Assignment: At least 200 words; APA format; use chapter 5 textbook below for citations; assignment will be submitted through safe assign, please be sure to use your own words
What are important factors to consider when forming a group? Consider how you would recruit, screen, and choose members for a group and what are the implications when making these decisions. Be sure to cite at least one reference and respond to at least one classmate.
Textbook:
Corey, M.S., Corey, G., Corey, C. (2018). Groups: Process and Practice (10th ed.). Cengage.
Chapter 5
5-1Introduction
Group practitioners are creating an increasing variety of groups to fit the special needs of a diverse clientele in many different settings. The types of groups that can be imagined are limited only by your own creativity and the needs of your clients. For example, Joan VanderSchaaf (2013) created a unique group that combined yoga classes with group psychotherapy. The participants reported an increased sense of well-being and self-awareness along with increased strength and a sense of empowerment. Practitioners continue to find creative ways to design groups that blend various themes and modalities in new ways.
Groups have become increasingly popular and have been designed to meet both the needs of clients and the demands of agency settings. Group members have opportunities to gain insight and to practice new skills, both within the group and in their everyday interactions outside of the group. Feedback from other group members and the counselor help members gain new perspectives. Groups offer many opportunities for modeling, and members often learn how to cope with their problems by observing the work of others with similar concerns.
We cannot overemphasize the importance of giving careful attention to the preparation of the members for a successful group experience. It is useful to think about what kind of group you will lead and to prepare yourself for your leadership role and functions for that group. The more clearly you can state your expectations as early as possible, the better you will be able to plan and the more meaningful the experience is likely to be for participants. Some situations for forming groups are less than ideal and may limit your ability to adequately prepare and plan ahead. Even in such circumstances, it is helpful for you to consider the information in this chapter on how to set up your group experience for success.
-2Developing a Proposal for a Group
LO1
Many excellent ideas for developing and implementing groups never reach fruition, sometimes due to a lack of resources or training, and at other times due to a lack of adequate preparation on the part of the group leaders. These five general areas can serve as guidelines for forming a proposal:
1. Rationale. Do you have a clear and convincing rationale for your group, and can you present data to support your rationale? Are you able to answer questions that might be raised about the need for this group?
2. Objectives. Can you clearly state what you most want to attain and how you will go about doing so? Are your objectives specific, measurable, and attainable within the specified time?
3. Practical considerations. Is the membership defined? Are meeting times, frequency of meetings, and duration of the group reasonable? Is the physical location of the group easily accessible to all members?
4. Procedures. Have you selected specific procedures to meet the stated objectives? Are these procedures appropriate and realistic for the given population?
5. Evaluation. Does your proposal contain strategies for evaluating how well the stated objectives were met? Are your evaluation methods objective, practical, and relevant?
The following questions can be considered by both you and your coleader and by the participants of the group. Discussion of group rules and guidelines may be better suited for initial group sessions with all members present to increase members’ sense of ownership in the group process. We suggest that you bring these questions for discussion to your supervisor and your colleagues.
· What type of group are you forming? Will it be long term or short term?
· For whom is the group intended? Identify the specific population. What do you know about the developmental needs of this population?
· What is your motivation for forming this type of a group? Have you conducted a needs assessment, and if so, how can this be a help in designing your group?
· How will members be recruited for participation in your group? Are there any people that you would want to exclude from this particular group? What is your rationale for your exclusion criteria?
· What is the cultural mix of the group, and what are the implications of the cultural mix for forming the group?
· Are you skilled in both group process and the content of the group you are proposing? If not, what supervision or support is available to help you in facilitating the group?
· Is the group composed of voluntary or involuntary members? If it is a mandatory group, what special considerations will you address?
· What are the general goals and purposes of this group? What will members gain from participating in it?
· What screening and selection procedures will be used? What is your rationale for these particular procedures?
· How many members will be in the group? Where will the group meet? How often will it meet? How long will each meeting last? Will new people be allowed to join the group once it has started, or will this be a closed group?
· How will the members be prepared for the group experience? What ground rules will you establish at the outset?
· What structure will the group have? What techniques will be used? Why are these techniques appropriate? In what ways can you employ your techniques in a flexible manner to meet the needs of culturally diverse client populations?
· How will you handle the fact that people may be taking some risks by participating in the group? What will you do to safeguard members from unnecessary risks? Will you take any special precautions if some of the participants are minors?
· How will you handle situations such as a member arriving at a group session while under the influence of alcohol or drugs?
· How will you deal with a group member who wants to leave the group before it is over?
· What evaluation procedures will you implement? What follow-up procedures are planned?
· What topics will be explored in this group?
Regardless of the type of group you expect to form, having a compelling written proposal is key when translating ideas into action. Twelve sample proposals for groups in schools and community settings are presented in Chapter 10 and Chapter 11. These proposals will give you good ideas for designing a group, even if you are dealing with a different population and different topics. As you review these proposals, consider how you can draw from each of them to fit your interests and to meet the needs of the clients you serve.
5-2aWorking Within the System
If you hope to have your proposal accepted both by your supervisors in a community agency and by the potential members, you will need to develop the skills necessary to work within a system. To get a group started, you need to negotiate sensitively with the staff of the institution involved. In all clinics, community agencies, schools, and hospitals, power issues and political realities play a role. You may become excited about organizing groups only to encounter resistance from your coworkers or your administrators. Sometimes colleagues or the system can sabotage your efforts without you fully understanding why your efforts are being undermined.
