C6438 Group Theories and Practices

1
C6438 Group Theories and Practices

• Presented by
• Jim Messina, Ph.D.
• Adjunct Professor, Argosy University
• jmessina_at_argosyu.edu

2
Overview of Groups
3
Different Types of Groups

• Task groups aim to foster accomplishing
  identified work goals
• Psychoeducational groups aim to educate
  well-functioning group members who want to
  acquire information skills in an area of living
• Group counseling aim at preventive
  educational purposes utilizes methods of
  interactive feedback within a here-and-now time
  framework
• Group psychotherapy aims at remediation of
  in-depth psychological problems often focuses
  on past influences of present difficulties

4
Some Advantages of Groups

• Group setting offers support for new behavior and
  encourages experimentation
• The group is a microcosm of the real world
  allows us to see how we relate to others
• Group setting provides an optimal arena for
  members to discover how they are perceived and
  experienced by others
• Groups help members see that they are not alone
  in their concerns

5
Misconceptions about Groups

• Groups are suited for everyone
• The main goal of a group is for everyone to
  achieve closeness
• Groups tell people how they should be
• Group pressure forces members to lose their sense
  of identity
• Groups are artificial unreal

6
Group Process vs. Group Techniques

• Group process all the elements that are basic
  to the unfolding of a group from beginning to end
• Examples group norms, generating trust, how
  conflict emerges in a group, patterns of
  resistance, inter-member feedback
• Group techniques leader interventions aimed at
  facilitating movement within a group
• Examples conducting initial interviews, asking
  a member to role-play a conflict, challenging a
  members belief system, suggesting homework

7
Multicultural Perspective in Group Work

• Effective group work involves considering culture
  of participants
• Practitioners cannot afford to ignore diversity
  in group work
• Group workers must have awareness, knowledge
  skills to effectively deal with diverse
  membership
• Cultural similarities differences need to be
  addressed in a group

8
What it takes to be a Diversity Sensitive Group
Leader

• Diversity competence involves a deep
  understanding of ones own culture
• Culturally competent group workers need to
• Be aware of their biases, stereotypes
  prejudices
• Know something about the members of the group
• Be able to apply skills interventions that are
  congruent with the worldviews of the members
• Ethical practice entails diversity competence

9
Competence Requirements for Diversity Sensitivity

• Group workers need to
• Consider the impact of adverse environmental
  factors in assessing problems of group members
• Be aware of how their values beliefs influence
  their facilitation of a group
• Respect the roles of family community
  hierarchies within a members culture
• Respect members religious spiritual beliefs
  values
• Acknowledge that ethnicity culture influence
  behavior

10
Some personal characteristics of effective group
leaders

• Courage
• Goodwill and caring
• Becoming aware of their own culture
• Stamina
• Presence
• Openness
• Personal power
• Willingness to seek new experiences

11
Issues for Beginning Group Leaders

• Anxiety is normal it can work for you
• Learn to recognize challenge your inner
  dialogue
• Gaining experience in facilitating a group with
  supervision
• Too little versus too much self-disclosure
• Learning appropriate facilitative
  self-disclosure
• Coping with the challenges of working in a system
• Know yourself be committed to making positive
  changes

12
Important to Determine Your Competence to be Lead
Groups

• Determining your level of competence
• How can I assess my level of competence?
• How can I upgrade my knowledge skills?
• What techniques can I successfully employ?
• How can I make use of consultation supervision?
• How can personal counseling be a route to
  competence?

13
Group Leadership Skills

• Essential to acquire refine skills applied to
  group work
• Group leadership skills cannot be separated from
  the leaders personality
• It is an art to learn how to use group skills
• Ways to learn leadership skills supervised
  experience, practice, feedback experience in a
  group as a member

14
Group Leadership Skills include

• Clarifying
• Linking
• Suggesting
• Interpreting
• Facilitating
• Modeling
• Blocking
• Summarizing
• Terminating

15
Skills for Opening Closing Groups

• Procedures for opening a group session
• Make it a practice for members to briefly check
  in
• Learn to link sessions
• Be attentive to unresolved issues from prior
  sessions
• With the members, create an agenda for each
  session
• Procedures for closing a group session
• Allow time for closure
• Encourage members to identify what they learned
• Fostering the willingness to do homework

16
ASGW Best Practices Guidelines

• Professional competence in group work is not a
  final product, but a continuous process for the
  duration of ones career
• Some suggestions for increasing ones level of
  competence as a group leader
• Keep current through continuing education
  participation in personal professional
  development activities
• Be open to seeking personal counseling if one
  recognizes problems that could impair ones
  ability to facilitate a group
• Be willing to seek consultation supervision as
  needed

17
ASGW recommendations for competent group
facilitators

• Knowledge competencies course work is essential
• Skills competencies specific group facilitation
  skills are required for effectively intervening
• Core specialization in group work task
  facilitation groups Psychoeducational groups
  counseling groups psychotherapy groups

