Group Work

Rapprochement

(15 months and beyond): The young child once again becomes close to his mother, but begins to differentiate itself from his mother. The child realizes that his physical mobility demonstrates psychic separateness from his mother. The toddler may become tentative at this point, wanting his mother to be in sight so that, through eye contact and action, he can explore his world.

Hatching

(5 to 9 months): The infant becomes aware of the differentiation between itself and its mother. It becomes increasingly aware of its surroundings and interested in them, using its mother as a point of reference or orientation.

Practicing

(9 to 16 months): The infant can now get about on its own, first crawling and then walking freely. The infant begins to explore actively and becomes more independent of its mother. The infant still experiences itself as one with its mother.

Information

A group can be a vital resource for learning new things and getting advice. Some groups incorporate more advice and teaching than others. Regardless of the group's style, shared insights are inevitable

Normal Symbiotic Phase

According to Mahler, this phase extends from the first signs of conscious awareness at four to six weeks until about five months of age. In this phase the infant is now aware of its mother, but has no sense of individuality of its own. The infant and mother are as one, and there is a barrier between them and the rest of the world.

an identity

According to psychoanalytic theory, establishing ______ is an ongoing process during most of a life cycle

• Members benefit from each other's work • Multiple transferences can be formed • Members learn to identify their own transferences • The group can function as a family

Advantages of group work with a psychoanalytic approach are:

Democratic

Allows everyone within the group to have a voice in the decision-making process, although the final power of decision may still rest on the groups leader

Laissez-Faire

Allows everyone within the group to make their own decisions. It should be noted that this leadership style gives the most individual freedom to those within the group but it also gives those individuals full responsibility for any errors or mistakes that may happen

Problem Solving Groups

Although these groups deal with problems that could probably have been solved through individual effort, the group adds diverse resources, error safeguards and motivation

Group Culture

Arising from beliefs, customs and values of its members and the environment in which a group is set, this influences objectives, tasks, interaction and methods.

Existential Questions

As members of the group imagine a typical day three years previous, questions arise: • Are there any major differences in life then and now? • Was life more meaningful then? • Were you stuck in your comfort zone? • Was death a meaningful term for living day by day? • Could you accept your own death more realistically then or now? • Does anxiety bring harmony?

Self Monitoring Group

As the group beings to take responsibility for its own functioning, the therapist must not allow clients to become spectators. Therapist teaches members about "good groups" then transfers the responsibility for the group to them. By asking questions such as "Are you satisfied with group today?" the leader shifts evaluation to group members

Giving

Being an active member of a group that helps others contributes to each individual's feelings of value and purpose; what better way is there to strengthen a sense of self than by helping others?

1.) calm self-destructive behavior 2.) enable members to see how others respond to them 3.) opportunity for immediate self-definition 4.) diverse views of behavior 5.) chance to practice new behaviors

Benefits of behavioral groups

Heterogeneous, Homogeneous, Ego Strength, Age, Place, Time, Size, Preparation

Characteristics to consider when composing group

Storming Stage

Characterized by competition and conflict .Individuals have to bend and mold their feelings, ideas, attitudes, and beliefs to suit the group. Because of "fear of exposure" or "fear of failure" there will be an increased desire for structural clarification and commitment. Although conflicts may or may not surface as group issues, they do exist. There may be wide swings in members' behavior based on emerging issues of competition and hostilities. Some members may remain completely silent while others attempt to dominate. The most important trait in helping groups move on to the next stage is the ability to listen

Working Stage

Cohesion and Productivity Key Issues: Disclosure versus anonymity Honesty versus superficiality Spontaneity versus control Acceptance versus Rejection Cohesion versus Fragmentation Characterized by member's commitment to explore significant problems that they bring to the group and by the attention they pay to the dynamics of the group

Final Stage

Consolidation and Termination Characteristics- sadness and anxiety, fears of separation and application, evaluation of group experience, plan for follow-up sessions. Major task facing members is consolidating their learning and transferring it to the outside environment: -deal with feelings about separation and termination -prepare to generalize learning to everyday life -complete unfinished business -make future plans Leader functions- provide a structure that enables participants to clarify the meaning of their experiences in the group and to assist members in generalizing their learning from the group to everyday life.

