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We recently asked Julia Ojeda, founder and CEO of RIO Recovery Inspired Opportunities, to assess GPS’s training program for support group facilitators. Ojeda shared feedback from her assessment in an informal interview with GPS CEO and Co-founder Liz Friedman, which we’ve summarized in this post.

To assess our facilitator training, Ojeda watched six modules of the training program. As she progressed through the curriculum, Ojeda, a public health expert and peer recovery specialist, experienced “the curriculum as a participant” in ways she didn’t expect.

“It was probably the most inspirational curriculum I’ve ever participated in,” said Ojeda.

Ojeda said she was impressed with how the training accounted for the ways in which trauma affects people, by emphasizing physical and emotional safety and empowering participants to reassert control over their lives. Ojeda noted that trauma-informed practices were infused throughout GPS training materials, from detailed facilitator guidelines, the sequencing of information, and the care given by the training facilitators to the check-in questions that precede each training module.

“Creating check-in questions takes skill. You don’t just wake up and go, ‘Oh, here’s our question for the day,’” she said. “It was so thoughtfully done. I loved that the facilitators met each morning to discuss what the check-in question would be and that they incorporated the words used by participants into the discussions.”

Ojeda did say that GPS facilitator trainings could benefit from a few tweaks to improve how the material is presented. Referencing a professional colleague’s critique that GPS trainings are long and lecture-like, Ojeda suggested that the trainings be made more interactive and broken down into smaller groups of participants.

But she said that the length of the training, while long compared with other facilitator trainings, is a result of its being so comprehensive.

“If you truly pay attention, and you really hang in there, and you do the homework and the practice, there is no way someone would not be transformed by this training,” Ojeda said. “I could feel myself being transformed, and that was not what I expected, in any way, shape, or form. Your facilitators are spectacular, and they’ve been trained well. The stories they tell, the sharing they do—I’ve been moved by everything and everybody in this training.”

Nelly Willis walked into her first GPS Group Peer Support (GPS) group seven years ago and took a seat by the door. She didn’t plan on staying. As the leader of a nonprofit providing perinatal support to low-income parents, Willis routinely led support groups. In fact, she was running about 10 groups a week.

“I thought, ‘I don’t need this. I already know how to run groups,’” Willis recalled.

But the founder of the nonprofit that Willis led urged her to take GPS’s facilitator training which provides professionals and people with lived experience the tools necessary to run trauma-informed support groups where healing can—and often does, as Willis soon discovered—take place.

A requirement of the facilitator training is that trainers attend a GPS support group together to gain firsthand experience with the model. So Willis showed up. But she expected to leave shortly after the group started.

To her surprise, however, she felt compelled to stay. To her even greater surprise, she was deeply moved by the experience.

“I felt a validation. It was a validation that I didn’t even know I needed. I felt seen,” she said.

The reality for Willis at that time was that although she was excelling professionally, she was struggling in her personal life. Her two-year-old son had been hospitalized multiple times and undergone numerous surgeries to treat complications from a congenital chronic illness. Willis felt overwhelmed with guilt for having passed it on to him. She was also experiencing post-partum depression, suicidal thoughts, and symptoms of obsessive-compulsive disorder (OCD). When she showed up for the GPS group, she had come straight from the hospital where she had been told by her son’s caregivers that he wasn’t expected to survive. As she watched her fellow trainees socialize with one another before the meeting, she couldn’t imagine engaging in conversation with any of them. They all looked “normal” to her while she felt “like a monster” who was responsible for her son’s pain.

As the group got underway, though, Willis noticed that it was run differently from other support groups. People didn’t interrupt each other. They listened. When someone cried, no one jumped up with a tissue box to get them to stop.

Willis found herself opening up and sharing information she hadn’t shared with anyone else. Such as her belief that her son’s caregivers were scrutinizing her parenting skills and judging them to be inadequate.

“But in that moment, in that group, I felt like my true self. I spoke and nobody interrupted me. I cried, and nobody ran with the tissue box to stop my suffering,” she said. “People just witnessed and watched. I think that’s exactly what I needed.”

Today, Willis serves as GPS’s Program Director and Director of GPS en Español. She develops and directs all GPS programs, including trainings and webinars, and translates and adapts materials for GPS en Español. She also hires, trains, and supervises more than 50 GPS facilitators and coaches. Willis has also led GPS Postpartum Mothers groups in Spanish for years, serving primarily immigrant, refugee, and undocumented women living precariously on the border between Arizona, where she lives, and Mexico.

