Counseling center groups: A trainee’s perspective

It goes without saying that psychology trainees differ enormously in their interests and in their motives for pursuing a career in mental health. Even within the subpopulation that chooses to engage primarily in clinical work, the focus of each developing psychologist is unique. My own professional path has been strongly influenced by the university counseling center environment, a setting which provides a distinctive blend of experiences for trainees. One of the benefits of that blend is extended exposure to the modality of group psychotherapy.

I’ll be the first to acknowledge that group therapy was not a particular area of interest to me when I entered graduate school, and it has taken time to adjust my automatic bias for working in a one-to-one format. Often, psychology students spend the bulk of their clinical training learning skills for working with individual clients, with the unfortunate side effect that group psychotherapy comes to be perceived as a supplementary or secondary treatment option used to maximize efficiency rather than outcome. Though I took only a single group process class in graduate school and did not initially plan for group facilitation to be a large part of my career, I have since been fortunate to be mentored by several talented and dedicated group clinicians. As a result, I have come to hold a deep appreciation for group and believe that it is a powerful first-line treatment of choice for many clients.

In considering the evolution of my attitude toward group therapy, several things stand out which helped me develop the knowledge, skill, and confidence to facilitate group work. The following is an attempt to identify and describe a few elements that were integral for shaping and enriching my understanding of group therapy.

First and foremost, I feel that much of my appreciation for group stems from participating in the many different forms of group therapy. Didactic training in theory and practice is of course necessary (and I learned a great deal from my coursework and reading), but true learning happens experientially and over time. Prior to beginning internship at Oregon State University’s Counseling and Psychological Services (CAPS), I had some general exposure to both interpersonal process and skills-building groups, and the scaffolding approach of gradually increasing autonomy helped push me to step outside my comfort zone. During internship, my colleagues and I were strongly encouraged to run at least one process group, and there were numerous other opportunities to co-lead support or skills groups. Across my internship year, I co-facilitated three different styles of group, each with different senior staff, and I learned to adapt my leadership and therapy approach to fit the needs of each one. Seeing first-hand the variety of forms that group can take helped me appreciate the flexibility and power of the group modality.

Additionally, I grew in noticeable ways through working with a diverse range of clinicians who approached group work from a variety of frameworks. Throughout my training, I have worked with nine different group clinicians, each with a different theoretical orientation and unique way of interacting with group process. My exposure to different co-leadership styles taught me to adapt, flex and trust my own clinical judgment in the room, and I learned how to conceptualize group dynamics and process from multiple perspectives.

One particularly important skill I gained on internship was the concept of using group process to facilitate outreach workshops; this came about as a result of my membership on the CAPS Diversity Committee. Michele Ribeiro, PhD, who organized a number of outreach projects for the Diversity Committee, introduced me to the practice of facilitating one-time group dialogues around important but infrequently discussed topics such as mental health stigma and intersecting identity markers. The feedback from students and staff who participated in these dialogues was strongly positive and reinforced for me that change occurs most readily through interpersonal means, and group process is a powerful tool for addressing a wide spectrum of concerns.

Finally, I believe that system structure is crucial for fostering group skills among psychology trainees. The culture of a system determines how group therapy is perceived and carried out, and my best learning has occurred in systems where group interventions were highly valued and continually evaluated. One of the ways this has occurred is through staff-wide participation in group programming, and one of the strengths of the counseling center where I completed internship was a stated commitment to offering a wide variety of groups that match stated student needs. One of the groups I was fortunate to have a hand in developing and running on internship was a Family of Origin process group, a project that was born from data suggesting that a significant number of students sought therapy specifically for interpersonal problems stemming from dysfunction in their families. The experience of working collaboratively with my co-facilitator to design, market, and recruit was invaluable, and I grew immensely as a result of having a balance of support and autonomy.

I am now coming to the end of my internship year and will soon be transitioning into a university counseling center staff position. This new step brings with it much anticipation and adjustment. Reflecting on the many lessons that have come about as a result of my training experiences provides an enhanced respect for the necessary role that group therapy plays in counseling center work and in trainee development. I look forward to shifting my role to one of supporter and nurturer of group interest in other trainees and budding group therapists.