In some cases, the representatives of institutions need to be educated about the potential value, as well as the realistic limitations, of groups for their clients. It is helpful to be able to predict some of the major concerns that administrators and agency directors are likely to have about the proposal you submit. For example, if you are attempting to organize a group in a public high school, the administrators may be anxious about parental complaints and potential lawsuits. If you are able to appreciate their concerns and speak directly to the ethical and legal issues, you stand a better chance of having your proposal accepted. If it is not clear in your own mind what you hope to accomplish through group work or how you will conduct the meetings, the chances are slim that a responsible administrator will endorse your program. By attending to the suggestions described in this chapter for designing a group, you stand a better chance that your proposal will be met with success.
5-3Attracting and Screening Members
LO2
Once you have been successful in getting a proposal accepted, the next step is to find a practical way to announce your group to prospective participants. How a group is announced influences both the way it will be received by potential members and the kind of people who will join. Although professional standards should prevail over a commercialized approach, we have found that making personal contact with potential members is one of the best methods of recruiting.
5-3aGuidelines for Announcing a Group and Recruiting Group Members
Professional issues are involved in publicizing a group and recruiting members. The “Best Practice Guidelines” (ASGW, 2008) state that prospective members should have access to relevant information about the group (preferably in writing), such as the following:
· A professional disclosure statement
· A statement of the goals and purposes of the group
· Policies related to entering and exiting the group
· Expectations for group participation, including voluntary and involuntary membership
· Policies and procedures governing mandated groups (where relevant)
· Confidentiality and exceptions to confidentiality
· Leader’s theoretical orientation that includes possible interventions
· The qualifications of the leader to lead a particular group
· Role expectations of members and leader(s)
· The rights and responsibilities of both group members and the group leader
· Documentation procedures and disclosure of information to others
· Implications of out-of-group contact or involvement among members
· Procedures for consultation between group leader(s) and group member(s)
· Education, training, and qualifications of the group leader
· The logistics of a group including fees, cancellation policies, and methods of communication with the leaders outside of group
· A realistic statement of what services can and cannot be provided within a particular group structure
· Potential impact of group participation
· The potential risks and benefits of participating in a group
These guidelines can assist you in creating an informed consent document for your group. Give an accurate picture of the group, and avoid making promises about the outcomes of the group that may raise unrealistic expectations. As we have indicated, making direct contact with the population most likely to benefit from the group is an excellent way to follow up printed announcements. These personal contacts, which can include distributing printed information to those interested, lessen the chance that people will misunderstand the purposes and functioning of the group.
It is also important in announcing and recruiting for a group to inform your agency colleagues. They can then refer clients to you who are appropriate for your particular group. In addition, they may do the preliminary screening, including giving written information on the group to potential members with whom they have contact. Involve your coworkers as much as possible in every phase of organizing your group.
5-3bScreening and Selection Procedures
After announcing a group and recruiting members, the next crucial step is arranging for screening and selecting the members who will make up the group. The ASGW (2008) “Best Practice Guidelines” state: “Group Workers screen prospective group members if appropriate to the type of group being offered. When selection of group members is appropriate, Group Workers identify group members whose needs and goals are compatible with the goals of the group” (A.7.a). This guideline raises several questions: Should screening be used? If so, what screening method suits the group? How can you determine who would be best suited for the group, who might have a negative impact on the group process, or who might be hurt by the experience? How can you best inform those candidates who, for whatever reason, are not selected for your group?
Sometimes leaders screen out individuals due to their own personal dislike or countertransference issues even though these individuals might be appropriate clients for the group. Whether the group leader likes or dislikes a potential member is not an appropriate basis for selecting members of a group. The goal of screening is to prevent potential harm to clients, not to make the leader’s job easier by setting up a group of homogeneous members. For some types of groups, screening is based on whether potential members have a specific problem area that is in alignment with the general objectives of the group. For example, in Chapter 10 Teresa Christensen describes a group for children who have been abused. In selecting children for her group, she finds it essential that these children be ready to participate in the various interactive activities that are involved in the group. In addition, all the children she selects have completed or are concurrently involved in individual or family counseling. She believes screening is essential to determine when children would benefit from her particular group. In a women’s support group for survivors of incest described in Chapter 11, Lupe Alle-Corliss seeks clients who display a readiness to deal openly with the trauma of incest. In both of these sample groups, screening is done to determine the readiness and the appropriateness of group treatment for potential members.
When selecting members of your group, it may be appropriate to consider diversity issues. You may want to put together a group of individuals who share common experiences but also are different in a number of respects. Through interaction in a diverse group, members often have an opportunity to dispel stereotypes and misconceptions about one another. If member composition is carefully considered and balanced, members have opportunities both to connect with and to learn from each other.
Ultimately, the type of group should determine the kind of members accepted.
Ultimately, the type of group should determine the kind of members accepted. A person who can work well in a structured, short-term group designed to teach social skills or to cope with stress might not be ready for an intensive therapy group. Individuals with severe emotional trauma would probably be excluded from a counseling group, but they might benefit from a weekly group for outpatients at a mental health center. Carefully evaluate your screening and selection process to confirm that your criteria are appropriate for your particular group. The question that needs to be considered is: Should this particular person be included in this particular group at this time with this group leader?
