Group Dynamics, Processing & Counseling Melanie J Drake Wallace, PhD, LPC, NCE Yalom’s Therapeutic Factors Yalom (1995) defined therapeutic factors as "the actual mechanisms of effecting change in the patient" (p. xi). Yalom identified 11 factors that influence the processes of change and recovery among group therapy clients. 11 Therapeutic (Curative) Factors of Group Therapy 1. Altruism - the sense of value derived from giving to others. 2. Cohesion -group and individual interdependence and inter-member acceptance. 3. Catharsis - the expression of positive and negative feelings. 4. Insight - acquiring selfunderstanding 5. Interpersonal Skills - learning to listen, respond, and resolve conflict. 6. Feedback - has a different impact from each peer. 7. Family Re-enactment (Recapitulation of primary family group) - family conflicts and patterns are recaptured and corrected. 8. Instillation of HOPE - from others who have learned to cope with similar problems. 9. Universality - sharing similar experiences counteracts uniqueness and loneliness. 10. Identification - modeling the self after another member. 11. Spectator Learning - vicarious learning by observing others confront and resolve problems. NOTE: The importance of the therapeutic factors depends upon the type of group. Different goals emphasize different therapeutic factors. The factors in bold are the most important and complex according to Yalom. General Ideas about Group Structure * General size for adult groups is 8 10 * Generally meet once a week for one or two hours; the average is one & 1/2 hours. * Heterogeneous in social-economic and client problems or conflicts. * Homogeneous with respect to intelligence, developmental level, age, ego strength, vulnerability, and ability to tolerate anxiety. * Adolescents do better with peers so they can explore views of authority, peer pressure, social development, and consolidation of their identity. * Children groups should be kept small (two or more) within 1 year of age with diverse problems. General Stages of Group Process General Stages of Group Process 1. Inclusion - members strive to be accepted and loved by the leader. 2. Power - members attempt to gain autonomy from the leader. 3. Affection - members look to one another for aid (giving and receiving help). Leadership Styles, Responsibilities, Roles, Skills, and Characteristics Leadership Styles Authoritarian - high productivity / low morale - see themselves as experts most compatible with psychoanalytic perspective. Democratic - most used style - high productivity / high morale - shared leadership. Laissez-faire - low productivity / high moral - no leadership - most compatible with humanistic theoretical perspective. Leader Responsibilities * Create (must screen members) and maintain the group. * Build the group culture. * Activate and illuminate the here-and-now. Leadership Roles & Involvement 1. Telling - high risk (directive) low relationship (supportive) behavior to orient the group and establish group rules. A lot of structure is good this early in the process. 2. Selling - high risk / high relationship behavior to facilitate testing and questioning and a cohesive climate. 3. Participating - high relationship / low risk behavior - members assume responsibility for the group Leadership Roles & Involvement, cont. 3. Participating - high relationship / low risk behavior - members assume responsibility for the group 4. Delegating - low relationship / low risk behaviors - the group is productive and able to function with minimal leader intervention. Leader Skills 1. Active Listening 2. Reflection and Clarification 3. Questioning and Summarizing 4. Encouraging and Supporting 5. Modeling 6. Self-disclosure Leader Characteristics * Poise / Group Judgment * Maturity / Ego Strength * Free From Excessive Anxiety * Perceptive / Intuitive * Empathic * Tolerance for Frustration and Ambiguity Advantages of Group Work * Setting is similar to communication and interaction of everyday life * Members learn to give and receive Disadvantages of Group Work * Less individual attention * Confidentially is more difficult to maintain * Counselor has less situational control (Leader can loose control and members can to harm to other members) * Scapegoating - shared reality - “Group Think” (forcing group opinion on all members) Advantages of Co-Leadership 1. One leader can correct the mistakes of another 2. Reduces likelihood of missing significant moments or data 3. One can observe while the other is actively involved in the group 4. Doubles the energy brought to the group by the leaders Advantages of Co-Leadership, cont. 5. Leaders can model an effective interpersonal relationship 6. Reduces burnout 7. Reduces the risk of countertransference Note: It is important for leaders to meet between sessions to prevent working at crosspurposes Corey - Leaders must have been in a therapeutic group to be effective. Trust is the most important trait in a group. Most Successful Leader high on caring and meaning moderate on emotional stimulation and executive function. Important Terms Lewin T-Groups: National Training Laboratory (Sponsored by the National Education Association) Helps people develop human relationship skills in the organizational setting by examining group process rather than personal growth Rogers / Esalen Encounter Groups emphasize personal growth and focus on the here-and-now and the I-thou encounter. Consciousness-raising a societal and political emphasis on sensitivity training about various “groups” that make up society (minorities, women, LGBT populations, etc.) Sociogram - a mapping of group interactions Star - the central person Isolate - outside the group Cluster - majority Closed vs. Open Group Open groups - allow new members. The advantage = the the number of people are more stable. The disadvantage = new members miss information and trust level is set back. Closed groups - do not allow new members. The advantage = promotes cohesiveness. The disadvantage = losing members. Group Counseling Theories and Techniques Group Counseling Theories and Techniques Johari Window Applied to Group The goal is to move from the Secret Area (Known to Self / Unknown to Others) through self-disclosure and from the Blind Area (Unknown to Self / Known to Others) through feedback into the Open Area (Known to Self and Others). Unconscious Area (Unknown to self and others). It is unethical for a therapist to bring this up in the group. It should be done in individual counseling. Psychoanalytic Groups Leader interprets, analyzes resistance and transference, remains anonymous so members develop projections toward the leader, avoids directive leadership, and lets the group determine its own course. Five Major Techniques 1. Free association “go around technique” 2. Interpretation 3. Menbers sharing insights 4. Dream analysis 5. Analysis of transference, multiple transference, and counter-transference Adlerian Group Counseling Assessment techniques: 1. Exploring family contellations 2. Reporting recollections 3. Investigating lifestyles Main Technique: * asking members to behave “as if” they are who they want to be and explore social dynamics and lifestyle Glasser Reality Therapy Groups Techniques: Leader: Rational Emotive Groups Techniques: Leader: Berne Transactional Analysis Techniques: Leader: Existential Themes: 1. Self awareness 2. Self transcendence 3. Freedom 4. Responsibility (authenticity) Existential, cont. Techniques: Leader: Rogers / Egan / Carkuff / Ivy’s Person-Centered Groups Techniques: Leader: Group Stages: know in order 1. 2. 3. 4. 5. 6. 7. 8. Milling around Resistance Description of past feelings Expression of negative feelings Exploration of meaningful material Expression of here-and-now interpersonal feeling Development of a healing capacity Self-acceptance 9. Cracking of facades 10. Feedback 11. Confrontation 12. Helping relationships outside the group 13. Basic encounter 14. Closeness 15. Behavior change Rogers * encounter groups * to promote world peace Gestalt Groups Goals Leader Roles Techniques Behavioral Groups Meichenbaum - stress inoculation and assertiveness training Lazarus’ B.A.S.I.C. I.D. approach Leader: actively teaches coping skills and behavior modification Techniques: behavior changes, cognitive restructuring, implosive therapy, operant conditioning, reinforcement, coaching, modeling, feedback, challenging, and changing cognitions Moreno’s Psychodrama Components: The Stage Director (Leader) Techniques: Protagonist Anxiliary egos Audience Psychoanalytic Groups