The experience of telling her story uninterrupted was the most impactful and healing part of the group for Willis.

“People just listened. They didn’t try to fix me,” she said. “Every time you tell your story, and someone listens without interrupting you, your defenses start to drop, your body’s stress response calms down, and you can genuinely start to heal. That’s what happened with me. I started healing in my very first GPS support group.”

Willis subsequently sought treatment through therapy, medication and other sources. But her transformational experience with GPS inspired her to bring GPS to the Latino community in Arizona and beyond. She began by adapting GPS materials culturally and linguistically for Latino audiences. She also created Spanish-language groups and facilitator trainings, and developed strategies to build relationships in the Latino community so that people would be receptive to GPS programming.

“GPS is a bridge that’s filling gaps in the healthcare system,” she said. “When I found GPS, I didn’t really know that I needed support. But even if I had, I would not have gone to a clinic for help. I was afraid. Even though I’m a U.S. citizen, I get asked for my passport all the time. I was afraid that if I told people I was having suicidal thoughts and that I had OCD, they might try to take my son away from me.”

The community-based GPS model of care provides an easy point of entry into care, Willis said.

“GPS isn’t a replacement for intensive therapy or medication, but GPS is therapeutic. It can be that door to other resources,” Willis said. “It’s not magic, but it can empower and transform people in many ways. That’s what it did for me and I’m so grateful to be able to bring it now to my community. There is so much need out there and with our group model, we can reach a lot of people.”

In her position as GPS Project Manager, Marcy Langrock applies a broad range of skills that keep us going. Her work touches on everything from finance and tech to administration and marketing.

“It’s a small company, so we just step in where we’re needed,” said Langrock of GPS staffers. “I have an MBA and I’ve worked as a project manager in the tech sector, at healthcare-focused organizations and nonprofits, so I’m pretty comfortable working across the entire company.”

Langrock is also a certified GPS Support Group Facilitator with plenty of experience creating and running groups in her Seattle community.

Langrock was introduced to the GPS model several years ago when she enrolled in a course on dismantling white supremacy led by noted academic, civil rights activist and reproductive justice advocate Loretta J. Ross. The course included a session of GPS for Solidarity, a support group GPS developed in partnership with Ross to help people address the emotional aspects of conflicts and expand their ability to navigate challenging interpersonal situations respectfully, with integrity, honestly, and compassionately, with an eye toward a productive outcome.

Langrock had studied the work of prominent anti-racist scholars and activists, but said she found GPS for Solidarity “so much more transformative.”

“It made me realize that I was sitting in that shame space. I remember one of the leaders saying, ‘Hey, you’re not to blame for white supremacy, but you’re responsible for dismantling it,’ which to me felt like such a different mindset,” said Langrock. “Like, I don’t need to be sitting there and working through the shame and blame for our country’s entire history of racism, but rather, I am empowered. I actually have the power to help break down white supremacy.”

That realization inspired Langrock’s anti-racism work anew. She began working with Ross as a Solidarity Group facilitator. When Ross teamed up with Loan Tran, an organizer, human rights activist and national director of Rising Majority, to present the solidarity-building course series “Calling In the Calling Out Culture,” Langrock facilitated groups for both of them, and also provided tech support.

Langrock also joined the Coalition of Anti-Racist Whites (CARW), her local chapter of the national network Showing Up for Racial Justice (SURJ). As part of her work with CARW, she helped write curriculum for neighborhood cohorts, which were similar to GPS solidarity groups, drawing on the GPS model. She also helped train group facilitators, again drawing on her GPS background.

Tackling Another Unmet Need in Her Community: Autism Support

At the same time, as the parent of two autistic children—now adults— Langrock was active in online communities related to the condition. While she found some of the discussions helpful, she also observed that groups often included gatekeepers who aggressively chastised other well-meaning community members for perceived slights such as poor word choices, or for speaking up despite not being autistic themselves.

“I was noticing that there were spaces where people were just being shut down,” Langrock said. “I was also being told that I don’t have anything to say in those spaces, when I actually have helpful experience dealing with schools, for example.”

