Patient%20Selection

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Patient Selection

• Who Do We Really Want To Let In?

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YAVIS

• Young
• Attractive
• Verbal
• Intelligent
• Socially Competent

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SOLEN

• Socially Distressed
• Older
• Loners
• Emotionally Unattractive
• Nonverbal

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How do counselors select clients for group?

• They dont, clients are selected for them and
  then deselect themselves out!

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Exclusion Criteria

• braindamaged
• paranoid
• hypochondriacal
• substance addicted
• psychotic
• sociopathic

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Focus Can The Client DO Group?

• Can the client develop trust?
• Can the client develop relationships?
• Can the client interact in a manner that is
  honest and open?
• Can the client interact in a manner that will not
  harm others?

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Other Contraindications

• Crisis- better treated as crisis!
• Acute Suicidal- detrimental to other members
• nonattenders- zap vitality and motivation

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Dropouts

• Less Psychologically Minded
• More Somatic Complaints
• Therapist liking and ability to empathize
• Lower SES?
• In crisis- leave when crisis resolves
• High deniers- leave when confronted
• Isolates who disrupt the group
• very angry
• withdrawn and nonparticipatory
• They functioned on a different level of
  communication from that of the rest of the group.
  They remained at the symptom-describing,
  advice-giving and -seeking, or judgemental level
  and avoided discussion of immediate feelings and
  here-and-now interaction.
• Fear of emotional contagion- voyeaurs are good

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Criteria for Inclusion

• Motivation
• Interpersonal concerns for which the client
  accepts some responsibility
• Clients who cannot readily see themselves
• Ability to disclose and be active popular

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Preparing Members for Here and Now Counseling

• Unabashedly Stolen from Sklare, Keener Mas-
  University of Louisville

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Active Membership Is Essential For Growth

• Membership Criteria and Roles should be well
  defined
• Pre-group Traing reduced anxiety, promotes
  action, increases self-exploration, cohesion
  interpersonal interactions
• Increase expectations and Hope
• Use written information after 3 sessions to
  increase here and now interaction

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Create Awareness of Behavioral Expectations

• Help members
• focus on present
• avoid blaming
• avoid making suggestions
• avoid dependency

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Pregroup Meeting

• Teach about sumbling blocks
• feeling puzzled, discouraged
• frustration over sharing time
• annoyance with the leader
• keeping info secret
• subgrouping
• Reduce Dropouts

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Overpreparing?

• It is possible to overprepare and therefore do
  some of the work the group needs to do itself

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Norms of Group Behaviors and Possible Leader
Responses
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You Language

• teach members not to use de-personalizing
  language
• you speech dilutes self-expression
• avoids responsibility
• allows members to incorrectly speak for others

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We Language

• discourages individual thinking
• inhibits confrontation by creating false we
• provides support where none may exist

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Questioning

• are declarative statements hidden by sender
• allows false activity because questioner is
  hidden
• increases defensiveness and resistance

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Speaking in the Third Person

• avoids direct contact and others response
• signals that person being discussed is somehow
  deficient
• disguises some other issue

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Approval Seeking

• signals self-doubt
• member seeking support passively

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Rescuing

• When members are interrupted from expressing
  thoughts and feelings, chance of resolution is
  diminished
• increases dependency
• opportunity for growth is removed

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Analyzing

• allows distancing from group
• elevates the member to superior position
• minimizes members own problems
• evokes resentment in others