Amy Nitza Ph.D.
Leadership
Closing Some Gaps
As you likely know, the hard work and dedication of numerous members of our Division over a number of years resulted in the recognition of group as a specialty in 2018. This recognition represents a major advance in our field. At the same time, it has served to highlight important gaps in training to support the competent and effective practice of group psychotherapy. The tremendous work of the Group Specialty Council, led by Noelle Lefforge following the long-term leadership of Nina Brown, is actively working to close these gaps. As a division, we continue to support the Group Specialty Council in its crucial work, having committed ongoing financial resources to the effort, as well as having representation on the council itself.
Yet, as documented in two important articles published by members of our Division (Hahn, Paquin, Glean, McQuillan, & Hamilton, 2002; Whittingham, Lefforge, & Marmarosh; 2021), point out significant training gaps remain. So, while the work of the Group Specialty Council continues, there are several other important initiatives and efforts underway in our Division to continue to close these gaps.
Empirically supported group treatments website: We are in the process of developing a section of our Division website that will summarize and make accessible the substantial research evidence supporting the effectiveness of group psychotherapy in addressing a range of mental health problems. This important project, a collaboration with the American Group Psychotherapy Association, will provide essential support to the dissemination of research to inform training and practice at all levels.
Increasing group representation in leadership: At our most recent board meeting, we discussed the need for placing more Division members in leadership positions within APA. Doing so will increase the visibility and representation of group psychology and psychotherapy in key areas in which we are, or should be, stakeholders. Identifying key areas on which we want to focus these efforts, both within and outside of APA, and connecting with other divisions with similar interests to amplify our voices will also be key to this strategy. The more that our collective ‘group voice’ is heard around the table as decisions are being made, the more likely it will be that people will recognize its value. If there is a group-related area within APA or external to it that you would like to see us focus on, or if you would like to serve in one of these roles, please let us know!
Training and skill building opportunities: We continue to seek opportunities to share our expertise with psychologists both within and outside our Division. Our Diversity, Equity, Inclusion and Belonging Committee has developed some incredible training resources available on our YouTube channel. Now, having successfully applied to be a Continuing Education provider with APA, we are currently making our first CE training workshops available. We will also be putting our most popular skill building and how-to articles from past newsletters on the website to increase their accessibility.
What training needs do you have? What expertise do you have that we might help you make available within our Division and to those interested in learning more? As we continue to work to close the group training gap, we want to hear from you.
President Elect
Noelle Lefforge Ph.D. ABPP
Group Training Activities for the Classroom
With the Education and Training Guidelines for Group Psychology and Group Psychotherapy on the horizon for publication in Training and Education in Professional Psychology (Brown & Lefforge, in press), it is only fitting that I would find myself back in the classroom teaching group psychotherapy after a hiatus of several years. I had the opportunity to teach the group psychotherapy course for our Clinical Psychology PsyD program over the summer and now I am teaching it for our International Disaster MA program. It’s truly a gift (and a challenge!) to be able to integrate the academic concepts of education and training into action with the next generation of group psychotherapists. As any professor will tell you, it’s harder and harder to hold the attention and interest of students these days, especially after years of Zoom and general destabilization. It is common for us group-oriented psychologists to be islands in our institutions, which is difficult when we are…well, group-oriented. For this last column as President-Elect, I’d like to try to build some community and share what have come to be some of my favorite activities for teaching group psychotherapy.
Activities for Engaging Students in Group Psychology Courses:
• I spend a lot of time on teaching students about doing good pre-group orientations to increase patient engagement and retention. I spend a substantial time discussing how to address common pre-group hesitations. I provide a demonstration and then they role-play with one another. For the capstone activity for this skill, I have them generate a handout to summarize and disseminate what they learn. The handout is either intended for use by other clinicians to orient them to key concepts before a pre-group orientation or intended for use by clients and provided during the pre-group orientation. The more user-friendly, the better!
• One of the major graded components of my course is a group presentation in which they present an effectiveness/efficacy study on a particular group therapy and demonstrate a sample of the therapy for the class. This has been a great way to highlight the scientific underpinnings of group while exposing the class to an array of group therapies.
• When teaching therapeutic factors of group, I break them up into small groups and assign a therapeutic factor to each group. For each factor, the group generates: 1) what group leaders do/not do to facilitate the factor, 2) what group leaders do/not do to hinder the factor, and 3) what cultural considerations should be kept in mind when working with the factor, particularly in consideration of including minoritized identities in the group process.
