Group Therapy

Question 1

leader’s tasks

Answer 1

1. Creation and maintenance of the group
2. Group Culture Building
3. Activation and illumination of the “here and now”

Question 2

creation and maintenance of group

Answer 2

First task is to create and convene the group
Importance of selecting and preparing group members
Certain individuals do poorly in group – paranoid, psychopaths, brain-damaged, acute psychosis, drug addicts/alcoholics
When group begins, therapist needs to deter anything that threatens the group’s cohesiveness
Repeated tardiness, absences, formation of cliques within the group, scapegoating – all threaten the integrity of the group and require intervention

Question 3

group culture building

Answer 3

When group becomes a reality, therapist attempts to develop it into a therapeutic social system
Establish a code of norms that guide the interactions of the group
Leader task: develop a group culture that facilitates therapeutic interaction among the members
Norms – active involvement, self-disclosure of failings, acceptance of other members, desire for understanding and change, freedom to express self

Question 4

therapist facilitates building of norms through 2 roles

Answer 4

technical expert

model-setting participant

Question 5

model-setting participant

Answer 5

provide a model of acceptance and appreciation of strengths along with weaknesses.

Question 6

technical expert

Answer 6

instructs clients about group rules prior to beginning and during its early stages

Question 7

activation and illumination of the here and now

Answer 7

Activation: members must live with each other in the present (experiencing) and need to express feelings towards each other
This is not a common form of group therapy – normally there is more focus on a specific topic for the day, etc.
Illumination: cognitive component – observing and understanding one’s experience and interactions

Question 8

stages of therapeutic groups

Answer 8

1. exploratory stage
2. transition stage
3. working stage
4. termination stage

Question 9

exploratory stage

Answer 9

Members introduce themselves, explain why they are in the group, and the nature of their therapeutic goals
Ground rules established
Interaction appears superficial
Issues of inclusion and influence are salient – will members fit in and be liked? How much influence will they have in group?
Efforts at self-disclosure occur and beginning of group cohesion emerges
Leader helps establish therapeutic norms
Important that a sense of trust develops

Question 10

transition stage

Answer 10

Members attempt to disclose more deeply
Ambivalence – desire to explore more deeply accompanied by avoidance of disclosing more personal information
Aggression often emerges in this stage
Issues of power and influence become more central
Leader is often the target of aggressive behavior – he/she is too controlling or not controlling enough
Some members may seek to take control from the leader
Major challenge for leader – intervene in a sensitive and timely way
Important to avoid defensiveness or hostility in response to challenges and attacks from group
Leader needs to reinforce growth-enhancing behaviors, such as acceptance and respect, constructive feedback, non-destructive disagreements, deeper self-exploration and disclosure

Question 11

working stage

Answer 11

Deeper sense of trust and cohesion develops
Members are able to disclose deeply and give and receive feedback
Feel more supported by each other. Willing to engage in new behavior – take risks
Defensiveness has diminished
Norms established
Members able to live in here and now
Leader function: assist members in translating understanding into action, both within and outside group

Question 12

termination stage

Answer 12

Major tasks:
Review what has been accomplished
Discuss member’s plans/goals for the future
Say goodbye
Members tend to experience some sadness and anxiety about ending of group, usually overshadowed by sense of growth and accomplishment
Leader main tasks:
Help members face termination
Deal directly with issues of loss and separation, and positive feelings as well
Help clarify the meaning of the group experience
Reinforce positive development and growth

Question 13

therapeutic factors in group work

Answer 13

1. instillation of hope
2. interpersonal learning
3. group cohesiveness
4. altruism

Question 14

instillation of hope

Answer 14

Observing others change within the group can engender hope

Question 15

interpersonal learning

Answer 15

Group comes to represent individual’s social world
Client becomes more open about self and displays his/her interpersonal issues and problems
Client can gain insight on impact on others, maladaptive interpersonal behavior, distortions of others

Question 16

group cohesiveness

Answer 16

Has parallels with therapeutic alliance in individual therapy
Definitions – the attractiveness of a group for its members, a sense of bonding, solidarity, “we-ness”

Question 17

altruism

Answer 17

Desire of group members to help each other
Giving stimulates others to give in return
Giving enhances one’s sense of effectiveness and self-esteem