I have facilitated many different types of pre-and perinatal groups. Each is different and is effective for different reasons. Because I have long believed in and experienced the healing power of groups, especially when working with early material, I am regularly looking for safe and therapeutic ways to bring meaningful groups together in which my clients may do the work they are ready to do. Here are a few examples.

I have facilitated larger groups with 10 to 30 participants, either over a weekend or longer, where the clients act as facilitators for each other and one or more therapists mill about and assist. For this model to be effective, participants need to have a high level of skills. Although some powerful work can and does occur, it sometimes moves too fast to be integrated by the client. There is a risk of disconnected and unresourced catharsis (mentioned later in this paper) in which the client experiences hyperarousal and dissociation.

At a residential treatment facility for teens, I conducted multi-family groups where several therapists work with a family in having a turn. Members of other families support. This can be quite effective and life-changing work. Every family has a turn, but not every family member. Usually the turn is focused on one family member. For example, we once worked in a family group with 16 year old Shauna who had been brought to the Center for self-mutilation and depression. Shauna wanted very much to change but felt helpless and stuck. During her family session, she spontaneously moved into an experience of her Cesarean section birth. Another mom came to support her mother and another dad stepped up to stand beside her father and help him express his fear. Shauna was able to express her anger at being taken away from her mother as another teen in the room, an adoptee, held and encouraged her. She was able to re-experience and repattern her birth and the self-mutilating behaviors stopped. Shauna is now attending college.

In my practice I sometimes work with an adult family for extended sessions. Usually one or more parents is working with one or more adult children. Each session usually focuses on one family member in a similar way as a process intensive workshop.

I have conducted a number of on-going weekly groups. These are usually groups of six to eight adolescents or adults who meet for two to three hours weekly. After rounds, the group decides whose turn it is. Each week, one member has an individual session with group support. The advantage is that the group can grow and deepen over time. One disadvantage is that it is easy to spend most of the time checking in and "avoiding" someone having a "real" turn.

The ideal group, in my mind, is what we called a "Village" where a small group commits to meet for one weekend a month for a period of time, usually a year, where each member has a turn each time. The obvious downside is that few people have the resources or the time to make that kind of commitment.

The most practical and effective group in my experience is the weekend process intensive. This is the structure with which l work in group psychotherapy classes at Santa Barbara Graduate Institute and in my private practice assisted by doctoral students.