Exam 3: Group therapy and research in counseling psychology Flashcards

1
Q

group

A

two or more individuals who are connected to one another by a particular social relationship

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2
Q

group therapy

A

psychotherapy in which one or more therapists treat a group of clients together as a group

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3
Q

types of groups

A
  1. support group
  2. psychoeducation group
  3. process groups
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4
Q

support groups

A

focuses on providing support for specific issues and offering comfort and connectedness to others ⇒ focus on the clients supporting and validating one another

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5
Q

psychoeducation groups

A

focuses on providing information about particular topics and developing skills ⇒ more information based, less personal sharing, less self disclosure
- May feel like a presentation/lecture rather than therapy

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6
Q

process groups

A

focuses on the process of being in the group, guiding the clients to note how they interact with other group members and how that mirrors their lived experiences ⇒ attention is paid to feelings, thoughts, and experiences that arise in there group
- There will be opportunities to explore the meaning of these behaviors

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7
Q

who benefits from group therapy? (2)

A
  • People who have difficult time in relationships may benefit significantly from a process groups ⇒ interpersonal process group
  • Almost anyone can benefit from a group
    Note: Usually form a group by creating exclusion criteria
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8
Q

reasons for group exclusion (4)

A
  1. Acute situational crisis ⇒ if you are in your own crisis it is difficult to help others
    - May need to do crisis or individual counseling first
  2. Suicidal clients ⇒ these clients usually need more focused attention to themselves to make sure they are safe
  3. Members who are unable to attend regularly ⇒ especially true for process group interpersonal connections
    - It can disrupt the dynamic of the group
  4. Clients with antisocial personality disorder ⇒ unlikely they will support others
    - these patients often wouldn’t seek therapy as they don’t see themselves as having problems but in reality have more difficulty (less empathy and may hurt others )
    - May be better for individual therapy
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9
Q

considerations for groups (4)

A
  1. group size
  2. duration of sessions
  3. group structure
  4. ethics
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10
Q

group size considerations

A

varies from 3 to several hundred group members depending on the type of group
- process groups usually work best with 6-8 members ⇒ enough to share but not too many to have anxiety about sharing
- Several hundred is usually the psychoeducation groups

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11
Q

duration of session considerations

A

groups sessions usually range from 1-2 hours ⇒ depending on how often they meet as well

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12
Q

group structure considerations (2)

A
  1. Open: allowing members to enter and leave the group as needed
    - Typically psychoeducation group
  2. Closed: only the group members who started at the beginning are in the group at the end
    - Process groups shouldn’t have new members added because they will be behind
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13
Q

ethics considerations

A

confidentiality cannot be guaranteed ⇒ everyone will agree about this at beginning but this works as an honor system and you cannot monitor that

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14
Q

therapists role in group therapy (3)

A
  • express concern, acceptance, genuineness, and empathy toward all group members
  • facilitate dialogue
  • Serve as a role model of how to give and receive feedback to group members
    → In psychoeducational groups, instructors often instruct, educate and give examples
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15
Q

process group components (4)

A
  • who communicates, how long, how often, to who, who interrupts, are there patterns related to gender/age/race?
  • what roles conflict on the surface (what, who, resolution)
  • what is the emotional content of the discussion
  • what are some of the unstated assumptions underlying the discussion
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16
Q

techniques of group therapy (3)

A
  1. Creation and maintenance of the group
    - group screening interview
  2. Culture building
    - Norms of process
    - Therapist models desired behavior
  3. Using the here and now (often immediacy technique)
    - Process illumination
    - Self reflect
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17
Q

process illumination

A

help group members figure out what’s going on inside of them

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18
Q

who created the group stages in 1965?

A

Tuckman
- Originally 4 stages and later added a 5th to address termination

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19
Q

Tuchman’s stages

A
  1. forming
  2. storming
  3. norming
  4. performing
  5. adjourning
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20
Q

forming stage

A

orientation stage
- Typically polite, limited interactions
- Members are getting to know their role
- Greater dependency on therapist

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21
Q

therapist role in forming (2)

A

provide structure and direction

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22
Q

storming stage

A

conflict stage ⇒ challenging but healthy
- Ideas are criticized and challenged; coalitions begin to form
- Members may be judgemental of one another
- Power struggle among members

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23
Q

therapist role in storming

A

distinguish between an attack on your person and an attack on your role/ideas ⇒ therapist models ways of providing feedback
- Unpleasant stage for most therapists
- Maintain safety for people and show they are valued but practice confrontation

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24
Q

norming stage

A

structure stage
- Agreement on procedures
- “We” feeling among group members
- Cohesion

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25
Q

concerns for group members during norming

A
  1. Not being liked
  2. Not being close enough with others
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26
Q

therapist role in norming

A

foster group cohesion so group can be optimally effective

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27
Q

performing stage

A

work stage
- High task orientation
- Emphasize performance and cooperation
- Full expression of positive and negative emotions
- Most productive therapy at this stage

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28
Q

therapist role in performing

A

look out for subgrouping, conflict, and self disclosure

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29
Q

therapeutic considerations in performing (3)

A
  • Subgrouping: inevitable in all groups; often disruptive in therapy groups if kept secret
  • Conflict: cannot and should not be eliminated from group
  • Self-disclosure: essential for therapeutic benefit; member must reveal personal information for group therapy to be useful
30
Q

adjourning stage

A

dissolution/termination
- Completion of tasks; increased independence and emotionality
- Termination

31
Q

therapist role in adjourning

A

assist in termination process and guide client conclusions

32
Q

Yaloms therapeutic factors (11)

