Group Counseling

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Group Counseling

By Raymond T. Brock, Ed.D

I. Definitions -- A group is a collection of individuals who are interacting in such a manner that each person influences and is influenced by each other person.
A. Association -- two or more individuals

B. Interaction -- communicating with one another

C. Influence -- affecting and being affected by one another
II. Purpose
A. Group counseling offers an approach to healing within the community that takes into account the communal aspects of human nature.
B. Group counseling focuses on a specific type of problem -- personal, educational, spiritual, social, or vocational
C. The counseling group deals with conscious issues and is not aimed at major personality reconstruction.
1. Group counseling is generally oriented toward resolving specific problems in a short-term intervention
2. Group therapy, on the other hand, is designed to resolve specific emotional/behavior disorders in an effort to transform or reconstruct personality structure

III. The group facilitator

A. Role of the counselor -- primarily facilitative
1. The climate of group counseling is produced by the counselor's personality as a potent agent for change.
2. The counselor exerts personal influence as a potent agent for change.
3. The counselor exerts personal influence that taps such variables as empathy, warmth, and respect.
B. Responsibilities of the counselor
1. Assists in identifying counterproductive behaviors

2. Moves the group toward self-understanding through the process of uncovering psychological "payoffs" for self-defeating behaviors

3. Encourage group members to experiment with healthier and more productive responses and behaviors
4. Provides the group with feedback opportunities to assist the individuals in reality-testing as they incorporate new behaviors into their world
5. Techniques of the facilitator
a. Reflection -- mirroring the verbal and nonverbal messages of a group member

b. Clarification -- interpreting Issues or feelings

c. Confrontation -- bringing a group member to face avoidant and self-defeating behaviors that interfere with recovery

d. Role-playing -- inviting members of the group to adopt roles and playing out an intervention for analysis; role playing is an effective way to practice new skills in interpersonal situations while deciding how these skills and perspectives can be transferred to out-of-group situations

IV. Mechanics of group counseling
A. Group Information
1. Each counselee approaches the group initially in a way unique to him
2. The counselee uses his typical adaptive abilities, defense mechanisms and ways of relating but a process inherent in group formation requires that the counselee suspend his previous ways of coping and allow his consciousness to be taken over to some degree by the collective assessment provided by the total membership including the leader
3. To do this at all, the counselee must have developed a sense of basic trust, and must feel that he is able to rely on the outer providers represented by the group as a whole
B. Group process
1. Reality testing -- thoughts and feelings are examined by the leader and the membership
2. Transference -- feelings are transferential when they are irrational and not consonant with reality
a. Stimulation of transference -- feelings that may have been repressed or suppressed can emerge
b. Multiple transferences -- a variety of group members may stand for the people significant in a particular counselee's past or current life situation; role-playing is an appropriate technique in this regard
c. Transference neurosis -- when a counselee's transferential attachment to the counselor or, in group therapy, to another counselee becomes excessively strong - a transference neurosis is said to exist; the counselor should not allow one or several counselees to attack him in a group but should insist that negative transference be discussed in individual sessions
3. Identification -- the counselor must be a suitable model
4. Universalization -- in the group, the counselee recognizes that he is not alone in having an emotional problem; the simple sharing of experiences regardless of whether or not they are labeled pathological is an important human need
5. Cohesion -- "we-ness" or sense of belonging; counselees learn to work together and take responsibility for one another and are willing to endure a certain degree of frustration to maintain the group's integrity -- cohesion is the single most important factor in group counseling
6. Group pressure -- every group member is susceptible to group pressure to alter his behavior, thinking, or feeling
7. Intellectualization -- a cognitive awareness of oneself, others, and the various life experiences, both good and bad, that account for current functioning; interpretation, a derivative of intellectualization, also provides the counselee with a cognitive framework within which he can understand himself better
8. Ventilation and catharsis - it is important that the leader be flexible in allowing the ventilatory and cathartic processes to emerge in the group
9. Abreaction -- abreaction (removal of a complex or repressed desire) brings about an awareness, often for the first time, of degrees of emotion previously blocked from consciousness - a highly therapeutic experience
V. Stages in group counseling
A. Pregroup issues
1. Establish the purpose and goals of the group

2. Identify the intended population to be served

3. Develop plans to promote the group and to select group members
4. Conduct pregroup individual interviews and screening to determine suitability for group membership
5. Establish the size of the group, its duration, and the frequency and time of group meetings
a. Size –3, 10, or 15 members, but 8 to 10 preferable

b. Frequency of sessions -- once a week

c. Length of session -- 1 to 2 hours, average 1 ½ hours

d. Composition -- heterogeneous groups ensure maximum interaction; at times homogeneous groups are appropriate

6. State a theoretically determined group structure and format (e.g., open vs. closed group membership, voluntary vs. involuntary attendance)
7. Organize plans for follow-up and group evaluation procedures
B. Orientation stage
1. Develop trust and identity for each member within the group

