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Irvin Yalom

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"11 reasons why groups work well". Existentialist. Group theorist.

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Yalom- Altruism

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Giving help to others gives members a sense of well being

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Yalom- Universality

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Helps you feel like you are not alone, you are not the only one in the world with this problem (may also use the term mutuality)

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Yalom- Inspiration of Hope

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Members expect group to work, gives hope that things can be different

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Yalom- Catharsis

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Talking about your problems can be beneficial

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Yalom- Group Cohesiveness

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A sense of "we-ness" or we are all in this together (also known as group unity)

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Yalom- Imitative behavior

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Groups copy or model leader or other group members (based on Bandura- social/observational learning)

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Yalom- Family Reenactment

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The ability to have corrective experiences and safe space to work through family of origin experiences

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Yalom- Imparting Information

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Groups share psychodynamic insights or information to others within confines of safe space/group experience

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Yalom- Interpersonal Learning

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Members receive feedback about how their behavior affects others

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Yalom- Socialization Techniques

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Feedback and instruction are helpful in developing skills

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Yalom- Existential Factors

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Discovering life can have meaning, even if it is unfair or unjust at times

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Ideal group size

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5 or 6 to 8 (8 is preferable). Groups that are conducted for longer than six months can function effectively with up to 10 members. Size should be smaller for children

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Closed group

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No new members can join after it has started, advantages are group cohesion, trust, and unity, group more stable, may be a cost-disadvantage or lessen group interaction of people drop out. Good for intensive therapy. Not necessarily more or less structured.

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Open group

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New members can join after the group begins, allows for more group stability. Disadvantage is groups members that are added late miss some information or experiences.

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Advantages of Co-leaders

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-Two or more role models, perhaps of different gender -Can provide more feedback -Are able to see group dynamics/what is transpiring in the group

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Disadvantages of Co-leaders

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-Working for cross-purposes/needs or approach is not aligning -Conflicting models for therapy -Power struggles -Differences in what to charge/fees

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Benefits of Group over Individual Counseling

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-Cost effective -Can see more than one client at a time

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Stages of Group Development- Forming or Orientation Stage (also called preaffiliation, and/or exploration)

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First stage/Initial stage (get acquainted). Exercises which build trust and openness are desirable.Characterized by getting acquainted and learning norms.This where people feel the most suspicious of others b/c have not established trust yet.

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Stages of Group Development-Transition/Storming/Conflict (power and control)

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Second stage (power struggles for control and resistance). Characterized by judgment, resistance, power struggle, establishment of hierarchy. Might attack eachother and the group member verbally.

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Stages of Group Development- Working/productive/performing/action (norming, cohesion, negotiation, intimacy, frame of reference)

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Third stage (Work toward goals in a cohesive manner), focus of group exercises should be on critical feedback

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Stages of Group Development- Termination/closing/completion/mourning and adjourning (separation)

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Last stage (saying goodbye, feelings of improved insight, awareness, accomplishment, enhanced self-esteem, may be necessary to make additional referrals)

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Positive Group Member Roles

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Helping others and being positive role model

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Monopolizing Group Member

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The storyteller, monopolizes group time by telling endless irrelevant tales. Group leader may ask them to get to the point or will need to ask exactly how their story is productive in the context of the group setting

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Intellectualizing Group Member

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...

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Silent Group Member (or isolate group member)

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Person who is ignored by others, generally feel afraid to reach out and are genuinely rejected (negative group role), can also be known as the "silent one" who receives little or no attention.

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Attacking Group Member

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...