18
Ethical Issues Involved in Group Work

• Issues in involuntary groups
• Freedom from coercion undue pressure
• Freedom to leave a group
• Protecting members from psychological risks in
  groups
• Subgrouping out-of-group contact

19
Informed Consent in Group Formation

• Informed consent
• Provide members with adequate information that
  will allow them to decide if they want to join a
  group
• Provides information for prospective members on
• The nature of the group
• The goals of the group
• The general structure of the sessions
• What is expected of them if they join
• What they can expect from you as a leader

20
Involuntary Group Members

• Many groups are composed of involuntary members
• The challenge is to demonstrate the value of a
  group for members
• Basic information about the group is essential
• Avoid assuming that involuntary members will not
  want to change

21
Psychological Risks of Group Participation

• Although there are benefits to participating in a
  group, there are also potential risks that group
  leaders need to monitor
• Members may be pressured to disclose violate
  privacy
• Confidentiality may be broken
• Scapegoating may occur
• Confrontation may be done in an uncaring manner
• Group leaders may not have the competencies to
  deal with some difficulties that arise in a group

22
Confidentiality

• Confidentiality is the foundation of a working
  group
• Leaders need to define the parameters of
  confidentiality including its limitations in a
  group setting
• Members need to be taught what confidentiality
  involves
• Leaders talk to members about the consequences of
  breaching confidentiality
• Leaders remind members at various points in a
  group of the importance of maintaining
  confidentiality

23
Ethical Guidelines for Using Different Group
Techniques

• Your techniques should have a rationale
• Introduce techniques in a sensitive timely
  manner
• Dont stick to a technique if it is not working
  effectively
• Give members a choice invite them to experiment
  with some behavior
• Use techniques that are appropriate to the
  members cultural values
• Techniques are best developed in response to what
  is happening in the here-and-now

24
Group Leader Guidelines to Monitor their Values

• Essential that you are aware of your values how
  they influence what you think, say do in groups
• Groups are not a forum for you to impose your
  values on members
• Purpose of a group to assist members in
  examining options that are most congruent with
  their values
• Group members have the task of clarifying their
  own values goals, making informed choices
  assuming responsibility for what they do

25
Legal Ethical Safeguards for Group Leaders

• Take time and care in screening candidates for a
  group for preparing them on how to actively
  participate
• Demystify the group process
• Strive to develop collaborative relationships
  with the members
• Consult with colleagues or supervisors whenever
  there is a potential ethical or legal concern
• Incorporate ethical standards in the practice of
  group work

26
Stages of Groups

• Forming
• Initial
• Transition
• Working
• Final

27
FORMING a Group

• Five areas for a practical proposal for a group
• Rationale What is the rationale for your group?
• Objectives Are your objectives specific
  attainable?
• Practical considerations Have you considered
  all the relevant practical issues in forming your
  group?
• Procedures What kinds of techniques
  interventions will you employ to attain the
  stated objectives?
• Evaluation How will you evaluate the process
  outcomes of the group?

28
How to Screen for Potential Members of Groups

• The type of group determines the kind of members
  that are suitable or unsuitable
• The key questions are
• Should this person be included in this group at
  this time with this leader?
• Other questions -What methods of screening will
  you use?
• How can you decide who may benefit from a group?
  
• And who might not fit in a group?
• How might you deal with a candidate who is not
  accepted to your group?

29
Practical Considerations in Forming a Group

• Group composition
• Group size
• Open versus closed group
• Length of the group
• Frequency duration of meetings
• Place for group sessions

30
INITIAL STAGE of Group

• Characteristics of initial stage
• Participants test the atmosphere get acquainted
• Risk taking is relatively low exploration is
  tentative
• Members are concerned with whether they are
  included or excluded
• A central issue is trust versus mistrust
• There are periods of silence awkwardness
• Members are deciding how much they will disclose
  how safe the group is

31
Common Fears of Group Members in Initial Stage

• Anxiety over being accepted or rejected
• Concern about the judgment of others
• Afraid of appearing stupid
• Concerns about not fitting into the group
• Not knowing what is expected
• Concern over communicating feelings thoughts
  effectively

32
Advantage of Here and Now Focus in Initial Stage

• Dealing with the here-and-now energizes the group
• Members are best known by disclosing here-and-now
  experiencing
• Being in the here-and-now serves as a springboard
  for exploring everyday life concerns

33
Leader Attitudes Behaviors which Build Trust

• Careful attending genuine listening
• Empathy
• Genuineness self-disclosure
• Respect
• Caring confrontation

34
Establishing Goals in Initial Stage

• Main task helping members formulate clear
  specific goals
• Absence of goals considerable floundering
  aimless sessions
• Collaborative process in identifying goals
• Goals lead to contracts homework assignments

