Mental Health Expert At Circles On How Support Groups And Therapy Assist Mental Health - Exclusive Interview

When times are tough, it's easy to feel alone — especially now, navigating through the challenges of a pandemic when social distancing is the new norm. Oftentimes, it can feel like the people around you don't quite understand exactly what you're going through, even though they love you. "When a person is dealing with a life challenge, it can be a very lonely time," says mental health expert Yohnit Spruch. "Connecting with others in a support space can provide a sense of relief and comfort knowing that there are others out there who can relate to what you are going through."

Yohnit Spruch is the head of emotional health at Circles, a mental health service that offers group support where up to 10 people experiencing similar life challenges are matched into groups and meet weekly via video chat to give and receive emotional support, guided by trained, vetted mental health professionals. Their newest feature invites people to connect around the common issues and challenges they face in their daily lives. People going through similar life challenges enter voice-only support rooms around specific topics in a safe space — to give and get support whenever they need it — guided by a peer with that same lived experience as well as a professional therapist.

In an exclusive interview with Health Digest, Spruch talked about the effectiveness of support groups and therapy, the pros and cons of meeting virtually versus in person, and the current barriers and accessibility issues to mental health support that people face today.

Circles support

Can you tell us a bit about your background and about your involvement with Circles?

I am a social worker with 20 years of experience in a range of mental health areas. I strive to live my life authentically and with empathy by actioning my beliefs and ethos around recognizing the innate inner strengths of others and helping them to reach their full potential. I am a busy mom of five incredible children who inspire me every day through their enthusiasm for life and the resilience that they demonstrate when times get tough. I have a strong sense of community and belonging and [make] sure that people around me know that they matter.

I have always had a passion for helping people, and I knew from a very early age that this is where I wanted to focus my professional life. The words of Bernard Meltzer — "There is no better exercise for your heart than reaching down and helping to lift someone up" — really inspire me as a professional. When people feel that someone cares for them and is invested in their overall health and well-being, then they can achieve so much. Taking the time to listen and then to help people recognize and acknowledge their strengths and resilience can be an extremely empowering experience, even more so on a group level.

I discovered Circles one day by chance, and the company's values and philosophy were so aligned with my own that from that day on, my life changed. I became a part of a company with so much passion and motivation to make a difference in the world, even if it meant focusing on one person at a time. The philosophy of alleviating loneliness and providing support to people in the world dealing with a life challenge — who, for many reasons, were not able to access help until they found Circles — really appealed to me. I am now in a position where I can contribute toward improved mental health on a global level, and I have the immense privilege of witnessing this profound impact every single day.

I currently work with a community of over 140 mental health professionals who all have the same passion to use their knowledge and expertise to bring people together in a healing space where they can feel cared for, nurtured, and supported. I am inspired every day by their commitment and dedication to their groups and for their warmth, empathy, and care.

Bringing new experiences to support apps

What is Circles? How does it work?

Circles is the leading platform for anyone dealing with a life challenge to find group support, available on the App Store and Google Play, where up to 10 people experiencing similar life challenges are matched into groups and meet weekly via video chat to give and receive emotional support, guided by trained, vetted mental health professionals.

The platform also provides access to CBT-based self-reflection exercises as well as webinars on relevant topics related to the support provided. Until now, Circles' offering was subscription-based, supporting thousands of paying members across the country with hundreds of groups. Following Circles' success, it is launching Voices, the platform's newest, cost-free offering, which lowers the barrier even further for anyone who could use support but finds that 1:1 therapy isn't a feasible or effective solution.

How is Circles different from other mental health apps like TalkSpace and BetterHelp?

The current landscape of the mental health market is flawed. Many people who are going through a life challenge turn to 1:1 therapy, but the trauma of life challenges is inappropriately addressed under the general cloak of depression and anxiety — the more prevalent concerns in the current mental health landscape.

Adding on to that, psychotherapy is expensive and often intimidating. Those who can't afford it turn to online forums and Facebook groups, which are often rampant with misinformation.

