group midterm

ADDRESSING MODEL:

• Don’t judge a book by it’s cover

• Age, disability- acquired development, religion, ethnicity, SES, sexual orientation, indigenous heritage, national origin, gender/sex

• Groups provide a natural laboratory and a sense of community that demonstrates to people that they are not alone and that there is hope for creating a different life.

• Therapeutic groups are used to increase members’ knowledge of themselves and others, to help members clarify the changes they most want to make in their lives, to provide members with the tools they need to make these changes and to support their changes

• The Association for Specialists in Group Work identified a set of core competencies in general group work, and in addition to these competencies group leaders must possess advanced competencies relevant to their specialty, those have four areas of advanced specialties 

1. Task (Facilitation) Groups: commonly seen in community, business, and educational settings. The focus of these groups is on the application of group dynamics principles and processes to improve practice and foster the accomplishment of identified work goals 

• Examples: planning groups, study circles, learning groups, staff development groups, etc.

• Here-and-now and organization are extremely important in these groups  

2. Psychoeducational groups: focus on developing members’ cognitive, affective, and behavioral skills through a structured set of procedures within and across group settings.

• Goal: Provide members with targeted education on a variety of psychological issues or informational deficits 

• Utilizes planned skill-building exercises, sessions are 4-15 weeks lasting two hours per session; leader job = provide instruction, a positive and safe climate that fosters learning    

• Examples of this group: Substance abuse prevention group, stress management, anger management, and behavioral problems 

3. Counseling groups: focus on interpersonal processes and problem-solving strategies that stress conscious thoughts, feelings, and behavior. This helps participants resolve usual but often difficult problems of living such as education and career. 

• Deals with conscious problems, not aimed at major personality changes, geared toward the resolution of short-term issues, and is not concerned with the treatment of the more severe psychological and behavioral disorders

• Typically found in university counseling centers, schools, and community mental health clinics and agencies 

• Goals: Helping people develop more positive attitudes and better interpersonal skills, using the group process to facilitate behavior change, and helping members transfer newly acquired skills and behavior learned in the group to everyday life 

• Examples: Anger management group for high school students and bereavement groups (for individuals with grief, used to connect with others going through the same thing and understanding grief) 

4. Psychotherapy groups: helps individual group members remediate psychological problems and interpersonal problems of living. 

• Group members often have acute or chronic mental or emotional problems 

• Goal: Aid each individual in reconstructing major personality dimensions 

• These groups are found in community mental health agencies, an example would include a group for interpersonal violence offenders

• Reexperiencing earlier experiences and methods to work with unconscious dynamics, exploring dreams, and dealing with transference that emerges   

• Brief Group Therapy (BGT): refers to time-limited groups, that have a preset time for termination, have a process orientation, and are professionally led 

• Having clear ground rules is vital and leaders provide structure for the group process

• Clear and concise goals are important in time-limited groups 

• Popular in community and school settings

• Treatment of choice for specific problems: existential concerns, complicated grief reactions, medical illnesses, personality disorders, trauma reactions, or adjustment problems

• It cannot produce lasting personality changes, for this to be effective group leaders need to have training in group process and BGT  

• Culture will influence the behavior of both you and your clients with or without your awareness 

• Culture: encompasses the values, beliefs, and behaviors shared by a group of people

• According to DeLucia-Waak culturally skilled group counselors need to be aware of their their own values, attitudes, biases, assumptions, and prejudices; have a general knowledge about the ways the diverse backgrounds of members may affect the group process; and be able to implement interventions that are appropriate for the life experiences of the members of the group

• Our identities shape the way we view others as well as the ways in which others experience us

• Make a commitment to  “lean into your discomfort”

• The goals and processes of the group should match the cultural values of the members of that group

• Helping professions continue to emphasize a monocultural approach to training and practice

• Sue, Arredondo, and McDavis (1992): Conceptual framework for multicultural competencies and standards in three areas:

1. Self-awareness regarding their beliefs and attitudes about race, culture, gender, and sexual orientation

2. Knowledge and understanding of the worldview of the helper and specific knowledge of the diverse groups with whom he or she works

3. Skills and intervention strategies needed to serve diverse client groups 

• Culturally skilled group counselor

• Members watch what we do as much as they attend to what we say

• Nonverbals MATTER and actively listen to clients especially when it comes to discussions of culture and identity 

• We need to be open to feedback from clients and colleagues 

• It’s important to understand your own racial and cultural identity, recognize and be open about your racial biases, encourage a discussion about feelings, pay more attention to the process than to the content of race talk, and encourage and support people who are willing to take the risk of expression themselves    

• Points to remember Page 24

Ch. 2- Molly

Introduction

• The Group Counselor as a Person:

  • The personal qualities, values, and life experiences of a counselor significantly influence group dynamics.

  • A counselor’s self-awareness and ongoing self-reflection are crucial for effective leadership.

  • Being a beginning group leader comes with challenges, but also the advantage of energy, creativity, and a fresh perspective.

  • Practicing self-care and managing stress is important for maintaining vitality and effectiveness throughout one's career.

• Problems and Issues Facing Beginning Group Leaders:

  • Common concerns

    • Getting the group started 

    • Managing group dynamics 

    • Personal involvement

    • Cultural sensitivity

    • Handling conflict

    • Emotional involvement 

  • Fear of Making Mistakes: 

    • Both new and seasoned group leaders may experience anxiety about making mistakes and harming the group.

  • The Role of Supervision:

    • Supervision is essential for beginning group leaders to develop their skills. Feedback from experienced supervisors, co leaders, or fellow students helps leaders reflect on their actions and grow.

    • Group supervision allows leaders to experience group processes firsthand, observe leadership models, and receive feedback from multiple perspectives, which is essential for both cognitive and emotional learning.

  • Developing Leadership Skills:

    • Becoming a skilled group leader takes time, and progress happens gradually.