35
Group Norms

• Norms and procedures enable a group to attain its
  goals
• Examples of group norms
• Expectation of promptness regular attendance
• Norm of sharing oneself in personal ways
• Expectation of giving meaningful feedback
• Members encouraged to offer both support
  challenge to others
• Members functioning within the here-and-now
  context of the group

36
Member Guidelines to Benefit from the Group

• Express persistent reactions
• Come prepared to group sessions
• Decide for yourself what how much to disclose
• Be an active participant
• Be open to feedback consider what you hear
• Experiment with new behavior in group

37
Group Leader Issues in Initial Stage of Group

• Division of responsibility How to achieve a
  balance of sharing responsibility with members?
• Degree of structuring Creating a structure
  that will enable members to make maximum use of
  group process
• Opening group sessions How to best open a
  group help members gain a focus?
• Closing group sessions How to best bring a
  session to closure without closing down further
  work later on?

38
TRANSITION STAGE of Group

• Characteristics of the transition stage
• Transitional phase is marked by feelings of
  anxiety defenses
• Members are
• testing the leader other members to determine
  how safe the environment is
• struggling between wanting to play it safe
  wanting to risk getting involved
• observing the leader to determine if he or she is
  trustworthy
• learning how to express themselves so that others
  will listen

39
Measure of Trust in Group

• Some signs of a low level of trust
• Members are
• Hesitant in expressing what they are thinking
  feeling
• Unwilling to initiate personally meaningful work
• Denying that they have any problems or concerns
• Hiding behind global statements
  intellectualizations
• Not willing to deal with conflict in the group

40
Thoughts on Dealing with Resistance
Therapeutically

• Dont label all hesitations as a sign of
  resistance
• Respect resistance Realize that member
  resistance may be serving a function
• Invite members to explore the meaning of what
  appears to be resistance
• Describe behavior of members avoid making too
  many interpretations
• Approach resistance with interest, understanding
  compassion

41
Common Fears Emerging in Transition Stage

• Fear of making a fool of oneself
• Fear of emptiness
• Fear of losing control
• Fear of being too emotional
• Fear of self-disclosure
• Fear of taking too much of the groups time
• Fear of being judged

42
Some Guidelines for Effective Confrontation

• If you confront, know why you are confronting
• Confront if you care about the other
• In confronting another talk more about yourself
  than the other person
• Avoid dogmatic statements judgments about the
  other
• Give others the space to reflect on what you say
  to them

43
Group Leader Interventions in Dealing with
Difficult Behavior

• Avoid responding with sarcasm
• State your observations hunches in a tentative
  way
• Demonstrate sensitivity to a members culture
• Avoid taking members behavior in an overly
  personal way
• Encourage members to explore a resistance
  dont demand they give up a particular
  resistive behavior

44
Examples of Problematic Behaviors within a Group

• Silence
• Monopolistic behavior
• Storytelling
• Giving advice
• Questioning
• Dependency
• Intellectualizing

45
Leader Functions During Transition Stage

• Show members the value of recognizing dealing
  fully with conflict situations
• Help members to recognize their own patterns of
  defensiveness
• Teach members to respect resistance to work
  constructively with the many forms it takes
• Provide a model for members by dealing directly
  tactfully with any challenge
• Encourage members to express reactions that
  pertain to here-and-now happenings in the sessions

46
WORKING STAGE of Group

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

47
Group Norms Behaviors in the Working Stage of
Group

• At the working stage of a group there is further
  development solidification of group norms
  established earlier
• Some group behaviors at the working stage
• Both support challenge to take risks in group
• Leader uses a variety of therapeutic
  interventions
• Members interact with each other in more direct
  ways
• Healing capacity develops within the group
• Increased group cohesion fosters action-oriented
  behaviors

48
Characteristics of Productive Group

• There is a focus on the here now
• Goals of members are clear specific
• Cohesion is high a sense of emotional bonding
  in the group
• Conflict in the group is recognized explored
• Members are willing to make themselves known
• Trust is increased there is a sense of safety

49
Characteristics of Non-Working Group

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

50
Choices to be made during the Working Stage of a
Group

• Disclosure versus anonymity
• Honesty versus superficiality
• Spontaneity versus control
• Acceptance versus rejection
• Cohesion versus fragmentation

51
Value of Homework in Groups

• Group not an end in itself
• Group is
• A place to learn new behaviors
• A place to acquire a range of skills in living
• Training ground for everyday life
• Homework a means for maximizing what is learned
  in group
• Members can devise their own homework assignments
• Ideally, homework is designed collaboratively
  between members leader

52
Therapeutic Factors Operating in Groups

• Self-Disclosure
• Confrontation
• Feedback
• Cohesion Universality
• Hope
• Willingness to Risk Trust

• Caring Acceptance
• Power
• Catharsis
• The Cognitive Component
• Commitment to Change
• Freedom to Experiment
• Humor

53
Guidelines for Member Self-Disclosure with Groups

• Disclosure related to the purposes of the group
• Persistent reactions useful to express
  persistent thoughts feelings
• Members decide what how much to disclose
• Safe climate disclosure increases in a safe
  group
• Level of disclosure stage of group may
  determine what is appropriate

