Group Therapy Question

[WestCoastPsyD]

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Hi, I'm a clinical PsyD student and this past spring semester took a group therapy course required by my program. I'm wondering if anyone has similar experience and could offer some feedback. For this class we were required to participate in group therapy, facilitated by the TA, with our classmates. Like it was a real group, a lot of us brought up issues we had with each other, and participation in this group was part of our grade. Do other programs have this requirement? I'm not positive on the ethics of having us do group therapy with fellow students as part of our grades. I may be overreacting, but some of my classmates were really upset over the requirement and saying it was unethical?

Thanks in advance for any feedback.

 

[HomeworkHelper]

Our program did not have anything like that, and I would feel similarly odd about having that as a required class. Was there even a didactic component where skills for facilitating a group were highlighted/practiced?

 

[Markro311]

A group therapy class wasn't mandated in my program, but I couldn't imagine not taking one. Plus, it was required if you wanted a masters along the way at my school.

At the beginning of the semester, the professor let us vote on whether we wanted group to involve talking about real issues or "fake" issues ("fake" meaning we'd essentially be acting/making stuff up). We pretty unanimously agreed to discuss real issues.

We didn't have a TA facilitate our group. Instead we split our class into 2 (pretend we had 12 students in the class). So for half the semester, 6 students were the "group", and the other 6 students rotated facilitating the group (I believe 2 group leaders at a time). Halfway thru the semester the groups switched.

Our class time was pretty evenly split between didactic (discussing chapters from Yalom's book, discussing articles, etc.), the experiential group experience (the group), and processing the group afterward (the group leader was given feedback by the observers, we applied Yalom/articles to what we saw, etc.). Although the most time was probably spent in the experiential component.

 

[WestCoastPsyD]

Our program did not have anything like that, and I would feel similarly odd about having that as a required class. Was there even a didactic component where skills for facilitating a group were highlighted/practiced?

There was, when we came to class the first half was lecture and then the lecture prof left and the TA came to do the "group." Also we didn't get the option of real or fake issues, we were just told to use real ones.

 

[AcronymAllergy]

I could see the utility of such a group if: A) it focused predominantly/entirely on professional issues, such as work-related problems group members might have with one another, since being able to bring such things up is important but can be tough to become comfortable with, and/or B) students were given the option (as mentioned above) of using "fake" issues, and the crux of the grade was based on your time spent as facilitator. However, receiving a grade for participation in a group discussing personal issues with a TA as a lead just seems...odd to me. What exactly would they expect you to gain (professionally) from that process that you couldn't instead get from a mix of supervised role-playing and sitting in/co-facilitating groups with non-students?

 

[thewesternsky]

My program does not have such a requirement. We do have a didactic course that focuses partly on group therapy, and then most of our students get supervised experience leading or co-leading skills based groups on practicum. I also co-led a Process-Oriented group on one of my practica, which I thought was interesting but probably not something I'll do in the future.

I agree that it seems odd to be graded on your performance as a "client" in a group. What's the purpose of such an exercise? Do you feel like you actually gained useful skills from this? It may be worth speaking with your classmates and setting up a group meeting to discuss your concerns with a receptive faculty member / the DCT.

 

[WestCoastPsyD]

Thanks everyone for responding! To clarify, they had us discuss personal stuff, like family issues or personal conflicts between classmates. Their reasoning (according to the professor) for grading based on client participation was to make sure that people actually shared, I guess so that the facilitator actually had something to do and everyone wasn't just sitting there in silence the whole time.

 

[AcronymAllergy]

Thanks everyone for responding! To clarify, they had us discuss personal stuff, like family issues or personal conflicts between classmates. Their reasoning (according to the professor) for grading based on client participation was to make sure that people actually shared, I guess so that the facilitator actually had something to do and everyone wasn't just sitting there in silence the whole time.

I just don't understand the professor's reasoning as to why it was important to share personal issues rather than offering the option of acting (which my program had us do for individual therapy exercises). If they want you to have experience with "real" problems, then I'm of the opinion that they should just let you observe or co-facilitate an actual group.

I'd personally be uncomfortable sharing that sort of information with colleagues, especially in the quasi-involuntary context of it being required for a course grade.

