Madeline King

Title: Outpatient clinicians’ attitudes toward leading group therapy: Barriers, benefits, and breakthroughs

Abstract

In response to growing global demand for accessible and efficient mental health care, outpatient treatment models must evolve to meet patient needs while optimizing clinician capacity. Nurse-led innovation plays a critical role in addressing system-level barriers that limit the implementation of evidence-based interventions. Group therapy is a cost-effective psychiatric intervention that improves access, enhances patient experience, and supports continuity of care; however, it remains underutilized in many outpatient settings. This quality improvement project had two primary aims: (1) to explore outpatient clinicians’ attitudes and readiness to lead group therapy, and (2) to assess differences in perceived barriers and facilitators based on individual and organizational factors. Using a descriptive concurrent embedded mixed-methods survey design with a cross-sectional approach, this nurse-led initiative integrated quantitative and qualitative data to inform practice improvement. An anonymous, voluntary online survey collected demographic information, Likert-scale ratings of confidence and readiness, and open-ended responses about organizational and individual barriers and facilitators. Quantitative data were analyzed descriptively, while qualitative responses were coded thematically to capture clinicians’ lived experiences. Seven valid responses were obtained from interdisciplinary outpatient clinicians (LICSWs, LMHCs, and PMHNPs), with a mean age of 39 years and an average of 5.4 years of clinical experience. The majority (71%) reported prior experience facilitating group therapy. Confidence in key group facilitation competencies, including conflict management, client selection, and leadership, was moderate to high (mean scores 3.7-4.5 on a five-point scale), indicating strong clinician readiness. Despite this readiness, significant system-level barriers limited implementation, including lack of protected time (86%), low client attendance or engagement (71%), scheduling constraints, limited physical space, and insufficient training. Facilitators included administrative support, access to designated group space, structured training, and peer mentorship or co-facilitation models. Qualitative findings emphasized that sustainable group therapy implementation depends more on organizational infrastructure than on individual motivation. Findings were synthesized into targeted, nurse-driven recommendations presented to organizational leadership. These included allocating protected clinician time, supporting co-facilitation models with adequate physical space, and offering structured training and peer mentorship to promote sustainable group therapy implementation. Collectively, these findings demonstrate how nurse-led, data-informed quality improvement can guide organizational decision-making and enhance outpatient mental health delivery. They also support scalable implementation of evidence-based psychotherapy models across diverse outpatient practice settings.

Audience Takeaways:

1.Understand how nurse-led data collection and mixed-methods analysis can drive innovation in outpatient mental health care.

2.Identify practical strategies to expand group therapy programs in resource-constrained settings.

3.Recognize organizational and system-level changes that improve patient access, engagement, and experience.

4.Apply insights from a quality improvement model to guide service redesign, program implementation, and teaching initiatives.

5.Gain a transferable framework for integrating evidence-based group therapy into outpatient and global health contexts.

This presentation equips nurses, administrators, and educators with practical tools to enhance outpatient mental health delivery through innovation and data-informed practice. Attendees will learn how nurse-led quality improvement initiatives can identify implementation gaps, support interdisciplinary collaboration, and expand access to evidence-based group therapy. The findings are applicable across diverse outpatient and community health settings, including those with space, staffing, or resource limitations, making them highly relevant to global healthcare delivery and scalable innovation efforts.