Have you ever been in or worked in group therapy? What are the advantages of having group therapy? Are some myths of group therapy holding you back from trying it out, both as a therapist and as a client?
We are sharing the Killin’It Camp speakers series. In this podcast episode, Carrie Haynes speaks about groups in private practice and how you can expand your impact and income.
While there may still be a lot of uncertainty about what this year will have in store, there’s one thing we know for sure – your services as a therapist have never been more essential, making it the perfect time to ensure that your private practice website attracts your best-fit clients and gets them to call you.
Whether you’re a seasoned clinician with a website in need of a refresh, or you’re fresh out of school needing your very first therapist website, Brighter Vision is the perfect solution. During the month of January, they’re running their biggest sale of the year!
From now, until the end of the month, they’re completely waiving all setup fees and only charging $39/month for your entire first year of a new website! Head on over to brightervision.com/joe to learn more.
Meet Carrie Haynes
She has spent her career specializing in group work and is passionate about supporting therapists and healers in facilitating transformational group experiences for their clients. She truly believes that powerful group work can change the world.
In This Podcast
- The more you believe in group therapy, the more your clients will too
- How does your community observe group therapy?
The more you believe in group therapy, the more your clients will too
Carrie discusses that 70% of clients feel more comfortable and trusting in the group therapy process when their therapists fully trust it and are immersed in it as well.
Often, it is mental or mindset blocks that the therapist has to group work that can impact the client, so when therapists are fully present and working in the group it can motivate their clients to add their piece to the table and also be present in their healing.
In well-facilitated groups, clients are never forced to share. We actually want them to learn boundaries and learn building trust and part of that is not sharing too much too soon, it’s taking their time to feel out the relationships in the room. (Carrie Haynes)
How does your community observe group therapy?
Perhaps you are excited about the prospects of group therapy, however, not many people are in your community.
If we have more accessible information and training for therapists and clients in terms of how helpful group can be, this can really change … rather than targeting clients, start to talk to therapists. (Carrie Haynes)
By increasing support and connection between therapists who offer group therapy, therapists can support one another by referring to, working together, learning their different therapy styles and what each group offers.
If you are in a group practice, work on building a group therapy culture within your practice. The best way to get started in having a group therapy session is by taking three or four of your own clients who struggle with the same issue and work with them together.
- Jessica Tappana on SEO for Online Counseling Services – Killin’It Camp Speakers Series 2 of 4 | PoP 523
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Meet Joe Sanok
Joe Sanok helps counselors to create thriving practices that are the envy of other counselors. He has helped counselors to grow their businesses by 50-500% and is proud of all the private practice owners that are growing their income, influence, and impact on the world. Click here to explore consulting with Joe.
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Well, we did it. 2020 has finally come to an end. And we have made it out on the other side. And while there still might be a lot of uncertainty about what this year will have in store, there’s one thing we know for sure, your services as a therapist have never been more essential, making it the perfect time to ensure your private practice website attracts your best fit clients and gets them to call you. Whether you’re a seasoned clinician with a website in need of a refresh, or you’re fresh out of school needing your very first therapist website, Brighter Vision is the perfect solution. And during the entire month of January, they’re running their biggest sale of the year. From now until the end of the month, they’re completely waiving all setup fees, and only charging $39 a month for the entire first year of a new website. That’s a savings of $240 for your first year of website service with Brighter Vision. All you have to do is go to www.brightervision.com/joe to learn more and take advantage of this great deal. That’s www.brightervision.com/joe.
This is the Practice of the Practice podcast with Joe Sanok, session number 524.
Well, over the next four sessions, I am so excited to bring you four different talks from Killin’It Camp. These are speakers that rocked it out, got great audiences, connections, and, you know, honestly are just kind of top tier people. And I’m really excited. It was so hard because we have over 30 speakers, we have over 20 hours of content, so many amazing speakers. These were some that seemed to represent a few of the biggest questions that we get. And so in this first session, we’re having Whitney, she’s going to be talking all about Instagram for therapists. Then in the next one, we’re going to have Jessica Tapanna talking all about SEO. And those are each 25 minutes sessions aimed at just kind of quick hit things. Then after that, we’re gonna have Carrie Haynes, who is talking about adding groups to your practice, specifically online groups, how do you add groups. Not a group practice, but actual groups, she has The Art of Groups podcast. So that’s coming up, the third one. And then the fourth one is this awesome group practice discussion. We have Alison, Whitney, Susan, and Dawn that are all going to be talking about group practice.
