Group Work- Final Exam

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1

Describe the dynamics associated with group process and development

  • No arbitrary lines between the phases of group
  • There is considerable overlap between the stages of the group in practiceà especially true for the transition stage and the working stage
  • Groups do not all evolve to a true working level, but significant work takes place at every stage of the group
  • Conflict, hidden agendas, lack of motivation, anxieties and fears, lack of cohesion are all reasons for lack of group progression
  • Being in a working stage doesn’t mean all members are functioning optimally = some may not feel accepted, on the fringe, not ready for in-depth exploration
2

Identify and define key characteristics of a group during the working stage

  • Deeper exploration and an increased level of group cohesion are typical of this stage
  • Members must make commitment to face and work through barriers that interfere with the group’s progress
  • Group norms that were formed in earlier stages are further developed and solidified
  • Members increasingly interact with one another in more direct ways
  • Dependence on leader lessens
  • If interpersonal conflicts emerge, they tend to be worked through
  • Healing capacity develops in the group
3

Characteristics of a working group

-members trust members and leaders; willingness to take risks

-goals are clear and specific

-communication is clear and direct

-group members use each other as resources and show interest in each other

-willingness to risk disclosing threatening material

-conflict is recognized, addressed, worked through

4

Characteristics of a non-working group

-mistrust is expressed via hostility; members stay to themselves

-goals are fuzzy and unclear, abstract

-communication is unclear, indirect

-members are interested only in themselves

-members hold back and disclosure is surface level or minimal

-Conflict is ignored

5

What are some choices to be made during the working stage

  • Disclosure vs anonymity
  • Authenticity vs guardedness
  • Spontaneity vs control
  • Acceptance vs rejection
  • Unity vs fragmentation
6

Describe guidelines for giving and receiving feedback

  • Feedback= occurs when group members or leaders share their observations and personal reactions regarding the behavior of another
  • Clear and concise
  • Share with members how they affect you rather than giving advice
  • Specific here-and-now feedback
  • Feedback should be timely and nonjudgmental
  • Can be powerful when its about the interpersonal relationship
  • Address person’s strengths rather than weakness are areas for improvement
7

Identify coleader issues at the working stage

  • Ongoing eval of the group= leaders to discuss with each other and with the group how the group is progressing
  • Discussion of techniques= one leader might be afraid to try new techniques, while the other is too domineering
  • Theoretical orientations= coleaders don’t have the same theoretical orientation, but sometimes theoretical orientations can be in conflict
  • Self-disclosure issues= if one coleader shares a lot and you do not, you may be perceived as holding back and may not be trusted by the group
  • Confrontation issues= one leader can be too harsh or too lenient.. either way, it can affect the group dynamic
8

Leader tasks at Final Stage of group

  • Assist members in learning to put what has occurred in the group into a meaningful perspective; applying what they’ve learned to their life
  • Close group= leaders to help member review their individual work and the evolving pattern from the first to final session
  • Open group= leaders to help current members and leaving member in the leaving process; give opportunity to say goodbye
9

Member tasks at Final Stage of group

  • Learn to use what they’ve learned in group in their real life
  • Say goodbye to group as a community and develop other methods of support (so they don’t feel “empty”)
10

What can hinder effectively terminating a group experience

  • Timing of when and how to bring up the idea of termination (some say start preparing for termination at the first session)
  • Dealing with feelings of separation
  • Establishing what the leader’s relationship will be with the members after the group ends
  • Establishing what the members’ relationships will be with each other after the group ends
11

Explain some methods for reviewing the group experience

  • Comparing early and later perceptions in the group= leaders ask members in the first session to take note of their surroundings, the people around them, how they feel, etc. At the last session, ask them to do the same thing, then reflect on how they felt at that first session. What has changed?
  • Ask members what they learned about themselves in the group
  • Ask members how the group has been meaningful to them
  • What have you learned that you most want to remember?
12

