I've just returned from The American Group Psychotherapy Association's National Conference. I was Colorado's representative there, it was an honor to represent my state on the national stage. I got the opportunity to see the inner workings of this organization who I highly respect. AGPA is committed to increasing the quality the effectiveness of group psychotherapy treatment across our country.
Last week I wrote about the Power of Group and how group psychotherapy differs from individual sessions. In summary, group allows members to work on their relationships to others and to explore how their emotions impact or influence connection. In the field, group psychotherapy is often viewed as a simply more economical version of individual treatment, this is not the case, there are many things that one can only learn about themselves while in relation to others.
This week I'll offer some skills on how to create an effective and healing group. This is helpful primarily for any budding psychotherapists aiming to increase their proficiency in group treatment. However, it will also be beneficial for leaders, managers, teachers, directors, and coaches looking to get more out of their groups.
The techniques below are adapted from the Modern Psychoanalytic tradition, namely the works of Lou Ormont and Hyman Spotniz. Click on their names to order their seminal works. This list contains a few basic techniques to help with group facilitation but is, by no means, exhaustive. If you're interested in learning more about group psychotherapy, please don't hesitate to reach out. It's one of my favorite topics to speak about.
The Bridge- This is perhaps the most important intervention, and it is the one that is lost on most clinicians. Many therapists treat group psychotherapy as round-robin treatment, ie. spending time speaking to each member individually, in turn. The key strength of group psychotherapy is that there are other members present, use them! A healthy group essentially runs itself, remember, your job is to build a healing community, not to be the center of attention.
The Bridge is simple, point out when one members says something that another member can relate to. Get the members talking to each other, and eventually, caring about each other. For example, if two members are expressing anger you could say "Member A, I'm curious if you relate to Member B." It's just that simple! Get your members talking to each other instead of to you. If you, as a leader, feel compelled to speak, differ first to the group.
Making Room for Unheard Voices- it is important that all your members feel welcome and have the chance to speak. An unskilled group leader will often get swept up in the group conversation and forget to notice all the members. If you've run groups or been a member you may know that some people are very skillful at being invisible.
Inviting quieter group members can be done in three ways, they are listed here in increasing intensity:
1. Group wide - "I'm noticing that a few members haven't spoke, I want to take the time to invite them in."
2. Direct - "Member A, how do you feel about what's going on in group?"
3. Double Direct - "Member A, how do you feel about what Member B just said?"
Some people do not feel as though they can speak unless they are invited. As a leader, it is your job to open the door for them and make them feel welcome. Once they have been invited in enough they will start to participate by themselves. You could then talk to them about their hesitation to participate.
Receiving Feedback- It is important that the group members feel safe offering feedback to the leader and other members. Healthy feedback is a great way to grow, both personally, and professionally. I could write a whole blog on feedback, but essentially, healthy feedback is more focused on how others make you feel instead of what they could do better. It is very helpful to know how we are affecting others. This is a key part of group psychotherapy, and again, is often ignored.
As the leader, it is your job to elicit and model feedback. Members will test out giving and receiving feedback from you before they try it will their peers. It is important that all feedback is held and validated. It doesn't have to be true or even acted on, it just has to be welcomed.
Similar to inviting in members there are a few ways to elicit feedback:
1. Group wide - "How are we doing as a group?" or "How do you think I'm doing has a leader?"
2. Direct - "Member A, I noticed that when I speak you tend to look away, I'm curious about what is going on for you."
3. Paradoxical - "Would this group be better if I didn't say anything at all?"
Modeling giving and receiving feedback allows the group members to feel more in charge of the group and allows them to explore their projections and transference onto the leader. Oftentimes, a group member can learn a lot about how they relate to authority or parental figures by being curious about their relationship to the group leader.
Applying these basic skills will deeply your skill as a group leader. I'm interested to know if they were helpful and how they impact the groups that you are a part of. Again, please don't hesitate to reach out if you'd like more instruction or want to speak about group treatment.