NCE-Group Work

Group Leader Skills (Knowles, 1959; Corey, 1995)

1. Active listening 2. Reflection and clarification 3. Questioning and summarizing 4. Information giving 5. Encouragement and support 6. Modeling 7. Self-disclosure at appropriate times 8. Blocking - intervention to stop counterproductive behaviors (scapegoating, group pressure, excessive questioning, etc.) 9. Attending behavior - evidenced by facing a group member who is talking, etc.

Therapeutic Forces within a Group (Ohlsen, 1988)

1. Attractiveness of the group 2. Acceptance by the group 3. Expectations of the client by the group 4. Sense of belonging 5. Therapeutic tension 6. Therapeutic norms 7. Client participation 8. Client acceptance of responsibility for his/her own growth 9. Feeling of security 10. Commitment to openness and risk-taking 11. Congruence between members 12. Feedback

Closed vs. Open Groups

1. Closed Groups No new members are allowed to join after start date. Promotes cohesiveness and trust since membership is consistent. Drop in membership may cut the overall interaction of members. 2. Open Groups New members are allowed to join after the start date. Cost effective since new people may replace those that drop. Members joining after the first session do not receive information/experiences shared earlier.

Classification of Groups Guidance, counseling, and counseling groups can be described using Caplan's model:

A. Guidance groups - primary (preventative) groups; sometimes called affective education groups or psychological education groups; do not deal with remediation; leadership requires little training. B. Counseling groups - secondary; focused on conscious issues; not likely psychodynamic; leadership requires some training. C. Therapy groups - tertiary; the psychological disturbance is rather severe and will require a longer term of individual work; deals with remediation of more severe pathology; may be psychodynamic; leadership requires much training.

Assessing Group Outcomes/Results

A. Member-Specific Measures 1. Measure change (or lack of change) in individual members. 2. Include self-ratings and ratings by outside observers. 3. Are not standardized. B. Group-Specific Measures 1. Measure change (or lack of change) in all members of the group. 2. May include follow-up sessions in which group members share experiences. C. Global Measures 1. Utilize projective measures in a pre-test and post-test format. 2. Will probably assess changes in areas not addressed in the group. Note that critics propose the use of more independent observers to validate group counseling results (i.e., having unrelated observers sit in during group sessions to rate behavioral change).

Classification of Groups One model is Gerald Caplan's Crisis Intervention Model:

A. Primary groups - preventive; teach coping strategies or life-style characteristics that can reduce the incidence of a problem (ex. diet and weight management to prevent diabetes). B. Secondary groups - attempt to reduce the severity or the length of time of disturbing behaviors; a problem is present but is not usually severe (ex. grief group). C. Tertiary groups - deal with severe, longstanding problems or disturbances; has more of an individual focus.

What Research Says about Group Work

A. While group work is both popular and effective, group work in general has not been proven to be superior to other modes of treatment. Research says group work works, just not necessarily better. B. Outcomebasedresearchhasconcludedthatgroupsareeffective. Outcome based research asks: "Where the goals met?" C. Process based research has not been able to determine why or how groups are effective. Process based research attempts to determine what transpired within the group to allow it and/or its members to reach its desired goals. D. In particular, studies in group work are not often well controlled, e.g. the independent variable has not been scientifically defined. E. Research studies have not been able to pinpoint the "most important" characteristics that propel a group leader to the position of "great group leader." Flexibility, enthusiasm, and common sense have been shown to be slightly helpful. F. Group work is predicted to become focused on forming groups that will deal with a broader spectrum of issues than is now seen with most groups. Whereas currently most groups have a specific, narrow focus (anger management, for instance), a "comprehensive life-skills model" would afford the opportunity to present preventive mental health skills. As this transition is made, the leader of a life-skills group would function as more of a trainer than a counselor. The need for "therapeutic groups" should lessen.

Developmental Group Counseling (Life-Skills Training) (George Gazda) The primary mode of group counseling for preschool and early school-aged children (ages 5-9) is

active play. Thus, the play group involves modeling, psychodrama, behavior rehearsal, coaching, and group feedback.

Behavioral Groups Theoretical Basis

Behavior therapy is grounded in learning theory: factors of the human experience, such as emotions, cognitions, and behaviors, are learned and can, therefore, be relearned or unlearned. Overt problem behaviors are dealt with; insight or self-understanding is not sought. Testing, empiricism, and clear goals are key elements of this modality.

Developmental Group Counseling (Life-Skills Training) (George Gazda) Since adolescents and adults are generally verbally efficient,

interview group counseling is considered to be the preferred mode of treatment for these ages. Meichenbaum's cognitive- behavior integrative approach is recommended by Gazda (2001) as being most consistent with the developmental model: Phase 1 is self-observation; Phase 2 is described as initiating cognitions and behaviors that interfere with the maladaptive ones; Phase 3 involves the counselee exhibiting coping behaviors and accurately expressing the changes verbally.

Developmental Group Counseling (Life-Skills Training) (George Gazda) The group therapist is

responsible at each age level to deal appropriately with developmental tasks and expectations. Group member selection and group composition, group size, media, and the setting should all be developmentally appropriate.

Disadvantages and Limitations of Group Counseling

1. Each member receives less attention than that received in individual counseling, particularly if the leader is process rather than content oriented. 2. Group counseling has less situational control. 3. Confidentiality is more difficult to maintain. 4. The danger of "group think," the forcing of a group opinion on all members, is present. 5. A shared reality may replace one's individual reality. 6. A group leader must make many more decisions than an individual counselor makes. 7. Scapegoating must be guarded against. 8. Group members could experience emotional harm if the leader loses control. 9. Clients may benefit more from group counseling after receiving some individual counseling. 10. Group counseling is not initially applicable to clients in crisis, clients needing testing interpretation, clients who are phobic regarding speaking in public, or clients needing strict confidentiality.

Encounter Groups

1. Emphasize personal growth. 2. Are associated with Rogers. The focus is on the here-and-now experience and includes the I-Thou encounter. Marathon groups are the most commonly known type.

