Peer Consultation

IMHPA members form an interdisciplinary community which promotes and supports sound clinical practice through participation in peer study and consultation. 

IMHPA Bylaws require that active members belong to a Peer Consultation Group or have other formal study, consultation or supervision. The expectation is that consultation/supervision or study meetings will be held at least once a month. IMHPA members may choose to meet with a single peer consultant or supervisor. 

Peer consultation

• creates and supports professional community.

• encourages ethical practice and provides networking opportunities.

• supports IMHPA members as they provide quality care to clients.

• supports counseling and therapy services through appropriate referrals and improved decision making capabilities.

• helps prevent therapist burnout by decreasing the isolation therapists often experience in private practice.

• allows mentoring opportunities in therapy skills and business practices.

• is a quality assurance strategy. When IMHPA present their practices to the public, and when we enter contracts for services, the fact that we practice with peer consultation is an assurance of our well-developed skills and our clinical depth.

• is a growing standard of practice across the country. In many cases, peer supervision is a required standard of behavior.

Four Excellent Reasons to Start, Join, and Maintain Consultation Groups

1. Less Risk and Lower Liability.

2. Save Time and Money.

3. Create long term supportive clinical relationships.

4. Professional Growth.

Members interested in joining an existing peer consultation group, or would who like to form a new one are encouraged to post a message on the IMHPA listserv or post messages on the Groups Forum at OregonTherapyForum (OTF).  

 PEER CONSULTATION REFERENCE

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1. The purpose of the group should be defined by the group; each initial or new member should share his/her motives for participation. Unrealistic as well as realistic expectations for group participation and process deserve exploration.

2. Frequency, place, and duration of sessions are worth careful consideration, the format of peer supervision groups frequently receives less thought than therapy groups which is a mistake. GROUP MEMBERS MUST TAKE THE PROCESS AND THE GROUP SERIOUSLY.

3. The process of adding new members to the group should be examined in terms of possible mechanisms of denial and avoidance of uncomfortable agendas, which have come to exist in the group.

4. Those who intend to drop out of a peer supervision group should be required to observe the courtesy of reporting their intent to do so in a meeting of the group, and with enough notice that the feelings of each group member about that intended change can be explored.

5. A contract for sharing needs to be established by the group such that feelings and reactions concerning one another are always admissible to the larger group process. Each group member should make a personal commitment to the group not to be party to conversations about other group members that are not (ultimately) shared with the whole group.

6. The question of whether the group functions as "leaderless" with a rotation of leadership or with the occasional participation of a non-member leader needs to be explored. Various options for leadership might be considered from time to time in the life of the group.

7. Differences in experience, treatment philosophy and personal style may invigorate a peer supervision group and offer support for professional growth. Too much similarity may incur the problem of unwillingness to expose and share fears and feelings. On the other hand, too much difference among group members may lead to superficiality or factioning.

8. Personal attributes are of concern ... a prime attribute for membership in a peer supervision group is the capacity for equity, the ability, and willingness to give and receive sentiments and ideas in exchange with colleagues. Critical and candid exchanges among peers must be tempered with personal concern, warmth and support.

9. Sharing intimacy, particularly among leaderless peer supervision groups requires a high degree of psychological maturity. The setting and process of peer supervision groups, as with the setting and process of therapy, can function to enhance or to discourage the growth inherent in self-disclosure and emotional intimacy. "Emotional intimacy involves the striving to become real. The advent of intimacy is only possible between people who recognize and respond to the humanity of the other."

10. Existential concerns and issues of personal value and meaning need exploration within the peer supervision process, groups which restrict themselves to clinical issues have limited utility to their members.

11. The process of peer supervision groups can be expected to shift between content, client or peer issues, and process examination of individual responses to issues, and examination of group interactions.

12. The group's degree of formality and its system of case or issue presentation needs discussion, agreement and appropriate review. Precedence may be given to crises or concerns. Attention should be given to avoiding a norm that only perfectly formulated or executed therapeutic work is discussed.

13. As in a therapy group, it is wise that the members of a peer group attend to manifestations of group process; concerns that are not openly acknowledged can create too "intellectual" a group process.

14. The sense of trust that fosters intimate disclosure in a peer group may take six months, a year, or longer to develop. For trust to develop each group member must take responsibility and must risk personal disclosures.

15. The sharing process ... especially for clinical presentation, no discussion of a clinical case, no matter how thoroughly examined, should be ended until each of the participants has shared his/her personal feelings about the material presented. This kind of sharing can be an antidote to supervising one another with theoretical systems.

16. Openness and examination of personal motives are essential. If the need to keep one's personal reputation intact at all costs is paramount, very little meaningful learning will take place.

17. Peer group organizers should be aware of the occasional pointed criticisms they will receive when the group is discontent, by the very fact of their having "started this!"

18. There must be decisions made, prior to inevitable issues of conflict, about how conflicts will be resolved. If an outside consultant is necessary to resolve disagreement, that consultant and the consultation process must have careful consideration.

19. If sexual and gender agendas are not aired in the group, they may cause considerable conflict.

20. Legal ramifications of peer supervision may require some attention, but probably do not require anxiety. Goldberg asserts that he has never heard of members of peer supervision groups becoming involved in legal proceedings as a result of their peer supervisory experience. However, he cautions that there should be some early discussion of the relevant statutes governing each of the professions represented in the group that bear on issues attended to in the group.

 Carl Goldberg’s On Being a Psychotherapist, (Jason Aronson, Inc., Northvale, New Jersey; 1991) Guidelines for peer supervision adapted from the book cited.