Leading Psychoeducational Groups for Children and Adolescents

Janice L. DeLucia-Waack

• Publisher: SAGE Publications, Inc
• Year: 2006
• ISBN:
  9781452237510
• Edition: 1
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

This book provides readers with direction on how to organize psychoeducational groups while also helping them enhance skills for effectively leading such groups—all in one comprehensive volume! Offering an applied, pragmatic approach, author Janice L. DeLucia-Waack uniquely integrates research and practice to suggest valuable leadership strategies while addressing special issues such as children of divorce, anger management, bullying behaviors, and much more.

CHAPTER 1

Introduction

“EVERYBODY NEEDS A FRIEND”*

I don't know why bad things happen to good people like you
But I do know there's a way to work things through
I'm not your boss and I don't want to tell you what to do
But everybody needs a friend
You gotta find somebody to talk to
You're gonna need somebody to talk to
You gotta tell somebody what you've been through
Everybody needs a friend
Now a friend is someone who is there to try and understand
A friend could be a boy or girl, a woman or man
A friend is someone you can trust to lend a helping hand
And everybody needs a friend
You gotta find somebody to talk to
You're gonna need somebody to talk to
You gotta tell somebody what you've been through
Everybody needs a friend
Now some people feel funny ’bout when stuff goes on at home
And they're out there in the school yard feeling all alone
Time goes by and they just feel as lonely as a stone
Until the day they find a friend
You gotta find somebody to talk to
You're gonna need somebody to talk to
You gotta tell somebody what you've been through
Everybody needs a friend. (Conley, 1994)

______

*Reprinted with permission of D. Conley.

This song emphasizes some of the major themes and benefits of psycho-educational groups for children and adolescents. I often use the song as a stimulus to generate discussion in initial sessions about how groups can be useful. Group members quickly identify the themes:

• Everybody needs a friend.
• Friends support you.
• You can talk to a friend.
• Friends can be different.
• Everyone has stuff to talk about, especially related to school and home.
• It is good to talk about your problems.
• It is good to talk about your feelings.
• People get lonely if they do not have friends to talk to.

We then talk about how groups are a safe place for children and adolescents to connect, feel supported, and talk about their feelings and challenges.

Another lead-in to psychoeducational groups that I often use with adolescents is the movie The Breakfast Club. I ask group members as part of the introductory activities to reflect on the movie and talk about how each character acted out his or her poor self-esteem in a different way and what all of the characters learned about themselves as a result of being in that Saturday detention group. Typical answers often focus on how each character felt alone despite very different family situations and groups of friends; and how each experienced difficulty in different areas—sometimes personal, sometimes academic.

“Younger clients may benefit more from group treatment” (Fuhriman & Burlingame, 1990, p. 14). The intent, function, and delivery may be substantially different in group work than other therapy, and may benefit a populace with developmentally appropriate needs. As such, “groups can be especially helpful to adolescents in making a successful transition from childhood to adulthood. They can provide support, facilitate new learning, help ease internal and external pressures, and offer hope and models for change” (Gladding, 1995, p. 221). Techniques implemented in group are different from those in individual treatments, which may be particularly helpful in the instances of therapeutic work with a younger population.

There are many advantages to groups for adolescents: they are a natural way for adolescents to relate to each other, they emphasize the learning of life skills, they focus on generalizing behaviors practiced in the group to real-life situations, and they provide multiple feedback and increase self-esteem that comes about through helping others. (Shechtman, Bar-El, & Hadar, 1997, pp. 203–204)

Much has been written that suggests groups for children and adolescents are just as effective but also differ in style and content from groups for adults.

Psychoeducational counseling and psychotherapy groups are standard counseling practice in a variety of settings. The majority of research on groups with children and adolescents is conducted in schools (Prout & Prout, 1998; Riva & Haub, 2004). In addition, psychoeducational groups are the most commonly utilized groups in the schools, both for prevention and as a first intervention for students at risk (Vera & Reese, 2000). Psychoeducational interventions assist group members in sharing and developing coping skills and behaviors to deal with new or difficult situations. Such groups also address social competence deficits, adjustment to parent divorce, behavior problems, and learning disabilities (Dagley, Gazda, Eppinger, & Stewart, 1994; Hoag & Burlingame, 1997). Smead (2003) sums up nicely by saying

the child will participate in the interpersonal experience for the purpose of learning improved ways of functioning. Specifically, that the child will be exposed to new cognitive concepts, ideas, and explorations of her issues. Secondly, that more adaptive behaviors will be explored, discussed, and practiced for transfer to school and home. Third, that improved self-esteem, efficacy, and emotional satisfaction will result from learning from the healing interactions of the group experience. (p. 11)

Current topics for psychoeducational groups include the following:

