The End of Time
by Marc G. Schramm, Psy.D., C.G.P.
I recently heard from a group psychotherapist who has begun having time management problems in his group. It seems that for most of the last couple of months, group sessions have run over the allotted time, sometimes by as much as twenty minutes. While group members have been bringing up important concerns, it would be an exaggeration to say that there have been any crises that would account for the stretching of group boundaries. What, he asks, do I suggest.
It is not unusual for less experienced therapists to have difficulties with the management of time-boundaries (in individual as well as group therapy), since limit-setting is often an acquired skill. In the case in question, however, the psychotherapist has not normally experienced such problems, and this group has itself only recently begun to run late. This suggests that the problem reflects both specific group issues on the one hand, and countertransference response (in not maintaining the boundary anyway) on the other.
I use the term countertransference here in a "totalist" sense, and as a means of aiding the therapist in his or her "use of self." My first suggestion, then, is for this therapist to explore his own countertransference feelings.
What feelings did the therapist have in reaction to the content as the scheduled ending time first came and went? Was the therapist aware of running over, or did he lose track of time in the face of the group content and process? Have his feelings changed since the first few weeks of late-running sessions? What feelings does he have each new week when the group runs overtime yet again?
Answering these questions might provide a starting place for what is going on in group. If the therapist can identify where similar feelings have been evoked in other situations (whether or not related to therapy), this might be a clue to contents and processes not already apparent.
Part of this exploration can occur with the group. It may be quite useful to take the process of weakened time-boundaries and make this the content of the group's work. Is the group in fact rebelling against the very idea of time-limits? Of limits in general? Something may have occurred that has left the group discontent with having a professional rather than a purely personal relationship with the leader.
Is the group preoccupied with themes of loss? Is there a sense of anxious vulnerability? Perhaps the group knows of the therapist's upcoming vacation, or has become aware that he has health problems. In what ways could the process of running late provide a parallel to other issues the group has recently been dealing with? Parallel processes are an oft-noted phenomenon, particularly in in-patient groups.
Of course the leader's issues could be evoking a reaction from group rather than the other way around. Perhaps the leader has suffered a narcissistic injury not long ago, and the group has intuitively picked up on his greater need to feel needed at this time. Or maybe the therapist is giving off vibes that lately he is in no hurry to end group.
He may now have a difficult patient or an annoying meeting scheduled shortly after the end of group. If group is his last appointment, the members may sense that he is in no hurry to return home lately. The group might intuitively sense these sorts of things even if the therapist is not aware of them. Thus it could be valuable to have feedback from the group about their perceptions of the therapist (so long as the therapist keeps his focus on repairing the group boundaries rather than on doing his own therapy.)
My own approach to managing the time-frame developed as one reaction to a group that was prone to long silences. I noted to them that, as an individual hour was really fifty minutes, so an hour-and-a-half group session really need not run more than seventy-five minutes. While I would be happy to provide the entire ninety minutes for the group's use, if they indicated a lack of issues to talk about (as demonstrated by a silence longer than five minutes), then I might bring group to a close any time within those last fifteen minutes.
Not long thereafter, I did indeed end a group session with about ten minutes to go, but since that time I have finished group as much as five minutes early on only two occasions--which in fact is fewer than the number of times I've run up to five minutes late. If I begin finding that my group sessions are routinely ending more than five minute early or late, I will have to start asking myself why. I would enjoy continuing further on this fascinating subject, but I'm afraid we've run out of time...
Marc G. Schramm, Psy.D., is a Founding Certificant of the National Registry of Certified Group Psychotherapists, a clinical member of the American Group Psychotherapy Association, and President of the Tri-State Group Psychotherapy Society. He is currently Cincinnati-Dayton Regional Director for Counseling Consultants, Inc. Call Dr. Schramm at 513-984-9222
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