Preliminary Screening Sessions
We support screening procedures that include a private session between the candidate and the leader. In the event there are coleaders, ideally they would interview each of the potential group members together. There are some clear benefits when potential members are interviewed by both coleaders, including seeing how the individual reacts to both of them. This practice will give the coleaders a sense of how this member might be in the group situation. During the individual session, the leader or coleaders might look for evidence that the group will be beneficial to the candidate. How motivated is this person to change? Is this a choice of the individual or of someone else? Why this particular type of group? Does this person understand what the purposes of the group are? Are there any indications that group counseling is contraindicated for this person at this time?
Group applicants are to be encouraged, at their private sessions, to interview the group leader or coleaders. They can be invited to ask questions concerning the procedures, basic purposes, and any other aspect of the group. This questioning is important as a means not only of getting information but also of developing a feeling of confidence in the group leader or coleaders, which is necessary if productive work is to take place. Questions the applicants ask can help to establish their readiness for the group, their curiosity about the group process, and their interpersonal style. We believe screening is best viewed as a two-way process and that potential members should be encouraged to form their own judgment about the group and the leaders. Given enough information about the group, a member can make a more informed decision about whether to join.
From our perspective, screening and selection procedures are subjective and the intuition and judgment of the leader are crucial. We are concerned that those who are considering a group benefit from a group, but we are even more concerned that they might be psychologically hurt by it or might drain the group’s energies excessively. Certain members can remain unaffected by a group yet sap its energy for productive work. This is particularly true of hostile people, people who monopolize, extremely aggressive people, people in a state of crisis, and people who act out. The potential gains of including certain of these members must be weighed against the probable losses to the group as a whole. Group counseling is contraindicated for individuals who are suicidal, extremely fragmented or acutely psychotic, sociopathic, facing extreme crises, highly paranoid, or extremely self-centered (Yalom, 2005b).
A leader needs to develop a system for assessing the likelihood that a candidate will benefit from a group experience. Factors that must be taken into consideration are the level of training of the leader, the proposed makeup of the group, the setting, and the basic nature of the group. For example, it might be best not to accept a highly defensive individual into an ongoing adolescent group, for several reasons. A group may be too threatening for a person so vulnerable and may lead to increased defensiveness and rigidity, or such a person may have a counterproductive effect on group members by impeding their attempts to work.
In some cases it may not be possible to conduct individual interviews, and alternatives will have to be used. If you work in a county facility or a state hospital, you may simply be assigned a group and have no opportunity to screen members. The basis for assigning members could be their diagnosis or the unit in a residential facility where they are placed. Even if you are not able to select members for your group, you can make at least brief individual contact to prepare them. You will also have to devote part of the initial sessions to preparation because many of the members may not have the faintest idea why they are in the group or how the group might be of any value to them. In “open groups,” whose membership changes when some individuals leave and new ones are added, it is a good practice to meet individually with incoming members so you can orient them.
If you cannot screen members for your group, you could still have a successful group. However, you will need to provide some form of orientation so members understand what the group is about and how to best participate in it. The more you can assist members in being informed about group process, the better are the chances that the group will be effective.
Assessing and Choosing Members
We are often asked these questions: “How do you decide who will best fit into the group, who will most benefit from it, and who is likely to be harmed by the experience?” “If you decide to exclude a person from the group, how do you handle this in a respectful and therapeutic manner?” As a group leader, you are expected to make the ultimate decision to include or exclude certain clients. Because the groups we typically offer are voluntary, one factor we look for during the interview is the degree to which a candidate wants to make changes and is willing to expend the necessary effort. We consider whether a group seems the appropriate method of intervention to accomplish the desired changes. We also weigh heavily how much the candidate seems to want to become a member of this group, especially after he or she is given information about it.
There have been times when we were reluctant to let certain people into a group in spite of their desire to join. As we’ve mentioned, we do pay attention to our clinical hunches concerning a person, so in the last analysis our screening and selection process is a subjective one. A variety of clinical reasons might lead us to exclude a person, but whatever our reservations are, we discuss them with the prospective member. At times, after we’ve discussed our concerns, we see matters differently. At other times, we simply cannot with a clear conscience admit a person. In making decisions about selecting members for a group, the leader needs to think of what is best for all the members, not just what one member may want.
If we do not accept people, we tell them how the group might not be appropriate for them. We strive to break the news in a manner that is honest, direct, respectful, and sensitive, and when possible we suggest other options. Ethical practice involves offering those candidates who are not accepted into the group the support they need in dealing with their reactions to not be included in the group, and as well, suggesting alternatives to group participation. For example, we might determine that a highly defensive and extremely anxious person who is very frightened in interpersonal relationships is likely to benefit from a series of individual counseling sessions before being placed in a group situation. We would explain our rationale and encourage the person to consider accepting a referral for an appropriate type of intervention. In other words, we do not close the door on people we exclude from a group with no explanation, nor do we convey that there is something intrinsically wrong with them because they were not included in this particular group.
