David Chirko, A.B., Professional Affiliate Member &
Psychologically oriented researcher and author
Sudbury, Ontario, Canada
How a Patient Might Select a Group & Therapist
Social Worker Sean Grover (2019), liaised with psychiatrist Molyn Leszcs Past-president of the American Group Psychotherapy Association (AGPA), to map out five facets a client must consider when deciding on an appropriate group and group therapist.
First, note the differentiation of group therapy from individual therapy. Group therapy, it has been established, is just as efficacious as individual therapy, however, in the former, interpersonal and coping skills can be ameliorated. One will also derive feedback from other group members who can be utilized as models, whilst challenging the member constructively–when the need arises.
Second, realize how one should first embark on selecting the most apropos kind of group therapy. Therefore, they have to ask themself what they must realistically work on and change in their own personality and behavior. For instance, getting treated for anxiety, depression, stress, social conflict, and drug abuse are common issues that can be specific to certain groups. The prospective client must therefore select a group that delves one or more of these issues pertaining to them. Leadership is germane to a good group fit, too. Thus the leader must be properly trained as a certified group psychotherapist (CGP). Frequently, such a therapist first privately convenes with an interested client to discover if they would be a good complement to their group.
Third, know that the goals of short-term and long-term groups must be scrutinized. The short-term groups comprise anywhere from eight to 12 weekly sessions dealing with more general problems, such as a personal loss, medical illness, or, as earlier stated, anxiety, depression, and stress. In long-term groups there is more latitude in attendance. More time allows for more personal and profound issues to be covered. Grover (2019) asseverates that “Group therapy becomes a social laboratory,” when the short-term member learns new skills to maintain a relationship, however, opts for the long-term arrangement when they discover that the same relationship problems that emerge are recrudescent.
Fourth, try to ascertain if group therapy is available in their community. Often one’s primary provider, be they a psychologist, social worker, or psychiatrist, can refer them. If not, they may consult The American Group Psychotherapy Association directory. Said also can connect to a score of affiliate group therapy organizations throughout the country that can assist here.
Fifth, address the feasibility of a group therapy participant still maintaining therapeutic contact with their primary provider. Yes, group therapy and individual therapy can have a pronounced rapprochement. The two therapists involved must collaborate effectively. If only one therapist is involved for both modalities, there would be no conflict.
In sum, as Yalom and Leszcz (2020) contend, the significance of interpersonal relationships within the social microcosm of a group, with its behavioral patterns and dynamic interactions, are key. Of course, clients would not always be equipped with sufficient foreknowledge of this, but, on the other end, the selection of clients is something any effective group leader would have expertise in.
Peer-led Support Groups
Todd and Gueren (2024) believe that, although individual counseling cannot be replaced and being transparent to a group of unknown people isn’t everyone’s fancy, group therapy, including virtual, can be salutary and cost less—if not offered gratis. They, as well, emphasize peer-led support groups1 whose judgement free nature enhances experiences with, social worker Theresa Nguyen explains, relatable people in a social support kind of network. Learning to listen becomes de rigueur. To begin one’s group search, they suggest the following organizations: Anxiety and Depression Association of America, Depression and Bipolar Support Alliance, National Alliance on Mental Illness, and Psychology Today (more on them later). Psychologist Vaile Wright, director of healthcare innovation, in this article also adds that there is an extensive amount of work involved, that can be personally disheartening. Costs can be less if the group is orchestrated by a community health centre, she says.
Schultz (2022), refers to Nguyen, who also avers that both public and private group psychotherapy often comes at no charge. Such are usually peer-led support groups that are sponsored by a mental health organization in one’s area, which hosts a group talk that anyone in the public can visit. The talk may feature a specific theme, like sexual assault or depression. Also, a company specializing in health care might present a stress management group dissertation at one’s work office. Any branch of Mental Health America can be delved for additional information.
