NCE Section 4- Group Work/ Group Counseling/ Clinical and Programmatic Interventions 3/18/2024

Betsy describes herself as a religious person and often states a religious reason for her convictions. One of the members of the woman's group discloses that she is in love with another woman. Betsy, in response to the disclosure, calls the member a "Dyke and states that she is going to hell." What role has Betsy taken on in the group? a. Self-righteous Moralist b. Rescuer c. Informer d. Authoritarian

A) Self-righteous moralist. The moralist has the need to always be right and believes that everyone else is wrong. She is the "authority on all moral issues".

Bob shares that depression is the leading cause of disability in the U.S. after another group member shares her struggle with it. He is playing the group role of: a. The information giver b. The opinion giver c. The procedural technician d. The encourager

A) information giver- gives pertinent facts or generalization to help the group discussion

In terms of a process group, pre-screening clients _____________________ group member satisfaction. a. Increases b. Decreases c. Has no effect on

A- Yalom noted that pre-group preparation increases member satisfaction with the overall group experience.

Rebecca makes an insensitive comment to another group member with racist overtones. Another female group member confronts her on her racial overtones and Rebecca cries out, "I don't understand why you all are attacking me?" She looks over at Bill as she starts sobbing. Bill reaches to across the group to hand her a tissue and suggests that the group change the subject. What role has Rebecca taken on? a. Hostile Member b. Seducer c. Rescuer d. Self-Righteous

B) Seducer. A seducer uses subtle attempts to manipulate and control other members of the group. She may play the victim or may act or pretend to be fragile in attempt to get others to either sympathize with her, reach out to her, or even rescue her.

Generally speaking, group size with kids in relationship to adult groups should be: a) larger b) smaller c) about the same

B- children's groups should be about half the size of adult groups.

Which of the following is not a type of group role? a) Blocking b) Task c) Maintenance d) None- all of the above are group roles

D

Alysia helps you pass out hand-outs and then gather them at group's end. Her role is: a. As group observer b. As recognition seeker c. As procedural technician d. As help-seeker

c) Procedural technician- expedites group movement by doing things for the group that moves it along

T-group has how many members?

12-15 and has a focus on specialized training

Therapy group has how many members?

6-8 people and is a formal and structured process

What is an optimal group size?

6-8. Groups with too few members have limitations in terms of preocessing roles, group dynamics, and the amount of feedback offered to others. Groups of 10+ prove to be difficult to manage, and time may not allow for adequate processing or attention to each member's needs

Which of the following roles does the information giver play in a group? a) task role b) maintenance role c) blocker role d) peripheral role

A) An information giver completes a task (offering information)

Penny tells the group that she doesn't know why her boyfriend puts up with her. She pulls up her sleeve to reveal a bandaged arm and tells the group she had to go to the ER to get stitches after she cut herself. She is playing the _________________ role, which is a ___________________ role. a. Help-seeking, blocking b. Initiator, task c. Opinion giver, maintenance d. Standard setter, maintenance

A- Help-seeking roles call forth a sympathy response from the group through insecurity, self-deprecation, or confusion. This blocks the group from moving forward.

A counselor is setting up group therapy screening appointments. She gathers the information that she will give the members to help them understand the process of being part of a therapy group. The best predictor of client success in a therapy group is: a. Commitment b. Dispelled myths about group c. What role one takes on d. Their level of participation

A- Members that commit to change tend to attain positive outcome and therapeutic benefit from group therapy.

Which of the following is not an appropriate step in preparing the group for termination? a) Not giving giving members an opportunity to express their feelings about the ending of the group to protect them from emotional distress. b) Providing members with suggestions on how to apply what they have learned in groups to their real lives. c) Preparing group members for the realities of the problems they may face outside as they leave the group. d) Providing members with referrals to other counesling, therapy, and community services.

A- Not giving members an opportunity to express their feelings about the ending of the group is NOT an appropriate step.

