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
how do avoidance and dismissive attachment styles display in group x4
self reliant and resist the pull of belonging, mistrust the care of others, slow to engage,
what overall emotional state makes group work hard
shame
what makes for a better outcome, sense of belonging or high cohesion
sense of belonging.
what would make us consider bringing a narcissist or those that hate self-disclosure to enter the group x3
if they don’t liek their current interpseonal relationships, have a motivation for change, and have a curiousity about their inner lives.
why don’t we want a narcssisit in the group
they tend to withdraw, or devalue others or engage in self-aggrandizement which harms group process.
how can we lower early drop out x2
by having prepgroup preparation especialy for a gropu that is established and fast moving or adding individual therapy to the group work.
what is the fear of emotional contagion
the fear of those in group in “catching the emotional distress of others. they have a sense of permeable ego boundaries (not solidided self)
how can group work to help an inividual therapist
when the client is dependent on the therapist and they need to be weened off of the indiviudal therapist.
what is critical for group work to take place
motivation to change
what is the number one reason for being in a group
having interpersonal issues.
what is needed to make use of group theray beside smotivation
interpersonal competene and appreciation of their issues of an interpersonal nature (Awareness)
do impulsive people do better in group or in individual
group
would a person that intellectualizes often do well in group or invididual
in group due to the affective presenec
how do we measure to know a group is being productive for a person x2
client’s attraction to the group, and client’s popularity in the group
what 2 thigns lead to high populairty
high self disclosure and abiltty to be introspective .
what qualities do you want in a group member x5
desire personal change, high expectations for group, saw deficit in self in understanding and sensitivity to the self, think the group can help
what does expectation of group equal
the more they expect from therapy, the more useful it will be
how do we view group dynamics
as the actor and partner interedependene
what does a therapists feelings towards a client say about their inclusion or exclusion
if a therapist does not feel a like or dislike towards them or a disinvested than they should not be let into the group
what does it mean to say that with the greater the defiict in interpersonal ability then the grater we can predict a person
the more pathologically maladaptive a person is, the more we can predict their trajectory.
does an standard individual interview allow for us to make a good call on a person as being allowed into a group
it does not
what should an interview focus on for group work
the client’s relationships.
how else can estimate how a person will be in group
by looking at their prior group work history.
what are the 4 attachment styles
secure, insecure/anxious, inescure-detached (dismissive/avoidant), and insecure-fearful.
what attachment style does well in all therapies
secure attachment - seek connection and can tolerate distress
how do anxious attachment appear in gruop
hungry for onnection and don’t trust if it is reliable.
how do avoidance/dismissivel show up in group
dismiss connections and are slow to warm up.
how do the insecure fearful client appear in group
overwhelemed by the demands of the group.
how does the anxious attachment appear to a group x3
amplify emotions and seek evidence of others and the response of the therapist.
how does dismissive attachment appear in grop
minimizes disteess and is not interested in engaging with others.
what kind of group would a dismissive attachment do well in
a mature grop that is slow moving (not in a newly formed group).
what kind of groups do best with each attachment
if each attachment style is heterogenous in the groups (not all the same)
how does the inventory of interpersonal problems (Assessment) portray client tendencies into 2 dimensions
control (domineering to submissively) to affiliation (warm/nurturing to cold)
how do hostile and dismissive people view others in the group
as hostile and dismissive.
what does affiliation do for group work
it helps the work come along but it is not enough and they need to take risks to grow.
how can we help cold and dominate personalities in group x3
pregroup preparation, active and supportive leaders, in a time limited interactional group.
what trait slows a group
neuroticism
what traits help a group move along x3
extraversion, conscientious, and openness
how does being agreeable help a group x2
allows for the group to be strengthened and create a sense of belonging
how does being psychologically mindful (able to identify intrapsychic factors and relate them to issues) help group work x3
can explore, reflect, and understand
what ahppens when you put someone in a group with very poor relationships into active and dynamic groups
they don’t do well and the group suffers.
does a diagnosis help to decide if a group member is a good fit
absolultely not.
how should an interview be used to help decide if a person is a good group member x2
if they are focused on the here and now and focus on interpersonal function
what predicts group work better - diagnosis or attachment styles
attachment styles
what goals work well with a homogenous group
deep goal of interperonal learning and have high ego strenght
what are the advantages of a homogenous group compared to heterogenous groups x 6
gel quickly and are more cohesive and give more support, better attendance, less conflict, more relief of symptoms quickly
what is a concern for hterogenuous groups
can marginalize someone
should the social microcosm be solid and fixed or flexible
flexible, people should be able to change their roles
should groups be male or female
mixed
what groups work best with only women
focus on sexual abuse and shame
who likes group therapy more, men or womene
women
how do men behave in all men grous
aggressive and less intimate.
how do women behave in mixed groups
less ative and defer to the males.
why would you want group veterns in a group
they help to establish group norms.
why would a homogenous group appear superficial
due to the mindset of the laders and view they have of group as such. do not think of them as one thing. they are unique individuals.