Langrock knew that securing the proper education services for autistic students is often an uphill battle that requires parental advocacy to ensure students are placed in the least restrictive educational environment possible.

“But schools don’t have enough resources and if you’re not an advocate, or you don’t know what’s going on, they’re just going to go the path of least resistance for you, and make it the easiest on them,” said Langrock. “I had that experience, and I was in spaces where parents were asking about this, but then I would be shut down.”

It brought back the feelings of isolation she experienced in the absence of support when her children were younger.

“You have the ‘experts’ giving you advice, but you’re the parent, you’re the one who knows your kids the best and they don’t always need what the experts say,” Langrock said. “I wanted to create a space where parents can get together and share those very hard things that aren’t easy to say out loud.”

At the time GPS did not have a group tailored to parents and caregivers of autistic individuals. GPS CEO and Co-founder Liz Friedman suggested that Langrock write curriculum for one.

Her group provided a place where parents and caregivers felt safe to share difficult truths—including doubts about whether they should have had children—and hard-won successes. Langrock said her group attracted participants from a range of different backgrounds, family constellations, and experiences with autism.

Regardless of their circumstances, what people raising autistic children have in common, said Langrock, is the challenges it poses within families. That’s why creating space for them to share their experiences is so important.

“The divorce rate is really high for parents of autistic children because there’s a lot of stress that goes on and having the space where you can talk about it almost feels disarming,” said Langrock. “There are really heavy things that we care about and carry around, and when we can share it out, then we’re all helping to carry it now. It just feels so much lighter.”

Participants also processed the rapidly evolving and changing autism therapies they tried or were considering. Such discussions, she said, were particularly beneficial for single parents or those with limited resources who don’t have the time or money to do research or experiment with different therapies.

“Raising an autistic child looks so different for people who don’t have economic resources,” said Langrock. “So that was another thing I wanted to help share out — information about what’s out there for our kids—for parents who might not otherwise hear about the range of therapies.

Due to her Project Manager responsibilities, Langrock’s autism support groups are currently on hiatus, but, working from a lengthy waitlist, she’s planning to start one again this spring.

“I could never run enough of these groups to meet the need,” she said.

To that end, Langrock is eager to support others in her community who would like to launch a GPS group.

“There is a woman with autism in our neighborhood who wants to run groups for autistic adults. And I was like, ‘Hey, if you want I will support you however you need.’ I think that would be a really great perspective,” said Langrock.

Langrock has a deep appreciation for how effective the GPS model is for the populations she works with. Its emphasis on creating a judgment-free zone, a no-advice zone, and bearing witness to emotion without trying to rescue each other empowers participants to reach their own conclusions and make their own decisions about their next steps.

“And I think that is beautiful, because it means that they have control,” she said. “They know, ‘Hey I’m still processing this. I’m not sure what my next steps are. But now we’ve all talked about this, we’ve all held this, so now it’s becoming clearer for me.’ There’s just so much power in that model.”

One of GPS’s longest-running partnerships is with Perinatal Support Washington, a nonprofit organization that has run support groups using the GPS model for the past six years. In the organization’s most recent annual report for GPS groups offered during 2022 – 2023, participants reported experiencing high levels of engagement and satisfaction with the groups and felt strongly that they made an important difference in their life.

“Thank you, because in this place I felt supported, listened to and above all I was able to express my feelings,” wrote one parent in a post-group survey.

“We rarely talk about mental health in our community so it’s interesting to see and learn from you guys,” said another participant.

One parent said simply, “It gives me something to look forward to each week.”

In developing our Perinatal Support Groups, GPS drew upon a body of research including a study showing group-based parenting programs that used behavioral, cognitive-behavioral, or multimodal approaches were associated with short-term improvements in depression, anxiety, stress, anger, guilt, confidence, and partner relationship satisfaction.

Another study on which we have relied showed that a series of four interpersonal group therapy sessions was successful in preventing post-partum depression in low-income women at risk for the condition.

Some of these results were reflected by Perinatal Support Groups participants in Perinatal Support Washington’s annual report. Fifty-five percent of participants reported that their feelings of anxiety and depression had improved, while fifty-eight percent reported they felt less stressed about responding to their baby’s needs. Fifty-three percent of group members said their satisfaction as a parent/caregiver had improved.