Group Task Roles: That Which Helps a Group Get the Job Done

1. Energizer/Initiator - Prods for action; generates enthusiasm 2. Information/Opinion Seeker - Pushes for clarification 3. Information/Opinion Giver - Adds facts, makes suggestions, and shares ideas 4. Elaborator/Coordinator - Furnishes the reality orientation for the group 5. Orienteer/Evaluator - Judges and focuses on the task at hand 6. Procedural Technician - Is similar to the gatekeeper but focuses on mechanics and procedure

Yalom's Reasons for Dropouts (1985)

1. External factors 2. Group deviance (the person is not a good fit) 3. Inadequate orientation 4. Subgrouping (cliquing) 5. Problems with intimacy 6. Fear of emotional contagion 7. Inability to share the counselor 8. Early provocation by the group 9. Competition of individual versus the group process

Group Building and Maintenance Roles: That Which Helps Hold a Group Together

1. Facilitator/Encourager - Encourages, extends friendship, and offers security 2. Gatekeeper/Expeditor - Acts as the counselor's assistant and keeps members within group norms; may avoid working on own issues; may secretly want to lead the group 3. Standard or Goal Setter - Pushes for goal definition 4. Harmonizer/Conciliator - Mediates mostly emotional or feeling issues 5. Compromiser/Neutralizer - Mediates mostly cognitive alternatives 6. Observer - Gives feedback but does not participate in depth 7. Follower/Neuter - Bends with the wind and doesn't really participate

Yalom's Leadership Types (Yalom, 1985)

1. Impersonals - Are distant and aggressive. They rate low on caring. (Poor) 2. Managers - Use lots of structured activities and control how members interact. (Poor) 3. Laissez-faires - Provide low input, low support, and low control. (Poor) 4. Social Engineers - Are group-focused and concerned with how members relate to the social system. They rate low in charisma and low in emotional stimulation. (Moderate) 5. Energizers - Are caring and charismatic providing intense emotional stimulation and firm control. (Moderate) 6. Providers - Specialize in caring and meaning attribution. They focus on individuals and give love and information but don't press their own views on group members. (Best)

Too much structure:Yalom

1. Interferes with group stage development as stages sometimes are skipped. 2. Causes members' feelings to be purged before the members are properly prepared. 3. Can make the members dependent on the leader for direction. 4. Produces lower outcome results.

Psychodrama Groups (Jacob Moreno) Theoretical Basis

1. Jacob Moreno (1889-1974) discovered that both the actors and the audiences of improvised theatrical representations of current events and topics experienced catharsis (a release of pent-up feelings and emotions) as the actors and audience members related their reactions to the performances and discussed how they might have played roles differently (Corey, 2000). These experiences led Moreno to develop specialized group methods and therapeutic techniques that evolved into what became known as psychodrama. 2. Creativity, defined by Moreno as the expressing of God's purpose, became one of Moreno's central concepts, along with other themes that he felt were ignored in other theoretical approaches: fostering creativity with spontaneity and the openness, newness, and willingness to take risks that accompanies it, encountering significant others in dramatization, dealing with past events as though they were occurring in the present, the two-way flow of feelings between people which Moreno called tele, reality testing, and role theory (not role playing which is solution oriented but role dramatization which is insight oriented).

T-Groups (Training Groups)

1. May be called laboratory-training groups or sensitivity groups; called microlab if short in duration. 2. Focus on human relations processes in business settings; help people from organizational settings develop human relations skills by examining the group process rather than personal growth. 3. Are associated with the National Training Laboratory and Kurt Lewin. The National Training Laboratory was established under the National Education Association to sponsor "T-Groups" (basic skill training groups). Leland Bradford guided T-group development.

Self-Help or Support Groups

1. Members all have the same issue to deal with (weight, grief, alcohol). 2. Members learn from and receive support from each other. 3. Membership is voluntary. 4. The leader is not necessarily a professional. 5. Many follow the Alcoholic Anonymous 12 steps and are therefore called 12-step groups. 6. Over half a million self-help groups exist in the U.S. with over 15 million members.

Other Group Behavior Considerations

1. Risky Shift Phenomenon - Research shows that the individual will shift toward the social norm. In simple terms, an individual will tend to go along with the group. His or her decision will be more liberal when made with the group than if the decision had been made before the individual met with the group. 2. Some theorists believe that the roles people play in groups are mirrored from their roles in their nuclear families and can be explored on that basis. 3. Since needs of group members change, the roles group members fill should change to meet these needs. The capacity to be flexible and change roles indicates a healthy group. A group stuck in task roles will experience lower levels of interaction; a group stuck in maintenance roles will accomplish low levels of work or tasks. 4. Role conflict denotes a discrepancy between a member's expected behavior and his or her actual behavior. 5. Conflict of interest denotes a group member meeting his or her need instead of the group's need.

Negative and/or Destructive (Anti-Group) Task Roles

1. Scapegoat - a member who is the object of accusations and blame by other members 2. Interrogator - constantly asks questions 4. Peeping Tom - asks other members inappropriate questions 5. Storyteller - takes up valuable time telling long, often irrelevant, stories 6. Joker - uses jokes as smoke screens or to belittle others or self 7. Isolate - are genuinely rejected and ignored; are given little or no attention

The Word "Structure"

1. Structure can refer to the basic format or formulation of the group, i.e. an adult group, a heterogeneous group, a closed group, etc. (often referred to as the group structure). 2. Structure can refer to the use of (or absence of) structured exercises or tasks given by the leader to the group, i.e. "Today we will answer this question..." (often referred to as structuring the group). Note that behavioral groups employ many specific exercises and are, therefore, generally highly structured. Existential groups, nondirective groups, and psychodynamic groups, on the other hand, generally employ few directive techniques and have few concrete treatment objectives. They are, therefore, considered less structured. Since a group must have some structure to even exist, the term "unstructured" would imply a group with a very low degree of structure. 3. Structure can refer to a group focused on a particular theme or topic, such as a group for single parents, assertiveness training, etc. (often called a structured group).

