Encouraging Intern Growth & Groups

Welcome to Group Work. I'm your host, Katie Kay May, and I interview mental health therapists to find out what happens in the space where group therapy takes place. Take a deep breath and find your seat inside the circle. This episode Episode of Group Work is about to get started. Dr. Tara Sanderson is a licensed psychologist, supervisor, and group practice owner. She teaches courses in how to start a private practice.

and how to have interns in your practice. She loves to talk about interns, and I am so excited to learn more about encouraging interns to run groups today. Hey Tara. Hello. How are you? I'm doing well. How are you? I'm good, thanks. I've been looking forward to speaking with you so much because I've seen you like exploding on the internet talking about building up.

a practice that really supports interns. And I'm excited to tap into your expertise today. Well, I am excited to be here because I think that groups are one of the most underused resources, especially when we're talking about interns. So I'm excited to share and collaborate. Yay. So both of us excited is a great starting point. I'm glad we're both here on our own will. Great to be there.

I'm curious before we dig into your group of just learning a little bit more about, you know, the trajectory of your career and how you came to own a group practice that really does. focus on supporting interns and, you know, elevating up interns into their clinical positions. Yeah, absolutely. When I graduated my undergrad degree, I moved to Oregon, getting ready to go to grad school and started working in group homes.

And realized that the other 23 hours of the day, the other six days of the week, people are living their lives outside of the therapy office. And it was really important to me to develop a new sense of what they go through every day and how they navigate everything. And so when I got into doing therapy work through my graduate degree,

I realized that we focus so much on that 60 minutes that we forget some of the rest of the world that goes on. So I got really excited about bringing interns into the group home experience. so that they could start seeing the rest of the human picture because we forget it so quickly when we're in therapy.

And so from that point forward, I really just kept trying to feel figure out ways to bring students and supervisees into the world of therapy as well as group home work so that they could get the practice before they got this degree and started kind of rolling off on their own. And then as I moved out of group homework and into my own private practice, I knew that I wanted to have interns and grow that experience as well. So I brought two on board with me the day that I opened my practice.

Well it was really intense. They did meet all their hours. They graduated. They did so great. But it was a labor of love to bring them into the room therapy room with me. uh to have them be a part of my full experience. And so from from day one, I was writing my intern manual alongside my own manual of running my business and really trying to grow that part of my

my practice. There's a few things that you shared that really stand out to me. And the one is just acknowledging all of the things that happen in life outside of the therapy room and that hour a week. And I think You know, oftentimes it's an oversimplification of a person's experience to toss out this intervention and then not, you know, understand the context that happens outside of the the safety of that office. And so I love that you're

you're really conceptualizing like what does therapy look like in a bigger context and not just in the therapy room. And that's really beautiful. And even more powerful than that is this, I'm gonna say, like courage and confidence that it took to bring on two interns when you opened your group practice. I'm remembering myself as a new group practice owner and having these thoughts about like these people's lives are in my hands and now, you know.

I'm taking peop people are trusting me and they're they're growing with me and I don't know what the hell I'm doing, but I'll pretend that I do so no one else feels scared. Like but you just did it. You started day one and you you took them on and and taking on interns is

It's no easy feat because they also have that self-doubt, you know, the the greenness of not even having all the clinical interventions and experience under their belt that you do. Well, I'll let you share more about it. So From that point, where is your practice now?

Yeah, it's a it has grown a lot. So I have six student interns at the moment. I have three associates who are uh, well actually four. She just got moved into that world, four associates that are pre-licensed and then one licensed therapist as part of my practice. And part of how I have hired all of my associates as well as my licensed person was asking them questions in the interview about how do you feel about supervisees? How do you feel about sharing your wisdom?

you know, back down along the line of people as they are growing because I wanted to build a practice where everybody wanted to learn and wanted to grow. and wanted to pass on information. So part even part of our didactic schedule is that everybody presents something that they're learning, whether it's a book or a podcast they just listened to or some training that they went to, we're all constantly sharing learning.

to make sure that we're growing and I think that's a perfect environment for fostering our little supervisees. I love it. So you've built this culture where learning and giving back and growing and supervising is is really this core value of of your Whole practice. And I want to even highlight that in itself is is such beautiful group dynamics, right? Of like intentionally choosing the practice and the group and the feel and the standards within it. I think that you've

you're doubling your your group experience, group practice and the groups within it, just with that idea. Yeah. Those dynamics are wild as you go through the process of kind of screening people and figuring in It's the whole dynamic of going through the phases where things don't quite fit and having to work together to to manage them. Yeah, it's a pretty incredible. That's so cool.

