Group final exam

what characteristics are common in transition stage

Anxiety and defensiveness are common

Members

test the leader and other members to determine how safe
the environment is
struggle between wanting to play it safe and risk getting involved
observe the leader to determine his/her trustworthiness
learn how to express themselves so that others will listen
With children, model what this may look like

When there is a low level of trust, members may:

• show up late, leave early, or miss sessions
• not express what they are thinking and feeling
• be unwilling to initiate personally meaningful work
• deny that they have any problems or concerns
• hide behind global statements and intellectualizations
• be unwilling to deal with conflict in the group

Common fears emerging at transition stage

Making a fool of oneself
Emptiness
Losing control
Being too emotional
Self-disclosure
Taking too much of the group's time
Being judged, challenged, singled out, or rejected

Guidelines for effective confrontation

• Have a rationale for confronting a person
• Confront if you care about the other
• Talk more about yourself than the other person
• Avoid dogmatic statements and judgments about the other
• Give others space to reflect on what you say to them

Dealing with difficult behaviors of members

• Avoid responding with sarcasm
• State your observations and hunches in a tentative way
• Demonstrate sensitivity to a member's culture
• Avoid taking member's behavior in an overly personal way
• Encourage members to explore reluctance - don't demand
  they give up a particular "resistive" behavior

Problematic Styles of behaving in a group

Silence
Monopolistic behavior
Storytelling
Giving advice
Questioning
Dependency
Intellectualizing
Hostility
Acting superior
War stories- garnishing attention
Avoidance by adopting role of "assistant leader"
Subgrouping- can cause issues with feeling left out
Offering pseudo support

Dealing with Reluctance therapeutically

Don't label all hesitations as a sign of "resistance"

Respect reluctance- it may

serve a valuable function

Invite members to explore the meaning of

what appears to be "resistance"

Describe behavior of members - avoid making

too many interpretations

View reluctance with

interest, understanding, and compassion

When an entire group chooses not to work/ avoids/ is unwilling to deal with several hidden agendas, it is important to:

1. commit to face what is going on
2. bring to the surface the hidden agendas
3. refuse to give up
4. not indulge in feelings of frustration and annoyance

Transference:

feelings members project onto the counselor, which are rooted in the members past relationships

Countertransference:

feelings aroused in the counselor by members, which are related more to unresolved conflict from other past or present relationships than to any feature of the therapeutic relationship

A group context has the potential for

multiple transferences. Feelings can be productively explored so members become aware of how they are keeping these old patterns functional in present relationships

Coleader issues at the transition stage

• Negative reactions toward one leader
• Challenges to both leaders
• Dealing with problem behaviors
• Dealing with countertransference

Leader functions: transition stage

• Show members the value of dealing fully with conflict
• Help members to recognize their own defensive patterns
• Teach members to respect reluctance and to work constructively with the many forms it takes
• Model how to deal directly and tactfully with any challenge
• Encourage members to express reactions that pertain to here-and-now happenings in the group

Member functions: transition stage

express persistent reactions and deal with what is occurring in the group
respect their own defenses but work with them
move from dependence to independence
learn how to confront others constructively
work through conflicts rather than remain silent or form subgroups outside of sessions

Key Points: Working Stage

• There are no arbitrary dividing lines between each stage
• Group development ebbs and flows - does not stay static
• Work can occur at every stage - not just the working stage
• Not all groups reach a working stage
• Not all members function at the same level in a working stage

Group norms and behavior at the working stage

There is further development and solidification of group norms established earlier

Some group behaviors at the working stage

Both support and challenge to take risks in group
Use of a variety of therapeutic interventions
More direct interactions between members
Healing capacity within the group develops
Increased group cohesion fosters action-oriented behaviors

Characteristics of a productive group: focus in on the

here-and-now

Characteristics of a productive group: Members' goals are / Members are willing to…

Clear and specific
Members are willing to make themselves known

Characteristics of a productive group: Cohesion is / conflict is / trust is

cohesion is high - a sense of emotional bonding in the group
Conflict in the group is recognized and explored
Trust is increased and there is a sense of safety

Characteristics of a non working group

• Mistrust is manifested by an undercurrent of unexpressed feelings
• Participants focus more on others than themselves
• Participants hold back and may feel distant from one another
• Conflicts are ignored or avoided and communication is unclear and indirect

Choices to be made during the working stage

Disclosure versus anonymity
Authenticity versus guardedness
Spontaneity versus control
Acceptance versus rejection
Unity versus fragmentation

The value of homework in group:

