Jeffrey Kottler writes in his book On Being a Therapist about the hypocrisy of our profession in asking our clients to do what we are unwilling to do ourselves – to make ourselves vulnerable and to ask for and accept help.
While still in graduate school, I was invited to join my colleague and her husband (who was a newly graduated therapist), Jean and Perry Christenberry, to meet bi-weekly for an entire year to discuss our clients and to begin to learn together about Ericksonian hypnosis and trance work.
It was in that small, intimate group (and not in graduate school) that I began to learn about the gifts that come in giving myself permission to make mistakes and to let go of my family’s rule of perfection.
That was my first experience with peer consultation.
A year later, Perry invited me to join a newly forming and much larger consultation group of peers led by Licensed Marriage and Family Therapist Tom Chancellor; there, we spent our time discussing clients and our own clinical and personal challenges through the lens of solution-focused and brief therapies.
It was in that group that I first heard a peer – much more seasoned than me – discuss the recent loss of his client by suicide; it’s also where I learned from another group member as he grappled with his own new and shaky sobriety.
Years later, while attending a psychology conference for feminist therapists in Rhode Island I sat among a group of forty women speaking openly about the many things that we often avoid talking about as therapists.
Up until that group . . . that day, I had thought I was the only one to grapple with these issues.
When I moved from Texas to Colorado I knew no one here in mental health; I had no peer support (neither 1:1 or in a group) and it was the loneliest and scariest year of my professional life.
If you are bored with your work, overwhelmed by challenges you are facing, looking for therapists to refer to and / or just wanting to stretch yourself professionally, I would encourage you to actively seek out clinical consultation.
For me and many other therapists, too – peer consultation gives us a space to tell the truth about our personal and professional strengths and challenges, to learn from and to receive support from our peers.
Licensed Professional Counselor Catherine Wilson is one of those peers who I’ve come to rely on . . . to hold me accountable, to challenge me, and to support me on my personal and professional journey.
Today is seems only appropriate to introduce you to Cathy as she discusses some of the benefits of peer consultation in private practice.
A commonly known concept in the mental health field is peer consultation or case consultation.
It comes up often in the context of being an ethical obligation we must do for client care in certain situations, such as when a clinician feels they need to talk with someone who has specific skills or when the ethical thing to do isn’t completely clear.
It is a very important part of our work.
At the same time, there is a lot more to consultation than simply an ethical obligation.
For my entire mental health career, I have always had some form of supervision or consultation.
Some of it was required; most of it wasn’t.
Peer Consultation and Success as a Professional Counselor
It wasn’t until recently that I’ve realized how important it has also been for my own well-being, self-confidence, and dare I say even my success as a professional counselor.
Here are a few ways that I have found peer consultation to help me:
Education and Skill Building – In one of the peer consultation groups that I attend, we have a guest speaker or one of us presents on a topic each month to share knowledge.
My skills as a counselor have grown a lot by participating in this – both as a presenter and as a participant.
Even meeting one-on-one, we have the opportunity to learn from our peers in this consultation group.
Networking – Without networking or reaching out in some way, you may not have another way of knowing your peers well enough to consult with someone.
The term is usually used in the context of building a business and that is definitely an important reason to network.
In this field though, networking not only helps you build a list of professionals to refer to and get referrals from but it also allows you to have a list of people you know have skills or knowledge to support you in specific areas.
Relief from Isolation – Being a counselor can be an isolating job.
I own a group practice and there are eight of us in all, but we often go weeks without any contact.
Sometimes that contact is only a quick wave and eye contact when two of us are in between sessions.
Being able to regularly meet with peers can give us some relief from that isolation.
I believe that isolation from others who do the same work can lead to a couple of problems.
One is loneliness.
And, a second is that a therapist’s skills can stagnate without the learning, growth, and validation that can come from discussing the work you do with peers.
Self-Care – This one was a recent revelation for me in the past few years.
In the first few years I was in private practice, I knew I needed to be networking and getting to know my peers.
There were at least two reasons for this: one was so that I had other clinicians to refer to if I wasn’t able to help a particular client and the other was to get referrals and grow my own business.
I made it a fairly regular practice to reach out to other clinicians to set up meeting for lunch or coffee, to get to know each other better.
In the beginning, it was a chore.
I’m an introvert and it felt like “marketing” myself and it was hard to get myself to do it.
I kept at it and usually enjoyed each meeting.
In the past few years though, I realized that these other professionals I met in groups or one-on-one were a critical part of my own self-care.
Spending time with them had become a significant support system for me!
This is true for me in the groups I am part of as well as each and every person I meet with one-on-one.
