midterm Flashcards
group process
all elements that are basic to the unfolding of a group from beginning to end
task groups
aims to foster the accomplishment of identified work goals
psychoeducation groups
aims to provide members with targeted education on a variety of psychological/mental health issues
(eg. substance abuse prevention group, couples relationship education)
counselling groups
focuses on interpersonal process and problem-solving strategies that stress conscious thoughts, feelings & behaviour
psychotherapy groups
remediation of in-depth psychological problems and restructuring personality dimensions
usually to alleviate specific symptoms or psychological problems
brief groups
time limited, structured groups with clear ground rules
2-3 months, 8-12 weekly sessions
advantages of brief group therapy
- well suited to the needs of both clients & health authority budgets
- cost effective
- widely applicable to diverse client populations and problems
- can be used in different settings
what type of group would be beneficial for someone wanting to learn about the risks of cannabis use in young people?
psychoeducation group
what type of group would be best for bereaved people?
counselling group
what are some things a diversity competent group leader should know?
- self-reflection to avoid stereotyping clients
- understand the client’s worldview & backgrounds
- be aware of institutional barriers that prevent marginalized people from utilizing resources
- view diversity in a positive light
- be knowledgeable about group members & their communities
what are some ways to accentuate multicultural dimensions into your group work?
- ask members how they identify
- engage members in comfortable conversation about culture/ethnicity
- address differences
- recognize and acknowledge how power, privilege, and oppression can affect interactions with clients
- open to learning
what are the goals of multicultural group work?
- human development/interpersonal relationship enhancement
- task achievement
- prevent mental, emotional, behavioural disorders
- lessen distress, disability, or loss of dignity, autonomy, or freedom
components of a group proposal
- rationale
- objectives
- practical considerations
- procedures
- evaluation
what is meant by an open vs closed group?
OPEN: anyone can show up at any meeting
CLOSED: once you reach the limit, nobody else can be let in
why is a pre-group meeting important?
to set expectations, establish group rules, role preparation
& focus on client’s perceptions, expectations & concerns
what logistics are considered when planning a group?
- group composition
- group size
- frequency/duration of meetings
- length
- location
- open vs closed
what are some of the criteria for selecting group members?
look for people who are wanting to make changes and willing to expend the necessary effort
do they want to become a member?
ethical issues
standards that govern the conduct of professional members
legal issues
define minimum standards society will tolerate, enforced by the rule of law
clinical issues
involve using your professional judgement to act in accordance with ethical and legal mandates
cultural issues
differences that affect the way we understand and intervene with client’s problems
what is informed consent?
presenting basic information about a group to potential participants to allow them to make an informed decision to enter the group or not
what information would you give to a prospective group member?
- nature of group
- goals
- general structure
- what is expected from them
- what they can expect from you
do all group members have to be voluntary?
no, many groups are composed of involuntary members
showing them how they can personally benefit can increase voluntary participation
ethical considerations for freedom to withdraw from a group?
- informing group leader/members before making their decision
- group leaders must intervene if other members use pressure to force any member to remain in the group
- outline policies of attendance and withdrawing during initial meeting
what are some psychological risks for group members?
- MISUSE OF POWER
- SELF-DISCLOSURE
- MAINTAINING CONFIDENTIALITY
- SCAPEGOATING
- CONFRONTATION
how can you minimize psychological risks?
use a contract (members specify what they are willing to do and explore within group)
what is the best approach regarding scapegoating?
group leader should explore what is going on with the person doing the scapegoating before focusing on the person being scapegoated
confidentiality in a group
- leaders need to define parameters around what it entails
- talk about consequences of breaching
- reminders throughout of importance
what ethical and legal responsibility do group members have in regards to confidentiality?
- inform members of potential consequences
- avoid talking to parents/teachers without permission
- do not mention others in group
- do not promise to keep material within the group that they may have to disclose
ethical concerns in using group techniques
have a clear rationale for using each technique
leader may unethically employ techniques if they are unfamiliar, enhance their power, creates intensity, pressure members, alter a group member’s personal values.
what are some legal safeguards for group leaders?
