chapter 8 - selecting clients and composing groups Flashcards
what might make individual therapy better for others than group therapy x3
need active clinical management, have less relationship issues and would benefit from personal insight over interpersonal insight
what is deselection
the process of a having a pool of clients and picking out those that would not fit and then proceeding to accept all other clients from the pool.
whom pays the cost for poor selection in a group therapy x2
the individual and the group
what is exclusion over inclusion
the use of the deselection method.
what is the main way that we know someone won’t do well in group
if they are unable to participate in the primary task of the group - let it be due to logistics, intellectual, psychological or interpersonal reasons.
what 6 things make someone not a good candidate for heterogenous outpatient therapy
TBI, paranoia, or antisocial, somatizing, SUD, acutely psychotic
what expectation does a member need to make group likely to be a worthwhilte candidate
they need to expect group to be of value as this undermines the client relationship from the start.
what kind of group suffers the most from poor client selection
brief and time limited groups.
what kind of group should an antisocial person work in
a homogenous group population with an institutional presence.
why should someone that is suicidial or massively depressed not be in a group x2
becaus group cannot give theme specialized individual attention that they need. and threat of suicide is too much for the group.
what kind of group would serve thos with high SI
a homogenous SI focused group
why would we not include someone with transportation issues
good attednacne is necessary for cohsion and group work so not being there would destroy group work for others and themslves.
if a person were to miss x amount of sessions they should not be included
4-5 sessions
why should we not have someone with a long commute in the group
long commute adds to the frustartion so a group day that is not paricularly satisfying might make it more likely for them to drop out or take out hte commute on the group .
what will all people fit into
some sort of group at some stage.
what can drop outs early on in grop formation cause
a wave effec of more drop outs.
what is the drop out rate for group in percentages
17%-57%
do those that drop out in group ever get a benefit down the roa
no, they stay the same and rarely recover from such.
what are the 18 traits of those that are likely to drop out
lower awareness, acting out tendency, less motivation, more reactive and less reflective, low positive emotion, denial of need or distress, high somatization, SUD, anger/hositility, low SES, low social effectiveness, low intelligence, lack of understaing of group dynamics, expect insensitivity, poor social sills, high levels of emotional/mental distress, in crisis, prefer individual, early dissatisfaction with group members or leader
what is there to be said about drop outs tratis
they are the ones that are most in need of help and the most likley to lave.
how should we orient groups ?
to the needs of the client
what are 9 reasons people drop out
external factors, group deviancy, intimacy issues, fear of emotional contagion, inability to share, complications from indiviudal to group therapy, early agitatros in the group, poor orientation to therapy, complciations from subgrouping.
what are the 3 most common issues that cause drop out
external factors, group deviancy, intimacy issues.
what are extrneral factors that cause drop out
logisttical reasons like time and transportation.
how long does it take for therapy to alleviate symptoms and make changes for the person
about 6 months (brief therapy is not pliabel for them)
what kind of group fits acute grief
time limited especially if the grief is complex and unremitting.
whom does brief group work for best
those with a particular aim or need quick alleviation of issues.
is it truly the external stessors that caused early drop out
no. this is a cop out tpyically. and is a focus on external things rather than a focus on the internal things.
what is group deviancy
when a person doesn’t fit into a group and interferes with the group task.
what is the most common traits of those that would be considered a group deviant x8
they don’t fit into the group due to a lack of psychological mindedness and lack of interpersonal sensitivity, disengaged, concrete and directive, disconnected from here and now, low SES, low education,
how do group deviants typically communicate x3
in the advice giving or seeking manner or at the level of judgement and avoid discussion of feelings and the here and now interactions.
what is the best kind of group for those with schizophrenia
structured, supported and psychoeducational
why do you not want deviants in a group
they slow down the process causing the group only to be able to move at their speed of their slowest member. they don’t beneift the group and cause issues for others.
how do therapists tend tor eact to deviants
they eventually will put their energise into those that rewad their effort by putting in the group work. thus, causing the deviant to be even less interactional.
how do issues of intimacy manifest in terms of causing group drop out
schizoid withdrawal, uninhibited or inhibited self-disclosure, or unrealistic demands for instant intimacy.
what kind of attachment style is hard for group work
avoidance and dismissive styles