Group Counselling

Unit – 1: Group Counselling:

·         Definitions,

·         Concepts and Explanations,

·         Types of Group –

o   Group Guidance,

o   Group Therapy,

o   T- Groups,

o   Sensitivity Groups,

o   Encounter Groups,

o   Task Group,

o   Psycho- education Groups,

o   Mini groups,

·         Brief Group Work

·         Group vs. Individual Counselling

·         Theoretical Approaches

·         Selection of Group Members

Group:

Meaning:

-          A number of people or things that are put together or considered as a unit.

-          A group is a collection of people with some common characteristics or purpose. 

-          A collection of individuals who have regular contact and frequent interaction, mutual influence, common feeling of camaraderie, and who work together to achieve a common set of goals.

Reference: http://www.businessdictionary.com/definition/group.html#ixzz3fIP9Naow

Definition:

Gladding defined a group as “a collection of two or more individuals who meet in face-to-face interaction, interdependently, with the awareness that each belongs to the group and for the purpose of achieving mutually agreed-on goals.”

Group counselling is a form of therapy where people with similar experiences/issues come together with a professional therapist. The therapist runs the session, but generally everyone contributes in some way, listening to others and talking themselves. It's usually focused on a particular issue, like: addiction.

What is Group Counseling? – Group is a therapy format that approaches issues of personal growth through the use of interpersonal interaction – to interact with others to identify and understand our maladaptive patterns and how to change them.  Group interactions provide an opportunity to build relationships and receive interpersonal feedback about how we experience one another.  You can gain specific skills and strategies to meet personal goals, explore areas that present personal challenges, and gain support and encouragement from others.  Group is one of the most effective ways to explore and support changes you wish to make in your life.

History of group counselling

-          Joseph Pratt, Alfred Adler, and Jacob Moreno, Cody Marsh and Trigant Burrow were the first to use group counseling.

-          Early group efforts were similar to the traditional group guidance or psychological educational groups we see today.

-          WWII:  The war and its effects ushered in a proliferation in the use of group therapy.

-          T-Groups:  This is a group experience whereby individuals come together to learn how to work in a group and to effect interpersonal change.

-          The Human Potential Movement: Began in the 1960’s and founded on the belief that most people only use a small percentage of their capabilities but that within a group experience, they can recognize their full potential.

-          Encounter Groups:  Designed to help normal individuals remove blocks that inhibited their functioning so that they could lead more fulfilling lives.

-          Personal Growth Groups: These are any groups that promote the  personal growth of the individual (e.g. Gestalt groups, T-groups, encounter groups).

-          Marathon Groups:  An intensified encounter group that meets for a long period of time (e.g. 8 hours or a whole weekend.)

Group Counselling                

What is it?

Group counselling, or group therapy as it is sometimes called, is a form of therapy where a small group of clients meet regularly to talk, interact and discuss problems with each other. It provides beneficial advantages, where people can share experiences and contributions from other members in the group are considered valuable, since all the group share similar experiences. A group therapist, there are usually two, provides an anchor point in the group to allow members to share openly and safely.

Group counselling is no different to 1-2-1 counselling, confidentiality and respect for all form part of the same clinical, ethical and professional boundaries.

One of the main principles behind group counselling is the idea that dealing with specific issues may cause isolation and a feeling that one is alone in facing one's problems

Group counselling attempts to counteract this isolation by assembling people with similar issues to enforce that each individual's issues are not singular to one person. Additionally, knowing other people with similar troubles can be comforting to each individual, who may not have access in their family or friends to people with the same issues.

Group counselling can be highly organised, with people doing specific activities together and then sharing the results. Or it can be more freeform, where people share current issues related to the group's purpose. For example, one person's verbal contributions to a group may be discussed, validated and provoke problem solving by other members of the group. This interaction is then primarily led by the group therapist/s.

