Westminster Pastoral Foundation Group Analytic Psychotherapy History and Training

8th July 2024 

Abstract  

This chapter is written by a small cohort of Group Psychotherapists who trained at the WPF  from its inception onwards through the different stages of its history. Group Psychotherapists  at WPF ran experiential groups for counselling trainees and patient groups; provided  supervision groups to training group analysts and ran open groups for young people and  adults, and enabled the training to be recognized by the UKCP. In addition, they had  considerable involvement in assessments for differing therapy modalities on offer at the time  at the WPF. The chapter uses illustrations from the clinical practice of four Westminster  Pastoral Foundation (WPF) to highlight how the training influenced their subsequent  careers. 

Context 

The history of the WPF is a long and complicated one. Changes over many years evolved  from a mixture of internal and external developments, driven by professional demands,  various differing management styles and cultural changes in the social environment. The  name of the organisation reflects a shift from the original religious influences of the 60’s  when it was known as the Westminster Pastoral Foundation to an emphasis on  psychodynamic psychotherapy when it became known as WPF Counselling and  Psychotherapy in the 90’s. Since 2010 this evolved into WPF Therapy to incorporate the  change of direction which now includes Time Limited Therapies and CBT. For the purposes  of this chapter we will offer a small overview of the development of Group Analytic  Psychotherapy.  

In 1969 the Westminster Pastoral Foundation (WPF), was founded by Rev. Dr William Kyle  to provide counselling, pastoral care and individual therapy training. It began at Westminster  Central Hall and moved from 1978 to the Maria Assumpta Campus at Kensington Square. In  

2008 when the lease was not renewed in Kensington, the service moved to London Bridge  where it remained until its closure in 2024.  

The early life of the WPF is described by David Black (1990) as one where the first decade  was one of pioneers, the second that of managers. One of those pioneers was Bill Kyle, a  Methodist Minister. He had a vision, in which he noted the changing pattern of emotional  and spiritual care in Britain in the 1960’s, following especially the development of the  Welfare State. He thought that if pastoral needs were to be met increased knowledge and  specialisation were called for. This applied particularly in the large cities, where he thought the range of emotional problems were beyond the resources of the normal ministry of the  churches. He thought the church could learn from sociology and psychology and also drew as  additional influences on the poverty of his own early life and later training in the USA.    

Initially, the WPF offered individual therapy. However, in the early 70’s an influential figure, John  Millar, joined the WPF and helped Christopher Fenton, who did the” first ever pastoral counselling at  the WPF”, with the establishment of the group work department. Millar was a Canadian pastor who  had worked with Martin Luther King in the 60’s and trained in psychotherapy and group work in the  USA. Fifty years later, we as authors and ex WPF trainees feel that the importance of class, culture,  race and intersectionality remain important when approaching groups and where we feel  psychotherapy should be in the wider world and its applications.  

Gregory Van Der Kleij, a Benedictine monk and member of the IGA, later took on the role of  assistant to Fenton. Van Der Kleij was a Catholic priest whose experiences of the Holocaust  shaped his thinking as a therapist and anti-nuclear campaigner. Fenton was a Church of  England priest, trained with the British Association of Psychotherapists and later at the IGA.  He was the first Head of WPF’s group work department in 1974, was later succeeded by Tom  Hamrogue and Brian Boswood, then from1983 just Tom Hamrogue. 

From the mid 1970’s a range of group activities was initiated including the experiential  groups for all counselling trainees as part of their training. In addition, due to a huge swell of  clients wanting therapy, Open Groups for adults were formed initially by Van Der Kleij and  then inherited by Dick Blackwell from the IGA. In 1987 a similar service for young people  followed. The aim of these open groups was to provide waiting list clients with an alternative  to being alone with their pain and anxiety (not knowing when they’d be relieved of this  isolation by the occurrence of a vacancy). It was a place to talk with others in a similar  predicament about how they felt. They were not designed to provide therapy, insight or  understanding, although this was sometimes a by- product from the support of a group  setting. Clients often decided after these experiences to switch from a wish to be seen  individually, to preferring therapy in a group context.  