• We often watch video of group (e.g., the YouTube series Group that Elliot Ziesel has released) and I have them practice working at all levels of group process. What do they think is happening intra-psychically for the individual members; what’s happening interpersonally among the dyads and/or between individual members and the leader; what’s happening with the group as a whole?
• Perhaps my favorite activity is in-vivo teaching of the “good goodbye”. I borrow from Leann Diederich’s column on Semi-structured termination exercises. They pick the one they want to try, and we adapt it to the classroom. It provides a great opportunity to emphasize the importance and complexity of endings.
I hope that reading about a just few of my favorite classroom activities got you thinking about your own! I’d love to see some posted on our Division listserv: DIV49@LISTS.APA.ORG There will be a lot more to come this year in terms of solidifying group as specialty (see the Group Specialty Council update in this issue) while promoting that health service psychology training programs at all levels provide at least a basic level of training in this much-needed modality.
Past President’s Column
Joshua Gross PhD
Thank you for your vote of confidence in electing me to the Division 49 leadership trio. It has been an honor and privilege after teaching group therapy in the APA accredited doctoral internship service. There are so many psychologists who teach general and specialty clinical practice in the APPIC internship system but there aren’t enough of us teaching Group Psychology and Group Psychotherapy. I do believe that my influencing so many practitioners in my 22 years of internship training service led to my being elected to the presidential sequence. Thank you all for that.
I have also been involved with the issues surrounding our achieving and maintaining our Group Psychology and Group Psychotherapy specialty and there is one big thing that I want to leave you all with. It has to do with the APA training model for clinicians and follows the training taxonomy of Coursework and Practicum, Internship, Post-Doctoral Residency and then Licensed Practice.
We face this challenge most anywhere where doctorates are granted that lead to licenses for clinical practice in psychology. It is also present almost anywhere that practicum training is proffered in preparation for the doctoral internship year of full time practice. It is present in post doc where only some those candidates have exposure to training and expertise in group psychology and group psychotherapy. And finally, it is present in the cohort of licensed psychologists who are working hard to make up for their lack of training and are active in our various professional associations that offer continuing professional education to address this need for essential practice skills.
That big thing is the fact that basic coursework followed by practicum, internship and post doc clinic training in group psychology and group psychotherapy is scarce, intermittent and hard to find. This is wholly inconsistent with APA policies for the accreditation of training for counseling and clinical psychology candidates which spell out clearly the need for training in the specialties. But if you start looking at the course catalogs of the programs there isn’t much out there across the board save the programs we all work for because we are the ones training the next generation.
I am hoping that the division can enjoin itself in the uniform position that group psychology and group psychotherapy coursework should be present in every clinical doctoral training program in the United States. And we know it does not. Most of us with knowledge and training in group psychology and group psychotherapy got there by luck and good fortune and likely by finding those rare weigh stations where the expertise was present, and the clinic ran groups and trained the candidates. For now, we know that there is a dearth of coursework and training in our specialty and that it leaves us with insufficient numbers of psychologists who are prepared to provide the training or the clinical practice of Group Psychology and Group Psychotherapy when they matriculate to licensed practice.
It is almost as if there is an assumption that Group Psychology and Group Psychotherapy are generalist skills and that all clinicians already know how to practice. This cannot continue, and our future depends upon it. We are already a marginalized specialty and most often last on the list of training priorities.
It is my greatest hope that the leadership of Division 49 will work together with The American Group Psychotherapy Association, The Association for Specialists in Group Work, The American Academy of Group Psychology and other organizations that oversee and advocate for the specialty practice of Group Psychology and Group Psychotherapy to address this insidious and longstanding issue.
Informal surveys have revealed over the past ten years that this dearth is real and longstanding. I hope the Division begins to address this problem which at its core will require lobbying APA Accreditation to ensure that the fundamental skills and techniques of Group Psychology and Group Psychotherapy be present in all stages of the APA Training Taxonomy for all accredited clinical and counseling psychology programs.
Moving mountains takes time. We all stand on the shoulders of those who have served before us. It is my parting hope that we begin to address this longstanding and insidious problem within APA where students train to be clinicians in accredited programs and internships but far too often they don’t get much exposure to Group Psychology and Group Psychotherapy.