Support Groups in Oxford, MA

What is Flower Therapy? Flower Therapy is... self-care groups with floral and creative arts! Experience the therapeutic benefits of floral design and get some self-care, creativity, and FUN with Flower Therapy in Oxford, MA! No experience necessary, ages 14+ (minors must have adult present). Pre-registration is required. Note: This is a recurring wellness workshop, not group therapy. For more info: www.PerfectHarmonySolutions.com
Photo of Ashley Starzec - Perfect Harmony Relationship Solutions, LLC, Marriage & Family Therapist, MA, LMFT
Hosted by Perfect Harmony Relationship Solutions, LLC
Marriage & Family Therapist, MA, LMFT
Group meets in Oxford, MA 01540
What is Flower Therapy? Flower Therapy is... self-care groups with floral and creative arts! Experience the therapeutic benefits of floral design and get some self-care, creativity, and FUN with Flower Therapy in Oxford, MA! No experience necessary, ages 14+ (minors must have adult present). Pre-registration is required. Note: This is a recurring wellness workshop, not group therapy. For more info: www.PerfectHarmonySolutions.com
(508) 921-7131 View (508) 921-7131
On Saturday, July 19, 2025, 10am-12:30pm, discover a powerful connection between fresh flowers and your inner wisdom at "In Bloom!" This unique self-care workshop offers a refreshing blend of intuitive flower arranging and SoulCollage®, a creative way to craft personal insight cards that reveal your own inner wisdom to guide you! You'll leave this workshop feeling inspired and more connected to your creative self, and with a beautiful floral arrangement and custom-made insight cards! Note: This is a wellness workshop, not group therapy. **Pre-registration is required; email to sign up!**
Photo of Ashley Starzec - Perfect Harmony Relationship Solutions, LLC, Marriage & Family Therapist, MA, LMFT
Hosted by Perfect Harmony Relationship Solutions, LLC
Marriage & Family Therapist, MA, LMFT
Group meets in Oxford, MA 01540
On Saturday, July 19, 2025, 10am-12:30pm, discover a powerful connection between fresh flowers and your inner wisdom at "In Bloom!" This unique self-care workshop offers a refreshing blend of intuitive flower arranging and SoulCollage®, a creative way to craft personal insight cards that reveal your own inner wisdom to guide you! You'll leave this workshop feeling inspired and more connected to your creative self, and with a beautiful floral arrangement and custom-made insight cards! Note: This is a wellness workshop, not group therapy. **Pre-registration is required; email to sign up!**
(508) 921-7131 View (508) 921-7131