And so, I mean, we only have four episodes to do this. And so if you want to get the full access to all 30 speakers, all the 20 hours of content that we have, this was such a large three day event, with just tons of great content, head on over to killinitcamp.com, you can grab that for only $197. Now we’re gonna probably be raising our prices for this soon. So you’re gonna want to grab that, you get lifetime access. Again, that’s killinitcamp.com. Without any further ado, here we go.
To get started, I’m just going to tell you a little bit about myself. I worked at a University Counseling Center for most of my career, probably, I guess it’s been 12 years that I was there. And my main focus was on group work, I was the director of group services. And I was just fortunate to be in a community that groups filled easily and swiftly. And we ran tons and tons of groups. And I don’t know how many of you have had this experience but the minute that I moved out of that University Counseling Center environment and moved into private practice, I was shocked at how our community here just didn’t have that same group vibe. So I would talk to a lot of private practice therapists and they would say how they couldn’t get their groups going, they couldn’t get groups running. So I’ve just decided to use the skills and knowledge that I learned from that time and just my love of groups to share a little bit about what I’ve seen work in getting groups running in private practice.
So as we can see, here’s the problem. The problem is, we know groups are effective. Like if you’ve ever seen any of the research, we know that group has been proven to be as effective or more effective than individual therapy for many presenting concerns. But it’s surprising, right? Because group work is so really underutilized. And a lot of clients, we have this great idea. I don’t know if you’ve been there, you have this great idea. You’re like, oh my gosh, this would be an awesome group. I would join this group. And you get the flyers done and you get the marketing out and then it’s crickets. Nobody shows, nobody calls, and it’s like, what’s going on here? Why aren’t people showing up? I know that people need this. I’ve talked to people about this, but no one comes, no one shows interest. It’s very, very frustrating and discouraging.
We also know that groups can bring in more income for therapists. So typically, people price their groups around $50 a session, that’s the average group price across the country, it depends on where you are, what kind of group, a bunch of different things. But average, it’s about $50 a session. And usually people have, I’m just kind of doing the median group, about eight members. So that’s $400 on the low end, and sometimes people can go up to about $75 a session. And so that’s $600. And it’s more affordable for clients, right? Because we know $50 to $75, for an hour and a half group, is a lot lower than an individual session.
So okay, so we can make more money, it’s more affordable for clients. It’s super effective. Why isn’t it happening? We also know that especially right now, and I feel stronger than ever that like what do our clients need, we need to be connected to each other. We need to feel community, we need to be able to reach more clients, I don’t know how many of you have had an uptick in the number of people reaching out for your services. But I have definitely seen that because of the stress in the world. So we know that mental health resources are in demand right now. And if your practice is full, or you have a group practice, and it’s full, it’s great to find a way to not turn away clients that are calling. So why aren’t we running more groups?
So let’s talk a little bit about what I have found for the reason that it’s not happening. One, it is not your fault. What I know is that group has really been devalued in the field of psychotherapy. So what happens is we go to our training programs, if you are a master’s level clinician, you may have had one class. If you are a doctoral clinician, you may have had two at the most. If you were very fortunate, maybe you got great group training. And if you did, you’re ahead of the game. But most of us have gotten very little training. I don’t know how many of you had experiences like mine, but I started out and I was the… I had an assistantship in the Center for Drug and Alcohol Education. So my first groups were mandated clients who did not want to be there and they were forced to be there. And I was trying to facilitate these groups, and be creative in how to get the information across and get them what they needed, all while dealing with the resistance to being there. So that wasn’t the best group experience and this was before I had any training.