Adlerian Groups Theoretical Basis

1. While Freud based his work on the individual psychodynamics of neurotic, affluent patients, Alfred Adler showed a social concern for the common person. He couched his psychological concepts into practical methods for a diverse population. He chose the term "individual" psychology to denote the struggle of individuals to become all that they could be (Corey, 2000). 2. Rudolf Dreikurs refined Alder's concepts into a streamlined, teachable system that could be applied to education, preventive mental health, family life, and, particularly, group psychotherapy. He incorporated groups into his busy psychiatric practice in 1928 and found them to be an effective means of reaching people (Corey, 2000). 3. As with one-on-one Adlerian therapy, group members move toward a more positive self-esteem as they explore their early family environment (birth order and early experiences) to gain insight into mistaken goals and self-defeating behaviors. 4. A typical Adlerian group will progress through four phases: a. Establish and maintain relationship b. Assessment c. Insight d. Reorientation

Psychoanalytic Groups Techniques

A group "go round" is frequently used to begin a group meeting to aid free association. Interpretation, dream analysis, analysis of resistance, and analysis of transference are all acceptable techniques.

Curative Factors, according to Irvin Yalom, that make up the process of therapeutic change are the following (Yalom, 1985): The corrective recapitulation of the primary family group

A group bears a resemblance to a family, and as such, it contains family patterns and serves as a vehicle for group members to resolve past or present family-related issues. Ways of interacting with family members can be "tested" in the group for their effectiveness.

Gestalt Groups (Fritz Perls) Techniques

Action-oriented techniques are particularly favored by the Gestalt group leader including but not limited to role playing, how and what questioning, the empty chair, dialogues with self and others, exaggerating behaviors, dream work, and fantasies.

Adlerian Groups Techniques

Adlerian techniques are typically educational in nature and intended to invoke insight. Motivation and lifestyle are evaluated. Confrontation, acting "as if," contracts, modeling, paraphrasing, encouragement, etc. are all acceptable techniques.

Curative Factors, according to Irvin Yalom, that make up the process of therapeutic change are the following (Yalom, 1985): Catharsis

Affording expression of those feelings inside of a person acts as a catharsis for the person. Only if the client is willing to express these feelings can change result and/or can interaction take place

Curative Factors, according to Irvin Yalom, that make up the process of therapeutic change are the following (Yalom, 1985): Altruism

Altruism is effected as each member of the group comes to see him/herself as important to the group. Some members tend to see the counselor as a "paid" group leader and will listen more readily to another group member. As the counselor conveys the idea that each member is important and is potentially important to the other members, each member gets an ego boost.

2. Transition - Power and Control - Storming Stage

Anxiety, defenses, resistance, and ways to address the goals are the issues. a. Vying for position or power b. Exhibiting resistance or judgmentalism c. Verbally attacking the leader and other members d. Fighting among subgroups and factions e. Leaders must learn to distinguish between a "challenge" and an "attack" (Corey and Corey, 2000) f. Leader responses: genuineness, concreteness, deeper self-disclosure g. Employing techniques specifically chosen to Deal with defensive behaviors Deal with difficult members Deal with conflict Explore common fears and resistance Deal with challenges to the leader

Behavioral Groups Techniques

As members attempt to fulfill their contracts for behavior change, many techniques and strategies are applied including modeling, behavior rehearsal, role-playing, reinforcing, contingency contracting, cognitive restructuring, desensitization, homework, problem solving, assessing, and feedback.

Leadership Functions Emotional stimulation

Challenges, confronts, takes personal risks, self-discloses.

Transactional Analysis Groups Techniques

Contracts are the fundamental technique in TA groups. Other techniques include imagery, fantasy, homework, psychodrama, role-playing, cognitive and affective techniques, and script and game analysis.

Reality Therapy Groups (William Glasser) Theoretical Basis

Current behavior should meet current needs; problems arise when individuals make irresponsible choices and use ineffective behaviors. By increasing control over conduct and substituting new behaviors and choices, quality of life is enhanced. William Glasser, the founder of Reality Therapy, believed that we as individuals may be the product of our past experiences, but only victims of the past if we choose to be so. Making excuses and blaming others is not accepted (Corey, 2000).

Rational Emotive Behavior Therapy Groups (REBT) (Albert Ellis) Techniques

Educational techniques are mainly employed with the A-B-C-D-E of behavior used consistently. Role playing, behavior rehearsal, desensitization, cognitive restructuring, group discussion, teaching, homework, and confrontation are all acceptable REBT techniques.

Existential Groups Techniques

Experiencing the present moment of and with the client is key, so leaders choose techniques from whatever orientation they feel will facilitate this subjective understanding. The leader sets the tone of the group by "being" and "becoming," not "doing" (Corey, 2000).

Leader Training

Experts in group work such as Marianne Schneider Corey, her husband Gerald, and Irvin Yalom agree that additional training in group leadership is necessary (more than the course on group work in most graduate programs). Such training could include: 1. Participation in a group for leaders where the focus is leadership skills. 2. Participation in a personal counseling group so that any of the leader's issues that might lead to countertransference can be dealt with.

Leadership Functions Meaning attribution

Explains, clarifies, interprets, and provides a cognitive framework.

Developmental Group Counseling (Life-Skills Training) (George Gazda) By the late 1970s,

Gazda had finalized a life-skills training model that runs parallel in most respects to his developmental counseling model. He developed 10 basic assumptions regarding the acquisition of life-skills which basically say that life-skills are acquired in sequential order and cannot be mastered before a previous component is mastered. Also, Gazda suggested that there is an optimal age or time for a life-skill to be acquired. As such, life-skills training is either of a preventive or a remediation nature and should not be confused with therapy.

