Group Practice: A nonstandard approach in NYC therapy
This is the first in what will be a series of conversations completed by our NYC therapists. The conversation, discussing our therapists’ views on the significance of working in a group practice, was completed over a series of days.
Matt: We practice therapy as part of a group practice. We collaborate in our clinical work, share a strong point of view about what constitutes good therapy. We are different people who share not just space but values. While not unique to our therapy practice, group practice isn’t the standard in therapy. Most therapists in New York hang out a shingle and go it alone.
What’s meaningful to you about practicing therapy in this group context? What do you see as the value to you as a practitioner? What do you see as the value this set up offers to our therapy patients?
Rachael: We don’t practice alone just as our patients don’t do therapy alone. I think about the walls in my office as fluid–I can utilize energy and presence from all of our work on each side of the walls. If I find myself hesitant to go somewhere in therapy session I think about the support I have from my colleagues to go where my patient needs me to go. There are also times I’ve needed my therapeutic work to get unstuck. When that’s the case, you all call that out. I can’t do as much by myself.
Matt: What’s the value to patients in our having a shop of multiple therapists? Do you think it matters for them? How might you pitch that?
Kiran: There’s so much I want to give my therapy patients. I see this group practice as a “home” that helps me to do that. It’s where I come to get support, nourishment, and ideas. It’s where I can listen, provide feedback, and work collaboratively. It’s where I feel a part of and separate. I believe my patients know that I am a part of something great, a place that moves the conversation forward. They have a sense that working with me is more than just working with me.
Heather: There is so much value in the way our practice is set up for the patients and the practitioners. Patients have the opportunity to really be treated by the practice as a whole. We are constantly evolving and growing ourselves and the practice and this trickles down to our relationships and work in the therapy room. If I’m asked to make a referral for new patient in the practice, it is so nice to be able to think about making a good match and really knowing that the patient is going to be in great hands with a person who is well suited for him or her.
And visa versa: When a patient is being referred to me from one of my colleagues here it makes me feel valued. I’m not just an open slot in the schedule.
Karen: I like the idea of my work environment mirroring the values and demands of what goes in my therapy room. For me this means that I deeply value collaboration, am excited by ideas of others, put great importance on creating connection and believe that there is always another perspective and that this is exciting. I offer that with my patients and build that with my colleagues. There is a commitment to growth at this practice–our growth as practitioners–the growth of us as a group and as individuals and in this context we can say tough stuff, be demanding and push each other in ways that are not easy but are so valuable. They know that their therapist is a part of healthy and growing organization and this energy will be a part of their experience in therapy. I think it so valuable for patients to know this work doesn’t happen in isolation.
Matt: It seems like there’s an acknowledgment, implicitly and explicitly in what we are all saying that therapy is terribly hard, for the patient and the therapist. Naming that seems at odds with the traditional archetype of the therapist, don’t you think? Perhaps this comes from medicine–the idea that the “doctor” has access to some special knowledge and always steps in to intervene with a knowing, steady hand. In a sense, one might ask of us, “Why do you need any help? Can’t you handle this all on your own?” It’s a myth I don’t have much of an investment in perpetuating. Do you think us having this dialogue here, which we intend to share on our website, might seem a deterrent to prospective or current patients? In a sense we’re putting our limitations on display by implying that we need the help that comes with working as part of a collaborative practice. Is that bad for the therapy?
Karen: I’m interested in what you’re saying. Wondering about what the impression might be. I think part of what is missing is that as a grouping of therapists we have quite high expectations for the quality of our work and that this is also why we value group practice. I do think that folks reading how hard therapy is could be a deterrent. I like the idea of the group practice and being involved in that being viewed by others as an expression of our high expectations and commitment. Part of what makes the work hard is that we are all so disinclined to settle for low expectations.
Matt: To mention, practically, we may invite therapy patients who work with us individually to engage in couples therapy or family therapy with a colleague, either as a one-time engagement or for ongoing therapy work. We refer folks to therapy groups led by colleagues in the practice. This isn’t the only way we collaborate and the only benefits of working with a group therapy practice but it is perhaps the most concrete and I always feel our work is strengthened by these more formal collaborations.
I often say when speaking with a prospective therapy patient on the phone about our practice that we are a group of people who are surely different people–there are variations in our training and dispositions as therapists and we come to our work as therapists with different life experiences, but we also work together for a reason–we share values and a sensibility about the practice of therapy. I think that contrast matters. In conceiving of this practice back when I was a therapist practicing solo in Tribeca years ago it was important to me not to create (or suggest to others that I was creating) a set of Therapy Clones. We don’t have a “Tribeca Therapy” method, and yet there are clear resemblances in our practice as therapists. I love that about how we work.