chapter 6 groups. – Flashcards

A dyad is a unit of two functioning as a pair. In this case the counselor and the counselee form the pair. The popularity of family therapy and behavior therapy was not evident in the 1950s. I cannot forego mentioning that counselors often confuse the word dyadic with didactic which means to teach. (c)

Put the choices together and you have a fine definition of the word group. A group is really a cluster of people in a recogniz- able unit. (d)

Ten years before Moreno coined the term group therapy he not- ed that individuals in Vienna involved in theatrical productions without scripts experienced a cathartic reaction which seemed to be curative. In psychodrama the client expresses spontaneous feelings via role-playing. Psychodramatic techniques are appro- priate for family therapy as well as group work. Perls, although he did not coin the term group therapy, is considered a major figure in the history of group therapy. The name Joseph H. Pratt might also find its way onto your exam. Pratt, a top Boston physician, formed what might well be the first counseling/therapy groups from approximately 1905 to 1923. The groups dealt with the issue of tuberculosis. Freud's Group Psychology and the Analysis of the Ego was published in 1921; however, his interest in individual treatment seemingly kept him from becoming a major player in the history of groups and from creating a com- prehensive model of group therapy. (b)

Choice "b" mentions the ASGW, or the Association for Special- ists in Group Work. This is the division of ACA that focuses pri- marily on group intervention. The ASGW journal, The Journal for Specialists in Group Work, is the publication you will need to keep you updated in this area. Other abbreviations are the National Association of Social Workers (NASW), established in 1955, and the American Association of Suicidology (AAS). By now you should be familiar with the others. (c)

Adler was actually engaging in group treatment during the early 1920s at his child guidance facilities located in Vienna. His ra- tionale for group work was simply that "...man's problems and conflicts are recognized in their social nature...." (d)

Examinations and literature in the area of group processes will often classify groups using a model popularized by community mental health experts such as Gerald Caplan, a pioneer in the crisis intervention movement. The three classifications are pri- mary, secondary, and tertiary. A primary group stresses a healthy lifestyle or coping strategies which can reduce the occurrence of a given difficulty. A group which teaches birth control to prevent teen pregnancy would be a fine example. In a secondary group a problem or disturbance is present but not usually severe. The secondary group works to reduce the severity or length of a prob- lem and generally includes aspects of prevention. Thus, a group that deals with grief or shyness might fall into this category. The tertiary group usually deals more with individual difficulties that are more serious and longstanding. (The word tertiary literally means the third rank.) Choices "c" and "d" would apply mainly to groups categorized as tertiary. (a)

Choice "a" is not entirely false since a secondary group does have preventive qualities. Nevertheless, this is not the major feature; hence, this is not the best answer. When two therapists are used in a group setting the procedure is known as "coleadership" or "cofacilitation." (b)

Choice "a" stands incorrect because the tertiary group focuses more on the individual than the primary or secondary group. In reference to choice "b," a counselor dealing with the here-and- now often relies on the skill of "immediacy," which takes place (in a group or an individual session) when the counselor explores the client-counselor relationship as it is transpiring right at that moment. Immediacy relates to the counselor's ability to convey what is happening between the counselor and the client. (d)

Let's not make this complicated. Norms are explicit and implicit (i.e., not verbalized) rules which tell group members how to be- have and how not to behave in a given situation. Group special- ists are quick to point out that all groups have norms, though often they are not formally presented to group members. Sing- ing loudly while taking the NCE would be violating a norm, al- though I doubt whether anyone will specifically tell you not to sing at the onset of the exam! Norms actually refer to "expected behaviors." Now of course norms vary depending upon your role in a group. In an educational class group, for example, the norms for the teacher may indeed be different than for the student. (d)

During World War II many individuals were plagued with se- vere psychological problems, yet a personnel shortage made it impossible for each and every person to be treated using indi- vidual therapy. Moreno had brought the idea of group therapy to the United States in 1925, but the supply and demand issues sparked by the war effort were the catalysts which generated this idea whose time had come. (c)

Group content refers to what the group is discussing. Group process refers to analyzing the communications, interactions, and transactions. The process is the way in which the discus- sion takes place. Choice "c," or T-group, merely means "train- ing group." The first T-group was conducted in 1946. Originally, T-groups were used in industrial and organizational settings to process personnel interactions and improve efficiency. A wealth of work in this area was done by National Training Laboratories (NTL) in Bethel, Maine, created by Leland Bradford, Kenneth Benne, and Ronald Lippitt. (d)

Cohesiveness is a sense of caring for the group and the other group members. The term cohesiveness is associated with Kurt Lewin's "field theory" in which cohesiveness was seen as a bind- ing force among group members. Lewin called the binding force between group members "positive valence." When cohesiveness goes up, absenteeism and other negative factors go down. High cohesiveness leads to high group productivity and commitment. Lewin was a key player in the T-group movement in the United States. And here's a helpful tidbit of information. Often when a group displays little or no cohesiveness the group will be viewed as "fragmented." Just for review, you will recall that choice "c" (coleadership) is implemented when two persons lead the group. (a)

George Gazda proposes a typology of three distinctive types of groups: guidance, counseling, and psychotherapy. A guidance group is a primary group in the sense that it is mainly preven- tive. Listen carefully, however. Some exams and texts no longer use the term guidance group. Instead, you may see the term affective education group or psychological education group, or even psychoeducational group. Guidance groups, which origi- nated in the public school system, do not deal with remediation of severe psychological pathology. Guidance/psychoeducational groups are preventative and provide instruction about a poten- tial problem; for example, drug abuse or improving study skills. In most cases they are time limited and occasionally use videos and guest speakers to enhance the experience. Exam hint: In the last several years the term psychoeducational group seems to be replacing the term guidance group as the term guidance group has become associated with negative practices such as excessive advice giving. Here is another key point. In individual treatment the words counseling and therapy are often used interchangeably. However, in the context of group work, therapy is implied when the problem is more se- vere and more individual work is needed for a longer duration. Psychotherapy groups are commonly used in inpatient psychiat- ric hospitals and residential facilities for patients with in-depth psychological problems. The psychotherapy group is tertiary and may emphasize the role of the unconscious mind and childhood experiences more than a counseling group. A counseling group would not tend to be psychodynamic and therefore would focus primarily on conscious concerns. A counseling group generally has less structure than a guidance group. In terms of education, the assumption is that the leader of a counseling group needs more training than an individual running a guidance group. That being said (and yes this sounds a bit contradictory) experts will concede that at times a counseling group may overlap with the features of a guidance/psychoeducational group. The group therapy leader must have the most training because he or she may need to treat people who are not functioning in the range of "normality." (b)