When we do in-service training workshops for group leaders in various agencies and institutions, many leaders tell us they do not screen people for their groups. They cite any number of reasons: they do not have the time; they do not have much voice in choosing group members because people are simply assigned to a group; they do not really know how to determine who will or will not benefit or will be negatively influenced by a group experience; they are not convinced that screening is important; or they do not want to make a mistake by turning away people who might gain from a group. When individual screening is not practical, we encourage practitioners to devise alternative strategies. For example, instead of screening people individually, screening and orientation can be done with several potential group members at once. If this is not possible, it is a good idea to at least briefly meet the members of your group prior to the first session. Another alternative is to make the first session of a group the time for orientation and getting a commitment from the members.
-4Practical Considerations in Forming a Group
5-4aGroup Composition
LO3
Whether a group should have a homogeneous membership or a heterogeneous one depends on the group’s purpose and goals. In general, for a specific target population with given needs, a group composed entirely of members of that population is more appropriate than a heterogeneous group. Consider a group composed entirely of older people. It can focus exclusively on the specific problems that characterize their developmental period, such as loneliness, isolation, lack of meaning, rejection, and financial pressures. This similarity of the members can lead to a great degree of cohesion, which in turn allows for an open and intense exploration of their life crises. Members can express feelings that they typically withhold, and their life circumstances can give them a bond with one another. Even though members may share a common problem, their life experiences will differ, which brings another level of diversity into these homogenous groups. Several group proposals for groups for older people are described in Chapter 11: “A Successful Aging Group,” “An Older Adult Bereavement Group,” and “A Group Treatment Program for Institutionalized Older Adults.” Each of these groups has a different purpose and focus, and the general goal of the group will guide member selection.
Sometimes a microcosm of the outside social structure is desired, and in that case diverse membership should be sought. Personal-growth groups, process groups, interpersonal groups, and certain therapy groups are often heterogeneous. Members can experiment with new behavior and develop interpersonal skills with the help of feedback from a rich variety of people in an environment that represents everyday reality. Many groups offered at college counseling centers are process oriented or have an interpersonal focus. Other groups may have a particular theme, and some psychoeducational groups have both an educative and a therapeutic slant. Some of these groups are briefly described in Chapter 10
5-4bGroup Size
What is a desirable size for a group? The answer depends on several factors: age of clients, experience of the leader, type of group, and problems to be explored. For instance, a group composed of elementary school children might be kept to 3 or 4, whereas a group of adolescents might be made up of 6 to 8 people. There may be as many as 20 to 30 children in developmental group guidance classes. For a weekly ongoing group of adults, about 8 people may be ideal. A group of this size is big enough to give ample opportunity for interaction and small enough for everyone to be involved and to feel a sense of the “group.”
5-4cFrequency and Duration of Meetings
How often should a group meet? For how long? Should a group meet twice weekly for 1-hour sessions? Or is 1½ to 2 hours once a week preferable? With children and adolescents, it may be better to meet more frequently and for a shorter period to suit their attention span. If the group is taking place in a school setting, the meeting times can correspond to regularly scheduled class periods. For groups of relatively well-functioning adults, a 2-hour weekly session might be preferable. This 2-hour period is long enough to allow some intensive work yet not so long that fatigue sets in. You can choose any frequency and duration that suit your style of leadership and the type of people in your group. For an inpatient group composed of lower functioning members, it is desirable to meet on a daily basis for 45 minutes. Because of the members’ psychological impairment, it may not be possible to hold their attention for a longer period. Even for higher-functioning inpatient groups, it is a good practice to meet several times a week, but these groups might be scheduled for 90 minutes.
5-4dLength of a Group
What should the duration of a group be? For most groups a termination date can be announced at the outset, so members will have a clear idea of the time limits under which they are working. Our college groups typically run about 15 weeks—the length of a semester. With high school students, the same length seems ideal. It is long enough for trust to develop and for work toward behavioral changes to take place. Elementary and middle school groups typically run for 6 to 8 weeks, depending on administrator and teacher support for allowing students to miss class for the group sessions.
One of our colleagues has several closed therapeutic groups in his private practice that last 16 weeks. The advantages of time-limited groups are that the time span allows for cohesion and productive work and that members can then continue practicing newly acquired interpersonal skills with a new group of people. Members are often motivated to work because they realize that they do not have forever to attain their personal goals. At different points in this 16-week group, members are challenged to review their progress, both individually and as a group. If they are dissatisfied with their own participation or with the direction the group is taking, they have the responsibility to do something to change the situation.
Of course, some groups composed of the same members meet for years. Such a time structure allows them to work through issues in some depth and to offer support and challenge in making life changes. These ongoing groups do have the potential for fostering dependency, and it is important that both the leader and the members are aware of that.
5-4ePlace for Group Meetings
Where might the group hold its meetings? Many places will do, but privacy is essential. Members must be assured that they will not be overheard by people in adjoining rooms. Groups often fail because of their physical setting. If they are held in a day hall or ward full of distractions, productive group work is not likely to occur. We like a group room that is not cluttered and that allows for a comfortable seating arrangement. We prefer a setting that enables the group to sit in a circle. This arrangement lets all the participants see one another and allows enough freedom of movement that members can spontaneously make physical contact. It is a good idea for coleaders to sit across from each other. In this way the nonverbal language of all members can be observed by one leader or the other and a “we-versus-them” atmosphere can be avoided. This also allows the coleaders to read each other more easily.