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Scapegoat as a Group Member

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Person that everyone blames for problems, target of severe anger or hostility

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Group Leadership Style- Autocratic or authoritarian

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Advocates making decisions for members. It is appropriate in crisis or when a quick decision is necessary but in most cases fosters resentment (or aggressive behavior in children)

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Group Leadership Style- Laissez faire or hands off

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Little involvement, interference, or direction from leader. Appropriate when all group members are committed to group outcome or goal, when group has made a decision and is committed to it,

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Group Leadership Style- Democratic/Authoritarian

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Allows input from group members with regard to making decisions. Generally the style that members are most satisfied with, but does not always lend to productivity. Better in more situations than not (when compared to laissez faire and autocratic)

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Group Leadership Style- Charismatic

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Rely on personal power, attractiveness, and charisma to move group in desirable direction. Often adored and group members look up to them, although they are not peer oriented. Not superior to the confrontive or vice versa. Whatever style is used, must not impose personal values on group members.

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Group Leadership Style- Confrontive

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Facilitator reveals impact that his behavior has on himself and reveals the impact that that other group members have on him (transparency). Not superior to the speculative or vice versa. Whatever style is used, must not impose personal values on group members.

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Types of groups- Psychoeducational (or guidance groups)

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Provide members with information relevant to their situation, preventative, originated in public school system, not used for long-standing psychopathology

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Types of groups- Counseling Groups

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Focus on conscious issues related to personal growth and development

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Types of groups- Group Therapy

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Term coined by Jacob Moreno- who founded psychodrama- can focus on unconscious material, the past, and personality change

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Types of Groups- T-Groups

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Training Groups. Intended for business or personal motivation. Started in 1946- initially used in organizational and industrial settings to process personnel interactions and improve efficiency. Most work done in this area took place in Maine by National Training Laboratories. Main players: Leland Bradford, Ronald Lippit, and Kenneth Benne. T groups can also be called laboratory-training groups (micro. lab) or sensitivity groups. Focuses on human relations not mental health issues.

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Types of Groups- Structured Groups

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Centered around particular issue (ex: shyness, prepare for job interview, etc.) Highly structured- specific treatment objectives and concrete techniques, generally focused on specific theme or topic (assertiveness, coping with test anxiety, etc.)

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Types of Groups- Self help groups/support groups

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Not led by a professional, follow AA model, 12 step groups (weight watchers example). All people in group trying to cope with a similar issue. Common goal or problem and learn from each other. Very popular! Most are voluntary and provide a good adjunct to professional counseling.

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Prior to the 1960's most counseling took place in what form?

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Dyadic- the counselor and counselee formed a pair

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Characteristics of a group:

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-Membership can be defined -Some degree of unity and interaction is evident -A shared purpose

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Jacob Moreno "Group Therapy"

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Developed based on psychodrama- Moreno is the father of "psychodrama"

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Psychodrama

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Client expresses spontaneous feelings via role-playing. Can be used in family therapy or group therapy.

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Joseph Pratt

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1905-1923 had first group therapy groups around issue of tuberculosis

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Freud "Group Psychology and the Analysis of the Ego"

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1921 published this book, but was not a major player in the development of group therapy

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ASGW (Association for Specialists in Group Work)

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Division of ACA that focuses on group intervention

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Position to face when group member speaking

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Toward the group member who is speaking!

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Expressing genuine emotion is:

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preferable in all therapeutic settings (congruence/authenticity= genuine emotion)

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1940's Two organizations for group therapy were created: What were their names?

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American Society for Group Psychotherapy and Psychodrama AND American Group Psychotherapy Association

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This therapist's work prefaced the "group movement"

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Adler (work focused on attempts to address unconscious feelings of inferiority). Group work was a "recognizing problems in their social nature"

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Primary Groups

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Stresses healthy lifestyle or coping mechanisms, which can reduce the occurrence of a given difficulty. A group that teaches birth control to prevent teen pregnancy (example)

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Secondary Groups

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A problem is present but not severe. The group works to reduce the severity or length of a problem and generally includes aspects of prevention. A group that deals with grief or shyness (example)

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Tertiary group

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Deals with individual difficulties that are serious and longstanding (focuses more on individuals than other types of groups), generally utilized in long-term psychotherapy, often focused on person's childhood

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Co-leadership/co-facilitation

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Two therapists are used in group setting: Good b/c group can go on if one leader is absent, leaders can process feelings between groups, two people can focus on group dynamics better than one person, can provide more feedback to group members, can learn from each other, and model participation to group members, reduces burnout and helps ensure safety, work well when have similar philosophy/style, best to sit on opposite sides of group rather than next to each other. Can be helpful when one leader is experiencing countertransference (issue that is unresolved and having a negative impact on intervention) b/c other leader can address the issue. Can model healthy resolution of conflict. (better not to pretend everything is wonderful!)