It has become so much more than just “consulting; today I realize it is also connecting and recharging.
The Many Faces of Peer Consultation
Peer consultation takes many forms:
- Consultation Groups – My favorite, especially a well-organized group!
- One-on-One Meetings – Meeting another professional on a regular basis for short meetings to get to know one another, consult, refer, and enjoy the connection.
- Seeking a Professional with a Specific Skill – Finding another professional to help with a client in an area I’m not as familiar with or a clinician with a specialty I need to understand better.
- Large Networking and Consultation Groups – Larger groups are often good to be part of and although not everyone will make every meeting, I have the opportunity to meet several colleagues at once with less effort on my part.
- Social Media Groups – On Facebook and Meetup in particular, there are many specialized groups that allow therapists to come together who have similar interests or pursuits. For instance, on Facebook, I am part of several counseling-related groups that allow for sharing of business and clinical information as well as connecting with other professionals.
- Employees/Members of a Group or Agency – Depending on the organization, therapists may also have the opportunity to consult with others in their own organization.
Investing in Peer Consultation
Should we pay for this?
The short answer here is yes, of course, we should!
Our time as professionals is valuable.
To expand on that, it is absolutely appropriate to compensate a peer for sharing their time and hard-earned knowledge with you if you seek them out.
It is also appropriate to compensate a peer who puts in the time, effort, and skill to organize a group.
What Makes a Valuable Consultation Group?
What makes a valuable consultation group?
As I said above, this is my favorite form of peer consultation.
And I think when a group is organized well it can have limitless value to you as a professional and it will be well worth the cost of participating.
Here are a few of the qualities I believe are most important to consider when choosing a consultation group:
- Organized – Meetings occur at a regular time, day, and frequency; there is an agenda; expectations of members and the group leader are clear; group structure is reviewed on a regular and consistent basis (for instance, each year there is discussion of what works and doesn’t in the group, potential changes, etc.).
- Education/Skill Building – A variety of speakers and topics is offered.
- Continuing Education Units (CEUs) – The group leader has taken steps to allow members to earn continuing education credit for participating (if this is available in your state or for your professional organization; I’m in Colorado and time in a consultation group does count towards our CEUs for licensure).
- Diversity – Members come from a variety of therapeutic approaches to you gain multiple perspectives in case consultation, feedback, and learning opportunities.
- Size of Group – The group shouldn’t be too small or too large. My personal perspective is that a group of approximately ten professionals allows for good discussion, everyone has a chance to share and be heard, and if one or two can’t make it you still have enough individuals to make it valuable to those who are there.
- Closed Group – Once the group is formed, there is some structure to how members can be added and also requires that members commit to a certain amount of time.
- Group Membership – Potential members must apply to join the group. This allows the group leader to assess whether a particular person would fit well with an existing group or a group that he or she is forming.
- Safety In the Group – The most important quality is that the group feels “safe.” To get the very most out of a consultation group it is essential that members trust each other. The best groups will have members who know that all members of the group will respect the confidentiality of the group; all will know that each group member operates with ethics and integrity; each person knows they can be vulnerable and cared for by the group.
For six of the last eight years, I have been part of a consultation group that Tamara leads near her office in Castle Rock, Colorado.
This group has every one of the qualities listed above and has been one of the most important things I have done to succeed in private practice.
What Has Your Experience Been?
Tell us how you engage in peer consultation.
One-on-one?
In a group?
In person?
Online?
And, what are the experiences you have had in peer consultation?
I hope you’ll take a moment to drop in below to chat!
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Cathy Wilson, LPC, ACS is a counselor and director of a group mental health practice called LifePaths Counseling Center in Littleton, Colorado. She and her colleagues help people deal with mental health issues such as addictions, relationship problems, life transitions, and trauma.
Thank you for letting me contribute to your blog, Tamara! It is one of the most valuable resources for therapists and I’m honored to be a part of it.
Cathy, it’s such a treat to have your thoughtful voice here! Thank YOU for taking time to share your experiences with us!
Thank you for your comprehensive blog post about peer consultation, Cathy. I agree it’s valuable, particularly for relief from isolation, self-care, and gaining new perspectives that I might not have been exposed to otherwise. I prefer in-person, have benefitted from one-on-one, and am now beginning participation in a small, closed group. I can’t imagine practicing without meaningful connection and consultation with peers.
Thanks, Annette! I love what you said about meaningful connection and I absolutely agree, I can’t imagine practicing without that either.
Hi, Annette! Thanks for dropping in to chat! I wonder if there is something in particular that has been particularly helpful to you within the context of consultation with peers. You mentioned preferring in-person consultations so I’m thinking that they must feel different in some way. Care to share?
