INFORMATION AND GUIDELINE FOR PARTICIPATION IN AN ON-LINE
INTERPERSONAL GROUP FOR MDs
This is a closed 10-month group with weekly sessions On-Line HIPAA compliant
(private and secure) Zoom group covered by OHIP. The participants will be MDs
working in Ontario. The participants have the option of continuing with subsequent
yearly modules. The group module ends at the end of June when some members
may be terminating, and new members will be joining the following September if
space is available. The Maximum size of the group will be 12.
ON-LINE groups are effective but follow a different dynamic than face to face inperson groups. (This will be further discussed in our pre-group assessment
sessions)
You would need to be referred to this virtual group by your GP. Prior to entering the
group, you will be meeting with me Online via Zoom for one or more sessions so to
get acquainted and for us to learn and articulate your goals and assess if this group
is suitable for your purposes.
FIRST SESSION:
Hopefully by the first session, or shortly after, you will have had a chance to read
through the following pages. The first session will be like subsequent sessions, as
described below, however I expect some of the discussion will focus specifically on
the guidelines presented here.
SOME GOALS OF AN INTERPERSONAL GROUP FOR MDs:
• Receive and offer support
• Gain insight/understanding of one’s own thoughts, feelings, actions and
behaviours by looking at patterns in relationship in early life and present life,
inside and outside the group.
• Gain understanding of other peoples’ thoughts, feelings, actions and
behaviours
• Improve self-confidence, self-image and self-esteem
• Improve interpersonal relationships through learning how to better
communicate with people
• Explore and understand interpersonal dynamics (affects, changes in
behaviour/interaction, changes in mood) that occur in groups/ in the
therapy group.
• Achieve personal and interpersonal learning which must be carried over into
outside (of group) life
• Experiment with new behaviours
• Talk honestly and directly about feelings
CONFIDENTIALITY:
All participants in the group expect and can be assured that all they talk about will
be treated with the utmost respect and confidentiality. It is an essential of ethical
professional conduct. The more public nature of group therapy does make it a less
private form of therapy however and these guidelines are important to keep in
mind.
a) By Therapist
After each group I will be recording confidential notes on each group
member and group as a whole. Each person can have access to his or her
personal notes though not to the group summary notes.
If you are in concurrent individual therapy or receiving care from a health
care provider for mental health issues, I request your permission to
communicate with your other therapist on as needed basis. This ensures
good integration of your care. If this is the case, please sign and forward the
document to me and your other health care provider.
b) By Group Members:
Confidentiality is expected of group members as well as it is of group
therapist, regarding who is in the group, and each group participants ‘story’. “
It is a very small world especially in the “MD community”. This degree of
confidentiality is absolutely necessary for group participants to feel safe and
for the development of trust within the group.
You may know another group participant from your personal or professional
activities. I hope that you do not discuss group issues outside of the group.
In case you notice a shift in your thought / feelings/ or conduct or
relationship towards your friend/colleague (who is in the group) outside of
the group, please bring those issues for exploration in to the group as it
provides a great opportunity for learning for you and others in the group.
Please feel free to discuss with your own therapist freely about the group, as
that relationship is bound by the same professional confidentiality codes.
Though, if you find yourself in discussion with friends or family, wanting to
refer to the group outside of the group, please do not attach names to what
you are saying and avoid saying anything that might identify a person
specifically. Talk about your own story and not other members’ stories.
c) Video Conferencing Platform, Zoom
Virtual “face-to-face” sessions or VC (Videoconferencing) are real-time interactive audio
and visual technologies that enable a clinician to provide mental health services remotely.
Treatment delivery via VC may be a preferred method due to convenience, distance, or
other special circumstances. The VC system used in my practice is a professional version
of Zoom which meets HIPAA standards of encryption and privacy protection. You will
not have to purchase a plan when you “join” an online meeting. When you reach the
“Join a Meeting – enter meeting id” screen, please edit your name so that only your first
name shows in order to protect your privacy in group sessions.
Here is a link that is helpful if you are not familiar with Zoom. I recommend that you
experiment with it ahead of your sessions; it will show you how to join a meeting, and
how to check your audio and video.
https://support.zoom.us/hc/en-us/articles/201362193-How-Do-I-Join-A-Meeting
Please read and note that:
• There are many benefits and some risks of videoconferencing that differ from inperson sessions.
• Confidentiality agreements that are always integral to your care, are the same for
telepsychology services.
• Recording of sessions is NOT permitted.
• A webcam needs to be used during the session.
• It is important to be in a quiet, private space that is free of distractions (including
cell phone or other devices) during the session.
• It is imperative that no family member or friend is in hearing or visual proximity to
you or to your electronic device during the session.
• It is important to have a secure internet connection rather than public/free Wi-Fi.
• In order to be punctual please set up for the appointment at least 5 minutes before
it is due to begin. You will be admitted to a virtual waiting room.
• A back up plan in the event of technical problems may include restarting the
session, or more likely supplementing with a phone for audio.
• Our safety plan includes at least one emergency contact and your location during
the call.
WHAT DO I DO? HOW AM I EXPECTED TO BEHAVE?
Generally, there will not be a specific agenda for each session. Participants are
encouraged to talk about any personal or relationship issues relevant to the
problems and goals that bring them to group; this may also include interaction with
your own patients. Other participants will talk about their own
issues/problems/goals.
Participants are encouraged to offer support, to ask questions, to wonder about
things said/not said, to share associations/thoughts and to relate to one another
back and forth and with the group. A lot of emphasis will be placed on the here-and
now of interactions, and the thoughts, fears and wishes that are associated with
them.
