ACPA Commission

Dr. Cindy Cook is the Associate Director and Training Director at Counseling Services at the University of Houston-Clear Lake. She has been an active member of CCAPS for over ten years and has served on the directorate in the past. Dr. Gary Adams is a Psychologist and the Coordinator for Group Counseling at Counseling Services at the University of Houston-Clear Lake, and Elizabeth Huddleston is a former practicum student and current intern there.

Group counseling is an integral psychological service provided at many university and college counseling centers. When a counseling center has trainees providing services, group counseling can be an excellent learning opportunity for them. Our counseling center provides mostly ongoing therapy groups and uses a trainee-as-co-leader model. We have found this to be an effective and powerful model for developing group skills. However, when trainees participate as a co-leader in group therapy, a number of issues arise that can and should be discussed in supervision.

The co-leader model is both common and preferred by many (Yalom, 1995; Levine, 1981; Posthuma, 1992). In this model, trainees are introduced as a co-leader to the group and are encouraged to actively interact with the group right from the beginning. This can be a more effective and efficient way for trainees to learn-by-doing in the presence of a senior co-leader. In some ways this model provides a parallel process of what we encourage members to do in group – to learn by experiencing and practicing in the safe context of group. This model minimizes the number of non-client members in the group and is less distracting and disorienting than having process observers present. One focus of a training program is to socialize the trainee into the field of counseling center work. This model allows trainees to develop a full appreciation of group work in counseling centers and also empowers their ability to successfully engage in group work. It also introduces them to the process of working collaboratively with senior staff and allows for the early exploration of the co-leader relationship and dynamics. Finally, this model may benefit the group, as the trainee brings new energy to an ongoing group.

Several supervision issues that affect the co-leader relationship have arisen from our utilization of this model. The senior staff member should be aware of these issues and be prepared to process them. Supervision should occur in a safe environment and allow for adequate time to address these issues.

The degree of concern or anxiety the trainee has about their own competency may have a significant effect on the co-leader relationship and on the trainee’s level of activity and effectiveness in group. If trainees have higher general levels of anxiety or if they have less knowledge and familiarity about the focus of the group, (e.g. an anxiety disorder group or other topical group) these effects may be greater. Research has suggested that competency concerns have been shown to involve anxiety about their own effectiveness as a co-leader, concern about their co-leaders’ evaluation of their competence, and apprehension about how these affect their relationship with the co-leader and group (Okech & Kline, 2006). These authors propose that the establishment of a sense of competency is a developmental process. We have found that the more competency concerns are present, the more trainees are reserved and reluctant to be active in group. Therefore, attention to where trainees are developmentally with regard to competency concerns is an extremely important supervision issue.

Miles and Kivlighan (2008) have found that, when group members perceived the co-leaders as dissimilar in leadership style, the group climate ratings were higher in terms of engagement and conflict which are productive for intergroup dialogue. The discussion of personality similarities and differences has not been as well studied, but is an important consideration, especially if there are differences in extraversion/introversion or need for time to process. For example, if the trainee is particularly introverted and needs additional time to process and the senior staff is more extraverted and quick, this can impede the trainee’s effectiveness in group. Also, multicultural issues should be considered in the co-leader relationship. These should be discussed in terms of similarities and differences in gender and other cultural factors regarding the co-leader relationship, but also in terms of the group membership and how the makeup of the co-leader team may impact the group. For example, what are the implications of a mixed gender co-leader team in a women’s group or the implications of a heterosexual co-leader in a GLBT group? Finally, if there is a difference with regards to belief in group effectiveness (often with the trainee having less experience and therefore less conviction of the efficacy of group), there needs to be an open discussion of its impact on the co-leader relationship and possibly the group.

Fall and Wejnert (2005) also discuss the parallels between the developmental sequence of the co-leader relationship to the stages of group development that Tuckman and Jensen laid out in the 1970s (Forming, Storming, Norming, and Performing). Thus, it is important to recognize how these developmental stages play out in the co-leadership relationship and understand them in the context of a developmental process common in co-leader relationships, versus pathologizing behavior common to one of these stages.

Awareness and open discussion of perceived and actual power differentials operating in the co-leadership relationship is a critical supervision issue. This model offers a challenging dynamic to trainees. They are at the same time co-leaders but also under supervision evaluation. Trainees have to be able to switch in and out of these different roles, which can cause some confusion and discomfort. Active involvement in the group involves risk-taking (Herzog, 1980) and trainees must feel safe to explore these issues in order to feel safe taking those risks. Levine (1980) talks about the necessity to aim for equalitarian co-leadership so that the less-experienced therapist can overcome the power differential and participate more fully. Stempler (1993) suggests that that the equalization of power between the co-therapists happens over time, when attention is paid to it. Power can also be more equalized in supervision by allowing the trainee to provide the supervisor with feedback about his/her interventions in the group, or by asking questions about how and why the supervisor made decisions about group interventions. This type of feedback can lead to a rich discussion and teachable moments about group leadership and dynamics. These discussions will also benefit the group as a whole.

At times, especially in ongoing groups of clients who continue and have longer term working relationships with the senior staff member, clients can view the trainee as being a “junior” co-leader. One of the challenges within the group and supervision of this model is the working towards equalization in the co-leader relationship not only in the co-leader relationship as discussed above, but also in the eyes of the group members. One way to work towards this equalization is to arrange for the trainee to lead the group alone, which gives them additional credibility in the eyes of the clients but also builds their confidence in leading the group. They will often step up to the challenge and become more active in the group with the senior staff absent, which will continue upon his/her return.

The last supervision issue is the use of the supervision time itself. Within this co-leader model, supervision will consist of processing what happened in group and, as importantly, the supervisor’s provision or feedback about the trainee’s group skills, to facilitate skill development. The balance of how much time is spent on each of these may differ depending on developmental and skill level of the trainee. Especially with more beginning trainees, it can be useful to conduct evaluations periodically to give the trainee and supervisor an opportunity to formally discuss the strengths and weaknesses of the trainee and to facilitate their growth. Finally, adequate time needs to be spent on managing the co-leader relationship, as the co-leader relationship has been shown to determine the effectiveness of group outcome (Yalom 1995, Corey, 1995). Okech & Kline (2005) and Okech (2008) discuss the importance of engaging in a reflective relational process in order to strengthen the co-leadership relationship.

In summary, the trainee-as-co-leader model can be quite effective both for the trainee and the group, as long as the co-leader relationship remains strong and positive. Most of the disadvantages to a co-leader model arise from a problematic working relationship in which the leaders are not coordinated, are competitive, or collude (Okech & Kline, 2006; Posthuma, 2002; and Gladding, 2008). Alfred (1992) also states that if one leader dominates the others and calls attention to the leadership roles, the impact of both leaders is diminished. In addition, a supervisor critiquing the trainee during the group has a negative impact on both the group and the trainee. These pitfalls have the potential to occur when the co-leader is a trainee. However, by considering the supervision issues discussed above and ensuring that they get adequate time and discussion, counseling center staff can feel confident in utilizing this model with trainees. We have certainly found it to be very powerful and effective in our training program, and feedback from practicum students indicate that it is one of the things that attracted them to our program and one of their favorite experiences at our center.