The Importance of Therapist Consultation Groups

The field of mental health care is rapidly changing. Due to advances in telehealth provision, clinicians searching for more autonomy, and increased access to entrepreneurial resources, many private practice owners are opting to provide services in a solo or online practice. 

Prior to 2020, there were already a growing number of therapists who were migrating to providing some or all of their services online. At the same time, more and more clinicians were completing master’s degrees and looking for options to begin working in solo private practice during or after meeting their requirements for licensure. 

Previously, one option was to work in community mental health settings, and then at some point transition into private practice. This provided more access to supervisors—and also greater access to their peers. Getting case consultation was simply a matter of walking to the office down the hall or discussing a case at a weekly team meeting. But with the change in the way clinicians are practicing, there needs to be an accompanying change in access to essential clinical case consultation and peer support.

The Consultation Challenges of Virtual Practice

Therapists who started offering virtual care quickly discovered what solo practitioners already knew: working alone can be lonely. While being your own boss has its perks, the lack of regular collegial support takes a toll on both your mental wellness as well as your clinical skills. This can lead to increased occurrences of imposter syndrome, stagnation of clinical growth, and can eventually lead to burnout—if it’s not addressed.

Many solo and virtual practitioners used to be able to meet up with a local network of colleagues on a regular basis for support and clinical consultation in counseling. These meetings allowed for the clinical and socio-emotional support that clinicians and business owners need. However, with the changes and risks brought on by the pandemic, many providers no longer feel this is a safe option. 

At the same time, clinicians were swamped with an influx of new client requests—all while living under the same stressors their clients were experiencing. For many, the physical and emotional strain that working under these conditions caused meant that finding a therapist consultation group fell way lower on their list of priorities. 

All of this—an increased caseload, the emotional toll of working through COVID, and other business responsibilities—has had an immense impact on solo providers, who have little to no collegial support. Clinicians without a network in place have the option to pay a colleague on a case-by-case basis for case consultation. But unfortunately, this type of consultation tends to be used only for emergent cases, and may not be financially sustainable in the long-term. It doesn’t always allow for the consistent, safe support that comes from meeting regularly with a group of colleagues you know and trust. 

Without regular support, clinicians miss out on both the clinical and socioemotional wellness aspect of consultation in counseling. Clinicians in the groups I facilitate are often very comforted by having a colleague simply affirm the toll a challenging case is taking on them, in addition to providing clinical support. This aspect has been especially valuable during the pandemic when most clinicians are finding the ongoing personal tolls to be especially challenging. 

The Importance of Consultation in the Counseling Process

I’ve talked to a lot of clinicians about their experiences with both clinical supervision and consultation. Some of them have found a lot of value in both types of support, and have had great experiences with supervisors and colleagues alike. However, there was a larger number than I would’ve guessed who have had bad experiences with consultation or supervision. I heard stories about things like unprofessional behavior, bullying, fear mongering, or unwarranted accusations of ethical violations. Because of situations like these, I’ve seen clinicians be hesitant to expose themselves to the possibility of unfair treatment, and many find it difficult to trust in meeting with their colleagues for support. 

Most of the ethics guidelines of the governing bodies for licensed clinicians reference clinical case consultation as a recommended practice. For many clinicians, however, once they have completed their supervision hours, they are ready to have more autonomy—and underestimate the value of clinical consultation. Conversely, more experienced clinicians may feel they have enough colleagues to get support on an as-needed basis.

But in my experience, having a group of peers readily available to consult with can assuage concerns, as well as help make sure the case is being handled with due diligence—whether a report is made to protective services, a client has contentious parents, or a client has a risk of suicidality. In addition to clinical support, regular group meetings can serve to build confidence in clinical skills, decrease feelings of imposter syndrome, and help with maintaining passion for your work. 

A therapist consultation group can help you focus on creating a better work setting to give you more freedom and fulfillment in your career. It can alleviate fears about being judged for your skills and decisions. And since the beginning of the pandemic, clinicians in my groups are finding much-needed support and normalization around how hard the pandemic has been on our profession. 

Although most clinicians join regular consultation groups to gain support while managing difficult or high-risk cases, clinicians in my group have also reaped a lot of benefits of being in a community with other mental healthcare providers. Providing consultation and support to a colleague who is also of great support to you not only benefits that colleague, but also affirms your own clinical knowledge. And it always feels good to give back to our communities! 

The Benefits of Virtual Consultation in Counseling

In addition to finding the efficacy, ease, and convenience of seeing clients online, clinicians have discovered that online consultation groups are an expansive new way of getting clinical consultation. Through online meetings, they’re able to get to know and consult with clinicians all around the country, and even the world. 

Virtual consultation groups can be scheduled during normal work hours—since there’s no added time needed for transportation, it’s a lot easier to fit these groups into your existing schedule. Plus, a virtual format means that support is more readily available. Clinicians who are working on cases that feel too urgent to wait for the next scheduled meeting can reach out and get support on much shorter notice. Clinicians in the groups I facilitate have sent emails to their group between sessions to see who might be available for virtual consultation between their regularly scheduled meetings. 

How to Access Clinical Consultation

For clinicians who already have a network of colleagues they can lean on for support, simply moving those meetings online is the easiest solution. But many virtual or solo practitioners don’t yet have those networks in place to create this kind of support for themselves. While it’s still possible to consult with colleagues for emergent or urgent cases, the most effective and beneficial way to get support is to have a standing meeting once or twice a month. 

With a little bit of research and networking, you can find and join an existing therapist consultation group. There are a variety to choose from—some free, some paid, some facilitated, some drop-in, some closed. There are pros and cons to each kind of group depending on what you’re looking for. Many clinicians find that meeting with the same small group of colleagues on a regularly scheduled basis—which is the format of the group that I run—allows them to develop enough vulnerability to go deep with cases, or bring up cases that they’d like support on, but don’t have a specific question about. 

Whether you’re a seasoned clinician with a strong network of colleagues, or a newer online clinician needing support, it’s easy to lose sight of how valuable of an asset clinical consultation can be. Thanks to the expansion of online meetings and access to affordable, secure platforms to discuss cases, it’s now possible to get the support you need in a new way—whether you’re working online or in an office. If finding a group has slipped down on your list of priorities in recent years, I’d encourage you to find the time to prioritize yourself in the coming year. You deserve the clinical and emotional support that therapist consultation groups can provide.