In his presentation on September 27th for the luncheon meeting of the Santa Clara Valley chapter of CAMFT, held at Michael’s Shoreline, Jamie Moran, LCSW/CGP, addressed the various criteria he uses in assessing individuals for psychotherapy groups. As a highly experienced and certified group psychotherapist in the Bay area, Jamie was careful to distinguish between psychotherapy groups, which work with conflict directly, and support groups, which typically interrupt and reframe conflict.
Jamie emphasized how one of a group’s important functions is to mirror family as well as current, “here and now” dynamics for a client. This helps set the stage for important repair and re-working of original wounds that a client brings to his or her current relationships; and it provides the client with insight and new ways to address his or her issues outside the group. Most group issues, according to Jamie, involve joint responsibility.
I appreciated Jamie’s detailed discussion of his screening process and found it very helpful to hear him review how he assesses clients. As part of his handout, Jamie also provided a detailed list of questions that he incorporates in his assessment process. In order to get a good sense of whether a client and a particular group would be a good fit for one another, Jamie spreads his interview out over two full sessions, charging his usual group fee for these meetings.
Some of the factors he considers are:
- Interpersonal issues, especially depression or isolation
- Client motivation and curiosity
- Ability to provide and receive feedback
- Ability to work with issues in the here and now
- Willingness to deal with conflict
- Ability to leave the session with unfinished issues
Toward the end of each assessment, Jamie expresses any reservations he might have and checks them out with his client. He might refer the client to another group or suggest continuing with individual therapy for a while. He keeps a wait list for full groups and checks-in periodically with clients whom he determines to be a good fit. I like that he does not automatically rule out clients with personality disorders -- the way I had been taught to do in my first internship -- and appreciate his perspective that “moderate Axis II can work in group”.
After a discussion of assessment criteria for general groups, Jamie turned to placement factors for LGBTQQ clients. He takes demographic profile into account, assessing where a client fits within the group profile, and explores possible impact of the current group on the client. Critical issues such as homophobia, shame, and humiliation typically unfold, and the Therapist’s role is to invite joining of the other members, which helps break through judgment and isolation. Jamie also shared his personal guidelines around members socializing outside of group: i.e., either no socializing between group sessions or, socializing permitted with reporting during group.
Lastly, he addressed the issue of empathic failure on the part of the therapist, sharing a personal anecdote and emphasizing the value of empathic failure repair. Interestingly, Jamie does not use check-ins to begin each group session. His view is that these serve to increase safety. While check-ins can be useful in support groups, Jamie’s preference for psychotherapy groups is to leave the responsibility of owning or sharing an issue with each individual group member.
Jamie Moran has offices in San Francisco and Menlo Park where he works with individuals, couples, and groups. He is currently leading six different groups; he also coaches and offers various workshops and in-service presentations throughout the U.S. I found Jamie's presentation both thought-provoking and highly informative. As someone who enjoys facilitating support groups, I feel inspired to incorporate some of his techniques in my own groups.
Author: Elanah J. Kutik, MA, LMFT
Presented by: Jamie Moran, LCSW, CGP