54
Guidelines for Giving Feedback

• Give feedback with honesty with sensitivity
• Concise feedback given in a clear
  straightforward way is useful
• In giving feedback, let others know how their
  behavior affects you
• Avoid giving global feedback
• Avoid being judgmental in giving feedback

55
Catharsis in Groups

• Catharsis the expression of pent-up emotions
• Catharsis can be healing can lead to increased
  cohesion
• Catharsis is not appropriate for all types of
  groups
• After a catharsis
• It is useful to integrate cognitive behavioral
  work
• Insights are common
• It is crucial to put insights into action

56
FINAL STAGE of a Group

• Tasks of the final stage of a group
• Dealing with feelings of separation
• Dealing with unfinished business
• Reviewing the group experience
• Practice for behavioral change
• Giving receiving feedback
• Ways of carrying learning further
• The use of a contract homework

57
Leader Functions During Final Stage of Group

• Assist members in dealing with any feelings they
  might have about termination
• Reinforce changes that members have made during
  the group
• Work with members to develop specific contracts
  homework assignments
• Provide opportunities for members to give one
  another constructive feedback
• Reemphasize the importance of maintaining
  confidentiality after the group is over

58
Leader Functions after Termination of Group

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

59
Giving and Receiving Feedback in Final Stage

• The sentence completion method can enhance the
  quality of feedback and can result in focused
  feedback
• Examples
• My greatest fear for you is ...
• My hope for you is...
• I hope that you will seriously consider...
• I see you blocking your strengths by...
• Some things I hope you will think about doing for
  yourself are...
• Some ways I hope youd be different with others
  are...

60
Applying What is Learned in Group to Every Day
Life

• Members can be reminded of ways to translate what
  was learned in group assisted in developing
  action plans geared to change
• Some points
• A group is a means to an end
• Change is bound to be slow subtle
• Focus more on changing yourself than on changing
  others
• Decide what you will do with what you learned
  about yourself

61
Psychological Theories Applied to Group Work
62
Psychoanalytic Concepts

• Influence of the past
• Experiences of first 6 years of life are critical
• The Unconscious
• Thoughts, feelings, experience kept out of
  awareness
• Anxiety and ego defenses
• Dynamics of anxiety are related to concept of
  defense
• Resistance
• Unique meaning of resistance as a key defense
• Transference and Countertransference
• How these operate in a counseling group

63
Psychoanalytic Developmental Perspective

• Developmental stages Implications for group work
• Why it is essential to understand stages of life
• Freuds psychosexual theory
• Basic aspects of traditional Freudian theory
• Eriksons psychosocial theory
• Understanding critical turning points at each of
  the stages of life

64
Psychoanalytic Handling of Defense Mechanisms in
Groups

• Help Group Members recognize that Defenses are
  normal behaviors which operate on an unconscious
  level tend to deny or distort reality
• Members often manifest same defenses in a group
  that operate in their lives outside of the group
• Help the individual cope with anxiety prevent
  the ego from being overwhelmed
• Defenses have adaptive value if they do not
  become a style of life to avoid facing reality
• Defenses, if respected, can lead to greater
  self-understanding in a group setting

65
Adlerian Approach in Groups

• A phenomenological approach
• Social interest is stressed
• Birth order sibling relationships
• Therapy as teaching, informing encouraging
• Identify basic mistakes in the individuals
  private logic
• Emphasis on the therapeutic relationship as a
  collaborative partnership

66
Adlerian Phenomenological Approach in Groups

• Adlerians attempt to view the world from the
  clients subjective frame of reference
• How life is in reality is less important than how
  the individual believes life to be
• It is not the childhood experiences that are
  crucialit is our present interpretation of these
  events that matters
• Ones subjective view includes beliefs,
  perceptions, and conclusions
• Adlerian group leaders strive to understand the
  members world

67
Adlerian Focus on Social Interest within Groups

• Refers to an individuals attitude toward
  awareness of being a part of the human community
• Mental health is measured by the degree to which
  we successfully share with others are concerned
  with their welfare
• Happiness success are largely related to social
  connectedness
• Community feeling involves the sense of being
  connected to all of humanity
• Living entails the courage to face lifes problems

68
Adlerian Use of Encouragement in Groups

• Encouragement is the most powerful method
  available for changing a persons beliefs
• Helps build self-confidence stimulates courage
• Discouragement is the basic condition that
  prevents people from functioning
• Through encouragement, members experience their
  own inner resources power to choose for
  themselves direct their lives
• Members are encouraged to recognize that they
  have the power to choose to act differently

69
Psychodrama Key Concepts

• Creativity
• Spontaneity
• Working in the present moment
• Encounter
• Tele rapport vs. bad vibes
• Surplus reality what could have happened if
  only
• Catharsis insight
• Reality testing
• Role theory