 

[VeryHopeful2010]

Even "fake" issues would bring up important group dynamics that would be processed and discussed for educational purposes. So, while the issues may not be real, group is very much about the here and now interpersonally. I really question the ethics behind your program's decision:

7.05 Mandatory Individual or Group Therapy
(a) When individual or group therapy is a program or course requirement, psychologists responsible for that program allow students in undergraduate and graduate programs the option of selecting such therapy from practitioners unaffiliated with the program. (See also Standard 7.02, Descriptions of Education and Training Programs.)

 

[paramour]

I believe like this has come up here before, either specific to someone's complaint about their group class and/or to complaints about mandated therapy where someone brought about their group class with the required group component.

I was in a clinical program but we didn't have a group course, so I hopped on over to the counseling dept and took their group counseling class (much to the chagrin of some of our clinical faculty). It did require a "process" group as one of the components of your grade. Advanced grad students in their program (not enrolled in the course) served as facilitators. Although some personal issues were discussed, they tended to revolve around topics that could be considered "safe" ... for the most part. I think the only thing that got a bit hinky was when they had the group decide how to handle one of the group members who was a regular issue (e.g., not participating or being productive, arriving late, not attending, distracting behaviors during groups, etc.) and process this in group. Everything was "TRUST THE PROCESS!" It allegedly would all work out how it should work out in the end... That damned phrase is still in my head some many moons later.

 

[bmedclinic]

Markro311 and I are likely not in the same program (if your name is Mark, at least), but it appears to be the exact same situation.

 

[psychRA]

That situation sounds totally inappropriate. I can't imagine being required to discuss actual issues in a group therapy setting with my classmates, especially one that was led by a TA.

For internship, many of the sites I looked at offer an optional process group for interns. Many of these groups are held after the work day is over, they're facilitated by someone from an outside institution, and the group roster is confidential - they stressed to us during interviews that no one from the internship site would even know which interns had participated. That, to me, seems like an appropriate way to offer a group experience as part of professional development.

 

[WisNeuro]

Can be unethical given APA CoE (as above statement). Also, when it's within the program, I see it as having limited instructional value. You're with professional colleagues, who you will spend a lot of time over the next several years with. I imagine that disclosure would be a major problem, specifically, people not willing to talk about things, or just making up some "safe" issues so they can get their participation points. Also, I am not aware of any research that supports the efficacy of such instruction over more unambiguously ethical teaching options.

 

[thewesternsky]

Thanks everyone for responding! To clarify, they had us discuss personal stuff, like family issues or personal conflicts between classmates. Their reasoning (according to the professor) for grading based on client participation was to make sure that people actually shared, I guess so that the facilitator actually had something to do and everyone wasn't just sitting there in silence the whole time.

Do you feel like you learned anything from participating in this that will help you as a therapist? Specifically, did you learn anything that you couldn't have learned from alternate instructional practices, such as observing or co-leading a real group?

 

[PHD12]

I actually think process type groups can be very valuable when they are optional and facilitated by someone outside the program/evaluator role so the students feel safe and comfortable. They can be very useful on internship as a way for the interns to discuss professional issues and stressful cases/supervisors in a confidential format, and also to increase self-awareness as therapists. Because of the power differential, it is difficult for interns to discuss real struggles and professional issues with a supervisor (We've all been there). All therapists have anxieties about making mistakes, pleasing their supervisors, developing their own style, and sometimes feel strong emotions towards certain patients so a confidential process type of group is very useful. There are many good programs/internships that have this format. I also think it's extreme to say that that participating in process groups during your training is not helpful at all. It's a different type of learning than co-leading a real group and not really a comparison. I don't think anyone was saying that though. I think Westcost Psyd's situation is a good example of what not to do when implementing a process group as part of a training experience. Experiential learning can be more valuable than didactic instruction when implemented in an ethical manner.

 

[WestCoastPsyD]

Do you feel like you learned anything from participating in this that will help you as a therapist? Specifically, did you learn anything that you couldn't have learned from alternate instructional practices, such as observing or co-leading a real group?

I feel like my gains were more personal than professional. Then again I went in having just completed a practicum that was a large portion group experiences--I'm not sure how my classmates who have never led a group felt but the general consensus seems to be that it wasnt significantly helpful.