When I sat down in the circle of chairs among eight other therapists for my first consultation group in 2009, I clearly remember the words of one of our facilitators. She said, “You cannot do this work alone.” As my career has taken various twists and turns since then, I have felt the weight and truth of those words with every move.
That particular consultation group was geared specifically towards therapists working with clients with histories of relational trauma; what Judith Herman refers to as a “violation of human connection” (Judith Herman, 1992). However, the assertion that therapists cannot do this work alone is not specific to trauma therapists.
Our clients trust us with parts of themselves that they may not have shared with any other person in their lives. This degree of intimacy can be a gift to both therapist and client. Holding another person’s story is a great responsibility and it can range from exhausting to dangerous to try to do it alone.
A social worker with a Master’s degree needs 3,000 supervised hours in order to sit for the licensing examination. A supervisee should meet with their supervisor at least four hours per month during the period in which they are accruing these 3,000 hours. After a social worker has earned their license, there are no requirements for supervision or consultation. There are requirements for continuing education (most states require between 30-36 hours of continuing education within each 2-year licensing period), but none for individual or group consultation. This leaves many licensed clinical social workers in private practice isolated and disconnected.
From my own personal experience and from talking with others, I know that many social workers remain in agency settings for exactly this reason. Agency work can be extremely rewarding and fulfilling. It can also be taxing due to the long hours, low-wages, requirements from outside funders, and ever-present anxiety related to the uncertainty of federal, state, or local grants. And yet, I have heard many social workers say their primary reason for staying in agency work is due to the support and camaraderie from colleagues.
This support from colleagues is what sustains many social workers. The ability to pop into a colleague’s office (or cubicle) to say, “I just had a tough session. Can you talk?” is invaluable. Giving up this ease of accessing support from others who understand your work is a difficult decision to make.
Finding community in private practice is much more challenging, but as my group facilitator indicated, it is a must. Since I have been in private practice for the past five years I have participated in consistent individual and group consultation. Throughout this time, I have been periodically participated in concurrent consultation groups, each with a different focus. This is how I sustain connection and community in private practice.
My individual consultant knows me and through my stories, knows my clients. She is able to provide an outside perspective and see patterns, relational dynamics, and enactments that I may not be able to. She is able to ask questions and challenge me. But mostly, she is able to hold my clients’ stories with me. Often that is holding someone’s story of loss, fear, or shame. But also, she is there to celebrate the big and small moments of joy and connection that I share with my clients.
Group consultation provides a different, but equally important function for me. We begin each group by sharing how the work has been affecting us during the month. We are able to see and feel that, although we each sit in individual therapy offices, we are not alone. Throughout the evolution of the group we have established relationships that we can draw on between group sessions. Group members often share cases. One therapist may see a client for individual therapy while another therapist in the group sees the couple. Two therapists may see individual family members. We communicate and collaborate on how to best serve the clients that we “share” (with appropriate Release of Information documentation). All of this collaboration is in service of our clients and serves to provide the professional community that so many in private practice are missing.
On my website, there is a short Judith Herman quote. It reads, “Recovery can take place only within the context of relationships; it cannot occur in isolation.” This is what drew me to this work and it is what sustains me in this work. Just as our clients cannot heal in isolation, we cannot help in isolation either.
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Herman, J. (1992). Trauma and Recovery; The aftermath of violence – from domestic abuse to political terror. New York: BasicBooks.