Additionally in the early 1980’s a Group therapy training was established; initially as a  Certificate in Groupwork (Organisational and Community Settings), as the precursor to the  Diploma in Group Psychotherapy, later to become the Group Analytic Diploma. This  training was one of only three in the UK. Groups became increasingly central to the WPF  during this time, with twelve weekly psychotherapy groups for clients being run at any one  time. These were able to provide a much needed low cost effective therapy service.  

At the beginning of the 1990’s, the pastoral care element had largely been phased out and the  WPF service as a whole was fundamentally psychodynamic, systemic, group analytic and  psychoanalytic. However, by the mid 1990’s to early 2000’s, funding changed dramatically.  The funding from Local Authorities (LAs), who had provided grants related to the number of  clients seen from each Borough, began to dry up. LA’s stopped subsidising clients and other  funding became limited. It was thought that the WPF could only survive if cuts to  expenditure were carried out. At this time it was stated that there were now only a few therapy groups available and clients did not want them nor group therapists to conduct them.  Staff were made redundant within the whole organisation, and differing ideologies of  management and change impacted on how and whether services could continue.  

The WPF had always had a much larger individual training and focus and unfortunately  group psychotherapy was eventually pushed out as a discipline, perhaps an illustration of  how the valuing of one approach over another can lead to a reduction in variety and choice as  seen in the emerging prevailing climate within the NHS and Government over the coming  decades where short term focused therapies have been given value and precedence over  longer term more complex therapies, usually seen as the cheaper option.  

The group training between 1984 and 2012  

The training was by necessity concentrated on conducting therapy groups, due to the reality  of each cohort of trainees being very small and little opportunity to work in house with large  groups. Before joining, all were expected to have completed an introductory year on group  work, often at the IGA, but not exclusively.  

In general the format of the training consisted of theoretical seminars conducted by Tom  Hamrogue and visiting lecturers such as Dennis Brown, co facilitating experiential groups for  trainee counsellors for a year, observing an experiential group through a one way mirror  culminating with discussions between those observed and the observers, being in a  supervision group , and conducting a patient group for a minimum of 18 months, and being in  personal group analytic therapy for the duration of the training as a minimum. By 1989, the  course became accredited by the UKCP and by the end of the nineties, the perceived need for  academic acknowledgement morphed the training into a Post Graduate Diploma accredited  by the University of Roehampton.  

Our training combined academic rigour, to include papers written by trainees being peer  reviewed, alongside the experience of being encouraged to think critically for oneself and  with our peers. So what emerged was a sense of freedom to develop as a practitioner and to  value our own unique styles within the framework of what is considered to be group analytic  psychotherapy.  

Most, if not all, went on to develop group psychotherapy within the NHS, social care,  voluntary sector and in private practice.  

Although the Group Training had ended by 2012, the peer group section of our graduate  body, FPC(foundation for psychotherapy and counselling), continues to thrive. We meet  quarterly and enjoy the sense of belonging. It is a time when we share information,  knowledge, updates of each others work and give clinical presentations. The influence of its  training lives on, as illustrated in the careers of the four authors.  

Clinical Applications 

The history of WPF as documented above included people who knew Martin Luther King  and other activists. This developed a culture that was felt to have influenced and liberated us  (through our training) to be more creative with our applications of Group Analysis ( GA) in  our careers and lives. The origins of WPF group therapy introduced a different perspective  and a common theme and thread emerged from the authors, who reflect on this as follows:  

“The group analytic training opened many doors both internally and externally. The  relationship between people with emphasis on the dialectic became more significant and  wider ranging than the more medical individual psychoanalytic discourse with its limitations  of personal narrative as distinct from the main political, cultural norms of the times. Such  expansion of thinking initially proved a challenge to the individual mores of institutions  throughout the UK. The experience was one of considerable resistance away from the safe,  individual private spaces for treatment and supervision”.  

“My training in the 1980s gave me particular perspectives as a psychiatric social work  disillusioned with child protection and mental health. I worked in a therapeutic day centre  with an informal drop-in. This was an informal group in terms of the dynamics and issues  that arose that needed more than an individual perspective to manage the potential emotional  outbursts, challenges and dynamics in the room. The focus of group therapy has always been  on fostering agency, self-responsibility and awareness of the group and its impact on you and  you on it. This group dimension has brought me so much in terms of skill, understanding and  perspective”.  