So tell me then about the group because you had referenced helping interns, encouraging, not just helping, but encouraging interns to run teen groups. Talk to me a little bit more about that process. I think that even though a lot of my interns come to me because they want to work with teams. They are scared of running groups for teams. Especially when we start looking at teen groups for like the one that I traditionally run is a teen anxiety group.

So I think most of my interns have said something along the lines of like, well, how do I entertain teams for that long? Or what if they get rowdy? Or, you know, what do what do I do to can to manage that? And uh and of course my teen anxiety group tends to be on the other end of the spectrum where it's just quiet.

And they're going to just do what you ask them to do most of the time. But they just get so scared. And so when you were looking for podcasts, I was thinking, gosh, it would be really good to just kind of talk through how we encourage our people to do something a little outside of their comfort zone. Even if they like working with teams, working with them one-on-one versus working with them in groups.

are two different things. Absolutely. And I think the follow-up for that for me is that a lot of our school programs in my area anyway teach how to do group process groups. I was wondering if that was it. Okay. A lot of our schools teach how to do process groups. but they don't really teach how to do curriculum-based groups or psychoeducational groups. And I tend to lean more into the psychoeducational group realm.

So I so it's also a big ask for them to be handed this manual, to read the manual, to do the stuff and then be like, wait, I have to teach somebody something. The process groups we ran in school were just the people came there and just kind of magically taught. So what do I do with teenagers if they're not going to talk and I don't know the material and they just kinda wanna tear their hair out? You just sit there.

Yeah. So I just um I just thought it would be kind of cool to talk about how how we encourage that. Cause I know you do some groups that are curriculum based as well, right? Yeah, so most of our groups right now are curriculum based and we intermittently run process groups. I'll say the pandemic put them on hold because they're better suited for in-person, at least the way that our therapists prefer to do them.

It's harder to process when we're just squares on the screen. Not to say it can't happen. I don't want to say you shouldn't do it, but for our preference and our energy was better spent in doing psychoed groups in the online space. Yeah, yeah, absolutely.

So one of the things that I I was trying to come up with like three things this morning or three like tips this morning that I could kind of impart into the psych into the podcast world. And the first one that I really resonated the most with that I know most people, including us therapists, hate, is role play. And that one helps. so much with my newly moving into this group dynamic.

intern folks. And although they hate it and they tell me every time, like, there, no, no, no, I'll be fine. I'll just I'll just jump in and try it. No, let's just slow down. I know it's nerve-wracking, but we're going to just play this out and let me show you how some of my teams have been in groups and do these experiences. I role play a lot of our phone calls to do the onboarding into groups.

Because I think that that part is so important for them to have practice. And there's something to be said for doing that real life practice of what's going to happen in this phone call and how we're going to make it work. Especially when we're talking about anxious teens. So sometimes we're able to have a phone call with the kiddo and sometimes it's just with the parents and the kiddo like isn't even sure they really want to even come to growth. So there's a lot of dynamics to be played out.

You are really into role play things too, right? You do that with Are you interviewing me? Yes, we are. I'm joking. Yeah. So I mean, I'm a DBT therapist. So activating new behavior, role-playing, doing. I can't just talk about something without being able to see your competency level and doing that thing.