Although valuable perspectives and new ideas can be gained through all forms of consultation, for me developing in-person connections increases a sense of trust and reduces a sense of isolation. People share not just ideas, but also their feelings, which contributes towards building meaningful bonds. As Cathy mentioned in her post, a feeling of safety that can be created helps each person know they can be cared for by the group, which for me is an important part of self-care.
Oh, Annette! Thank you for expanding on this aspect of in-person consultation. You’re right, of course, but I don’t think I had ever taken the time to put that into words. I appreciate you weighing in here!
Annette, I love the way you put that about self-care. That is very much what I was referring to when I wrote that I realized in the past few years how important my colleagues are for my own self-care, in my consultation group and those that I meet one-on-one. Safety with a group or a person is so very important for it to be self-care!
Thank you for breaking it down and explaining the importance of this! I love your emphasis on “connecting and recharging.”
Thank you, Traci! Consultation in all its forms has become so important to me, and I feel like that aspect is way more important than I understood in my earlier years as a counselor. I’m so grateful to you and all the others I consult with regularly. I appreciate you taking the time to read it and leave a comment here!
Thank you for writing this article, Cathy and Tamara!
As an 8-year member of a committed consultation group, I can fully agree that this group of trusted colleagues — who have have cheered me on and challenged me — have helped me grow into the clinician I am today. And, I am so thankful for that.
My life is wonderful and full, and, nonetheless, keeping my commitment to attend my monthly consultation group is a VERY high priority for me because I gather strength and courage and feel “happily fueled” after our meetings.
SIde note: A number of years ago I had the privilege of hearing Dr. Irvin Yalom speak at a conference. My big takeaway from this was Yalom speaking to the benefits, almost a necessity, of attending a consultation group. He stated that he, in fact, was part of a group that had been meeting for more than a decade. My thought: If it’s good enough for Yalom, it’s god enough for me! LOL! 🙂
Thanks again for talking about a topic that I think needs more attention and brings greater connection.
Hi, Barbara! Welcome back! I love that you are talking about your commitment to your consultation group.
I think that’s something that can be a deal breaker in the success of a group – especially one that requires the trust that Cathy mentioned – in order to work successfully.
Some consultation groups have attendance policies while others do not.
I can make an argument for either one but if members don’t, won’t, or can’t show up consistently, consultation groups, in particular, can be sabotaged in a variety of ways – not enough therapists showing in order to actually benefit from the dynamics of a group, not enough stability in order to build expectations and trust among group members, etc..
Of course, if members are inherently committed to the attendance and work of the group, much of the above never occur!
Barbara! Thanks for sharing your thoughts on this. I didn’t know this about Irvin Yalom! It is really great to hear of his support for consultation groups – both words and actions. Especially since he is such an inspiring person in our field.
I’ve been a part of multiple consulting groups, one I organized for a while for play therapists in my area and was free I enjoyed it but had a difficult keeping interest going. Right now I’m more involved with a local networking group and a few Facebook groups. The local group has been valuable to me in making friendships with other therapists finding others to refer to and also open up opportunities I would not otherwise had. I’ve participated in several online group that met by video and got a lot out of them but the most successful ones seemed to have been time limited for a specific purpose or interest drops off. I’m interested in your insights on keeping momentum going and when to charge rather than offering something as a service to the community
Hi Jill, thanks for taking the time to comment! Yes, keeping momentum going and figuring out when to charge/when not to is a challenge.
For one-on-one consultation, the most common thing I have noticed when I’ve asked to consult with others about a specific topic or situation is that for a 10-15 minute phone call most do not charge; for longer they do charge. For me, these have all been clinicians who are very knowledgeable about a particular topic, and I feel strongly that if you are considered by your peers to be the go-to person on a topic, charge for consultation on that!
My thoughts on charging for a group you organize are this: if you put in the effort of organizing the group and you take care to set it up with things like expectations, an attendance policy, and making CEUs available…you charge for it. There may be exceptions, but in general I think this would be true. If you split the labor between group members, for instance, perhaps you don’t charge.
Keeping momentum going…I would be interested to hear what others feel about this. What do you feel has kept the momentum going in a group you’ve been part of? Two things come to mind for me when I think about the group I am part of. One is *interesting* educational topics. In my group, we have had so many that were absolute gems! The other thing that comes to mind is feeling valued as a group member. That might be opposite from what you would expect, you might think feeling like you are receiving value by being a part of the group is important. It is, but I think that feeling valued as a group member is a stronger draw for me, it strengthens my identity as a therapist and feels good that I am giving as much as I receive.
