Thinking About Our Work: Groups in Public Mental Health and Agency Settings

Abstract

GROUP, Vol. 36, No.3,Fall2012 Thinking About Our Work: Groups in Public Mental Health and Agency Settings Eric Oxelson1 I havelongbelieved that many treatment groups wereinpublic andagency settings; nowI amnotso sure.Theymayevenbe anendangered species.Several considerationssuggest tomea needtochange mybelief. Manyfirst-time attendeesat AmericanGroupPsychotherapy Association (AGPA) conferences workin publicand agencysettings. However, publicand agency professionals tendnottoappearas repeat attendees. Relatively lowsalaries andbudgets contribute tothis, butworking with groups maymakeupa smallpart ofpublicpractice. Theclinicians whogenerally workinprivate practice settings, often engaging in solo practice, andwhomakeup theapparent majority ofthe regular attendees atAGPAnationaland affiliate meetings maybe theoneswho managemostexisting groups. Ifso,accesstogrouppsychotherapy isdifficult for thoselacking personal affluence. Recently, a clinicaldivision manager ina community mental health program toldmethat clinicians donothavetime todoindividual therapy. Numbers ofpublic mental health programs nowarticulate a service delivery mission that emphasizes self-help andservices provided byclients rather than psychotherapy. Sucha mission doesnotcallfor theprovision ofgrouppsychotherapy. I havefoundthatfewmanagers ofpublicagenciesseektohavemoregroups addedtoservice options. One particular administrator stated thatgrouptherapy wasmuch cheaper thanindividual therapy andavowed satisfaction whenadditional groups wereoffered, buthedidnotactively facilitate newgroups. A limited knowledge ofthevalueofgroups amongdecision makers mayresult 1 Member, Behavioral Health Advisory Board, Madera County, California, retired from direct practice. Correspondence should beaddressed toEric Oxelson, LCSW, 502 Willis Avenue, Madera, CA93637. E-mail: oxelson@sbcglobal.net. ISSN 0362-4021©2012 Eastern Group Psychotherapy Society 347 348 OXELSON from limited exposure togroups. I haveheardclinicians inpublicagencies comment that running groups iseasy. I think thisreveals limited experience with group therapy andlittle interest inlearning aboutit. As a youngclinician, I washiredinthelate1960sbyan enlightened county mental health department director whoaskedmetostart tomakevisible as many groupsas I couldin theSt.PaulRamsey CountyDepartment ofMentalHealth, Minnesota. Within twoyears, I wasleadingninegroupsthatmetweekly, oneof whichmetthree timesa week.I thought theease withwhichI wasabletostart groups andthesupport I experienced weregenerally tobe found inother, similar settings. I suspectnowthatI was in an unusualposition.Later, after I had the stature ofacquiredexperience, I encountered little ifanyresistance tostarting or running therapy groups, primarily, I suspect, owing tomystatus as a manager and a seniorclinician. Today, I find itdifficult toelicit anyinterest instarting newgroups within public settings. Thisexperience, together with theobservations justlisted, givesmelittle hopeofseeinggrouptherapy becomea significant partofpublicmentalhealth programs, andI wonder ifiteverreally was.HowI wouldlovetobewrong! ...