• Loneliness
• Body image
• Disordered eating
• Career development
• Career exploration
• Job skills
• Interviewing skills
• Conflict resolution
• ADHD/ADD
• Bullying prevention
• Shyness
• Relationship skills
• Communication skills
• Friendship skills
• Middle school transition issues
• Cultural differences
• Family relationships
• Cognitive coping skills
• Self-esteem
• Making friends
• Social skills
• Children of parents who have cancer
• Children of divorce
• Grief
• Teen pregnancy/parenting skills
• Parenting skills
• Anger management
• Aggression
• New students
• Prevention of depression
• Depression management
• Antisocial behavior
• Defiance
• Self-harm/suicide prevention
• Substance abuse

There are more reasons than just cost-effectiveness to use groups as both preventive and remedial strategies for children and adolescents. Depression for many people, and particularly for adolescents, is often related to a lack of social skills or cognitive strategies that result in not having friends or having relationship difficulties, feeling isolated and alone or different, and having unrealistic expectations and beliefs about oneself. Group therapeutic factors, such as universality, altruism, vicarious learning, and interpersonal learning, operate to help group members develop better relationship skills; develop adaptive thought patterns; and normalize feelings, thoughts, and events. If a lack of social skills and/or unrealistic expectations about oneself are the predictors of depression in adolescents, then it makes sense to teach social skills and self-assessment strategies that help students develop a more balanced and realistic self-concept in an effort to prevent depression, poor self-esteem, and relationship difficulties.

Carrell (2000), writing from her work with a more remedial population, has some valid points about why groups are effective with children and adolescents:

1. Groups challenge the myth of uniqueness by emphasizing shared emotions and experiences.
2. Groups provide adult leadership that adolescents want but with avenues to assert power and independence.
3. Groups reduce the discomfort of adult-child dynamics that occur in individual counseling, particularly with adolescents with bad experiences with adults.
4. Groups confront adolescent self-absorption because in groups members need to take turns talking and helping each other.
5. Groups may be the first place that an adolescent truly experiences peer acceptance. (pp. 14–15)

All of Carrell's (2000) points are certainly applicable to psychoeducational groups, emphasizing support, learning of new skills, and how to help and be helped.

Very little has been written in the field of group work specifically about psychoeducational groups for children and adolescents. The topic is much more likely to be covered as a chapter in a group text, rather than in an entire volume. Often, the focus of these chapters is on the content and structure of these groups, rather than on how to design effective groups or what leadership skills are needed to lead such groups effectively. Most of the current literature on psychoeducational groups has been focused on choosing goals and activities with little emphasis on the other areas, such as processing of these activities to apply what has been learned. This book has been written to address that need and provides specific suggestions on how to both structure and lead psychoeducational groups for children and adolescents in both schools and community agencies.

Goals of This Book

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My reasons for writing this book are both theoretical and pragmatic. First, theoretically, a great deal of literature suggests that the focus, pace, content, and leadership style must vary by age of the group participants. What little has been written specifically about psychoeducational groups does not differentiate based on age of group members, even though much theory and research has supported a clear differentiation in goals, interventions, and leadership style by age. Groups with children and adolescents need interventions to help group members discuss their feelings, connect with others, and identify potential solutions for their concerns (Smead, 1995). Children and adolescents often respond better to nonverbal techniques than “talk therapy” exercises because of their limited vocabularies and their disposition to display feelings through play (Gladding, 1998). Creativity in activities and exercises is helpful. Drawing, singing, dancing, using puppets, role-playing, and play writing are all ways to identify and express feelings and to brainstorm and practice new behaviors and coping skills. This book will suggest specific interventions that cultivate interest and participation on the part of children and adolescents, and also meet the goals of teaching new skills and adaptive behaviors. Theoretically, there is some support for the application of therapeutic factors to groups for children and adolescents. According to Fuhriman and Burlingame (1990), common process dimensions in groups are the therapeutic relationship, therapeutic interventions, and therapeutic factors. All three of these topics will be a focus of this book.

The structure and length of groups for children and adolescents is also very different from that for adult groups. Psychoeducational groups tend to be briefer in terms of number of sessions and session length, but also more structured, with activities designed to facilitate discussion of a topic and/or development of new skills and behaviors. Thus, interventions for groups that may meet no more than 6 to 8 sessions and for brief amounts of time, sometimes only 35 minutes, will be suggested.

Pragmatically, counseling, psychology, and social work practitioners typically have received training in adult counseling and therapy groups, which tend to be of longer duration and smaller in size than psychoeducational groups. Thus, information and training are needed to adjust the goals, structure, time frame, and interventions used in a psychoeducational group. Furthermore, the techniques, interventions, and leadership behaviors that are needed for children and adolescent groups need to be differentiated from those needed for adult groups.

