Group Champions

Class by class, SSW instructors spread the gospel of group therapy

BY LAURIE LOISEL

If you talk with social workers who run psychotherapy groups, it doesn’t take long to hit on why they do it. They’ll remember a specific group, a single participant, a particular moment when they witnessed with great clarity the healing power of the modality. Kirk Woodring, M.S.W. ’95, experienced it early in his career working with men with terminal AIDS diagnoses. A group member resisted bonding with others, often using humor to guard against other emotions. Three months in, the other men gently, kindly confronted him about his distancing ways. Woodring watched in amazement as he cracked wide open.

“It was one of those cathartic, aha moments,” he said. “He teared up. It was the first time he showed authentic emotion. That moment was pivotal and I’m not sure it could have come in individual therapy.”

For Paul Gitterman, M.S.W. ’94, it was when he became co-facilitator for a long-running group for ex–prisoners of war who had survived World War II, the Korean and Vietnam Wars.

“People didn’t leave the group— they just aged out or died,” said Gitterman. “I was struck by the power of that connection. It was almost a sacred place.”

Kurt White, M.S.W. ’04, thinks back to his internship in a hospital psychiatric ward after his first summer at Smith. He witnessed a seasoned group clinician help the unit work though difficult staff dynamics impacting their work.

“She did this masterfully and began to explore some of the larger systems dynamics and helped people move beyond this impasse,” White said.

Alison Berman, M.S.W. ’95, recalls watching teenagers in a public high school transform before her eyes. They came to a therapy group dealing with substance misuse, anxiety or depression, and discovered something all had in common: Each felt they had no true friends they could trust.

“What they created in that group was so moving—they created such trust,” Berman said. “This was a place where they felt like they could actually talk and say things they couldn’t tell their friends outside. That couldn’t have happened if that group hadn’t been created.”

Meet the seasoned clinicians who are the core instructors of the Smith School for Social Work’s group therapy courses. They are passionate about the modality. They are committed to its practice. And they are fierce in their desire to prepare emerging social workers for a therapeutic intervention increasingly sought after in a wide variety of settings.

“Smith has always been known for its focus on individuals and families particularly,” said Woodring, coordinator for the SSW group practice offerings. “Over time, the School has recognized that there’s a real need for training in group practice.”

Woodring, Gitterman, White and Berman want to ensure that students are fully prepared to take on what can be an extremely intimidating—but also deeply healing—modality.

“First-year students in particular are going out in their placements and finding out, almost without exception, that they are being asked to do group work,” said Woodring.

For many years, SSW required students to take a single introductory, five-session group class. That was the requirement in 1995, when Woodring graduated. Shortly after that, in the late 1990s, the introductory group course was increased to a 10-session, full-semester requirement for firstyear students.

Students in their second and third year are offered two electives, Advanced Group Theory and Practice, taught by Woodring, and Group Theory and Practice With Adolescents and Youth, taught by Berman.

Woodring noted that changes in the field motivated the changes in course offerings. “We were seeing more and more students having to do groups in their first placements, and there was a cry from the students that they needed more training in group work,” he said.

“They’re all coming back saying, ‘We’re doing groups,’” confirmed Berman. “Everyone is doing groups.” Given the demands on students in the field, Woodring would like to double the sessions for the required introductory class from 10 to 20, and add to the electives offered.

“Smith has this history of doing really fine training in individual and family psychodynamic, psychotherapeutic models,” said Woodring. “Times have changed. There’s been an evolution in social work. Group work has developed a greater standing within the social work community.”

While groups have been a longstanding therapeutic intervention for people dealing with substance misuse disorders and on psychiatric units, they are becoming increasingly common in many other settings.

There are many reasons for this trend, prime among them that groups can more efficiently engage clients. There’s also a sense that this intervention can be extremely effective for a wide variety of people, at times even more effective than individual therapy. “They serve more people and cut down on wait times,” said Woodring. “Groups allow a different kind of assessment over time than what you would get in individual therapy.”

Gitterman, who runs groups both at Williams College and in private practice, says the structure offers a type of healing other modalities cannot.

“You have an opportunity to work through dynamics with people who are equally invested in helping each other. It’s larger than the sum of its parts,” said Gitterman. “No matter what theory you use, the connection of the people to each other is really the powerful part of the healing.”