A structured group exercise is like an assignment for group members. The leader says, "today we will do so and so...." The benefit is that the exercise helps to speed up group interaction and can help the group focus on a specific issue. Although struc- tured group exercises are very popular and beneficial, they are generally not as effective as unstructured methods. This answer could surprise you if you are new to group work. The well-known existentialist and group theorist Irvin Yalom pointed out that structured exercises can create a situation where group stages are passed over. In addition, the exercise itself often serves to purge feelings too rapidly when members are not emotionally equipped to handle this. Also keep in mind that the excessive use of structured exercises can cause the group to lean on or rely too strongly on the leader for support and direction. Per- haps the crowning blow in regard to relying too heavily on structured group exercises came out of an encounter group project by Lieberman, Yalom, and Miles. The project demonstrated that leaders who utilized many structured exercises were more popu- lar than leaders who did not; nevertheless, the outcome for the group participants was lower! Here is an excellent rule of thumb: Group exercises must correspond to the level of group develop- ment. In a beginning group, for example, exercises which build openness and trust are desirable. In the later stages, the focus of the exercises ideally switches to critical feedback. (b)

Choice "a" is especially apt to occur if the leader is process-ori- ented. Remember: Content is the material discussed, while process focuses on the way it is being discussed. A word to the wise: The word process can also refer to a type of program re- view (conducted while a study or a program is in progress or ongoing) and a type of note taking (i.e., psychotherapy notes). You'll need to zero in on the context of the question on your exam. Choice "d" is certainly not the best answer since a leader focusing on content would not be process-oriented. (a)

Perhaps what I'm about to suggest is a bit scary to think about but bear with me anyway. Think back for a moment to when you were a teenager. (If you can't remember that far back, think of a teenager with whom you are currently familiar, such as a relative or a client.) For the most part, your decisions and be- havior were probably fairly rational—conservative if you will. Now think about your behavior when you got together with a bunch of your friends, say for a party or a night out on the town. Wouldn't you have to admit that the group's decisions and be- havior were not as conservative as your views prior to the group interaction? In other words, weren't group decisions, well, just a bit more "risky?" If your answer to the aforementioned ques- tions was "yes," then you have the social psychology theory of the "risky shift phenomenon" to explain (not condone!) the behavior of your wild and crazy teen peer group. The risky shift phenom- enon dispels the popular notion that groups are very conserva- tive. Some newer research indicates that the group behavior is not necessarily more risky, but does at least shift more toward the social norm than an individual decision made prior to group participation. Social psychology research also indicates that the group experience can polarize decisions such that they are more in line with members' initial views. This tendency is known as "group polarity" or "group polarization." In essence, group po- larization predicts a person's views may become more extreme after they participate in a group. (a)

The "T" merely stands for "training." It is not unusual for T- groups (i.e., training groups) to be called "laboratory-training groups" or even at times "sensitivity groups." Such a group will focus not on mental health issues but rather on human relations processes between personnel in a business setting. Shared lead- ership is a common area of concern. Occasionally, a short en- counter group or sensitivity group will be termed a "microlab." Taxonomy (choice "b") is the science of classification. In the field of counseling, the most common method of determining a client's classification (which is termed a diagnosis) is to compare the client's symptoms with those listed in the American Psychi- atric Association's Diagnostic and Statistical Manual (DSM). The DSM is generally used for third-party and insurance pay- ments or research purposes so that mental health professionals will mean the same thing when referring to a client with a given diagnosis. Hint: The exam you will be taking may use the word nosology in place of the word taxonomy, since nosology is the classification of disease. (c)

Groups that rely on numerous exercises are considered "struc- tured" groups, while those which have few exercises or tasks are often known as "unstructured." Behavioral groups such as an as- sertiveness training group are generally highly structured. You should be aware that some experts shy away from the term un- structured, stating that a group cannot "not" possess structure. Such theorists would simply say that a given group has a low de- gree of structure or "less structure." Nondirective groups, psy- chodynamic groups (choice "b"), and existential groups (choice "c") generally would lean toward a low degree of structure. Therapies that stress directive techniques and concrete treat- ment objectives generally have a high degree of structure. Some theorists use the term structured group only when discussing a group which focuses on a specific topic or theme, for example, assertiveness training, stress management, or coping with test anxiety. (d)

A self-help group (also known as a "support group") is composed of a group of people who are all attempting to cope with a given issue (e.g., alcoholism, gambling addiction, or weight control). These groups have become much more popular in the last 25 years. Members have a common goal or problem and learn from each other. The group is not led by a professional, though a self- help group may indeed rely on a professional for consultation purposes. And believe me, self-help groups are extremely popular. It is currently estimated that over 500,000 self-help groups exist in the United States and serve the needs of approximately 15 million members. Most self-help groups are voluntary and make an excellent adjunct to professional counseling. Many of these groups follow the 12 steps in Alcoholics Anonymous and therefore are referred to as "12-step groups." The term mara- thon group introduced in choice "d" is an easy one to remem- ber. A marathon race is a long race, and a marathon group is one long group. A marathon group—somewhat like a marathon race—plays on the theme that after an extended period of time defenses and facades will drop and the person can become hon- est, genuine, and real. A marathon group generally lasts a mini- mum of 24 hours and may be conducted over a weekend or a period of several days. The marathon group paradigm is usually credited to Frederick Stoller and George Bach who created the idea in the 1960s. Splitting hairs— well—maybe? Some ad- vanced exams will split hairs and make you discern a self- help group from a support group although the terms are generally synonymous. The distinction is that a support group is conducted by an organization (say AA or Weight Watchers) and might charge fees, while a self-help group (say a group of neighbors getting together to brainstorm ways to clean up after a flood) would not have either or both of these features. (b)