At Circles, we have found that the best way to cope with a life challenge is with the support of others who are going through the same struggle. We're challenging the current approach to mental health by harnessing the power of human connection to help people cope together with life's events and tough challenges. Rather than addressing mental health issues only if they're labeled as a "condition," we disrupt the current landscape by making room for these events and paving the way for effective healing through connection.

We offer virtual support groups, while our technology matches people from all over the U.S. with people who are going through a similar life challenge. Every Circle is also accompanied by a mental health professional. Circles provides the bridge between access to mental health and technology in an easy-to-use and affordable way.

How support groups help

How are support groups effective in assisting mental health?

Support groups provide a space for people to go where they won't feel so alone. When a person is dealing with a life challenge, it can be a very lonely time. Connecting with others in a support space can provide a sense of relief and comfort knowing that there are others out there who can relate to what you are going through.

The reciprocal nature of support groups also allows for the mutual benefit of being able to both give and receive support. There is nothing that compares to hearing your own feelings echoed in the words of another person, which provides a significant feeling of relief. People naturally tend to reach a stage in their healing journey when they want to be able to give back and walk alongside others who are facing a similar struggle. Trying to explain in words some things that are beyond words sometimes feels like an impossible task. Those who are dealing with a similar situation get you immediately.

The opportunity to gain knowledge and insight from the challenges and experiences of others is also a unique benefit of support groups in mental health. The sharing of ideas and resources can provide a new perspective on situations allowing for more opportunities for growth.

Support groups harness the power of human connection, which has a significant impact on feeling more hopeful and connected at a time when you need it most. The group space becomes a safe place where one can model and practice skills and experiences that can then be transferred into a real-life situation. In this process, the feedback loop that is created can build a greater level of self-confidence and self-worth.

Online vs. in-person

Do you think online support groups work well as therapy and can stand alone as mental health treatment, or should they be a supplement to therapy?

This is relative to the needs of each specific person and the reason for seeking out support. Support groups work very well alongside individual therapy as they open up a space to implement the learnings and insights gained in a one-to-one situation in a safe and comfortable place. This can lead to dramatic improvements in day-to-day life and social interactions.

Certain life challenges such as grief, chronic conditions, and relationship difficulties naturally lean toward a group support environment as a stand-alone support, as the shared personal experiences provide a framework to process and normalize the different thought and emotion patterns that emerge. Group support can bring a realization of hope by seeing others further along in the grieving process who are functioning and coping well and reflecting on how far you have come.

Are online support groups and therapy as successful as in-person sessions?

Since the start of the pandemic, when the idea of virtual mental health support was still a relatively new phenomenon, we have seen a significant shift in that even though in-person support is more available again, people are still choosing to connect virtually. The safety and convenience of being able to connect with others without having to leave your home is very appealing to many. The success of any intervention depends on the relative expectations and needs and wants of the person being met in a safe and supportive way. Setting the expectations from the start and then making every effort to ensure those expectations are reached goes a long way toward increasing the probability of success.

The virtual relationships that form can often mirror the deep, meaningful connections that can occur in the in-person space. People in the online space may feel safer to be true to themselves and talk to other people much more openly than if they were people in their daily lives. People choose to join an online forum with a specific goal in mind and have made a conscious decision to connect, form meaningful relationships, and support one another.

It is often very challenging for people to reach out to those around them and speak openly. They don't want to be a burden, and they often report feeling like no one around them understands what they are feeling or that they have to maintain a strong "front" for people in their lives. Virtual connections can be honest and transparent right from the start. Even though it might take time to feel comfortable, with less body language online, people learn to be much more direct with their communication.

We are seeing significantly meaningful connections and life-changing friendships forming in our online space. For some people who have not been able to enjoy this in their lives before, it opens new doors and opportunities. Digital connections are focused, fill a need for both people, and become close and trusting often much faster than in "real" life.