“My training in the 1980s helped to develop my work facilitating groups for clients from  socio economically deprived backgrounds, be they young people, families with young  children. Struggling with unemployment with very few formal qualifications was not  dissimilar to people now, participating in groups provided people with an opportunity to  share how their circumstances affected their mental health and find agency to act in the  world outside the group as well as within it. The group showed them that interpersonal  exchange could lift some of the pathologizing factors of diagnoses such as learning  difficulties, depression and the poverty of life socially, emotionally and socio economically”.  

“I was drawn to group work training from my personal experience of having been part of a  group at particular time when my inner world and life was fragmented. The group analytic  group experience and relationships, provided me with a different lens of the world and  empowered me to make healthy changes, significantly with relationships with my children  and consequently halted and amended the destructive generational patterns.  

My work in the mid 1990’s continued with the charity that worked with parents and families  to change generational patterns of abuse and this experience opened to me a window into the world of group psychotherapy and how valuable it would be to train in the practice to be able  to share them with those who would otherwise not be able to access it”.  

The understanding of mental health that underpinned the training links to past and current  clinical work:  

“Through the decades groups and group analytic theory have been incredibly important and  applicable to all aspects of life for instance team functioning and understanding how the  tensions and topics within teams are often reflections of patient work and dilemmas. On going tensions between the individual and the group are on every level both macro and micro  of relevance for all of us.  

As manager and clinical lead in the NHS service it was fundamentally helpful to have a  grounding in analytic group theory and practice. To understand and be aware of how acting  out, splitting, projection and retraumatising can occur in the work and clinical groups as well  as the staff groups and the systems that are embedded within the organisations was crucial in  surviving and managing the work. I worked with teams, systems in CAMHS and AMHS and  these group dynamics were always relevant and alive.  

More recently in COVID alternative ways to offer therapeutic support had to be developed.  In the Therapeutic Community where I worked we offered some out door groups in a park  where there happened to be a space with rocks in a circle. A small cohort of patients would  come once a week and then after checking in and talking we would walk together round the  park.  

Zoom groups have become a functioning way of offering group interventions around the  world. I piloted a group from London to doctors in the Midlands returning to work after  maternity leave. This felt supportive and helpful and offered a safe space to meet as women  without the hierarchy of medicine to share experiences and feel equally anxious and hopeful.  

Experiential groups for trainee psychotherapists were also offered on zoom. I found running  a group for 13 on zoom quite challenging but also believe it was effective”.  

As can be seen in the above quotes, group psychotherapy was practiced in combination with  other professional roles and also influenced the training, practice and theory of those other professions. The next quote highlights this by referencing particular clinical practice and  research publications.  

“As an arts therapist integrating group dynamic principles in arts therapies training and  practice was crucial and the group analytic training thus influenced art, drama, dance  movement and music therapists, some of whom continued their training as groupanalyst ( i.e.  McNeilly 1983), whilst others collaborated with groupanalysts (Davies et al 2014). More  generally, arts psychotherapy groups were underpinned by group dynamic principles ( see  special issues Groupanalysis edited by Diane Waller in 1990 and GROUP edited by Craig  Haen and Joan Wittig in 2010).  

Research into (arts psychotherapy) groups was and is a developing area, often ‘sold’ as cost  effective (Uttley et al 2015). These types of studies often focussed on randomised control  trials, to aim for quantitative evidence. I found the group analytic training more helpful in  my qualitative doctoral research in a therapeutic community in the 1990s where the impact of  the cultural background of arts therapists and their clients was studied within the therapeutic  community arts therapies groups (Dokter 2010) using participant observation and focus  group methodology.  

As head of an arts therapies department in adult mental health I found the group analytic  training invaluable in understanding the dynamics between different professions and the  system of interaction with the organisation as a whole. An example of this was an audit of  referral dynamics to psychological therapies, which raised how ethnic and cultural  background influenced those referrals. My interest in this as head of department developed  from earlier training and research (Dokter and Khasnavis 2011) which continued to be  influenced by my group analytic training. What could be considered individual assessments  and referrals were influenced by group dynamic patterns. The audit showed that the cultural  and ethnic diversity of clients referred to the arts therapies was greater than those referred to  psychology and psychotherapy. As we collaborated in our assessments it meant reviewing  these assessment and referral decisions more critically, taking into account intersectional  biases (Dokter and Sajnani 2023)”.  