Screening is easy enough to define. A professional counselor uses a screening process in order to determine who is appropri- ate and who will not be appropriate for a given group. Simply put, the membership of a group can determine the success or failure of that particular group. If a prospective group member is undergoing individual counseling and therapy, the group leader should contact the person performing the individual treatment before making a final decision. (a)

Let me help you think this one through. First, the individual's occupation and the time of the group (i.e., Tuesday nights) are irrelevant. The key factor in answering the question is to identify a personality pattern which may not lend itself to group work. Hostile individuals who act out aggressively (choice "c"), persons who are actively suicidal or homicidal, paranoid clients, those who are totally self-centered, or psychotic individuals (psychotic implies that the person is not in touch with reality) are not ap- propriate for most counseling groups. I have purposely hedged and used the word most since there are certainly psychotherapy groups which cater to the aforementioned populations (e.g., a group for hospitalized schizophrenics or a group for suicide at- tempters). Remember that psychotherapy groups focus more on individual concerns, deal with remediation of more serious pathology, and are of longer duration. Nevertheless, it is still possible that if an individual is too dysfunctional in one of the aforementioned areas, he or she would be inappropriate even for a psychotherapy group and the treatment of choice should be an individual modality. Clients who are very verbal, open to feedback from others, and believe in group therapy often make excellent group members. (c)

If you missed this one then you failed to read the answer from the previous question. I can't stress strongly enough that you will need to understand the practical application of counseling theo- ry—in all eight areas, not just groups—to do well on your exam! Questions of this nature require understanding rather than just rote memory to answer correctly. (a)

ASGW ethical guidelines recommend a pregroup interview for screening and orientation. In essence, the client's needs must match the goals for the group. The guidelines do not, however, discuss specific selection processes. An individual screening in- terview allows the client to voice concerns regarding what he or she wants from the group and what procedures will be imple- mented. The person also can ascertain whether he or she has faith in the leader's ability. Some of the literature emphasizes that screening is a two-way process (i.e., the leader can decide whether the member is appropriate and the member can decide whether the group and the leader are appropriate). Individual screening modalities also can serve to build trust. However, I'm sure you've come across clients as well as acquaintances whose behavior is markedly different in a group as opposed to an indi- vidual situation. (d)

Expert Irvin Yalom feels that the main factor in selecting par- ticipants for a group is that members can feel cohesive (a sense of we-ness, if you will). Research indicates that high denial, low motivation, and low intelligence are associated with premature termination from group therapy. (c)

You absolutely must be familiar with this important distinction in group work if you want to do well on your exam. A closed group can be likened to a room with a closed door—no new persons can enter. In a closed group the decision is made initially that no new members can join for the life of the group. So, here's a simple little memory device: "closed groups" have "a closed door policy" regarding new members. Most of your graduate classes would fall into this category. Would a new student be permitted to join your group practice class 8 weeks into a 16-week semester? Hey, in most cases I'd have to say, I don't think so! An open group simply abides by an "open door policy," if you will, by allowing new members to join. (d)

Generally a closed group will have more cohesiveness or "unity" since the membership is more stable (i.e., new members are not joining), and members get to know each other. Nevertheless, a closed group is not a panacea. Since the closed group does not accept new members after the group is up and running individuals may drop out, and this lessens the overall amount of group interaction. In terms of cost effectiveness (choice "a"), the closed group is at a disadvantage. The agency or private practitioner loses revenue when clients leave and are not replaced.(b)

It doesn't take a mathematician to discern that if you have six group members and six members quit you are left with no group! In reference to choice "b," there is no evidence to demonstrate that a closed group could not provide excellent in-depth thera- py. Since the closed group promotes cohesiveness (yes, I'm re- peating myself, but I want to be certain you grasp this concept) and trust (well, that eliminates choice "c" because trust reduces paranoid ideation in many cases) it could be an excellent modal- ity for intensive therapy. And although a closed group could be more structured than an open group, this is not always the case: So much for choice "d." (a)

This is the type of question you might quibble with on an exam; however, it would be mighty difficult to defend any answer ex- cept choice "a." Yes, I agree that some of the literature uses the term stability to describe the membership in a closed group. The stability, of course, comes from the policy of not allowing new members. If you read this particular question very, very carefully it speaks of the "number of people in an open group." Remember the hypothetical situation discussed in the last an- swer. You have a closed group of six members and six members leave the group. You are left with nobody. I'd hardly call that stability, would you? This question is asking you to choose the group strategy, open or closed, which would keep that number of six members stable. In the open group, if six people drop out you could replace them with six new members. I rest my case. Remember that regardless of which exam you must tangle with, a word could be used in a different context than you have en- countered in the past. (a)

Open groups have changing membership, and thus different members have been present for different experiences. Choice "a" is obviously incorrect since new members could indeed enter the group after the first session. (c)

Choice "a" is often difficult to accomplish as groups are often set up such that members sit in a circular fashion; yet when it is possible, it fosters good "attending behavior" on the part of the group leader. In reference to choice "d," the qualities which enhance individual counseling are also beneficial when doing group work. Genuineness, which is also known as congruence or authenticity, is advisable in all therapeutic settings. (a)