Basic Tasks of Group Leader

Create machinery of therapy, Set machinery of therapy in motion, keep the machinery of therapy operating effectively

Transition Stage

Dealing with resistance This stage is about recognizing group problems such as conflict, anxiety, defensiveness, challenges to or conflicts with the leader.

T-Groups

Emphasizing feedback, problem solving and decision making. These groups aim to improve organization relationship skills by focusing on the group process

Education Groups

Exemplified by study groups and designed to advance learning, these groups should have demographically similar methods with different ability levels

Counseling Groups

For secondary prevention and/or correction, these groups include encounter, sensitivity and organizational development groups

1.) How might this person impede progress of the group? 2.) Will this deviance be helpful or lead to early drop out? 3.) Will this person get satisfaction from the group 4.) Be valued?

Four issues to consider when screening people out of group

A microcosm

Functioning as a little society, most groups contain those with various personalities. Feedback from other group members can allow a person to see something about them-self as a member of society that would not be revealed alone or in a less supportive setting. Social-skill training can often be easily incorporated into a group because of this quality

Guidance, Counseling, Psychotherapy

Gaza recognizes these three types of groups

1.) Initial 2.) Transition 3.) Working 4.) Final

Group development states according to Corey and Corey

1.) Facts 2.) personal experience 3.) rational explanations

Group leader should provide these three things to demystify the therapy process

Psychodrama

Here, members act out their problems, experiences, wishes and fantasies, with some or all other members playing assigned roles. Personal change and growth come from encountering buried feelings and experiencing new situations. Since the group leader designs and monitors these enactments, obviously his/her knowledge, skill, judgment and good character are pivotal.

transference, resistance

In analytic group therapy, dealing with ______ and ________constitutes the bulk of the work

Psychoanalytic therapy groups

In group work, it is particularly important to focus on experiences from the first six years of life, because the roots of present conflicts usually lie there. Group work encourages participants to relive significant relationships. Ideally, the group functions as a symbolic family so members can work through these early relationships.

insight, understanding, working through repressed material

In psychoanalytic therapy groups, ____, ___, and ___, should be given primary focus

Separation-Individuation Phase

In this phase the infant breaks out of its "autistic shell" and begins to connect with its environment and with the people in it.

Role Expectations

Individual group members perform different functions including task and maintenance roles (helping to keep the group on track) and individual roles (often selfishly at odds with group goals)

Support

Individuals feel safe, consequently they are willing to reveal themselves in ways they do not share elsewhere, knowing others will attempt to nurture them regardless of revelations or actions

Norming Stage

Interpersonal relations are characterized by cohesion. Group members are engaged in active acknowledgment of all members' contributions, community building and maintenance, and solving group issues. Leadership is shared and cliques dissolve. Members begin to experience a sense of group belonging and a feeling of relief as a result of resolving interpersonal conflicts. Members may begin to fear the inevitable future breakup of the group and may resist change of any sort

Interpersonal Functioning

Interview questions should focus on __________

Adjourning Stage

Involves termination of task behaviors and disengagement from relationships. A planned conclusion usually includes recognitiion for participation and achievement and an opportunity for members to say personal goodbyes. There is a regressive movement from giving up control to giving up inclusion in the group. The most effective interventions in this stage are those that facilitate task termination and the disengagement process

Autocratic

Is one in which the leader does not seek any sort of input or consultation with others of the group, resulting most often in high levels of discontent

Deviants

It is best to screen out these people, who represent an extreme in at least on of these dimensions: youngest, unmarried, sickest, "the only this or that"

A sense of belonging

It is part of the human experience to want to belong to a group. For those who feel they are struggling alone with problems, this is especially true

1.) Orientation and resistance 2.) Negotiation and intimacy 3.) Termination

Klein's Arrangement of group development stages

Shared Problems

Knowing others share experiences, thoughts and feelings can be highly therapeutic. In a group, generally at least on other person "gets it" when an individual discusses problems or issues.