- screen candidates thoroughly
- demystify the group process
- develop collaborative relationships
- consult with colleagues when there is a potential concern
- incorporate ethical standards in the practice of group work
advantages of the co-leadership model
- decreases chance of burnout
- less overwhelming
- peer supervision
- managing countertransference
- aid in processing member’s reactions to other leader
- group can still happen with one leader missing
disadvantages of the co-leadership model
- poor selection of a co-leader
- random assignment
- failure of the two leaders to regularily meet
group characteristics at the early stage
- members are getting acquainted and learning how the group functions
- silence & awkward periods
- members deciding how much they want to disclose & evaluating safety
- low risk taking
- trust vs mistrust
common fears experienced by group members
- anxiety over being accepted
- judgement of others
- appearing stupid
- unexpected
- concern over communicating effectively
how can members & leaders create trust?
- sharing personal expectations
- modeling interpersonal honesty, respect and spontaneity
- careful attending, genuine listening
- empathy
- understanding nonverbal behaviour
- self-disclosure/genuineness
- respect
what are the major tasks in the initial stage of group?
establishing trust & assisting members in identifying and clarifying specific, achievable goals
group norms
norms enable a group to attain its goals
- expectation of promptness
- regular attendance
- sharing meaningful aspects of self
- expectation of giving feedback
- confidentiality
- encouraged to support and challenge others
what are three key constructs that capture the essence of the TR in group treatment?
- GROUP CLIMATE
- COHESION (sense of togetherness)
- ALLIANCES
addressing conflict within a group
ADDRESS EARLY OR IT WILL INHIBIT COHESION
respond, facilitate a resolution
implicit vs explicit norms
IMPLICIT: not openly stated, preconceived ideas about what takes place in a group
EXPLICIT: standards of behaviour stated in a group
what leadership style has the highest risks?
aggressive confrontation
how can you help group members get the most from a group experience?
- building trust
- express persistent feelings
- self-disclosure
- participate fully
- embrace change
- listen
- take feedback
- discover new dimensions of yourself
leader issues during the initial stage
- DIVERSION OF RESPONSIBILITY (responsibility for direction and outcome of the group, encourage members to take an active role)
- DEGREE OF STRUCTURING
- OPENING GROUP SESSIONS (don’t focus on one person talking, check in)
- CLOSING GROUP SESSIONS (have time to summarize and debrief)
characteristics of the transition stage
ANXIETY & DEFENSIVENESS
Group members may:
- test the leader
- wanting to play it safe
- observe leader to determine trust
- learn how to express themselves
what are some signs of low trust in a group?
- inconsistent attendance
- reluctance to participate
- deny problems/concerns
- hide behind intelectualizations & global statements
- unwilling to deal with conflict
what common fears emerge at the transition stage?
- making a fool of oneself
- emptiness
- losing control, being to emotional
- self-disclosure
- taking too much of the groups time
- being judged
what is at the root of resistance behaviour?
reluctance to bring into conscious awareness threatening material that has been previously repressed or denied
PROTECT OURSELVES FROM ANXIETY
is resistance counterproductive in a group?
no, resistance is natural and can lead to productive exploration in the group
as long as you don’t respond defensively resistance can allow the leader to get to the source of the members hesitation and understand the underlying feelings
should conflict be avoided at all costs in groups?
no, conflict is expected in all relationships
unexplored conflict is problematic and needs to be worked through, and acknowledged
caring confrontation
a form of constructive feedback to help members make an honest assessment of themselves or to speak more about their own reactions
guidelines for effective confrontation
- have rationale for confronting a person
- confront if you care about the other
- talk more about yourself
- avoid dogmatic statements/judgements
- give others space to reflect
how should the group leader to react to difficult behaviours of members?
- avoid being reactive
- encourage members to explore their defensiveness
- state your observations tentatively
- find ways to explore conflict
- avoid personalizing members reactions
what is a hidden agenda?
unstated individual goals that may conflict with group goals
how can you deal with avoidance by the whole group?
- bring to the surface hidden agendas
- refuse to give up
- not indulge in feelings of frustration and annoyance
how can a group leader deal with someone who is silent during a group?