Studies have shown that both group and individual psychotherapy benefit about 85% of the clients that participate in them. Optimally, clients gain a better understanding of themselves, and perhaps a stronger set of interpersonal and coping skills through the Group Counselling process. Some clients may continue therapy after group sessions end, either individually or in another group setting.

Simply...

Group counselling can offer a unique environment in which to learn about and experience both self and others.

We all live in groups for much of our lives and working together with others can provide valuable insights into characteristic patterns of thinking and relating in a group setting.

The group experience gives individuals an opportunity to explore their issues in more depth, in a setting which closely resembles work, study, social and family groupings.

The Facilitator

A professionally trained counsellor acts as 'the facilitator', helping the group, and individual members to learn, and find a solution or reach a consensus, without imposing or dictating an outcome. The facilitator works to empower individual members of the group to learn for themselves, or find their own answers to problems without control or manipulation.

Some clients may not be able to tolerate agressive or hostile comments from group members, clients who have trouble communicating in group situations may be at risk of dropping out of group counseling. If no one comments on their silence, or makes an attempt to interact with them, they may begin to feel even more isolated and alone instead of identifying with the group. Therefore, the facilitator usually attempts to encourage silent members to participate early on  in treatment. 

The Clinical Services Manager and Group Therapist/s will discuss the suitability of clients for group work following initial assessments.

Group Counselling Contract

A 'Group Counselling Contract' is agreed by all members of the group which includes:

• What you hear here stays here
• What you see here stays here
• What you say here stays here
• Treat other members with the same respect as you would expect to receive
• All content within the group counselling sessions are confidential (Except where harm to self or others may occur)
• Any additional agreed content to the contract

 Aftercare

The end of long-term group counselling may cause feelings of grief, loss, abandonment, anger, or rejection in some members. The group therapist will attempt to foster a sense of closure by encouraging members to explore their feelings and use newly acquired coping techniques to deal with them. Working through this termination phase of group counselling is an important part of the treatment process.

 Feedback from previous group members

1. '..it was very challenging and helped me to see things from an entirely different perspective..'
2. '..I developed a high level of respect for all members of the group..'
3. '..It has taught me about what i value, such as commitment and openness..'
4. '..It has helped me in my relationship, my friendships and the contact with my family..'
5. '..Fifteen weeks seemed a long time at the start, but by the end it was difficult to leave..'

Types of Groups

1.       Task Groups:  A group that comes together to perform a task  that has a concrete goal (e.g. community organizations, committees, planning groups, task force).

2.       Guidance/Psycho-educational Group:  Preventative and educational groups that help group members learn information about a particular topic or issue and might also help group members cope with that same issue (e.g. support group for a suicide, transition group to prepare students to enter high school etc.)

3.       Counseling/Interpersonal Problem-Solving Groups:  These groups help participants resolve problems of living through interpersonal support and problem solving. 

4.       Psychotherapy Groups:  These groups focus on personality reconstruction or remediation of deep-seated psychological problems. 

5.       Support Groups:  These deal with special populations and deal with specific issues and offer support, comfort, and connectedness to others.

6.       Self-help Groups:  These have no formal or trained group leader.  (e.g. Alcoholics Anonymous or Gamblers Anonymous.)

Types of Groups

Groups may be formal, brought together for a particular purpose, or they may be informal such as family groups, groups of friends or colleagues.  You may come into contact or work with a range of different groups. 

These types of group may include:

• Work Groups:  Either formal, such as teams, committees or training groups, or informal maybe setup to tackle an ad-hoc problem.
• Neighbourhood Groups:  An example of a neighbourhood group would be one established to develop local amenities.
• Social Groups | Special Interest groups:  These are groups established to meet the needs of a particular sector (e.g. age group, gender) or interests (e.g. music or sports).  Examples include Women’s Institute and Scouts.
• Self-Help Groups:  Such groups are often established to work through particular emotions or to provide support for people with a certain illness, e.g. helping to overcome an addiction such as Alcoholics Anonymous.
• Inter-Agency Groups:  These are developed between agencies/organisations that work in related fields to improve product and/or client services.  In addition, they aid communication and establish joint ventures to prevent duplication and confusion.
• Pressure Groups:  The function of pressure groups is to challenge the status quo, often by using high profile tactics to gain media attention to achieve their aims.