Advantages of Group Counseling over Individual Counseling (Corey, 1995; Gazda, 2001)

Group counseling provides: 1. Reality testing of one's self-perception. 2. The desensitizing of a distorted self-image. 3. Psychological safety to support the elimination of self-defeating behavior. 4. "In-vivo"/real life situations in which a person may try new behaviors. 5. An awareness of universality; an "I'm not alone" reality is conceived. 6. The practicing of giving and getting feedback and self-disclosure. 7. The enhancement of one's empathy and social interest. 8. Over time, the making of changes and the receiving of reinforcement. 9. Deeper understanding and acceptance of individual differences. 10. Feedback from both group members and the counselor to enhance one's accuracy in perception and communication. 11. Modeling as members observe other members dealing with problems. 12. The ability to see more clients in the same amount of time. 13. Less expensive and less time-consuming help.

Curative Factors, according to Irvin Yalom, that make up the process of therapeutic change are the following (Yalom, 1985): Installation of hope

Hope is the necessary element which allows the client to believe that a change will occur through counseling. Clients need to believe in the benefits of counseling; the degree of expectation of change will usually correlate with encountering positive effects from counseling.

Developmental Group Counseling (Life-Skills Training) (George Gazda)

In an attempt to provide an approach to group counseling that would be useful at all age levels, George Gazda has organized generally accepted classifications of human development (psychosocial, moral, affective, ego, cognitive, vocational, and physical/sexual) into four generic life-skill areas: 1.) interpersonal communication/human relations, 2.) physical fitness/health maintenance, 3.) identity development/purpose in life, 4.) and problem solving/decision making. These life-skills are then viewed in relationship to four settings: 1.) home and family, 2.) school, 3.) work, and 4.) the community at large (Gazda, 2001). Gazda feels that since most of Western culture is organized on the basis of expected progressive development, that the concept of developmental tasks has wide applicability.

1. Introduction - Initial - Orientation - Exploration - Forming Stage

Inclusion, identity, trust, and establishment of goals are the issues. a. Self-disclosure b. Setting structure of the group meeting c. Setting norms d. Getting acquainted based on externals (dress, language, culture, occupation) e. Clarifying expectations f. Defining individual goals g. Leader responses: warmth, empathy, respect for members h. Characterized by approach-avoidance conflicts i. Employing techniques specifically chosen to Initiate getting acquainted Focus members Create trust Deal with initial resistance and fears Start a session Ending a session Teach member self-evaluation

Group Developmental Stages

Just as Erik Erikson proposed a series of psychosocial crises to explain human growth and development, the life cycle of a group relies on the effective completion of the previous stage. Most group development theorists propose from three to seven stages, and they have labeled the individual stages of group development many ways. There seems to be a general consensus, however, that there are major tasks associated with a pattern of moving from initial orientation to transition to working to termination. Keep in mind that these stages overlap, and even regression from a higher level will occur at times. The usefulness of interventions should be based on the counselor's understanding of these tasks and the general order in which they occur. Associate the theorist's name with their model and have a thorough understanding of the general order that occurs, the terms associated generally with each stage, and the general characteristics of each stage.

Leadership Styles Democratic

Leadership is shared. (Example: Group-centered counseling; non-directive counseling) Members behaved appropriately. Liked by members but not shown by research to be the most productive style.

Curative Factors, according to Irvin Yalom, that make up the process of therapeutic change are the following (Yalom, 1985): Existential factors

Life presents issues that we all are going to face. The client has to be aware that there will be pain, death, etc., and the counselor or group leader can't change these facts of life. These factors have to be incorporated into counseling to help the person deal with and cope with these issues.

Existential Groups Members' Roles

Members challenge their value systems in the "safe" group setting and determine if they are making honest evaluations. Members reflect on accomplishments and gage their satisfaction and authenticity levels. Members, with the help of the group leader, deal with the anxiety that surfaces as one accepts freedom, responsibility, and the inevitability of death.

Gestalt Groups (Fritz Perls) Members' Roles

Members choose the "feeling issues" to be explored and acted out in the group. "I" statements and acting out unfinished business from early life are key concepts. Offering and receiving feedback and taking responsibility for becoming aware of and dealing with their own unfinished business are fundamental tasks of members (Corey, 2000).

Behavioral Groups Members' Roles

Members come into the group pre-committed to a contract for behavior change and are required to agree to the specified behavior changes. Progress is reported weekly; logs are sometimes required. Members practice new behavioral roles, support other group members in their new behaviors, and agree to a follow-up session after the group terminates.

Adlerian Groups Members' Roles

Members commit to be active members: to state goals openly, to deal openly with trust issues, to examine the affect of family structure on current behavior, to take responsibility for one's actions, and to search out and admit faulty motivations (Fehr, 1999).

Person-Centered Groups (Carl Rogers) Members' Roles

Members formulate their own goals, encourage and support other members, express feelings, and move to greater genuineness. Becoming more internally focused results from further self-exploration.

Psychoanalytic Groups Members' Roles

Members give feedback based on their observations of members' defense mechanisms. Members attempt to bring the unconscious to the conscious through free association to their dreams, interpretation of dreams, and exposing their own resistances (Gazda, 2001).

Transactional Analysis Groups Members' Roles

Members identify goals and commit to contracts for change. They explore the games they play, decide how they will change, and then plan specifically how a change in behavior, thinking, or feeling will occur.

Curative Factors, according to Irvin Yalom, that make up the process of therapeutic change are the following (Yalom, 1985): Imitative behavior

Members may copy the behavior of the group leader or other group members. This can be effective because a member sees a model to follow, and this makes him/her realize what elements of another person can be tried in his/her own life.

Psychodrama Groups (Jacob Moreno) Members' Roles

Members willingly and intensively participate physically, emotionally, and cognitively. A group member acts as a protagonist and chooses a conflict to dramatize in the group. Group members participate as significant others or objects for the protagonist. They then share and interpret on a personal level, not cognitive or analytical. An essential element of the education of the group members is the discussion and the processing of the dramas (Fehr, 1999).