(However please keep in mind that there will be a back and forth flow between
sharing of personal experiences outside of the group and focus on the current
interaction and one’s experience of what is happening in the group in the here and
now. Both themes are essential as they continuously inform each other)
The more we are able to work in the here and now of the group, the more likely we
are to be effective. This kind of direct feedback and engagement is often anxiety
generating at first but can be deeply supportive and meaningful as well. In order to
keep the group environment a therapeutic place, I ask that members always try to
say things to the other members in a way that will allow for connection.
Direct advice giving or getting amongst group members or from the therapist is not
a large part of how the group helps. Neither are general issues such as sports or
politics expected to be discussed at length in the group unless there is something
about a current event, which has relevance to one’s personal or interpersonal issues.
Extra group socializing is generally discouraged. Though the reality is that most of
you may know at least another person in the group in your professional life. Please
keep in mind that the primary goal of this group is to learn from the interpersonal
interaction in the group rather than to nurture a new and supportive relationship
with a new colleague. The goal being that exploring and working towards
understanding interpersonal relating in the group with the view; that this
experience/understanding will, over time, be helpful in relationships outside of the
group.
Participants often have feelings about seeing group members/therapist outside of
the group. It is important therefore that these interactions, as well as the feelings
associated with them, to be talked about in the group session following their
occurrences. Also, at times members may develop romantic/sexual feelings
towards another group members/therapist. We acknowledge that this happens and
hope that such feelings can be discussed in the group just as other difficult feelings,
such as anger; hopelessness or disappointment should be able to be discussed.
GROUP THERAPIST:
I am not going to ‘run the show’. My role is more that of a facilitator rather than that
of an instructor. I will from time to time make observations about group interaction
and behaviours (including my own) or what particular individuals say or not say do
or not do in the group. My intention for doing so is to help facilitate the group
process and understanding and personal learning of members.
I hope as much as possible that if you have something to ask or say to me that you
do so in the group sessions. However, if you absolutely feel you need to meet with
me outside of the group, between sessions, on the phone or personally this can be
arranged. But I expect that what be discussed between us to be brought up in the
following group session. I hope that there really are no issues that are tagged in
your mind as being only for discussion in your individual sessions. Generally
speaking, there should be nothing that can’t be talked about within the group. At the
same time, I recognize that trust develops only over time and that some personal
statements will not be easy to make.
ANTICIPATED LENGTH OF THERAPY AND INITIAL LENGTH OF TRIAL
PERIOD/COMMITMENT:
This is a closed group format that runs from beginning of September to end of June
so that planned departures and entrances by group members are least disruptive
and most productive for the members.
The participants have the option of continuing with subsequent 10-month long
modules of the groups if I am offering this group. The Max size of the group will be 12.
Group therapy sometimes does not show immediate positive benefits to its
participants. Because of this fact, participants sometimes find themselves wanting to
leave therapy as it becomes stressful for them. However, I ask that you suspend your
early judgements of the group’s possible benefits and continue to attend and to talk
about the stresses involved and your doubts about group therapy for at least three
months when you first join the group.
COST:
The cost of the group therapy is covered by OHIP. As of April 2022, OHIP pays the
cost of $66.00 for every group session that you attend.
You are responsible for payments for missed sessions regardless of the reason i.e.:
vacation/sickness/work related issues/emergencies. A missed session fee of $62.6 will
be applied on a sliding scale so the fee is not financially burdensome.
I will email you a bill for any missed sessions at the end of each month.
If you decide to leave the group at any time, you will not be responsible to pay for the
remaining sessions of the 10-month module.
Participants are asked to make responsible use of their opportunity to be involved
in this type of therapy. The availability of this group is quite limited, so I ask that the
participants be responsible about their involvement and attendance while in this
group.
ATTENDANCE/LATENESS/GROUP PARTICIPANTS VACATIONS/THERAPISTS
VACATIONS:
Arrival on time to each session as well as regular attendance is expected. Please try
to attend five minutes before the On-Line session to make sure the technology is
functioning well.
If you know that you are going to be late or absent, I ask that you
Text me at:
416 627 4590
Or email me at:
kasra.khorasani@utoronto.ca
As far ahead of time as you are able, with the reason for your lateness or absence, so
that I can let the group know at the beginning of the session.
To continue with this group you would need to make at least %75 of the group
sessions. Ideally members aim to make it to all the sessions if possible.
If you know a week or more ahead of time of a lateness or absence, you should let
the group know about this at a session before such a lateness or absence. I ask that
you let the group know your vacation plans well ahead of time, if at all possible. I
will do the same. The group works most effectively if it is cohesive, reliable and
predictable. Regular attendance is a key part of that, and I therefore request that you
make it a priority in your schedule.
SUMMARY:
You have decided, by agreeing to participate in an interpersonal group, to begin a
process of giving and receiving support and working towards needed changes in
your personal and interpersonal life. Sometimes group will be difficult for you.
There will be days when the last place you want to be is in your group. These are
probably the days when the group can be most helpful to you. I encourage you to
come in particular at those points, in order that we can continue to work together
towards individual and group goals. I look forward to the opportunity of working
together with you in this group.
PS:
Document updated August 2023
This document is a modified version of:
Mount Sinai Hospital, Group Therapy Program, Department of Psychiatry
“INFORMATION AND GUIDELINE FOR PARTICIPATION IN GROUP PSYCHOTHERAPY “