How A Clinician Might Seek a Group & Therapist in Another City For a Client
Assistance Through Listservs
Listservs are often used by clinicians and professors, requesting referrals for their clients or students to clinicians in an out of town location, where the former are moving away to. Therein, they describe their client’s disorder and what they are seeking for them, including the kind of therapist they think said client would best interface with in a group setting.
Therefore, keep in mind what Francis Kaklauskas and Les R. Greene, et al declare their 2019 manual’s group objective is: “To demonstrate increased sensitivity and proficiency in multiculturalism and diversity related to group psychotherapy” (p. xvi), providing a liaison between client and group. Pages 3-24, Kaklauskas and Elizabeth A. Olson discuss a cavalcade of approaches for group arrangements, utilizing techniques like CBT, gestalt, and psychoanalytic. The last, employed in many group psychologists’ repertoires, involves group-analytic psychotherapy, which Elizabeth T. Foulkes avers, is “…therapy in the group, of the group, and by the group” (1980, p. 261). This inclusive posture, incorporating diversity of client background and group therapist’s strategies, is what should be utilized when assisting listserv enquirers with recommendations for their clients.
Selection Process
Professionals, when seeking recommendations on listserv, often stipulate a desired ethnicity, language(s) spoken, religion, gender and orientation, of a therapist. All this so a client with specific needs can be matched and sensitized to a similar leader–which could be a psychologist, psychiatrist, social worker, psychiatric nurse practitioner, or counselor–and their group.
Many therapists know about the major site here: Psychology Today (Thomas, 2018-2021), but those in the public may not. In their lists of verified therapists, the aforementioned diversity is reflected. Thus, one should examine the background pages of each therapist’s profile where their philosophical approach, and academic and methodological background, is described, followed by their financial charges and accepted insurance plan(s). Clients bereft of coverage are termed “out of network,” although therapists sometimes fill out their necessary forms. Costs are usually $100-$300 per hour, with sliding scales, geared to client income.
Further listed are the therapist’s qualifications—license, school attended with graduation date, institution endorsing them, and employment history. Next, their address, telephone number, and online treatment availability. This, followed by three specialties they deal in (anxiety, depression, and grief are common), the dozens of issues (like addictions, phobias, and self-harming), and many specific disorders (such as impulse control disorders, mood disorders, and personality disorders), they treat. Items under the rubrics “specialties,” “issues,” and “disorders” could be interchangeable. Then, the sexuality they treat, client focus and age, communities (aviation, veterans, whatever), treatment approach, and modality (individuals, couples, or family). Group psychology is often found under “Treatment Approach – Types of Therapy.”
At another site, healthgrades.com, questions posed entail: acceptance of new patients; care philosophy; specialties; whether younger, seniors, couples, or LGBT, are focused on; approval of insurance; if evening or weekend visits are available; if there are other therapists nearby; top areas of care; office location; telehealth sessions; and where amelioration of the therapist(s) themselves might be required.
A Personal Look
One should examine a therapist’s pictures, exhibited on their linked web site, where dress and grooming are essential. Office, waiting room, group sessions space and building exterior should manifest a nice, warm, homey touch. Knowing their geographic location and directions are most helpful, too. After browsing dozens of pages and hundreds of therapists, it might take one up to an hour and a half to secure one good prospect, summarizing, via e-mail to the enquiring clinician on the listserv, who the recommended clinician is and why they may be a good fit. Whether or not this could totally be perceived by online profiles, they (and eventually their group), should display sustained interest and observational skills in addressing emotional problems (Reik, 1998, p. 3). The response one should receive from interested colleagues will usually be one of encomium and copious thanks. After their watching of, if available, a terse video of the recommendee presenting themself on their own site, they just have to phone them and use their intuition. For other sites, GoodTherapy.org gives admonishments and listings. Thumbtack.com helps locate therapists, among numerous other things.
Ratings Systems
Like other professions, of all psychotherapists out there, 60% are good, 30%, outstanding and 10%, substandard. There are numerous sites one could visit in order to acquire a synopsis on a practicing clinician or therapist facilitating a group.
