Any Nitza, PhD

We Need New Models

As I was thinking yesterday about what I wanted to write about in this column, a colleague called and said “Amy, we need to send someone to meet with and support the mental health needs of the staff who have been responding to the Buffalo shooting.”  My immediate response was “Great.  We are in.  But… what would this person do?  What is the intervention?”  We sat in silence for a moment.  This colleague and I have been collaborating on disaster mental health and emergency response work for a number of years.  And in that moment, it struck us, again, that there is something missing in our tool kit. 

We both knew that it needed to be a group intervention.  A primary effect of interpersonal trauma is the disruption of social relatedness and attendant isolation of the victim.  Relatedly, we know that one of the best predictors of outcome following a disaster is the amount of social support and connectedness people perceive themselves to have. Group interventions offer the cohesion, universality and related therapeutic factors that promote connectedness and healing. 

 At the same time, rates of depression and anxiety across the country are at peak levels and the demand for mental health services has skyrocketed. Wait lists for therapists in my own county in New York are as much as 400 people long.  Individual therapy is not a viable solution to getting people access to the help they need.  Furthermore, these mental health concerns, particularly as they have arisen during the pandemic, are largely interpersonal in nature, making group interventions potentially both more efficient and effective.  Yet group interventions in private practice are quite underutilized, which compounds challenges with equity and access.

These issues are just two of so many we currently face that illustrate what members of our division know well: groups are an intervention of choice for addressing many of the social and psychological problems we face as a country and a planet.   Yet I am not convinced our current models of group intervention and training have kept pace with need and demand.    I offer here just two quick examples of opportunities for advancement that I see in my work and my role as Division President.

1. In a column for this newsletter that I wrote as President-Elect, I said:

In my day job, I am the Director of the Institute for Disaster Mental Health at SUNY New Paltz.  As a long-time ‘group person’, I came to the field of disaster work with some clear ideas about the role of groups in disaster recovery, yet the confluence of the two fields is not near where it should be.  Among the many lessons of the past year, we have learned that disasters will be an increasingly common factor in our world, and that groups have a major role to play.  As just one example, the sheer numbers of people impacted by disasters around the globe will necessitate the provision of early interventions in groups, yet we do not know nearly enough about how to make that happen.  Now is the time to figure it out.

A year and a half later, I am not aware of any solid advances on this front.  Yet according to the national Gun Violence Archive, from the day I wrote that column until today, there have been 900 mass shootings (defined as those in which a minimum of four victims were shot, either injured or killed, not including any shooter who may also have been killed or injured in the incident.  While the horrific impact on the victims and families is clear, the extended impact on communities is often left unaddressed.  The need for and evidenced based group-based intervention to support people in the early aftermath of a disaster remains a gap in our current tool kit.  It is urgent we figure that out. It is urgent we figure that out.

• We need models that increase access to group services.  As part of the equity efforts of our division, Martyn Whittingham, Cheri Marmarosh, Pete Mallow and Michael Scherer have been working on a national solution to improving quality and access to mental health care.  They currently have an article accepted to a special issue of the American Psychologist that will outline the health economics case for private practitioners increasing their use of group. In it, they make the case the current workforce shortage of therapists is leading to burnout of therapists and the inability of clients to access needed care before it become more chronic and severe.  They demonstrate the health economics case for increasing group therapy in private practice. The results of their economic analysis show that if 10% of unmet need was met by groups and not individual therapy, 3.5 million more people could be seen, over $5 billion saved and over 34,000 less new therapists needed.  It also makes the case that group therapy needs to be a required class in psychology graduate programs and that assessment is needed to ensure outcomes – something already happening in Germany, Australia and England. APA Practice Directorate and AGPA are both exploring strategies for discussing this with private insurers and government agencies. 

However, for this solution to solve the problem, we need new models of training across the spectrum, from graduate school through to professional development for practicing psychologists.  Our emerging Continuing Education program is one avenue for this work that we are actively engaged in.  There are certainly others.

These are just two examples.  All my years of training and work have cemented in me the belief that what we know and do as group psychologists and group psychotherapists holds so much potential for addressing many of the current challenges are world faces.  Let’s get together and talk about that! Some of these important topics will be addressed throughout our Division programming when we are together in Minneapolis in August.  Topics will include addressing microaggressions in group and in supervision, furthering our understanding of on-line groups in a variety of contexts, advancing the use of groups in private practice, developing sexual assault support groups, and dealing with the death of a group member.  In addition to these content sessions, we will have a number of opportunities to (re)connect with each other including celebrating our newest Fellows and award winners, and our first in-person Division 49 Social Hour since 2019.   Come join us.  I look forward to seeing you there!

President Elect Column

President Elect Noelle Lefforge, PhD, ABPP

Advancing the Group Specialty

The ongoing synergy to advance formal recognition of group psychology and group psychotherapy as a specialty continues to amaze me. Since the formal recognition of APA’s Commission for the Recognition of Specialties and Subspecialties in Professional Psychology (CRSSPP) in 2018, many efforts have been underway to solidify, advance, and expand the specialty. We’ve made considerable progress and have several achievements worth announcing.