70
Psychodrama Components

• The protagonist
• The person who is the focus of the enactment
• Protagonist selects the event to be explored
• Auxiliary egos
• Other members who take part in the enactment
• The audience
• Others in the group who observe participate
• The stage
• The area where the psychodrama enactment occurs

71
Phases of Psychodrama

• The warm-up phase
• Initial activities to increase involvement of
  entire group
• Aimed at establishing an atmosphere of
  spontaneity
• The action phase
• Involves the enactment working through of a
  past or present situation or of an anticipated
  event
• Protagonist is encouraged to move into action
• Theme is Dont tell us, show us
• The sharing and discussion phase
• Sharing involves statements about oneself
• Discussion of the process comes after personal
  sharing

72
Techniques in Psychodrama

• Self-presentation
• Role reversal
• Double inner self
• Soliloquy
• Empty chair
• Replay
• Mirror Technique
• Future projection
• Magic shop
• Role training

73
Existential Approach to Groups

• Basic dimensions of the human condition
• The capacity for self-awareness
• The tension between freedom responsibility
• The creation of an identity establishing
  meaningful relationships
• The search for meaning
• Accepting anxiety as a condition of living when
  we face the givens of existence
• Death
• Freedom
• Existential isolation
• Meaninglessness
• The awareness of death nonbeing

74
Existential Capacity for Self-Awareness

• The greater our awareness, the greater our
  possibilities for freedom
• Awareness is realizing that
• We are finitetime is limited
• We have the potential, the choice, to act or not
  to act
• Meaning is not automaticwe must seek it
• We are subject to loneliness, meaninglessness,
  emptiness, guilt isolation
• Main purpose of an existential group is to
  increase awareness
• Existential group assists members in making a
  commitment to a lifelong journey of
  self-exploration

75
Existential Concept of Identify Relationship

• Identity is the courage to beWe must trust
  ourselves to search within find our own answers
• Our great fear is that we will discover that
  there is no core, no self
• RelatednessAt their best our relationships are
  based on our desire for fulfillment, not our
  deprivation
• Relationships that spring from our sense of
  deprivation are clinging, parasitic symbiotic

76
Existential Search for Meaning

• Meaninglike pleasure, meaning must be pursued
  obliquely
• Finding meaning in life is a by-product of a
  commitment to creating, loving working
• Struggle to find sense of significance purpose
  in life is part of human existence
• The will to meaning is our primary striving
• Life is not meaningful in itself the individual
  must create discover meaning
• The group experience can assist members in
  finding new meaning in their lives

77
Person-Centered Group Approach Challenges

• The assumption that the group leader knows best
• The validity of advice, suggestion, persuasion,
  teaching, diagnosis interpretation
• The belief that group members cannot understand
  resolve their own problems without active
  directive intervention of the leader
• The focus on problems over persons
• The necessity of using techniques to get or keep
  a group moving

78
Person-Centered Approaches in Groups Emphasize

• Therapy as a shared journey
• The persons innate striving for
  self-actualization
• The personal characteristics of the facilitator
  the quality of the therapeutic relationships
  within the group
• The facilitators creation of a permissive,
  growth promoting climate
• People are capable of self-directed growth if the
  core conditions are present
• Trust in the group process Members can be
  trusted to move in a constructive direction

79
Person-Centered Growth Promoting Group Climate

• Congruencegenuineness or realness
• The greater the extent to which facilitators are
  real, the more members will change grow
• Unconditional positive regard acceptance
• Caring is not the same as approval of all
  behavior
• An attitude of receptiveness toward the
  subjective experiential world of the members
• Accurate empathic understanding
• This is the ability to deeply grasp the members
  subjective world
• Facilitators attitudes are more important than
  knowledge

80
Person-Centered Expressive Arts within Groups

• Principles of expressive arts therapy
• Expressive arts as a multimodal approach to
  integrating mind, body, emotions spiritual
  inner resources through art forms
• All people have the ability to be creative
• The creative process is healing
• Conditions that foster creativity
• Openness to experience
• Internal locus of evaluation
• Some guidelines for creative expression in groups
• Important to offer stimulating challenging
  experiences
• Essential to create a nonjudgmental supportive
  climate
• The facilitators way of being is more
  important than techniques used in expressive arts
  therapy

81
Gestalt Therapy in Groups

• Existential and Phenomenologicalit is grounded
  in the members here and now experience
• Emphasizes how each member views the world
• Initial goal is for group members to gain
  awareness of what they are experiencing doing
  now
• Promotes direct experiencing rather than the
  abstractness of talking about situations
• Rather than talk about a childhood trauma the
  group participant is encouraged to become the
  hurt child
• As members acquire present-centered awareness,
  significant unfinished business emerges
• Awareness is seen as curative growth-producing