Leadership Styles Laissez-faire

No leadership is in place. This is considered to be generally ineffective. (Example: New counselors and those who have a strong need to be liked.) Members exhibit aggressive behavior. Preferred when a decision has been made and committed to.

Leadership Functions Caring

Offers support, affection, praise, protection, concern, and acceptance.

Rational Emotive Behavior Therapy Groups (REBT) (Albert Ellis) Members' Roles

REBT members must concentrate and work on their cognitive processes. Outside practice is required and members learn to rationally and logically discuss their own and others' irrationalities.

Reality Therapy Groups (William Glasser) Members' Roles

RT group members must engage in honest self-evaluation. They must be willing to assess their wants and needs and to evaluate current behaviors based on that evaluation. Members construct a plan for change and commit to it, thereby taking greater control of their lives.

4. Termination - Separation - Adjourning Stage

Reinforcing the growth experienced by members, making sure differences between members are worked out before departure, and assisting with ongoing individual counseling as needed are the issues. a. Summarizing the group's activity and discussion b. Evaluating the group process c. Allowing the group to evaluate the group and themselves individually d. Providing for referral or continued counseling for those who feel they should continue e. Explaining that because of emotional involvement it may be strange to not have group and there may be a period of adjustment; outside bonds should be established f. Saying good-bye g. Employing techniques specifically chosen to End a session Terminate a group Assess and follow-up Evaluate a group

Marathon Groups

Rely on long sessions (over a weekend or several days) to break down defenses and facades of members so the members can confront issues in an honest, real, and genuine way.

Psychodrama Groups (Jacob Moreno) Techniques

Sessions usually begin with warm-up exercises which may include musical expression, light dramatic scenes, dancing, guided fantasy, drawing, a "go-around," etc. The second stage is the action stage which focuses on acting out and working through past, present, or future situations. Presentation of self and others, interviewing self and others, soliloquy, time travel, and role reversal, etc. are all employed at different times. The last stage begins with the sharing of non-judgmental observations by the protagonist and by other group members. Discussion techniques, a solution roundtable, personal interpretation, etc. may then be used to provide closure. Perhaps the greatest contribution of psychodrama is its ability to be integrated into most other group therapy modalities.

Leadership Functions Executive duties

Sets limits, rules, and goals; manages time, paces, and intercedes. Experts report that a lack of goal setting is a weakness often found in group work and that if goals are defined they are often too vague to be effective.

Reality Therapy Groups (William Glasser) Techniques

Since ascertaining needs and contracting for behavior that meets those needs is of paramount concern in the RT group, the leader uses a multitude of techniques to accomplish this end including open group discussions, questions, avoiding punishment, paradox, homework assignments, confrontation, role-playing, asking for commitment, etc.

Person-Centered Groups (Carl Rogers) Techniques

Since there is no formal, set structure, few planned activities are presented to the group. The leader and the members exhibit the following: active listening, showing respect, reflecting, clarifying, self-disclosing, encouraging, and embodying the three core conditions.

Specific Developmental Group Stages Proposed by Theorists Corey and Corey (2000)

Stage 1: Stage 2: Stage 3: Stage 4: Stage 5: Stage 6: Pregroup Issues - Formation of the Group Initial Stage - Orientation and Exploration Transition Stage - Dealing with Resistance Working Stage - Cohesion and Productivity Final Stage - Consolidation and Termination Postgroup Issues - Follow-Up and Evaluation

3. Working - Action - Productive Stage

Taking responsibility for attaining goals and changing behaviors are the issues. a. Increasing cohesion and trust to a high level b. Increasing mutuality and self-exploration c. Less dependence on the leader d. Modifying interaction patterns e. Committing to change in the here-and-now context f. Leader responses: interpreting meaning, appropriate confrontation, and feedback g. Employing techniques specifically chosen to Deal with expressed confusion Deal with issues of closeness Teach appropriate disclosure Elicit emotional responses when they are being held back Deal with the fear of losing control Deal with intense emotions in all members simultaneously Work with dreams Work with projection and self-awareness problems

Gestalt Groups (Fritz Perls) Theoretical Basis

The Gestalt paradigm holds that as an individual becomes aware of his or her own thoughts, feelings, senses, and fantasies that personality change will occur, problems will be solved, and impasses will be identified and resolved. The focus is on the "here and now" and characterized by action and insight (Fehr, 1999).

Rational Emotive Behavior Therapy Groups (REBT) (Albert Ellis) Leader's Role

The REBT leader is both process and outcome oriented and is both an active teacher and confronter. The leader shows how cognition leads emotions and behaviors and how to identify and overcome irrational beliefs. The leader challenges, confronts, convinces, probes, and encourages new thinking and behavior patterns.

Reality Therapy Groups (William Glasser) Leader's Role

The RT group is leader centered and outcome oriented. The leader keeps the group rational and action oriented. The leader encourages facing reality and evaluating current behaviors in light of current needs.

Rational Emotive Behavior Therapy Groups (REBT) (Albert Ellis) Theoretical Basis

The Rational Emotive Behavior Therapy modality views problems as stemming from people's responses, processing, and interpretation of external events. By replacing irrational beliefs with a more rational cognitive processing, members reject self-defeating behaviors (Corey, 2000).

Transactional Analysis Groups Leader's Role

The TA group leader educates members about the three ego states (parent, adult, and child) and about the language and process of TA. The group is leader centered and is both process and outcome oriented.

Behavioral Groups Leader's Roles

The behavioral therapist is an active and directive teacher. The leader prescreens, interviews, and educates members on the behavioral group process. The leader actively assists with goal setting, teaches self-management skills, supports members' behavioral undertakings, monitors progress, facilitates therapeutic alliances between group members, and encourages the maintenance of targeted behaviors by follow-up interaction with group members after the group has terminated (Fehr, 1999).

Leadership Styles

The classic Lewin, Lippitt, and White study of 1939 identified three basic leadership styles and evaluated their effectiveness.

