Group therapy has been given the short end of the stick by graduate programs and agencies across the country. It is perplexing because group therapy has been shown in numerous studies to be as effective or more effective than individual therapy, more cost-effective for clients and quite lucrative for clinicians and agencies. Despite these benefits, most clinicians are only required to take one (if any) group therapy courses and often have no direct supervision of their work as group therapists. Often times, students are given intensive individual therapy supervision and then, early in their programs, are asked to lead groups with little to no training or supervision. This leads to the student typically having a “less than stellar” group therapy experience and thus devaluing group work altogether. Not to mention the clients who experience the groups that are led by untrained therapists and the damage that can be done leading to a negative reputation for group work.
Why? Dr. Irvin Yalom suggests that perhaps it is the difficulty in conducting rigorous, truly meaningful research because of the unique obstacles presented by groups. It may also be clinicians’ avoidance of the anxiety inherent in the role of the group therapist (greater public exposure, less sense of control, more clinical material to synthesize and little support or training). Or perhaps it evokes unpleasant memories of difficult peer group experiences for clinicians.
In my experience, I have also seen the “trickle-down effect” where because of the lack of training of clinicians in the past, they then devalue group work and feel less effective as group facilitators, so when they are mentoring trainees, they are not able to pass along enthusiasm and skills in group work and instead (often without awareness), pass on the same false beliefs about group work to them and the cycle continues.
On a positive note, I have been fortunate to be in an agency where a few individuals in leadership positions were fortunate to receive intensive training in group therapy and this resulted in a huge amount of enthusiasm for group work in the agency culture. It also resulted in prioritizing excellent group training for students and a thriving group therapy program. It was not uncommon for the majority of trainees that entered the program to have major hesitations about group work at the beginning of their internship and by the end, to feel truly passionate and inspired-sharing group work as their primary interest area.
This makes sense because group work is complex and requires a very specific skill set. If we have only been trained as individual therapists, we will not be able to use the unique energies of group work to create therapeutic experiences. And in the worst cases, we may inadvertently cause harm. Thinking that individual training is enough is similar to saying that being a “good listener” is the same as being a good therapist. Of course, that skill is very helpful and a great base to build on but there is so much more to learn to be truly effective.
And it’s not your fault! The American Group Psychotherapy Association requires a minimum of 12 hours of didactic training, 300 hours of group therapy leadership training, and 75 hours of group therapy supervision with a group therapist who has met the standards of certification. When we match this with the training most of us get in our graduate programs we realize that our educations are sorely lacking. And post-graduate education & training is difficult to come by. There are very few opportunities to get training and supervision in group work by trained therapists.
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