I am probably a good example of the incongruence between how I was trained and what seems to work best in psychoeducational groups. My group training taught me to appreciate and use the process and interactions in groups. However, as anyone who has led a group for children and adolescents knows, if you begin the group by asking “What should we talk about today?” the answers could range from the movie they saw Saturday night to Pokémon to the meanest teachers in the school. Thus, I learned the importance of balancing structure with content and the importance of directing, but not controlling, the direction and process of the group. Process is important and needs to be attended to in all groups; however, psychoeducational groups use skill development (cognitive, affective, and behavioral) as the content and focus of the group, whereas interactional patterns develop around the content and can be used when necessary to facilitate group goals. I hope that this book will be helpful to new counselors and psychologists in training as they learn how to lead psychoeducational groups, and also to established practitioners who want to more effectively lead psychoeducational groups for children and adolescents.

The biggest mistake that leaders make is trying to run a psychoeducational group like a counseling or therapy group, or a counseling group like a psychoeducational group. If people expect content and techniques (e.g., how to study more effectively), then they will be frustrated by the lack of structure and the probing of a counseling group style. If they are expecting time to share and discuss and analyze relationships, and they get activities and exercises, they will be frustrated.

The goal of this book is to provide a single resource that provides comprehensive directions about how to organize and lead psychoeducational groups based on the Association for Specialists in Group Work's (1998) Best Practice Guidelines for planning, performing, and group processing. Other books have either focused on how to lead counseling groups in general for children, or psychoeducational groups for all ages, but not specifically on psychoeducational groups for children and adolescents. Several books designed for groups with children and adolescents have suggested the content and specific activities to be used for different kinds of groups (e. g., children of divorce, grief, communication skills), but have not addressed specific leadership skills.

The Best Practice Guidelines (ASGW, 1998) address planning, performing, and processing groups. Planning focuses on pregroup decision making, and selection and preparation of both members and leaders. Performing focuses on group leadership skills, provision of effective interventions, and assessment of effectiveness. Processing focuses on using interventions to help members learn and evaluate group interventions to assess effectiveness, supervision, and follow-up with group members. This book will address these areas with specific suggestions about how to organize groups as well as suggestions about content using the model of Planning, Performing, and Processing.

How This Book Is Organized

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My approach to this book is very applied and pragmatic. Based on a review of current research, theory, and practice on groups, specific strategies to lead psychoeducational groups in general will be outlined, and suggestions will be made about the content for specific topical groups (e.g., children of divorce, grief, anger management, bullying behaviors, etc.). The uniqueness of this book lies in the integration of research and practice to suggest effective leadership strategies.

Some people might ask why the combination of research and practice. My answer would be that research informs practice, and practice informs research. Yes, all counselors and psychologists know that mantra from their graduate training; thus, they conscientiously read every page of every research journal to which they subscribe (and of course, they subscribe to all in their counseling practice area) the day they receive it in the mail. So, let me tell you my story, the one that I tell my students during the first day of class every year. Remember, this comes from the person who has taught at least one group course a year since I began my academic career (sometimes as many as four) and whose major area of research is what makes groups effective.

Our counseling program had decided to add a new practicum and internship site, a family support center working with students and their families at an alternative middle and high school. It was a brand-new facility fully equipped with two-way mirrors, the ability to call into the counseling rooms, and the ability to be fully videotaped. I volunteered to be part of the first team of counselors, both observing behind the two-way mirror and perhaps serving as a co-therapist for a family or two. When the school counselors and a supervisor heard that I would participate, they asked me to lead an anger management group for ninth-grade boys. I agreed, and 2 weeks later, I was standing in the outer room of the principal's office waiting to escort the 8 ninth-grade boys (who had been selected by the school counselor) to the family support center. The principal announced over the loudspeaker, “Would the following boys report to the office to go to their anger management group?” Remarkably, all of them arrived within 5 minutes, but all were muttering that they did not belong in this group. Then, the principal, in front of me, the boys, and everyone else present in the office, went around the room and told each boy what he had done to merit being in this group. Each of the boys had exhibited some violent behavior in the school, ranging from kicking in a door to punching a fellow student.

Luckily, my co-leader, who was a counseling intern in the school and knew most of the boys, arrived to help me escort our newly formed group to our room. Needless to say, the boys spent most of the first two sessions compl...

Table of contents

• Cover Page
• Dedication
• Title
• Copyright
• Contents
• 1. Introduction
• 2. Planning for a Psychoeducational Group for Children and Adolescents
• 3. Pregroup Interviews and Group Sessions
• 4. Group Leadership Skills for Psychoeducational Groups
• 5. Initial Sessions
• 6. Middle Sessions
• 7. Termination Sessions
• 8. Using Activities Effectively in Group Sessions
• 9. Follow-Up After Group Ends
• 10. Assessment of Group Effectiveness
• 11. Considerations
• 12. Conclusions
• Appendices
• References
• Index
• About the Author