    • Experience, combined with guided supervision, is crucial for improving leadership abilities.

  • The Importance of Competence and Ethics

    • As group counseling becomes more widespread, it's vital for leaders to be both competent and ethical. Group supervision plays a key role in helping leaders achieve these standards, contributing to their growth and development as ethical and effective group counselors.

• Personality of group counselor 

  • Personality of the Group Leader → The counselor’s personality is crucial to the success of group therapy. Traits like courage, willingness to model behaviors, and authenticity are important for effective leadership.

    • Courage

    • Willingness to Model

    • Presence

    • Non Defensiveness in Coping with Criticism

    • Cultural Awareness

    • Identifying with Clients' Pain

    • Personal Power

    • Stamina

    • Commitment to Self-Car

    • Goodwill, Genuineness, and Caring

    • Belief in Group Process

    • Openness

    • Self-Awareness

    • Sense of Humor: 

    • Inventiveness:

    • Personal Dedication and Commitment

• The Group counselor as a professional

  • Therapeutic Relationship & Competence: A positive relationship with group members is essential for change but requires knowledge of group dynamics and the skills to intervene effectively. Leaders must foster an environment of respect, openness, and concern to ensure successful group outcomes.

  • Personal Characteristics & Skills: Personal traits like warmth, empathy, and genuineness are key, but group leaders also need specialized group work skills. These skills can be developed through training, practice, and feedback.

  • Skills on a Continuum: Group leadership skills should be seen as a spectrum—leaders can continually refine their abilities. Experience and feedback are crucial for improving these skills, and they should be integrated into the leader’s personal style.

  • Multitasking & Supervision: Group leaders need to observe verbal and nonverbal communication, track content and process issues, and manage multiple tasks at once. Having a co-leader can alleviate some of the pressure.

  • Skills Interdependency: Active listening, reflection, and clarification are interconnected. Improving one skill will naturally lead to improvements in others.

  • Skill Development: The key skills for group leaders include active listening, reflecting, summarizing, facilitating, empathizing, interpreting, questioning, confronting, and more. Each plays a role in fostering group cohesion, supporting members, and encouraging productive interaction.

  • Active Listening: This involves more than hearing words—it includes interpreting body language, gestures, and other nonverbal cues. Active listening can help the leader identify underlying emotions and issues that the speaker may not directly express.

  • Reflection: Reflecting involves communicating back to members the essence of what they've shared, helping them process their thoughts and emotions. This requires good listening and can be used to deepen exploration and clarity.

  • Facilitating: Group leaders should help members express themselves, foster trust, encourage participation, and manage group dynamics. The goal is to help members take responsibility for their own growth within the group.

  • Empathizing: Empathy allows the leader to understand a member’s emotional experience, even if the leader hasn’t had the same experience. It’s important to remain objective and avoid losing personal identity in the process.

  • Interpreting: More directive leaders may use interpretations to help members understand their behaviors and emotions. These interpretations should be offered carefully, with respect to cultural differences, and presented as hypotheses for exploration rather than fixed facts.

  • Questioning: Effective questioning, especially open-ended ones, can help members deepen their self-awareness. However, it’s important to avoid overusing questions or turning them into an interrogation.

  • Linking: Linking connects the experiences or feelings of one group member to others, encouraging more interaction and helping members find common ground.

  • Confronting: Confrontation should be done thoughtfully and respectfully, focusing on behaviors that disrupt the group dynamic or cause discrepancies in communication. It encourages honest reflection and change.

  • Supporting: Offering support should come after allowing members to process their emotions. It’s crucial that support empowers members rather than interrupting their emotional exploration.

  • Blocking: Leaders need to prevent counterproductive behaviors, such as excessive questioning, gossiping, or violating confidentiality, to maintain a healthy group environment.

  • Assessing: Group leaders must evaluate the group’s progress, individual members’ growth, and overall dynamics to guide the next interventions and help determine whether a group is beneficial for a particular member.

  • Modeling: Leaders should demonstrate desired behaviors such as openness, respect, and responsibility. Modeling can teach members how to engage authentically and with integrity.

  • Suggesting: While suggestions can guide members, it’s important to avoid offering advice too freely, as it might undermine members' autonomy. The goal is to support self-exploration.

  • Initiating: The leader’s initiative provides structure and direction to the group. A balanced approach is important—too much can stifle creativity, and too little can lead to passivity.

  • Evaluating: Evaluating group progress allows the leader and members to assess their achievements and make necessary adjustments for future sessions.

  • Terminating: Leaders need to know when and how to bring a group to a close. Proper termination involves preparing members for the end of the group experience, providing ongoing support if needed, and helping members integrate what they’ve learned into their lives.

• The Co Leadership Model

  • Advantages of Co Leadership:

    • Group members benefit from the perspectives of two leaders.

    • Coleaders can collaborate, share insights, and improve their skills through feedback and observation.

    • Supervision of coleaders provides an opportunity for feedback and growth.

    • Helps reduce the anxiety of new group leaders by having a trusted partner.

    • Coleadership allows for better management of group dynamics, as one leader can focus on certain members while the other observes the overall group.

    • Burnout Prevention: Sharing responsibilities can prevent burnout, especially in high-stress group environments.

    • Handling Emotions: One leader can focus on intense emotions from members while the other observes the group as a whole.

    • Peer Supervision: Coleaders can provide ongoing support, feedback, and guidance to each other.

    • Countertransference Management: Coleaders can help each other navigate their emotional reactions to group members, facilitating better objectivity.

    • Cultural Sensitivity: If there are differences in power or privilege between coleaders, these can be addressed by working together.

  • Potential Mistakes in Coleadership:

    • Poor coordination, such as not making eye contact or sharing plans and goals.

    • Competition and power struggles between coleaders.

    • Taking turns leading instead of cofacilitating.