What I find is that that’s many of our first experiences, we get very little training, we get one group therapy class that goes over a broad range of different types of groups. And there’s like there’s psycho educational groups, there’s support groups, there’s process oriented groups, there’s, you know, this gamut, and you get that one class, maybe you do like a mock group therapy with your classmates. And that’s it, one and done. And then usually at people’s internships, they may be thrown into groups, like, okay, you’re ready to run them. So maybe you’re in an inpatient treatment center, and you’re running groups all day. But what I’ve found is that that lack of training results in unskilled group facilitators. And then the group facilitator has a bad experience because it’s overwhelming to be in a group and trying to manage all those dynamics when we weren’t really trained or taught. And then the clients might not have the best experiences.
And the way that I think about this is my husband did an externship in emotionally focused couples therapy. I don’t know how many of you have done that. But it’s such an amazing training for couples work. And when I saw what he had to do, like sending in all these tapes of him working with couples, all the advanced training that he did to work with couples, it was really humbling because I could work with couples in my private practice, like that’s okay, right? They say that we can do that. But I realized that like I did not have that type of expertise, couple’s work was not my expertise. Sure, I could get through it. I could do a decent job. But it’s not the same as somebody who has a specialization. And I feel like it’s kind of the same for group, like it’s just like, we’ll just throw you in there, you’ll figure it out.
So if you haven’t had a lot of training and you haven’t had the best experiences, it is not your fault. But also you do not need to go and get, I mean, the training available right now is maybe years to get certified as a group therapist where you’re flying to New York to be in a process group. So there needs to be something in the middle where a group therapist gets support and some training so that they can grow their skills and not feel over their head.
The other barrier that happens for all of us is the media representation. So there’s so many jokes and skits about group therapy, and so much misinformation out there about groups, that it’s kind of hard to combat that in our own minds, because we’re in this culture as well. But also in our clients’ minds, right? Like group therapy can be seen kind of as a joke, or as a place where you just say, like, hi, my name is Carrie. And, you know, it’s kind of made fun of. So there’s a lot of misinformation about how group works. And that leads to clients being a little afraid of group therapy, and us being afraid to share that with our clients.
The last piece that happens is that we’re uncertain of how to market our group offerings in our communities. So we’re going to talk a lot more about what I have found to be effective in doing that, and also what I have found to help with the lack of training that we’ve had, because that’s not true for all of us. Many of you, I’m sure out there, love group work and have had very good experiences. And that’s great. But if it’s not your thing, or you’re pretty hesitant, or you started noticing people started dropping out slowly, it’s just because you weren’t given the skills that you need to be able to run groups as effectively as you can.
So I want you to drop in the chat, what do you think is the number one reason clients do not participate in group? What have they told you? What do you see? What is the number one reason that your clients…? Fear of judgment by their peers. Not confidential. Yes. Having to talk, commitment. They don’t want to share their story. Speaking in public. They don’t want to do online groups. Shy. Yes. Having to share. Yes, it feels too personal. Yes. Yes. Great. So all of these reasons are reasons that clients don’t participate in group. But the number one reason that clients don’t participate in group that I found is our beliefs. Us as therapists, our beliefs about group work, which was shocking to me when I was in my graduate training, and I learned this. And again, it’s not our fault. We get these beliefs, because they’re passed down from our supervisors, they’re passed down in our graduate programs that if we are not in a very pro group environment, if we have not been mentored by somebody who really has high level skills in group therapy, we will actually have beliefs about group work or about our clients in group work, that inadvertently keeps them from being part of the group.
So let’s talk about this a little bit. So what happens is, we love our clients, and we create these really strong bonds with them, we all came into this work because we have hearts to help. And so we create this really strong rapport with our clients, and we want to do whatever it takes to make them successful. And if we hear about a group offering, we also hold fears about what our clients might experience in that group. So we have our own beliefs around group and what can come up is like one, we feel like clients might not want group, like they came to individual, and they want individual and the minute we bring up group, they’ll probably show hesitation. Every client I’ve brought up group to shows some hesitation, and I just know to expect it. But the thing that I know is that because I was fortunate, I got really wonderful training, I just happened to be in the right place at the right time, where I had a mentorship model where I was given a ton of supervision, support, and practice in not only the practice of group therapy, but also how to talk to clients about group. This was education that I never got in my graduate program, but I got it in my internship and it was just I just got fortunate in that way. Most of the therapists that I spoke to when I was the director of group services that would come to our site for their internships, said they had never received anything like it in their training.