One other note about your comment…I also spend time consulting with others in a variety of ways like you describe for yourself – I think having that variety is helpful because the benefits of a group, or one-on-one, or online meets are each a little different.
I appreciate you sharing your thoughts here!
Jill, I love the you are asking these questions here and, Cathy, thank you for taking time for such a thoughtful response!
I agree with Cathy in that charging is determined by (1) how much time, effort, and resources I invest in a group / individual and (2) how much I’m giving vs. getting.
For example, I have colleagues that support me in a variety of ways personally or professionally – they are quick to refer to me, to sing my praises, bring me perennials to plant for my garden, or consult with me on my own sticky client situations.
I rarely charge them for consults whether they are asking for business advice / brainstorming or clinical issues or their own family crises.
On the other hand, I have total strangers and also colleagues I know well – online or off – who value my thinking around similar issues as those noted above but for a variety of reasons do not have that reciprocal relationship with me.
I don’t take that personally; it doesn’t offend me.
However, I value my time, energy and resources; I know the value of having an honest opinion and experienced sounding board and I do charge for that and my time.
It might be helpful for you to know that I made that transition to charging when I found my (free) consulting was actually costing me time that I literally could have been making money for.
That often sounded like “Can we go to lunch and I pick your brains?” — A question that years ago I found to be actually flattering.
But, over time, I realized I was starting to resent that some therapists who did this didn’t offer to pay for lunch (at the end of a 2-hour lunch) and didn’t even offer to say “thank you.”
When I sought my own consultation around this issue is was gently pointed out that I was entirely responsible for this dynamic I had set up and was nursing my own grand pity party!
It’s true – I was.
These days I give away at least 10-15% of my work hours for free every week in a variety of ways supporting my colleagues and my clients; I track it so I know.
It’s a pleasure to do so; I also considering part of my work . . . and my ethical and moral obligation; some of that comes in the form of mentoring, some of it in the form of coaching; some of it occurs in formal structured environments like in one of my consultation groups or in 1:1 appointments . . . and some of it comes during less structured times like networking, social, and charity events.
And, by the way, Jill and Cathy, I know that each of you does the same thing – you give often and large to your colleagues in your community; if others in your community are not aware of that, then that’s a different issue – right?
Jill, I’ll be back here in a bit to address your other question, too, about interest dropping off because I’ve been in groups where that was also the case and it’s frustrating – as a participant and also as a leader.
But, got to run right now!
Jill, I wanted to drop back in to also respond to your inquiry about “keeping momentum going” in a consultation group.
Over the years, I’ve learned some tricks . . . and am happy to share them with you.
The first is, just like with your ideal client and your blog, it’s important to know your audience, what they want and what they need.
That way, you can tailor the focus of the group to them rather than to your own interests.
I know it is counter-intuitive but the tighter you keep the focus, the more likely you are to attract the right therapists and the more likely you are to hold their interests.
I didn’t do this with my oldest consultation group and I regret it.
I believe it would have held my interest and enthusiasm better as well as the members’ interests and enthusiasm.
You can also divvy up responsibilities in the group – even if you charge – so that members feel more responsibility for the group.
In one of my consultation groups, each person assumes responsibility for arranging the food we share during one month / year; in that same group, each therapists assumes responsibility for either presenting or arranging for a presenter (their choice) each month.
One of the things this does is to position each of the members as a content expert on a particular topic – something I decided to do early on because all but one of the therapists in this group had 5 years or less experience; I wanted to help build their own sense of competence as well as build their peers’ confidence in them.
This also removed a considerable bit of responsibility from me and also allowed me to then be absent if needed due to illness or travel without worrying about what might happen in the group.
My biggest takeaway concerning keeping the momentum going is threefold:
(1) Just like with group therapy, having too few members is as detrimental to a consultation group as having too many. That’s because too few will not allow for group dynamics (especially when illness, family obligations or travel call prevent members from attending) and too many will not permit the intimacy that allows a group to flourish.
(2) Groups that are highly focused and structured may not be what therapists initially say they “want” but are often needed in order to create that forward momentum.
(3) Someone actually needs take charge and manage the group. Otherwise you will find people-pleasing and personality clashes and vastly different ideas about what the group culture “should” be to strip your group of all good things.
I’m sure there are other things to consider in addition to these.
Hopefully others can join in here, too.
Jill, I just ran across this terrific little article – 7 Ways to Create Emotionally Intelligent Teams .
I realize that the article was not written with an eye toward clinical consultation groups but found the information, in large part, to be in sync with creating successful ones so I thought I would share it with you here.