A student doing her group practicum makes an observation that Donna has shifted from the group observer role to the gatekeeper role in your psych-ed group. The proper response is that: a. She's right, the sign of a healthy group is when clients can change roles b. She's incorrect, members can shift roles, but only from task to maintenance roles c. She's incorrect, members do not ever shift roles d. There are no roles in a psycho-educational group

A- all groups, regardless of type, produce roles. In a healthy group, members are flexible and shift roles in an ongoing manner, both ways from task to maintenance and vice versa.

This week the group leader begins group with an idea that the group should role play. The suggested scenario is that group members will act as a dysfunctional family. Members are to "act out" a better way to communicate with coaching from the group members. This type of creativity in group work on behalf of the group counselor is called: a. Inventiveness b. Crystallization c. Empathy work d. Triangulation

A. Inventiveness- the ability to be spontaneous and creative as a group counselor.

Mike, a group member in his 20s, tells a group member about a support group and a coping strategy he finds beneficial. This is an example of which curative factor? a. Imparting of information b. Catharsis c. Imitative behavior d. Group cohesiveness

A. When members and leaders offer useful information for group participants about mental health, they are imparting information.

A counselor notices that, as her group develops, it is becoming a little chaotic as members attempt to jockey for positions in the group. According to Bruce Tuckerman's Five Stages of Group Development, what stage of development is this group in? a. Forming b. Storming c. Norming d. Performing

B- Storming. Where members are becoming restless with one another and there is a chaotic competition for leadership among the group members. This is the trial of the group process, where all the personalities and personal agenda emerge and begin to clash against each other.

Maria, a 43-year-old woman going through a career change, disagrees with what someone in group said. She recognizes that, although many heads are nodding at the other group member's idea, she simply has a different opinion. She most likely feels free to speak up because: a. The group is storming and she should find a sub group to which to belong. b. The group is in the performing stage. c. The group is just forming and she needs to let her opinion be known now. d. The group is adjourning and she should say it quickly and leave so she can't be judged.

B- The group is in the performing stage. Although it's possible that Maria is to speak and leave, it is likely she recognizes and respects each member's opinion and contribution, including her own. In the performing stage, differentiation develops and gains respect and open feedback is expressed shared.

A group member tells another that he did not appreciate a comment he made during the last group, and he did not think he should let it go. During a silent pause, John cracks a joke. John is playing the role of: a. Compromiser b. Harmonizer c. Energizer d. Playboy/playgirl

B- The harmonizer of a group reconciles differences between others by relieving tension.

Which of the following might be inappropriate for a group? a) a mother with post-partum b) a young adult with bi-polar that is easily irritated c) a recent retiree with generalized anxiety d) and 18 year old with school refusal

B- Those that display impulsive behaviors and/or anger present a risk for the group. Other groups that produce risk include those with psychosis/paranoia, those with substance abuse or dependence, and those with psychosocial tendencies.

Dawn is facilitating a substance use disorders group and several of the group members are new. As one group member talks about how he is fighting for custody of his daughter, Dawn turns to another group member and points out the similarities in his experience. Dawn's connection of the two members can be referred to as- a. Chaining b. Linking c. Connecting d. Sharing

B- linking is connecting on group member's experiences to another. The purpose is to highlight the sameness and mutual experiences of the two to create cohesion in the group.

If a counselor is interested in starting a psycho-educational group for people who are grieving the loss of a pet in the community, the counselor would have to ______________________ for members. a) assess and diagnose b) recruit and screen c) plan and organize d) find resources and referrals

B- recruit and screen

The group believes that the scapegoat is only a problem because of ____________. a. group forces b. individual differences c. changes in roles d. an Ineffective leader

B- the group believes that if the scapegoat would change, the group would resume normal functioning, and they see the scapegoat's problems as a result of the scapegoat's personality characteristics, and as independent from the group dynamic.

The concept of the group as an entity dates back to: a. 1992 b. 1895 c. 1905 d. 1940

B. 1895. According to Rutan and Stone, the scientific study of effects began as early as 1895 when LeBon referred to the phenomenon of "the group mind", MacDougall also observed that groups have the potential to enhance individual behavior.