At its best, group therapy can help participants use the interactions with fellow group members to recognize and resolve patterns that hold them back, and then transfer that experience to relationships outside the group.

“There are those moments in group when it feels like you’re on the best, highest functioning athletic team you’ve ever been on, the best orchestra, everyone is in synch,” said Woodring. “It feels almost magical. You don’t get that anywhere else. You don’t get it in individual therapy in the same way.” He believes group therapy can help people recognize patterns within themselves that they’ve never seen before.

“That really comes from both feedback and self-disclosure that comes in the groups,” he said.

White sees the taproot of group therapy as the way it helps participants understand themselves as part of a bigger whole. This can be a normalizing experience as well as a healing epiphany, he said, as people realize, “‘Oh, my God, the thing that I’m thinking and feeling isn’t just about me, it’s about a whole group system.’ ”

White spends time in his courses both teaching about these theoretical concepts, and also helping students experience such revelations.

“It’s not just about learning about a therapeutic model; it’s learning to see the world in a completely different way,” said White. “The phase a group is in affects each individual’s thoughts and feelings maybe as much as their own past experiences.”

And because most people live their lives in the context of a variety groups—including families, schools and workplaces, to name a few—interpersonal dynamics are often sparked by larger group systems as much as by individual interactions.

“When people begin to get it, it’s a little like the scales falling from their eyes and they look at the world in a different way,” said White.

For all the benefits of group therapy, there are many challenges and pitfalls to navigate. Smith professors work hard to prepare their students for all of these.

“I think it’s one of the modalities that intimidates people the most,” said Gitterman, who teaches the required first-year introductory group course.

Intimidating for so many reasons. Kurt White shared an old therapy saw: “It’s not that people talk about their problems in group, it’s that people are their problems in group,” he said with a mischievous smile, only half joking. He quickly followed up: “Of course, from a strength-based perspective, you are also your strengths in group.”

Smith’s group instructors know that many social workers in training are understandably nervous about the prospect of running groups. “The fear is of being eaten alive by groups,”

Woodring said, also only half jokingly. “It is daunting and it is frightening. Even seasoned clinicians are challenged by group dynamics.”

Berman, who said she learned how to run groups largely through trial and error, has sympathy for students new in the field. “It can get really chaotic— groups can get out of control, definitely,” she said.

Woodring, who runs his classes both as a group and as a course about groups, models for his students how a clinician should approach the role of group facilitator—a bit gingerly and with a lot of humility.

“I tell my students at the beginning of class that I can guarantee that I will make mistakes and that I will need to repair, and that’s part of what you need to learn as a group leader,” he said.

Berman said a key task for therapists running groups is to navigate the other relationships within a given setting.

“Groups don’t exist in a vacuum,” she said. For example, when running a group within a school a therapist might need to advocate for a room with enough privacy to build trust within its members. The therapist might also need to correct misunderstandings people may have about the process. Playing cards, for example, doesn’t mean the group is goofing off; it may be simply an activity the therapist is using to help participants feel safer opening up.

Gitterman and Berman say time pressures sometimes conspire against it, but it is essential to have individual meetings with prospective group members to prepare them for the experience and also to discern if the group is appropriate for the issue they are dealing with.

Another element key to success is having a clear vision of the group’s purpose. This can help keep the group from spiraling out of control or feeling directionless, they said.

Elizabeth Castrellon, M.S.W. ’10, is a senior social worker running multiple groups at a psychiatric hospital in Houston, Texas. She credits Smith with preparing her to effectively run groups. Most helpful, she said, was the way the advanced class she took with Woodring taught her theoretical underpinnings and the clinical issues raised in groups, while also experiencing being in a group.

Throughout the course, students took turns being part of the group while the others observed in a fishbowl format. “I felt really prepared to really think about groups in a different way,” she said. “It was a pretty big part of Smith and the way that classes are approached.”

Helen Chong, M.S.W. ’98, runs many groups in her private psychotherapy practice and is president of the Houston, Texas, chapter of the American Group Psychotherapy Association (AGPA). She said she’ll never forget being impressed in her first group theory class by how experiential it was.

“It’s embedded in the group class,” she said. “You learn via the environment. I fell in love with it.”

Chong attends the AGPA annual conference, where she sometimes leads groups to train emerging therapists. “When I see other Smithies, I just say, ‘Oh, they know group, because that’s how they were taught.’” ◆