    • Poor Coordination: Lack of communication or preparation can lead to disjointed group dynamics.

    • Competition/Rivalry: Coleaders may vie for dominance, affecting group harmony.

    • Distrust: A lack of respect or trust between coleaders can disrupt the group’s progress.

    • Siding with Members: One leader siding with group members against the other can create division.

    • Personal Issues: If coleaders have an intimate relationship, it can interfere with their professional roles during group work.

  • Importance of Choosing the Right Coleader

    • Successful coleadership depends on compatibility, mutual respect, and clear communication.

    • Conflicts between coleaders can divide the group and hinder progress.

    • If coleaders have significant conflicts, they must resolve them before continuing, potentially considering a change in coleaders if needed.

Ch. 3- Ethical and Legal Issues in Group Counseling- Alex

Introduction pg 60

• Ethical issues pertain to the standards that govern the conduct of professional members. Found in ethics codes.

• Legal issues define the minimum standards society will tolerate, which are enforced by the rule of law at the local, state, and federal level. 

• Clinical issues involve using your professional judgement to act in accordance with ethical and legal mandates.

• Cultural issues are factors such as a persons ethnic background, gender, sexual orientation, religion, values and other differences that affect the way we understand and intervene with clients problems

• Practicing ethically demands a high level of consciousness on our part both personally, and professionally. 

Ethical Issues in Group Membership

Informed Consent

• Informed consent is a process of presenting basic information about a group to potential group participants to assist them in deciding whether to enter the group and how to participate in it. 

• This information typically includes therapists qualifications, techniques that are often used in the group, and risks and benefits of participating in the group

• It also contains information about a clients right to confidentiality as well as limits of confidentiality

Involuntary Membership

• Participation is in a group is voluntary, but sometimes mandatory and in that case much efforts need to be directed toward clearly and fully informing members of the nature and goals of the group, procedures that will be used, the rights of members to decline certain activities, the limitations of confidentiality, and ways active participation in group can affect life outside of group

• Basic information about the group is essential to provide special care

• It is critical that leaders not start out with the assumption that a mandatory group will automatically be composed of unmotivated clients, for this belief is bound to have a negative effect on group members.

Freedom to Withdraw from a Group

• Adequate preparation and screening can reduce the risk of members leaving a group prematurely.

• It is a good policy for a leader to begin the initial session with a discussion of the possible risks involved in leaving the group prematurely. Ideally, both the leader and the member work in a cooperative fashion to deter- mine whether a group experience is productive or counterproductive for each individual.

• Many times the behaviors we see are indicative of their daily lives and these reasons should be explored

• We emphasize how important it is for members to verbalize any doubts or concerns they are having about group rather than keeping it to themselves

Psychological Risks for Members

• It is unrealistic to expect a group will not involve risk

• The ACA mentions “a group setting, counselors take reasonable precautions to protect clients from physical, emotional, or psychological trauma.” 

• Members who come from backgrounds in which conflict was harmful and abusive may find healing by learning new ways to resolve difficulties

• After an intense group experience, there may be an incline of risk to making rash decisions 

• Sometimes members imagine concerns of their own about the group experience and very fearful

Possible Risks for group: 

1. Misuse of power

2. Self-disclosure

3. Maintaining confidentiality

4. Scapegoating

5. Confrontation

• One way to minimize risks is to use a contract where there are specified responsibilities of the leader and the members. 

Confidentiality 

• It is especially important because in leading a group you must not only keep the confidences of members but also get the members to keep one another’s confidences. You must be concerned with your own ability to act ethically, but you also must respond to ethical dilemmas that may arise, sometimes outside of your control, between group members.

• An ethical breach might involve a member disclosing personal information or details about one’s personal history to someone not in the group. 

• An example of a more subtle breach of confidentiality can occur when members come from a group of individuals that know each other from work or school

Educating Members about Confidentiality

• Reminders are good from time to time

• Modeling the importance of maintaining confidentiality is crucial in setting norms

Ethical and Legal Dimensions of Confidentiality

• Rights to confidentiality of all members must be safeguarded

• Group counselors have an ethical and legal responsibility to inform group members of the potential consequences of breaching confidentiality.

• Generally, members do not violate confidentiality when they talk about what they learned in group ses- sions. But they are likely to breach confidentiality when they talk about how they acquired insights or how they interacted in a group.

• Privileged communication means that professionals cannot break the confidence of clients unless they are likely to cause harm to themselves or others or property, abuse of children or elderly, court ordered, supervisees in a supervisory relationship

Multicultural Dimensions of Confidentiality

• Culture may affect a members views on confidentiality in these ways: 

1. Considering therapy as shameful/ stigmas.

2. Legal status or residency

3. Seeking asylum or refugee status

4. Promotion of sharing all personal information/ or vice versa

5. Language barriers or reading difficulties may lessen the understanding of consequences

Confidentiality of Minors in Groups

• State laws differ regarding counseling minors. It is important for group workers to be aware of the laws related to working with minors in the state in which they are practicing as well as local policies for those working in a school setting.

• Circumstances in which a minor may seek professional help without parental consent, defining an emancipated minor, or the rights of parents (or legal guardians) to have access to the records regarding the professional help received by their minor

• Before any minor joins a group, best practice requires school counselors to notify parents or guardians that their children are participating.Written permission is a good policy.

• When working with minors, vocabulary for understanding 

Summary Guidelines Regarding Confidentiality

• Confidentiality is crucial to the success of a group, but the leader can do little to guarantee that the policy on confidentiality will be respected by all members. Leaders can only ensure confidentiality on their part, not on the part of others in the group.

• Group leaders must become familiar with the local and state laws that will have an effect on their practice. This is especially true in cases involving child molestation, neglect or abuse of older people and children, or incest.

• Group leaders describe at the outset the roles and responsibilities of all parties and the limits of confidentiality.