Reference: http://www.skillsyouneed.com/ips/groups.html#ixzz3fIPd5TRD

Types of Groups

Since groups are formed for different purposes, the Knowledge Network has three types of groups with different levels of privacy.

• Open groups appear in group lists to all users. Discussions and the member director in open groups are visible to all users, but only members can view questions, files, and other group content. Anyone can join an open group with one click.
• Closed groups also appear in group lists to all users, but only group members can see discussions. Other group content is also limited to members only. Users who are pre-approved can join a closed group with one click. Other users can ask to join a closed group, and the request goes to a group moderator for approval.
• Hidden groups function much like closed groups, except only group members can see them in group lists. Users can only join hidden groups with an invitation from a group moderator.

See the comparison table below for more detail on user permissions in different types of groups.

Pre-approval and linked groups

In some groups, members can be pre-approved, or membership can be linked to an external list.

Pre-approval - Some users are pre-approved for certain closed or hidden groups, which means that they can click to join immediately instead of asking for permission. For example, all ICMA members are pre-approved for the Small Communities group.

Linked Groups - Some groups, like those for ICMA board members and special committees, are linked to lists in the ICMA membership database. Only ICMA staff can add or remove people in these groups, so you won't find a button to "Join this group" on the group page. If you're not in a certain group but think you should be, contact the appropriate ICMA staff person.

Group Type Comparison Table

Formal Group

A formal group is created within an organisation to complete a specific role or task. This may be a one off objective such as the launch of a particular product or service or a permanent/ongoing objective such as the provision of Information Technology (IT).

Informal Group

Informal groups are established by individuals who decide they want to interact with each other. Informal groups usually do not have a specific purpose; often the group forms because the group members regularly happen to be in the same location or because they enjoy each other's company. For example people may form a group because they sit close together in an office or live together in a house.

Primary Group

A primary group is made up of a small group of people who interact regularly. A small team with a leader is an example of a primary group. A family can also be called a primary group. Within the primary group, values, beliefs and culture are all very important.

Secondary Group

When a large number of people get together (who do not normally get together) it is called a secondary group. Secondary group members do not get the opportunity to get to know each other as well as primary group members because the interaction with each other is less than in a primary group. When a secondary group is formed, individuals usually have their own agenda and goals. The relationship they form is not long term and social interaction within a secondary group is likely to be low.

TYPES OF GROUPS

Since the 19th century, the scientific method has been applied to investigating, categorizing, and working with groups. In 1986, Daley, Gaza, and Pistole defined groups as psychologically interdependent and interactive individuals joined in a common goal.

Groups may come together for remedy, prevention or enrichment through guidance, therapy or psychotherapy. Following are some of the most common group classifications by task:

 Problem solving groups – Although these groups deal with problems that could probably have been solved through individual effort, the group adds diverse resources, error safeguards and motivation.

 Education groups – Exemplified by study groups and designed to advance learning, education groups should have demographically similar members with different ability levels according to Shaw.

 Experimental groups – These include T-groups as well as therapy, encounter, personal growth and sensitivity-training groups. Since the idea is that simply being part of the group will be good for its members, screening is almost always recommended.

TYPES OF THERAPEUTIC GROUPS

Categorized by Corey and Corey as T-groups, therapeutic groups include encounter, awareness, self-help and leaderless groups as well as consciousness raising, sensitivity training, and personal growth groups.

 T-groups – Emphasizing feedback, problem solving and decision making, T-groups aim to improve organizational relationship skills by focusing on the group process.