Existential Groups (Irvin Yalom; also May, Frankl, Jourard, Maslow, Bugental, Moustakas) Theoretical Basis

The existential approach is a dynamic approach that recognizes four ultimate concerns in the human existence: death, freedom, isolation, and meaninglessness (Yalom, 1980). Existentialism assumes we are free and responsible for the choices and the actions that make up our lives. Therefore, existential groups encourage members to explore choices that would represent an honest exploration of themselves, that would widen their perspectives on themselves and the world around them, and that would make life meaningful.

Existential Groups Leader's Role

The existential group leader facilitates a therapeutic alliance amongst group members as well as between him or herself and the group. The leader's input is purposefully subjective so as to encourage group members to express their subjective feelings (Fehr, 1999).

Person-Centered Groups (Carl Rogers) Theoretical Basis

The focus in person-centered groups is on meanings, feelings, insight, affect, and personal attitude. Three environmental attitudes provide the backdrop for a person to achieve self-actualization: genuineness, unconditional positive regard, and empathy. Change toward wholeness and self-actualization occurs as both the leader and group members create these core conditions (Fehr, 1999). A typical person-centered group will go through these stages: 1. milling around 2. resistance 3. description of past feelings 4. expressions of negative feelings 5. exploration of meaningful material 6. expression of here-and-now interpersonal feelings 7. development of a healing capacity 8. self-acceptance 9. cracking of facades 10. feedback 11. confrontation 12. helping relationships outside group 13. basic encounter 14. closeness 15. behavior

Curative Factors, according to Irvin Yalom, that make up the process of therapeutic change are the following (Yalom, 1985): Development of socializing techniques

The group can affect the way we act and function socially. In group, there is appropriate and inappropriate behavior just like in society. In group, a person can deal with his/her problems constructively and enhance his/her social skills in the process.

Person-Centered Groups (Carl Rogers) Leader's Role

The group leader functions more like a guide than a director and is process oriented as he or she models the three core conditions while allowing the group to move in the direction it chooses.

Curative Factors, according to Irvin Yalom, that make up the process of therapeutic change are the following (Yalom, 1985): Group cohesiveness

The group members, including the group leader, will form relationships with each other. This unity provides an atmosphere of free expression, the freedom to remain silent, and the facilitation of change.

Curative Factors, according to Irvin Yalom, that make up the process of therapeutic change are the following (Yalom, 1985): Imparting of information

The imparting of information takes place as the client learns of different elements involved in the process of psychotherapy. A client will learn a great deal about the group process by experiencing it. His/her knowledge may not be formulated explicitly, but in general terminology, he/she would be able to discuss the process knowingly.

Psychoanalytic Groups Leader's Role

The leader addresses members' defense mechanisms, directs the focus to early childhood, and helps members work through transference.

Leadership Styles Authoritarian

The leader sees him/herself as an expert; very directive. (Example: Psychoanalytic counseling; teaching) Liked the least by members. Members exhibit aggressive behavior; thirty percent higher hostility rate than with the other two styles. Preferred when an immediate decision is necessary.

Adlerian Groups Leader's Role

The leader supports the goals of the members by examining their goals to gain further understanding. The leader can then encourage members, help assess and clarify problems, and allow members the freedom to remember and to interpret early childhood experiences.

Gestalt Groups (Fritz Perls) Leader's Role

The leader uses "how" and "what" questions while pointing out unauthentic behaviors and maintaining a member and process oriented environment. Both verbal and nonverbal messages are noted as well as any resistances.

Psychodrama Groups (Jacob Moreno) Leader's Role

The psychodrama leader is a director who fosters strong group bonding (necessary for group members to feel comfortable enough to participate), who encourages intense participation, and who facilitates the integration of what has occurred for the "protagonist" by requesting feedback from group members.

Psychoanalytic Groups

Theoretical Basis 1. The psychiatrist and psychoanalyst Alexander Wolf first applied psychoanalytic principles and techniques in groups in 1938 as he tried to help people that could not afford intensive individual therapy. His success led him to adopt group therapy as his primary therapy mode (Corey, 2000). 2. As with individual psychoanalytic therapy, group members work through repressed conflicts to restructure their personality and character. The individual's unconscious is explored, particularly the first six years of life. GROUP THERAPY THEORIES AND TECHNIQUES 3. A typical psychoanalytic group will go through these six stages: a. Preliminary individual analysis to determine suitability for the group b. Rapport through interpretation of dreams and fantasies c. Free association interaction d. Analysis of resistance e. Analysis of transference f. Conscious personal action and social integration

Curative Factors, according to Irvin Yalom, that make up the process of therapeutic change are the following (Yalom, 1985): Interpersonal learning

Through the group process a member will become very aware of the different aspects of self. The individual will interact in group and give clues of what he/she is and where he/she is going to the other members. This can be discussed and the learning process will begin. Steps of interpersonal learning: a. Members exhibit disturbed behavior. b. The group becomes a social microcosm, a representation of each member's universe. c. Members become self-aware through other members' feedback and self- observation. Members witness their own behavior and come to appreciate the impact their behavior has on three things: the feelings of others, the opinions that others have of them, and the opinions they have of themselves. d. Awareness of this sequence makes the member personally responsible for it. "Each individual is the author of his or her own interpersonal world." e. Accepting responsibility means that if they created their social-relational world, then they have the power to change it.

Transactional Analysis Groups Theoretical Basis

Transactional Analysis is an interactional modality and structural analysis founded on Eric Berne's belief that individuals make decisions based upon current beliefs. Identifying illogical beliefs is the catalyst for change as a revised basis for decision- making must be formulated. Thus, individuals' control what they think, do, and feel (Fehr, 1999).

Curative Factors, according to Irvin Yalom, that make up the process of therapeutic change are the following (Yalom, 1985): Universality

Universality refers to the realization that the client has problems that are similar to those of other people. A client will begin counseling feeling that his/her problems are unique. He/she will feel enormous relief when he/she learns that "I'm not alone."

Therapy

attends to people's unconscious needs and their past in an effort to bring about personality change.

