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group therapy

How to Set Up a Therapy Group in Private Practice

My last blog post, 5 Reasons Why We Need More Group Therapy, was a plea to fellow counsellors and therapists to get more therapy groups up and running. Groups can be powerful vehicles for personal development and change. Many people wanting to access help are priced out of private individual counselling. Help through the NHS is usually time limited and waiting lists are long.

Many therapists I speak to like the thought of running groups but don’t know where to start. The logistics can get a bit complicated. Finding a group of ready clients all prepared to start at the same time, then assessing everyone and finding a suitable venue can all be a bit of a headache.

psychotherapist ealing binge eating

In this article I’m sharing what I have learned about setting up groups to help you get that group up off the ground and running.

1.     Pick a theme – Don’t get me wrong, I think general therapy groups work very well but usually it’s other therapists or trainees that seek out such groups. For the general public, joining a therapy group is scary. They want to know there will be people who they can relate to in the group. If your group is focused on a shared issue, it creates a mutual task for the group and any prospective clients will be reassured that they are more likely to connect with people. Themes could be anything from anxiety to depression to OCD. My groups are focused on people struggling with binge eating and run open ended. You may prefer to run a closed group for a specific number of sessions.

2.     Find a suitable location – I run my group from home. There are no extra overheads this way, zero traveling for me and I like the informality of the setting. However, for many therapists running a group from home just isn’t a viable option. Most counselling centres have rooms for groups but don’t be afraid to think outside the box on this one. Is there a local café that closes at 5pm who might be willing to let you use their space one evening a week? A community hall or a church? See where your local Alcoholic Anonymous meetings are held, perhaps some of those locations may rent the space to you.

3.     Pick a start date – This one is so, so important. I made the mistake of believing I should find participants and then announce the start date once I had enough people to run the group. Potential participants are likely to feel a bit unsure and ambivalent about joining a group. People are more likely to join if there is at least some certainty about when it will start. In the end I picked a start date of 29th January and started marketing in October. Nothing happened. Ten days before the first session I still had no-one signed up for the group but then, during the last week, there was a rush for spaces and the group was full! I even had to turn someone away. A deadline is crucial for people to decide to commit but it will test your nerve.

4.     Get the word out – Many therapists don’t enjoy the idea of marketing. They believe people will come for therapy when they are ready and have already decided to do so. Quite right. But marketing your group is simply finding ways to let people know about it. They need to know where you are and what you are offering and they will come and enquire if they are interested.

Some ideas to try – edit your online directory profiles to include details of the group, let local therapists know what you are offering in case they have someone to refer, put it on your website and ask your therapist friends to add a link to their websites, print out posters and display in local supermarkets and cafes, share on your social media and ask friends and colleagues to re-share on their accounts, consider a Facebook or Instagram ad campaign, write to local GP practices and include your poster and just talk about it everywhere you can without being too much of a nuisance. I personally found the printed posters (just simple ones created at home) put up locally and my Instagram posts yielded the most results.

One of my posters for the binge eating group

5.    Managing the money – Taking deposits from people before the group starts benefits everyone. It’s a demonstration of commitment and makes no shows much less likely. Nerves will build as the first session looms closer but having already paid it’s harder for clients to talk themselves out of at least coming and giving it a try. I suggest holding a deposit equivalent to two session and using this to cover the last two sessions in the group. The deposit works particularly well in open ended groups because when the client is ready to leave it encourages them to use those pre-paid sessions to process their ending and say goodbye.

It’s possible that some participants may want to use the group as a drop in service, which can have a negative impact on group cohesion. I recommend you request participants to pay for their space in the group, rather than for their attendance so, if they miss a session, they still pay because it is the seat they are paying for. This helps to encourage commitment and regular attendance.

Setting up a group in private practice really is doable. I have found there is a demand for it. People are designed to be in groups and with a mutual problem they work together, provide mirrors for each other and challenge one another. Doing group work is some of the most satisfying work I have done in my life. I don’t even like to use the word work because it doesn’t feel like work, it feels like a privilege.

