How Dr. Amelia Richardson moved six anxiety support groups out of email and into one private space

Nine weeks after the migration, drop-out across her 12-week anxiety programmes had halved and weekly homework completion had tripled. She also, in her own words, "got Sunday evenings back".

Where she started

Amelia qualified as a clinical psychologist in 2011 and set up an independent practice in Clifton, Bristol, in 2017. Around 60% of her caseload is 1:1, and the rest is groupwork — specifically, a 12-week CBT-informed anxiety programme that runs four cohorts a year, plus two shorter 6-week groups for postnatal anxiety and health anxiety.

By 2024 she was running six groups simultaneously across the calendar, with 8–12 members in each. She had no practice manager. Her entire between-session infrastructure looked like this:

• A Gmail group label for each cohort, with a weekly recap email to all members.
• A WhatsApp broadcast list for urgent updates and reminders.
• A paper A4 session diary where she hand-wrote notes on each member during group and transcribed them to her clinical notes later.
• A Google Form that went out each Monday for between-session reflections, which some members filled in and most didn't.

It worked, technically. It was also consuming her Sunday evenings and Wednesday mornings.

The breaking point

The specific moment that pushed her to find a different tool was not, as she expected, an administrative failure. It was an ethical one.

"A member of one of the health anxiety groups had sent me a really honest reflection over WhatsApp about a panic episode she'd had at work. She meant it for me. But the way WhatsApp broadcast lists work, if you reply to the broadcast, your reply becomes visible to everyone. She did not realise that and nor, in that moment, did I. Nothing awful happened — I caught it and pulled the reply before it went out — but I realised I was one tired Tuesday evening away from a real privacy breach."

She spent the next fortnight looking at options. She tried two of the large telehealth platforms, both of which quoted her more than £400 a month and required her to route 1:1 clinical records through their system, which she did not want. She tried a Slack workspace. "Absolutely not, for therapy."

A colleague running a postnatal support group had mentioned Bitir. Amelia downloaded it on a Saturday.

The first week

She migrated her smallest group first — an 8-person postnatal anxiety cohort that was in week three of six. She created a private, invite-only group in Bitir, set herself as manager, and invited the eight members by phone number. Seven joined within two hours, the eighth the next morning.

The first thing she set up was a recurring weekly poll — a five-question mood and sleep check-in that went out every Monday at 9am and stayed open until Wednesday. Previously she had been sending this as a Google Form and getting 2–3 responses out of 8.

On the Bitir version she got seven responses the first week, with the eighth coming in late Wednesday. The response rate stayed above 80% for the rest of the cohort.

She thinks the difference is not the tool — it's the fact that the poll arrived in the same app where members were reading their session recap and checking what their homework was. No context switching. No remembering to open a different app.

How she set up the full programme

Once the postnatal group was stable, she migrated her next cohort — a full 12-week anxiety group of eleven people — and used a structure that has since become her template for every subsequent cohort.

1. Group. Private, invite-only. Members' display mode set to "handle" rather than real name. Amelia is the only one who sees the phone-number mapping.
2. Goals. One group goal ("complete 12 weeks of structured practice"), plus individual goals set in week one and reviewed at week six.
3. Weekly assignment. A single assignment per week, with a deadline the day before the next session, and space for the member to attach a written reflection or photo of a worksheet.
4. Weekly poll. Five questions: mood, sleep, anxiety level 1–10, use of breathing exercises, one thing that helped this week.
5. Session recap. Posted by Amelia as a manager-only post within 24 hours of each session, summarising what was covered and linking to resources.
6. Celebrations. She celebrates — publicly, inside the group — any member who completes their weekly assignment for four weeks in a row.

What private member posts changed

The feature she talks about most is private member posts. In Bitir, when a member writes a post it is private to the manager by default. Amelia decides, reading it, whether to leave it private or publish it to the group.

This matters in a therapy context for a specific reason: members need to be able to report honestly to their clinician without performing for the rest of the group. On a WhatsApp chat there is no version of "tell me honestly, but between us". On Bitir there is.

She estimates that about 70% of member reflections stay private. The remaining 30% she publishes, with a light-touch manager note, because she thinks the whole group will benefit from seeing that someone had a hard week and survived it.

Results after one full cohort

The drop-out number matters to her most. Anxiety groups are hard to finish — members drop out when they feel the tool is not working, when they feel invisible, or when a bad week makes them quietly disappear.

"A weekly check-in, visible goal progress, and the knowledge that I could see they were trying even when they didn't come to session — that's what kept them in."

What she would tell another therapist

Her advice to other psychologists considering a move like this is practical:

• Migrate one group first, not all of them. Get comfortable before the stakes are higher.
• Use handles, not real names. It changes how members write.
• Set up the recurring weekly poll before the first session. Do not try to add it later.
• Treat private-by-default as a clinical feature, not a technical one. It changes what members are willing to tell you.

What's next

Amelia is planning to run a seventh group — a daytime group for older adults with generalised anxiety — starting in September. She is also, separately, co-authoring a practice paper on the clinical implications of private-by-default digital tools in group therapy. Her working subtitle: "A small feature, a big difference."