Leadership Functions Risk information and informed consent

a. Ethical guidelines require that risks of group membership be discussed during the screening interview or as soon as is possible thereafter. b. Group confidentiality is desired but cannot be guaranteed. c. The leader will attempt to reduce risks and dangers and will attempt to protect clients from risks. d. Informed consent includes information regarding the stated purpose of the group, the qualifications of the leader, the potential risks involved (including negative outcomes), the rights of members to be treated with respect and dignity, the agreement to openly share concern's and to be open to the concerns of others, etc. e. ASGW ethical guidelines state, "Group leaders shall inform members that participation is voluntary and they may exit the group at any time" (ASGW, 1998). If clients are in "mandatory treatment" (i.e., required by court order), clients should be told that appropriate notification will be made to the applicable authorities should the clients leave the group.

Specific Developmental Group Stages Proposed by Theorists Gazda (2001)

a. Exploratory Stage - superficial b. Transition Stage - significantly deeper self-disclosure c. Action Stage - working, productive d. Termination Stage - tapering off of self-disclosure

Specific Developmental Group Stages Proposed by Theorists Tuckman & Jensen (Tuckman & Jensen, 1965)

a. Forming/Orientation (Acceptance, approval, commitment, search for orientation and structure) b. Storming/Transition (Dominance, control, power) c. Norming (Risk taking, openness, cohesiveness, caring) d. Performing/Working (Honesty, spontaneity, responsibility, self-disclosure) e. Adjourning (Terminating, distancing, summation, closure)

Specific Developmental Group Stages Proposed by Theorists Schutz (1973)

a. Inclusion - Members strive to be accepted and loved by the leader. b. Power - Members attempt to gain autonomy from the leader. c. Affection - Members look to one another for aid both in giving and in receiving help.

Specific Developmental Group Stages Proposed by Theorists Yalom (1995)

a. Orientation b. Conflict c. Cohesion (in two levels) great mutual support - the group against the world. true teamwork - each member against his or her own resistances.

Leadership Functions (Knowles, 1959; Corey, 1995) Screening of potential members

a. Recommended by ethical guidelines for all groups. b. May be conducted individually or in the group setting. c. Allows both client and counselor expectations and concerns to be expressed. d. Allows client to evaluate leader's qualities and competence. e. May engender trust in the client. f. If done individually, may not evoke behavior that will be displayed in the group setting. g. Remember: i. Only appropriate members should be admitted. ii. When individual counseling is being received by a potential member, the individual counselor should be contacted before admission is granted. h. Several types of individuals have been identified by research as poor choices for group membership unless the group is specifically designed to deal with these particular issues: hostile physically aggressive paranoid actively suicidal actively homicidal psychotic (not in touch with reality) totally self-centered i. The most important member traits: the ability to trust; the ability to feel cohesive. j. Members' traits correlated to premature termination from group included: low intelligence low motivation high denial

Leadership Functions Strategy and intervention variation

a. Should the counselor's approach be content or process oriented? i. Content - the client's material; how the client is or seems. "Jill seems relaxed." "I hear hurt in George's voice." ii. Process - how communication happens or transpires; how the client acts. "Bill looks away or Rachel closes up when something is mentioned." b. Should the counselor's approach be horizontal or vertical? i. Horizontal - the leader works with the group as a whole and employs techniques which facilitate group processes, tasks, interactions, and relationships; sometimes called interpersonal. Interpersonal leaders tend toward here and now interventions. ii. Vertical - the leader works with individuals within the group and, in effect, provides individual counseling in a group setting; sometimes called intrapersonal. Intrapersonal leaders tend to focus on the past and sometimes use psychodynamic principles. Effective counseling will exhibit both horizontal and vertical interventions.

Developmental Group Counseling (Life-Skills Training) (George Gazda) Activity-interview group counseling or activity group counseling is

appropriate for the preadolescent ages 9 to 13. An activity is used to involve the group. This participation lowers inhibitions and defenses and gives way to interpersonal interactions.

Sensitivity groups

are groups whose direct focus is on personal and interpersonal issues.

Sociograms

are pictorial representations of a group's interactions. Moreno and Jennings were the first to graphically display the affiliations and interactions of group members.

Norms

are the rules, whether spoken or unspoken, that tell individuals how to act in the group. All groups have norms, meaning that there are expectations of behavior within the group even if these guidelines are not formally laid out. Norms will vary depending on the type of group and the role of the member in the group.

Types of Groups Requiring Specialized Training Task and Work Groups

focus on leading groups in correcting or developing their organizational functioning; may include facilitating planning or evaluation. 1. Leader role Facilitator 2. Techniques standard discussion methods team building collaborative group problem solving consultation regarding program development strategies to effect change 3. Required contextual understanding Organizational, community, and/or political dynamics since task groups often occur within these settings. 4. Related required components a. maintaining task/work group focus b. maintaining relationship with the larger organization of which the task/work group is a part c. clear goal setting and measurement d. clearly defined decision-making options e. preparing the group to expect conflict, to recognize it, and to constructively deal with it f. observing task/work group processes including group climate, membership, norms, task maintenance, feelings, participation levels, decision-making, individual influence, etc. g. quality feedback

Types of Groups Requiring Specialized Training Psychoeducation Groups

focus on particular themes chosen from needs assessments or relevant literature; impart information and provide education and support. 1. Leader role Instructor; facilitate skill development. 2. Techniques Structured or semi-structured group facilitation Each session is structured and exercises within the sessions are structured. 3. Required contextual understanding a. Often focused on prevention (primary prevention is intervention intended to lessen new occurrences of behavior); group activities change with the degree of "at-risk" potential of members. b. Comprehension and application of human lifespan development with accompanying diversity, environmental, demographic, social marketing, and system development influence issues. 4. Related required components a. Systematic, clear, organized relaying of information. b. Interrelated goals, strategies, activities, methods, delivery, and evaluation. c. Psychoeducation group leader skills include i. Knowledge of, research in, and concepts of content area. ii. Ability to select and recruit appropriate members, especially with "at risk" populations. iii. Competence in designing appropriate structured sessions and exercises. iv. Awareness and monitoring of structure to prevent "information overload." v. Self-perception and choice-making leads to empowerment of members. vi. Ethical considerations include: Attending to individual needs of members. Avoiding invasion of privacy in "healthy," low-risk members.