Autocratic, Democratic, Laissez-Faire

Kurt Lewin's field studies in the area of leadership and leadership styles, especially among those responsible for decision-making, identified these three distinct styles of leadership

Heterogeneous

Long term advantages - microcosm. Strive for this in conflict areas and patterns of coping

DSM Diagnosis

Looking for ___________ is the least helpful factor to predict group behavior

Cohesiveness

Major factor in successful outcome. Members' strong affinity for each other and toward the group as a whole makes a more open, supportive and accepting group

Performing Stage

Members work interdependently in personal relations and problem solving. Members are both highly task oriented and highly people oriented. There is unity: group identity is complete, morale is high, and loyalty is intense. Overall goal is productivity thought problem solving and work

Charm, Honesty, Acceptable, Self-Disclosure (limited), Empathy (accurate)

No technique takes precedence over CHASE, which represents...

Initial Stage

Orientation and exploration Central task- establishing trust Leader- establishes structure and models trust Members- developing trust by how leader handles the group's fears and hesitations

Forming Stage

Personal relations are characterized by dependency. Group members rely on safe behavior and look to leader for guidance and direction. They set about fathering impressions and data about the similarities and differences among them and forming preferences of future subgrouping. Rules of behavior keep things simple and avoid controversy. Serious topics and feelings are avoided.

Creation/Maintenance

Preparation before group, gate keeping, stability, deter anti-cohesiveness

Guidance Groups

Primarily for prevention of problems facing high-risk populations, these groups focus on improvement of life skills and overall direction of members

1.) Psychoanalytic 2.) Learning 3.) Field 4.) Social Exchange/Interaction 5.) Systems

R.W. Toseland and R.F. Rivas listed these five theories as important to group practice

Transactional Analysis

Rather than beginning as an extension of individual therapy, this started as a specifically conceived group therapy model with an established framework, structure and nomenclature. Open membership and an honest, egalitarian spirit between therapist and members distinguish these groups, with each member submitting personal decisions to multiple assessments to learn how to make better choices.

Norms

Rules of behavior may be tacit or explicit, informal or formal, veiled or overt, the therapist tries to head off automatic conforming responses

Existential cries

Seen as part of living and not something to be remedied. These frequently concern the meaning of life, anxiety, guilt, the recognition of one's aloneness, awareness of death and finality and the fear of choosing and acceptance of responsibility for one's choices. It is not necessarily pathological; it can be externally alleviated, lived though and understood in the context of a group.

Continued tardiness, absences, sub grouping, disruptive extra group formation

Signs of anti-cohesiveness

Homogeneous

Support of systematic relief over brief periods of time - build-in cohesiveness. Strive for this in degree of vulnerability and capacity to tolerate anxiety

Psychotherapy

Tertiary prevention groups with the purpose of reeducating, rehabilitating and generally bringing members to healthy function

- Insight - Self-acceptance - Knowledge of the environment • Responsibility for choices, actions and behaviors • Paradoxical theory of change • Ability to make contact with others

The Gestalt therapy process promotes awareness in client through:

A sense of belonging, shared problems, support, a microcosm, information, giving

The factors that make group therapy unique

responsibility, social conditions

The focus on _______________ rather than on __________ is a limitation of the existential approach in working with a culturally diverse client population.

interpretation

The group therapist frequently makes ________ for individuals in the group session

1.) Screens out psychopaths and those with inadequate ego strength 2.) Allows potential members to get to know the group leader 3.) Lets the group leader explain members' rights and the group's goals and format

The interview does these three things

1.) Communication patterns 2.) Cohesiveness 3.) Social control 4.) Norms 5.) Role expectations 6.) Status 7.) Group culture

The seven areas of internal group dynamics

1.) Hatching 2.) Practicing 3.) Rapprochement

The three sub-phases of the Separation-Individuation Phase

Groupthink

There is an illusion of the group's invulnerability or invincibility. The group will also create a rationale and morality for their attitudes or behaviors. the group will often put pressure on its members to conform, as well as form stereotypical opinions of members of other groups. There will often be individuals within the group will censor themselves from expressing critical thoughts of the group, as well as individuals who actively suppress any doubts individuals may be having about the group

Experimental Groups

These include T-groups as well as therapy, encounter, personal growth and sensitivity-training groups

Social Control

This involves the norms, roles, expectations and status that let groups function effectively, if not always smoothly

risky shift

This was the idea that a group was likely to make riskier decisions than the average of the individuals' likelihood of making those same risky decisions.

