From Support to Structure: Lessons Learned Facilitating a Group Without Formal Training
Alexandra Kim
Clinical Psychology Student – George Washington University
Abstract:
This paper reflects on the experience of co-facilitating an online, open-format support group for parents of children with anxiety and depression prior to formal training in group psychotherapy. The author describes initial feelings of unpreparedness, challenges inherent in online and open-membership group formats, and difficulties navigating group dynamics, co-leadership, and role expectations. Drawing on subsequent doctoral-level training in group psychotherapy, the paper integrates clinical insights with foundational group therapy concepts, including therapeutic factors, group cohesion, and leadership structure. The discussion highlights the importance of training in group facilitation, while also considering the value of accessible, peer-oriented support spaces. Implications for novice group therapists and training programs are discussed.
Keywords:
group psychotherapy; support groups; online therapy; group leadership; therapeutic factors; group cohesion; co-facilitation; psychotherapy training
A year ago, prior to starting my Clinical Psychology doctorate at George Washington University, I was immersed in the research world working as a lab manager and hoping to become more deeply engaged in clinical practice. Although my position in a developmental lab offered valuable exposure to working with families, I longed for more sustained and meaningful interactions with parents and children in a clinical setting.
Almost a full year before beginning my doctoral training, I began co-facilitating a weekly online support group through a nonprofit organization that provides accessible services for parents via a 24/7 stress line and a series of weekly support groups. These groups address a wide range of topics– from supporting parents of children in foster care to assisting single parents and those raising children with special needs. After completing two brief online training sessions, I was paired with a social work intern to co-lead a group for parents of children experiencing anxiety and depression. While eager to contribute, this experience preceded any formal education in group psychotherapy and quickly highlighted the complexity of group leadership.
During the first session, several parents logged on and began sharing deeply personal challenges, including navigating their children’s emotional dysregulation, school-related struggles, and difficult co-parenting situations. These were parents facing urgent concerns and looking to us for support. Not only was it my first time co-facilitating a group, but my co-leader was new to this as well. I was immediately aware of both the weight of this responsibility and my own lack of preparation. Despite clarifying that I was not a licensed clinician, I questioned whether I was adequately equipped to respond in a helpful and appropriate way. While I felt in awe of the position I suddenly found myself in, I felt immensely untrained.
Support groups are often conceptualized as requiring less formal training than therapy groups, as they differ in a few meaningful ways. Support groups are typically open, ongoing, and centered on shared experiences rather than structured intervention (Nichols & Jenkinson, 2006; Worrall et al., 2018). They are aimed at helping members cope, rather than change. However, research suggests that even support-based formats can significantly impact participants’ well-being, underscoring the importance of thoughtful facilitation. In practice, I found that even non-directive roles—such as listening, validating, and encouraging—were shaped by my own assumptions and values. I felt concern about unintentionally influencing participants without sufficient clinical grounding and knowledge.
In addition to internal uncertainty about finding my place as a leader of this group, I encountered challenges inherent in the structure of the group itself. As an online, open-membership format, attendance and engagement were inconsistent. Participants joined late, left early, kept cameras off, or attended while multitasking. As a leader, I often struggled to find the line between upholding values that I felt would be helpful to the group, while also understanding that certain aspects are out of my control in this format. There was also the fear that if I held individuals accountable in some of these less-than-ideal actions, I may risk continued attendance, and participants would dropout. In a format like this, I wondered if it was it better to sacrifice a contained group dynamic for the flexibility of parents fitting this into their busy schedules, or if it would be more conducive to demand certain guidelines be followed and sacrifice the attendance of some members. I oscillated from week to week; what is a support group like this, if not convenient and accessible? On the other hand, what is a support group’s purpose if it does not uphold certain standards and provide a safe and helpful environment? It felt as though I could either allow flexibility for parents to participate or have cohesion and accountability – but not both at once.
Many of these challenges can be understood through the lens of core therapeutic factors in group psychotherapy, as described by Irvin D. Yalom. Factors such as group cohesion, universality, and interpersonal learning are central to effective group work (Yalom & Leszcz, 2020). In an open, online group with fluctuating membership, these processes were difficult to establish. Limited continuity weakened cohesion, while inconsistent participation reduced opportunities for meaningful interpersonal exchange. Greater awareness of these therapeutic factors may have helped guide my priorities and interventions as a group leader.