5-4fOpen Versus Closed Groups
Open groups are characterized by changing membership. As certain members leave, new members are admitted, and the group continues. Closed groups typically have some time limitation, with the group meeting for a predetermined number of sessions. Generally, members are expected to remain in the group until it ends, and new members are not added. The question of whether a group should be open or closed depends on a number of variables.
There are some advantages to open groups that incorporate new members as others leave, one of which is an increased opportunity for members to interact with a greater variety of people. This also more accurately reflects people’s everyday lives wherein different people enter or exit our relationships. A potential disadvantage of open groups is that rapid changing of members can result in a lack of cohesion, particularly if too many clients leave or too many new ones are introduced at once. Therefore, it may be better to bring in new members one at a time as openings occur. It is a challenge to provide new members of open groups with the orientation they need to learn how to best participate in a group. One way to educate incoming members about group process is by providing a videotape explaining group rules, which can be followed by a face-to-face contact with the group leader. One colleague who coleads open groups in an agency stresses reviewing the ground rules with each incoming member. Rather than taking group time whenever a new person is included, he covers the rules with the new member as part of the intake interview. He also asks other members to teach the new member about a few of the guidelines in an attempt to have them take more responsibility for their own group. If members are dropped and added sensitively, these changes do not necessarily interfere with the cohesiveness of the group and can even enhance cohesion.
In some settings, such as a mental health facility in a state hospital or some day-treatment centers, group leaders do not have a choice between an open and a closed group. Because the membership of the group changes almost from week to week, continuity between sessions and cohesion within the group are difficult to achieve. Cohesion is possible, even in cases where members attend only a few times, but a high level of activity is demanded of inpatient group therapists. These leaders must structure and activate the group. They need to call on certain members, they must actively support members, and they need to interact personally with the participants (Yalom, 1983).
If you are forming an open group, you want to have some idea about the rate of turnover of the members. How long a given member can participate in the group may be unpredictable. Therefore, your interventions need to be designed with the idea in mind that many members may attend for only one or two sessions. In conducting an open group, it is good to remind all the members that this may be the only time they have with one another. The interventions that you make need to be tailored to that end. For example, you would not want to facilitate a member’s exploration of a painful concern that could not be addressed in that session. You also have a responsibility to facilitate member interactions that can lead to some form of resolution within a given session. This involves leaving enough time to explore with members what they have learned in a session and how they feel about leaving each session.
One of our colleagues regularly conducts several open groups in a community mental health agency. Even though the membership does change somewhat over a period of time, he finds that trust and cohesion do develop in most of these groups because there is a stable core of members. When new members join, they agree to attend for at least six sessions. Also, members who miss two consecutive meetings without a valid excuse are not allowed to continue. These practices increase the chances for continuity and for trust to be developed.
-5The Uses of a Pregroup Meeting
5-5aResearch on the Value of Pregroup Preparation
LO4
A good deal of research has examined the value of pretherapy preparation for both individual and group psychotherapy. The overwhelming consensus is that preparation positively affects both early therapeutic processes and later client improvement (Burlingame, Fuhriman, & Johnson, 2004b; Fuhriman & Burlingame, 1990). Pregroup preparation (setting expectations, establishing group rules and procedures, role preparation, skill building) is positively associated with group cohesion and members’ satisfaction with their experience (Burlingame et al., 2004b); preparing members for a group experience is a key aspect of informed consent (Rapin, 2014).
Pregroup orientation is a standard practice for members of short-term therapy groups. A number of factors make such orientation sessions necessary for these clients: the diversity of members in a typical group, the range of personal concerns, the different settings, the time-limited framework, and the unfamiliarity of the group format. The content of this pregroup orientation reflects the perspective of leaders who conduct short-term group therapy. A thorough orientation sets the stage for later development of leader–member and member–member therapeutic relationships (Burlingame & Fuhriman, 1990).
Members who understand what behaviors are expected of them tend to be more successful. When goals, role requirements, and behavior expectations are understood by members from the outset, therapeutic work proceeds more effectively. Unproductive anxiety can be reduced by informing members about group norms in advance. Available research shows that preparatory training increases the chances of successful outcomes because it reduces the anxiety participants often experience during the initial sessions, provides a framework for understanding group process, and increases self-disclosure (Yalom, 2005b).
5-5bOrientation and Preparation of Members at a Pregroup Meeting
We suggested earlier that a preliminary meeting of all those who were thinking of joining the group was a useful device when individual interviews were impractical. Such a pregroup session provides an excellent way to prepare members and to get them acquainted with one another. This session also provides the members with more information to help them decide whether they are willing to commit themselves to what would be expected of them. If an individual interview or a pregroup session with all members is impractical, the first group meeting can be used to cover the issues we are discussing in this chapter. Our preference is for a separate individual screening and orientation session followed by a pregroup meeting for all participants.
Patterns begin to take shape from the moment a group convenes.
At this initial session, or at the pregroup meeting, the leader explores the members’ expectations, clarifies the goals and objectives of the group, imparts some information about group process, and answers members’ questions. This is an ideal time to focus on the clients’ perceptions, expectations, and concerns. This process does not have to consist of a lecture to the members; it can involve the members and encourage them to interact with one another and the leader. This interactive model of preparation can reveal interesting information about both the dynamics of the individuals and the “personality of the group.” Patterns begin to take shape from the moment a group convenes. Structuring the group, including the specification of procedures and norms, will likely be accomplished early in the group’s history. Some of this structuring can be done during the individual intake sessions, but a continuation of it can be the focus of the first group session. Group counselors may either establish ground rules or ask the group to do so. Ideally, group rules are cooperatively developed by the leader and the members as part of the group process.