• Members should be told about the limits of confidentiality so they can deter- mine when, what, and how much personal information they will reveal in group sessions.

• Leaders have the responsibility of helping members, as well as parents or guardians of minors, understand the importance of maintaining confidentiality and for protecting the personal disclosures of other members.

• It is a wise policy to ask participants to sign a contract in which they agree not to discuss or write about what transpires in the sessions or talk about who was present.

The Role of the Leaders Values in the Group

• We can increase effectiveness by becoming aware of our values

• We may hold a very different set of values, but our ethical obligation is to assist group members in meeting therapeutic goals consistent with their worldview and values, not our own.

Ethical Aspects of Working with Values

• Members often bring a number of value-laden issues to a group: religion, spirituality, sexual orientation, abortion, divorce, and family problems. The purpose of the group is to help members clarify their beliefs and examine options that are most congruent with their own value system.

• Values are often conveyed in a subtle way, even without conscious awareness. 

Dealing with Conflicts of Values

• Consultation is best sought if facing dilemma between values and ethics

• Leaders must be clear about their own values and remain objective

• Ethical bracketing is the process of intentionality setting aside our personal values to provide ethical and appropriate counseling

• Consider the tendency for others to push their values on others and how to intervene

The Ethical Imperative of Addressing Diversity in Group Counseling

• Attending to and addressing diversity is an ethical mandate and effective

Values and Working with Diversity

• Some group norms may not be associated with cultural norms for some clients

• Examples to include: staying in the here and now, expressing feelings, asking for what one wants, being direct and honest, sharing personal problems with others, making oneself known to others, being willing to take risks, improving interpersonal communication, giving personal feedback to others, learning to take initiative, dealing with conflict, willingness to challenge, and making decisions for oneself. 

• Cultural diversity affects the issues brought to the group and ways of interaction

Ethics and Standards of Preparation and Practice

• In working with groups characterized by diversity, counselors need to be aware of the assumptions they make about people based on factors such as race, ethnicity, or sexual orientation. It is essential that the goals and processes of the group match the cultural values of the group members

• The best way to examine our own biases is to engage in experiential exercises and other meaningful encounters that require critical thinking and self-examination.

Social Justice Approach to Group Counseling

• social justice “is based on the idea that society gives individuals and groups fair treatment and an equal share of benefits, resources, and opportunities”

• By recognizing how these systems may have influenced the psychological health of members, we can ensure that the group experience does not become another force of oppression.

• main goal is for a group to provide a safe place for members to talk about painful, harmful events and to experience opportunities for healing

• Group work, perhaps more than any other counseling intervention, has the potential to further a social justice agenda 

• recommendations for integrating social justice in group work:

• Group leaders must find new ways of developing groups that will promote equity, access, participation, and harmony.

• Leaders must promote egalitarianism by educating group members about their rights and assisting them in assuming an active role in bringing about social change.

• Leaders have the responsibility to encourage discussion about identity development processes, cultural concerns, and privilege and oppression, and how these factors might affect group process and group members.

• Leaders should focus on how client systems influence group process and outcomes and conduct a cultural assessment of all group members.

• Group leaders can empower the members of their groups by building on the strengths of individual group members and the resources of the group as a whole.

Special Issues Pertaining to Sexual Orientation

• Heterosexism can leak out in various ways, ranging from blatantly discriminating to more subtle and covert messages of disapproval. Regardless of the intensity of the offense, the result can be damaging to group members and to your own status as a professional.

• In some circumstances it may be appropriate and even facilitative to self-disclose, but we caution leaders to weigh heavily the costs against the possible benefits of making certain disclosures regarding their values. Reflect on the purpose of the disclosure, and ask yourself whether you are more likely to regret making a self-disclosure or not disclosing.

• The Association for Lesbian, Gay, Bisexual and Transgender Issues in Counseling (ALGBTIC, 2008) lists these attributes of effective group counselors:

• Counselors are sensitive to the dynamics that occur when groups are formed that include only one representative of any minority culture.

• Counselors establish group norms and make interventions that facilitate the safety and inclusion of LGBTQ group members.

• Counselors strive to establish group norms and create a climate that allows for voluntary self-identification and self-disclosure on the part of LGBTQ clients.

• Counselors take an active stance when other members express either overt or covert disrespect of LGBTQ group members.

Ethical Concerns in Using group Techniques

• Techniques can be abused or used in unethical ways. Here are some ways leaders might employ techniques unethically:

• Using techniques with which they are unfamiliar

• Using techniques to enhance their power

• Using techniques whose sole purpose is to create intensity between members or within the group

• Using techniques to pressure members, even when they have expressed a desire not to participate in an exercise

• Using techniques to alter a group member’s personal values or beliefs

-  Another major ethical issue pertaining to the use of group techniques relates to providing immediate help for any group member who shows extreme distress during or at the end of a group session, especially if techniques were used to elicit intense emotions

- One way for group leaders to learn is by taking part in groups themselves. By being a group member and first experiencing a range of techniques, a therapist can develop a healthy respect for using techniques appropriately to meet clients’ needs.

Competence and Training of Group Counselors

• Experienced as well as beginning group leaders must provide only those services and use only those techniques for which they are qualified by training and experience.

Competence as an Ongoing Developmental Process

• “Best Practice Guidelines”  provide these general suggestions for increasing one’s level of competence as a group worker:

• Remain current and increase knowledge and skill competencies through activ- ities such as continuing education, professional supervision, and participation in personal and professional development activities.

• Seek consultation and supervision to ensure effective practice regarding ethi- cal concerns that interfere with effective functioning as a group leader.

• Seek appropriate professional assistance for personal problems or conflicts that are likely to impair professional judgment or work performance.