Therefore, of significance is the ratings systems for a potential therapist. Ratemds.com/doctors-ratings has four parameters adumbrated: staff, punctuality, knowledge and efficacy, with one to five points (the higher the better) allotted for each category. The last two would indicate interest and observation skills. Sometimes what appears to be an eminent, incisive, compassionate group therapist (not to mention their group) later turns out to be horrendous—with accompanying ratings–according to the independent testimony of clients who employed their services, as they describe them on a ratings site. Not that the therapist on the listserv reported that this was their client’s experience, however. Therapists are enjoined to eschew responding to such ratings, often by disgruntled clients, who number a scant percentage of their clientele.
Healthgrades.com, unlike Psychology Today, have patient ratings, with questions concerning what a patient thinks of: scheduling of appointments, office environment, amicability of staff, wait times, the rushing of appointments, therapist listening and responding to their queries, their disorder being thoroughly explained, and the diagnosis being sound.
Conclusion
When selecting a prospective group therapist and group, one should employ an elimination process, considering only those dealing with specialties, issues, and disorders diagnostically pertaining to an interested patient, or a colleague’s client. One should also examine what the patient is seeking in a group therapist–like ethnicity, gender, etc.–and group; then, their age, circumstances, and insurance provider they have. Lastly, and most importantly, delve the ratings systems to ensure one is recommending a quality therapist, who facilitates a group that demonstrates sustained observation and interest, in dealing with emotions.
Notes
1.Peer support groups are not run by therapists, but those who experienced what members do. They mollify and empower them, sans any theoretical orientation. Members’ feelings can be validated without altering their behaviors (Fraga, 2022).
References
Foulkes, Elizabeth T. (1980). Group-Analytic Psychotherapy, in Richie Herink (Ed.), The Psychotherapy Handbook. New York, NY: Meridian Books.
Fraga, Juli. (2022, July 2). With therapists in short supply, group counseling offers alternative. The Washington Post. https://www.washingtonpost.com/health/2022/07/02/group-therapy-alternatives-mental-health/
Good therapy. (2021-2023). https://www.goodtherapy.org.
Grover, Sean. (2019, January 3). How to Choose the Best Group Therapy For You. Psychology Today. https://www.psychologytoday.com/us/blog/when-kids-call-the-shots/201901/how-choose-the-best-group-therapy-you
Healthgrades. (2019-2023). https://www.healthgrades.com.
Kaklauskas, Francis J., & Greene, Les R., et al. (Eds.). (2019). Core Principles of Group Psychotherapy An Integrated Theory, Research, and Practice Training Manual. New York, NY: Routledge Publishing.
Kaklauskas, Francis J., & Olson, Elizabeth A. (2019). History and Contemporary Developments. Core Principles of Group Psychotherapy An Integrated Theory, Research, and Practice Training Manual. F.J. Kaklauskas, & L.R. Greene, eds. New York, NY: Routledge Publishing.
Psychology Today. (2019-2022). https://www.psychologytoday.com.
Rate MDs. (2019-2023). https://www.ratemds.com.
Reik, Theodor. (1998). Listening with the Third Ear. New York, NY.: Farrar, Straus and Giroux Publishing.
Schultz, Rachael. (2022, December). How to Find Affordable Therapy When You’re Broke. SHAPE. https://www.shape.com//lifestyle/mind-and-body/affordable-therapy-when-youre-broke
Thomas, John. (Ed.). (2018-2021). Psychology Today. https://www.psychologytoday.com/ca .
Thumbtack. (2016-2023). https://www.thumbtack.com.
Todd, Carolyn L., & Gueren, Casey. (2024, January 3). How to Find a Great Therapist You Can Actually Afford. SELF. https://www.self.com/story/how-to-find-a-therapist
Yalom, Irvin D., & Leszcz, Molyn. (2020). The Theory and Practice of Group Psychotherapy 6th Edition. New York, NY: Basic Books.