After the group session, one counselor asks his co-facilitator, "It's been six weeks, so what changes do you see taking place in the group?" This group counselor is: a. Participating in the group b. Evaluating the group c. Auditing the group d. Re-organizing the group

B. Evaluating the group- An effective group counselor will take time after every group session to reflect and evaluate the group process and dynamics that are taking place.

Imanji is quiet and says or contributes very little to the group. She is agreeable and easily goes along with whatever the group wants or decides to do. When invited to participate she tends to decline and prefers to just fade into the background and observe the group. What role has Imanji taken on in the group? a. Referee b. Follower c. Compromiser d. Standard Setter

B. Follower

Jacob, a 32-year-old man with severe anxiety, has been in the group for nine months and has decided it's time for him to move on. During his last group, he discusses how the group is one of the only places he ever felt as if he belonged. He is expressing which curative factor? a. Imparting information b. Group cohesiveness c. Existential factors d. Altruism

B. Group cohesion allows members to feel a sense of belonging and group identity.

According to Gladding and Corey, group member anxiety may increase during this stage. a. Initial b. Transition c. Working d. Completing

B. It is in the transition stage that gladding and corey found an increase in anxiety as the group members settled into their roles and became more comfortable with the group. This would result in the group leader being challenged.

Andy always arrives to group early. He takes the initiative to help set up the chairs, make coffee and set out any refreshments. After the group session has ended Andy always stays after to put away the chairs and clean up. Andy volunteers to do this on his accord. What role has Andy taken on in the group? a. Recorder b. Procedural Technician c. Janitor d. Volunteer

B. Procedural Technician

You started a group a month ago. You notice this week that people have settled into a consistent seating arrangement and are having side conversations with those next to them before and after group. Three participants in particular have pulled you aside and told you that one of the other group members is annoying them by monopolizing the group time. This is characteristic of: a. The forming stage b. The storming stage c. The adjourning phase d. The performing stage

B. The storming stage- during this phase, sub groups form as members try to establish a status hierarchy.

A support group for people experiencing divorce is ready to move to the topic of discussing forgiveness. Maria is the only member of the group who is resistant to this idea. Maria's negative behavior in the group distracts the group from moving forward. What role has Maria taken on?

Blocker

Desiree has been working at a local community mental health center for several months and she has been asked to assist with their quarterly new patient group. When Desiree arrives, she is shocked to find over 50 people at the center. This group is likely a: a. T-group b. Therapy group c. Encounter group d. Marathon group

C) Encounter group. An encounter group can have 8-200 members with a specified or open-ended format.

Matthew is a new member in a substance abuse recovery group and appears quiet and shy. Stanley, who is a veteran to the group, begins to bombard Matthew with a lot of over-whelming questions. Matthew is obviously uncomfortable by Stanley's interrogation. What should the group counselor do in this situation? a. Stay silent b. Silence the group to give Matthew a chance to answer c. Block Stanley from interrogating Matthew d. Change the subject

C- Block Stanley from interrogating Matthew. It is a responsibility of the counselor to keep its group members safe.

Nancy states that she is afraid to fill out an online job application. Bob, quickly volunteers to help her. The group counselor says to Bob, "Thank you Bob for offering but I'm not sure that is good idea. Remember Nancy's goal is to become more independent. Nancy, I believe that you are quite capable of doing this on your own. You have what it takes!" What is the group counselor demonstrating in this statement? a. Empathy b. Confrontation c. Support d. Blocking

C- Support. The skill of a group counselor to demonstrate support to every group members requires knowledge of when "supportive behavior" is helpful/therapeutic and when it is enabling and counter-productive.

The same student notes that Mark seems to be assuming the harmonizer role, in addition to his information giving and initiator roles. The proper response is that: a. She's incorrect, no one takes on more than one role at a time in group b. She's incorrect, a group member cannot take on more than two roles at a time in group c. She's right, members can shift and take on a limitless number of roles in group d. She's right, harmonizing always comes from taking initiative

C- group members can take on multiple roles at one time, and in a healthy group, they can shift between roles.