More Groups Nearby

Are you an adult experiencing low self esteem, depression or anxiety? Our 3-day immersive course merges nature's tranquility and companionship of friendly animals with engaging CBT strategies, empowering you with invaluable self-awareness and resilience tools to overcome life's challenges. December 26-28 ONLY.
Photo of Emily Brewster - Bracken Hill Farm, Counselor, LMHC, LICSW, PhD
Hosted by Bracken Hill Farm
Counselor, LMHC, LICSW, PhD
Group meets in Northborough, MA 01532
Are you an adult experiencing low self esteem, depression or anxiety? Our 3-day immersive course merges nature's tranquility and companionship of friendly animals with engaging CBT strategies, empowering you with invaluable self-awareness and resilience tools to overcome life's challenges. December 26-28 ONLY.
(508) 501-7979 View (508) 501-7979
Our Partial Hospital Program is a voluntary, short-term, structured outpatient mental health program that helps patients to develop independent living skills and healthy lifestyles. Patients in our program have either completed an inpatient psychiatric stay or are taking part in this program as an alternative to being admitted to an inpatient mental health setting. Program Length The expected length of the program is approximately 10 days.
Photo of Chris Lauzon - Hospital for Behavioral Medicine, Treatment Center
Hosted by Hospital for Behavioral Medicine
Treatment Center
Group meets in Worcester, MA 01606
Our Partial Hospital Program is a voluntary, short-term, structured outpatient mental health program that helps patients to develop independent living skills and healthy lifestyles. Patients in our program have either completed an inpatient psychiatric stay or are taking part in this program as an alternative to being admitted to an inpatient mental health setting. Program Length The expected length of the program is approximately 10 days.
(774) 214-2845 View (774) 214-2845
A unique therapeutic experience on a peaceful farm, where teens can connect with animals build mindfulness skills and enhance emotional resilience. Hands-on interactions with horses, goats, chickens, guinea pigs, and calming campfire sessions. With the support of a licensed therapist, participants receive guidance and learn practical coping skills to manage stress and anxiety. Our farm setting provides a safe and nurturing environment where teens can gain confidence, explore their emotions, and form lasting connections
Photo of Emily Brewster - Bracken Hill Farm, Counselor, LMHC, LICSW, PhD
Hosted by Bracken Hill Farm
Counselor, LMHC, LICSW, PhD
Group meets in Northborough, MA 01532
A unique therapeutic experience on a peaceful farm, where teens can connect with animals build mindfulness skills and enhance emotional resilience. Hands-on interactions with horses, goats, chickens, guinea pigs, and calming campfire sessions. With the support of a licensed therapist, participants receive guidance and learn practical coping skills to manage stress and anxiety. Our farm setting provides a safe and nurturing environment where teens can gain confidence, explore their emotions, and form lasting connections
(508) 501-7979 View (508) 501-7979
Online Group Therapy for 8 Women focuses on learning about the Internal Family Systems (IFS) model of healing and connecting with other women who may be experiencing the same challenges in life. You will receive compassion and support as you “find your way back home” to your Authentic Self. Women who are interested in joining the next group starting in September 2025 should contact me so we can set up an interview to see if we are a good fit.
Photo of Nadine Lucas, Counselor, CAGS, LMHC
Hosted by Nadine Lucas
Counselor, CAGS, LMHC
Group meets in Northborough, MA 01532
Online Group Therapy for 8 Women focuses on learning about the Internal Family Systems (IFS) model of healing and connecting with other women who may be experiencing the same challenges in life. You will receive compassion and support as you “find your way back home” to your Authentic Self. Women who are interested in joining the next group starting in September 2025 should contact me so we can set up an interview to see if we are a good fit.
(774) 757-6134 View (774) 757-6134
Once three or more persons contact me, this group will focus on individual's skills to practice in order to sense early signs of anxiety in the body; to master behaviors targeting early signs in order to minimize/eliminate them; mild, physical movements to strengthen one's sense of control over one's body; and to find the "good enough" words each member can choose to use to communicate their anxiety challenge(s). Framework: CBT or hypnotherapy.
Photo of John Richard Casey - J R Casey Counseling & Hypnosis, Clinical Social Work/Therapist, LICSW, CCH
Hosted by J R Casey Counseling & Hypnosis
Clinical Social Work/Therapist, LICSW, CCH
Group meets in Worcester, MA 01603
Once three or more persons contact me, this group will focus on individual's skills to practice in order to sense early signs of anxiety in the body; to master behaviors targeting early signs in order to minimize/eliminate them; mild, physical movements to strengthen one's sense of control over one's body; and to find the "good enough" words each member can choose to use to communicate their anxiety challenge(s). Framework: CBT or hypnotherapy.
(774) 221-6116 View (774) 221-6116
Women with breast cancer can carry life-long physical and emotional changes that impact many areas of their lives and relationships. For many, that impact may not end when the treatment does. Many women face breast cancer as a life-long and ongoing experience. Dr. Megan Brault, a breast cancer-survivor herself, facilitates this support group focused on the female experience from diagnosis, to treatment, to survivor/thriver-ship.
Photo of Dr. Megan E Brault, Psychologist, PsyD
Hosted by Dr. Megan E Brault
Psychologist, PsyD
Group meets in Shrewsbury, MA 01545
Women with breast cancer can carry life-long physical and emotional changes that impact many areas of their lives and relationships. For many, that impact may not end when the treatment does. Many women face breast cancer as a life-long and ongoing experience. Dr. Megan Brault, a breast cancer-survivor herself, facilitates this support group focused on the female experience from diagnosis, to treatment, to survivor/thriver-ship.
(508) 709-7765 View (508) 709-7765