Describe how contracts and homework help members consolidate their learning

  • Writing contracts during the last session helps members continue to live the new beginnings established in group (helps members increase chances of successfully meeting their goals when the group ends)
    • Can read them out loud to get feedback from other members
  • Homework that is member-led/ designed; can be included in the member contracts
    • Use should be increased as termination nearsà emphasizes the idea of using the skills learned in group outside of the boundaries of group
13

Identify methods for evaluation of a group experience

  • Ongoing process throughout the group
  • Leader can create their own rating scale and questions aimed at assessing the group process
  • Standardized instruments can also be used
  • Questionnaires can be sent to members after the group ends- can be helpful to give members a little bit of time after the group ends to give them time to truly reflect on the effect of the group
14

Explore coleader issues at the end of a group

  • Concerns about a specific member at the end of the group
  • Must agree not to bring up new material at the end of the group
  • Both leaders but be willing to acknowledge that the group is ending, and have appropriate feelings… or else one of the leaders might collude with the members in trying to continue the group
15

Types of Groups in school settings

  • Often emphasize prevention and intervention strategies to support healthy student development
  • Focus on enhancing personal and social development
  • Typically have a psychoeducational purpose
  • Usually integrate academic and person-social development
16

Characteristics of groups in schools

  • ***brief, structured, problem-focused, homogeneous, may have a cognitive behavioral orientation
  • ***both counseling and psychoeducational groups in schools focus on wellness and prevention
  • **not for tx for severe problems
17

guidelines for group work with children and adolescents

  • Self disclosure= it is not always appropriate to let members go into detail
  • Emphasize confidentiality= hard to maintain in school settings; use language tailored to developmental ability of group members; teach and practice with group about how to talk about the group; special attention paid to members’ responsibility to each other
  • Maintain neutrality as the leader
  • Appropriate exercises= at the beginning, use interactive exercises that do not necessarily promote deep self disclosure; activities/ exercises can become more challenging as members become familiar and comfortable with each other
  • Listen and remain open= reflective communication; let the members lead the way
  • Prepare for termination= kids are quick to for attachments to adults who show concern for them so counselor must prepare child for end of group;
18

key developmental themes of adolescence

  • Identity exploration
  • Clarifying system of values
  • Stressors and conflicts
  • Significant growth
  • Major cognitive advances
  • Increased orientation toward social world
  • Physiological changes
  • Understanding how experiences shape their current feelings/ behaviors
  • Need opportunities to explore and understand a wide range of feelings, wants, thoughts, and beliefs
19

challenges in leading adolescent groups

  • Establishing trust= counselor cultural sensitivity is necessary (learn slang, trends, music, entertainment, etc), respect for young people,
  • Know comfort zone with self disclosure= adolescents will ask direct and personal questions (they may test you); you can be truthful but do it thoughtfully
  • Be authentic because adolescents are quick to detect inauthenticity
20

Explain the value of group work with women

  • Support for the experience of women
  • Identify and deconstruct the messages they have internalizes about their self-worth and place in society
  • Create social network
  • Eliminating patriarchal oppression
  • Opportunity to construct a gender analysis of what it means to be female in a patriarchal society
21

Explain the value of group work with men

  • Gender roles of men are identified and deconstructed
  • Emphasis on identities outside of societal norms
  • Positive masculinity= emphasis on men’s existing strengths, on capabilities and resources
22

Describe key aspects of group treatment associated with domestic violence

  • It can be especially helpful for offenders
  • Therapeutic factors (universality, cohesion, interpersonal learning) help identify and address abusive behaviors and reduce recidivism
  • Usually solution focus (so brief); emphasis on concrete, behavior-specific goals
23

rationale for group treatment of people with substance use disorders

  • Usually open and have revolving membership
  • Group work is usually the tx of choice for substance use dx
  • Different types of groups meet clients’ needs during various phases of the recover process
    • Psychoeducation= accurate info about harmful effects of substance use; edu of withdrawal; cravings and relapse triggers
    • Skills groups= combine education component with role playing so clients can practice assertiveness, communication, and relapse prevention
    • Cognitive behavioral= help connect thoughts, feelings, and behaviors to choices that support their drug-free lifestyle
  • Treatment is highly structured, with emphasis on abstinence, stabilization, and learning skills necessary to progress in the recovery process
24