Jack is a 48-year-old man with first-break psychosis. He has been medicated, and still has some transient paranoia. Which statement is most true? a. Jack would make an excellent group therapy candidate. b. Jack would most likely not benefit from group. c. Jack would most likely not benefit from group and he could impair the group process. d. Jack would likely not only benefit from group therapy himself, but he would be a therapeutic force for others in the group.

C- those with paranoia or psychosis and who are out of touch with reality have difficulty trusting. This would be disruptive to the group process.

Of the following, which is not a curative factor of a group, as outlined by Yalom. a. universality b. instillation of hope c. intrapersonal learning d. group cohesiveness

C. IntERpersonal learning is a curative factor.

Jose always keeps a pen and pad handy and keeps notes of any pertinent information, decisions, ideas or plans that the group makes during the session. What role has Jose taken on in the group? a. Personal Assistant b. Progress Note Writer c. Recorder d. Group Historian

C. Recorder

You refer Holly to a grief support group. She has also been attending your coping skills training group. She asks if she can stop coming to the coping skills training group you have been running, because it seems redundant with the grief support group. Your best answer to Holly would be: a. "Holly, you're right. Let's put the coping skills group on hold for now." b. "Not exactly Holly, the grief support group is a psycho-educational group and the coping skills training group is a support group." c. "Not exactly Holly, the grief support is a support group and the coping skills training group is a psycho-educational group." d. "Not exactly Holly, the grief support group is a psychodynamic group and the coping skills training group is a psycho-educational group."

C. The grief support group is a self-help, support group. Any group with education as a goal is psycho-educational in nature, and it is not a support or self-help group since it is run by a counselor who is the leader.

It is Jack's first group. He was quite ambivalent about coming. Several of the members discuss where they have been compared to their more peaceful state in the moment, and they talk about how the group has helped them. From noting their progress, Jack will likely experience: a. Catharsis b. Existential factors c. The instillation of hope d. Universality

C. The instillation of hope occurs when group members gain confidence in the group process to help them recover.

Which of the following is not an accepted personal characteristic of a group counselor? a)presence b)courage c)humor d)hubris

D) Hubris- Hubris or conceit is not a good characteristic of a group counselor. Group counseling is never about the counselor, but about the group.

One advantage of group work is? a) elitism b) cultural collectivity c) equal access d) economy of approach

D- Economy of approach is one of the advantages of group work. Individual therapy can be costly but group work is more cost effective because several people can receive treatment at one time by 1 or 2 group leaders with the added benefit of community and connection.

Samuel is very encouraging with other members of the group. He is warm and friendly and agreeable. He is always praising other members of the group and wants to always have a good and positive experience in group. What group vitalizing or maintenance role has Samuel taken on in the group? a. Harmonizer b. Compromiser c. Brown-noser d. Encourager

D- Encourager.

Which of the following can be a benefit to group members when participating in therapeutic groups? a) corrective recapitulation of the primary family group b)Development of socialization techniques c) The learning and adaptation of new behavior d) all of the above

D- Group members can reach all of these benefits.

A group member discloses that they are struggling with forgiving their absentee father. The group leader discloses how difficult it was for him and how he was able to eventually forgive the father that was not in his life for 30 years. This group counselor is demonstrating what technique? a. Diagnosing b. Evaluating c. Counter-transference d. Modeling

D- modeling. Modeling is one of the best ways a group counselor can teach desired behavior by demonstrating, disclosing, or giving examples to the members of what the appropriate behavior looks like.

After forming, a group has found a nice rhythm and starts to work through and reach their goals. According to Bruce Tuckerman's Five Stages of Group Development, what stage is the group in? a. Forming b. Norming c. Storming d. Performing

D- performing. Where members are participating and doing work. A group in this stage is meeting objectives and reaching its goals. The members know and accept each other and are able to work together and trust each other.

Benefits to having a group co-leader include which of the following? a. managing issues of counter-transference from either leader b. group continuity when one leader is absent c. different points of view and different observations d. all of the above

D. All of the above. Group co-leadership assists the leaders to notice and work through their countertransference in a therapeutic way, while relying on the other group leader to take over when needed. Differing perspectives enrich the group process and the continuity of any group remains crucial to its success.

