is another great practice for secular groups and it’s relatively easy to rouse joy with.

1 Like

Thank you for these helpful comments. A few other questions:

  1. Title: What do you think of the title “Meditation and Emotional Wellness Support Group”? Other titles include:
    1.a: Meditation for Wellness Support Group (or Meditation and Wellness Support Group)
    1.b: Meditation for Behavioral Health Support Group
    1.c: Meditation for Anxiety and Stress Support Group
    1.d: Meditation Peer Support Group

I’m avoiding the term “mindfulness” (even though that will be frequently discussed) because so many people think this means “mindfulness-based stress reduction/MBSR”.

  1. I’ll probably host it as an in-person event (I don’t trust Zoom for a support group) perhaps in late Feb once the Omicron surge has passed.

  2. A tentative description is: “Join us to enhance your applied meditation practice and share lived experiences while finding support in a safe space. This group meets twice a month in-person on Mondays at 7:30 PM. We’ll begin with a 20 minute sitting meditation, then transition to a discussion/support group for 40-60 minutes. Participants can share challenges they’ve experienced, offer advice, and discuss application of various meditation strategies, incorporating practical guidance from the suttas.”

  3. We’ll likely focus on strategies described in MN19 (Two kinds of thought), MN20 (Removal of distracting thoughts), MN118 (mindfulness of breathing), MN121 (the Shorter Discourse on Emptiness), SN 1.08 (Karaniya Metta Sutta) and Snp 4.15 (Attadanda Sutta)

  4. I’ll be using “Leading Peer Support and Self-Help Groups” by Charles Drebing, as a guide

  5. I’ve reviewed various documents, several of which were kindly provided by members of the D&D community, to create the following list:
    Code of conduct: Support Group
    6.1. Privacy: Everything said and heard in the group should respect the participant’s privacy. What is said in the group stays in the group.
    6.2. Silence is acceptable. We can say “I pass” or “No, thank you” if we don’t wish to speak
    6.3. The group is a safe place to share feelings. It is an opportunity to obtain and provide support, information, reassurance, and encouragement. The group is meant to be supportive rather than judgmental.
    6.4. Only one person talks at a time; no one should dominate the conversation. If you feel that one person is speaking too much, please let us know.
    6.5. It can be difficult to be present. Please make every effort to not be distracted by your phone or other devices; we recommend you place them in “do not disturb” mode and no recording of any type is allowed.
    6.6. When listening, please attempt to listen deeply with full attention. We listen to understand, not to respond
    6.7. When speaking, try not to make judgements, problem solve for the other person or tell them what to do. Instead, consider sharing what has worked or not worked for you.
    6.8. Attending a group can be therapeutic, however, the group is not meant to replace individual therapy. We encourage you to see an individual therapist as needed.
    6.9. We will begin and end meetings on time. Sessions are held in person to facilitate communication. We will follow the current meditation center guidelines in place for that day re: social distancing/masking.
    6.10. We would appreciate if you could let us know in advance if you cannot attend a session so we can plan accordingly.
    6.11. We encourage you to invite others to join, but please let the Support Group facilitator know in advance so that they can speak to the new member before the group actually meets.

Any other advice you have would be appreciated,
With metta

1 Like

Over the past few months, I’ve been working to assemble the support group in terms of identifying time/location, creating a code of conduct, announcements, and reading a guide on support groups. If you have a moment, I would appreciate any feedback you’d like to offer. Briefly, I’ve created the following documents:

  1. Code of conduct
  2. Intake questionnaire
  3. Facilitator Guidelines
  4. Draft Announcement

I’ve assembled some of these documents here:
https://drive.google.com/drive/folders/1IPB2SCuUmVQO1ABxxFoh9n8dd2pwDdz4?usp=sharing

We’ll be hosting our first session on 4/11 and I’ve posted it on MeetUp

Thank you in advance for any advice!