1.) Forming 2.) Storming 3.) Norming 4.) Performing 5.) Adjourning

Tuckman's progression of group stages

encounter, awareness, self-help, leaderless groups, consciousness raising, sensitivity training, personal growth groups

Types of therapeutic groups according to Corey and Corey

Encounter Groups

Typically meeting for a set time, these groups encourage risk taking for personal growth and development

Conditions that make groupthink more likely

When the group is both highly cohesive and separated from information which may disagree with their beliefs or attitudes, as well as a leader who carries preconceptions about the validity of those beliefs or attitudes

Existential therapy groups

Work focuses on the subjective aspects of a member's experiences. The central issues are freedom, responsibility, and the anxiety that accompanies being both free and responsible. People become what they choose to become.

Status

______ outside the group combined with behavior in the group, contribute to in-group ranking of members, willingness to conform to group norms is affected by this as well

Meaning of Life

______________ is sought via confronting mortality

Contact

a key concept in Gestalt therapy, ____________ happens when a person interacts with another person or the outside world

Ego Strength

a person's capacity to maintain his/her identity despite the psychological pain, distress, turmoil, and conflict between internal forces as well as the demands of reality.

Gestalt therapy groups

based on the here-and-now. Ensuring they are fully present themselves, the therapist promotes self-awareness and the ability to take responsibility for one's actions and behaviors. They must help the group develop the skills necessary to satisfy needs without violating the rights of others or one's own moral standards; and develop the willingness to help others and ask for help when needed, moving from environmental support to internal support

Free Association

can be used for uncovering repressed material, helping members develop more spontaneity, working on dreams and promoting meaningful interactions within the group

Psychoanalytic dream work

consists of interpreting the latent meaning of a dream

Logotherapy

developed by Viktor Frankl and focuses on challenging group members to search for the meaning in life. "healing through reason"

Group malequilibrium

exists when group members become so comfortable with one another, they avoid challenging each other's defenses

Object-relations theory

focuses on predictable developmental sequences in which early experiences of the self shift in relation to an expanding awareness of others

Rational Emotional Behavior Therapy groups

groups seek to replace members' irrational, self-defeating beliefs with rational, self-enhancing ones. With the leader pointing out applicable unreasonable beliefs, the group examines the problems of one member at a time, confronting, challenging and persuading. This approach encourages members to examine beliefs that are negative and perhaps irrational.

Vertical self-disclosure

in depth revelation of a secret

Group polarization

includes many attitudes or behaviors that become more extreme within a group setting

meaning of death

is a productive focus for group sessions; from dealing with this concept comes the realization of the meaning of living. "What does not kill me can only make me stronger."

Horizontal self disclosure

meta disclosure about disclosure (feelings about disclosing)

Group disequilibrium

occurs when members experience too little intimacy (isolation) or too much intimacy (engulfment)

Communication Patterns

paying attention to verbal and non-verbals helps the therapist effectively move toward group goals

Separation

refers to the development of limits and to the differentiation in the infant's mind between the infant and the mother

Individuation

refers to the development of the infant's ego, sense of identity, and cognitive abilities.

Existential Vacuum

the condition of emptiness and hollowness that results from meaninglessness in life.

Uncovering early experiences

the primary goal of analytic group work

Behavior therapy groups

these groups work by modifying observable and measurable behaviors, rather than thoughts, unconscious conflicts or past events. Using positive and/pr negative reinforcement, stimulus control, modeling, extinction, and other modification techniques tailored to each member's needs.

Culture Building

unwritten code of behavioral rules, or norms, that must be established