And so I do think it's such I mean, there's a reason that we do role plays and there's a reason in grad school that we do our like process recordings where we're faking, you know, with our my friend Sarah, who was my fake client throughout grad school. Like, because it's what works, because it's, you know, we're rehearsing those behaviors for when we need them. I am curious about your process. Are you just like

tossing them a book and saying like come at me and role play when you're ready. Like what does it look like to get them to that point? Yeah. So in the initial part where we're just doing some of the phone calls and things, I've written a few scripts from a few different angles and I give them those usually it like As we're kind of planning out our getting ready to start up group, you know, probably about six weeks before we start their first group, I have them practice those role plays.

So I give them the script. They're they're required to call two of our other practitioners in the office as if their clients and Jessie. play that out together. And of course the other practitioners know this is happening. So it's not just a cold call. But they just kind of play that out and then they report back to me how those go.

Sometimes I've had a few interns get very excited and tape that session so that they can bring that back to me, which is super cool. I really encourage a lot of taping of things if possible. And then once they get those phone calls underway, then they start really digging into the manuals that we have for our psychoeducational group.

And we go week by week and make sure that they know the slides, make sure that they know the information. And then they do they pick one of the groups for the first out of the first three weeks. to preview in our didactic training. Because honestly, who couldn't get a refresher on how to deal with anxiety or DC skills or whatever? So it's really nice that throughout the year we have these as our didactic trainings as well, made by one of our interns. So they've got a real live audience.

and they're just teaching the thing and we can give feedback because we care and we're not going to just like abandon ship on group, which then you know helps them build that confidence and helps them get ready to move forward. It's beautiful. Do you the anxiety curriculum that you use, is it one that you've created for your interns or do you use an existing curriculum? We use an existing curriculum. It is, I want to say it's the exploring anxiety workbook. Okay. From New Harbinger.

I could be really wrong on the title, but it's something like that for teams. We'll find it. We'll link it. But it's really great. It just kind of takes you through a lot of the different steps and One of the cool things I think too is that a lot of my interns end up ad libbing things in from other things that they know from like ACT or DBT or from different pieces, which is super great because then I feel like they're they're making the material their own.

And that can be really effective for them to be competent in giving it out to the students. I always think that that's a marker of one of my supervisees growing is when they're taking something that was a template and they're making it. their own in terms of the language or how they're delivering it. It shows that they truly understand it and they're not just like spitting out something that you've programmed in. Yeah. Yeah. Yeah, absolutely.

Do your interns run groups just one leader? Do you put who interns equals one therapist? Is that how we like see it? How do you do that? Who interns equals one therapist for the most part? Occasionally we'll have a scheduling conflict where we can't do that, but I always like for there to be two. And I do that with with my licensed or pre-licensed folks as well. Yeah. Mostly it's because I never want group to suffer if a therapist can't be there.

Sure. So it's easier if we just have two people. I also, especially for my for my new guys, I have them rotate who leads and who writes the notes. So that they get an opportunity to do both sides and understand both elements of that. And then every time we have a group going, I have a group supervision for that group specifically so that I'm not talking to each of them in individual supervision, trying to remember what I told them about groups.

That's really smart. So when you have a group that two interns are running, you have a separate group supervision about the group that you're running. Yep. Love that. Yeah. And most of the time it's not like a full hour long necessarily. Sometimes we only need a little bit of time, but especially if it's their first time running a group, I want to make sure that they feel so supported in what they're doing and can ask all the questions.

it is amazing by the third or fourth session where they really start seeing the storming kind of come up in group of kids pushing limits or or people kind of dropping out or what kinds of things. How much intense anxiety comes around are my own interns of like, wait, I must be doing something wrong because it's all falling apart and it's not working.

That's such an incredible learning experience for a new therapist and not personalize what's showing up in the room as you doing something wrong. And you're giving them such a gift, right? Like

They can take that and then generalize it to new therapist experiences moving forward in a way that's going to be really helpful. Yeah. Again, we're talking about that in in real life learning, right? And these are these are Uh luckily, I think we've we've got a really good experience of building resiliency in our therapists in this way. Right. They've got the support of their school, they've got the support of us and what they're working with the kids on.

isn't going to be detrimental. We're not opening up huge trauma wounds that are going to have it be problematic if they don't continue. If the kid is not ready to do the work. for the anxiety management or it's just too stressful being in the room, then they can go back to their own therapist and continue to do that work and hopefully either rejoin us or rejoin somebody someday and continue to work through that part.