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Immediacy

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Counselor focusing on here and now (in individual or group setting), primarily focusing on interaction between counselor and client

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Group Norms

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explicit and implicit rules that tell group members how to behave in a given situation. All groups have group norms (even if haven't been formally presented), can be thought of as expectations for acceptable behavior, depends on your role in the group. Socially acceptable behavior (the do's and don'ts)

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Group therapy flourished in the United States due to:

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A shortage of individual counselors during WWII

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Group content

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Material discussed in group

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Group process

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the manner in which discussions and transactions occur (analyzing communications, interactions, and transactions) as opposed to content (focuses on material)

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Group cohesiveness

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Sense of caring for the group and other group members- Associated with Kurt Lewin's "field theory" in which cohesiveness was seen as a binding force amongst group members. Lewin called this "positive valence". When cohesiveness is up, abseteeism and other negative factors go down. High cohesiveness leads to productivity and commitment. Cohesiveness can stunt creativity and help with conformity.

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Fragmented Group

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Group displays little or no cohesiveness

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Difference between psychotherapy GROUP and counseling GROUP

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Psychotherapy for more long-standing and severe problems (within group context). Typically tertiary and may emphasize role of unconscious mind or childhood experiences. Counseling group focuses on "here and now" concerns, conscious concerns, and requires less training to lead than a psychotherapy group.

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Counseling vs. guidance group

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Guidance group follows educational model, has more structure than a counseling group. Counseling group the leader needs more education than guidance group.

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Structured Group Activities

answer

Can help speed up the group interaction and can help group focus on a specific issue. Not generally as effective as unstructured methods. May create a situation where some of group stages are passed over, feelings are purged too rapidly (when members not emotionally prepared to deal with it), can cause group to lean on leader too strongly (for support and direction). Helpful to initially establish communication between group members and can promote healthy model for feedback later on.

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Group exercises must:

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Correspond to the level of group development.

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Downfall of process oriented counselors in group work

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may not examine individual issues

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Risky Shift Phenomenon

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Group decisions will be less conservative that the average group member's decision, prior to the group discussion

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Group Polarization

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Decisions are polarized to be more in line with the members' initial views (person's views may become more extreme after they participate in a group)

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Difference between self-help group and support group

answer

Support group organized by an organization and may charge a fee (Weight Watchers or AA)

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Psychodynamic groups or Non-directive

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Low structure

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Existential Group

answer

Low structure

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Marathon groups

answer

Take place over long period of time (weekend) to help person drop defenses and be honest, genuine, real. Frederick Stoller and George Bach are brains behind this, started in 1960's.

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Screening Group Members

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-determine who is appropriate -should happen with all groups if possible -can determine success or failure of particular group -should consult with person's individual counselor before making final decision -client goals must match the goals for the group

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Inappropriate clients for most counseling groups

answer

Hostile, suicidal, psychotic, homicidal, paranoid, self-centered

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Appropriate clients for group counseling

answer

verbal, open to feedback, believe in group therapy

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Individual screening for groups

answer

-allows person to assess the ability of leader -allows person to voice what they want from group -is a two way process: leader and member can both decide if group is appropriate for person -helps build trust

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Most important characteristic for group members

answer

TRUST (Yalom)

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Contributing factors for discontinuing group therapy

answer

low intelligence, low motivation, high denial

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Homogenity

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level of similarity in group composition- weight watchers, people all have same concern, feel more cohesiveness. Can help to have similar levels of intelligence and development (esp. for children ages more 2 years apart or less is best).