In conducting pregroup preparation, we caution against providing too much information at the preliminary meeting. Many of the topics that relate to participation in the group can be handed out in written form to the members, and members can be encouraged to raise any questions or concerns they have after they have read this material. Throughout the life of a group, there are critical times when structuring and teaching can assist members in becoming actively involved in the group process.
Many groups that get stuck at an early developmental stage do so because the foundations were poorly laid. What is labeled “resistance” could be the result of a failure on the leader’s part to adequately explain what groups are about, how they function, and how members can become actively involved. If extensive preparation is not possible, even brief preparation is better than none at all. In addition to preparing members for a group, it is a good practice to periodically review with the members some of the guidelines on how they can make the best use of group time. This will increase the chances that the group will become a cohesive autonomous unit that encourages individuals to engage in productive work.
5-5cClarifying Leader and Member Expectations
The pregroup session is the appropriate time to encourage members to express the expectations they are bringing with them to the group. We typically begin by asking these questions:
· What are your expectations for this group?
· What did you have in mind when you signed up?
Their replies give us a frame of reference for how the members are approaching the group, what they want from it, and what they are willing to give to the group to make it a success.
We also share our expectations by giving members an idea of why we designed the group, what we hope will be accomplished, and what we expect of ourselves as leaders and them as members. This is a good time to reemphasize and clarify what you see as your responsibilities to the group and to further discuss the members’ rights and responsibilities.
5-5dGoals of Pregroup Preparation
In his system of pregroup preparation, Yalom (2005b) emphasizes the collaborative nature of group therapy. He not only describes how a therapy group helps members enhance their interpersonal relationships but assists members in anticipating disappointments, including predicting stumbling blocks participants are likely to encounter. Demystifying the therapeutic process is central in preparing members for a group.
Demystifying the therapeutic process is central in preparing members for a group.
As a leader, during the screening and pregroup meetings it is important to clarify what needs can or cannot be met within the group. For instance, if you do not view your role as being the expert who provides answers, potential members have a right to know this so that they can determine if this group is what they are seeking. For some groups, it may be both appropriate and useful for you to engage in teaching members the purposes and functions of the group. It is important to invite the members of your groups to verbally state their reasons for joining a group, and it is critical that you be willing to explore these expectations during the initial session. It is also useful to encourage members to raise questions about the purpose and goals of the group, as well as to identify and talk about what they most want from the group and to begin formulating personal goals. You will want to strive for congruence between members’ purposes in attending the group and the overall purpose you had in mind when you designed the group. A great deal can be done to prevent unnecessary anxiety by allowing members to talk about their reactions to coming to the group and by considering ways the group can lead to their empowerment.
5-5eEstablishing Basic Ground Rules
The pregroup session is the appropriate place to establish some procedures that will facilitate group process. Some leaders prefer to present their own policies and procedures in a nonauthoritarian manner. Other leaders place the major responsibility on the group members to establish procedures that will assist them in attaining their goals. Whatever approach is taken, some discussion of ground rules is necessary. Some group leaders also choose to review these rules at the beginning of each group session, especially for open groups.
In formulating procedures that govern a group, it is important for leaders to protect members by defining clearly what confidentiality means, why it is important, and the difficulties involved in enforcing it. Ideally, confidentiality will be discussed during the individual interview, but it is so important to the functioning of a group that you need to restate it periodically during the life of a group. At the pregroup session, it is a good idea to state that confidentiality is not an absolute and to outline the restrictions. Members have a right to know of the circumstances when leaders must break confidentiality for ethical or legal reasons. In cases of incest and child abuse, elder or dependent adult abuse, and in cases of clients who pose a danger to themselves, others, and/or physical property, confidentiality must be breached. Limitations to confidentiality apply especially to groups with children and adolescents, groups with parolees, groups composed of involuntary populations such as prisoners, and groups of psychiatric patients in a hospital or clinic. Members in these groups should be told that certain things they say in the group may be recorded in their chart, which might be available for other staff members to read. Furthermore, these individuals need to be informed that if they attend a group session and do not participate, that also will be recorded. The members then have a basis for deciding what and how much they will disclose. This kind of honesty about confidentiality will go a long way toward establishing the trust that is essential for a working group. Review Chapter 3 for a further discussion of confidentiality.
Leaders must be aware of and discuss with members any additional ground rules and policies particular to the setting in which they are working. You will not be able to fully discuss all the policies and procedures you deem essential to the smooth functioning of your group in one or two sessions, but having an established position on these matters will be an asset when particular issues arise at some point in the development of the group.
Critical Incident
On the Outside, Looking In
1.Description of Incident
This situation occurred in a pregroup session for an interpersonal-growth group for master’s degree students in counseling, which is a required component of an introduction to counseling class. The second half of the class is devoted to participating in the small group, which was facilitated by Anahi, a doctoral student under the supervision of her professor. The goals for this first session included members getting to know one another, identifying any concerns members had about participating in the group, discussing their expectations, and formulating personal goals to assist them in being active participants in the small group.