Generally persons who are similar will sit next to each other. In this case, choice "d" is the only choice that mentions two persons of the same race. Now I want to introduce you to two important terms which are related to group composition. In a group where the members are very similar or alike the group composition dis- plays what is known as "homogeneity." Weight Watchers would be a case in point. Groups which have "homogeneity" are said to be "homogeneous." Since everybody really has the difficulty or concern (e.g., weight control in this case or alcoholism in AA), people often feel a greater degree of "we-ness" or cohesiveness. Some experts are convinced that homogeneity in terms of intelligence and level of development is desirable. In children's groups, this would mean an age span of no more than two years (e.g., 10- to 12-year-olds). A "heterogeneous" group or a group which has "heterogeneity" has members who are dissimilar. A general therapy group which has clients with various prob- lems and backgrounds would be an example. (This distinction is easy enough to remember since "heterosexual relationships" are formed via two individuals of a different sex.) The heteroge- neous group is more like a microcosm of the social system most of us live in. Moreover, when you combine people you discover that people can learn from each other and this is said to facilitate personality change. (d)

Forget the poles of a magnet; in groups "likes" attract. The likelihood is that people who are similar or believe they have "something in common" initially will sit together. Some evidence points to the fact that social class means more than race in terms of group seating. (b)

The counselor's level of education is totally irrelevant. Process focuses on the "process," or manner in which the communica- tion transpires. All of the other choices focus primarily on the analysis of the client's material, or what is called "content." (d)

Can you guess what is irrelevant in terms of answering this ques- tion? (a)

It is therapeutic just to know that you are not the only person in the world who has a given problem! In this respect the group model has an advantage over individual treatment. Your exam might substitute the word mutuality for universality. (d)

The classic study regarding leadership styles was conducted by Lewin, Lippitt, and White in 1939. The importance of the study was that it demonstrated that leadership styles do make a dif- ference. In this famous study, 10- and 11-year-old children met with an adult who behaved in an autocratic (authoritarian), dem- ocratic, or laissez faire fashion. The French term laissez faire im- plies that group members can do as they please without leader interference or direction. Children displayed the best behavior when treated in a democratic fashion, while aggressive behavior occurred in response to the other two leadership styles. Gener- ally, the autocratic style proved to be the style members liked least. The study revealed that hostility was 30 times greater in autocratic groups than it was for the other two. This study set the stage for the National Training Laboratories (NTL) mentioned in a previous question. Do not, however, assume that the demo- cratic style is always best. It is not. The autocratic mode seems to be superior when an immediate decision is necessary. When a group has made a decision, and is committed to it, the laissez faire style is usually the leadership model with the most merit. It is interesting to note that although member satisfaction is often highest in response to democratic leadership, this style does not necessarily lend itself to high productivity, according to Stogdill, who reviewed the major research studies related to this topic. Your exam might also mention the charismatic leadership style in which the leader uses his or her personal power, charisma, and attractiveness to abet facilitation. Just for review purposes, choice "d" describes the three communication modes used by assertiveness trainers to determine or discriminate (as it is often called) client response patterns. (b)

Choice "d" refers to a group that does not sport a given num- ber of sessions or an ending date. If you missed this question please review the previous answer. Stick this sentence on your mirror at home and read it every morning: Effective leaders have discovered that modeling appropriate behaviors improves group participation, even when the members are resistant. (b)

Here is every test taker's nightmare. The question is vague. It decidedly does not delineate the specific group situation. Hence, the best way to answer this question is to think in terms of "most situations." Again, the democratic style is not the most effective in every case; however, it probably lends itself to more situations than the other two. Leaders that focus primarily on the here- and-now are now being called "speculative leaders" on some exams. (c)

Coleadership (i.e., the use of two group leaders) has a number of advantages. In addition to those listed in choices "a," "b," and "c," I could add that two leaders can supply more feedback to group members than one leader. They can learn from each other and can model effective communication for the group. (d)

Noted authors on group practice, Marianne Schneider Corey and her husband Gerald Corey, mention their preference for coleadership but indicate that many leaders do in fact work best on their own. Coleaders work best when each leader has a simi- lar philosophy and group style. It is generally accepted that it is best for coleaders to physically sit on opposite sides of the group rather than next to each other. (a)

If you have an issue that is unresolved and it is having a nega- tive impact on your intervention (i.e., countertransference), then your coleader can deal with this particular person or issue. A coleader also provides a second role model for participants. Reminder: Transference refers to a client's issue, while countertransference implies that the helper has issues that are interfering with the treatment process. (a)

It is generally accepted that if there are problems between co- leaders, it is best if such difficulties are aired in a format that models effective conflict resolution during the session rather than "pretending everything is wonderful." The best advice is to pick your coleader wisely and meet with this person before and after sessions whenever possible. (d)

Choice "b" is recommended for coleaders, while choices "c" and "d" are irrelevant. Coleadership is an excellent way for new lead- ers to learn the ropes, if they can be paired with a seasoned pro- fessional. (a)

Sorry folks, but according to some experts a wall filled with de- grees, plaques, and certifications is not enough; specific training in group work is necessary in order to become a group leader. A 1985 study by Huhn, Zimpfer, Waltman, and Williamson found that 27% of the 76 programs reviewed offered only one course in group counseling. Today a group practice course is generally required prior to taking a licensing exam. A training group for future group leaders is one solution to this dilemma. A training group is composed of "leader trainees," and unlike a therapeutic group it is focused on leadership skills. Yalom has gone on record as saying that self-exploration (e.g., personal therapy) is gener- ally necessary for potential group leaders to help them deal with issues which could cause countertransference. (c)

An ideal group would have about eight adults. An adolescent group might be slightly smaller, perhaps five or six members. Some experts feel that a group conducted over a long period of time (say six months) can safely have as many as 10 members. (d)

Three or four children is usually recommended, versus about eight people in an adult group. (b)

One and a half to two hours is sufficient for adult group work. Longer groups often beget fatigue in the group members. With children, the group leader should note the members' attention span, which is generally shorter than for adults. Since a children's group will have shorter sessions, it is often best to rely on more frequent group sessions. (d)

