ms. suzy milano-berrios, director ms. isabel rodriguez-duncan, chairperson mental health and crisis...

Ms. Suzy Milano-Berrios, DirectorMs. Isabel Rodriguez-Duncan, Chairperson

Mental Health and Crisis Management Services

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Group counseling in the United States can be traced back to the late nineteenth and early twentieth centuries, when millions of immigrants moved to American shores.

Most of these immigrants settled in large cities, and organizations such as Hull House in Chicago were founded to assist them adjust to life in the United States. Known as settlement houses, these agencies helped immigrant groups lobby for better housing, working conditions, and recreational facilities.

These early social work groups valued group participation, the democratic process, and personal growth.

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Some early psychoanalysts, especially Alfred Adler, a student of Sigmund Freud, believed that many individual problems were social in origin. In the 1930s Adler encouraged his patients to meet in groups to provide mutual support.

At around the same time, social work groups began forming in mental hospitals, child guidance clinics, prisons, and public assistance agencies.

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Group counseling offers multiple relationships to assist an individual in growth and problem solving. In group counseling sessions, members are encouraged to discuss the issues that brought them into counseling openly and honestly. The facilitator works to create an atmosphere of trust and acceptance that encourages members to support one another.

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Unlike the simple two-person relationship found in individual counseling, group counseling offers multiple relationships to assist the individual in growth and problem solving.

Counseling groups exist to help individuals grow emotionally and solve personal problems. All utilize the power of the group, as well as the facilitator who leads it, in this process.

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Dr. Irvin D. Yalom, Psychiatrist, identified 11 "curative factors" that are the "primary agents of change" in group therapy.

1. Instillation of hope

2. Universality

3. Imparting of information

4. Altruism

5. Corrective Recapitulation of Primary Family

6. Improved Social Skills

7. Imitative Behavior

8. Interpersonal learning

9. Group Cohesiveness

10. Catharsis

11. Existential Factors

Conduct a needs assessment. Tell students about the group. One way to

do this is to mention the group(s) in classrooms.

Inform Administrators and Teachers Obtain Parent /Guardian consent. (Passive

Consent) Screen potential group members. Select group members. Use an evaluation procedure that will

demonstrate the effectiveness of the group.8

“I need to facilitate a group for my IPEGS Goal”

“If I facilitate a group, I can see more students at one time with the same problem.”

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Individuals that share a common problem or concern are often good candidates for group counseling, where they can share their mutual struggles and feelings.

In schools, groups for students who have or are currently experiencing their parents divorce, grief/loss, social skills deficiencies

Consider the age, grade level, gender,

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Children who are suicidal or who have a psychiatric diagnosis that indicates a need for therapy, or are in the midst of a major life crisis are not typically placed in group counseling until their behavior and emotional states have stabilized.

People with severe cognitive impairments may also be poor candidates for group counseling, as are patients with sociopathic traits, who show little ability to empathize with others.

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Siblings or relatives should not be in the same group.

Children who habitually lie or steal Children who are victims of abuse Children who are so different from the

others that they may not be accepted Children who are extremely aggressive

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Some students may participate in both individual counseling and group counseling

Before a student begins group counseling, the facilitator should interview them to ensure a good fit between their needs and the group's.

The student should be given preliminary information before sessions begin, such as guidelines and ground rules, and information about the problem on which the group is focused.

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Therapy groups may be homogeneous or heterogeneous.

Homogeneous groups have members with similar presenting issues (for example, they may all have parents who are divorced).

Heterogeneous groups contain a mix of individuals with different presenting issues

The number of group members typically ranges from five to 10.

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The number of group counseling sessions depends upon the group's makeup, goals, and setting.

Some are time limited, with a predetermined number of sessions known to all members at the beginning.

Others are indeterminate, and the group and/or counselor determines when the group is ready to disband.

Membership may be closed or open to new members. Plan for the group: one fun exercise and one structured

activity

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Groups for prevention may be strictly informational, concerned with providing information on subjects timely to adolescents such as peer pressure or decision-making.

Or, they may be designed to help students improve their coping skills though such techniques as problem-solving or the reframing of situations.