Although we highlighted the demise of the group psychotherapy training and practice at the WPF we  have noticed that, over time, there has been a gradual shift, often for pecuniary reasons,  towards the value of group analytic thinking. Currently groups no longer remain as the poor  cousin and have become valuable conduits to providing support as well as clinical  application.  

The training afforded a move towards the relational aspects of enabling people.  In the context of therapy groups, a more holistic experience of realising clients/ patients’ own  potential is important. Not only managing their own internal difficulties, but also sharing and  developing within a climate of support, hope and less alienation. Patient groups flourished  within the NHS, also relieving the burden of long waiting lists for individual therapy.

Applied to supervision, groups enabled through sharing, much learning from one another and  mitigated the shame and fears often evoked if thought to be the only one struggling, similar to  patient groups. The group dynamics that invariably surfaced were useful reflections to  understanding the underlying dynamics of their patients within groups or individuals.  

Reflective practice groups for staff teams became more prominent as contexts to  understanding team dynamics and staff relations. This is where group analytic training was  valuable with its emphasis on context and systems thinking.  

Within the above wider application each of the authors experienced particular aspects of  group therapy they found helpful:  

‘Including groups as an additional mode of therapy allowed paying patients this valuable  clinical experience at an affordable fee, which previously had been beyond the reach of many  within individual modalities. Private groups, initially conducted by us in person, have since  Covid become more inclusive because of Zoom and also accessible on a much more  international basis, increasing further the diversity of group membership ”. 

“The training has been pivotal in underpinning my work as a strategic Director and the  group analytic approach provided a lens through which the organisational dynamics could be  identified, processed and at times understood to initiate change’.  

‘My career evolved through the charity in various guises and supported my thinking and  practice over the coming years with development of fourteen family centres and the  implementation of a psychotherapy group work module for other staff who were facilitating  groups for parents’.  

‘As the Director of government funded programme, (supporting families with under 5’s) , the  group work training became the applied practice and informed the development of a  governance and operational structure was implemented based on a group as a whole culture  ethos’.  

‘I am currently working as a Clinical Consultant which focuses on organisational dynamics  across the charity – facilitating a structure of reflective practice groups within a framework  that links and triangulates to inform the charity and brings the unconscious dynamics of the  trauma into spaces which they can be understood in the conscious realm of the group”.  

Conclusion  

Overall, the clinical applications show a move away from the leadership orientation of many  groups, to that of more democratic, inclusive relationships that both attend to individuals’  internal preoccupations but within the frame of the impact of the external and vice versa. It is  important to emphasise that emotional wellbeing, health and functioning have a foundation  and are all about relationships. Group analysis can help to find ways to understand and get  through defensive strategies, fear and anxiety and help connect people to themselves and  others. As authors we are concerned that GA is not as available in the NHS as it used to be,  which is a worrying move away from relational therapies.  

The stripping of psychodynamic therapy within NHS mental health services means that group  therapy is again limited beyond protocolised interventions. An example is a Group therapy  centre, which provides alongside manualised time limited CBT groups also sliding scale fees  for longer term group analytic therapy to clients with enduring mental health problems. This  developed from face to face to online therapy during covid, and now offers both, all aiming to  ensure that access to therapy is as low threshold as possible, thus ensuring more equitable  access in an increasingly polarised and individually pathologised world.  

The changing nature of available therapies within our public services over the last few  decades has resulted in thinking and approaches which tend to reduce behaviour and  emotional well-being to individual pathology and brain changes. Manualised models and  short-term offers of treatment are then measured by limited and often meaningless scales for  the patient using statistics and numbers. The relevance and importance of group analytic  theory is lost and often resisted and members of staff struggling to adapt may be accused of  resistance or being old fashioned and not open.  

It is therefore perhaps interesting that staff “reflective groups” seem to be prolific and desired  by managers and provided to teams who may be working in stressful areas of mental health.  This seems on one level to recognise that the work can impact on staff members and teams.  Sadly, these are often run monthly or less, not everyone prioritises or attends, and facilitators  may not be group trained leading to frustration, non-attendance and disappointment. The  challenges of running these groups by group analysts can be enormous as they can feel added  on and not integrated into the rest of the team work and approach and in that sense can cause  tension and resistance.  