attitudes and skills needed in working effectively with older adults in groups

  • Genuine respect
  • Positive experience with older people
  • Deep sense of caring
  • The ability to and desire to learn from older people
  • Working knowledge of the skills needed to work with older adults
  • Healthy attitude toward one’s own ageing
  • Patience, especially with repetition of stories
  • Sensitivities to burden and anxieties of older people
  • Ability to deal with extreme emotions like hopelessness, grief, depression, isolation
25

Explain what is meant by a critical incident

  • Events that have the potential of disrupting the group’s progress and therefore require an immediate response from the leader
  • Requires the advanced skill of recognizing these events and responding
  • Moments in the group that have the potential to change the direction of a group
    • Fight/ argument between group members
    • Suicidal group member
    • Group member leaving the group
    • A resistant group member becomes more involved
    • Member with massive emotional experience that doesn’t fit in context of what is being done in group
26

Describe some problems that might develop in the first session

  • Members are new to each other, anxious about disclosing problems, feelings, and self-perceptions
  • Members come to group at different levels of readiness
  • *silent member in the first session, premature deep disclosure,
27

explain leader interventions to address the problem at beginning of group

  • Welcome members
  • Review purpose of group
  • Develop group norms
  • Structure group to reduce member anxiety
  • Engage all members
  • Encourage appropriate disclosure
  • Review and clarify goals
  • Promote expectation that the group can help members progress toward goals
  • Start process of cohesion-building
28

Suggest possible reasons why a member might question, confront, or attack the leader

  • Usually in the middle phase of group
  • Challenge the leader’s qualifications (if group is older and leader is younger)
  • Challenge leader’s ability to lead a specific group (trauma or addictions groups)

The group is getting more comfortable and challenge the leader

29

Discuss possible leader interventions in conflicts between members

  • Minimize possibility of conflict= have a plan for the session and be an active leader
  • Cut off the member (stay with topic, leave topic, or redirect)
  • Remind group of norms and mutual respect
  • Reestablish physical safety immediately (physically separate fighting members)
  • Process the nature of the conflict with the members having the conflict and process the experience with other members of the group
30

Concerns for member departure from session and how leader responds

  • If one member is attacked by other members of the group and is trying to leave
  • Member becomes emotionally upset by the content of the group discussion
  • Leader has clear and immediate responsibility to provide for that member’s safety= may ask another member to check on the member who has left (depends on the members and the groups; may go on break and you can check on the member; call parents to pick up child
  • This is where coleading is a big advantage
31

Concerns for member departure from group experience and how leader responds

  • Determine why
  • Address safety issues
  • Express appreciation for the member
  • Determine is member desires further counseling and provide appropriate referrals
  • Indicate that the member’s group case record will be closed
  • Provide appropriate hotline numbers
32

Discuss possible concerns of the remaining members if a member leaves the group

  • They may be upset, wonder if they cause the member to leave, have genuine concern for departing member, be concerned that the departing member will break confidentiality, watch to see if leaders act to provide for the safety of the departing member, or be less trusting of other members
33

Write examples of interventions that leaders could use to respond to critical incidents

  • Process the nature of the conflict with the members having conflict
    • Cut off inappropriate comments and inaccurate info
    • Clarify information and interpersonal feedback
    • Check out accuracy of information and/ or interpersonal feedback with whole group
  • Conflicts allow leaders to facilitate a reflection with the group on what has happened in the group up to the point of conflict while making intervention to decrease intensity of emotional reaction
34

considerations for leading final sessions of multi-session groups

  • Deep disclosures at the end of group= no enough time to fully process that experience and hinders the closing experience
  • Members may have anger issues= informing security of time and location of group and have them on duty
  • Leave an hour after the final session open to meet with individual members (if necessary)
  • Complete case notes within 24 hours of the final meeting
  • Try to have backup counselors available (if no coleader) in case a member needs on during the final session
35