Beyond structural challenges, I struggled with practical aspects of facilitation: interrupting dominant members, managing conflict, encouraging interaction among participants, and navigating co-leadership. Some of these skills developed through experience, while others remained unclear without formal guidance.
Upon beginning my doctoral training at The George Washington University and enrolling in a Group Psychotherapy course, many of these uncertainties began to take shape within a theoretical framework. Reading about group therapy, watching videos of group therapy being facilitated, and listening to my professor, Dr. Marmarosh, speak about group dynamics helped answer so many of my previous questions, as well as opened my eyes to many facets of group therapy I had not even considered. Training emphasized that group therapy is not always comfortable or harmonious; moments of tension, disagreement, and emotional intensity are often integral to growth (Tasca et al., 2016). I began to understand that maintaining cohesion does not require avoiding discomfort, but rather supporting members in navigating it productively.
I also learned that my struggle to lead an online, ongoing group open to anyone was not unfounded. As discussed in Weinberg’s article, Online Group Psychotherapy, there are numerous challenges to online groups such as not being able to manage the setting patients are in, dealing with a disembodied environment, questioning patients’ presence, and the unpredictable backgrounds client’s display (Weinberg, 2020). These aspects add additional layers of challenge to group therapy. While I may not have been able to change the online format, having a deeper understanding of these challenges would have helped me greatly. Also, the investment and time in selecting group members is essential for establishing the potential for the clients’ individual growth in group as well as for the cohesion of the group at large (Whittingham & MacNair-Semands, 2023). Even if a group has an open format for reasons of accessibility and support, understanding the importance of curating a group may have prompted me not to take the open group format as lightly. If I were to have been more thoughtful about the fact that members may not share a lot of commonalities, perhaps I would have put additional effort into coming up with questions that might unify group members during the beginning of the group process.
This shift in perspective also changed my approach to leadership. I became more comfortable setting boundaries, interrupting when necessary, and prioritizing the overall health of the group over any single individual’s participation. I also recognized that empathy and challenge are not mutually exclusive; it is possible to validate members’ experiences while encouraging deeper reflection and interaction.
The role of co-leadership also became more salient over time. Research suggests that co-leaders serve as powerful models of interpersonal dynamics within the group (Chang-Caffaro & Caffaro, 2021). There was an instance with a new co-leader where he skipped over me in introductions and spoke over me on another occasion. While I didn’t want to display a rupture in front of the group members, I also felt the need to model standing up for myself. I did ultimately jump in to introduce myself, and I now understand why that was such a positive choice for the group at large. Groups are microcosms of the larger world – and by modeling myself (a minority woman) refusing to be ignored by an assertive man, I am modeling subverting some common norms and acting with courage and self-respect (Chang-Caffaro & Caffaro, 2021). Introducing co-leaders in a way that emphasizes mutual respect and shared leadership may help establish norms of psychological safety and cohesion from the outset.
Additionally, exposure to literature on online group psychotherapy clarified many of the difficulties I had encountered. Online formats introduce unique challenges, including limited control over participants’ environments, reduced nonverbal communication, and questions of presence and engagement (Weinberg, 2020). Understanding these constraints helped contextualize my earlier frustrations and highlighted the importance of adapting facilitation strategies to the medium.
Reflecting on this experience, it is clear that formal training in group psychotherapy is essential. Effective group leadership requires not only interpersonal sensitivity, but also an understanding of group dynamics, therapeutic factors, and evidence-based practices (Burlingame et al., 2011). At the same time, this experience demonstrated that there is also value in accessible, peer-oriented support spaces. The ability to listen, validate, and connect remains a powerful component of helping, even in the absence of formal intervention.
Rather than viewing these perspectives as contradictory, it may be most useful to hold both simultaneously. Structured training can enhance the effectiveness and safety of group interventions, while the authenticity and accessibility of support-based interactions can foster meaningful connection. Early experiences, even when imperfect, can serve as an important foundation for developing confidence and clinical judgment in group leadership.
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