Degree In Sight

After suffering a physical assault on the George Washington University campus, first-year doctoral student Robin Belamaric reached out for psychotherapy. Her aim was to prevent post-traumatic stress disorder, but she worried that using the university's counseling services might make it hard to keep her troubles confidential.

The counseling staff, however, clearly informed her of her confidentiality rights, which made for a safe environment in which to work through her concerns and ultimately better understand the therapeutic process.

"Knowing that what I revealed in the course of therapy wasn't going to be revealed to the people responsible for my educational experience allowed me the huge benefits of the therapeutic experience," says Belamaric, now a predoctoral intern in clinical psychology.

Similarly, University of Oregon clinical psychology student May Lim felt comforted when she learned that she wouldn't have to disclose anything she didn't want to in the experiential part of a group therapy course and that discussion would focus mainly on common issues of academic stress and anxiety.

Certainly, psychology students can reap enormous benefits from experiencing individual psychotherapy or the dynamics of group therapy; not only do such experiences help them handle personal problems, but they advance students' learning about the therapeutic process, faculty say. However, initial fears about revealing personal information to faculty members and fellow students are not uncommon, says Carol Williams-Nickelson, PsyD, APAGS associate executive director. Such concerns are understandable given that revealing information about a learning disability, family of origin or sexual orientation, for example, could have unintentional consequences, Williams-Nickelson says.

The nature of the experience can be tricky as well. Even students who've made careful personal decisions about what not to reveal in an experiential group therapy class may find that the in-the-moment experience lowers inhibitions and prompts a disclosure that they wouldn't otherwise make, Williams-Nickelson says.

But students can ease those worries and gain the maximum benefits from therapy if they arm themselves with information, as Belamaric and Lim did. What do students need to know? Lim and others with experience advise familiarity with:

  • Confidentiality measures in APA's Ethics Code regarding the protection of graduate students.

  • Requirements of your graduate program for either individual psychotherapy or an experiential group therapy class.

  • Steps you can take to increase your comfort with participation in either group or individual psychotherapy.

UNDERSTAND THE APA ETHICS CODE

APA's Ethics Code addresses student concerns about protecting themselves with an emphasis on privacy, says attorney and psychologist Stephen Behnke, JD, PhD, APA's ethics director. The new version of the code, which went into effect June 1, emphasizes the idea that students be informed about a graduate program's content. As part of that, graduate programs must indicate if therapy is a required part of training, Behnke explains.

The code also says students cannot be required to disclose personal information-including sexual history, history of abuse or neglect, psychological treatment and relationships with family-to supervisors in program-related activities. There are two exceptions though, Behnke says. Required disclosures of personal information are permissible if the program has made this requirement clear in admission and program materials or if information is needed to evaluate whether students' personal problems are interfering with either their training or professional ability.

"Programs may have very legitimate reasons for asking students to disclose," Behnke says. "But that can all be known up front. When you're looking at programs, ask lots of questions and make sure you're an informed consumer."

Finally, the code prohibits a certain kind of dual relationship by stipulating that programs that require psychotherapy allow students to seek treatment from a therapist outside the program.

Even programs that encourage but don't require individual psychotherapy need to avoid dual relationships, says University of Pittsburgh psychologist Nancy Elman, PhD, who has studied the use of personal psychotherapy in graduate programs with University of Oregon psychologist Linda Forrest, PhD.

Programs routinely offer students lists of therapists not affiliated with the school and willing to treat students at a reduced rate-important because cost can be a limiting factor for students, Forrest says. Some programs may also arrange for the school's counseling center to offer therapy with psychologists who are separate from a student's academic department.

KNOW GROUP THERAPY COURSE REQUIREMENTS

Just as it's important for students to know the individual therapy requirements of their program, it's also important for them to understand group therapy course requirements, says Shoshana Kerewsky, PsyD, who teaches group therapy at the University of Oregon.

She suggests these tips for any student nervous about taking a group therapy class:

  • Ask what kind of privacy you have: With that knowledge, consider what you are comfortable talking about and what you need to keep private.

  • Find out what topics will be discussed: If the teacher intends to discuss only common and innocuous topics like academic anxiety, there may be little reason to worry about revealing personal information.

  • Know the class's evaluation criteria: Many instructors require that students simply attend therapy sessions, while others require significant contributions to group discussions.

  • Keep academic goals at the forefront: Relate the dynamics of the group back to the class literature.

THERAPY AS A LEARNING EXPERIENCE

Such measures are worth taking, Kerewsky says, because experiential participation teaches students valuable lessons about therapeutic boundaries and handling their own emotions in professional settings.

Similarly, receiving individual psychotherapy helps students "gain a better understanding of countertransference reactions and dynamics of client relationships," says third-year Pacific University graduate student Dawnn McWatters. "It's also an opportunity for role-modeling with a seasoned professional."

On a basic level, therapy is also just a good way to navigate graduate school, Forrest says.

"Personal psychotherapy is a wonderful opportunity to address some of the stress that comes up in being a doctoral student," Forrest says. "So long as the program is respectful of that, provides appropriate boundaries and is thoughtful, it can only be a gain."