- DON’T constantly call on them
- explore meaning of silence with the members
- approach members with concerns rather than judgements about the silence
what is monopolistic behaviour?
person who exhibits a high degree of self-centeredness
claims to identify with others but takes others statements as openings for stories about them
how can you handle a member who is storytelling?
assist members in moving beyond telling irrelevant stories and teach them to express themselves in personal and concrete ways
“if i allowed you only one sentence to express what you just said, what would it be?”
transference
eelings clients project onto the psychiatric nurse which are rooted in the members past relationships
countertransference
psychiatric nurse projects their own unresolved conflicts onto the client and can be damaging to memebrs
multiple transferences
A process whereby group members develop intense feelings for certain others in a group
do all groups reach a working stage?
no
does work only occur at the working stage?
no, work and learning occur at every stage of a group but deeper exploration and in increased level of group cohesion are typical of the working stage of a group
how does leader interventions for working with a member’s fear look at the different stages?
INITIAL: aimed at providing encouragement
TRANSITION: demand more from the member than initial stage
WORKING: involves the entire group in a member’s personal work
FINAL: encourage members to see how the changes practiced in the group might affect significant people in their life
does trust may need to be re-established during the working stage?
YES
some members may have second thoughts about how involved they want to remain, are frightened by conflict, or are anticipating the eventual ending of the group.
what are the tasks of the working stage?
- support and challenge risk-taking
- variety of therapeutic interventions
- more direct interactions between members
- healing capacity within group develops
- increased group cohesion
characteristics of a working group
- trust increased, safety
- clear & specific goals
- here-and-now focus
- members willing to make themselves known
- cohesion is high
- conflict is explored
characteristics of a non-working group
- mistrust, unexpressed feelings
- participants focus on others more than themselves
- participants may hold back and feel distant
- conflicts ignored or avoided, unclear communication
disclosure versus anonymity
for group to work effectively, members need to share meaningful dimensions of themselves
authenticity versus guardedness
authenticity is essential, genuine intimacy is not possible when people remain unknown or feel compelled to guard their true feelings
spontaneity versus control
encourage members to allow themselves to respond spontaneously in the moment
acceptance versus rejection
members may discover that they are frightened about being accepted as well as being rejected
unity versus fragmentation
unity is a result of the group developing a sense of community and establishing bonds with each other
some subgroupings may be beneficial
hope
belief that change is possible
commitment to change
members being willing to make use of the tools offered by the group process to explore ways of modifying their behaviour
power
sense that one has the resources necessary to direct one’s own life
feedback
group members or leaders share their observations and personal reactions regarding the behaviour of another
catharsis
physical and emotional release of stored up pain and unexpressed feelings
what are the tasks in the final stage of group?
CONSOLIDATION OF LEARNING
- clarify & integrate the meaning of their experiences in the group
- consolidate the gains they have made
- decide what newly acquired behaviours and changes they are committed to bringing to their everyday lives
consolidation of learning in an open group
- educate members to give adequate notice when terminating
- allow time to prepare emotionally
- gives an opportunity for others to say good-bye
- explore cultural influences on members perceptions & understanding of endings
- help members identify how they can incorporate what was meaningful in the group into their daily life
- make referrals, when appropriate
tasks of the final stage of a closed group
- deal with feelings of separation
- compare early / later perceptions
- deal with unfinished business
- review group experience
- personal gestures in expressing meaning of group
- use of a contract & homework
- deal with setbacks
what are some important leadership functions in the final stage?
- assist members to deal with feelings about termination
- deal with unfinished business
- work with members to develop specific contracts & homework
- assist participants in consolidating learning
- provide opportunity for feedback
what is important for the leader to do when helping members deal with feelings of separation?
remind members that the cohesion they have now is a result of active steps they took
assist members in identifying what they did to create a successful group
how can the group leader help group members review concrete highlights of their experience?
encourage members to be concrete and make specific statements, ask what they learned about themselves in the group
state the ways in which they have translated their insights into action
how can members best deal with unfinished business in the final phase of a group?
discuss the members choice to withhold until the end of group
