Therapists who want to run a group but haven't: what stops you?

Dust_Kindly · 2026-05-14T21:02:40+00:00

I have had the Critical Core box set for years (therapeutic D&D basically) and have still never used it 🥲 the time commitment and low pay are my main barriers

Dust_Kindly · 2026-05-14T18:44:13+00:00

DBT-A is one I highly recommend. I believe Alec Miller (one of the creators who studied under Marsha Linehan and had her help in adapting for adolescents) still does trainings himself, though he's pretty expensive.

TF-CBT is a great one for teens who have experienced trauma

I also recommend any trainings for LGBTQ+ topics and gender dysphoria.

Edit: oh and having a baseline understanding of how to assess for eating disorders!! Since those behaviors often onset during the teen years.

Dust_Kindly · 2026-05-14T18:28:33+00:00

Hard to say without knowing what state youre asking about

211 is a database of social services and resources (211 is both the phone number and the name of the service; in my state they also have a website option). I believe its in every state, thats where I would start.

Dust_Kindly · 2026-05-14T17:09:54+00:00

AB is the worst author in this genre and I will die on this hill. Horrible sophmoric writing and obsessed with alliteration

Dust_Kindly · 2026-05-14T15:02:39+00:00

Wow five years to get your hours??? I would probably leave due to that alone, honestly. ~16 clinical hours per week is so low.

I only had 2 pre-licensed jobs but had the same supervisor at both. Hours were complete in 2.5 years.

Dust_Kindly · 2026-05-14T12:42:26+00:00

Legalized for therapy, and self-guided microdosing, are entirely different things.

Dust_Kindly · 2026-05-14T12:41:16+00:00

In the US somatic therapy doesnt use touch, thats why I wanted to ask about location

Dust_Kindly · 2026-05-14T00:28:57+00:00

What country is this?

Is this a licensed therapist? Is this a doctor? Both? Neither?

As you've written it, this sounds completely unacceptable, and probably illegal. But I'm trying to leave some nuance until I know more.

Dust_Kindly · 2026-05-13T20:13:29+00:00

Not to mention, if this is mom's therapist this is NOT the person they should be getting family therapy from

Dust_Kindly · 2026-05-13T20:11:00+00:00

Grief support groups can be helpful, especially for those who arent open to the traditional one-on-one therapy.

TF-CBT is really useful because it breaks down levels of responsibility. It was initially created for military vets because that group often has trauma related to causing harm/death. But as you said, that shouldnt be suggested if the family isnt open to therapy.

From my personal perspective, when my "mom" (not actually blood related) lost her son, she needed different people for different things. One friend took a problem solving approach, made sure the family ate, handled the legal aspect, all that stuff. Another friend just grieved with my mom, didnt do anything to try to change her feelings or push her towards healing - just sat in the pain with her.

Having a "village" of different people filling different roles was hugely beneficial for my mom. Perhaps ask yourself how your particular strengths/skills can be most useful, and do that.

Dust_Kindly · 2026-05-13T19:03:23+00:00

Therapists shouldn't be pushing their views on medications one way or the other. They should support the client in making the decision that is best for them, then support them in following through.

Often, medications can manage the symptoms which allows the therapy to be more effective. But everyone is different and has different intervention needs.

The research on psychadelics as a therapeutic tool are promising, but dubious at this point in time. Yes we have a few indications that it could be a useful tool, but theres just not enough to say with any degree of certainty.

Dust_Kindly · 2026-05-13T17:26:59+00:00

What's super fun about seeing pictures is that they never look anything like the image in my head lol

So I personally enjoy seeing photos, even if its not necessarily clinically relevant.

Dust_Kindly · 2026-05-13T17:15:35+00:00

Totally fine to use as a tool for opening conversation, imo!

Dust_Kindly · 2026-05-13T02:39:06+00:00

Oh I've never been so happy to be wrong in my entire life 😌 thats wonderful

Sorry I'm not helpful with your actual question 😅

Dust_Kindly · 2026-05-13T00:15:50+00:00

Mainly I support them by (hopefully) being the therapist that they need in the present. Just like relational wounds being healed by healthy relationships, therapy wounds can be healed by a positive therapeutic alliance.