As the session began, Anahi invited all of the members to form a circle and to begin introducing themselves. Milena took a chair but placed it outside the circle near the corner of the room. When it was Milena’s turn to introduce herself, she briefly commented in a vague and disinterested tone. Milena remained quiet for the remainder of the session.
Anahi found herself very distracted by Milena and decided to ask if there was something Milena would like the group to know about why she chose to sit outside of the circle. Milena responded, “I just don’t like to be close to other people. Whenever I go into a room, I always find a place in the corner to sit.” Anahi asked the other group members how they were affected by Milena choosing to sit outside the circle during the session. The members reported
1. being curious as to why Milena chose to sit in the corner,
2. being distracted by her behavior,
3. feeling uncomfortable with her sitting outside the circle, and
4. wondering if she was judging them.
After the preliminary group session, the group leader met with Milena privately to discuss her involvement in the group. Anahi inquired about her feelings of safety and about her participation in the group. Anahi also asked Milena about her expectations, what she thought about the group being a part of a required course, and what she imagined it would be like for her to be in this group, especially if she kept herself apart from others. Milena indicated that she was planning to remain in the group because she did not have other options, but she did not want to receive any pressure to be a part of the group circle, nor did she want to feel pressured to talk about her personal problems with others in her cohort.
2.Process Questions for Group Leaders
· What could the group leader have done during this first session to address Milena’s behavior?
· Should Milena be allowed to remain in this group if she has no intention of participating?
· If Milena stays in the group, how might Anahi address her ongoing decision to remain seated outside of the group and engage minimally?
· If you are facilitating this group, how might you address this situation?
· If you were the group leader, what agenda would you prepare for this pregroup meeting? What would you most want to say to the members about being in this group?
3.Clinical Reflections
Milena’s behavior and minimal participation in the preliminary session could not be ignored. This situation illustrates how crucial it is to engage members in a thorough informed consent process as a vital part of orienting members to their rights and responsibilities as participants in the group. We would be interested in knowing what kind of informed consent process took place. Students give informed consent when they enter a master’s program, but we don’t know how the instructor of this introduction to counseling course introduced the interpersonal-growth group that would take place each week during the second half of the class session.
Anahi could have asked members to say something about their thoughts and feelings about being expected to be in such a group. This discussion is central to clarifying expectations and taking some steps toward creating a trusting climate that would allow the members to participate in a way each of them found meaningful. If members are not oriented to the purpose of the group and of what is expected of them, a hidden agenda is likely to operate that makes meaningful interaction extremely difficult. Preliminary preparation is necessary for this kind of group to be successful.
4.Possible Interventions
· Anahi could explore Milena’s feelings of “not wanting to be close to people.”
· Anahi could ask all members to share how their cultural backgrounds might influence their comfort level with sitting in a circle or sharing openly with others.
· Anahi could let Milena know that she is puzzled by her behavior and decide to verbalize her internal dialogue, which might go something like this: “As Milena remained silent in the corner, I felt distracted by her behavior. As much as I tried to focus on the other group members, my thoughts were on why she does not want to be part of the group. Could it be that Milena is fearful of group interaction? Is she not trusting others in the group, and if so, what can any of us do to make the group a safe place for her? Is she concerned that any disclosures she makes can be used against her in her evaluation in the program?”
· Anahi could invite Milena to comment on hearing the leader’s self-talk.
· The leader can assure all members that they will not be pressured to disclose personal problems or experiences. However, members are expected to find some way to participate, even if they restrict their participation to here-and-now reactions to what is taking place in the group and how they are affected by being in the group.
5-6Building Evaluation Into Group Work
If you do group work in a community agency or an institution, you may be required to demonstrate the efficacy of your treatment approach. Federal and state grants typically stipulate measures for accountability. In most settings you will be expected to devise procedures to assess the degree to which clients benefit from the group experience. We suggest that you include in your proposals for groups the procedures you intend to use to evaluate both the individual member outcomes and the outcomes of the group as a unit. (Developing a research orientation to practice is addressed in detail in Chapter 2.)
There is no need to be intimidated by the idea of incorporating a research spirit in your practice. Nor do you have to think exclusively in terms of rigorous empirical research. Various qualitative methods are appropriate for assessing a group’s movement, and these methods may be less intimidating than relying exclusively on quantitative research techniques. One alternative to the traditional scientific method is evaluation research, which provides data that can be useful when making improvements within the structure of a group. The practice of building evaluation into your group programs is a useful procedure for accountability purposes, but it can also help you sharpen your leadership skills, enabling you to see more clearly changes you might want to make in the format for future groups. We have been greatly influenced by feedback we have received from member evaluations.
5-7Coleader Issues on Forming a Group
LO5
We have emphasized the value of preparing members for a group experience, but coleaders also must prepare themselves for a group. When coleaders meet prior to the formation of a group, they can explore their philosophy and leadership styles and enhance their relationship, which will have a beneficial impact on the group. According to Luke and Hackney (2007), the relationship between coleaders can either enhance or complicate the group process. Luke and Hackney’s review of the literature suggests that the coleader model offers different and perhaps better leadership dynamics than can be offered by the single-leader model. However, effective coleadership requires coleaders to have a good working relationship, which entails a willingness to address any relevant aspects of their work together.