The group meets once a month to talk about the ups and down of waiting for that call to come to possible adopt a new baby/child. The group will learn new strategies to manage this difficult time and frustrations that go along with this trying process.
Photo of Robbin Miller, Counselor, LMHC
Hosted by Robbin Miller
Counselor, LMHC
Group meets in Northborough, MA 01532
The group meets once a month to talk about the ups and down of waiting for that call to come to possible adopt a new baby/child. The group will learn new strategies to manage this difficult time and frustrations that go along with this trying process.
(508) 593-9274 View (508) 593-9274
DBT is a specialized treatment protocol that addresses problematic behaviors that individuals have developed to cope with overwhelming emotions. Some of these behaviors may be self-injury, suicidal thoughts/behaviors, substance use, sudden and intense anger, and difficulty in relationships. DBT combines unconditional validation of an individual's emotional experience while teaching concrete strategies to manage intense emotions effectively and build "a life worth living." Our DBT program for adults includes weekly DBT Skills Groups, weekly DBT Individual Therapy, and in-the-moment coaching support.
Photo of Kerrie Toole - Castlebrook Counseling Services, Inc., Treatment Center, LICSW
Hosted by Castlebrook Counseling Services, Inc.
Treatment Center, LICSW
Group meets in Westborough, MA 01581
DBT is a specialized treatment protocol that addresses problematic behaviors that individuals have developed to cope with overwhelming emotions. Some of these behaviors may be self-injury, suicidal thoughts/behaviors, substance use, sudden and intense anger, and difficulty in relationships. DBT combines unconditional validation of an individual's emotional experience while teaching concrete strategies to manage intense emotions effectively and build "a life worth living." Our DBT program for adults includes weekly DBT Skills Groups, weekly DBT Individual Therapy, and in-the-moment coaching support.
(508) 475-9110 View (508) 475-9110
This group gently encourages healthy risk-taking behaviors (i.e., initiating conversations; self-advocacy; expanding one's social circle). Separate groups are available for people in their 20's, 30's, and 40's.
Photo of Kimberly S Gerber, Psychologist, PsyD
Hosted by Kimberly S Gerber
Psychologist, PsyD
Group meets in Westborough, MA 01581
This group gently encourages healthy risk-taking behaviors (i.e., initiating conversations; self-advocacy; expanding one's social circle). Separate groups are available for people in their 20's, 30's, and 40's.
(617) 410-8046 View (617) 410-8046
Focuses on developmental changes, aging, illness and facing death
Photo of Marcia Joan Amarsingh, Drug & Alcohol Counselor, MSc, LADC- 1, CDP, CADC
Hosted by Marcia Joan Amarsingh
Drug & Alcohol Counselor, MSc, LADC- 1, CDP, CADC
Group meets in Worcester, MA 01608
Focuses on developmental changes, aging, illness and facing death
(508) 338-4797 View (508) 338-4797
The goal of Dialectical Behavioral Therapy (DBT) is to “build a life worth living.” One of the modes for achieving this goal is to learn skills. Much like building a motorcycle, when we have the right tools and skill sets, we are more effective and successful. The skills taught in DBT skills group include: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. The hope is by mastering these skills, we can more effectively live our lives. DBT has been shown to improve self-destructive behaviors, depression, mood management, emotion regulation, experiential avoidance, assertiveness, social functioning, coping skills, and communication.
Photo of Tessa Hayes Licsw - LIKEMIND Mental Health & Wellness, Inc., Clinical Social Work/Therapist, LICSW
Hosted by LIKEMIND Mental Health & Wellness, Inc.
Clinical Social Work/Therapist, LICSW
Group meets in Worcester, MA 01608
The goal of Dialectical Behavioral Therapy (DBT) is to “build a life worth living.” One of the modes for achieving this goal is to learn skills. Much like building a motorcycle, when we have the right tools and skill sets, we are more effective and successful. The skills taught in DBT skills group include: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. The hope is by mastering these skills, we can more effectively live our lives. DBT has been shown to improve self-destructive behaviors, depression, mood management, emotion regulation, experiential avoidance, assertiveness, social functioning, coping skills, and communication.
(508) 841-3038 View (508) 841-3038
This group helps you navigate through the many lifestyle changes (i.e., putting oneself first; managing cravings) necessary for successful adjustment to post-operative life.
Photo of Kimberly S Gerber, Psychologist, PsyD
Hosted by Kimberly S Gerber
Psychologist, PsyD
Group meets in Westborough, MA 01581
This group helps you navigate through the many lifestyle changes (i.e., putting oneself first; managing cravings) necessary for successful adjustment to post-operative life.
(617) 410-8046 View (617) 410-8046
DBT is a specialized treatment protocol that addresses problematic behaviors that individuals have developed to cope with overwhelming emotions. Some of these behaviors may be self-injury, suicidal thoughts/behaviors, substance use, sudden and intense anger, and difficulty in relationships. DBT combines unconditional validation of an individual's emotional experience while teaching concrete strategies to manage intense emotions effectively and build "a life worth living." Our full DBT programs include DBT Skills Groups, DBT Individual Therapy, Skills Coaching for Parents, and in-the-moment coaching. We also accept referrals for our DBT Skills Group as adjunct to traditional therapy.
Photo of Kerrie Toole - Castlebrook Counseling Services, Inc., Treatment Center, LICSW
Hosted by Castlebrook Counseling Services, Inc.
Treatment Center, LICSW
Group meets in Westborough, MA 01581
DBT is a specialized treatment protocol that addresses problematic behaviors that individuals have developed to cope with overwhelming emotions. Some of these behaviors may be self-injury, suicidal thoughts/behaviors, substance use, sudden and intense anger, and difficulty in relationships. DBT combines unconditional validation of an individual's emotional experience while teaching concrete strategies to manage intense emotions effectively and build "a life worth living." Our full DBT programs include DBT Skills Groups, DBT Individual Therapy, Skills Coaching for Parents, and in-the-moment coaching. We also accept referrals for our DBT Skills Group as adjunct to traditional therapy.
