Passing on your knowledge and experience to the next generation of therapists can enormously enrich your life as a therapist.
One of the most satisfying aspects of my own professional life has been providing supervision to psychology interns and practicum students, and having the joy of watching self confidence and competence steadily develop. However, this joy also comes with challenges. I have found this to be particularly so in the current climate in which trainees often find themselves placed in practicums or internships where the program may be too understaffed to provide ideal programming for clients, or adequate on-site supervision for trainees.
Since many of these programs are group oriented, I’d like to focus on some of the supervisory hurdles that are most likely to come up for the supervisor who trains beginning group therapists in these settings.
Trainees’ past experience: Some trainees may have led therapeutic groups in the past but without training or supervision — their experiences merely reinforcing ineffectual interventions, which have now become habitual. Others come for training with no prior experience leading therapeutic groups (their knowledge of group leadership coming solely from watching the group leaders they are most familiar with — teachers and parents). In either case, much of the trainee’s ‘knowledge’ is likely to run counter to effective leadership in therapeutic groups. The supervisor’s job is to help the student undo old learning and replace it with strategies that are more clinically useful, taking nothing for granted and making no assumptions about what the trainee would ‘naturally’ know to do.
Clinical setting: It is equally important that the supervisor take nothing for granted about the clinical setting in which the supervisee is working, or the ways in which that setting supports effective group work. Increasingly, as funds for mental health care shrink and caseloads become overwhelming in inpatient and partial hospital settings, ‘doing groups’ seems like a good solution. Unfortunately, administrators who set up group programs often know very little about groups or what it takes to makes them therapeutic. They may know only that groups are a cost effective way of managing care when there are too many patients and too few staff.
Basic group parameters: Basic parameters that the supervisor might well take for granted are often ignored, such as enough chairs for every group member, ability to sit in a way that provides members and leaders visual access to one another, sound and heat control, time and physical boundaries that are respected.
Even in programs which require that members participate in all groups, the groups themselves may be so fluid that patients can enter any time without notifying the leaders that they will be late, or leave anytime (also without notice) to meet with doctors or caseworkers — the latter often entering freely to pull patients out. Often little attention is given to what will actually happen in the groups, and little preparation or training is given to new leaders other than watching another leader who may be equally unprepared and untrained.
Institutional fears about groups: Along with this, in many settings there is concern about potential dangers in groups — the notion that groups are scary places, where, unless things are tightly controlled, bad things can happen. As such, safety concerns and ‘containment’ often take on disproportionate importance, reflected in strong messages to trainees about not doing anything to ‘trigger’ patients. Often this amounts to encouraging them to avoid the topics that may be most important for patients to openly talk about, such as sex, drugs, thoughts about self-harm — clinical constraints that would rarely be imposed on an individual, couples, or family therapists, no matter how green.
While attending to these hurdles, the effective supervisor will assist the beginning group therapist to provide group structure, help group members to interact, and learn to apply simple moves to further group process, regardless of whether leading interpersonal process groups, psycho-educational groups, discussion groups, or skills-based groups. And having done so the supervisor will reap the rewards of watching their trainees develop and grow.
This article is adapted from: Vannicelli, M. Supervising the beginning group leader in inpatient and partial hospital settings. Int J Group Psychoth 2014; 64(2):145-63.
© 2018 Marsha Vannicelli