Counseling

focuses on conscious problems that may be social, educational, vocational, or personal. Counseling does not focus on neurotic or psychotic disorders. Counseling attempts to bring about resolution within a relatively short period of time.

Types of Groups Requiring Specialized Training Group Counseling

focuses on enhancing growth and self-awareness and removing blockages to growth. 1. Leader role Role characteristics will depend on the leader's personal conceptual framework (cognitive, existential, behavioral, etc.) and the group situation. Co-leadership or co-facilitation may be employed: a. Provides additional role model for group members. b. Provides support and safety for leaders. c. Guards against burnout. d. Facilitates the leaders' processing the group experience and evaluation; best if leaders meet both before and after each session. e. Requires a good match between leaders. f. Requires an on-going working relationship between leaders that is open and sharing; not questioning the other's competence; not working against each other; not in a power struggle. g. Allows stronger focus on group dynamics. h. Allows group to meet if one leader is absent. i. Provides additional feedback to group members. j. Allows effective communication to be modeled. k. Allows effective leadership to continue even when one leader is experiencing countertransference. l. Allows novices to learn to lead a group. Note: A male/female co-leading team is considered especially advantageous. 2. Techniques a. Chosen based on leader's conceptual framework. b. May include self-disclosure, feedback, modeling, skills training, confrontation, assigned homework, viewing videos, journaling, role playing, etc. 3. Required contextual understanding Potential group members must be matched with other members and the group as a whole to facilitate a successful group experience. Goals, expectations, levels of functioning, availability, and motivation are all factors. © Institute for Personal Growth and Achievement, Inc. www.NCEExamPrep.com Chapter 8 - Group Chapter 8 - Group Dynamics, Theories, and Techniques - Chapter 8 Group Dynamics - Types of Groups Requiring Specialized Training - Page 39 4. Related required components a. Counseling group leader skills include: i. Knowledge of and the ability to make referrals as necessary. ii. Knowledge of group processes, therapeutic factors, and feedback and self- disclosure behaviors. iii. Ability to assess interpersonal phenomena including engaging others, inclusion, openness, and control. iv. Assessing similarities and differences between stated beliefs and actual behaviors. v. Assigning reasonable meanings to nonverbal and culturally related behaviors. vi. Recognizing self-defeating behaviors. vii. Employing interventions appropriate for the group and the individual member's developmental stages. viii. Effectively responding to conflict within the group and to excessive or inappropriate behavior. b. Members must learn to apply learning from the group experience to everyday lives. c. Informed consent must be obtained during the formation process. d. Evaluation of group progress, effectiveness, and value is conducted by the leader's collecting relevant data (pre- and post-test methods, during sessions, at end of sessions). 5. Advantages of group counseling a. Benefit of interpersonal relationships and interpersonal learning. b. Less expensive than individual counseling. c. Therapeutic orientation. d. Provides automatic support group. e. Allows learning of problem-solving strategies. 6. Disadvantages of group counseling a. Difficulty in recruiting and appropriately matching members to a group. b. Individual needs may not be addressed. c. Client confidentiality is difficult to maintain.

Types of Groups Requiring Specialized Training Group Psychotherapy

focuses on remediation, treatment and personality reconstruction. 1. Leader role Role characteristics will depend on the leader's personal conceptual framework (cognitive, existential, behavioral, etc.) and the group situation. 2. Techniques a. Chosen based on leader's conceptual framework. b. May include: interpersonal and intrapersonal assessment diagnosis interpretation linking current problems with client's history, etc. 3. Required contextual understanding a. Knowledge of human development and personality development. b. Development of abnormal behavior and dysfunction. c. Knowledge of the Diagnostic and Statistical Manual (DSM) categories to match assessment with group membership criteria. d. Knowledge of crisis theory and the role it plays in individual and in group work. 4. Related required components a. Special screening attention because members can come from a wide range of psychological and emotional disturbance populations. Individuals with character disorders or poor reality contact are not good prospects for group psychotherapy. b. Leader competence to recognize and to deal with crucial behaviors: self- defeating, antagonistic, extremely dysfunctional, dangerous, disruptive, etc. May require the leader's direct intervention (even physical) or hospitalization. c. Gradiated goal achievement, recognition of incremental gains, increased support, and repeated group involvement are probable. Note: Some theorists make a distinction between guidance groups, counseling groups, and therapy groups. Individual treatment professionals often use the terms counseling and therapy interchangeably, BUT Group work professionals consider them as dealing with three different levels of severity of problems.

Open-ended

groups have no stated ending date or number of sessions.

Consciousness-raising

has a societal or political emphasis, such as raising the consciousness of women about their own power, of men about women's needs, of whites about minorities, etc.

Dynamic and dynamics

imply change and movement.

Laboratory training

is a generic term that means learning through experience.

Cohesiveness

or group unity denotes the sense of caring one has for the group and for other members of the group. Kurt Lewin (field theory) viewed cohesiveness as the binding force among group members and called it "positive valence." As cohesiveness strengthens, negative factors and behaviors such as absenteeism are lessened, group productivity increases, and commitment strengthens. A group with low cohesion is "fragmented."

Group Content

refers to the topic of discussion within the group.

Regarding structured vs. unstructured techniques through the stages of group development - Yalom (1995), in particular,

warns that unstructured techniques/exercises are more effective than structured ones in achieving the desired results at each stage.

Roles

which help with focusing the group, setting goals, and solving problems. These are generally classified as: 1. task roles (positive) - help the group carry out a task 2. maintenance roles (positive) - help maintain and strengthen processes of the group 3. self-serving/individual roles (negative) - intent on meeting own needs at expense of the group; work against the group