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The group therapist: Returning to in-person group therapy?

The global pandemic has not done the mental health world any favors. Many students elected not to seek counseling when the pandemic was at its worst; instead struggling through the isolation, loneliness and deep depressions with little to no support. Now that most universities have once again opened for business and many counseling centers have been able to re-engage with in-person treatment, the students have lined up at the doors like never before.

Cite this
Zukor, T. (2021, November 8). The group therapist: Returning to in-person group therapy? https://www.apadivisions.org/division-49/news-events/returning-in-person

In-person group therapy session

To those who know me well (and it’s a small group), I am extremely introverted. In my private life, I spend most of my time alone. I draw energy when not around other people. I am most comfortable when surrounded by my dogs, playing video games and reading books. At those times when I am most social and gregarious, I am almost certainly “on the clock” and performing some task that my profession (director of a college counseling center) demands. Like so many other people who are introverted and/or socially anxious, I can be engaging and (hopefully) even mildly charming. People who only know me professionally sometimes even believe that I’m an extrovert, but my 500+ unread Facebook messages and my nearly 100 unread text messages paint a different but likely far more accurate picture.

However, this week, I was reminded that no matter how much time I spend alone and no matter how overwhelming the demands of the world can sometimes be, I take immense solace in my groups—the spaces where I care deeply about others and know that other people are also connected to me. When the chips are down, and I need support to make it through the day, I almost naturally turn to various groups in my life to provide that care and grounding.

As mentioned, I am the director of a college counseling center. For anyone who works in the field, they know that this academic year has been particularly challenging. During a recent conversation with other directors in my state, it was universally agreed that our field has never experienced this combination of both volume and acuity. More students are in crisis than ever before. Hospitalizations are near an all-time high and the amount of cutting, suicidal ideation and acute pathology are enough to overwhelm even the most grounded of clinicians.  

The global pandemic has not done the mental health world any favors. Many students elected not to seek counseling when the pandemic was at its worst; instead struggling through the isolation, loneliness and deep depressions with little to no support. Now that most universities have once again opened for business, and many counseling centers have been able to re-engage with in-person treatment, the students have lined up at the doors like never.

This has happened at a time when many universities have suffered from significant financial hardship as a result of this same pandemic. Enrollment is lower at many places than either hoped or anticipated; which is only magnified by the millions of dollars of lost revenue that higher education experienced when so many colleges and universities physically closed their doors for almost 18 months and transitioned into a mostly remote learning environment.

One of the reasons I have spent nearly all my career in higher education is that I didn’t want to participate in the capitalistic grind. From both a pragmatic and value-based perspective, I strongly prefer to be paid a salary and to provide services to students without direct concern about their ability to afford the session. My clinical focus can be on how to provide the best service possible, with no regard as to whether some bureaucrat at an insurance company will approve of, and therefore pay for, the services I have already rendered to a client who is struggling.

However, COVID-19 has highlighted some dark truths about higher education. Public universities often say they are not beholden to the whims of the free market and the confines of a capitalist economy, but the truth is that though higher education may use different terms, it’s participating in the same game. Universities rarely talk about “revenue and income” and instead prefer the language of “retention” and maintaining student enrollment. The language is different, but the meaning is the same. At the end of the day, it always comes down to money. The more students that are enrolled, and remain enrolled for at least four years, provide the financial stability for universities to remain open. During this pandemic, when many places had to transition quickly to virtual services, it meant millions of dollars lost because of unused beds in residence halls and the sudden lack of demand for dining services; just to name a few of the issues. The end result has been cutbacks and furloughs. The math is simple—less money coming in means less money going out. Despite demand for mental health services being at a record high, enrollment at many places has decreased and that has led to a subsequent decrease in staffing and programing.

It is in this current environment that the rigors of collegiate mental health become even more challenging. I don’t know any director who doesn’t feel overwhelmed, under-appreciated and grossly under-paid. Fortunately, as the pandemic slowly begins to subside (thanks to vaccinations and behavior changes such as masking), many are grateful that travel is once again possible and in-person conferences have started to resume.

I am writing this article in an airport lounge; having spent most of the past week in Seattle, Washington, to attend the Association of University and College Counseling Center Directors conference. It is the time and place where hundreds of UCC directors from across the country get together to share stories, learn from each other and enhance the provision of services to our students.  

This year, it also felt like a lifeline. Even for someone like me, who does not socialize easily or often, I found the conference to be one of the most rewarding events of my professional career. It was exhilarating to spend time in the presence of other directors. While I love being a director, it can be a lonely experience. It is often not appropriate to share with counseling staff the challenges of the job. How do you tell an employee that you spent weeks “negotiating” with upper administration to avoid furloughs or that the “requirement” to see unvaccinated students in-person in small, poorly ventilated office spaces may feel hazardous (because it is), but is preferable to possible termination? 

For college counseling center directors, these are the real challenges of the moment. The stakes are high, and the work is isolating. I often cannot share these challenges with staff, but I can commiserate with other people who are experiencing the same dilemmas. I can not only bend the ear of other directors who find themselves in similar positions, but I can also learn from those who are smarter and almost-certainly wiser. The directors’ conference is the chance to connect with people who know the business and understand the unique challenges that the work presents. I have always been grateful to my director colleagues, but I didn’t appreciate how necessary that comradery can sometimes be, especially in times like these. They are “my” group and they are there for me. I am better able to care for other groups that I hold dear, such as “my staff,” who I have the pleasure of working with and advocating for during these difficult times.

As my conference concludes and I am minutes away from flying home, I am left with one inescapable conclusion: Even for many of us who prefer solitude and quiet contemplation over the raucousness of a more social world, we still need the groups that mean the most to us. Whether that group is family, friends, staff, or professional colleagues; being human, and struggling with the slings and arrows of the human condition, is almost always made more manageable by embracing the groups that we hold most dear.