Running Effective Groups

1
Running Effective Groups With Children
Adolescents
2
A Primer on Group TherapyYaloms Therapeutic
Factors

• Installation of Hope
• Patients belief in the efficacy of the group
  mode
• Things will improve during course of therapy
• Universality
• Disconfirm patients feelings of uniqueness
• See commonalities in each other, relief

3
Yaloms Therapeutic Factors

• Imparting Information
• Didactic instruction
• Direct advice
• Examine misconceptions
• Altruism
• Learning to give of ones self
• Seeing the benefit in doing so

4
Yaloms Therapeutic Factors

• Imparting Information
• Didactic instruction
• Direct advice
• Examine misconceptions
• Altruism
• Learning to give of ones self
• Seeing the benefit in doing so

5
Yaloms Therapeutic Factors

• Corrective recapitulation of primary family group
• Correctly resolve early family conflicts
• Group symbolically resembles original family
• Development of socializing techniques
• Basic social skills
• Both direct (role play) and indirect (feedback)

6
Yaloms Therapeutic Factors

• Imitative behavior
• Group members imitate behavior of other members
  and therapist (vicarious-spectator)
• Helps patients try new behaviors
• Interpersonal learning
• Diminish parataxic distortions
• Form rewarding relationships

7
Yaloms Therapeutic Factors

• Group cohesiveness
• Increases tolerance of disagreement
• Facilitates feedback and disclosure
• Catharsis
• Strong emotional component
• Cognitive component promotes change (necessary)
• Existential factors
• Face ultimate concerns of existence death,
  isolation, freedom, and meaninglessness

8
Co-Therapist Model

• Advantages
• Reduce chance of burnout
• Shared attention, greater observational range
• Infrequent cancellation due to illness
• Explore reactions together
• Sensitivity to countertransference
• Split roles provocative v. nurturing
• Help maintain objectivity

9
Co-Leadership Model (cont)

• Disadvantages
• Lack of synchronization
• Competition and rivalry
• Lack of trust in others competence
• Different theoretical orientation
• Openly siding with members against leader

10
Working with Children and Adolescents

• Legal considerations
• Clarify what you can and cannot keep confidential
• Be aware of your legal responsibility to report
  abuse or suspected abuse of minors
• Secure written consent of parents or guardians

11
Practical Considerations

• Frequency and Duration
• With children and adolescents it may be better to
  meet more frequently and for a shorter period of
  time to suit their attention span.
• If meeting in a school setting, meeting times
  should correspond to regularly scheduled class
  periods (if possible)
• Group Size
• elementary school children 3-4 people
• adolescents 6-8 people
• Setting
• Will the site provide privacy?
• Will there be enough room for all students?

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Practical Considerations (cont)

• Communicate expectations
• Set rules and follow through with firmness
• Preparation
• Avoid insisting on covering your agenda
• Parental involvement
• Meet with or write to parents about the group, if
  appropriate

13
Screening Process

• Define the following areas
• Population (age, gender, etc.)
• Frequency and Duration
• Length
• Size
• Open v. Closed
• Who will be present?
• What information do you want to collect?
• What information do you want to impart?

14
Working with Children and Adolescents

• Strategies in the Group
• Self-Disclosure
• Direct child to express how affected by incident
  rather than allow them to reveal everything about
  it
• Emphasize confidentiality
• Use language that is developmentally tailored to
  convey importance of privacy
• Encourage parents to avoid asking questions that
  could lead to breach

15
Working with Children and Adolescents

• Strategies in the Group (cont)
• Maintain neutrality
• Avoid siding with children or adolescents against
  their parents or a particular institution
• Use appropriate exercises and techniques
• Even though their unwillingness to participate
  may stem from a lack of understanding, children
  and adolescents have the same rights to not
  participate in exercises they see as inappropriate

16
Working with Children and Adolescents

• Strategies in the Group (cont)
• Listen and remain open
• Encourage young people to express themselves in
  their own words
• Be aware of preconceived labels and diagnoses
  that subtly influence your interactions
• Prepare for termination
• Let children know that the termination point is
  not far off well before your group ends
• This enables children to express their sadness
  (or other feelings related to termination)

17
Working with Reluctant Adolescents

• Explain the rationale of the group in jargon-free
  language
• Allow members to express reactions to being sent
  to a group
• Go with resistance Dont go against resistance
• Avoid getting defensive
• Be clear and firm with your boundaries
  
  
  
  

18
Key Points Child Groups

• Get the support of administrators
• Communicate the importance of confidentiality in
  their language
• Not all children are ready for group therapy
• Some structure is important
• Think about methods for evaluating outcomes

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Key Points Adolescent Groups

• Understand and respect resistance
• Role-playing techniques can often be creatively
  used in adolescent groups
• Find ways to involve parents
• Co-leadership models are especially useful in
  facilitating an adolescent group