Joe is an elderly gentlemen who attends a support group for people who have lost their spouse. This support group has been a real source of support for Joe and he really enjoys attending. Each week Joe brings something to group whether it's an article or idea. He is always contributing new insights and ideas to the groups. What role has Joe taken on in the group? a. Compromiser b. Harmonizer c. Coordinator d. Initiator

D. Initiator

Which of the following are appropriate rituals for termination? a. gift giving b. handshakes/hugs c. sharing of food d. all of the above e. both a and b only

D. Promoting a therapeutic good-bye can correct past negative termination experiences and set the stage for positive ones in the future.

Leaders in psychodynamic groups: a. Are very active b. Are relatively passive c. Guide rather than lead d. Both b and c

D. Psychodynamic groups are meant to allow anxiety to rise in the group as the group leader takes a more passive role. This anxiety allows for the emergence of unconscious material for processing.

Which of the following should be part of termination from a group? a. A review and reinforcement of changes and growth that occurred while in group b. a ritual c. Appropriate referrals d. All of the above e. Both a and c only

D. These factors should occur for proper termination and a ritual helps foster and bring closure.

Termination in time limited groups should include a discussion of: a. the group as an entity and it's cohesiveness b. individual relationships that formed between members c. individual's and the group's interactions with the leader d. how the members benefitted from the group e. all of the above f. all but b

E. The group process should be discussed from all angles, including what clients learned, how they will apply it in the future, what relationships were enriching and which were challenging and appraisal of the leader. This appraisal can help members shift their view of authority to serve them better in the future.

Which of the following are not valid types of treatment groups? a. activity groups b. self-help groups c. support groups d. psycho-educational groups e. None; all are valid

E. With wide range of leader participation and structure, all types listed are beneficial types of groups.

Groups in higher stages of development do not exhibit regression. a. True b. False

False- Even highly evolved groups may exhibit regression and reversibility at times, especially with a crisis, such as a long-term member leaving abruptly.

The emergence of a scapegoat is not potentially destructive (T/F)

False- if not handled properly by the leader, the system goes unexamined and unchanged and the scapegoat has a counter-therapeutic experience.

All groups share the same group stages; no group stage is ever truncated or absent (T/F)

False- open groups, due to their fluctuation in members' presence and duration, may have severely shortened phases, and sometimes may never reach certain stages.

Premature departures from group have no benefits because they disrupt the development of group cohesion and trust. a. True b. False

False- premature termination presents a useful opportunity to help participants deal with change.

There are no risks to group therapy (T/F)

False- risks of group therapy include the potential break of confidentiality, challenges with termination, and ineffective leadership around challenging group roles like the scapegoat.

A group member or leader terminating attendance at a group is a one-time event held on the member's last day of attendance (T/F)

False- termination is a process, not a one day event. It has it's own unique stage and can be a learning and growing experience for all. Termination in group often brings up issues around grief for participants, and this should be considered and processed over time accordingly.

A closed group is always preferential to an open group (T/F)

False- while closed groups grow to become more cohesive, they can dwindle in size if group members are not committed, leaving the group sub-therapeutic. Open groups add the opportunity for participants to learn/cope with change/grief.

Every group must have a clearly-defined group goal. a. True b. False

False- while many groups have a clear goal, such a learning coping mechanisms, enhance communication skills, or learn about substance abuse; psychodynamic groups have less of a common group goal, other than to "overcome difficulties".

Couch's article "Four steps to conducting a pregroup screening interview" and the associates for Specialists in Group Work's ethical guidelines do not include ______________ as a way of conveying pre-group information.

Filmed or videotaped information.

A group member has shared an accomplishment of quitting smoking for the past 30 days. James comments and seems to go on and on about how he was raised on a tobacco farm in Mississippi and about the hard work and challenges he experienced growing up poor in the south. What role has James taken on?

Monopolist

An aspect of an open group is that group members can join and leave anytime during the group series, as they see fit. (T/F)

True- The benefits of an open group is that the group size is more consistent and it offers opportunities for members to effectively cope with change and loss in a therapeutic setting.