Group is not an end in itself
Group is a place to learn new behaviors and acquire a range of skills in living. It is training ground for everyday life

Homework is a means for maximizing what is learned in group

Members can devise their own homework assignments
Ideally, homework is designed collaboratively between members and the leader
Think about your population when deciding 'what' homework to assign

Therapeutic factors in groups

Self-Disclosure, Confrontation, Feedback
Cohesion and Universality
Hope, Willingness to Risk and Trust, Humor
Caring and Acceptance
Power, Catharsis
The Cognitive Component
Commitment to Change; Freedom to Experiment

Disclosure should be related

to the purposes of the group

In regards to disclosure, it is useful to express

persistent thoughts and feelings

Level and nature of disclosure:

Stage of group may determine what is appropriate
Members decide what and how much to disclose

Self-disclosure increases

in a safe group

Guidelines for giving feedback

Give feedback with honesty and sensitivity
Concise feedback given in a clear and straightforward way is useful
Avoid giving global feedback

In giving feedback, let others know

how their behavior affects you, but avoid being judgmental

Catharsis is the

expression of pent-up emotions

catharsis can be

healing and lead to increased cohesion
but it is not appropriate for all types of groups

After a catharsis:

It is useful to integrate cognitive and behavioral work
Insights are common

It is crucial to put insights

into action

Co leader issues during working stage
Between group sessions:

• discuss reactions to group members
• think of ways of involving the various members in transactions with one another
• explore ways of helping participants understand their behavior in the group and resolve some of their conflicts

Co leader issues working stage

Engage in ongoing evaluation of the group and of your performance as coleader
Discuss with each other issues related to theoretical orientations, therapeutic styles, techniques, self-disclosure, etc

leader should

Continue to model appropriate behavior; provide a balance between support and confrontation
Promote behaviors that will increase the level of cohesion

leaders Support members' willingness

to take risks and assist them in carrying this into their daily living

leaders offer

interpretations at appropriate times to help members engage in deeper self-exploration and consider alternative behaviors

leaders explore common themes that provide

for some universality, and link one or more members' work with that of others in the group

leaders focus on the importance of translating insight

into action; encourage members to practice new skills

members

Bring into group sessions issues they are willing to discuss
Offer and remain open to feedback even though this may increase anxiety for some members
Practice new skills and behaviors in daily life and bring the results to the sessions
challenge and support others
engage in self-confrontation and avoid becoming too relaxed and comfortable in the group
continually assess their satisfaction with the group
actively take steps to change their level of involvement in the group, if necessary

Tasks of the final stage of an open group:
Educate members to give adequate

notice when they decide it is time to terminate

Tasks of the final stage of an open group:
Discuss informed consent from

the beginning of a group and explain how to terminate productively

Tasks of the final stage of an open group:
Assist the member leaving to

prepare emotionally for termination and give others the opportunity to express their reactions

Tasks of the final stage of an open group:
Explore cultural

influences on members' perceptions + understandings of endings

Tasks of the final stage of an open group:
Assist the member

who is leaving to review what has been learned in the group and, specifically, what to do with this learning

Tasks of the final stage of an open group:
Help participants learn how
and also
Make

to face future challenges w/ tools acquired in group
and also
make referrals, when appropriate

Tasks of the final stage of a closed group:
Dealing with

feelings of separation and with unfinished business

Tasks of the final stage of a closed group:
Reviewing and
Practicing for

the group experience and
Practicing for behavioral change

Tasks of the final stage of a closed group:
Giving and receiving
Discussing ways of carrying

Giving and receiving feedback
&
learning further- using contracts and homework

The ___ method can enhance the quality of feedback and can result in focused feedback

sentence completion

examples of sentence completion

My greatest fear for you is …; My hope for you is…
I hope that you will seriously consider…
I see you blocking your strengths by…
Some things I hope you will think about doing for yourself are…
Some ways I hope you'd be different with others are…

Assist members in

translating what was learned in group to their lives and developing action plans geared to change

Inform members that

relapses may occur. Prepare them to cope with unexpected outcomes

Some points to share with members:
A group is ___
Change is ___
Focus more on ___
Decide what you ____

A group is a means to an end
Change is bound to be slow and subtle
Focus more on changing yourself than on changing others
Decide what you will do with what you learned about yourself

Co-leader issues- important to:
Agree Discuss
Discuss feelings about _
Help members _
Critically assess the balance

Agree not to bring up new issues
Discuss unfinished business pertaining to group and/or each other
Discuss feelings about ending the group
Help members review and evaluate their experience
Critically assess the balance of responsibility and how you worked together as co leaders