Professional Training Standards for Group Counselors

• the following standards specifically devoted to group work in which students in counseling are to develop a set of competencies:

a. theoretical foundations of group counseling and group work

b. dynamics associated with group process and development

c. therapeutic factors and how they contribute to group effectiveness

d. characteristics and functions of effective group leaders

e. approaches to group formation, including recruiting, screening, and selecting members

f. types of groups and other considerations that affect conducting groups in varied settings

g. ethical and culturally relevant strategies for designing and facilitating groups

h. direct experiences in which students participate as group members in a small group activity, approved by the program, for a minimum of 10 clock hours over the course of one academic term

Adjuncts to a Training Program

1. Personal Psychotherapy for Group Leaders

2. Self-Exploration 

3. Group Supervision

Guidelines for Ethical and Legal Practice

• Ethical and legal issues are frequently intertwined, which makes it imperative that group practitioners not only follow the code of ethics of their profession but that they also know their state’s laws and their legal boundaries and responsibilities.

Legal Liability and Malpractice

• Group counselors who fail to exercise due care and act in good faith are liable to a civil suit

• Some aspects of this standard of care involve keeping careful records, consult- ing when necessary, and documenting your consultations. Consult and document all ethical and legal issues as well as the clinical implications that arise during your groups

Legal Safeguards for Group Practitioners

• Guidelines that follow are useful in translating the terms reasonable, ordinary, and prudent into concrete actions.

1. Take time and exercise care in screening candidates for a group experience.

2. Give the potential members of your groups enough information to make informed choices about group participation, and do not mystify the group pro- cess. Develop written informed consent procedures at the outset of a group, and make sure that you review this information with the members. Doing this will go a long way toward building a trusting climate.

3. Obtain written parental or guardian consent when counseling minors in groups. This is generally a good practice even if not required by state law. However, know that if a parent or guardian denies this consent, the minor will not be able to participate in the counseling group.

4. Keep records of group sessions in compliance with codes of ethics and institutional policies. Keep relevant notes on each group member and each group session, especially if there are any concerns about a particular member.

5. Be aware of those situations in which you legally must break confidentiality. Explain to members the limits of confidentiality, such as when it must be breached.

6. Restrict your scope of practice to client populations for which you are prepared by virtue of your education, training, and experience.

7. Be aware of the state laws and the ethical guidelines of various professional organizations that limit your practice, as well as the policies of the agency for which you work. Inform members about these policies, and practice within the boundaries of these laws and policies.

8. Make it a practice to consult with colleagues or clinical supervisors whenever there is a potential ethical, legal, or clinical concern. Clearly document the nature of the consultation.

9. Have a clear standard of care that can be applied to your services, and communicate this standard to the members. The best safeguard against legal liability is to practice good client care.

10. Document reasons for a group member’s termination and any referrals or recommendations given.

11. Do not promise the members of your group anything you cannot deliver. Help them realize that their degree of effort and commitment are the key factors in determining the outcomes of the group experience.

12. Do not engage in sexual relationships with either current or former group members.

13. Make it a practice to assess the general progress of a group, and teach mem- bers how to evaluate their individual progress toward their own goals.

14. If you work for an agency or institution, have a contract that specifies the employer’s legal liability for your professional functioning.

15. Learn how to assess and intervene in cases in which group participants pose a threat to themselves or others, and be sure to document actions taken.

16. Recognize when it is appropriate to refer a group member for another form of treatment.

17. Remain alert to the ways your personal reactions might inhibit the group pro- cess, and monitor your countertransference.

18. Be careful of meeting your own needs at the expense of the members of your group.

19. Incorporate established ethical standards in your practice of group work. Following the spirit of the ethics code of your professional organization is important.

20. The best way to protect yourself from a malpractice suit is to take preventive measures, such as not practicing outside the boundaries of your competence and creating collaborative relationships with the members of your groups.

21. Attend risk management workshops periodically with the goal of familiariz- ing yourself with current standards of practice.

22. Realize that you will never be completely safe from a potential claim or law- suit, regardless of how competent and ethical you are. However, proactive risk management strategies can lessen the possibility of such claims. Carry malpractice insurance.

Ch. 4- Theories and Techniques of Group Counseling- Alyssa

Introduction pg 99

• A theory is important:

  • Structure for appropriate interventions and evaluating outcomes of group as a whole and of the individuals 

  • A way of organizing information you get from the multiple interactions within a group. 

  • Important to develop a personal stance toward the practice of group counseling that fits the person you are and is flexible enough to meet the unique needs of the members that make up the group.

Theory as a Roadmap 

Our Theoretical Orientation 

• None of us subscribe to any single theory in its totality. Rather, we function within an integrative frame- work that we continue to develop and modify as we practice. We draw upon concepts and techniques from most of the contemporary therapeutic models and adapt them to our own unique personalities, our therapeutic styles, and to the needs of the members of a particular group

• Integrative approach involves the process of selecting concepts and methods from a variety of systems. Integrative counseling is an intentional process of selecting concepts and methods from a variety of therapeutic systems. An integrative perspective is well suited to meeting the diverse needs of members that are typically found in many groups.

• Technical integration tends to focus on differences, uses techniques drawn from many approaches, and is based on a systematic selection of techniques. 

  • Combines techniques from different schools without necessarily subscribing to the theoretical positions that spawned them. 

• Theoretical integration refers to a conceptual or theoretical creation beyond a mere blending of techniques. 

  • The synthesis of the best of two or more theoretical approaches offers richer possibilities than restricting practice to a single theory. 

• Knowing when and how to use a particular therapeutic intervention ask these questions:

  • What is occurring in the group from moment to moment?

  • What kind of relationships am I developing with the members of my group?

  • What role(s) do I take in the group, and how does this influence the group process?

  • What techniques am I drawn to, and can I explain why I am using various techniques?

  • How do I evaluate my client’s strengths and resources, define problems and solutions, and think about desired outcomes?