(508) 475-9110 View (508) 475-9110
NuLife is a company dedicated to enhancing well-being through innovative health and wellness solutions. They focus on developing advanced technology, personalized health programs, and supplement products designed to improve energy, mental clarity, and overall vitality. NuLife emphasizes a holistic approach to health, combining scientific research with natural ingredients to support optimal body function. Their offerings may include dietary supplements, functional beverages, and health coaching, all aimed at helping individuals achieve better physical and mental performance. Committed to quality and safety, NuLife prioritizes transparency and customer satisfaction, striving to empower people to lead healthier, more balanced lives.
Photo of Alexander Zeiger - Nulife Behavioral Health, Treatment Center
Hosted by Nulife Behavioral Health
Treatment Center
Group meets in Worcester, MA 01608
NuLife is a company dedicated to enhancing well-being through innovative health and wellness solutions. They focus on developing advanced technology, personalized health programs, and supplement products designed to improve energy, mental clarity, and overall vitality. NuLife emphasizes a holistic approach to health, combining scientific research with natural ingredients to support optimal body function. Their offerings may include dietary supplements, functional beverages, and health coaching, all aimed at helping individuals achieve better physical and mental performance. Committed to quality and safety, NuLife prioritizes transparency and customer satisfaction, striving to empower people to lead healthier, more balanced lives.
(508) 978-1739 View (508) 978-1739
Darling Mental Health provides a free (donations accepted) bi-weekly drop-in support group for those in the poly/kink community looking for support in navigating Ethical Non-Monogamy (ENM). Supervised by an AASECT certified sex therapist, groups will provide connection, support, resources, and feedback on how people who practice ENM can better address things like transparency, accountability, incidents of infidelity, and navigating what is authentic in their relationship. For more information please go to: darlingmentalhealth.com
Photo of Jeremy J Darling - Darling Mental Health, Counselor, LMHC, CST
Hosted by Darling Mental Health
Counselor, LMHC, CST
Group meets in Worcester, MA 01609
Darling Mental Health provides a free (donations accepted) bi-weekly drop-in support group for those in the poly/kink community looking for support in navigating Ethical Non-Monogamy (ENM). Supervised by an AASECT certified sex therapist, groups will provide connection, support, resources, and feedback on how people who practice ENM can better address things like transparency, accountability, incidents of infidelity, and navigating what is authentic in their relationship. For more information please go to: darlingmentalhealth.com
(508) 545-9756 View (508) 545-9756
SUSPENDED DUE TO COVID. WE ARE MEETING ONLINE CURRENTLY. This free weekly drop-in group MEDITATION class teaches MINDFULNESS of the breath, RELAXATION, an open HEART and AWARENESS in daily life. There is no charge to attend. It is a free service. It is NOT an "anger management group," it is NOT a discussion group, it is NOT a therapy or counseling group. It IS an opportunity to practice mindfulness meditation in a group setting. Similar to Jon Kabat Zinn's (U. Mass Medical. No minors. We sit on chairs
Photo of Paul Bail - Leominster Wellness - Dr. Paul Bail, Psychologist, Psychologist, PhD
Hosted by Leominster Wellness - Dr. Paul Bail, Psychologist
Psychologist, PhD
Group meets in Leominster, MA 01453
SUSPENDED DUE TO COVID. WE ARE MEETING ONLINE CURRENTLY. This free weekly drop-in group MEDITATION class teaches MINDFULNESS of the breath, RELAXATION, an open HEART and AWARENESS in daily life. There is no charge to attend. It is a free service. It is NOT an "anger management group," it is NOT a discussion group, it is NOT a therapy or counseling group. It IS an opportunity to practice mindfulness meditation in a group setting. Similar to Jon Kabat Zinn's (U. Mass Medical. No minors. We sit on chairs
(978) 571-9990 View (978) 571-9990
Our new group will be ran by one our DBT trained therapist. The group will run for 6 weeks and will be meeting on Wednesdays from 5-6pm in person. The group will be for 12-17 years old. The curriculum will focus on learning various DBT skills such as mindfulness, emotional regulation and interpersonal effectiveness.
Photo of Tanieka Gentles - Gentles Counseling Services LLC, Counselor, MA, LMHC
Hosted by Gentles Counseling Services LLC
Counselor, MA, LMHC
Group meets in Worcester, MA 01605
Our new group will be ran by one our DBT trained therapist. The group will run for 6 weeks and will be meeting on Wednesdays from 5-6pm in person. The group will be for 12-17 years old. The curriculum will focus on learning various DBT skills such as mindfulness, emotional regulation and interpersonal effectiveness.
(774) 241-9600 View (774) 241-9600
"Taking Control" is a Dialectical Behavioral Therapy (DBT) group for teens and adolescents. The group will focus on: Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness. If you ever feel overwhelmed with your emotions, say things and feel regret later, struggle telling others how you feel and what you need, have difficulty managing what is going on in your life, or need to be compassionate with yourself, you are not alone. The total cost for 8-week group is $280. It will be held on weekends and runs in cycles call or email to obtain info on the next group!
Hosted by Grishelda Hogan
Clinical Social Work/Therapist, LICSW, ACSW, BCPC
Group meets in Mendon, MA 01756
"Taking Control" is a Dialectical Behavioral Therapy (DBT) group for teens and adolescents. The group will focus on: Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness. If you ever feel overwhelmed with your emotions, say things and feel regret later, struggle telling others how you feel and what you need, have difficulty managing what is going on in your life, or need to be compassionate with yourself, you are not alone. The total cost for 8-week group is $280. It will be held on weekends and runs in cycles call or email to obtain info on the next group!
(508) 863-4924 View (508) 863-4924