 Personal growth and encounter groups – Typically meeting for a set time, these groups encourage risk taking for personal growth and development.

Therapy and counseling groups - Using unconscious needs and past experiences to prompt positive change is the purpose of group therapy. Not just for those with specific problems, group therapy appeals to well-adjusted folks who seek self-improvement. Nevertheless, since counseling groups may address neurotic (and in some settings, psychotic) disorders, group leaders typically hold advanced degrees in therapy, psychology, social work or psychiatry. Dealing primarily with personal, career, educational or other conscious problems, group therapy requires skilled, but less advanced, training. Group therapy is not long term; resolutions are expected to come in a relatively short time. Basic types of groups can be divided into:

 Natural – These are groups that develop on their own, including families, peers, friends and gangs.

 Formed – External factors give rise to these groups that are formed for a specific purpose.

 Treatment – Roles in these groups develop as group members interrelate, so communication is relatively casual and open-ended.

 Task – With roles often assigned, task group communication tends to reflect the designated task.

 Personal correction – Personal correction groups include psychotherapy, therapy, employee, relief and mutual help groups.

 Personal enhancement – Types of personal enhancement groups include personal and team development, life transition and T-groups. Gaza recognizes three types of groups:

 Guidance – Primarily for prevention of problems facing high-risk populations, guidance groups focus on improvement of life skills and overall direction of members.

 Counseling – For secondary prevention and/or correction, these groups include encounter, sensitivity and organizational development groups.

 Psychotherapy – Psychotherapy groups are tertiary prevention groups with the purpose of re-educating, rehabilitating and generally bringing members to healthy function.

Advantages of Groups

Ø  It provides a social atmosphere that is similar to the real world.

Ø  Members can test out and practice new behaviors.

Ø  Members can practice new interpersonal skills.

Ø  They are cost effective.

Ø  Groups help members see that they are not the only one who has that particular problem or issue.

Ø  Groups provide members with support.

Disadvantages of Groups

-          Less individualized attention from the counselor.

-          Confidentiality is more difficult to maintain.

-          There are concerns with conformity and peer pressure.

-          Not everyone can be in a group (e.g. those with issues too severe or those with poor interpersonal skills.)

-          Scapegoating may occur.

-          Group leaders are not always properly trained.

Stages of Groups

1.       Stage One (Orientation/Forming):  Group members become oriented to the group and to each other.

2.       Stage Two (Transition/Storming):  Anxiety and ambiguity become prevalent as group members struggle to define themselves and group norms.  This stage is often characterized by conflict.

3.       Stage Three (Cohesiveness/Norming): A therapeutic alliance forms between group members.  Trust between members has been established.

4.       Stage Four (Working/Performing):  Group members experiment with new ideas, behaviors or ways of thinking.  Egalitarianism develops.

5.       Stage Five (Adjourning/Terminating):  This is the time when the group disbands.

Group Counseling vs. Individual Counseling By Sarah Koszyk, MA RD

Questions always arise as to whether or not one should counsel in a group setting or in an individual setting. Before you decide which route to go, here are some questions to ask yourself and some pros and cons to each form of nutrition counseling.
Questions to Ask:

• Do I have space that can accommodate 5 or more people?
• Have any of my individual clients ever asked if I have forums or do group sessions?
• Do some of my clients need individualized care?

Pros to Group Counseling:

• Increase practitioners revenue by assisting the masses in one setting therefore optimizing counseling time, efficiency, and resources
• Clients get additional support, feedback, and advice from one another
• Clients save money since group sessions are generally cheaper than individual sessions
• Hearing other people’s challenges/struggles can sometimes reduce one’s personal stress on his/her own struggles and provide an alternate perception
• Improved social skills by having people interact with others in a safe setting

Cons to Group Counseling:

• Clients who are shy many not speak up during group sessions to express their challenges/struggles so these can go unattended
• Clients who may need more attention for additional needs, which are not discussed in the group session, can get lost in the crowd and overlooked
• Some people do not work well in group settings and prefer one-on-one counseling only
• Not all topics/subjects discussed will be pertinent to everyone in the group
• Group sessions have a non-flexible set time and date

Pros to Individual Counseling:

• Full attention is provided to the client which optimizes one-on-one care and tackles specific needs and circumstances by delving deeper into one’s challenges
• Scheduling is more flexible in regards to when each session meets, how long, and how often (i.e. once a week, every 2 weeks, once a month, etc)
• With individual counseling, clients do not have to worry about clashing personalities with other clients in a group setting. The only two people involved are the client and the practitioner
• More time is available for clients who need additional sessions to accommodate their needs versus in a group setting, a set number of sessions/classes are held. If the client needs more sessions at the end of the scheduled group sessions, the client and practitioner need to figure something else out
• Non-threatening environment and can feel “safe” for people who are shy about their situation

Cons to Individual Counseling:

• Cost is higher for individual sessions and may not be an option due to finances, even if the individual sessions are preferred
• Additional advice or ideas may not be expressed from just the practitioner which could lead the individual to have less options available
• Some topics can be missed if the client is not willing to share a specific area of need for improvement
• The practitioner has a limited amount of clients he/she can attend to due to the fact that only one client can be seen at a time
• Not as time efficient or cost effective for the practitioner if clients reschedule or skip appointments

Reference: http://www.nutritionjobs.com/blog/resources/group-counseling-vs-individual-counseling/#sthash.meQ2GArv.dpuf

Theoretically Oriented Group Counseling

—  Adlerian

—  Reality Therapy

—  Behavioral

—  Rational emotive behavior

—  Transactional analysis

—  Gestalt therapy

Theory used in Group Counseling:Adlerian

—  Focus on person’s history to understand how individuals have created their lifestyle

¡  Delves into the  early childhood to work forward.

—  Individuals are seen as social beings who do best in groups

—  Groups work together on cooperative tasks to make improvements in their lives.

Theory used in Group Counseling: Reality Therapy

—  Focuses on the ideas of belonging, power, freedom, and fun.

—  Group is microcosm of real world.  By acting in the group in a changed manner, change will generalize.

—  Members provide feedback to each other about behavior and plans for change.

Theory used in Group Counseling: Behavioral Counseling

—  Members help each other by providing feedback or reinforcement to change maladaptive behaviors

—  Directive leader who provides instruction for the training and helps establish any behavioral modification plans.

—  Use techniques such as: training, positive reinforcement, extinction, desensitization, and modeling.

Theory used in Group Counseling: REBT

—  Members recognize and confront irrational thoughts, and use feedback to learn new social skills

—  Leaders are role models for responsible, reality-oriented behavior.

—  Helps students understand moods and solve problems.

Theory used in Group Counseling: Transactional Analysis (TA)

—  TA therapists prefer to use this theory in groups

—  Used in groups that simulate life’s interactions by having the participates simulate a previous or real world event.

—  The group members then analyze the interaction between the individuals represented and generate reasons why it happened the way it did and how it could’ve been improved.

—  Great for social skills training.

Theory used in Group Counseling: Gestalt

—  Focus on one volunteer client in a group at a time

—  Does not explore the past, instead it focuses on the “here and now.”

—  The leader must plan structured interactions to be successful.

—  Example: Hot seat technique

Group Leadership Skills (Association for Specialists in Group Work)

—  Encourage the participation of group members.

—  Observe and identify group process events.

—  Pay attention to and acknowledge the behavior of group members.

—  Clarify and summarize statements.

—  Begin and end group sessions.

—  Give information when needed.

—  Model effective behavior.

—  Engage in appropriate self-disclosure.

—  Receive and deliver feedback.

—  Ask open-ended questions.

—  Empathize with members.

—  Confront group members’ behavior.

—  Help members recognize the meaning of an experience.

