After planning for your support group for weeks, or even months, it’s time for your first meeting. You feel rather organized. You’ve prepared a proposal to start up a support group which was approved by an organization or church. You’ve put together a welcome folder for new members and you have scheduled your topic or speakers for coming months.

So, does this mean that your illness support group meeting will run without a hitch? Unfortunately, despite all of your hard work, there are a few frustrations that you will likely encounter during those first few meetings. They are worth being aware of so that you are prepared in advance.

(1) Only a couple of people attend.

How it feels: Disheartening. After putting in so much of your personal time (despite your own illness), it can be very disappointing to feel like dozens of people aren’t benefiting from all of your hard work and passion. Recognize that a low turnout is typical and not something to be taken personally. It can be extremely difficult to organize people who are ill to show up at the same place at the same time. One obvious reason is that when they feel ill, they are less likely to leave their home and go socialize with others. Just talking can be physically draining. And when they feel well, the last thing they may want to do is sit around and talk about the days they are in physical pain.

What to do: Hope for the best and prepare for the few. As a Christian organization, the HopeKeepers small group program founder says, “Although it’s disheartening when just a couple of people show up, I know that God created that appointment. When I led a group once, just one person came, but we had the best conversation and she admitted that she was extremely shy and likely would not have even spoken if other people had attended the meeting.”

Keep a summary of your lesson plan, even including the topics that were discussed. This way you can easily “replicate” the meeting another time with little preparation. Lastly, consider calling people and, without adding undo pressure, ask them what challenges are preventing them from coming? Is it transportation? Is it the time of day? How could you make it easier for more people to come?

(2) Your lesson plan is completely ignored.

How it feels: You may be quick to assume that your ideas are just not interesting or helpful enough for people’s circumstances. You may even feel a touch of anger that people don’t appreciate the time you spent preparing.

What to do: Allocate flexibility at the first few meetings and let people know that you will add more structure as the group gets more comfortable. Most likely, it’s not that people don’t like your plans, they are just free from anxiety, excited to be able to share experiences with others who understand chronic illness. By just assembling people together in one room, floodgates of emotions that people have held back for years can break forth. If you’ve been through it, you know it’s pretty much impossible to hold up a book and a lesson plan when a member is in tears over the end of her marriage, for which she blames her illness. Although these situations can happen at any meeting, they may be more frequent at the beginning or with first-time visitors.

Talk to your group about your desire to allow people to share, but also that you want everyone to leave feeling refreshed. So regardless of what happens during the meeting, you will plan to end with an uplifting article, scripture, poem, prayer, devotional, etc.

(3) Everyone just complains about everything! Their relationships, the medical professionals, their illness-the list is never ending.

How it feels: Like you are expected to manage a small riot. There are many built up emotions where people have experienced deeply wounded feelings, unjust consequences, and even medical errors. It can seem they want you to fix the situation or else they will talk incessantly about it to everyone.

What to do: Write up some guidelines, before your first meeting if possible, and include the “venting guidelines.” Read “10 Ways to Make Your Illness Support Group Uplifting.” One practical tool is to set a timer and allow everyone to have 60 seconds to share their most frustrating experience of the week. Brainstorm about a contest your group could have that would bring some humor to the venting. For example, the person who handled their irksome situation the best or most creatively could win the “Aggravated the Alligator (a rubber alligator) Award” to take home for the week.

Group members should have a sense of freedom in sharing their concerns and annoyances, but be sure to include others in the conversation. If Jane can’t seem to let go of a situation, add, “Jane, I know some of us can identify with what you are sharing. Can someone else tell us how she or he has dealt with the emotions that accompany a situation that was similar?” If you are doing a study you can say, “Since we want to have plenty of time at the end to share something uplifting, let’s move on to question five. Jane, would it be okay if people could offer their encouragement after the meeting or maybe later this week with a phone call or email?”

(4) One person dominates the conversation and seems to take over the meetings, disregarding any plans you have or other’s need to talk.

How it feels: Infuriating! After all your preparation it can be annoying to have someone override your entire meeting and take the group down a path that lacks the encouragement you want to provide. You justifiably could be concerned about her impact on the group and how many people she could scare away.

What to do: Set firm boundaries from the beginning. While it’s vital that people are encouraged to communicate their frustrations, they are also responsible for respecting others in the group. They need to watch their language, the quantity of time they dominate a conversation, and how they comment on people’s treatments or decisions.

One of the best ways to approach this is to include guidelines about how the group will function that are given to all new members. If the person who dominates the conversations doesn’t understand your simple comments of “Let’s see how other people feel” then talk to her one-on-one. Politely go over the guidelines. You may want to put her in charge of a part of the meeting where she can have a leadership role. Having the guidelines to refer to will make it feel less of a personal attack than if you are simply correcting her behavior.

To wrap this up, know that facilitating a support group is often assumed to be a simple task. It’s a myth that you let people know you’re getting together to share and support one another, lots of people show up, and everyone’s personalities just click. It rarely works this way.

It takes a special person who can communicate with others effectively. One who can gently guide people in the direction you wish them to go, so that the group grows rather than becomes a complaint session. A leader must be able to offer compassion, but also set boundaries and even diffuse anger. As situations arise, talk to other leaders for ideas and support. Keep in mind that no leader ever feels one-hundred percent capable. A willingness to learn and listen is at the top of the list of leadership qualities.