This practice is specified in ASGW's Ethical Guidelines for Group Leaders, rendering choices "b" and "d" as blatant ethi- cal violations. Hint: Although group confidentiality is desirable, ACA Ethics stipulate that leaders should inform participants that they cannot guarantee confidentiality. Lack of confidential- ity is a risk of group intervention. (a)

Professional counselors should give clients "information" re- garding the group so the clients can make "informed" decisions regarding whether or not the group is appropriate (e.g., the pur- pose of the group, the risks involved, and the leader's qualifica- tions). This practice technically is known as "informed consent," and it is very likely that you will see an exam question related to this issue. Ideally, informed consent occurs during screening before the initial group session, although in the real world this is not always possible. (c)

In the words of ASGW ethics: "Group leaders shall inform mem- bers that participation is voluntary and they may exit the group at any time." Is this guideline realistic? Some experts certainly would question this guideline to say the very least. Consider a client who is "required" by the court to attend your group be- cause he has perpetrated sexual abuse. In the literal sense this client is not a "voluntary participant." When a client is required to go to counseling or therapy it is known as "mandatory treat- ment." When a client is referred for treatment and is not enthu- siastic about the intervention the term reluctant client is usually applied. (b)

When ground rules become the standard of behavior then it is known as a "norm." The leader can specify the ground rules early in the group. Examples might be no cussing or hitting an- other group member. The term ambivalent transference, choice "b," is a psychoanalytic notion often thrown out in multicultural circles which suggests that a client will treat a therapist with am- bivalence, as he or she would any person viewed as an authority figure. (Note: Ambivalence implies that the client will experi- ence contradictory emotions, such as love and hate, alternating from one to the other.) Choice "c," blocking, is a term often used in group work. Blocking occurs when a leader uses an interven- tion to stop—or block if you will—a negative or counterproduc- tive behavior which could hurt another member or the group. Choice "d," scapegoating, is precisely the type of behavior a leader would want to block. In scapegoating, members gang up on a single group member. (a)

Norms are the written or unwritten do's and don'ts of the group. (d)

Group dynamics refers to the study of the interrelationships and interactions between group members. Group stages, cohesive- ness, leadership style, and decision making are prime examples of group dynamics. Any factor that has an impact on the group can be referred to legitimately as a dynamic. The hot seat, choice "b," is a term popularized by Fritz Perl's gestalt therapy groups. A person who is the target of the therapist's interventions in the here-and-now is said to be on the "hot seat." Choice "d," or the structuring of the group, is determined by the presence (or lack of) structured tasks or exercises given to members by the group leader. Important point: Often when an exam uses the term structured group (not to be confused with the term group struc- ture) it connotes a group which focuses on a given theme, such as a group for veterans who served in the war in Iraq. (c)

Choice "d" is used quite a bit in the social sciences. In order to "operationally define" something you must demonstrate the concrete steps necessary to illuminate the concept. It sounds complex, yet it really isn't. To operationally define, say, positive reinforcement, you would first note how often a behavior is oc- curring. Then you might give the client a reward every time he or she performs a desirable behavior, and tabulate the fact that the behavior is occurring more often than before you instituted the procedure. To operationally define the action of writing the letter "t," you could tell the person to first draw a vertical line of one inch in length and then draw a horizontal line one half inch in length, perpendicular to and one third of an inch from the top of the vertical line. The idea of the operational definition is that another person can duplicate your actions (i.e., the exact steps) for therapeutic, research, or testing purposes. Behavior- ists have emphasized the notion of operational definitions more than other therapeutic schools. (b)

Most experts see choice "b," the use of a male and a female co- leader, as a distinct advantage. Often goals are defined yet they are too vague. (d)

Look closely at choice "a." An assertiveness training group would indeed generally use a lot of structured exercises. Choice "d" is also incorrect since a self-help group would not necessarily uti- lize a lot of structured exercises. (c)

Some research indicates that structured exercises in the initial stages of the group can facilitate better communication. (a)

If you marked choice "c," then stop this very moment and review the answer to question 436. So far as choice "d" goes, beware of any answer which relies on adverbs like "always" or "never." Answers sporting the word always are almost always incorrect, and those using never are almost never correct! (b)

The unity is actually a feeling of belonging, oneness, or togeth- erness. A sociogram (choice "b") is simply a pictorial account of a group which serves to diagram member interaction. Choice "c," Karpman's drama triangle, is used most often in conjunction with transactional analysis (TA) as a teaching device to illumi- nate the roles of persecutor, rescuer, and victim in interpersonal relationships. The final choice, the transition stage, is the group stage which occurs after the first or so-called initial stage. In the initial stage members get acquainted and learn norms. In the second or transition stage members are often judgmental, resis- tant, or involved in a struggle for power to establish a hierarchy or "pecking order." (a)

In counseling the term reactive means that a given condition is the result of environmental stress. Hence, reactive schizophre- nia would imply that the person experienced a psychotic episode following a traumatic experience. This would be in contrast to an individual who was seemingly always schizophrenic, and the pathology could not be traced to any given set of circumstances. Choices "a," "b," and "c" are common roles individuals will play in a group setting. The energizer stimulates enthusiasm in the group (e.g., "Come on folks this will be a lot of fun; and besides we'll really learn a lot"). The scapegoat is the person everybody blames. He or she is invariably the target of severe anger and hostility (e.g., "Look Marv, we all agree that if it weren't for you we would have solved the problem two weeks ago"). The gate- keeper tries to make certain that everyone is doing his or her task and is participating. This person may "secretly" or "uncon- sciously" want to lead the group and could even attempt to es- tablish norms. The danger is that a gatekeeper often does not work on his or her own personal issues (e.g., "From now on I'd like everybody to bring a journal to the group and write down at least one positive thing which happened during the week"). Is that the leader speaking out or the gatekeeper blowing off steam? Only the group members know for sure! (d)

