Demystifying Therapy: What's a Reflecting Team?

In my last post, I plugged the low-fee therapy services of the Argosy University Clinic. I mentioned that this clinic utilizes reflecting teams and I promised to write more about why I think they are fantastic. Here I am fulfilling my promise!

What is a Reflecting Team?

A reflecting team is a group of about 4-7 therapists who observe your therapy session and then have a conversation about what they noticed about the session. Sometimes, reflecting teams are utilized on a one-time basis, as a way for a therapist and client to obtain consultation on a case. But when you go to therapy at a site like the Argosy University Clinic, you will be assigned a regular therapist (who is a graduate student in training) and a group of students (also therapists-in-training) who will serve as your ongoing reflecting team each week. Your reflecting team will consist of the same team members each week for the course of your treatment.

What You Can Expect to Happen

You will be introduced to all of the members of the reflecting team before your session. Then you will go into the therapy room with your therapist and you will have your therapy session. Meanwhile, the reflecting team will observe your session from behind a one-way mirror. After a time period (usually 30-40 minutes), you and your therapist will switch sides with the reflecting team. Then you and your therapist will watch through the one-way mirror as the team spends about 15 minutes having an extremely respectful conversation about what they heard and observed. Your therapist will probably provide you with a note pad so that you may take notes on what the team says or asks if you wish. Then you will switch sides again and you will have about 10 minutes to respond to any of the team comments that stood out for you. Rest assured that you will always get to have the last word!

Why Aren’t We All in the Room at Once?

It is natural to wonder why everyone isn’t just in the same room at once. But there are a couple of reasons for this, the first being that it can get a bit crowded in there. But the main reason is that there is something special that happens for both the team and the client when they watch the action unfold on the other side of the mirror. When you take your turn behind the one-way mirror, it allows you to fully slip into observer mode, not feeling pressured to respond in the moment, and actually allowing you to listen and reflect. It would be much harder to sit and really listen and reflect if you were all in the room together. You might get distracted by trying to read the team’s facial expressions and reactions. It might interrupt the flow if you felt you need to respond immediately to a comment. Sitting behind the mirror removes the impulse to be in a conversation and facilitates real listening.

Why Would I Want to Share my Problems With So Many People?

Of course, most people are a little bit nervous when they attend their first therapy session with a reflecting team. Many people get nervous just meeting with a solo therapist for the first time. This is completely normal. It’s hard to face your problems and share them with a complete stranger, let alone a group of strangers.

Many clients are especially fearful that the reflecting team is going to notice all of their faults and be critical. But this is where the magic of the reflecting team comes in. They do not notice faults or problems. They mostly just notice things that happened and get curious about things you said or didn’t say that they’d like to know more about. They have a conversation with one another about their questions, ideas, perceptions, and other things that stood out for them. But they aren’t positive just for the sake of being positive, and they pretty much avoid being critical or pathologizing. Their job is really to just generate a variety of perspectives.

Also, even though they are a group of therapists, and it is traditional for therapists to share much less about themselves when they provide therapy, reflecting teams have a bit more leeway. So it is not uncommon for team members to share and contextualize their comments and questions. For example, one team member may ask why another asked a specific question, and that team member may share that he had a similar dilemma once to the one you’re experiencing, and he may talk about what strategies or challenges he faced and how this experience prompted him to ask his question.

If therapy is a place where people are able to find small glimmers of hope, then I think therapy with a reflecting team is a place where there is the potential to generate bushels of hope. At the very least, it’s like having 4-7 extra brains all devoted to helping you examine your problems and generate ideas which can potentially help you find some solutions.

My Experience on Teams

I spent four years of my graduate training at three different training sites involved with reflecting teams, both as a team member, and as a therapist utilizing the team. I also supervised a reflecting team for Dr. Herget for a year at the Argosy University Clinic. My involvement with reflecting teams was–without a doubt–one of the most amazing things I’ve ever had the honor of experiencing. Clients universally loved the teams and often experienced profound shifts during their sessions. Some clients would hug each and every team member after the sessions. The warmth, respect, and care that filled the room was palpable. When I worked in settings where we used teams on an as-needed basis, rather than weekly, my clients would often ask eagerly when we would get to meet with the team again because they found it so enjoyable.

As a therapist, I’ve also found teams especially helpful. We therapists can get stuck sometimes. But even if we’re not stuck, we are fallible and we may fail to notice new or important things or get fixated on one possible idea that we think is the answer for our client when it may not really be helpful for our client at all. Reflecting teams help us to break out of our own thinking and get more creative in our work with clients, and that is never a bad thing.

This is not to set up unrealistic expectations. Therapy can also be hard and even with a reflecting team, you may feel stuck and there will be weeks that are full of pain, anger, sadness, or other difficult emotions. But there is still something to be said for having a group of people who you really feel are on your side each week, bringing some creativity to the things you are working on.

Where Can I Learn More?

I learned about reflecting teams during my training in Narrative Therapy. If you’d like to learn more about reflecting teams and Narrative Therapy, I think one of the best books is Jill Freedman and Gene Combs’ book Narrative Therapy: The Social Construction of Preferred Realities.