So we think, you know, clients don’t really want groups, like groups kind of, they feel scared, they feel like their stuff isn’t going to be held confidential. And we don’t know how to address those myths because we don’t really know if that’s true. We don’t know if that’s going to happen. We’ve seen a lot of groups that things didn’t go well. So why would we want to refer our clients to that? But what we know is that if you believe in group, you fully believe in the group, then your client is, I think it’s 70% more likely to follow through with the group because of their relationship with you. And the more times you’re willing to bring it up and talk about it, the more likely they are to follow through. But there are certain ways to talk about it with clients. And we do have to believe in it, that’s the thing, I love what Christie was saying in her presentation, because, you know, I believe in being authentic. And if I don’t believe in a group, and if I’m not sure that it’s going to be helpful, I don’t want to sell it to a client, I don’t want to push them to be in group.
If you’ve been in an agency, you notice that group is kind of billed as second rate treatment, it’s sort of like, well, we have no individual slots left, so let’s send them to group. But that’s actually not true about group, like group really isn’t second rate treatment, it’s actually more effective for people dealing with relationship issues. And I don’t know about you, but I can’t think of a client that I’ve worked with that is not struggling with some type of relationship issue. So we get the myth that it’s second rate treatment, from the way that we approach it in the field.
We also think that groups need to be homogenous. So like, I need to make sure to get, you know, eight people who are all dealing with the same thing to meet together on Tuesdays from 1 to 2:30. That’s a little bit harder to do, if we get a group of eight people who are dealing with depression on Tuesdays from 1 to 2:30 might be a little more challenging to fill. But if you know that there are certain types of therapy groups that especially are process oriented, all the members are dealing with different things. But all the focus is on how to get better in relationships. One, they’re easier to fill. And a lot of times they’re more effective, because those clients are in a group that resembles their real life. And what we want is we want clients to take what they get, the practice that they get in group, and extend it to their real life. So groups don’t have to be homogenous.
Now there are some groups that do and I have some strategies around how to do that. But you also want to look at maybe you want to do like a heterogeneous group where the group really reflects the real world, but they’re all working on similar things, that might help you to get your groups going more quickly, and also help the clients to not say, well, of course I felt better here, because everybody here totally gets it. But people in my life don’t. We want them to be able to translate their experience in group to the outside world.
The next piece that we carry around is that clients are too fragile. And again, we come by this, honestly, I mean, I felt this way for so many of my clients, you have that client who it took them everything to get into your office, the last thing you want to do is send them to group work. You think, oh, my gosh, this person is barely able to talk to me. How are they going to talk to a group of six to eight people about this issue? But in some ways, we limit clients by believing that they’re fragile. So a lot of times what I have found is the clients that struggle the most in individual therapy actually benefit a lot from group work. Because when they’re in the group, they actually don’t have to speak a lot, but they can get a ton out of it. They have other members in the group that maybe are more comfortable talking about their emotions, or more comfortable talking about the issues that they brought to group. And the clients that I’ve had that have had a really hard time in individual learn so much just by watching. That’s one of the amazing things about group work is that clients really don’t have to share a lot to gain and get a lot. They also learn that they’re not alone, that other people are dealing with similar issues, other people that they respect. And so it’s really cool to see how much that can open somebody up who really had a hard time getting into individual therapy. They can really be transformed through the group work.
Another piece is that sometimes people think, well, my client’s issues are too complicated. And I don’t have that in here because it really falls under the fragile. And what I found is that there’s something really magical about group work where it’s almost like we have this bowl in the middle of the circle. And when we can unload whatever’s going on for us, even if it’s so complicated, and we can put it sort of in the bowl where everybody in the circle is holding that issue, it feels so much lighter. There’s something, you know, we do that for clients, we hold space and it’s like we hold a little bit of their suffering when we’re in the room with them. In a group it’s really powerful to feel like, no matter what’s going on, no matter what’s happening in your life, we can be here with you, we can hold this with you. And that in and of itself can be so transformative.