I can share countless examples of people who have connected in the virtual space on a deep level. We have group members who have flown across [the] country to meet each other in person after meeting virtually through our platform. Others say they cannot wait for their sessions each week to have an opportunity to catch up and check in with each other. The connections run deep and continue for extended periods of time.

Group therapy vs. individual therapy

What are the advantages and disadvantages of group therapy versus individual therapy?

There are many advantages to group therapy vs. individual therapy. In a group situation, one has the opportunity to form meaningful connections with others. The sense of group belonging and camaraderie helps toward knowing that there are other people who are dealing with a similar situation, which can give a tremendous sense of comfort.

The safe environment [that] is established in a group encourages an openness and honesty that might not be possible with others outside of the group. This contributes to an increased ability to be sincere and candid about difficult feelings and emotions that are not easy to express. A group environment promotes accountability to oneself and others and can contribute to a sense of progress that is less apparent when working independently.

For a person who is less comfortable in the spotlight, a group environment provides a space for healing at your own time and own pace without the pressure to have to be the center of attention. The group facilitator being there to draw shared connections and highlight commonalities has the benefit of normalizing what you might be feeling or experiencing, leading to a decrease in feelings of self-doubt. Group therapy is known to be much more cost-effective, which is particularly relevant to the current economic climate.

Some challenges of group therapy vs. individual therapy include the challenge of having to share the support space with others. Group support isn't for everyone and requires an openness and willingness to hear other people's stories and perspectives, even when you might not agree with them. The ability to show respect to differing opinions and agree to disagree is key to the success of any group situation.

A primary concern for people regarding groups, and why people find joining groups so daunting, is the idea that they need to be vulnerable in an unfamiliar environment and share private details of their struggles with strangers. It can take time to build up the courage to open up and share on a deep level.

Another challenge that can occur in a group environment is that hearing the experiences of others can be triggering, particularly when you are in an emotionally vulnerable space. However, with a skilled facilitator, this is something that can be addressed in a safe and supportive way.

Mental health accessibility issues

What are some of the current barriers and accessibility issues to mental health support that people face, and how is Circles working to break down these barriers?

One of the most prevalent barriers to accessing mental health support at the moment is the overwhelming need for services with a limited supply of mental health professionals. We are all still reeling from the aftermath of the pandemic and even more so from recent tragic current events, which means that the need for emotional support is higher than ever. Mental health professionals are inundated with requests that they are unable to meet. Circles offers a way to break down this barrier by the nature of group support, as it provides an opportunity for more people to have access to the insight of a mental health professional while having the added benefit of the insight from peers.

The team at Circles believes that no one should have to face a life challenge alone. Our groups are affordable [and] at convenient hours, and we do our best to make sure everyone who needs support is able to join. Voices was specifically designed for this purpose — to enable anyone who needs support to find someone there who cares about their well-being and will be there to listen and share.

Many people struggle to find a space to give back once they are further along in their healing process. Voices provides an opportunity to both practice and receive altruism, which is healing on many levels.

Another barrier toward accessibility to mental health support is the stigma associated with needing help and the pressure to always put on a brave face and be "okay." Lack of knowledge and education about mental health also contributes to this perspective. Circles believes in the concept of sharing without shame and that no matter what you are going through there is someone else who understands and can be there to support you. Many people continue to struggle in isolation because they are afraid to reach out or don't know who to turn to. Circles offers the ability to access support anonymously and in an open and trusting way.

The two main questions people ask themselves when seeking out group support are "Will they like me?" and "Will they be like me?" At Circles, we aim to help people find support with peers who are relatable and are going through similar life challenges so that they have a feeling of being truly cared for and understood.

Time and busy schedules can also be a barrier for accessing support. Voices provides a space where there is no pressure. People can join when on the go or pop in for a few minutes to touch base and catch up. The security in knowing there will be someone on the other end of the call when and if needed is immensely reassuring.

Circles offers small online support groups, guided by trained, vetted mental health professionals, to ensure that no one has to cope with life's challenges alone.

This interview was edited for clarity.