By Adam Silk
Inadequate care for people living in poverty is a serious problem in our health care system, including mental health care. The disparity between the care received by rich and poor is severe in child and adolescent mental health treatment, because the availability of trained clinicians is especially limited in impoverished communities. To address this problem, educators have turned in recent years to schools as places to address student mental health needs. The main reason for this is pragmatic: the students are already in the building, with adults who care about them.
One result of this trend has been new programs teaching social and emotional skills in schools. These programs are valuable in many ways, and address important needs. However, curricula typically focus more on individual student behavior, and overlook rich learning opportunities offered by the group setting. Social-emotional learning curricula also use a traditional approach to teacher preparation that is exclusively cognitive, and don’t train teachers in ways that engage their own feelings more directly. An experiential approach would give teachers a stronger sense of both the power of emotions and of group dynamics, and help them become more effective group leaders in the classroom.
I started volunteering at a middle school in Boston ten years ago, with three principles guiding my work. First, I hoped to design programs that used mainly on- site school staff to address student mental health needs. I wanted to avoid approaches that relied heavily on specialized clinicians, who might not be available in the long run. Second, I brought to this project a belief in group work. I knew that many mental health problems can be addressed effectively, and others prevented, if people belong to healthy groups. My belief in the power of groups grew out of my own clinical experience, but was not limited to my work as a group therapist. I had worked for years in the MIT Medical Department, and repeatedly saw that the difference between a student thriving or failing was due to whether they were part of a supportive laboratory or living group. Third, I brought to my work in schools faith in the value of clinical supervision and experiential learning, both of which enriched my own professional development. I am currently working in several programs in three different schools, with teachers, group work, and experiential learning at the heart of them all.
At a middle school for students whose family incomes are below the poverty line, we created a program of student discussion groups, led by teachers. Every student in the school is in a group that meets throughout the year. Students discuss whatever they choose in their groups: personal or family issues, academic problems, and relationships with peers all come up frequently. The teachers who lead these groups met with me for supervision for the first several years of the program; by now, two of them have enough experience to run the teacher supervision group, and I supervise them. We have replicated this program in an elementary school, where teachers lead therapeutically oriented play groups with younger children, and meet regularly for supervision with an experienced colleague, whom I supervise.
As these programs grew to include many teachers, I gradually came to understand that teachers receive no formal training in group dynamics and leadership. This surprised me, since teachers almost always work with students in group settings. I had naively assumed that effective group leadership is seen as a foundational skill needed by all teachers. But I learned this is not the case, and that many teachers feel unsure how to effectively handle common group problems, such as scapegoating.
I decided that if one could design a program to help teachers understand and lead a group well, the benefits to the school would extend into classrooms and beyond. We could efficiently address a broad range of mental health needs, by creating a school milieu in which students spend their day moving from one supportive, lively group to the next.
To design a program to train teachers to become skilled group leaders, I first reflected on how I had learned to lead groups. Participating in T-groups, attending AGPA and NSGP Institutes, clinical supervision, and exposure to Balint groups were all formative experiences for me. Since good training models abound, I decided to adapt them for teachers. Most of these approaches involve a small group experience led by a skilled leader, in which members can discuss topics freely, with extra time added for members to reflect on their experiences. The small group is typically embedded in a larger organization, such as NSGP.
To test such an approach for teachers, I found three Boston schools willing to try something new. I also received support from two foundations, and we launched it last fall. We named it RELATE: Realizing Educational Leadership and Teaching Excellence.
This year the program consists of four teacher groups I co-lead, in three different Boston schools. My co-leader in each group is a senior staff member who works full-time in that school, and is well-known to all the group members. Teachers are invited use the group to discuss their work, and are given complete freedom to focus on any aspect of their work they choose. Groups range from six to twelve members, and meet either weekly or every other week, at the group’s discretion. Both co-leaders work to shape each group into a cohesive and lively whole. I meet alone with my co-leader to debrief after every group. Next year, the group will continue with only the in-house leader, and I will provide support and supervision for them.
All the groups have now been meeting since September, and teachers have spoken to an education researcher hired to evaluate the project. They are enthusiastic about their groups. They stress above all that their groups feel supportive and cohesive. They describe meetings as “so important for the health of the teachers and the school,” and as a way to “share experiences, with common threads and common values.” Some say their group has improved how they relate to students, and how they think about their work as teachers.
Beyond the common thread of contributing to staff cohesion, the groups are quite different from each other. Some are only for beginning teachers, others are for people with years of experience. Group differences also reflect differences between participating schools. For instance, one of the schools has been under pressure from the School Department to enact major structural changes, so the teacher group has spent hours talking about how to respond to authority figures in ways that are assertive and constructive. Another school is designing systems to deal with student behavior problems, and the group there grapples with philosophical and practical questions about the role of special education, and how to balance the needs of a wide range of students.
We are in the process of planning for next year, hoping to expand the program within the participating schools, and perhaps to other schools. We have much to learn in the coming year. The transition to groups led only by a teacher, without a clinician, will create new challenges and opportunities. I believe this approach can, over time, improve the climate of schools, and help them become more collaborative and lively places to learn. I am excited to be building more fruitful collaborations between educators and therapists, which benefit students and the professionals in both fields. I believe there is enormous potential in this approach, and that we are just at the beginning. As an example of a new direction, this June we will offer a program for teachers at the NSGP conference. We hope it will extend our work as group therapists to a large and enthusiastic group of professionals.