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Heterogenity

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Group members are different in group composition- people with different problems, backgrounds, can help facilitate personality change b/c can discover and learn from eachother

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Three communication modes used by assertiveness trainers to determine or discriminate client response patterns

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Assertive, non-assertive, aggressive

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Effective leaders have discovered that modeling appropriate behavior improves

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Group participation (even when group members are resistant)

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Group Leadership Style-Speculative

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Focused on here and now

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Co-leaders can work at cross-purposes if:

answer

They do not meet between groups

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Gerald Corey

answer

Wrote extensively on group therapy- stated that participation in therapeutic group and participation in leader's group is necessary for an effective group leader (no matter what your training, licenses, education level is).

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Ideal size for a group (adults and adolescents)

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5 or 6 to 8 (adults = 8), adolescents = smaller (5-6). Groups conducted longer than six months can have up to 10 members

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Ideal size for a group (children)

answer

3-4 (smaller than adult groups)

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Ideal length of group counseling session

answer

1-2 hours, even if critical issues being discussed (for adults). Longer than this people lose attention span/fatigue group members. Children's groups should be shorter and meet more frequently.

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Group risks should be discussed with clients

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during initial session, stating cannot guarantee confidentially (due to other group members) but that confidentiality is desirable

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Informed consent is to:

answer

Inform client of potential risks and allow them to decide if they want to engage in counseling (is it appropriate, qualifications of leader, risk involved). Ideally should happen in screening

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Reluctant client

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Mandated to treatment or required to participate- although all participation based on ethical guidelines should be voluntary

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Group Dynamics

answer

The study of group operations (interrelationships and interactions between group members). Group stages, cohesiveness, leadership style, and decision making are examples of this. Any factor that has impact on the group.

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Hot Seat

answer

Fritz Perl's Gestalt therapy groups used this term to describe person that is the target of the therapist's interventions in the here and now

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Male/Female co-leaders are:

answer

A distinct advantage!

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A common weakness of groups

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Is a lack of goal setting or too vague of goals

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Gatekeeper

answer

Tries to make certain everyone is doing his or her task and participating. This person may "secretly" or "unconsciously" want to be the leader and could even attempt to establish norms. Danger is that this person may not be focusing on own issues

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Energizer

answer

Brings energy to the group, stimulates enthusiasm

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Interrogator or "Peeping Tom"

answer

asks never ending string of questions (usually inappropriate) while the "follower" goes along with the rest of the group

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Non-assertive group member

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goes along with what the rest of the group thinks

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Harmonizer/Conciliator

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Person who tries to make certain everything is going smoothly

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Isolate group member

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Person who is ignored by others, generally feel afraid to reach out and are genuinely rejected (negative group role), can also be known as the "silent one" who receives little or no attention.

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Faction

answer

Can be illustrated or identified with a sociogram- describes a group or clique within a group.

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Role Reversal

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common behavioral role-playing technique- gives person a new perspective on the problem/situation and allows the person to learn via modeling alternative ways of behaving

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Task Roles

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A task role helps the group carry out a task (by giving information or clarifying information), generally a positive thing. If stuck in task roles too long, and group is not flexible, then interaction can suffer.

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Maintenance Roles

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Helps maintain or strengthen group processes and interactions (Followers, encourager, etc.), support the group livelihood and are seen as positive. If stuck in maintenance roles too long, little work or tasks will be accomplished. Groups have to stay flexible and changing to be effective.

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Self-Serving Roles or individual roles

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Seen as a negative factor in group dynamics- person meets own needs at expense of group (refuses to participate, critical of others, etc.). Counterproductive for group and serve the individual.

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Task Group

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Focuses on accomplishing specific goals- sports team, work-groups trying to improve business are examples.

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Leader- task actions

answer

If group member has low maturity (lack of achievement and motivation) then leaders should use "high task" and "low relationship" behaviors. As maturity improves, "high task" and "high relationship" works best. Very high maturity, should use "low task" and "low relationship" leadership format should be utilized. Task-action leadership indicative of one-way communication, while relationship behavior is the result of two-way communication

question

One way to avoid group conflict is:

answer

Have all members work together on a task that requires participation from all to be successful.