See more therapy options for Oxford

FAQs - About Group Therapy and Support Groups

How can I find a support group in Oxford?

To find a support group in your area, start by entering your city, zip code, or the name of the group into the search bar at the top of the page. When searching, consider whether you prefer an in-person or virtual group. This can help you decide how broad your geographic search should be. If you are open to virtual groups, you might want to search by state instead of just your city, especially if there are limited options nearby.

Once you complete your search, you can use the filters to narrow the results by selecting specialties (such as grief, trauma, or eating disorders), therapeutic approaches, age groups, and other criteria to find a group that best fits your needs.

How does group therapy work?

Group therapy is led by one or more trained therapists and provides a space where participants can process their experiences and learn from others facing similar challenges. Groups may focus on a specific issue—such as addiction, grief, physical illnesses, parenting, or caregiving—or they may center around a particular therapeutic approach, such as Cognitive Behavioral Therapy (CBT), social skill development, or Exposure Therapy. Some groups are also designed for specific populations, such as teens, veterans, or LGBTQ+ individuals.

It’s also important to distinguish group therapy from peer-led support groups, like Alcoholics Anonymous. While both can offer valuable support, therapy groups are typically led by licensed professionals and follow a more structured format. Therapy groups often meet for a fixed length of time with a consistent group of members, while many peer support groups meet for an indefinite period of time with members coming and going.