Once a group is performing, it can regress to the storming phase. a. True b. False

True- groups in the performing stage may not successfully navigate ambivalence, leading to re-emergence of subgroups

The scapegoat is the repository for group members' denied and repressed emotions and longings (T/F)

True- members may displace their feelings of aggression onto the scapegoat. What the members dislike in the scapegoat, they dislike in themselves.

Which of the following is NOT a disadvantage of a heterogeneous group? a) there is a slower recovery of patients b) increased transference occurs c) group identification is slower so insight is slower d) attendance is more sporadic

b) increased transference is not a disadvantage, but an advantage of heterogeneous groups, as it allows the group members to work through their issues in the group setting.

Marc attends a counseling group for grief and loss. The night he first attends, he is the only person in the group who has lost a child; everyone else is attending the group for end-of-life loss. Marc leaves the group session angry and frustrated and tells his wife that the group was pointless. Marc may be dealing with: a. Poor pregroup preparation b. Perceived goal incompatibility c. Subgrouping d. Groupthink

b) perceived goal incompatibility between what he is looking for and the goals of the group. It is perceived, so it may not be accurate. There may be poor pregroup preparation as well, but this would be on the part of the counselor, not Marc. Marc wasn't present long enough for subgrouping to be an issue. Groupthink is a social construct.

Which of the following best demonstrates attending to group process? a) sarah, you are shaking your leg b) Jessica, you said you had a solution, can you share it c) pamela, you just started picking your fingers when samuel started talking d) i'm noticing the time and group is over

c) Process involves noticing the dynamic between group members, with the group serving as a social system. Attending to content happens when you notice something in and of itself without relating it to the dynamic of the group.

Which is not a disadvantage of group work? a) need for organization b) diversity of group work types c) group cohesiveness d) complexity of performing group work

c- Group Cohesiveness.

Bloch and Crouch identified all of the following except ____ as the areas that make up a therapy group. a. a therapeutic factor b. a condition for change c. vicarious learning d. a technique

c- Vicarious learning is one of Yalom's 11 universal factors and is not associated with Bloch and Crouch

Mary Jo volunteers first to review her homework. She talks directly to the group leader versus the group members and takes the first 15 minutes of group. When the leader moves on to another group member, she interrupts several times within the first minute of him talking. Mary Jo is playing the ______________________ role, which is a ________________ role. a. Playgirl, blocking b. Reality tester, maintenance c. Dominator, blocking d. Gate keeper, task

c- dominators assert their authority by manipulating the group or some of its members. This can take the form of giving authoritative directions, interrupting others, or asserting a superior status, all of which block the group dynamic.

Which of the following is not an ethical concern when running groups? a) confidentiality b) dual relationships c) having refreshments d) coercion of members

c- having refreshments does not pose an ethical issue.

Which of the following is not one of Bion's assumptions in group dynamics? a)dependency b)fight-flight c)optimism d)pairing

c- optimism was not one of Bion's assumptions, although he did believe it was important in the successful functioning of a group. Dependency, fight-flight, and pairing were all specific components of his group work.

Twenty-year-old Joan grew up with a hypercritical mother. Joan has taken a liking to a 52-year-old kind and empathetic caregiver. Joan has a good chance of experiencing which of the following curative factors of a group? a. altruism b. group cohesiveness c. corrective recapitulation of the primary family group d. imitative behavior

c. corrective recapitulation of the primary family group

The following is not appropriate content for the pre-group screening discussion? a) stages and roles b) common myths of group therapy c) client's needs/expectations d) none of the above- all are appropriate

d) During the screening process, the states, roles, common myths, expectations, needs and commitment should be discussed as should confidentiality.

Nicole is involved in Alcoholics Anonymous. Every few months, she and her husband attend a couple's weekend within the program that runs from Friday evening through Sunday afternoon. This would be considered a a. T-group b. Therapy group c. Encounter group d. Marathon group

d) Marathon group- by it's definition of lasting longer than a few hours.