Leader functions: ending stage

• Assist members in dealing with any feelings they might have about termination
• Provide members with an opportunity to express and deal with any unfinished business within the group
• Reinforce members' changes and ensure they have information about resources to continue their growth
• Assist members in determining how they will apply specific skills in a variety of situations in daily life
• Work with members to develop specific contracts and homework assignments
• Assist participants in developing a conceptual framework that will help them understand, integrate, consolidate, and remember what they have learned in the group
• Provide opportunities for members to give one another constructive feedback
• Reemphasize the importance of maintaining confidentiality after the group is over

Leader functions after termination of a group

• Offer private consultations if any member should need this service
• Provide for a follow-up group session or follow-up individual interviews
• Identify referral sources for members who may need further assistance
• Evaluate the strengths and weaknesses of the group

Member functions

• deal with feelings about separation and termination so they do not distance themselves from the group
• prepare to generalize learning to everyday life and decide on changes they want to make and how they plan to make them
• complete unfinished business, either issues brought into the group or issues that pertain to people in the group
• evaluate the impact of the group and remember that change takes time, effort, and practice

Group Counseling in the School setting

Groups emphasize* prevention and intervention strategies to support healthy student development and more effective ways of dealing with the tasks of daily living

Group Counseling in the School setting:
Research confirms __
Groups influence the
Groups are generally _
Treatment of more severe problems is generally ______
School counselors need to make it a practice to know about __

Research confirms that small groups are of value for both the student participants and the school counselors
Groups influence the personal and social functioning of students and have been shown to improve academic performance
Groups are generally brief, structured, problem focused, homogeneous in membership, and have a cognitive behavioral orientation
Treatment of more severe problems is generally not within the scope of counseling services offered in a school setting
School counselors need to make it a practice to know about referral resources

Reasons students participate in groups

Poor social skills
Chronic illness
Physical disabilities
Traumatic injuries
Low self-esteem
Inability to get along with peers
Struggles with cultural issues
Bullying or being bullied
Violation of school rules
Poor attitude toward school
Depression and anxiety
Pregnancy prevention
Feelings of failure
Loss and grief
Physical and sexual abuse
Feeling isolated and lonely
Dealing with divorce
Violent or angry outbursts
Homelessness
Excessive truancy
Substance abuse
Eating disorders

In planning groups for children and adolescents:

• Describe your goals and purposes clearly and develop a clearly stated rationale for your proposed group
• Identify the approach and evaluation procedures you will use and create an attendance policy and orientation materials for parents
• Clearly articulate to administrators, teachers, and parents the benefits children or adolescents may derive from participating in a group

When working in a school setting with children or adolescents:
Know your state's laws Plan to secure
Communicate your _
Emphasize Think about
Maintain
Use appropriate
Prepare members for

Know your state's laws regarding group work with minors
Plan to secure parental or guardian written permission
Communicate your expectations to those in your group
Emphasize confidentiality
Think about practical considerations (e.g., size of group and setting)
Maintain neutrality
Use appropriate exercises and techniques, be flexible, listen, and remain open
Prepare members for termination

Issues in leading adolescent group

• Group leaders need to clearly state the guidelines for conduct during sessions and gain members' acceptance
• Creative group techniques such as music, movement, visual art, drama, play, and humor can be used as catalysts for interaction in high school groups
• Common challenges include developing trust and setting limits to self-disclosure
• Deal directly, candidly, and openly with group members as they are quick to detect any traces of inauthenticity
• Leaders need to possess cultural sensitivity, understand current trends, and demonstrate respect for young people
• Understanding the world of young people does not mean that you become one of them.
• Adolescents may test group leaders and this needs to be accepted in a nonjudgmental and nondefensive way

Key points: groups for children

In designing a group in schools, get the administrators' support
Communicate with children about the importance of keeping confidences in language they can grasp
Ethical practice demands that you have the training required to facilitate a group with children
Not all children are ready for group participation
Provide structure in groups with children and give thought to helpful methods of evaluating your groups
Involve parents in group work with children

Key points: groups for adolescents

Understand and respect reluctance
Role-playing techniques can be creatively used in adolescent groups
Involve parents in group work with adolescents
Adolescent groups may focus on many different issues ranging from drug rehabilitation to teenage pregnancy
Co-leadership models are very useful with adolescents