The "interrogator" asks a never-ending string of questions, while the "follower" goes along with the rest of the group. (c)

Choice "c" relates to Andrew Salter's conditioned reflex therapy in which "excitation" or the practice of spontaneously experienc- ing and expressing true emotions (even negative ones) is seen as necessary in order to attain a state of positive mental health. "Inhibition," or constipation of emotions, is seen as the opposite of excitation. Salter said: "However, in psychotherapy we need have no fear. The diagnosis is always inhibition." (d)

I joke with my students about adding a note to the university course catalog under my groups course which says "only former gatekeepers need to apply." See answer 460 if you fail to see the humor! Choice "d" introduces the harmonizer role. Some books and exams bill this as the "conciliator," or the person who tries to make certain that everything is going smoothly. (b)

The storyteller, choice "d," monopolizes a wealth of group time telling endless (often irrelevant) tales. A group leader will some- times need to help this person get to the point or will need to ask the person precisely how the story is productive in the context of the group setting. This choice also lists a bevy of other self- explanatory roles members can play. (c)

One popular notion is that these roles relate to the person's pat- tern of behavior in his or her nuclear family, and if appropri- ate the group leader can explore this hypothesis. In addition to the popular aforementioned roles, Hartford spoke of an "isolate role." The isolate is ignored by others. Isolates generally feel afraid to reach out or do reach out and are genuinely rejected— for exam purposes keep in mind that the isolate is not the same as the scapegoat. Scapegoats receive attention, although it is not by any means overwhelmingly positive. Isolates—a negative group role often referred to as the "silent one"—on the other hand, receive little or no attention. (a)

The word faction in choice "d" describes a clique or a group of people within a group. You might, for example, have a faction which does not wish to go along with a certain task or group ex- ercise. The sociogram mentioned earlier can help identify group factions. A faction also may be called a "subgroup." (c)

In order to meet the "changing needs" of the group, members often need to "change roles." Choice "d," or role reversal, is a common behavioral role-playing technique. A client who is hav- ing difficulty communicating with another person in his or her life role-plays the person with whom he or she is having dif- ficulty. Another group member (or the leader) plays the group member with the problem. This valuable technique gives the group member a new perspective on the situation and allows the person to learn via modeling alternative ways of behaving. (c)

Here is a key concept. Group specialists classify member roles as: task roles, maintenance roles, and self-serving roles. (On some exams, self-serving roles will be identified as "individual roles.") The distinctions are actually fairly easy to remember. In everyday life when we refer to a "task" we mean a job or some- thing which needs to be accomplished. A task role (e.g., an in- formation giver or a clarifier) simply helps the group carry out a task. A maintenance role (e.g., the follower, mentioned earlier, or an encourager) helps "maintain" or even strengthen group processes. The final category (i.e., the self-serving role) is seen as negative. The person who falls into this category meets his or her own "individual needs" at the expense of the group. A per- son who downright refuses to participate or a person who criti- cizes or disagrees with others would be a prime example. Final hint: An entire group could be classified as a task group or perhaps a task/work group. A group of this nature fo- cuses on accomplishing work goals. According to former ACA president, textbook author, and group expert Sam Gladding, an athletic team would fall into this category, as would a quality circle employee run group attempting to improve a business. (d)

Remember: Maintenance really implies that the role maintains group interaction. Maintenance roles support the group's liveli- hood and hence are seen as positive. Paul Hersey and Kenneth Blanchard point out that leader activities generally fall into "task actions" and "maintenance actions" (i.e., relationship concerns). Hersey and Blanchard believe that the most effective leader- ship approach depends on the group situation. The research- ers speak of "maturity" in regard to a specific task. If a group member has low maturity—which is really a lack of achievement motivation—then the leader should use "high task" and "low re- lationship" behaviors. As maturity gets better, a "high task" and "high relationship" paradigm is ideal. And when group members display very high maturity, then a "low task" and "low relation- ship" leadership format would be desirable. Now listen closely: task action leadership is said to be indicative of one-way com- munication (i.e., the leader tells the members about a task to accomplish), while relationship behavior is said to be the result of two-way communication (i.e., the leader provides emotional support for members). Hersey and Blanchard suggest that it is not atypical for a member to display maturity on one task and a distinct lack of maturity on the next. Now I want to stress two very important points here. One is that when you see the words task and maintenance on your exam, the concepts could refer to either a group member's role or the leader's behavior. The other concept I want you to be familiar with is that conflict between group members can often be abated by having the leader pre- scribe a "task" on which all the members must work together in order to accomplish it. (a)

Self-serving or so-called individual roles are counterproductive. (d)

believe this clarifies the point made earlier that group mem- bers ideally will be flexible and able to change roles. (d)

The word conflict comes from the Latin word conflictus, which means "striking together with force." Please do not confuse "role conflict" with the group term conflict of interest, which occurs when a group member maximizes his or her needs and interests at the expense of someone else. (b)

Here is a very helpful hint. Do not—I repeat—do not attempt to memorize every single group stage theory ever invented. First because you have better things to do with your time (I would hope!), and second because there are far too many. Most of the theories are very similar and thus if you know the basic format you will have a very good chance of answering the question correctly. The first stage generally is known simply as the "initial stage." (Now there's one that's so simple you won't need a memory de- vice!) Others have termed this stage as "orientation and explora- tion," or "preaffiliation," or "forming." The next stage usually is designated as the "transition stage," though you will often see it termed "power and control" or "storming," which logically comes after "forming." The third major stage is the "working stage," "norming stage," "cohesion stage," or "negotiation, intimacy, and frame of reference." The final stage is sometimes known as the "separation stage," the "termination stage," "the closure stage," or "adjourning." Choices "c" (no relation to yours truly!) and "d" will be covered in the sections on research. (b)

