Group therapy justice settings

Question 1

Why do therapy in groups?

Answer 1

• Efficient cost-effective
• Form relationships with others
• See how people interact with each other
• Skills more easily practised

Question 2

Process vs task

Answer 2

• Structured = content, strategies, skills specific to CBT, little attention to process
  Setting
• Process = taking care of the group, focusing on here and now, group interaction seen as a vehicle of change
• Group Process can add value by:
  o facilitating self-disclosure,
  o attendance (come for others, don’t want to miss out),
  o access “hot” interpersonal cognitions (see them in the room – social anxiety, anger etc),
  o ready behavioural experiments and surveys (role play, BE),
  o shifting self-focus (being able to help others),
  o normalise struggles and concerns
• Should use the process to enhance the structure, analogous to CBT get them in touch with emotions not just psychoeducation (?)

Question 3

Group consideration
- Setting:

Answer 3

: preparation, expectations, practicalities
o safety, the make-up of the group, seating arrangements, access to exit, recourses, cultural greetings kia etc, consider each individual unique formulation, need, personality etc.

Question 4

Group consideration
- Relationship

Answer 4

• Multiple relationships + dynamic (not just one therapist and one client)
• Baggage = everyone + therapist brings own baggage
• History in groups – everyone has a role in groups based on past experiences (leader, facilitator etc)
• Transference
•  therapist needs to help form relationships “ how about asking one of the group members”, “I noticed you nodding as __ was speaking, do you want to share”, get them into pairs to discuss etc

Question 5

Group consideration
- Group tone

Answer 5

• Each group on any day has an unspoken emotional tone (vibe), reflective, nervous, warm, excited
• Often we don’t tune in but that can be a lost opportunity to get hot cognitions, we need to be comfortable in that space to discuss these

Question 6

Group consideration
- Creating the safe environment

Answer 6

• Feel safe to discuss anything
• Therapist characteristics: Warmth, humour, sincerity, honesty
• Impede: confrontation, cold, no direction, inflexible (same as always)
• Need to think about how we come across

Question 7

Group consideration
- Ground rules

Answer 7

• Discuss early, set collaboratively, and discuss appropriate actions if someone is not adhering
• Ideas of rules: attending, being on time, confidentiality, treating with respect, no judgment

Question 8

Group sessions - order - agenda

Answer 8

• Warm-up (linked to purpose) – can be a simple mood check, get them to talk to someone different, get up and move around – “discuss characteristics of diff groups u have been in and what made a good group”
• Body of work - Psychoeducation
• Integration sharing – always leave time for reflection and sharing,

Question 9

Group stages- COULD BE IN EXAM HAS A READING

Answer 9

• Forming – people originally polite, small talk can be in honeymoon period – people feel different things (excitement, nervous, observing),
  o Therapist’s role is to make people engaged and feel included
• Storming – People get into work + roles ‘where do I sit in this group’ arguments arise from things unsaid or unnoticed in the forming stage, people can compete over roles esp. if no clear roles
  o The therapist needs to assert their role and get people involved, clarify goals and use team rules that were set
• Norming – Trying to get balance for structure and process
• Performing – people leaving performing to take it all in and can feel like a happy family – conflict is managed
• Adjourning – when it comes to an end can be scary for people
  o Need change management and to talk about it, plan for moving forward

Question 10

Conflict + addressing conflict

Answer 10

• Conflict is expected and can be a good thing
• If conflict lacking may suggest apathy, disregard, or members feeling unsafe
• If unaddressed can escalate/lead to poor dynamic
• The therapist needs not just avoid conflict
  Addressing conflict
• Early action – open up the subject and encourage sharing
• Encourage to separate actions from feelings
• Re-oreint the group with rules (respect etc)
• Give the other party a chance to respond
• Can give them space to figure it out but keep a close eye on the situation

Question 11

Yalom’s 11 factors (rough - didnt really cover in class)

Answer 11

1. Hope
2. Helping others
3. Psychoeducation
4. Altruism
5. Social skills
6. Modelling
7. Listening
8. Need to take responsibility over our lives
9. Cohesiveness
10. Johari window

Question 12

9. Cohesiveness

Answer 12

a. Encompasses all the relationships within the group
b. If a cohesive group then should feel warmth, comfort, belonging, value and feel valued, accepted, supported
c. More cohesive = higher rates of attendance, participation, support
d. E.g., can achieve this through exercises like the yarn video we watched in class where they found things that connected them

Question 13

10. Johari window

Answer 13

a. expand 1 , 2 smaller = feedback from others
b. expand 1, 3 smaller = self-disclosure
c. make 4 smaller = shared discovery
d. Can share this with group for rational

Question 14

Focal conflict model

diffintations + examples

Answer 14

• The conflict between disturbing motive and reactive motive leads to anxiety so want to work toward a solution to deal with this
• Disturbing motive = shared wish or impulse/common wish by the group
• Reactive motive = shared fear or guilt which is in conflict with the disturbing motive
• Solutions = develop through the interaction of group members and function to deal with the associated group focal conflict
  o Restrictive solution = If the solution only deals with fear at the expense of the wish (pushing things under the rug)
  o Enabling solution = if solution deals with fear + allows for the expression of wish
• Example 1
  o Disturbing motive = members want to share their emotions
  o Reactive motive = fear of rejection
  o Restrictive solution = don’t share emotion.
  o Enabling solution = to talk about feelings and fears of sharing them
• Example 2
  o Disturbing motive = shared feelings of anger towards the therapist
  o Reactive motive = fear of abandonment by therapist
  o Restrictive solution = supress anger to keep them happy
  o Enabling solution = talk to therapist about it