We argue for a move from the pathological medical reductionist model of the human  condition to a wider social, economic political model in its widest form in order to truly  understand the individual and their context. We think it is increasingly important in this ever  more individualised world where human distress and behaviour on all levels is reduced to  individual pathology, that we desperately need to keep alive and reawaken awareness the idea  and frame that we are all social animals living in groups and systems which impact on and  are impacted by each of us and to ignore this dimension whether global, national, local team  and mental health work, is to deprive us all of deep and meaningful potential work in healing,  functioning and thriving.  

The legacy of WPF is to encourage us to be playful, creative and use ourselves to find different applications for GA and the fact we were predominantly women and used our own experiences both within the GA we were experiencing and the theory – all taught us lots.

The theme running through is relationships which are the key to health – on all levels of the  society we are in – understanding the unconscious processes that impact on the way people  interact and relate can only offer a huge way to make a difference.  

References  

Black, D. (1990) A Place for Exploration. The story of the Westminster Pastoral Foundation  1969-1990. London: Westminster Pastoral Foundation pub. ISBN-10 0951683004  

Blackwell, D. (2011) Ships in the Night: The “Open Group” for clients on the waiting list.  Group Analysis 44 (3) 247-265  

Davies, A. Richards, E. and Barwick, N. (2014) Group music therapy. A group analytic  approach. London: Routledge  

Dokter, D. (2010) Helping and hindering processes in creative arts therapies group practice .  GROUP 34.1: March 2010: 67- 83  

Dokter, D. and Khasnavis, R. (2011) Intercultural supervision. The issue of choice. In P.  Jones and D. Dokter (eds) Supervision of drama therapy. London: Routledge pp111-129  

Dokter, D. and Sajnani, N. (2023) Intercultural drama therapy. London: Routledge  

Driver, C and Murdin, L eds (2021)Memories of WPF Therapy 1990-2017. London: self  published  

McNeilly, G. (1983) Directive and non directive approaches to art therapy. Arts in  Psychotherapy 10: 211-219 

Utlley, L., Stevenson, M.Scope, A., Rawdin, A. and Sutton, A. (2015) The clinical and cost  effectiveness of group art therapy for people with non psychotic mental health disorders: a  systematic review and cost-effectiveness analysis. BMC Psychiatry 15, 151 (2015). https:// doi.org/10.1186/s12888-015-1528-4 

Waller, D. ed. (1990) Group analysis and the Arts therapies. Group analysis vol 23  

Van der Kleij, G. (1983) The setting of the Group-Group Analysis 16(1)    

Van der Kleij, G. (1985) The Group and its Matrix-Group Analysis-XV111 (2)  9

Authors’ Biographies

Ditty Dokter

Ditty is a group analytic psychotherapist and drama therapist who practices in the UK and the Netherlands. She has worked in the NHS and for various universities, working concurrently in private practice with clients and supervisee’s. Her research is in intercultural arts therapies practice. Her PhD research in this area was published in 2010 “Helping
and hindering processes in UK arts therapies group practice” GROUP 34 (1) : 67-84. Her most recent publication is Intercultural dramatherapy. Imagination and action at the intersections of difference, co-authored with Nisha Sajnani and published by Routledge in 2023.

Merryn Jones

Merryn Jones graduated as a group analytic psychotherapist at WPF in 1988. She has worked as a social worker, child mental health specialist and psychotherapist in a variety of NHS and Local Government settings. She was clinical lead of a therapeutic community for people with personality disorders before retiring to work privately as a therapist.

Philippa Marx

Formerly Principal Social Worker for a Child and Family Consultation Service, and Consultant Psychotherapist for an NHS Mental Health Trust. Supervised and trained on Intercultural and Group Psychotherapy training courses. Now in private practice working with groups and individuals.

Barbara O’Reilly

Registered UKCP group analytic psychotherapist and child psychotherapeutic practitioner. Clinical Consultant for a charity that works with “looked after children”, supervising individuals and groups. Actively involved in change management of organisation using psychodynamic and business development framework.