Idea 5: Peer Group Discussion

What is it?

  1. Meeting weekly in small groups to talk about ongoing work
  2. About 1 to 1.5 hours each time
  3. 3 to 5 clinicians only
  4. Multidisciplinary not unidisciplinary
  5. Stable or random groups - there are pro’s and con’s to both
  6. Aim for everyone to present and discuss a client each week


Thinking about service users in a multi-disciplinary way can be really helpful. It also helps us ‘Let Go’ by supporting clarity of goal setting and monitoring using outcome measures. Plus meeting and discussing casework regularly helps develop a learning culture and reduces variability in responses to service users’ needs. It keeps things safe by ensuring colleagues who may have other viewpoints can be ‘critical friends’ or devil’s advocate’, pointing out different formulations or ways of helping. Plus it’s fun!

Stable or random groups?

Either is fine - work out what is best for you.

Stable groups

Richmond uses stable small groups - this is helpful as clinicians get to know each other and, because they will have heard about the client several times in the past, little time is wasted repeating factual information. The nub of the issue can be reached straight away. However, stable groups always develop a culture of their own and it can slip into lack of challenge (in Richmond we have someone take to role of Devil’s advocate - whose task is to challenge everything! Done with humour, we find this keeps us having fresh eyes! Ann).

Random groups

East Herts CAMHS uses random groups - which means you get to discuss things over time with a wide range of staff thus creating many new fresh ideas plus you get to know people you don’t work with much. This really helps with team building. In addition a clinician can ask another clinician to be in their group that week if they would like a particular skills or knowledge in their peer group. The relative lack of history keeps the focus on where are the family now, what do they want and what needs to change?