2. Establish ground rules and norms

3. Model the facilitative dimensions of a therapeutic group

4. Assist members to develop general group goals and more specific and meaningful individual goals

5. Display essential therapeutic characteristics:
a. Psychologically present -- paying total attention to the issues of the group and being sensitive to the verbal and nonverbal messages (body posture, gestures, voice quality, etc.) as well as being able to identify underlying messages
b. Genuine -- being congruent, not resorting to various roles to maintain artificial distance, and being willing to participate, self-evaluate, and self-disclose along with the other group members
c. Empathetic -- being able to understand deeply and subjectively the internal world of another's struggles and feelings; reliving and experiencing another's world as if it were one's own
d. Unconditional positive regard -- communicating a caring that is unconditional, nonjudgmental, and not contaminated by evaluation
e. Belief in group process -- believing in the effectiveness of group techniques as a treatment approach
6. Educate members regarding their responsibility for the direction, outcomes, and personal change within the group
7. Work toward decreasing leader dependency on the part of the members
C. Transition stage -- group members test the leader, each other, and even themselves before moving to the working stage
1. Increased member anxiety, defensiveness, and resistance which gives way to deeper levels of self-disclosure and trust (if handled appropriately)
2. Heightened conflict and power struggles among the group members, serving as a testing ground for the establishment of freedom and trustworthiness within the group
3. Conflicts and challenges directed toward the group leader that promote individual autonomy and peer leader unity; if the group is led through this stage properly the members become more autonomous, thus achieving a peer-leader unity and higher level of development
D. Working stage -- the fulcrum of this stage is the members' sense of belonging, inclusion, and solidarity – in essence, the effects of group cohesion
1. Empathy -- a deep, subjective understanding of another's inner struggles and feelings
2. Intimacy -- genuine intimacy develops in a group after the members have revealed a part of themselves with which others can identify
3. Commitment to change -- one must believe that change is possible but it requires each member to:
a. Identify areas of their lives they would like to reconstruct

b. Formulate a plan of action

c. Commit themselves to the plan

d. Use the tools offered by the group process to explore methods of implementation

4. Self-disclosure -- members risk disclosing personal, often threatening issues; self-disclosure is not an end in itself, but a means to open communication, empathy, and intimacy within the group
5. Confrontation -- meaningful confrontation occurs when a member shares his or her perception (not judgment) with a fellow member in a caring and sensitive manner
6. Freedom to experiment -- the group is now a safe place in which to explore new approaches and restructured thoughts
E. Consolidation stage -- allows members to do the cognitive work needed to transfer the group experience, with its restructured behavioral changes, into the real world
1. Phase of the group process most ineptly handled by group facilitators because of:
a. Leader's need for reassurance from group members

b. Resistance to termination by group members

c. Lack of training and inexperience of group leader

d. Isolation of group members in order to deal with separation anxiety

2. Preparing for termination
a. Remind members some weeks before the scheduled termination of a group that only a few sessions remain
b. Acknowledge special attributes of the group
(1) Note the choice to commit, trust, work together and accomplish personal goals in the group interaction
(2) Illustrate how they can make similar choices and commitments and set new goals in relationships outside the group
c. Allow time to deal with the various ways in which members might go further with the issues they have dealt with in the group (additional therapeutic options for personal growth)
VI. Therapeutic considerations
A. Go-round -- the counselor asks each member of the group to respond in turn to a specific thought, feeling, behavioral pattern, topic, or theme introduced by another counselee or by the counselor himself -- each member must participate and no one is allowed to withdraw
B. Co-therapy -- each counselor becomes actively involved so neither is in a position of greater authority or dominance
C. New member -- It is essential that the group leader discuss the introduction of a new member prior to his arrival and that the counselor help the group resolve any conflicts about the addition of a new member
D. Acting out -- A counselee may attempt to avoid tension through activity, usually sexual or aggressive, that gratifies an impulse but provides no lasting solution to the conflict and contributes to the counselee's inability to delay gratification and tolerate frustration -- sexual acting out is devisive to the group
E. Electronic recordings -- audiotape and videotape are useful for counselee and counselor review and for supervision and case conferences but permission must be obtained before recordings are made
F. Termination -- the termination of the counselee from the group implies that goals have been achieved; this may cause turmoil and upheaval as well as feelings of rejection or abandonment or be experienced as grief by some of the remaining members
G. Short-term group psychotherapy --2 or 3 to 50 sessions
VII. Combined individual and group counseling -- the counselee is seen individually by the counselor and also takes part in group sessions on a regular basis conducted by the same counselor
A. Dyadic setting -- the dyadic relationship gives the counselor an in-depth understanding of the counselee as he delves into the meaning and implication of behavior; the group experiences tend to emphasize the here-and-now responses
B. Group setting -- counselees identify with one another through their common identification with the leader
C. Therapeutic process -- group sessions focus on the various defenses used by the counselee whereas the individual sessions examine the underlying psychic conflict against which the defense was erected in the first place
1. Resistance -- counselees confront each other with interpretations of resistant behavior such as absences, lateness, withdrawal, and silences
2. Insight -- attained as the counselee undergoes changes in both conceptualization and behavior; the group gives the counselee opportunities to test and reinforce insights gained in individual sessions
D. Techniques
1. Focal group member -- the group focuses on one member at each session
2. Go-round -- each group member speaks about his personal feelings toward the counselee who is focused on or who is up for discussion


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