So the anxiety group is really an intentional choice from you. It's like anxiety being low stakes in terms of no safety concerns. you know, that's not our under controlled teens who may be destroying property or self harming in the bathroom or any of those things that that, you know, would require a greater level of care or um yeah skill set to work with them. And then they have an individual therapist that is not the intern. So they have, you know, a okay.

So you've really thought this through. This is a well-oiled machine. I'm trying. What about pitfalls, things that you've learned just by doing that have not worked, that you can help us out so that we don't make those.

Mistakes slash learning experiences. Yeah. So one of the, I think one of the biggest pitfalls, especially that I think most people have figured out during the COVID experience is technology failures. And how that impacts everything. Like having backup plans to your backup plans are so important to making sure that everybody can find their way back together or have some way to connect if everything goes wrong on the internet.

And we've had those as well for our in-person group because, you know, we do use some sort of technology or we were going to use a game, but now it's in a therapy room that's being used with a with a client. So we can't go get it. So you got to have a backup plan for that piece of it. And uh and just making sure that you think through the logistics. And that's I think when when we when we plant plan out.

when we plan out our first through sixth weeks before they start the group, probably two through four are the weeks that we really kind of hone in on, okay, these are your sessions, this is what you're gonna do, you're practicing these pieces. What if this fails? Where are you gonna go if? How are you gonna contact them? And especially when you're dealing with teens, a lot of times you have their parents' email address or their parents' number.

But if technology is breaking in the moment, their parent may not be at the house where they're doing the thing. So we you have to try and figure out like how are we going to be able to connect with a kid and do those pieces. And I don't leave the discussion on what is going to fail. I have them think of all the things that could fail. And then we make the backup plans for that.

I love that. So you're not just telling them, you're actually having them critically think about what could go wrong. How can we course correct? How do we cope ahead of this? That's brilliant. Thank you. Thank you. It's it hurts when we're doing it because they look at me for all the answers and are just like, well, why can't you just tell me what's been going wrong before? well that's not the game we're playing today

So yeah, I give you a lot of credit for that because I feel like that's like moving through sand. Like, and I experienced that with new therapists in general, of like,

Like, I know the answer. It would literally take me two seconds to give it to you and fix this problem. But like I have to tolerate my own distress that we're gonna be here for a minute while I let you figure this out. So Good on you for having that ability to sit with that and and work through that because I I'm certain that your interns are better for it.

You know, and I think so. I think when when I think about how I want things to work out for them in the future, I'm trying to teach with the end in mind. I want them to sit in their own space someday when they're licensed and go Gosh, what would happen if my Zoom room failed or this thing failed or this thing failed?

and make those plans without feeling like, oh God, no one ever taught me how to, dot, dot, dot. Right. Yeah. And it's the same thing we do in our group of, you know, we we want them to explore these pieces so that we can develop the skills to navigate them effectively. I love it.

On a bigger scale, like do you what happens with your interns when they're not interns? Do you tend to hire them if they're hirable? Do you are you just a teaching practice where you move them on into their own practice? Like what's your system? Yeah, so I've been wrestling with my system for the last couple of years. I had uh I had really planned on my students, I'd been uh bringing them on board with the intent that they wanted to do their own private practice at the end.

And a part of coming to my practice was give me giving them all those tools to be able to set up their own private practice and launch and run. And then I met a few interns who I just really wanted to keep. Yeah. And so I started figuring out like how to move them into my face and do those pieces.

So now I'm at kind of an interesting balance point where I offer like if if we've got room where we're hiring and we're doing this thesis, I definitely want to keep them on board. Or if they want to run their own private practice, I'm happy to go that route. And we just talk about it a lot. throughout the experience because I I also am such a big believer in not hearing just one voice throughout your practice experience.

