Jennifer Alonso: Fostering connection and healing through group therapy

By on June 1, 2016

alonsoAs an undergraduate at Brigham Young University, Jennifer Alonso had no intention of majoring in psychology until, while doing research for her first psychology class in the library, she found herself lost and absorbed in the stacks.

“I was going through the psychology section and thought, ‘I want to read every book in here,’” she said.  “I just felt so passionate about it and immediately knew this was the area I wanted to dedicate my professional life to.”

Chalk it up to genetics. Alonso’s grandmother and aunt were also counselors, so in a way, it’s not surprising she followed the same path—whether she had intended to or not.

She went on to pursue her graduate studies in clinical psychology at BYU, initially intending to work with children and adolescents.  But after her first work experience at a college counseling center, she realized she had found the population with whom she wanted to work.

While completing an internship at the University of Houston, Alonso was also finishing work on her dissertation, which focused on the healing effects of cohesion found in group therapy.  And in 2011, after completing her doctorate, she joined the staff of the University of Florida’s Counseling and Wellness Center.  Within months, she was named coordinator of the center’s group therapy program, which has grown under her leadership to become one of the leading college group therapy programs in the country.

We sat down to learn more about Dr. Alonso and the Group Therapy program at UF.  Here’s what she had to say…

What drew you to practice in a university setting?

College students are at this incredible transitional stage in their lives where they are open to learning about themselves, exploring their identities, coming into their own and starting to really bloom. I have seen how intervening at this time in their lives can provide these life-changing trajectories in a more significant way compared to other age groups I have worked with. I feel like overall, college students have ambition and desire to be successful in so many areas of their lives — professionally, interpersonally, and emotionally — so it feels really exciting to be working with this population.

We read that you are one of only handful of “Certified Group Psychotherapists” in north central Florida.  Can you explain the significance of that certification?

The research is clear that individual and group therapy have equivalent outcomes for client success. However, many mental health graduate programs either do not offer a specific group therapy course, or it is optional. This is concerning because professionals may be leading therapy groups without the proper training given the types of interventions and therapeutic properties found in each treatment modality differ.

If a clinician is providing individual therapy in the group setting, then the whole point of the group is lost because you’re not actually harnessing the therapeutic factors that make group so powerful. What makes group [therapy] so powerful is the interactions and the dynamics that happen between the members within the group. Earning my CGP was an important way to acknowledge that group therapy is a specialty and to provide more legitimacy and support for training in this area. This certification also helps distinguish the advanced training and expertise I have garnered in this area.

The reason the CWC offers so many therapy groups is because it is the absolute best treatment option for some students’ particular areas of concern. Group therapy is not just an alternative treatment option we offer because we have filled all of our individual therapy appointments. In addition, groups allow the CWC to accommodate and see more students. Each academic year, the CWC is able to provide over 3,000 more client hours because of group therapy, compared to if those counselors were instead using that same time to only provide individual therapy.

What are some of the factors that make group therapy powerful?

One of the things that students describe as being most helpful is realizing they’re not alone in their problems. There’s a sense of universality in that “others can really relate to this issue I’m having,” and that sense of isolation or shame really goes down because they recognize, “ah, this is really normal and understandable to feel this way.”  And that alone is really healing and relieving.

Another factor is cohesion—the sense of belonging, acceptance and connection among the members, feeling like there is a place where they fit in and are valued for who they are. Yet another factor is increased self-understanding. Members have the opportunity to receive feedback from their peers about how they come across or the things that help others to connect or disconnect from them. They also learn ways to understand their lives more from hearing others’ experiences.

Group is all about experimenting.  It’s this social laboratory where the patterns that we have outside in our lives replay themselves within the group.  So if I’m someone who has difficulty trusting others, in group, that same pattern is going to happen.  If I find that I’m feeling timid about opening up to others, or asking for support or advice, in group, I have a safe place to practice experimenting with behaviors that would promote more trust in others and ultimately lead to an emotionally corrective experience.

How do the groups work at UF?

The average group is going to have between seven to nine members, and they all commit to attending group for the entire semester.  That’s really important because it takes time to build that trust and connection with each other—and that sense of safety—so that over time members can experiment with sharing things that feel more personal and vulnerable.  And they have this built-in support system of people who know and support them, and can also see their growth over time. “This is what I observed about you at the beginning of the semester, and look how things have changed now.”

Even though we have one the largest—if not the largest—group therapy programs in the entire nation for college counseling centers, we still have the need for more groups.  Each semester we run over 30 different groups—and the majority get full and we close them to new members.  But if a member drops throughout the semester, we’ll definitely fill that spot with a student who is waiting to accommodate as many students as we can.

How do you determine the types of groups that are offered?