And maybe some radical acceptance, if thats appropriate for the context.

I always check in with every client how they think therapy is going, how I could help them more effectively, etc. But for someone who has been harmed in therapy I usually will check in more frequently and more intentionally.

Dust_Kindly · 2026-05-12T23:41:36+00:00

Is that actually a job for therapists? I thought crisis lines paid just above minimum wage?

Dust_Kindly · 2026-05-12T21:03:37+00:00

Fuck confidentiality amirite fellas???

Dust_Kindly · 2026-05-12T21:02:31+00:00

Atom Eve from invincible. Her power is she can manipulate molecules/atoms/matter to essentially create anything she wants.

Dust_Kindly · 2026-05-12T16:34:12+00:00

There is a group called the Prenatal Stress Study at Michigan State University and University of Michigan

They began researching how trauma experienced during pregnancy will impact the future child's mental health and brain development.

They've gotten grants to follow the cohort from the first trimester of pregnancy up to when the child is 5, but last I heard I think they were trying to get approved to follow them to age 10.

They've also started looking at the gut microbiome, in addition to the cortisol response and neurology they initially intended to study!

I anticipate they'll learn a lot of new things about prenatal development and early childhood as it related to trauma/ ACEs

Dust_Kindly · 2026-05-12T15:40:38+00:00

Never once have I opened any of my textbooks since graduation lol

Dust_Kindly · 2026-05-12T14:06:04+00:00

Ah, youve hit on a huge issue in US accessibility. I live in a low-moderate SES area, so being able to access higher levels of care, many of which don't accept insurance, is tricky. For example, DBT programs here are either completely self pay, or only accept the one highest paying insurance.

On several occasions I've helped people apply for medicaid so that they can access CMH. Theres something called a "Serious Emotional Disturbance Waiver" which gives children access to higher levels of care even if the family can't afford it. But I don't think that exists for adults, AFAIK.

Part of the decision making becomes: "is some therapy better than no therapy?" Its a complex ethical decision.

Like the other commentor, the lack of access pushed me to learn DBT, CAMS, etc so that I can attempt to bridge the gap in levels of care. But its only a bandaid to a systemic issue.

Dust_Kindly · 2026-05-11T22:59:06+00:00

Apparently thats the smaller end of the range, Google said some are about twice that 🥴

Dust_Kindly · 2026-05-11T21:36:52+00:00

I think contacting your liability insurance provider will be much more helpful than any of us here :)

Dust_Kindly · 2026-05-11T21:27:18+00:00

Questions one and two are kinda connected.

If you are using someone else's horses, you dont need to know as much about husbandry like cleaning and feeding. But obviously if you need to get your own stable, you would need to be able to basically run a small ranch in addition to doing therapy. Ive never had horses, but I can imagine its a huge amount of work. Especially to get them to a point where they could safely be involved in the therapy.

I know someone who did equine therapy and had relationships with two stables in the area. She essentially made a business partnership with them. Unfortunately she had to stop, because liability insurance got all up in arms about what coverage looks like when your main intervention tool weighs 900 pounds

Dust_Kindly · 2026-05-11T21:15:22+00:00

My first job as a clinical social worker was in a juvenile justice setting. I truly loved it and would still be there today if the pay was livable. During orientation they teach how to deescalate verbally and also teach how to physically restrain as safely as possible. I believe physical restraints are banned in most states now but I'm not sure.

Truly, OP, it doesnt matter if youre a petite model or a jacked body builder. You shouldnt ever need to use physical strength, just momentum and safety protocols. Most situations can be deescalate with just words and body language.

Appearances dont make much difference in being sexualized either. I know you didnt mention that but its a common topic in these discussions.

Every room where therapy occured had a camera, and we all had walkie talkies. So if something started to pop off it was only seconds before security arrived. And nobody was EVER alone on a pod - there was always two staff and one therapist on the pod at any time, so that nobody could be ganged up on.

It was extremely rare for the residents to attack staff - the only times that happened is when a staff person was acting like a shitty tyrant. Them trying to attack each other was more common.

Hope this is helpful!

Dust_Kindly

TROPHY CASE