10 Important Tips for Creating a Therapy Support Group
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Creating and launching a therapy group is a challenge to even the most seasoned clinician. Two coaching questions I often receive on this topic are, "Mari, I want to start a therapy group, but I am worried it won't fill" and, "I've never done group therapy...how do I even begin?"
I love these questions! And, because these are asked so often I thought I'd outline some helpful tips to support other therapists who are new to group work.
Before we begin, here is a quick soundbite on my qualifications and a brief overview with respect to my group experience:
I am a Licensed Marriage and Family Therapist, a Certified Sex Addiction Therapist and Supervisor, a Certified Partners Trauma Therapist and Supervisor, a Certified Mindfulness Based Addiction and Trauma Therapist and Consulting Supervisor, a Certified Domestic Violence Therapist, and I am Certified as a Telehealth Therapist including Telehealth groups. I've been leading in person and online therapy groups for over 15 years.
I am also trained in EMDR and Gottman Couples Therapy, and am the founder of Growth Counseling Services, and the co-author of, "Facing Heartbreak: Steps to Recovery for Partner's of Sex Addicts", the author of, “Healing from Betrayal”, and the author of, “The Creative Clinician: Exercises and Activities for Clients and Group Therapy.”
I first began my training in group therapy starting with my internship many moons ago! I vividly recall being assigned the domestically violent men's group at an agency. This was an alternative prison sentence group with 18 angry men and little ol' me. We met each week in an old, dusty conference room for an entire year. Thankfully the agency provided excellent supervision and additional certification training in domestic violence, and, over time, I learned the ropes and fell in love with the process of helping these men learn, heal and grow.
My next group experience was working with female survivors of abuse. I worked with these lovely and courageous women for nearly three years while completing my clinical hours. During this time I also started a teen girls group, a parenting support group, and a group for grand parents . By the time I had my license and was starting my own private practice, I had several years of group work under my belt.
I went on to specialize in working with partners and spouses of sex and porn addicts, and eventually with the sex and porn addicts as well. I have been leading weekly therapy groups in this specialization for 15 years, and have had a 3 month wait list for my groups for the last 12 years.
That is the quick nutshell version of my group experience. Needless to say, I am passionate about group work! And as a business coach, I absolutely love helping other therapists start their own therapy groups to support hurting people who are in need of a healing community.
Now, on to the good stuff!
Here are my top tips, gleaned over many years, learned through trial and error, successes and mistakes. I hope this information offers support and encouragement as you launch your own successful therapy group. Before we begin, it is important to note that there is so much more to the therapeutic group process than outlined here, however, I wanted to provide a few important tips and first steps as a support to our clinical community:
1. Be Specific. Have a clear vision of what the group focus is and be very specific. For example, instead of Anger Management, niche that down, “Anger Management for Exhausted Professional Women.” Instead of, “Parent Support Group”, niche this down to: “Divorced Dads Support Group”, this will help you hone in on where to market to your ideal group client.
2. Create a name for your group that adds hope. For example, my women's group at Growth Counseling is for female partners of sex and porn addicts. However, I don't call my group, "Partners of Porn Addicts" because it felt labeling, and because that would focus on the problem not the solution. Instead, I named the group, "H.E.A.R.T" which is an acronym for, Heal, Encourage, Accept, Restore, Trust ©. When the women share with a friend or family member that they are going to their "Heart Group" meeting, it adds confidentiality and hope to the work we do.
3. Decide if your group will be open or closed. I prefer a closed group after the second meeting to encourage group bonding and less interruption. Figure out what feels best for you. Perhaps an open group is more your style. Do your homework on the pros and cons.
4. Have a time period for the group to meet. 1 meeting per week, for 90 minutes, segmented into 12-week modules have been the sweet spot for me. We then break for 2 weeks, and then start the next 12-week module. Clients who may be a little reluctant or shy in starting group therapy feel better knowing that there is a start and end date. That said, when you facilitate a positive group experience, very often clients will move forward into the next module.
Important note: Keep in mind that Mondays are challenging days for people due to holidays sometimes falling on Mondays. Fridays most folks are exhausted or heading out of town. In some communities, Wednesday nights are bible study nights or soccer nights. I have found that Tuesday, Wednesday or Thursdays are ideal, and if you don't mind working on Saturdays (I don't like to, but you may), then Saturday mornings work well too. Another tip: Be sure to give your clients enough time to get to your group after work, or get the kids taken care of. I like 6:00-7:30 or 7:00-8:30 PM.
5. Theme the group modules. I like to theme each group module to keep it fresh and inspiring for the group members (and for myself!). I also like to select a book and exercises that align with that theme. For example, in my HEART women's group our current theme for this 12 week module is "Phoenix Rising", and the book I selected to support the theme is, "Rising Strong" by Brene Brown. A helpful tip: Your therapy group is NOT a book club, so the book should be what I call the "back ground music" as a support to your work.
6. Group exercises are important. While the process piece of group is the most important in my experience, I suggest that you have exercises that you can do within the group, and/or exercises that the the group clients can do at home and then bring in to discuss. If you are in need of group exercises, you may enjoy, "The Creative Clinician: Exercises and Activities for Clients and Group Therapy." I've received some lovely feedback from therapists who have used this material here.
7. Law and Ethics. Make sure you have all of your legal and ethical foundation pieces in place. That includes informed consent forms, a pre-group assessment policy, limits of confidentiality, group rules, signature forms, contact out of group, mandated reporting, attendance, social media contact, fees, and so forth. If you prefer not to reinvent the wheel, The Group Therapy Forms Packet will be of support so that you have your client forms ready to go.