—  Help group members integrate and apply what they learn.

—  Demonstrate ethical and professional standards.

—  Keep the group focused on accomplishing its goals.

Leader Characteristics (Corey)

—  Presence – genuine care in “being there” for clients

—  Personal power – self confidence and awareness of one’s power

—  Courage – ability to take risks and be vulnerable

—  Willingness to confront oneself – being honest and self aware

—  Sincerity and authenticity – sincere interest in the well-being of others and behaving without pretense

—  Sense of identity – knowing one’s values, strengths, and limitations

—  Belief and enthusiasm for the group process

—  Inventiveness and creativity – open to new ideas and experience

Group Focus

Remedial

—  Study skills

—  Listening skills

—  Overcoming test anxiety

Support

—  Personal problems

—  Parental divorce

—  Bad habits

—  New school

Preventative

—  Problem-solving

—  Anger management

—  Handling stress

                        Greenberg (2003)

Developmental

—  Personal identity

—  Relationships

—  Emotional and behavioral development

—  Academic achievement

—  Career planning

                                    Bergin (2004)

Problem-centered (here and now)

—  Relationships

—  Conflicts with authority figures, peer groups

—  Dating

—  Sexual matters

—  Balancing commitments

Topic specific

—  Grief and loss

—  Divorce and separation

—  Suicide

—  Teen parenting

Starting a Group

—  Selecting group members

ü  Heterogeneous/Homogenous

ü  Appropriateness of group due to behavior

ü  Gender balance

—  Recruiting a Group

ü  Screening interview

ü  Size of a group

ü  Group setting

Group Crisis Intervention (James and Gilliland )

—  Define the problem.

—  Ensure the client’s physical and psychological safety.

—  Provide support through verbal and nonverbal means.

—  Examine alternatives.

—  Make plans – definite action steps.

—  Obtain client’s commitment to take positive action.

Counselor Responsibilities

—  Evaluate severity of crisis in client’s perception.

—  Appraise the client’s thinking, feelings, and behaviors.

—  Determine the danger and length of time in the crisis mode.

—  Look for contributing factors.

—  Evaluate resources.

INTERVENTION PHASES

—  Introductory phase

—  Fact phase

—  Feeling phase

—  Symptoms phase

—  Teaching phase

—  Summary phase

Introductory Phase

—  Ask members to introduce themselves and tell why they are in the group.

—  Help members clarify their goals regarding what they would like to accomplish in the meeting.

—  Discuss confidentiality – what group members talk about stays in the group. Get a commitment from all members to maintain confidentiality.

Discuss basic rules:

1. Take a bathroom break first because no one can leave the room after the group begins.
2. Encourage group members to stay the entire time. The group generally runs 2 hours; the time depends on the ages of the children.
3. Elect or appoint a co-leader or a peer leader to keep the gate (that is, not let people in or out).
4. Remind the group that no group member holds rank over any other group member and that everyone’s participation is valued equally.

Fact Phase

—  Focus on discussing what happened.

—  Encourage everyone to participate.

Feeling Phase

—  Ask, “What happened then?”

—  Ask, “What are you experiencing now?”

Clients’ Symptoms

—  Ask, “How is this affecting you?” (Is the member having trouble sleeping, studying, or is the member worrying too much?).

—  Ask, “How is this affecting your grades, your studies, your health?”

Teaching Phase

—  Explore the common responses to this incident.

—  Brainstorm about how people have been responding to the incident.

—  Discuss how each response is helpful or not helpful to people.

Summary Phase

—  Raise questions and provide answers.

—  Summarize what has been learned and shared.

—  Develop action plans for individuals and/or the group, if needed.

—  Provide support for group members to ensure their physical, emotional, and psychological safety. An action plan should be made to protect any group member needing protection.

—  Conduct a follow-up meeting in 3 to 5 days to see how well the group members are coping.

—  Arrange individual counseling sessions for group members who need further assistance.