 

5 Reasons Why We Need More Group Therapy

When I decided that I was going to try to set up a therapy group on my own and run it from my home, I received a few raised eyebrows from my colleagues. There appears to be a general consensus among therapists that groups are difficult to recruit for and take a lot of energy to manage.

During my training I did a placement at a private eating disorder clinic and I needed to get some group experience. The clinic approved my idea for an 8 week overeating support group and, despite high visibility and paid for marketing platforms, there was very little interest. The group ended up with three participants but I absolutely loved that little group. The way they supported and challenged one another felt like a privilege to be a part of. I came away each week feeling energised by the work and really looked forward to the next one. This was my first taste of running a group and I loved it!

Today I run therapy groups for binge eating from my home. I did my own marketing and this time the interest was there. I had always suspected there was a demand for it and through trying various different means, I managed to spread the word and the people came.

group therapy binge eating

Group therapy is something else. I would go as far as saying that I think group therapy is often more effective than one to one, at least when it comes to a shared problem, such as compulsive eating.

The power of groups cannot be overestimated in my opinion and here are some of the reasons why I believe we need more therapists willing to set up groups.

1.     “Money doesn’t bring happiness but it does bring options.” Anthony Bright

Let’s get really practical for a moment. Group therapy is so much more affordable than one-to-one therapy. Group therapy can be an opportunity for someone to access therapy who might ordinarily be unable to due to limited means. With many therapeutic services having their funding cut, group therapy is a way of getting more help to more people.

2.     “Shame dies when stories are told in safe places.” - Anonymous

In every session, at some point, someone will share a story or difficulty they are having and be met with a “me too” response. It’s so common to feel guilty and ashamed about the things we are struggling with. There is often a compassion for others that isn’t always extended to ourselves, so when we hear someone talking about their experience and it’s a similar thing we see in ourselves, it can be like looking into a mirror but the self-judgment subsides. This starts to change the way we feel about our problems, which makes it easier to make changes. No-one changes from a place of shame.

3.     “The transference phenomenon is an inevitable feature.” – Carl Jung

Groups offer so many opportunities to work through old relational hurts. What are the members projecting onto each other? With individual work, there is only the therapist as a transferential object. This could mean that a male therapist might never evoke transferential feelings about mother so that stuff doesn’t get worked through. We are born into family groups, so our sense of our place in the group is a powerful way to gain self-awareness and challenge self-beliefs or even identity.

4.     “Knowledge is of no value unless you put it into practice.” – Anton Chekhov

The group provides an opportunity to practice something new. If the struggle is conflict avoidance, the group can provide the opportunity to practice managing conflict in a contained environment. If the client finds it hard to ask for what she needs, she could start by asking for something from the group.

5.     “There is an indefinable mysterious power that pervades everything.” – Gandhi

There’s just something else that happens in a group, something I struggle to find the words for. When people gather with a shared intention, things shift and morph and create something new. Each group has it’s own identity and shared personality. Is it love? We don’t talk about love much in therapy but I have seen moments of deep connection in groups. People care for one another and sometimes that means challenging someone and dealing with difficult feelings that arise towards each other. I welcome the difficult situations because they are the biggest opportunity for growth.

 Fear and uncertainty often prevent clients from considering group therapy as an option. If group therapy becomes more popular, the idea will seem less daunting and people might be more willing to give it a go.

 This includes therapists too. Yes, I appreciate it’s not for everyone but I know a few counsellors who like the idea but don’t know where to start. Next week I’ll be posting my “Top Tips For Getting a Therapy Group Up and Running.” If it’s something you’ve thought about doing, hopefully it will give you a some ideas about how to make your group a reality.

Podcast Interview

I had a lot of fun recording a podcast episode for Better Mental Health this week. In the episode I talk about body image - the trouble with comparing yourself to others and the influence of social media.