82
Gestalt Emphasis on the Here and Now

• Our power is in the present
• Nothing exists except the now
• The past is gone the future has not yet arrived
• The past is important, but only as it is related
  to present functioning
• A here-and-now focus brings vitality to a group
• For many people the power of the present is lost
• They may focus on their past mistakes or engage
  in endless resolutions plans for the future
• The challenge is to come into closer contact with
  ongoing experiencing from moment to moment

83
Gestalt Concept of Handling Unfinished Business
in Group

• Feelings about the past are unexpressed
• These feelings are associated with distinct
  memories fantasies
• Feelings not fully experienced linger in the
  background interfere with effective contact
  functioning
• Result
• Preoccupation, compulsive behavior, wariness,
  oppressive energy self-defeating behavior
• Unfinished business needs to be addressed so that
  we can move toward health integration

84
Gestalt Therapeutic Techniques in Group

• The experiment in a Gestalt group
• Experiments evolve out of what is occurring
  within members in the present moment
• Members are encouraged to try new behavior pay
  attention to what they are experiencing
• Preparing clients for experiments
• Experiments with internal dialogues
• Rehearsal
• The exaggeration experiment
• Reversal technique

85
Transactional Analysis (TA) within Groups

• Transactional Analysis (TA) is an interactional
  contractual approach to groups
• TA is basically a Psychoeducational approach to
  group work
• TA is grounded on the assumption that people make
  present decisions based on their early
  experiences
• Redecision therapy is a form of TA that assists
  group members in taking charge of their lives by
  deciding how they will change
• The practice of TA is ideally suited to group
  work
• Basic assumption of TA is that we are in charge
  of what we do, of the ways we think of how we
  feel

86
Key Concepts of TA

• People have a basic trio of Parent, Adult, and
  Child (P-A-C) ego states
• We all need strokes
• Injunctions counterinjunctions
• Decisions redecisions
• Games
• Basic psychological life positions

87
The TA Ego States

• Group Members are taught how to recognize which
  ego state they are functioning at any given time
• The Parent ego state
• This ego state contains the values, morals, core
  beliefs behaviors incorporated from parents
• This ego state can be expressed in critical or
  nurturing behavior
• The Adult ego state
• This ego state is the objective part of
  personality functions as a data processor
• The Child ego state
• This ego state consists of feelings, impulses
  spontaneous actions

88
TA Concept of theNeed for Strokes

• People need to receive physical psychological
  strokes to develop a sense of trust in the world
• Positive strokes express warmth, affection,
  approval appreciation
• Negative strokes can be given to set limits
• When group members understand how they were
  reared on certain strokes, they can choose the
  kinds of exchanges they want
• Members sometimes have a difficult time in asking
  for or receiving positive strokes

89
TA Concept of Injunctions

• Injunctions are parental messages that we acquire
• Some examples of injunctions
• Dont be
• Dont be close
• Dont think
• Dont feel
• In TA groups members explore the dos donts
  by which they were trained to live
• Once members identify the messages they have
  internalized, they can critically examine them to
  decide if they want to continue living by them

90
TA Concept of Decisions Redecisions

• Early decisions
• Based on injunctions, we make early decisions
• Early decisions had a purpose at one time, yet
  they may not be functional as we become adults
• TA groups allow members to examine early
  decisions
• Making new decisions
• An assumption in TA is that whatever we decided
  can be redecided
• Redecision is done emotionally, not just
  cognitively
• Members can create a new ending to scenes where
  early decisions were made
• New endings can result in a new beginning
• New beginnings allow members to think, feel,
  and act in revitalized ways

91
Cognitive Behavioral Therapy Approaches to Group
Work

• A set of clinical procedures relying on
  experimental findings of psychological research
• Based on principles of learning that are
  systematically applied
• Treatment goals are specific measurable
• Focusing on the members current problems
• To help people change maladaptive to adaptive
  behaviors
• The therapy is largely educationalteaching group
  members skills of self-management

92
CBT Therapeutic Techniques

• Reinforcementsocial reinforcement a key method
  of shaping behavior
• Contingency contractsbehaviors to be performed
  are spelled out
• Modelingobservational learning imitation
• Behavior rehearsalpracticing in a session a new
  behavior
• Homeworkaffords members opportunities to
  practice new skills in between sessions
• Cognitive restructuringidentifying evaluating
  ones cognitions learning to replace negative
  cognitions with constructive cognitions

93
Cognitive Social Skills Training

• Social skills training deals with ones ability
  to interact effectively with others in various
  social situations
• Social skills training includes these strategies
  psychoeducation, modeling, behavior rehearsal,
  role playing feedback
• Three formats of social skills training
• Sheldon Rose model of structuring social skills
  training
• A structured group model for teaching
  practicing social skills
• Social effectiveness training
• A treatment program aimed at reducing social
  anxiety improving interpersonal skills
• Assertion training
• Groups that increase members behavioral
  repertoire so they can make the choice of being
  assertive or not