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Role Conflict

answer

discrepancy between the way a member is expected to behave and the way he/she actually behaves

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Avoidance-Avoidance Conflict

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Neither option is attractive (get fired or take a pay cut)

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Approach-Avoidance

answer

attracted but repelled by same goal (initial meeting of new group members... you want to meet eachother but are scared you might get rejected)

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Ecological planning

answer

process of obtaining information to determine whether group is desirable form of treatment, to decide on nature of group experience, look at demographics, community need, social considerations.

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Group planning/development should

answer

-Take place over entire course of group -consider whether to use single or co-facilitator -as assessment of surroundings -how group will receive payment (insurance, funding, etc.) -whether marketing or recruitment is necessary -what information can be useful from books, internet, journals, internet, etc. -how clients will be screened -how clients will be given informed consent

question

Sociometry

answer

quantitative study of relationship concerns in a group, sociogram (Moreno) displays group members affiliations and interactions

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Summarization

answer

Bringing together a number of important thoughts, feelings, insights, feelings, transactions

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Blocking

answer

Leader uses this technique to stop hurtful behavior. Can be necessary for protection of group members (in cases of gossip, breaking confidentiality, etc.)

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Clarification

answer

Figuring out important parts of client's message (figuratively picking apart client's story)

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Linking

answer

Used by leader to promote cohesion- attempt to bring together common patterns or themes within the group. Illuminates an area of mutual concern and enhances group interaction

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Vertical Interventions

answer

leader works with individuals within the group, Can be called intrapersonal leadership (focus on past and psychodynamic notions at times) may limit spontaneity of comments from group members

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Horizontal interventions

answer

leader works with group as a whole- techniques that focus on group relationships, processes, tasks, and interactions are horizontal intervention strategies. Can be called interpersonal leadership (favor here and now) but may lose some "expert power" by focusing on horizontal interventions

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A research practitioner split exists in group work, true or false?

answer

True. There is not a lot of research about what works best in group settings

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Groups are becoming more broad in focus, true or false?

answer

True! Life skills trainers are becoming more needed to deal with a broad spectrum of issues

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Groups are effective because...

answer

Cannot pinpoint exactly why (know that they achieve outcomes but don't know how-or the process that is effective)

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Limitations of group work

answer

- A group leader can lose control and members could experience emotional harm - client may need individual therapy before can benefit from group work -client may not be capable of trusting others enough to reveal key material since he or she fears others may find it unacceptable -that the group could become a substitute experience for the real world -that the group counselor may not be as effective with group as they are in individual treatment -clients may feel pressure to replace their personal norms with those of the group -disappointment can set in if group is not helpful and person loses faith in therapy before experiencing individual sessions -Client could be intimidated and not self-disclose -May not receive individual attention they need -May not be able to attend at a time that works for them - Lack of trust in confidentiality is a big deterrent!

question

Group work inappropriate when:

answer

client in crisis, needs interpretation psychological of tests, has fear of public speaking, needs confidentiality for protection

question

Advantages of group work

answer

members learn to give and receive help, it is more economical, allows for sense of belonging and "in vivo" interpersonal work, more people can be helped by counselor, promotes universality, can be effective support system, get feedback from multiple sources, members can model successful coping and communication skills, groups are like a microcosm of society that offers vicarious learning and support

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Group leaders that have flexibility, common sense, and enthusiasm

answer

Have a moderate impact on group leading success

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Conyne suggested group intervention is designed to:

answer

prevent, correct, and enhance behavior. "group work grid" includes four intervention levels- individual, interpersonal, organizational, and community. Interventions can be correction oriented or enhancement oriented for either personal or task functions.

question

Best way to measure the impact of group would be to:

answer

Have an "outside observer" sit in during group sessions and consequently rate level of behavior change. Not standardized.

question

Member specific measures

answer

Assess change in an individual group member. Self-rating is an example. Not standardized.

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