You can find the episode at https://podcasts.apple.com/gb/podcast/better-mental-health

I also share a bit about my own story with binge eating, which isn’t something I have done a lot of online. I do think we connect through sharing our stories. I see this a lot in the binge eating therapy groups I run. When we know we aren’t the only one facing this challenge, we feel less alone. When we feel compassion for someone else’s story that’s similar to our own, we can find a bit of compassion for ourselves.

Struggling with compulsive eating and bingeing is nothing to be ashamed of. It’s confusing and scary and it can be hard to find your way out on your own. There are many places to get support, professional or otherwise, you don’t have to face this alone.

Episode 11 - Sarah Dosanjh on Body Image

Episode 11 - Sarah Dosanjh on Body Image

Ending the Nightmare of Binge Eating

First published on the Counselling Directory https://www.counselling-directory.org.uk/counsellor-articles/ending-the-nightmare-of-binge-eating.

We have never had greater access to nutritional information than we do today. We also know more about how our bodies function than ever before, but it seems that we have never had a trickier relationship with food or greater dissatisfaction about the size and shape of our bodies.

More and more clients are approaching me because they are fed up of struggling with what they perceive is their out-of-control appetite. Are our appetites more out of control these days? This is often the reported experience but all may not be as it seems...

Our relationship with food and appetite is complex. We have many cues and triggers that encourage us to consume food, and these engage all the physical senses - sight, smell, taste, touch and even sound. Ever spotted that green Starbucks sign and suddenly wanted a caramel latte? It wasn’t even on your mind until you spotted the green mermaid in her circular frame!

Experts have termed our environment as ‘obseogenic’, and this simply means we are living in a culture that continuously primes us to eat.

Here lies the cultural paradox. Thin lean taunt bodies and “clean” disciplined eating is celebrated as a sign of success and bestowed with greater social value. Soft, squishy bodies are often judged as undisciplined and an example of what we shouldn’t be. The pressure is on to sculpt your body into a more acceptable shape.

The solution to this becomes a diet. Diets these days are often masquerading as wellness programmes, or healthy clean eating. Sugar is the enemy; we should be eating low carb, keto or paleo. There are long lists of what you should or shouldn't be allowing yourself to consume, and with each new bit of research more things are added to these lists.

The problem with this solution is that it requires you to ignore your body’s signals and hand over the decisions about what and how much to eat to a prescribed set of rules. People crave freedom, it’s a basic primal need, and for many the restriction imposed by dieting triggers rebellious eating, or binge eating.

Binge eating is much more than eating “too much”. It’s a sensation of completely losing control around food. It’s very scary to experience. Unfortunately the common response when people start to binge is to try and exercise EVEN MORE control over food, which sets up the next binge and so the cycle continues. This is how people get trapped in the cycle of bingeing and dieting.

Also, dieting causes emotional eating. As soon as you restrict food you like, you increase its emotional value. Eating and deciding what to eat becomes a more emotionally-charged experience, which confuses your hunger signals even more. Food can then become a way to manage your emotional state.

So what’s the solution?

Understanding some of the emotional reasons that perpetuate your eating is a good start, and counselling will help you gain insight into this and assist you to develop tools for managing your emotions without turning to food.

The emotional work is only part of the picture though.

I like to use the analogy of Newton’s third law, which states that each action has an equal and opposite reaction. Bingeing is the natural reaction to restriction. Even restrictive thinking can trigger the binge response. Ever planned to start a diet on Monday and ended up eating your way through the weekend before?

To break free from bingeing requires a rejection of diet culture and a re-learning of how to respond to your body’s signals.

When people stop believing their bodies aren’t acceptable as they are, they can begin to reconnect with the subtle sensations and signals in their bodies, and regain their sanity around food.

If you are struggling with binge eating, you may be interested in joining a binge eating therapy group. The group meets on Tuesday evenings in Ealing. For more info, click here.