*Groups in college counseling centers

Time-limited groups with structured topics or themes are most commonly offered in college counseling centers
Groups are typically short term, lasting up to 16 weeks
Groups in university settings often have a therapeutic focus with an educational component
A few examples are career planning groups, anxiety- and stress-management groups, grief groups, cultural identity groups, nontraditional age student groups, and self-esteem groups

Group treatment is the

preferred approach in many community agencies devoted to providing services for diverse client populations with a wide range of problems

Group work enables

community agencies to offer cost-effective and clinically appropriate therapeutic services to clients

Group practitioners must

have an understanding of the functioning of agency systems

Group proposals for community settings:
In designing a specific group, consider these components

Description of the type of your group
Rationale for your group
Goals of your group
Marketing methods
Screening and selection of members
Structure of group - description of sessions
Methods for assessing outcomes

Examples of groups in community settings

Groups for weight control
HIV/AIDS support groups
Women's and men's groups
Domestic violence groups
Sex offender groups
Support groups for survivors of incest
Older adult bereavement groups

Advantages for women who participate in a women's group:

Discovering their personal strengths and resources
Working on interpersonal relationships in the group context
Eliminating patriarchal oppression
Practicing and modeling new behaviors in a safe environment
Finding their "voice"
Opportunity to construct a gender analysis

Advantages for men who participate in a men's group:

The process assists men in clarifying their gender roles and helps them cope with life's struggles
The group provides a context where men can bring all of their feelings into the open and be healed by the support of others in the group
Most men's groups contain a psychoeducational component and an interpersonal, process-oriented dimension

Group treatment of dv offenders

The efficacy of a group approach in treating domestic violence offenders is supported by research
The therapeutic factors, specifically, increased universality, cohesion, and interpersonal learning are potent factors in the reduction of group members' domestic violence recidivism
An example of a successful treatment program was a solution-focused group that had a recidivism rate of 16.7% and a completion rate of 92.9%

Group treatments of sex offenders

Sex offenders often enter treatment with much reluctance toward therapy and denial about their arresting incident and inappropriate sexual behavior
Many sex offenders have never received psychotherapy prior to their conviction for a sexual offense, nor do they believe that they are in need of treatment
The mental set and attitudes of sex offenders, coupled with the serious nature of their maladaptive behaviors, present counselors with a range of challenges

Groups for people with HIV/AIDS
A support group can provide a safe place for participants to

deal with the impact of possible social stigma of HIV/AIDS
vent their anger and other feelings, enabling them to form
a new perspective on their situation
find some measure of hope by sharing their fears and
realizing that they are not completely alone
address their concerns about the various physical,
psychological, and spiritual tasks they are faced with

Groups for older adults

The rapid population growth among older people has resulted in a greater demand for mental health practitioners able to provide adequate psychological services to this group
Group work is one way to promote the positive aspects of aging and to help participants cope with the developmental tasks of aging
Groups offer unique advantages for older adults who have a great need to be listened to and understood
Older adults need a clear explanation of the group's purposes and potential benefits
Older people have a range of life experiences and personal strengths that are often overlooked
Revealing personal matters may be extremely difficult for some older adults due to their cultural conditioning
Specialized knowledge is required to treat the unique problems that older adults face

Themes with older adults

Loss and the struggle to find meaning
Loneliness and social isolation
Poverty
Feelings of rejection
Regrets over past events
Hopelessness and despair
Fears of death and dying
Grief over others' deaths
Dependency
Sadness over physical and mental deterioration

Examples of groups for older adults

Reminiscing
Physical fitness
Body awareness
Grief work
Occupational therapy
Reality orientation
Music and art therapy
Hopelessness and despair
Fears of death and dying
Grief over others' deaths
Dependency
Sadness over physical and mental deterioration

Al & Harmony

relationship boundaries
college students
final state

Karina

Initial stage
Students who brought weapons to school high school

Molly & Alyssa

Transitional stage
14-17 yo girls in recovery from Eds

Courtney and Emma

Older adults/ retirement
working stage

Evan and Corinne

College students on academic probation for drugs/alcohol use
Transitional stage

Courtney and emma

Solution-focused elderly group (65+) with a focus on making connections in retirement
Working stage

jessie and alex

Middle school aged co-ed group, children of divorced parents
Working stage

Alexa and rachael

Female college freshmen struggling with anxiety and stress management
Initial stage

kara and mitch

High school seniors struggling with the idea of life after graduation
Initial stage

rajni and beate

Grief group for women in addiction, adults older than 21
Working stage, session 7 out of 12

Deb and Feijiro

Grief group women ages 25-35
Initial stage