The Power of Peer Consultation in Therapy
Therapists often spend their days listening deeply, carrying stories that are tender, complicated, and heavy. We hold space for grief, anger, joy, and transformation, but often we do so quietly and alone. Unlike many professions, we cannot come home at night and casually talk about the details of our day. The silence can feel protective, but it can also feel isolating.
That is where peer consultation groups become so valuable.
Why We Need Each Other
There is an old saying: “If the only tool you have is a hammer, every problem looks like a nail.” Each of us has a different kind of hammer, shaped by our training, our worldview, and our personalities. Left alone, we might keep reaching for the same tool, even when the situation calls for something different.
Peer consultation groups open the door to other toolkits. Within a circle of trusted colleagues, we can share cases (confidentially, of course) and ask:
What am I not seeing here?
Is there an enactment happening, a dynamic being re-created in the therapy room?
Could this be transference or countertransference shaping the work?
Are there resources, frameworks, or modalities that might help me see the client differently?
In these conversations, blind spots come into view. Case conceptualizations sharpen. We leave the group carrying not just our own wisdom but the collective insight of many clinicians.
Beyond the Clinical Lens
Consultation is not only about deepening clinical skills, it is also about navigating the business of being a therapist. Especially in private practice, the unseen work can be overwhelming:
Sorting through insurance plans and renewals
Keeping up with legal and ethical responsibilities
Budgeting for overhead, office space, and staff
Training administrative teams in IT or client communication
Planning professional development and staff workshops
These are not the things most of us dreamed of when we decided to enter this field, but they are realities. Having a space to ask questions, share strategies, and get perspective on the backstage work of therapy can be a tremendous relief.
Additional Benefits of Consultation Groups
Peer groups can also offer practical and creative advantages that go beyond case discussion:
Shared resources and training: Groups can share the cost of continuing education opportunities or bring in guest speakers at a reduced rate.
Peer-led learning: Members can offer presentations to one another on areas of expertise, broadening knowledge across modalities and special topics.
Wellness and team building: Some groups integrate wellness practices or activities together, supporting both connection and resilience, always within the professional container of the group.
These benefits remind us that consultation groups are not only about solving clinical puzzles but also about strengthening the sustainability and vitality of the therapist’s professional life.
The Community That Sustains Us
And then there is the simple, human truth: we need community. We need a place where we can talk openly about the weight of this work and the beauty of it too. In peer groups, we find colleagues who nod in recognition when we speak, who laugh with us when humor is the only release, who remind us we are not alone.
Other professions that carry high emotional demands, such as emergency responders, have long recognized the importance of peer support. As therapists, we deserve the same. A consultation group, when grounded in professionalism, becomes a lifeline that prevents burnout and sustains our passion for the work.
Building a Thoughtful Group
If you are considering starting or joining a group, here are some guiding steps:
Set a shared purpose. Decide if your group will focus on clinical cases, business matters, or a blend of both.
Commit to regular meetings. Consistency builds trust and keeps the group alive.
Create a mission statement. Even a simple sentence can anchor your work together.
Hold confidentiality sacred. Clients’ trust depends on it.
Address ruptures openly. Disagreements or tensions will happen, repair is part of the practice.
Engage ethically. Keep the space professional and containing.
Consultation as Professional Self-Care
A day in the life of psychologists and other mental health clinicians is layered. It is not only emotional work, but also cognitive work: holding space with compassion while applying knowledge, judgment, and skill. The role asks us to carry nervous system activation, to reflect, to process, and to seek clarity as we navigate complex stories and experiences. Alongside this comes the practical side of the profession: drafting formal letters that must be written with both ethical and legal precision, weighing concerns about a client’s mental health, and asking ourselves ongoing questions about best practice. And all of this exists within the broader context of our own humanity. We are also parents, partners, caregivers, adult children of aging parents, organizers of households, managers of finances, and participants in hobbies, sports, and the small pursuits that bring zest to life.
In light of this, it becomes clear why consultation, community, and reflection are not luxuries, but necessities. They are a form of professional self-care, a way of tending not only to our clinical responsibilities but also to the personhood of the therapist. To care for ourselves in this way is to honor both the work we do and the lives we live, ensuring that we can continue to show up, steady and whole, for the people who trust us with their stories.
For New and Emerging Therapists
If you are just starting out, you do not need to wait until you feel seasoned to join a consultation group. It is never too early or too late to connect with others. It is important to remember that a consultation group is for the development of practice in the clinician and is not the same as a referral network. While you may gain insight into how colleagues work and therefore feel able to endorse them, referring a client requires an ethical stance that places the client’s needs above personal affiliations or bias. What is best for the client is always paramount.
Diversity in a group brings richness: varied theoretical orientations, cultural perspectives, and lived experiences broaden the conversation. At the same time, it is often helpful to be alongside peers at a similar career stage. Walking the same path together means that the questions you are asking, the challenges you are facing, and the decisions before you are shared. A group with too wide a range of experience can sometimes feel unbalanced, veering into the territory of supervision rather than consultation, which may unintentionally create hierarchy or even resentment. Finding the right balance is part of the art of building a group that truly supports and sustains each member throughout the life-cycle of a therapist.
I am a Registered Psychologist, a certified Sensorimotor Psychotherapy Consultant, and I offer Supervision. I write from this lens, offering reflections rather than directives, and I invite readers from the mental health professions to engage with my words thoughtfully, not as rules but as perspectives to sit with.
This article was authored by Penelope Waller Ulmer, a verified therapist in our network. Learn more about their expertise and approach below.
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