If group leaders are prepared, they are more likely to be able to effectively prepare members for a meaningful group experience. If you are coleading a group, it is useful for you and your coleader to have equal responsibility in forming the group and getting it going. Both of you need to be clear about the purpose of the group, what you hope to accomplish with the time you have, and how you will meet your objectives. Cooperation and basic agreement between you and your coleader are needed to get your group off to a good start.
This cooperative effort might well start with you both meeting to develop a proposal, and ideally both of you will present it to the appropriate authority. This practice ensures that designing and originating the group are not solely one leader’s responsibility. This shared responsibility for organizing the group continues throughout the various tasks outlined in this chapter. You and your coleader will be a team when it comes to matters such as announcing and recruiting for membership; conducting screening interviews and agreeing on whom to include and exclude; agreeing on basic ground rules, policies, and procedures and presenting them to members; preparing members and orienting them to the group process; and sharing in the practical matters that must be handled to form a group.
It may not always be possible to share equally in all of the responsibilities. Although it is ideal that both leaders interview the applicants, time constraints often make this impractical. Tasks may have to be divided, but both leaders need to be involved as much as possible in making the group a reality. If one leader does a disproportionate share of the work, the other can easily develop a passive role in the leadership of the group once it begins.
Time spent planning and getting to know one another as coleaders can greatly influence the success of your work together and start you off in a positive direction. Here are a few questions you and your coleader could discuss before the initial session:
· What kind of group work has each of you experienced? In what ways will your theory and leadership styles influence the direction the group takes?
· Will your cultural and ethnic background influence your way of being in the group and with each other? How might your differences be strengths in your working relationship? How might your differences be a challenge?
· Do you have reservations about coleading with each other, and if so, are you willing to talk about them?
· What are your strengths and weaknesses, and how might they affect your leading together?
· What ethical issues related to group work do you and your coleader consider most important?
· What types of members or situations might arise in a group that could pose a challenge for you personally and professionally?
· Are you willing to identify and manage conflict and disagreements as a coleader team?
These questions do not represent all the possible areas coleaders may explore in getting to know each other, but they provide a basis for focusing on significant topics.
Learning in Action
Leader/Listener
This activity can be done with two group members, classmates, or group coleaders to gain insight into how you lead, follow, and communicate with others. Each dyad will need a pen and two pieces of paper.
Instructions
· Leader: Draw a simple image on your paper, but do not allow your partner to see it. When you have completed the drawing, tell your partner how to re-create the image on his or her paper without showing your paper to your partner. As the leader, your job is to help your partner re-create the image you drew without ever seeing it.
· Listener: Your job is to follow the leader’s instructions as best as you can. You may ask questions.
Discussion Questions
After you and your partner have each had a chance to be Leader and Listener, discuss the following questions with each other.
As the Leader
· How did you feel in the role of the Leader? Was there anything about it that you particularly liked or disliked?
· Which role did you find easiest or most challenging? Describe.
· How would you describe your style as a Leader? How would you describe the Listener’s style?
· How well did you feel the Listener did in following your instructions?
· Did you ever feel frustrated with the Listener, yourself, or the process in general?
· What challenges might you and your partner have in working together as coleaders?
· In what ways might your and your partner’s style complement each other as coleaders?
As the Listener
· How did you feel in the role of the Listener? Was there anything about it that you particularly liked or disliked?
· Which role did you find easiest or most challenging? Describe.
· How would you describe your style as a Listener? How would you describe the Leader’s style?
· Did you ever feel frustrated with the Leader, yourself, or the process in general?
· What challenges might you and your partner have in working together as coleaders?
· In what ways might your and your partner’s style complement each other as coleaders?
Chapter Review
5-8aPoints to Remember: Forming a Group
Member Functions
Group members need to be active in the process of deciding whether a group is right for them. To do this, potential members need to possess the knowledge necessary to make an informed decision concerning their participation. Here are some issues that pertain to the role of members at this stage:
· Members can expect to have adequate knowledge about the nature of the group and understand the impact the group may have on them.
· Members can be encouraged to explore their expectations and concerns with the group leader to determine if this group with this particular leader is appropriate for them at this time.
· Members need to be involved in the decision of whether or not they will join the group; members should not be coerced into joining a group. In mandatory groups, leaders do their best to show involuntary members how a group can be personally beneficial, which can result in a shift of members’ attitudes.
· Members need to understand their purpose in joining the group. They can prepare themselves for the upcoming group by thinking about what they want from the experience and how they might attain their goals.
Leader Functions
Here are the main tasks of group leaders during the formation of a group:
· Develop a clearly written proposal for the formation of a group.
· Present the proposal to your supervisor or administrator and get the idea accepted.
· Announce and market the group in such a way as to inform prospective participants.
· Conduct pregroup interviews for screening and orientation purposes.
· Provide potential members with relevant information necessary for them to make an informed choice about participation.
· Make decisions concerning selection of members and composition of the group.
· Organize the practical details necessary to launch a successful group.
· Get parental permission, if necessary.
· Prepare psychologically for leadership tasks, and meet with the coleader, if any.
· Arrange a preliminary group session for the purposes of getting acquainted, orientation to ground rules, and preparation of members for a successful group experience.
· Make provisions for evaluating the outcomes of the group in a community agency.
· Meet with the coleader prior to beginning a group to get to know one another and to plan the general structure of the group.