A
  • Hope
  • Universality
  • Imparting information
  • Altruism ⇒ give help and get help
  • Corrective emotional experiences
  • Development of social skills ⇒ groups give people a chance to practice social skills
  • Imitative behavior
  • Interpersonal learning ⇒ getting feedback on how others perceive you
  • Group cohesiveness
  • Catharsis
  • Existential factors
33
Q

hope

A

having hope or expectation that it will work is positively related with good outcomes in therapy

34
Q

universality

A

pain can be a universal experience and we will always have some discomfort in life that we don’t talk about with one another very often
- In group therapy you realize you are not alone

35
Q

imparting information

A

the clients receive and impart information with other group members with gives you the experience of altruism

36
Q

corrective emotional experiences

A

roles in group may influence others behavior to solve problems so that people don’t have to take on certain roles and receive help instead of be the leader

37
Q

imitative behavior

A

observational learning for behaviors others in the group do

38
Q

group cohesiveness

A

can give you a sense of belonging and connection amongst similar goals

39
Q

catharsis

A

process of working through emotions and expressing them

40
Q

existential factors

A

chance for individuals to address meaninglessness and isolation in their lives

41
Q

advantages of groups (6)

A
  • Group dynamics can replicate dynamics outside the group and thus help group members work out those issues
  • Accountability
  • Skill building
  • Members receive feedback/suport/challenge that encourage or facilitate change
  • Groups offer diversity of perspectives
  • Cost effective
42
Q

disadvantages of group (6)

A
  • Not everyone can be in a group
  • Confidentiality is more difficult to maintain
  • Can be harder to build trust and safety
  • Group leaders are not always properly trained
  • Group leaders have less control than in individual therapy
  • Concerns regarding what a disruptive person could do
43
Q

components of being a scientist practitioner (4)

A
  • Conducting research
  • Being a good consumer of research
  • Applying research findings to practice
  • Approaching clients with a scientific mindset
44
Q

how is research generated? (5)

A
  1. Identify a research hypothesis or aim
  2. Choose an appropriate experimental method
  3. Conduct research
  4. Analyze the data
  5. Publish your research findings
45
Q

theory

A

Make a hypothesis and then test it to see if it is supported
- With lots of supporting evidence you have a theory

46
Q

can theories be proven?

A

theories can never be proven true or false because there will always be new evidence to change the current theory

47
Q

why do we care about research? (3)

A
  1. it helps us answer questions
  2. ethical considerations
    - Protect client welfare and safety and public trust
  3. practical considerations
    - Many different stakeholders ⇒ clients, clinicians, insurance companies, mental health agencies, taxpayers, governments, researchers pushing for evidence based treatment/practice
48
Q

2 type of research psychotherapy? What are the differences?

A
  1. outcome research
    - does it work and what specifically works?
  2. process research
    - when, why, and how it works based on components and who does it work for?
49
Q

what are the 2 types of research that can be done with outcome research?

A
  1. Single group design
  2. Randomized control trials (RCTs)
50
Q

Single group design

A

test treatment effectiveness by looking at an outcome variable before and after treatment ⇒ is there significant change
- Assess pre and post therapy but also outcomes at other time points

51
Q

Randomized control trials (RCTs)

A

test treatment effectiveness by comparing one or more groups against a control
- Two or more groups ⇒ individuals randomly assigned to a group
- Are the groups scores on the DV significantly different from one another at post treatment?

52
Q

considerations for RCT’s (6)

A
  1. Define the inclusion and exclusion criteria ⇒ establish whether a treatment works for a specific population or disorder with a strict diagnosis
  2. Even with people who have a specific diagnosis there is a lot of heterogeneity
  3. Recruitment issues ⇒ need a large enough sample size for evidence
  4. Must define the control group
  5. Must operationalize the therapy
  6. Therapist related factors ⇒ carried out by humans which is why it can get messy
53
Q

what causes heterogeneity in RCTs? (4)

A
  • How long they have the disorder
  • Family history
  • Previous treatment, therapy, medication, both
  • Comorbid disorders
54
Q

comorbid disorders

A

people with certain diagnosis may have other diagnosis too

55
Q

blinding

A

how you make sure the participants don’t know what group they are in

56
Q

placebo effect

A

show improvements because they think they are getting better when they actually are not

57
Q

Supportive therapy/treatment as usual

A

provide educational evidence for therapy or continue with treatments they are already doing ⇒ can still show placebo

58
Q

Pure control

A

no intervention

59
Q

Wait list control

A

receive intervention after the study

60
Q

Manualized therapy

A

specific protocol explaining how to carry out the therapy
- part of operationalizing the therapy

61
Q

therapist related factors (2)

A
  1. Therapist effects
  2. Therapist adherence
62
Q

Therapist effects

A

some individual therapist may be more effective than others

63
Q

Therapist adherence

A

therapist may differ in how closely they follow the manualized treatment

64
Q

Process research

A

when, why, and how it works based on components and who does it work for

65
Q

components of process research (2)

A
  1. moderation
  2. mediation
66
Q

moderation

A

third variable that affects the direction or strength of association between 2 variables
- When or who does treatment work
- What makes it more effective for some patients than others ⇒ strength + direction

67
Q

mediation

A

3rd variable accounting for association between 2 variables
- How or why does effects occur

68
Q

open science

A

a scholarly movement dedicated to the core principles and behaviors of making research transparent, credible, reproducible, and accessible

69
Q

key components of open science (2)

A
  1. Preregistration
  2. Open data, protocols, materials, and code
70
Q

preregistration

A

Require researchers to register their study’s hypothesis, methods, and analysis plans before conducting the research ⇒ reduces data manipulation