• A Thinking, Feeling, and Behaving Model: attending to the cognitive, affective, and behavioral domains. There is a reciprocal interaction between what people are thinking, and how these thoughts influence what they are feeling and doing. 

  • Can have an underlying philosophical leaning toward the existential approach, which places primary emphasis on the role of choice and responsibility in the therapeutic process

  • In addition to focusing on thinking, feeling, and behaving, help group members in consolidating what they are learning and encourage them to apply new behaviors to every day

    • Examples: contracts, homework, action programs, self-monitoring techniques, support systems, and self-directed programs of change

Developing Your Own Theory of Group Practice 

• Your theory needs to fit your population, setting, and the type of group you offer. Theory is an extension of your personality. 

• Draw on your life experiences and personal characteristics. Particularly important to become aware of and examine how your behavior, personality, culture, status, and privilege might enhance or hinder your work as a group leader. 

Using Group Techniques Effectively 

• Virtually anything a group leader does could be viewed as a technique, including being silent, suggesting a new behavior, inviting members to deal with a conflict, offering feedback to members, presenting interpretations, and suggesting homework assignments to be done between group sessions. 

• A technique refers to a leader’s explicit and directive request of a member (or members) for the purpose of focusing on material, augmenting or exaggerating affect, practicing behavior, or consolidating insight and new learning.

  • Techniques are the tools and interventions used to facilitate what is going on in a group.

• Techniques are adapted to the needs of the group participants, and we consider several factors: 

  • the purpose and type of group, 

  • readiness of members to deal with a personal concern, 

  • cultural background, 

  • value system, 

  • trust in us as leaders

  • the level of cohesion and trust among group members

Rationale for Use of Techniques 

• The rationale for techniques/ ask these questions:

  • Why did we use this particular technique?

  • What did we hope to accomplish by using a technique?

  • What did we expect the group members would learn from the intervention?

  • What theoretical framework guided our choice of a technique?

• Use following guidelines to increase effectiveness of techniques introduced in a group 

• Techniques used have a therapeutic purpose and are grounded in some theoretical framework.

• Techniques (and exercises) are presented in an invitational manner; members are given the freedom either to participate in or to not participate in a given experiment.

• Techniques are introduced in a timely / sensitive manner and are abandoned if they don’t work

• Techniques are modified so they’re suitable for group’s cultural / ethnic background.

• Participants have a chance to share their reactions to the techniques or activities used.

• The client’s self-exploration and self-understanding is fostered.

Viewing a Group Through a Multicultural Lens

• Leaders need to be aware of the power frequently attributed to them by group members and recognize that they may symbolize various institutions of oppression for some members. When introducing exercises or suggesting experiments, it is essential for leaders to be mindful of being invitational and not abusing the authority and power often given to them by group members. 

• Leaders need to be aware of the power frequently attributed to them by group members and recognize that they may symbolize various institutions of oppression for some members. When introducing exercises or suggesting experiments, it is essential for leaders to be mindful of being invitational and not abusing the authority and power often given to them by group members. 

• Western therapeutic models: choice, the uniqueness of the individual, assertiveness, personal growth, and a strong ego.

  • Therapeutic outcomes: improving assertive coping skills by changing the environment, changing one’s coping behavior, and learning to manage stress. 

  • Western therapeutic models: CBTs and relationship-oriented approaches

    • are oriented toward individual change. 

• Non-Western cultures: social framework, interdependence, play down individuality, think of the collective good, and emphasize healing in community. 

• Asians, Latinos/as, and African Americans often come from collectivistic cultures. Many Asian cultures stress self-reliance- may remain quiet and not disclose personal problems or personal details. 

• The goals, structure, and techniques used in a group need to be modified to make a group culturally appropriate and inclusive of members’ various worldviews. In an increasingly pluralistic society, there is an ethical imperative to avoid forcing all clients to fit a mold that may not be appropriate for their cultural background.

Relationship of Theories to Techniques 

• Key concepts and techniques of counseling theories (Overlapping concepts make it difficult to neatly compartmentalize these theoretical orientations.)

1. Psychodynamic approaches stress insight in therapy (psychoanalytic and Adlerian).

2. Experiential and relationship-oriented approaches stress feelings and subjective experiencing (existential, person-centered, Gestalt therapy, and psychodrama).

3. Cognitive behavioral approaches stress the role of thinking and doing and tend to be action-oriented (behavior therapy, cognitive therapy, rational emotive behavior therapy, and reality therapy).

4. Postmodern approaches stress understanding the subjective world of the client and tap existing resources for change within the individual (solution- focused brief therapy, narrative therapy, motivational interviewing, and feminist therapy).

Psychodynamic Approaches 

• Psychoanalytic therapy is based largely on insight, unconscious motivation, and reconstruc- tion of the personality.

• Adlerian therapy differs from psychoanalytic theory, but it can be considered from a psychodynamic perspective. 

  • Focus on meaning, goals, purposeful behavior, conscious action, belonging, and social interest. Although Adlerian theory accounts for present behavior by studying childhood experiences, it does not focus on unconscious dynamics.

Psychoanalytic Approach 

-KEY CONCEPTS

• Psychoanalytic group therapy consists of a lengthy process of analyzing inner conflicts rooted in the past. 

  • Focuses on the influence of the past on current personality functioning. 

  • Experiences in first 6 years of life seen as roots of one’s problems in the present. 

  • Interested in members’ past, but also intertwine that understanding with the present and with the future. 

  • The past is relevant as it influences the present & future (all 3 important in group)

• Longer-term analytic group therapy is largely a process of restructuring the personality, which has broader treatment goals than most approaches. 

• Brief psychodynamic group therapy approaches address more modest goals in a limited time frame

-THERAPEUTIC GOALS

• A primary goal is to make the unconscious conscious. Rather than solving immediate problems, the goal is the restructuring of personality. 

• Success of psychoanalytic therapy = change in personality and character structure.