We offer groups based on student demand and clinical concerns. Some of them are targeted for specific populations.  So we have groups for graduate and international students, students who identify as LGBTQ or of a particular gender, racial or ethnic background. We offer groups specific to presenting problems, such as addiction, eating disorders, sexual assault survivors, bereavement or medical challenges.

We also have skill-building groups to teach coping skills such as mindfulness meditation and academic confidence as well as dialectical behavioral therapy. However, our most popular group is Understanding Self and Others. It’s a general process group where members each come in with various presenting concerns; however, each has the common goal of wanting to improve relationships and explore their interpersonal patterns.  So we always have at least eight sections of that group every fall and spring semester because it’s so helpful for students.

How has the Group Therapy program changed since you came to UF?

When I came on in 2011, there were a lot of groups running, but most of the groups had few members, and in-house referrals to the groups were low. This was concerning because the research shows us that you need a minimum number of members in attendance each week for the therapeutic properties and group dynamics to be maximized, and we were not always reaching that mark. We were offering something helpful, but not yet really harnessing what we could to give students an even better therapeutic experience.

The first task I worked on when I became group coordinator a couple of months after I started here was creating a culture in which we all were able to identify that group is an equally effective mode of treatment. This dramatically helped because we had increased therapeutic allegiance to group, which ultimately increased referrals and the number of groups we offered.

A few years after I took over as group coordinator, we identified that our group program had grown over 30 percent terms of the number of clients we were seeing and service-hours we were providing, in addition to an increased number of counselors offering groups and trainees receiving training and supervision in group.

I felt really honored to be nominated by my colleagues and received the Student Affair’s Superior Accomplishment Award in 2014 for my work with the group program. It has been so exciting to see how as a culture, the CWC has really increased in the passion and excitement we have for group. I find I no longer need to be the primary voice and advocate for groups, as many of my colleagues now have adopted that similar love and passion for group and will speak up on their own about it now.

How is UF’s Group Therapy program distinct from those found at other colleges or universities?

Research shows that the more preparation someone has for group, the better outcomes they have. What we had found is that counselors were using their pre-group sessions with students to go over things like FAQs and guidelines—and we found that was taking a lot of time away from more clinically focused topics.

So we created an online orientation, the first of its kind that I am aware of, where students get all that FAQ information in advance, so that when they actually meet face-to-face with a counselor, they can use that time to really hone in on what are the specific behaviors that they can work on and experiment with in a group.  Or what topics and themes should they be focusing on that are going to give them the most “bang for my buck” for that experience.

This year we also partnered with the RecSports TRiP program to offer weekend wilderness retreats for students. The four trips we offered so far each sold out, and were focused on teaching students different mindfulness and meditation skills to assist them in living in a more balanced and relaxed way. And this upcoming academic year, we’ll be offering three or four trips per semester. Some will be focused on meditation, but we will also be adding new themes, related to diversity or self growth. Jackie Matthews, the Director of the TriP program, and RecSports has been amazing to work with in creating these together.

Another thing that’s unique about our group program is just the sheer number and variety of groups that we offer.  Most counseling centers are going to have just a handful of groups running each semester.  But just the fact that we have almost every topic you can think of represented is just a huge draw for our students.  I’ve never worked anywhere that had this many—or this variety—of groups.

Are there any trends you’ve observed among college students that may be new or changing?

Overall, the severity of mental health issues students present with, over time, increases—and that’s just nationally what the data are showing.  So we do offer a couple of groups that are really tailored for students who have more of those chronic mental health concerns.

Sara Nash and Jim Probert, two of our counselors, coordinate our Peer Support program. The Intentional Peer Support group is for students who may have been hospitalized or have a persistent mental illness, such as bipolar, schizophrenia, or severe depression. They also offer the Wellness Recovery Action Plan group, and that one is very skills-based.  It teaches what different coping skills and helps students create a plan to mitigate problems or stumbling blocks that are coming up again and again. Both of those groups are very unique and serve a small subset of population that might not otherwise be able to get services since we tend to focus on doing more short-term treatment here.

How do students find out about the groups that are offered?

Every semester we have more students coming in and asking for group therapy, or returning to attend group for a second or third semester.  Students are often finding out about groups from their friends, our website, or from their counselor or psychiatrist. Also, a student can come in for a triage appointment where they will meet with a counselor and share the concerns that they’re having, and then receive some treatment options.  From there, a counselor helps them to decide what the best treatment recommendation will be, and a group referral will be made when applicable.

I think one of the things that’s unique here is that the counselors are super-committed to group and they’ll only refer someone to group if they know that is going to be a really helpful treatment option for them.  And since almost all of our trainees and counselors provide at least one group throughout the year, we are able to draw on such a wealth of knowledge and skill sets that people have, which enables us to provide so many different kinds of groups. We also offer a variety of skill building workshops every semester that are very focused on student’s primary concerns, particularly related to stress and anxiety, mood concerns, and interpersonal problems. I’m really proud of the group and workshop services we offer.