Now know, as I’m talking about this, those of you who are interested in online groups, I have found that all this translates, that, again, it’s our own blocks around oh, online groups are not the same. If we believe in online groups, and we know the limitations, like, there are limitations, I would much rather be in person. But are we holding back from offering online services because of our own discomfort around offering it? I mean, how many of us didn’t want to do this until Coronavirus, and got kind of pushed into it? But I have found some surprising results in online spaces, like there’s a lot of benefits in online. And if we can share those with our clients and sort of let them know that you could just try this out, let’s just try this and see how it is, you might be surprised how many would be willing to do it. So just, you know, think about that with online because all this applies.
The next one is that clients will be forced to share. And I think there is some group pressure in sharing because we want to know you, we want everyone to match. But actually, in well facilitated groups, clients are never forced to share, we actually want them to learn boundaries and learn building trust. And part of that is not sharing too much too soon, it’s taking their time to feel out the relationships in the room, and to feel when is appropriate for them to share more. So clients actually are never forced to talk and are usually really respected in a well facilitated group to share at a pace that feels right. And that actually teaches them how to slowly build trust and deepen relationships as they go.
Finally, we have this myth and it’s again, throughout the whole field, that groups are for finishing skills. Once I get my client done with individual therapy, and we deal with most of this stuff, then they can do a group. And it makes group the second, you know, it’s just like, oh, everything’s too complex to be managed in a group environment. And I want to challenge us to think about that. That actually, I think it can be the other way around, that group might be the thing that we want to start with and clients learn ways to communicate, they learn ways to talk about what’s going on, they learn that they’re not alone, they learn that they have things to offer to other people, even if they’re suffering, there’s so much healing that can happen. And then maybe they learn some, they want to dig deeper into something that really would be better for individual.
Now, I’m not saying group is right for everyone. But I do think my motto is not like, who is right for group, or why group, but why not group. Who would not be, because actually, usually for every client, there’s some type of group that would be helpful. It just depends on which type, there’s a very small percentage of clients that wouldn’t do well in a group atmosphere. So those are some of the myths that I think we carry around. And I had all of these when I started. And I had had my own experiences in groups that weren’t positive. And again, that’s because we just have this legacy of not really preparing group therapists and then throwing them in to group work. And we don’t take the time to train them well, or to support them. And then we wonder why we carry around these myths. But it’s like, oh, if I facilitated a group with no training, and I realized, like, I don’t really know what I’m doing that well here, and then my clients aren’t getting that much out of this, I’m going to be really hesitant to share that with the clients that I love.
If you have had a ton of experience, or you just feel so wonderful about group and would love to do group, then maybe all we need to do is look at your community. And also look at, yeah, who’s around you and how they feel about group. Because that might be part of the block like you’re super excited about it, but you can’t get people to refer to you. So that’s another piece we’re going to talk about.
So, the solution. So what I found is that if we have more accessible information and training for therapists and clients, in terms of like, how helpful group can be, this can really change. And that’s what happened at the counseling center that I was at is that there was a ton of information and a real pro group atmosphere. So rather than targeting clients, the thing I would tell you to do is target therapists. Start to talk to them about their beliefs around group and their hesitancies, rather than most of us go and we make a flyer for clients. What I know is that that usually doesn’t work. Clients don’t usually self select into a group unless they’re our own clients, and we built trust with them. The people that are going to get you group clients are the therapists around you that know, like, and trust you, and believe that you can offer a great group experience. And you also want to reassure them that you’re not going to take their clients, that you’re only going to see them in group and not in individual.
We also need increased support and connection. So I’ve created here like a consultation group, for those of us that are involved in group work, so we can cross refer, and also get to know each other’s styles and what the groups offer. And in those consultation groups, it’s more likely that people will send each other clients and know how to talk about the group offerings that each of us offer. And then if you own a group practice, really your first focus should be on building a group culture in your practice. And if you’re in private practice, building a group culture in your community. So starting out with that consultation group, or starting to have conversations with other people interested in doing groups, that’s really where to start rather than to start with clients.