94
CBT Model of Mindfulness Acceptance

• Mindfulness acceptance-based cognitive behavior
  therapy
• Represents the new wave in CBT
• In mindfulness practice clients train themselves
  to focus on present experience
• Acceptance is a process of receiving present
  experience without judgment, but with curiosity
  striving for full awareness of the present moment
• Major approaches of this recent development of
  CBT
• Dialectical behavior therapy
• Mindfulness-based stress reduction
• Mindfulness-based cognitive therapy
• Acceptance commitment therapy

95
Reality Therapy Choice Theory in Groups

• Emphasis is on responsibility
• We may be the product of our past, but not the
  victims of past
• Leaders function is to keep therapy focused on
  the present
• We often mistakenly choose misery in our best
  attempt to meet our needs
• We can only control what we are presently doing
• Reality therapy is active, directive, structured,
  psychoeducational focuses on doing and action
  plans

96
Reality Therapy focus on Basic Needs

• All internally motivated behavior is geared
  toward meeting one or more of our basic human
  needs
• Love and belonging
• Power
• Freedom
• Fun
• Survival (Physiological needs)
• Choice theory based on assumption that all
  behavior is purposeful originates from within
  the individual
• Choice theory reality therapy
• Choice theory provides an explanation of our
  human nature
• Reality therapy offers a method for getting the
  relationships we need

97
Questions in Group Reality Therapy

• Group leaders challenge members with this
  question Is what you are now choosing to do
  getting you what you want?
• Skillful questioning is part of reality therapy
  and some questions include
• Do you want to change?
• What do you want in your life that you do not
  have now?
• If you changed, how would your life be different?
• What do you have to do now to make the changes
  happen?

98
Reality Therapy Procedures that Lead to Change

• W WantsWhat do you want to be do?
• Your picture album
• D Doing DirectionWhat are you doing?
• Where do you want to go?
• E EvaluationDoes your present behavior
• have a reasonable chance of getting you
• what you want?
• P PlanningSAMIC

99
Reality Therapys SAMIC Plan for Change

• S SimpleEasy to understand, specific
  concrete
• A AttainableWithin the capacities
• motivation of the group
  member
• M MeasurableAre the changes observable
• helpful?
• I Immediate InvolvedWhat can be done
  today? What can you do?
• C ControlledCan you do this by yourself or
  will you be dependent on others?

100
Solution Focused Brief Therapy in Groups

• Solution-focused brief therapy (SFBT)a future
  focused, goal-oriented therapeutic approach to
  group work
• SFBT looks at the strengths of a person past
  successes
• In a solution-focused group, the member, not the
  therapist, is the expert
• Leader engages members in conversations about
  what is going well, their resources future
  possibilities
• SFBT based on an optimistic assumption
• Members are viewed as resilient, resourceful,
  competent able to construct solutions that can
  change their lives
• The leader supplies optimism recognizes
  resources members already possess

101
Key Concept of Solution Focused Brief Therapy in
Groups

• Therapy grounded on a positive orientationpeople
  are healthy competent
• Past is downplayed, while present future are
  highlighted
• Therapy is concerned with looking for what is
  working
• Group leader assists members in finding
  exceptions to their problems
• There is a shift from problem-orientation to
  solution-focus
• Emphasis is on constructing solutions rather than
  problem solving

102
Assumptions of Solution-Focused Brief Therapy in
Groups

• People can create their own solutions
• Small changes lead to large changes
• It is not necessary to know the cause of a
  problem to solve it
• The best therapy involves a collaborative
  partnership
• A group leaders not knowing stance affords the
  member an opportunity to construct a creative
  solution
• Group members are empowered
• Little attention given to diagnosis, history
  taking, analysis of problems, or exploration of
  problems

103
Impact of Questions in Solution-Focused Brief
Therapy in Groups

• Skillful questions allows people to utilize their
  resources
• Asking how questions that imply change can be
  useful
• Effective questions focus attention on solutions
• Questions can get members to notice when things
  were better
• Useful questions assist people in paying
  attention to what they are doing what is
  working
• Questions can open up possibilities for members
  to do something different

104
Process of Solution-Focused Brief Therapy Groups

• Setting the tone for the group
• Assisting members in developing well-formulated
  goals
• Searching for exceptions to the problem
• Instilling hope encouraging motivation
• Assisting members in designing out of group tasks
• Terminating
• A key question is When the problem is solved,
  what will you be doing differently?
• Members are helped to identify barriers that
  could get in their way of maintaining the changes
  they made

105
Techniques used in Solution-Focused Brief Therapy
in Groups

• Pre-therapy change
• (What have you done since you made the
  appointment that has made a difference in your
  problem?)
• Exception questions
• (Direct members to times in their lives when the
  problem did not exist)
• Miracle question
• (If a miracle happened and the problem you have
  was solved while you were asleep, what would be
  different in your life?)
• Scaling questions
• (On a scale of zero to 10, where zero is the
  worst you have been and 10 represents the problem
  being solved, where are you with respect to
  __________?)