Okay, you deserved an easy one. Note that different group the- ories have differences in the number of stages. Your best bet on the exam is to try to note the similarities between the major theories. For example, the initial "group formation" stage ex- amined in this question (i.e., orientation, forming, preparation, engagement, and who knows what some creative theorist will dare call it next!) is focused on the establishment of norms and approach-avoidance behavior of group members. Members will be tentative and size up other members. Members will identify or get acquainted with others based on culture, language, mode of dress, or occupation. (a)

The final stage is said to represent a time of breaking away, or in plain, simple, everyday English: saying good-bye. Group mem- bers can experience loss and need to establish bonds outside of the group setting. The ideal situation would be that termination takes place after the group and its members have reached their goals (e.g., greater insight, improved self-esteem, accomplish- ment, and awareness) and have no further unfinished business. Certainly, in reality (such as when a client needs to leave a hos- pital group because his or her insurance has run out) this is not always the case. Additional referrals may be necessary. (d)

Yes, I'm being redundant with the words I'm using in my ques- tions and my answers, but this will help you become more ac- customed to the lingo of group work, and I've got this uncanny suspicion that it's working! In the first stage people want to be accepted but are scared to participate: Now, what about choice "a?" Well, an avoidance-avoidance conflict exists when you have two alternatives which are both unattractive, such as when your boss says you can either take a pay cut or lose your job. The approach-avoidance situation taking place in the initial group stage is a conflict wherein you are attracted and repelled by the same goal. In an analogous situation: You want to meet group members, but it's scary to think about the fact that you could be rejected. (c)

Safety comes from seeking common ground. That is to say, the new group member seeks out others of similar social status. Like Erikson's first psychosocial stage of development, the initial group stage hosts the "trust versus mistrust" drama. (c)

Garland, Jones, and Kolodny appropriately called stage 2 "power and control." This is the stage in which the fireworks fly as group members verbally attack one another, not to mention the group leader. (a)

Ditto! This is the stage movies are made of. Members rank themselves in terms of status and factions (mentioned earlier). Isolated members who are not protected by the strong subgroup (faction) sometimes drop out. It should come as no surprise that some authors have called this the "high anxiety" or "struggle for control stage." And how is a leader to handle this turmoil? Corey and Corey appropriately suggest that the leader learns to distin- guish between a "challenge" and an "attack." Do not assume, say the Coreys that every confrontation is an attack on your integrity as a leader. Leaders can model responsible assertive confronta- tion with open and truthful expression. (a)

The term ecological planning has been used to describe the pro- cess of obtaining information to determine whether a group is the most desirable form of treatment and, if it is, to decide the exact nature of the group experience. The counselor needs to look at demographics, community needs, and social consider- ations. After the group begins, program development or session by session planning is recommended. Planning can also include: (a) Whether to use a single facilitator or coleadership; (b) an assessment of the best surroundings (i.e., the room or rooms where the group will be held); (c) how the group will receive funding or payment for the group (e.g., will insurance pay for the service?); (d) whether a marketing or recruitment strategy is necessary; (e) what information can be useful from books, jour- nals, or the Internet; (f) how the clients will be screened and prepared for the group; and (g) providing clients with informed consent documents. (d)

This phase has been called "consolidation" and occurs after the working stage. The leader helps members make plans for the future. I must point out that group specialists feel that every group does not necessarily pass through every stage (even after an extended period of time) and that there is not always a clear- cut discernible line of demarcation separating one group stage from another. (d)

The study of measuring person-to-person relationships regarding what members in a group think or feel is known as "sociometry." In essence, sociometry is a quantitative study of relationship concerns in a group. The sociogram, credited to Moreno and Jennings, graphically displays group members' affiliations and interactions. Choice "a," or family sculpturing, is a family ther- apy technique in which the family members are instructed to arrange themselves spatially to create a live representation of family members' bonds, feelings of closeness (or lack of it), and sense of alliances. Choice "b" is a common practice in transac- tional analysis in which the counselor helps the client discern out of which ego state (i.e., Parent, Child, or Adult) he or she is primarily operating in a given situation. (c)

Summarization, which is also appropriate in individual work, is merely the act of bringing together a number of important thoughts, insights, feelings, or transactions. (a)

Blocking in groups is very much like blocking a punch in a box- ing match. Blocking is used by the leader to stop (or block if you will) a hurtful behavior. Blocking in therapy is often necessary for the protection of group members. Blocking can be used in cases of gossiping or breaking confidentiality. Choice "b," clari- fication, is another important skill group leaders must possess. A leader uses clarification to ferret out the important points in a client's message. Clarification brings out the gist of a message and illuminates what was really said to lessen any confusion. The final choice, linking, is used to promote cohesion. A link is an at- tempt to bring together common patterns or themes within the group. (c)

When used properly, linking illuminates areas of mutual con- cern. This often enhances group interaction. (d)

When working in a group setting, the leader needs to decide whether to work with the group as a whole (called a horizontal intervention) or with individuals within the group (called a verti- cal intervention—note choice "a"). Of course by now you realize how valuable memory devices are in terms of helping you to re- member distinctions. Here's the one I have found valuable in this case. If you picture a group in your mind it appears spread out "horizontally." On the other hand, if you picture yourself doing counseling with an individual in a group, the individual is usu- ally sitting up in a "vertical" position. In the case of the vertical intervention the leader is providing individual counseling in a group work setting. Techniques which focus on group relation- ships, processes, tasks, and interactions are said to be horizontal intervention strategies. The horizontal approach is often called the "interpersonal" method since it focuses on interactions. The vertical approach has been termed "intrapersonal" leadership. Shapiro, who suggested the intrapersonal-interpersonal leader- ship distinction, feels that a leader does not really choose one or the other but tends to behave on a continuum in this respect. Key point: You would do well to remember that interpersonal leaders favor here-and-now interventions while intrapersonal leaders are more likely to work on the past, sometimes employ- ing psychodynamic notions. An effective counselor should rely on both types of interventions. If, for example, a leader stresses vertical intrapersonal interventions, members may be hesitant to speak or react in a spontaneous manner. In this case the group member might literally think, "It's not my turn to speak yet Dr. X is working with Jane now." The other side of the coin, however, is that the horizontal interpersonal leader may lose some power as an expert who can model or reinforce appropriate behavior. (b)