-THERAPEUTIC RELATIONSHIP

• Range from leaders characterized by objectivity, warm detachment, and relative anonymity to those who are collaborative with group members. 

• A development of psychoanalytically oriented group therapy is the growing recognition of the central importance of the therapeutic relationship. Establishing a working relationship (therapist communicates caring, interest, and involvement) is now preferred model.

-TECHNIQUES

• Include maintaining the analytic framework, free association, interpretation, dream analysis, analysis of resistance, and analysis of transference.

• Two key factors in group: how transference and countertransference play out in the context of the current group situation

• The group constellation lends itself to multiple transferences that provide for reenacting past unfinished events

• a basic tenet of psychodynamic therapy groups: group members, through their interactions within the group, re-create their social situation, implying that the group becomes a microcosm of their everyday lives. 

• Leader has task of helping members discover the degree to which they respond to others in the group as if they were their parents or siblings. 

• A psychoanalytic group provides a safe, neutral environment in which members can express spontaneous thoughts and feelings, and the group is a conducive milieu in which to relive significant past events.

• By reliving the past through the transference process, members gain increased awareness of the ways in which the past is obstructing present functioning. 

• countertransference of the group leader, whose feelings may become entangled in the therapeutic relationship with members, obstructing objectivity. Countertransference can be viewed as the group therapist experiencing feelings from the past that are reactivated by the group member in the present

  • group therapists react to members as if they were significant figures of their own original family. Group leaders need to be alert to signs of their unresolved conflicts that could interfere with their leadership and create a situation in which members are used to satisfy their own unfulfilled needs.

-MULTICULTURAL

• Take into account clients’ cultural context and ways early experiences provide a new understanding of current problems

The Adlerian Approach 

Experiential and Relationship-Oriented Approaches 

The Existential Approach 

The Person-Centered Approach 

Gestalt Therapy 

Psychodrama 

Cognitive Behavioral Approaches 

Behavior Therapy 

Cognitive Therapy 

Rational Emotive Behavior Therapy 

Choice Theory/Reality Therapy 

Postmodern Approaches 

Solution-Focused Brief Therapy

Narrative Therapy 

Motivational Interviewing 

Feminist Therapy 

An Integrative Approach 

Points to Remember page 147

Ch. 5- Alexa

Introduction:

-Groups have become increasingly popular and have been designed to meet  both the needs of clients and the demands of agency settings.

-Group members have opportunities to gain insight and to practice new skills, both within  the group and in their everyday interactions outside of the group. 

 -Feedback  from other group members and the counselor help members gain new perspectives.

-Groups offer many opportunities for modeling, and members often learn  how to cope with their problems by observing the work of others with similar  concerns. 

-The more clearly you can state your  expectations as early as possible, the better you will be able to plan and the  more meaningful the experience is likely to be for participants.

Forming a proposal

1. Rationale. Do you have a clear and convincing rationale for your group, and  can you present data to support your rationale? Are you able to answer questions that might be raised about the need for this group?  

2. Objectives. Can you clearly state what you most want to attain and how you  will go about doing so? Are your objectives specific, measurable, and attainable within the specified time?  

3. Practical considerations. Is the membership denied? Are meeting times, frequency of meetings, and duration of the group reasonable? Is the physical  location of the group easily accessible to all members?  

4. Procedures. Have you selected specific procedures to meet the stated objectives? Are these procedures appropriate and realistic for the given population?  

5. Evaluation. Does your proposal contain strategies for evaluating how well  the stated objectives were met? Are your evaluation methods objective, practical, and relevant? 

-when wanting to form a group, it is important to come up with a proposal that will be accepted by your team.

-answering questions such as: How many members will be in the group? Where will the group meet? How  often will it meet? How long will each meeting last? What structure will the group have? What techniques will be used? Why are  these techniques appropriate?

-this best way to get the word out about a new group is to make personal contact with people. It is also important to tell your colleagues, as they can help you throughout the process

-it is important to give an informed consent document for  your group, which gives an accurate picture of the group, and avoid making promises  about the outcomes of the group that may raise unrealistic expectations.

arranging for screening and selecting the members who will make up the group.

-When selection of group members is appropriate, Group Workers identify group members  

             whose needs and goals are compatible with the goals of the group”

-The goal of  screening is to prevent potential harm to clients, not to make the leader’s job

             easier by setting up a group of homogeneous members.

-You may want to put together a group of individuals who share  common experiences but

             also are different in a number of respects.

-Ultimately, the type of group should determine the kind  of members accepted.

Preliminary Screening Sessions

-We support screening procedures that include a  private session between the candidate and 

the leader. In the event there are co-leaders, ideally they would interview each of the 

potential group members together. 

-During the individual session, the leader or co-leaders might look for  evidence that the group will be beneficial to the candidate.

-it is important that candidates are asking questions as well

-group counseling is contraindicated for individuals who are suicidal, extremely fragmented or acutely  psychotic, sociopathic, facing extreme crises, highly paranoid, or extremely selfcentered (Yalom, 2005b). 

-Factors that must be taken into  consideration are the level of training of the leader, the proposed makeup of  the group, the setting, and the basic nature of the group.

-if you can not screen the group, and it is given to you, it is important to still orientate them

-one factor we look for during the interview is the degree to which a  candidate wants to make changes and is willing to expend the necessary effort. 

-it is important to think about whether or not the candidate with fit in the with the members of the group

-we do not accept people, we tell them how the group might not be appropriate for them. We strive to break the news in a manner that is honest, direct,  respectful, and sensitive, and when possible we suggest other options.

Group composition

-Similar group members can lead to a great degree of cohesion, which in turn allows for an open and intense  exploration of their life crises.

Group size 

-a group composed of elementary school children might be kept to  3 or 4, whereas a group of adolescents might be made up of 6 to 8 people. There  may be as many as 20 to 30 children in developmental group guidance classes. For  a weekly ongoing group of adults, about 8 people may be ideal.