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OBJECTIVES Analyze how to make new friends Identify important qualities of a friend Understand common friendship

problems Learn how to manage conflicts Develop a plan to improve friendships

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OBJECTIVES Learn dangers of drugs and alcohol Understand and utilize the problem

solving model Learn refusal skills Identify ways to have fun and keep

friends while staying out of trouble Develop a plan to handle peer pressure19

Groups concerned with specific problems and their resolution.

Grief / Loss Parental Divorce / Separation Social Skills Anger (selectively) Attendance (selectively) LGBT Support (selectively) NOT Appropriate: Eating Disorders, Self

Injury, Bullying, and others that require the behavior for group membership

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OBJECTIVES Express feelings about loss Learn five stages of grief (denial,

anger, bargaining, depression, acceptance)

Discuss happy memories Identify ways to handle stress and

loss

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OBJECTIVES Express feelings about changing family Understand that divorce/separation is

not child’s fault Identify common problems associated

with divorce/separation Understand positive ways family and

group members can help in adjustment23

OBJECTIVES Identify factors that cause anger Understand the consequences of

irrational behavior when angry Examine why some situations make

everyone mad and others do not Identify different anger reduction

techniques

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OBJECTIVES Identify feelings and appropriately

express them Learn Win/Win resolutions Speak clearly Understand others point of view (be

empathic) Learn how to talk out conflicts

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Students are encouraged to discuss the issues that brought them into the group openly and honestly. Physical and Emotional Safety

The Counselor / Facilitator works to create an atmosphere of trust and acceptance that encourages members to support one another.

Ground rules must be set at the beginning, such as maintaining confidentiality of group discussions, showing respect for each other, taking turns talking, etc. (Students assist in creating rules)

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The Counselor facilitates the group process; the effective functioning of the group, and guides individuals in self-discovery.

Depending upon the group's goals, sessions may be either highly structured or fluid and relatively undirected.

Typically, the facilitator steers a middle course, providing direction when the group gets off track, yet letting members set their own agenda.

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The facilitator should guide the group by reinforcing the positive behaviors they engage in. For example, if one student shows empathy and supportive listening to another, the facilitator should compliment them and explain the value of that behavior to the group.

The facilitator should emphasize the commonalities among members during each session to instill a sense of group identity.

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Careful Planning Selection Group Composition Creation of GroupCareful Observation of Group Process Formative Stages Subgrouping Conflict Self-disclosure Termination Problem Behaviors

I. The Initial Stage: Orientation, Hesitant Participation,

Search for Meaning, Dependency

II. The Second Stage: Conflict, Dominance, Rebellion

III. The Third Stage: Development of Cohesion

IV. The Fourth Stage: Termination/Transparency

Fractionalization - splitting off of smaller units extra group socialization - cliques of 3-4; two become sexually involved; coalitions form within the group

Inevitable often disruptive event in life of group

If used properly may further work of group

‘conspiracy of silence’

Inevitable; absence suggests impairment of developmental sequence

Two step process includes:1) experience (affect expression);2) understanding of that experience

Can control conflict by having members switch from 1 to 2 - request group discuss their experience and understand it can learn to express anger more directly

Involves some risk on part of discloser As disclosure proceeds in a group, entire

membership gradually increase it’s involvement, responsibility and obligation to one another.

Facilitator must check-in with students individually to assess the value of group participation (difficulty communicating in a group setting, unable to handle aggressive / hostile comments from other members,

On-going assessment of group participation during the group

Recognize the role of each group member: leader,

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Groups terminate for various reasonsbrief therapy - preset termination dates Counselor’s role is to:

A. keep task in focus for membersB. remind group regularly of the

approaching terminationC. ensure focus on goal attainment prior to

terminationD. share own feelings about separation;

real loss for all

The termination of a group may cause feelings of grief, loss, abandonment, anger, or rejection in some members.

The facilitator should attempt to deal with these feelings and foster a sense of closure by encouraging the exploration of feelings and the use of newly acquired coping techniques for handling them.

Working through this termination phase is an important part of the process.

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