Local Facilitators Lead the Way in Stigma Reduction

The Community Conversations on Opioid Use Disorder project brings rural community members together to talk about stigma related to substance use disorder (SUD), its impact locally, and community-designed ways to reduce it. Since the project was launched in 2021 through May 2026, UR Medicine Recovery Center of Excellence has held 203 Community Conversations workshops with 2,283 participants across 23 states. The work doesn’t end there, however. To help rural communities sustain their stigma-reduction efforts for the long term, we train and support local facilitation leaders.

Training is available to people who have completed the workshop and are interested in going on to facilitate Community Conversations themselves. So far, we have held 75 training sessions with 848 participants. The training, which is free like the workshops themselves, prepares community members to hold these conversations—bringing more residents into the effort of reducing stigma locally. We combine the training with ongoing direct support for trained facilitators and other local organizers.

Starting with a conversation

By training local leaders to be facilitators and supporting their ongoing efforts, we hope to make this project sustainable in rural communities while increasing its impact. “While it’s important that we get out there and facilitate Community Conversations, it’s imperative that communities carry the torch, so to speak,” says Lisham Ashafioun, PhD, faculty lead for the project. Facilitation leaders are “ultimately the ones who can make the biggest impact since they live there, so we need to make sure they have the tools they need to feel confident in their role.”

The training, which lasts two to three hours, maps out the evidence-based curriculum and provides detailed guidance on how to hold a workshop. It discusses ways to facilitate difficult conversations and create a nonjudgmental atmosphere where people feel free to speak openly. Training also covers how to use the workshop materials provided—slides, discussion guides, and portraits and videos featuring the stories of people in recovery—to encourage participants to reflect on their beliefs, share their experiences, and take steps together to reduce stigma.

As Debi O’Connor, a facilitation leader in Spartanburg, SC, puts it, “Walking through a Community Conversation allows people to explore and understand what stigma is and how it forms, using their own words and experiences to become aware of how it has impacted their lives.”

Trusting the slides

The training stresses that facilitators don’t need to have all the answers. They are provided with a slide deck to use during workshops, which walks them through the curriculum step by step.

“We use a ‘trust the slides’ approach,” says Tedra L. Cobb, project consultant and facilitator. “Each video and discussion builds on the next, so the key is to trust the process and encourage participation. You don’t need to be an expert.”

Cobb encourages facilitation leaders to bring their own style and strengths to the role and trust the wisdom of people in the room. “Participants bring valuable lived experience—as people in recovery, family members, or health care providers. The facilitator’s role is simply to guide the conversation and create space for dialogue.”

Supporting sustainability

We provide free resources and support to trained facilitators and others working to organize Community Conversations in their rural area. In addition to the slide deck, resources include:

• Workshop planning guide

• Step-by-step facilitation guide

• Facilitator training video

• Facilitation leader best practices guide

• Community host best practices guide

• Handouts related to SUD

We also host monthly office hours where facilitators can ask questions, reflect on their experiences, and learn along with one another and the center’s project team. “Office hours have become a space where facilitators learn from one another as much as from our team,” says Project Manager Ken Sayres. “They share ideas about outreach, coalition partnerships, and ways to engage their communities, while also offering encouragement and practical advice to peers who are preparing to host their own conversations.” Sayres notes that many of the resources we now provide to facilitators were shaped directly by feedback shared during these sessions.

We also encourage facilitators to reach out to us for one-on-one assistance as needs arise. Refresher trainings are available for those interested in review.

“The training and materials provided me with the tools and confidence to lead effective Community Conversation workshops in my county,” says Brianna Halliwell of Pickens, SC. “With a clear and user-friendly workbook, along with the ongoing support from the [center’s] team—who are always just an email or phone call away—I successfully hosted workshops aimed to reduce stigma in collaboration with our local behavioral health/injury prevention coalition.”

Collaboration and change

Jessica Seel of the South Carolina Office of Rural Health says the Community Conversations project “has been instrumental in building strong partnerships and collaborative relationships across our state. Our events have been highly successful, often sparking new projects and, most importantly, equipping participants to lead their own workshops.”

At their February 2026 office hours, facilitation leaders reflected on how important “just letting people talk” has been in their community. Moreover, they are seeing perspectives about SUD and stigma changing through Community Conversations. The workshop “opened the eyes of the community to the issue—that it does exist,” says Joyce Runyan, who leads conversations in Quay County, NM. “Awareness is a first step toward recognizing there is a problem and working together to address it.”

Facilitators report strong interest from community members in learning more about and addressing stigma, with participants sometimes staying on beyond the scheduled time to start planning together. Connections made at workshops are leading to cross-sector collaboration to support recovery.

Ginger Miller, a facilitation leader in Warren and Washington counties, NY, sees enhanced collaboration and support for recovery in her rural community. For example, the hospital now welcomes peers to meet with people in the behavioral health unit, connects patients with peer services before discharge, and allows peers to bring activities (such as music, arts and crafts, and games) to enrich recovery groups onsite. The community has hired a court navigator and is developing a peer internship program, and multiple housing programs are using peers to support their efforts. Miller emphasizes these are “huge strides for our community.”

Continuing the conversation

As facilitation leaders move Community Conversations into the future, we work with them to support fidelity to the curriculum. For example, Cobb observes workshops led by trained facilitators and provides suggestions on improving its delivery. In addition to being opportunities for constructive feedback, this process helps us measure how effectively we are delivering the training program. Whether led by the center or by local facilitators, workshops include pre- and post-surveys to measure the project’s impact in shifting attitudes related to SUD.

“We are excited about disseminating Community Conversations and learning how it’s resonating in rural communities,” says Ashrafioun. “As the project matures, we continue to enhance the training, resources, and support we provide facilitators to help them sustain this effort in their communities.”