106
GROUPS for Different Populations
107
TA Concept of Games We Play

• Gamesan ongoing series of transactions that ends
  with a negative payoff
• Games are designed to prevent intimacy
• The process of game playing
• We receive strokes
• We maintain and defend our early decisions
• Racketsunpleasant feelings people experience
  after a game
• Members can identify the games they played as
  children the games they currently play
• In a group, members can become aware of games
  they play decide if they want to live more
  honestly authentically

108
TA Basic Life Positions

• TA identifies four basic psychological life
  positions
• Im OKYoure OK
• Im OKYoure not OK
• Im not OKYoure OK
• Im not OKYoure not OK
• A life script is a plan for life
• A personal life script is an unconscious plan
  made in childhood
• A life script is blueprint that tells us where we
  are going
• Script analysis
• In TA groups the members become aware of how they
  acquired their life script
• Members can learn how to free themselves of
  self-defeating patterns

109
Groups for Children

• In planning groups for children
• Describe your goals and purposes clearly
• Develop a clearly stated rationale for your
  proposed group
• State your aims, the procedures to be used, the
  evaluation procedures you will use the reasons
  a group approach has particular merit

110
Guidelines for Groups with Children Adolescents

• Be aware of your states laws regarding children
• Consider securing parental or guardian written
  permission
• Communicate your expectations to those in your
  group
• Emphasize confidentiality
• Maintain neutrality
• Use appropriate exercises and techniques
• Listen remain open
• Prepare for termination

111
Key Points Groups for Children

• In designing a group in both schools agencies,
  get the support of administrators
• Communicate with children about the importance of
  keeping confidences in language they can grasp
• Ethical practice demands that you have the
  training required to facilitate a group with
  children
• Not all children are ready for group
  participation
• Having some structure is particularly important
  in groups with children
• Give thought to helpful methods of evaluating the
  outcomes of your groups

112
Groups for Adolescents

• Organizing an adolescent group
• Conduct a needs assessment
• Develop a written proposal
• Market your group
• Get informed consent from parents or guardians
• Conduct pre-group interviews
• Select members for the group
• Design a plan for each of the group sessions
• Arrange for a follow-up group session after
  termination

113
Hints for working with Reluctant Adolescents in
Groups

• Explain the rationale of the group in
  jargon-free language
• Allow members to express reactions to being sent
  to group
• Go with resistance Dont go against resistance
• Avoid getting defensive
• Be clear firm with your boundaries

114
Key Points in Groups with Adolescents

• Understand respect resistance
• Role-playing techniques can often be creatively
  used in adolescent groups
• Find ways to involve parents in group work with
  adolescents
• A few kinds of adolescent groups include groups
  for students on drug rehabilitation, groups for
  unwed teenage fathers, teen delinquency
  prevention groups sex offender treatment groups
• Co-leadership models are especially useful in
  facilitating an adolescent group

115
Multiple Family Groups Plan

• Philosophy of group overall goals
• Overview of group
• Group format weekly sessions
• Practical considerations
• Contraindications to participation in group
• Outcomes of group

116
Groups for Adults-Key Points

• Theme-oriented groups with a psychoeducational
  focus are popular
• Short-term structured groups fit the needs of
  many adult populations
• Account for diversity in your groups
• Group work with women is increasing
• Most mens groups have a psychoeducational
  interpersonal focus
• Groups dealing with domestic violence are
  gaining prominence

117
Examples of Groups for Adults

• Groups for college students
• Groups for weight control
• HIV/AIDS support group
• Womens group
• Mens group
• Domestic violence group
• Support group for survivors of incest

118
Sample Proposal for Adult Group

• In designing a specific group, consider these
  components
• Description of the type of your group
• Rationale of your group
• Goals of your group
• Marketing methods
• Screening and selection members
• Structure of group description of sessions
• Methods for assessing outcomes

119
Groups with Elderly Key Points

• You may encounter obstacles in your attempts to
  organize conduct groups for the elderly
• Groups offer unique advantages for the elderly
  who have a great need to be listened to
  understood
• Groups can help elderly people integrate current
  life changes into an overall developmental
  perspective
• Elderly people need a clear explanation of the
  groups purposes why they can benefit from it
• Revealing personal matters may be extremely
  difficult for some elderly people because of
  their cultural conditioning

120
Some Themes for Groups for Elderly

• Themes that are prevalent with the elderly
  include
• Loss the struggle to find meaning in life
• Loneliness social isolation
• Poverty
• Feelings of rejection
• Dependency
• Feelings of uselessness, hopelessness despair
• Fears of death dying
• Grief over others deaths
• Sadness over physical mental deterioration
• Regrets over past events

121
Examples of Groups for Elderly

• Combined dance movement
• Pre-retirement post-retirement issues
• Remotivation
• Organic brain syndrome
• Health-related issues

• Reminiscing
• Physical fitness
• Body awareness
• Grief work
• Occupational therapy
• Reality orientation
• Music art therapy