Types of addiction groups

  • Psychoeducation
  • Skills development
  • Cognitive-behavioral
  • Interpersonal process
  • Support
36

addiction: Psychoeducation

  • educate about substance abuse and addiction process
37

addiction: skills development

  • cultivates the skill needed to attain/ sustain abstinences, such as those needed to manage anger or cope with urges to use substances
38

addiction: cognitive behavioral

  • alter thoughts and actions that lead to substance abuse
39

addiction: interpersonal

  • delve into major developmental issues that contribute to addiction or interfere with recovery
40

addiction: support

  • buoy members and provide a forum to share pragmatic info about maintaining abstinence and managing day-to-day, chemical free life
41

characteristics of a support group

  • Focus on offering emotional support
  • Objective is to provide relief and proven solutions
  • Led by member of the group
  • No set fee
  • rules set by group
  • open participation
  • open ended enrollment
  • example: AA
  • a place for people to give and receive emotional and practical support as well as exchange info
  • “self help”= there is no group leader, per se, but speakers, etc
42

characteristics of a therapy group

  • focuses on solving a personal problem
  • objective is to probe, addressing the impact of risk factors
  • conducted by licensed professional
  • may be supportive but also includes confrontation and probing
  • process is diagnosis driven and directed by psychological theory
  • set free for service
  • may have limited number of participants
  • example: what we’ve been talking about this semester lolz
43

benefits of support groups

  • Ends isolation
  • Don’t need money to be member
  • Sponsorship
  • Safety and confidentiality through anonymity
44

Research that supports AA

  • AA= anonymous (once you declare how long sober you are, the risk of relapse becomes higher)
  • When clients attend AA, the combination of treatment and AA predicts better outcomes
  • Anonymity protects group, as well
  • Because they are anonymous, they don’t open themselves up to research
  • Frequent AA meetings attendees report more use of behavioral change mechanisms, such as stimulus control, and behavioral management. Use helping relationships better
  • Associated with increased confidence and self efficacy in avoiding taking a drink à Helps in abstinence
  • Internalizing the program and the thinking of the program is a factor in abstinence rates
  • Friendship quality and support from AA
  • *once caveat* these research implications don’t mean AA is to be applied unthinkingly to all clients. Counselors must consider client’s need and history
45

Reminiscing

  • Act or process of recalling the past
  • Related to Erikson’s Ego integrity vs. despair stage of later life. Integrating previous life experiences with those of the present to determine life’s meaning and purpose
  • Naturally occurring process—integrated in multiple settings
46

Why reminisce?

  • Preserves sense of self— “I was that person”
  • Joins people to each other— “I’ve had similar experiences”
  • Provides a pleasurable outlet— “I can’t do that anymore, but I can remember and share it”
47

benefits of reminiscing

  • Communication, self-expression
  • Social interaction, connection
  • Feelings of belonging
  • Self-worth and achievement
  • Sharing of ideas, problems, concerns
  • Opportunity to learn about the past
  • Promotes the use of the five senses
48

Describe the process of reminiscence

  • Involves discussion:
    • Of past activities, events, experiences
    • With another person or group of people
    • Using photographs, household, and other familiar items from the past, music, and archive sound recordings
    • Takes place at least once a week
    • Aids in the life review process
49

Know the difference between symbolic and real experience

  • In utero, and younger and as toddlers= our needs are real; we have real-ass needs (food, warmth, attention, etc)
  • As we grow, our need change from real to symbolic (we take care of our own needs, but our needs change and grow)
50

Be able to describe the four basic needs

  • Nurturance
  • Support
  • Protection
  • Containment
51

nurturance

  • Individual gets what it needs to be able to grow emotionally and physically
52

support

  • Person feels that they have a structure around them to be able to keep them on a good path
53

protection

  • They are safe from the outside world
  • Sense of safety and security
54

containment

  • How I express myself as a child or as an adult is not too much for the world