Yeah. I want them to have other supervisors. I want them to have other people, other consult groups, other things so that they're not just becoming little mini me's because honestly I don't need any more of me. I'm happy that there are more Terra's. We're okay with it. Thanks. But I think that they've got something really cool to offer and they just need to continue to explore and build that thing. And they can't do that if the only thing they're hearing is.

my voice in their head, right? I think it's cool too if you do hire up interns that stay and then they give back, they know what that experience was like and they can do it in a way that's really congruent with your practice. Absolutely. And that was definitely the experience this year we had. I had an intern who I hired and then she mentored in, she was running one of the our DDT for emotional eating groups.

And uh she mentored in one of the interns to run that group who has an um a really big a passion for eating disorder treatment and it was just magical watching them work together. And having having them lead and follow. And it was beautiful to watch as a moving into that boss role, right? And watching this thing happen and being like, Oh, this is beautiful. This is exactly how I want it to like blossom and grow.

It's awesome that you saw it play out exactly how it was supposed to and how you intended it.

So we never have issues filling our interns, whether it's individual or group caseloads. And I see on Facebook and in the groups a lot that people do struggle with that. Like how do we fill our interns or our provisionally licensed therapists? So I'm curious your experience, if you get pushback for either group or you know, your individual whatever with your interns, how does it typically land with families and clients?

Yeah. With our groups, I don't think we have a problem at all because our group rate is pretty low for for most of our groups in general, but especially for our intern group. And I think that that resonates in our community as a as an affordable option. Right. And My name is pretty known in the community for working with teens and for running groups. So I think a lot of people just assume that there's gonna be good support and good training for for my people in that way.

Right. And then for individuals, I honestly haven't had a lot of trouble either. But a lot of that is is the way that I've structured how we return phone calls. So a lot of I I have my interns and my students return phone calls. And have some of those initial conversations with people. And we're able to have a really good conversion rate because we we have been working through doing uh role plays and scripts and those things for them to learn how to convert a client into a client.

The biggest pushback, I guess, sometimes we get is somebody saying, Well, but I'm not sure if I need somebody more advanced than you. And usually our comment to that is, Well the my d my supervisor's Doctor Sanderson's you're getting a twofer. You're getting two for one therapist in this moment. So you can't ask for more, you know, support as you're going through whatever you need.

And if they've built enough empathy and built enough rapport in that time, they're usually able to turn that over. The biggest issue I have is like somebody who has. no copay on their, you know, on their insurance. Right. And so they're like, well, but if I go see somebody in my insurance, I don't have to pay at all. So why would I come see you?

It's a valid question. I mean, I get it. No problem there. But it's usually not because it's their intern. It's just that my interns don't take insurance. Right. That makes sense. Well, I think what you're doing is amazing. Not only are you providing great therapy and a great resource for teens in your community, you are training up a new

generation of therapists to be really good therapists, which feels so important to me. Like the we need more therapists, especially, you know, in the times that we're in. And the fact that you're training them in in your model makes me feel encouraged, makes me feel good about more therapists coming into the world.

If you were to give advice to our listeners if they want to take on interns or run intern groups, what would be your top tip for them? My top tip for them is really to have a strong idea of what you want them to launch with, like what you want them to learn and build your manual and your training plan around that. If you start with, I want to make some extra cash or I just want to give back or this opportunity just landed in my lap.

you're gonna be like scrambling the whole time to make it all work together. But if you start with the end in mind and build everything from there, I think you can have an amazing success with inter and with having interns. Great advice. Be intentional, not reactive. Start with the end in mind. I love it. Tara, where can people find you if they wanted to learn more about you or your work or to see one of your interns if they're a client listening?

Yeah. So for my personal and consulting kind of world, you can find me at drterasanderson.com, not just drterasanderson.com. And if you want to see what my private practice is up to, you can go to Dr. Sanderson and Associates. dot com. Awesome. Thank you so much for being here today. Wonderful. Thank you so much. Hey Groupie, thanks for listening. For more resources on how you can market, fill, and run your group in private practice, check me out at becomeagroupguru.com.