Dissemination of the Specialty – We recently learned that the Education and Training Guidelines of Group Psychology and Group Psychotherapy will be published in Training and Education in Professional Psychology. This publication will offer a guide to programs on meeting standards for training students and professionals to become group specialists. Additional information about the importance of the specialty that was intended for a large audience was published as Group psychotherapy as a specialty: an inconvenient truth (Whittingham, Lefforge, Maramarosh, 2021).

Evidence-Base for the Specialty – The literature base underlying group as a specialty continues to grow. For example, Group Dynamics published several papers that are likely to be referenced in the next petition including Recent advances in the study of group cohesion (Forsyth, 2021). Efforts are currently underway to compile the group psychotherapy evidence-based treatments into a website for use by the general public, practitioners, researchers, and students. Group psychology and group psychotherapy’s dissemination are also gaining broader audiences through endeavors such as the American Journal of Psychotherapy’s Special Issue on Group Psychotherapy.

Sustainability – The Group Specialty Council shifted its financial model with an eye on sustainability. With a history of financial support from its sponsoring organizations, the Group Specialty Council’s focus this year has been to secure annual commitments of significant contributions from each one. We (Div. 49) have are the largest contributor given our ongoing investment in maintaining and furthering group as a specialty. The American Board of Group Psychology (ABGP, the group specialty board of ABPP) also formally approved the contribution that was requested. The American Group Psychotherapy Association will be reviewing the proposal in request of their contribution at their next Board meeting. All three organizations, in conjunction with the Association for Specialists in Group Work and training organizations like St. Elizabeth’s, have demonstrated their multifaceted dedication and support for the specialty.

As tempting as it is to take a moment to sit back and enjoy the fruits of our labor, we must keep on going. With the resubmission of our renewal petition due on January 1, 2025, there is no time like the present to amplify the momentum. This truly is a group task. To be successful, we will need to create a whole that is greater than the sum of its parts. We are well positioned to do just that – but we’ll need your help.

What Can You Do to Advance the Specialty?

Program Directors, Group Coordinators, and Faculty – If you are involved with a training program at any level (doctoral, internship, postdoctoral) and your program offers training in group, reach out to the Specialty Council for assistance with ensuring your are marketing your program effectively. The Specialty Council will soon be publishing tools on its website to help you evaluate your program and an outreach plan to programs will commence in the fall. We need more programs advertising their specialty training and including evaluation of the specialty in their accreditation processes.

Individual Psychologists – If you are a psychologist with experience in group psychology and/or group psychotherapy, become credentialed in the specialty through the American Board of Group Psychology. For more information visit: https://abpp.org/Applicant-Information/Specialty-Boards/Group-Psychology/Application,-Specialty-Specific-Fees.aspx

Students – If you are a student interested in training in group psychology and group psychotherapy, look for programs that offer training that aligns with the specialty. You can reach out to our Student Committee who is working on updating training sites. If you are in a program that offers training in group, help connect your faculty/directors with the Group Specialty Council.

Researchers – If you a researcher in group psychology and group psychotherapy, your publications help promote the underpinnings of the specialty. Notify the Group Specialty Council about your contributions to the literature base.

Learn more by visiting the Group Specialty Council’s webpage: https://www.apadivisions.org/division-49/leadership/committees/group-specialty

Brown, N., & Lefforge, N. L. (in press). Education and Training Guidelines of Group Psychology and Group Psychotherapy. Training and Education in Professional Psychology.

Forsyth, D. R., (2021) Recent advances in the study of group cohesion. Group Dynamics: Theory, Research, and Practice, 25(3), 213 – 228.

Whittingham, M., Lefforge, N. L., & Marmarosh, C. (2021). Group psychotherapy as a specialty: an inconvenient truth. American Journal of Psychotherapy, 74(2), 60-66.

Past President Column

Turning our Vision toward Continuing Professional Education in Group Psychology and Group Psychotherapy:  Providing supply in the face of demand

Having come to Division Trio as a full-time health service provider and long-standing advocate for the specialty I have more than four decades experience with continuing professional education (CPE) to renew my psychology license with my state boards.  For the most part we all have a range of CPE in our docket each cycle and many of us need specialty CPE in group psychology and group psychotherapy.  Our choice of venders has been limited, if not generally fairly excellent, in that AGPA and its Affiliate Societies have done the greatest amount of this work over the past twenty years.

Having achieved CRSPPP acknowledgement of Specialty it is essential that we work to teach, train, supervise and produce as much CPE as we can to ensure that there are educational events that uphold and honor the core principles of the specialty and the competencies and proficiencies that come with it.  There are so many domains in need of basic and advanced CPE programing that will help psychologists to gain basic skills in the group room as well as understand complex group psychology dynamics and processes that impact a wide range of social, occupational and therapeutic environments. 

Take as an example the three infographics developed by our student leadership group about 18 months ago reproduced here and available electronically for anyone who wants to use them.  Each of these posters could easily be the framework from which single hour and longer CPE programs may be generated. 

I want to strongly encourage all of us to consider producing CPE proposals in our specialty.  We need a lot more opportunity and this is an area where our Division can grow in numbers and in value.