What are the benefits of group therapy?

Group therapy offers several important benefits. It brings together people facing similar challenges—whether related to mental health, physical health, or life transitions—and creates a supportive environment where participants can exchange feedback, share experiences, and learn from one another. Hearing different perspectives can help individuals discover new coping strategies and practical tools they may not have encountered on their own. Sharing personal experiences, such as coping with a serious illness or navigating family struggles, can also reduce feelings of isolation and foster a sense of connection and understanding. In addition to emotional support, group members often gain useful, real-world advice from peers who have faced similar situations.

Group therapy is typically more affordable than individual therapy and, for certain conditions, can be equally effective. Many groups also include structured activities—such as guided journaling, cognitive-behavioral exercises, or role-playing—to help participants develop concrete skills they can apply in daily life.

Is group therapy as effective as individual therapy?

It is difficult to make a blanket statement about the effectiveness of support groups, as they vary widely in focus and the conditions they address. However, support groups can be highly valuable in helping individuals gain emotional support and achieve meaningful treatment outcomes. For certain conditions, such as substance use, research has shown that group therapy can be particularly effective—sometimes just as effective as individual therapy—in supporting long-term recovery.

Many professionals attribute the effectiveness of group therapy to the unique benefits of the group setting, which fosters peer-to-peer learning and a sense of connection through shared experiences. Group settings also offer accountability and encouragement from both facilitators and fellow participants, which helps sustain motivation and supports continued progress. These factors together play a key role in promoting the overall effectiveness of group therapy.

How much does group therapy cost?

Group therapy is typically less expensive than individual therapy, with sessions typically costing between $50 and $75 each. In comparison, individual therapy can cost anywhere from $100 to $200 or more per session, even with insurance. Some therapists or organizations offer low-cost or free group therapy options, particularly through community centers or nonprofit organizations. In some cases, groups may require payment upfront for a set number of sessions, such as paying for six weekly sessions at the first meeting. However, many providers offer payment plans to help make participation more accessible if this upfront payment is required.

Does insurance cover group therapy?

As with individual therapy, insurance coverage for group therapy varies based on factors such as your specific insurance plan, the purpose of the group, your diagnosis, and whether the group provider is in-network. Many insurance plans cover group therapy sessions that address diagnosable mental health conditions, such as substance use disorders, anxiety, or depression.

However, groups that focus on topics not directly tied to a mental health diagnosis—such as parenting support or divorce recovery—are less likely to be covered. Because coverage can vary widely, it’s important to check with your insurance provider before joining a group to confirm whether the sessions will be covered and what out-of-pocket costs you may be responsible for.

How long does group therapy last?

The length of each group therapy session typically ranges from 45 minutes to two hours, depending on the therapy approach, the group’s goals, and how often the group meets. In some cases, group therapy is part of a larger treatment program, such as an Intensive Outpatient Program (IOP), where group sessions complement individual therapy and are scheduled as part of the program’s overall structure.

The duration of participation in a group also varies. Some groups are designed to be short-term, lasting anywhere from 6 to 24 weeks—for example, bereavement groups or skills-based groups like those using Dialectical Behavioral Therapy (DBT). Other groups may be longer-term, lasting a year or more, and some ongoing support groups meet indefinitely, allowing participants to stay as long as they find the group helpful.

What are the limitations of support groups?

Support groups offer many benefits, but they also have certain limitations. Unlike therapy groups, many support groups do not provide formal therapeutic treatment and are not led by licensed mental health professionals. For individuals seeking clinical treatment for specific mental health diagnoses—such as depression, eating disorders, or substance use—individual therapy or group therapy led by a licensed professional may offer more personalized and specialized care.

The effectiveness of a support group also depends heavily on the group’s participants and the overall group dynamic. When members engage respectfully and offer constructive support, the group can foster valuable peer-to-peer learning. However, if certain participants dominate discussions, provide inaccurate advice, or create conflict, it can disrupt the group’s sense of safety and reduce its effectiveness. Confidentiality can also be harder to maintain in support groups, particularly in open groups where participants can join or leave at any time. With new members regularly entering the group, it can be more difficult to build and sustain a consistent sense of trust and privacy.