Again, use your memory device. See that individual sitting or standing—she's in a vertical position, of course. Choices "c" and "d" relate to transactional analysis (TA). A crossed transac- tion between two persons' ego states is said to be dysfunctional, while a parallel transaction promotes healthy communication. Although quite frankly TA is a bit, well, let's just say dated, it is conceivable that a question or two could still pop up on your exam. (a)

Thus, most experts would agree that it is more difficult to do productive group work than it is individual work. Nevertheless, in many settings the only way to reach all the people who need counseling in a finite period of time is to use group work. (d)

Practical research about what exactly works best in a group set- ting is scarce. Moreover, many studies in the field of group work have not been well controlled. In many studies, the independent variable (i.e., the experimental variable) has not been scientifi- cally defined. Say, for example, the independent variable in a study is a "T-group intervention." This indeed could create a problem since a T-group to leader A might not seem like a T- group to leader B. (c)

The position has been taken that in the past groups have empha- sized a narrow focus (e.g., a group for nonassertive bosses), and in the future groups should begin to deal with a broad spectrum of issues or what some call a "comprehensive model" of group work. A comprehensive educational life-skills model could stress preventive mental health skills, hopefully lowering the need for "therapeutic groups." Therefore, ultimately the counselor of the life-skills group would act more like a trainer than a therapist. (a)

Research in the area of group work is sometimes classified as "outcome research" or "product research." Outcome research addresses the question of whether the group was able to reach a given set of goals or simply the desired "outcome." An out- come study attempts to answer the question of whether or not the group was successful (i.e., does the group work). Process research is aimed at the question of "how groups work." Pro- cess research asks, "What allows the group to reach a target out- come?" (a)

Let me make certain that the purpose of this question is per- fectly clear: You must know the strengths and limitations of group work for almost any comprehensive exam. Choice "d" depicts a major limitation. Other limitations include: (a) that a client may need individual therapy before he or she can benefit from group work; (b) that a client may not be capable of trusting others enough to reveal key material since he or she fears oth- ers may find it unacceptable; (c) that the group could become a substitute experience for the real world; (d) that the group coun- selor may not be as effective with a whole group of people as he or she is with just one person in individual treatment; (e) that some clients may feel pressure to replace their personal norms with those of the group; and (f) that disappointment can set in if the group is not helpful and the person loses faith in treatment without experiencing individual sessions. Group work can of- ten be intimidating and this can squelch client disclosure. Clients also receive less time working with the counselor than in individual counseling. In today's fast-paced world, the lack of flexibility in terms of meeting times for the sessions may prohibit someone from attending a group. Finally, lack of trust related to confidentially often sways clients to opt for individual treatment. Group therapy gen- erally is not the treatment of choice when the client is in a state of crisis, needs an interpretation of his or her psychological tests, needs confidentiality for protection (groups are notorious for having more problems with confidentiality than individual treatment), or is phobic in regard to public speaking. Choices "a," "b," and "c" are totally false. PS: If your client is seeing an individual therapist that therapist needs to know that his or her client is planning to join your group. (d)

Other group advantages include (a) that group work allows for "in vivo" interpersonal work with a sense of belonging; (b) that it is cost effective and allows a trained counselor to help a greater number of people; (c) that it promotes universality; (d) that it can be an effective support system; (e) that members get mul- tiple feedback; and (f) that members can model successful com- munication and coping skills. Groups are like a microcosm of society that offers vicarious learning and support. And oh yes, although it would be nice if choice "c" were true (since group leaders generally need more training than individual help- ers), the truth is that many people are running groups without any training whatsoever in group work. (a)

Overall, research would support the notion that groups work, and yes, they have advantages. However—and this is one impor- tant point folks—there is no body of research which would say that in general group work is superior to other forms of treat- ment. Please reread the previous sentence—yes, it's that impor- tant! (d)

Yalom is an existential therapist. Choice "b" is psychoanalytic. (b)

Unfortunately, overall studies have turned up little in terms of "special characteristics" of group leaders' personalities. So much for the concept of super leaders! (c)

R. K. Conyne's "group work grid" model includes four interven- tion levels: individual, interpersonal, organization, and commu- nity population. The intervention can be correction oriented or enhancement oriented for either personal or task functions. (d)

Keep in mind that you are looking for the best answer here. All of the choices are correct; however, choice "c" is superior to the other three. Research in the area of group work has been criti- cized for not using independent observers. When taking your exam be aware that "member-specific measures" are designed to assess change (or lack of it) in an individual group member. Most member-specific measures, such as a self-rating or (better still) a rating by an outside observer, are not standardized. In contrast to the "member-specific measure," researchers speak of "group-specific measures," which are intended to measure the degree of change (or again, lack of it) in all persons participat- ing in the group. Lastly, the so-called "global measures," such as standardized tests, may well assess traits and factors not specifi- cally addressed in the group. For example, giving members of a Weight Watchers group a pre- and post-MMPI-2 would consti- tute a global measurement. (c)

Corey and Corey suggest that parental involvement can reduce resistance and improve cooperation. They also warn counselors not to take sides with a child against a parent or institution. (a)

This principle is true for adolescents as well as children under 10. When working with children and adolescents be careful what you say about confidentiality, since in the case of child abuse, sexual abuse, neglect, or exploitation you will be required ethi- cally and legally obligated to break confidentiality (just as you would if you saw an elderly individual who is being abused). In addition, ethics would dictate that you do likewise if a child is suicidal or plans to seriously harm another individual. Of course, these last two points would apply to all age brackets, in group or individual treatment. In closing this section I can share the fact that literally hundreds of studies attest to the effectiveness of group work. (b)