I have so much more to share with you. This just barely scratched the surface. But I know we’re running out of time. So I am doing a pop up event on Thursday, October 8th at 5 Eastern Time, and then you can see the other times. And if I would love if you’d show up and we could just like share about what your experience in group has been, what have been your issues, what have been your successes, and we can just help each other out. Because I really feel like now more than ever, the world needs us. And we need more opportunities like this, online and in person when we get back. That’s my website. And I’m also going to be sharing some resources with you. I have a podcast where I’m just going to teach more stuff about how to get people in groups. So if you want to be a part of that, just drop your email in the chat, and I’ll send you those resources. I’d love to hear your questions. And thanks for bearing with me with my throat.[SAM]:
Thanks so much, Carrie. So we have a few questions here that I noted while you were talking. And the one is insurances pay really low for groups, like in my area, the average is about $28 per session, how do you manage insurance? [CARRIE]:
Mm hmm. Yeah, that’s hard. Um, I am an all private pay practice so that’s where I got those numbers from. I do think that you can try to get that rate increased by going to that panel and asking for an increase for group, especially because it’s still cheaper for the panel to reimburse for group services. So a lot of times I’ve seen people be successful that way. Or having a diversity in your groups can help you to raise your rate, of people who are private pay and insurance. [SAM]:
Great, and have you run groups that have clients attending both virtually and in person. [CARRIE]:
I have not, I have only done either all virtual or all in person at this point. And I don’t know anyone who’s been doing it both, although I do have somebody that I’m working with that is thinking about that, because they’re doing like a yoga and process oriented group. So some of it is going to be online. So I’ll keep you posted on that. If I get that person’s name and let you know how it goes. But I haven’t done it. [SAM]:
Awesome. And then as a single practitioner, do you advise seeing a client both individually and in a group? [CARRIE]:
I do, I do. I actually think that’s the best way to get your group started is to start with three or four of your own clients who have a similar issue, and find out when they’re available. I think that’s like the best way to get started. And I think meeting with them, in individual can really help. And figuring out how to process what happens in the group, I just always tell them that anything that they share about the group, or about other group members, that I want to make sure that we find a way to bring it back because that can feel uncomfortable for members who are not seeing me individually. And I also make sure to mention it in my group, because it can create some dynamics with clients who are not seeing me individually and I just want to talk about whatever’s going on with everyone so we can keep that safety and cohesion. [SAM]:
And then last one, any specific marketing ideas for groups? [CARRIE]:
Yes. The main thing is to talk about it. Just keep sharing with your clients, even if they say no at first. Don’t stop bringing it up. If you see times an individual that there’s something that could be impacted, or that could be dealt with in group or that group might be helpful for, I’ll just bring it up. I’ll say, you know, this is another time where I feel like group would be so helpful for you. And this is why. Sometimes I just joke with them with a little smile. And say, again, I really think you would do so good in the group. The other thing is to go and meet with other therapists and tell them about your group, tell them about what you’re experiencing, and the changes that you’re seeing any questions they have. Really focus on therapists rather than flyers, or trying to get clients. And that’s sometimes that’s a lot of wasted energy, when you just need to get the referral sources that know, like, and trust you.
I’m so excited that you got a sneak peek into Killin’It Camp. We had, I think 150 people that signed up for Killin’It Camp this year. In 2019, when we had our live event we had 123 people. It is such a fun community of people that think differently about private practice, that they want that community, they want that connection, they want that learning, they want to push the envelope. And so if that sounds like you, I would love for you to sign up for the Killin’It Camp course where you get full access to those 25 minute sessions on pillars of practice, those 55 minute sessions on scaling your practice, and then those 55 minute sessions that are all about multiple streams of income. It is such important work that we do and if we don’t understand the business side of it, how’s it gonna help us? So make sure that you head on over to killinitcamp.com.
And today’s sponsor is Brighter Vision. Brighter Vision has amazing, amazing websites. So head on over to brightervision.com/Joe so that you can get that deal today.
Special thanks to the band Silence is Sexy for your intro music; we really like it. This podcast is designed to provide accurate, authoritative information in regard to the subject matter covered. It is given with the understanding that neither the host, the publisher, or the guests are rendering legal, accounting, clinical or other professional information. If you want a professional, you should find one.