8. Have a solid policy. Know what your policy is for missing group, group rules, late arrivals, food in group, cross talk, cell phones, payments, etc. and so forth (this is all outlined in the group forms packet here), and have a pre-group interview process in place as well as a termination policy. You will want to make sure that you carefully screen your group clients to ensure that your group is the right fit for them, and that they are the right fit for your group. I believe this process is one of the most important pieces in creating the foundation for a healthy group experience.
9. Have good boundaries with group members and individual clients. It is fine to have an individual client attend a group you are leading, but I would be very careful before inviting the spouse or close family member of a client into a group you are facilitating.
For example, let's say you are starting a therapy group for dads. Great idea! Now, let's say you work with a couple and the dad of this couple asks to join your group. And, while we are at it, let's say he has his partner’s blessing to do so.
Pretty great, right?
Well...maybe, but maybe not.
Let's say the dad shares in group one night that he has been having an affair. Oops! Oh crap. Do you have a no secret policy in place? How will you handle this information? What is your ethical responsibility here? What do your group forms outline? If, for example, you share this information with the partner in a couple's session without a having a policy with forms and signatures in place, you have put yourself in a very precarious situation both legally and ethically.
Conversely, if you do not share this, you are now the secret keeper and should this come out in a future couples session, the partner will very likely experience the trauma of betrayal by both the partner having the affair, and by you, the couple’s therapist who has been holding this information.
10. Seek additional support and consulting when needed. Launching a group takes some “rolling up your sleeves” work, but is a very rewarding experience. If you have further questions on group facilitation, assessment, curriculum, marketing and how to set up payments, fee collection, and process flow, it would be wise to seek out a colleague who is experienced in group work, or attend a webinar, a professional workshop, or hire a coach for a session or two to help guide you. It is best not to do this work in isolation and having supportive peers to consult with is important.
And as an additional tip, here are some important "do's and don'ts" when you announce and market your group:
Email is great, but don't spam your audience and DO NOT CC in a group - instead blind copy so that there is anonymity and not everyone is copied on responses. And, remember, confidentiality and HIPAA compliance is key if you are communicating with clients via email. Hush Mail (no affiliation FYI), is a great way of corresponding with therapy clients.
Also, think about who will benefit from knowing about your group, and be selective in emailing your audience. Flyers, newsletters, postcards, listservs, Linked In, social media, networking events and so forth are all great ways of marketing. Post it on your website as well, and make sure your SEO is tight with your URLs, titles, key words, etc. I also like to include a FAQ page as well.
Include this key information on the marketing email or flyer:
Name of group
Who the group is for (niche down, be specific, speak to the client and their needs)
Start date
Regular day/time/hours for group meeting (include A.M. or P.M. when listing your hours)
Duration of group
Fee (or contact for fee, however I prefer to include the fee)
Facilitator Name and spell out your professional letters if that is legally required by the board in your state or region
If you are an associate, you must include your associate number, info, and who your supervisor is
A photo of the group facilitator and a short bio of the facilitator
Include a statement that requires a pre-group assessment
Mention availability to manage expectations
Your contact information
A link to your website (this will have your group info with FAQs and a call to action button)
Artwork, photos or colors that support the spirit of your group
As a support, here is content from my own marketing flyer for my women's group (NOTE: please respect that this is copyrighted content, I share this here as an example and a support):
"Are you a woman whose heart has been wounded from being in a relationship with a sex or porn addict? Have you been betrayed in love and are ready to heal? If so, the H.E.A.R.T. Group for women in Glendora, California may be an important support for your healing process.
H.E.A.R.T = Heal, Encourage, Accept, Restore, Trust is a weekly support group for female partners of sex and porn addicts. All women, regardless of ethnicity, orientation, age or spirituality are welcome to contact the group therapist/facilitator Mari A. Lee, LMFT, CSAT-S who will set up a pre-group assessment to determine if the H.E.A.R.T group is a good fit at this stage of your healing journey.
Mari is a Licensed Marriage and Family Therapist, and a Certified Sex Addiction Therapist, the founder of Growth Counseling Services, a recovery center for addicts and their partners in Glendora, California. Mari has over 15 years of group therapy experience and, as a former partner of a sex addict, she understands first hand the pain that partners experience. She is also the co-author of," Facing Heartbreak: Steps to Healing for Partners of Sex Addicts", and “Healing Betrayal”, and teaches and speaks nationally on partner's betrayal trauma.
You can learn more about the H.E.A.R.T. group for women here (website page link), and contact Mari here (email/phone) to inquire about availability and to set up a pre-group assessment if space is available."
I could fill at least two more blogs on how to create, launch, market and facilitate a successful therapy group, but I will stop here for now. I hope this information has been of support and encouragement. Group therapy, when set up and facilitated properly, is a rewarding and enriching experience, not only for the therapy client, but for the clinician as well.
If you need group forms you can find those here: Group Forms.
If you need exercises and activities for group, you can find that here: The Creative Clinician.
If you need support, you are welcome to schedule with me here: Coaching Calendar.
You can read what other colleagues have to say about my coaching support here: Kind words.
Finally, don't forget that group therapy can also be a beautiful way to create a leveraged income stream (for more information on creating multiple income streams, this blog will offer great tips!).
I wish you all the best on your journey forward! Introduce yourself in the comments below, ask a question or two, or if you prefer to connect privately and schedule a consult session, you are welcome to schedule that here.
Kindly and in support,
Mari A. Lee, LMFT, CSAT-S