Meeting time

-With children and  adolescents, it may be better to meet more frequently and for a shorter period to  suit their attention span.

-For groups of relatively well-functioning adults, a 2-hour weekly session might be preferable. This  2-hour period is long enough to allow some intensive work yet not so long that  fatigue sets in.

-For an inpatient group composed  of lower functioning members, it is desirable to meet on a daily basis for 45 minutes.

-Even for higher-functioning inpatient  groups, it is a good practice to meet several times a week, but these groups might  be scheduled for 90 minutes. 

Length of groups

-highschool/college—--------15 weeks

-elementary/middle —--------------6-8 weeks

-The advantages of time-limited groups are that the  time span allows for cohesion and productive work and that members can then  continue practicing newly acquired interpersonal skills with a new group of people.

Place

-meet in a private space with no distractions

-in a circle

-co-leaders sit on opposite sides of each other to read body language 

Open vs. closed groups

Open 

-groups are characterized by changing membership. As certain members  leave, new members are admitted, and the group continues.

-increased opportunity for members to interact with a greater variety of people.

-disadvantage of open groups is that rapid changing of members can result in a  lack of cohesion

-Rather than taking group  time whenever a new person is included, he covers the rules with the new member  as part of the intake interview. 

-He also asks other members to teach the new member about a few of the guidelines in an attempt to have them take more responsibility for their own group.

-Cohesion is possible, even in cases where members attend only a few  times, but a high level of activity is demanded of inpatient group therapists.

-These  leaders must structure and activate the group. 

-They need to call on certain members, they must actively support members, and they need to interact personally  with the participants (Yalom, 1983). 

Closed 

-Closed groups  typically have some time limitation, with the group meeting for a predetermined  number of sessions. 

-Generally, members are expected to remain in the group until  it ends, and new members are not added.

Pre group preparation

-is positively associated with  group cohesion and members’ satisfaction with their experience (Burlingame et  al., 2004b); preparing members for a group experience is a key aspect of informed  consent (Rapin, 2014).

-A thorough orientation sets the  stage for later development of leader–member and member–member therapeutic  relationships

-When goals, role requirements, and behavior expectations are  understood by members from the outset, therapeutic work proceeds more effectively.

-reduces anxiety  

-At this initial session, or at the pregroup meeting, the leader explores the  members’ expectations, clarifies the goals and objectives of the group, imparts  some information about group process, and answers members’ questions.

-What is labeled “resistance” could be the result of  a failure on the leader’s part to adequately explain what groups are about, how  they function, and how members can become actively involved.

Clarifying leader and member expectations 

-The pregroup session is the appropriate time to encourage members to express  the expectations they are bringing with them to the group. 

We typically begin by  asking these questions: 

• What are your expectations for this group?  

• What did you have in mind when you signed up? 

-We also share our expectations by giving members an idea of why we designed  the group, what we hope will be accomplished, and what we expect of ourselves  as leaders and them as members.

Goals of pre-group preparation

-As a leader, during the screening and pre-group meetings it is  important to clarify what needs can or cannot be met within the  group.

-great deal can be done to prevent  unnecessary anxiety by allowing members to talk about their reactions to coming  to the group and by considering ways the group can lead to their empowerment. 

-make sure to talk about rules each group and confidentiality if it is an open group

Co-leaderhsip

-you are co-leading a group,  it is useful for you and your co-leader to have equal responsibility in forming the  group and getting it going.

-clear about the purpose of the  group, what you hope to accomplish with the time you have, and how you will  meet your objectives.

-both meeting to develop a  proposal, and ideally both of you will present it to the appropriate authority.

-You and your co-leader will  be a team when it comes to matters such as announcing and recruiting for membership; conducting screening interviews and agreeing on whom to include and  exclude; agreeing on basic ground rules, policies, and procedures and presenting  them to members; preparing members and orienting them to the group process;  and sharing in the practical matters that must be handled to form a group. 

Ch. 6- Jessie

Introduction pg 175

Group Characteristics at the initial stage

• Central process of this stage is orientation and exploration 

• Members are getting acquainted, learning how the group functions, developing norms, and exploring their fears and hopes pertaining to the group

Early concerns 

• Members may be hesitant to get involved

• May be moments of silence and awkwardness

• Trust can be lost or gained based on how the leader handles conflict or the initial expression of any negative reactions 

• Group leaders task is to be aware of the tentative nature of exploration and treat critical comments non defensively and with acceptance 

Initial Hesitation and Cultural Considerations 

• Group leaders need to be aware that hesitation to participate may be the result of their cultural background not being uncooperative 

• As a group leader you can minimize reluctance by inhibiting a discussion of how they could participate in the group in a way that does not violate their cultural norms and values

Identifying and Exploring Common Fears of Group Members

• A good way to deal with members fears is by listening to them and encouraging full expression of their concern 

• You can break the group into smaller groups to make talking about fears more comfortable and allow the members to get to know each other

Hidden Agendas

• A common form of resistance is the presence of a hidden agenda, an issue that is not openly acknowledged and discussed 

  • Ex: members not talking because they are scared on of the members will gossip

• If encouragement to face these issues is lacking, trust is low, interpersonal tensions, emerge, members are guarded, and the leader seems to be working harder than the members

• Group issues that do not get talked about almost always develop into a hidden agenda that immobilizes individuals and shatters trust in the group 

Address Conflict Early

• Conflict is most common during the transition stage

• It is critical that the leader teaches the norm of appropriate and effective confrontation 

Self Focus versus Focus on Others

• Many members in beginning groups tend to talk about others and situations outside of the group instead of dealing with their own feelings 

• Group leaders primary task is to get group members to focus on themselves 

Here and Now Focus vs There and Then Focus

• Some groups focus on what it occurring right now in the room other groups largely focus on outside problems