“I love the connection to my baby, we are one. This group has shown me that parenting isn’t easy, but there’s ways to help you get through it when it seems rough and there’s people to talk to,” said one parent.

Another described the group as “a godsend,” adding, “I’m a first time mom of color and not only does the group get me and baby out of the house, it gives me a chance to connect with other parents of color, and my baby a chance to socialize as well!”

Learn more about Perinatal Support Washington here. Learn more about our customized curriculums for perinatal parents and other groups here.

The on-going impact of the pandemic and post-pandemic years to the mental health and well-being of clinicians and caregivers cannot be overstated. Healthcare workers are grappling with pandemic-related trauma including PTSD, exhaustion, personal loss, moral injury, burnout, isolation from colleagues, job-related illness or injury, wages that are not keeping up with the cost of living, and difficulty accessing and/or prioritizing mental health. As a result, healthcare institutions across systems of care are struggling to fill positions. All of which weakens the Commonwealth’s ability to meet the healthcare needs of its residents.

Recognizing this danger, the state used $1 million in federal American Rescue Plan Act funds in 2021 to launch MASStrong for Healthcare Workers, a pilot program offering group-based mental health support to frontline healthcare workers including nursing home aides, long-term care aides, personal care attendants, home health workers, and residential counselors. All of the pilot program participants said they would like to attend more groups and 93% of participants said that they found the groups helpful.

When asked what was most helpful about the groups, feedback ranged from simply “being able to talk about being in healthcare” and “being listened to” to “learning about and gaining knowledge about self care” and “receiving a reflection from someone who was genuine.” What we learned in the pilot was that the power of MASStrong for Healthcare Workers is that it contradicts isolation by showing other healthcare workers that they’re not alone. By promoting personal resiliency, self-efficacy, and empowerment, participants learn to prioritize self care — which is, ironically, a very difficult skill for many caregivers to learn and adopt. Ultimately, sessions reinvigorated compassion and reduced burnout.

Based on this success, MASStrong for Healthcare Workers was expanded last year with $5 million from the Commonwealth’s Behavioral Health Trust Fund to reach additional health care workers including pharmacists, nurses, physicians, and social workers. The pilot and its expansion would not have happened with the support of legislators who champion mental health and mental health parity, including Senator Majority Leader Cynthia Creem and State Representative Ruth Balser.

Today, MASStrong for Healthcare Workers is administered by GPS Group Peer Support (GPS) in partnership with the Betsy Lehman Center for Patient Safety. The program acts as a first line of defense in the mitigation of trauma, grief, moral injury and burnout, fostering resilience, and increasing retention of the healthcare workforce. Massachusetts-based organizations that support MASStrong for Healthcare Workers include the Home Care Alliance of MA, MA Association of Behavioral Health Systems, MA Association of Emergency Nurses, MA Association of Physician Assistants, MA Assisted Living Association, MA Hospital Association, MA Nurses Association, MA Physicians Assistants, MA Senior Care Association, and 1199 SEIU.

MASStrong for Healthcare Workers utilizes the GPS model of group-based social support and mental health care, which incorporates mindfulness-based stress reduction, cognitive behavioral therapy, motivational interviewing, peer-to-peer support, psychosocial education, and other evidence-based modalities. A growing body of evidence shows that this form of care consistently reduces feelings of loneliness, anxiety, and depression and increases feelings of hope. Studies show that it has been effective with populations as diverse as parents dealing with postpartum depression, residents of rural areas living with chronic conditions, health care professionals who’ve made mistakes resulting in harm to patients, people living with schizophrenia, and people dealing with substance use disorder. It can be delivered by mental health clinicians or trained, non-clinical workers with relevant lived experience.

Another vital benefit of this form of care is that it addresses systemic inequities in healthcare treatment and services. It is just as effective when delivered online as in person. It can be easily tailored for culturally and linguistically diverse communities when groups are led by trained peer specialists who are also members of that community. This is vital for racial and ethnic minorities, people who are LGBTQIA+, people who are living with disabilities, refugees and new immigrants, and others who do not often find themselves openly represented in the ranks of mental health care professionals.

Healthcare professionals are invited to learn the model and bring it to their practice, community, and/or other providers. If you are interested in running a MASStrong for Healthcare Workers group, you will be paid while you are trained in the model and paid for group facilitation. Email MASStrong@grouppeersupport for more information.