This is my first column as president of Div. 49., and I am very honored to be able to represent our Society. We have a fantastic board of talented and hardworking people, and it is good to welcome some new members as well as saying an adieu to some others. It is a tremendous privilege to work to advance the practice and research of group psychology and group psychotherapy, and we always welcome people interested in joining our Society. We are a warm, inviting group and small enough that you won’t get lost. So, if you are reading this for the first time and are considering if you want to join the Society, then we look forward to hearing from you.
It is a very interesting moment for the study and practice of group therapy and group dynamics. We have a new journal editor, George Tasca, who brings tremendous editorial and research strength to the journal, taking over from the wonderful work performed by David Marcus. Over time, the journal has become one of the gold standard publications for APA, and we look forward to George continuing to grow the scope and quality of the publication. If you enjoy the journal, consider submitting. We are increasingly serving an international audience, so it is a wonderful vehicle for getting your work more widely read.
The challenge of group as a specialty
Group therapy is also now a specialty. After many years and a tremendous collaboration with AGPA, CRSPP recognized group as having its own therapeutic outcomes, research base, methods, techniques and processes that define it as separate from just being a delivery method for other therapies. The specialty committee, led strongly by Nina Brown, provided a powerful example of what we can accomplish when we all pull together.
This is highly consequential since it highlights what is unique about group and how specialized group training is essential. The strengths were evident in the submission to the Council. Group is as effective, on aggregate, as individual therapy and is broadly efficacious across a wide range of diagnoses. It has its own research, interventions, techniques and leadership trainings that enable practitioners to move from trainee to competence to mastery. Expertise exists in the field, and many agencies are now recognizing the importance of thorough integration of group therapy techniques, practices, philosophies and systems into the culture of their agencies. The role of group coordinator is becoming more prescribed and valued as agencies understand the importance of focusing on competence and mastery.
Group being recognized as a specialty is long overdue. Group is not just individual therapy in a group. Rather, it has its own, distinct set of evidence bases and clinical techniques that are separate from those learned in individual therapy. Equally, managing groups is a highly complex undertaking. Leaders must manage multiple relationships simultaneously and attend to group level data, interpersonal data, intrapsychic data and then select interventions. It places high demands on the group leader when it is done effectively. Moreover, adapting groups to match the demands of settings provides massive rewards in terms of increasing access for clients, while providing equivalent or sometimes superior quality to individual therapy. However, it also requires specialists understanding of how to manage flow, select clients, establish schedules, train therapists and measure outcomes. Done well, it can be a massive boon to a system’s overall effectiveness. However, “done well” is a key caveat, and group therapy provision requires complex understanding of the variables involved in successful programming.
The specialty nature of group also involves considering how to measure outcomes. In a recent survey of major agencies around the U.S. that I helped conduct, we found very few using formal outcome measures. Group assessment can help in screening, process and outcomes and has tremendous benefit to organizations. It can help group leaders gain confidence in the effectiveness of their therapy, spot potential dropouts, prevent groups failing to begin and give clients feedback on how they have been doing. Over the next few years, Center for Medicare and Medicaid Services (CMS) and the Joint Commission, which oversees hospitals, are going to be requiring assessment. I encourage you to look over the group literature on assessment, as this is a little known but cutting-edge innovation within our field.
The specialty status also has implications for group therapy training. Not all doctoral group programs currently offer group therapy as a required elective. In fact, some do not even offer it as an elective. The same survey I previously mentioned showed utilization of group therapy as a significant aspect of work in many agencies. Partial Hospitalization and Intensive Outpatient programs use it for over 50 percent of all therapy, while other reports show the Department of Veterans Affairs (VA) using group therapy as its primary treatment modality. Addictions work is primarily a group modality, while groups are increasingly being utilized in health psychology as part of treatment for physical conditions. Given this heavy utilization, it is incumbent on directors of training and curriculum committee members to consider why group therapy is not a required class. I would strongly encourage you to discuss this with your colleagues and consider how you might advocate for increasing practitioners’ skills in this crucial specialty.
So, lots to chew on. Group is a widely used treatment modality, with its own techniques and research, that performed well can provide efficiency and effectiveness in equal measure. I hope you join with us in a discussion over the next few months and years on how we can make sure how our wider field understands the unique role of group in treatment provision.