Conducting Effective and Productive Psychoeducational and Therapy Groups

A Guide for Beginning Group Leaders

Nina W. Brown

• Publisher: Routledge
• Year: 2018
• ISBN:
  9781315456959
• Edition: 1
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

Conducting Effective and Productive Psychoeducational and Therapy Groups offers a four-part structure designed to prepare future and beginning group leaders for the challenges that lie ahead: Getting Started, Encouraging Productivity, Troubleshooting/Problem Solving, and Closures. Along the way, readers will find practical, step-by-step instructions and guidance; activities to promote involvement, growth, and self-understanding; as well as processes and procedures to prevent and resolve difficult behaviors. Also included are 40+ activities, a typology of difficult member profiles, strategies to increase leader effectiveness, and a chapter on toxicity among groups as well as group members.

SECTION I
Getting Started

1
Introduction to Psychoeducational Groups, Professional Responsibilities, Beginning the Group, and Ethics

Introduction and Overview

Psychoeducational groups are a blend of cognitive components such as dissemination of information and of affective components such as expression of feelings, with each component having a role of equal importance. These groups have other characteristics that can be similar to those of other types of groups, such as the need for planning and screening of prospective group members and some that other groups have that psychoeducational groups do not, such as an emphasis on family-of-origin issues that characterize psychotherapy groups or a minimal focus on feelings and personal experiences that some task and educational groups have.

Psychoeducational groups are usually brief in that they have a specified number of sessions and/or life span; are usually organized around a commonly held issue, condition, or problem for all group members; the group goals are specific and limited; the past, family of origin, and other unfinished business are not central or critical to explore or to accomplish the goals for the particular group; and the membership is usually set, with no new members being added, although one or more members may leave the group. These groups are not task or cognitively focused as are skills-training and educational groups, but they have an equally important affective component, as do personal growth and psychotherapy groups.

It takes knowledge, training, a level of self-development, and an appreciation for the benefits and possibilities to be most effective as a psychoeducational group leader. This book is intended to provide guidance for leaders who are working to make their psychoeducational groups more effective and to elaborate on some topics that may have been minimally addressed in previous education and training experiences. In addition, there are procedures and activities that address some group-level problems and concerns, such as prolonged silence and socializing techniques, extending and enhancing members’ emotional expressions, and that teach new and more effective ways to behave, relate, and communicate. Also presented are problem-solving procedures and techniques for group-level and for member-level problems and concerns. Central to this presentation is that the developed group leader’s self is critical to be able to identify, understand, and respond most effectively to whatever emerges in the group, and presented are some strategies on how to develop and use the leader’s inner self and/or experiencing to capitalize on the group’s needs, wishes, desires, and processes.

Psychoeducational Groups

It may be helpful to review the characteristics that describe many psychoeducational groups to set a frame for the information that follows. Readers will want to remember that the information, strategies, techniques, and activities are intended to be applied to psychoeducational groups, although some may have applications to other types of groups. The characteristics that are presented are closed group membership; number of sessions; duration of the group; focus, goals, and issues addressed; screening, group placement, and orienting group members; minimal use of family-of-origin and other early life experiences; process and process commentary; and emotional and intellectual capacity of group members. These differences are important for planning and facilitating group sessions.

• Closed group membership: Psychoeducational groups are most usually closed in terms of group members, as they start with a specific set of group members, and although some may leave or terminate early, new group members are not added. The group stays intact, which is a considerable help in building trust and safety.
• Number of sessions: Psychoeducational groups usually have a specific number of group sessions that define the beginning and end for the group. These can range from one session to as many as 12 to 16 sessions. Sessions also generally occur at a set day and time, such as 10 a.m. on every Friday, for the predetermined duration of the group.
• Duration of the group: Psychoeducational groups are self-contained in that they meet for a specific number of sessions over a predetermined time period. The group ends for all group members at the same time, unless a member terminates prematurely.
• Focus, goals, and issues: Psychoeducational groups are generally more narrowly focused than are many psychotherapy groups. There is usually a commonly held condition, issue, or concern that group members have that comprises the focus for the group. The group goal is also focused and specific. Although the individual members’ goals may differ, the group goal is compiled from the purpose and individual members’ goals. Issues are the same and are not as complex as would be the focus for psychotherapy groups, some of which are focused on character change.
• Screening: Screening is desirable but may not be possible for some psychoeducational groups, such as those that are formed with mandated group members. Screening can help prevent accepting group members who are unsuitable for working in a group, who may be harmed, and who are likely to have a negative impact on the group. These are all concerns that leaders of psychoeducational groups may not be able to control and can result in some difficulties for the group.
• Orienting group members: Orienting new group members can be helpful to reduce some of the ambiguity and uncertainty surrounding the group and expectations of them, to explain how their personal goals fit with the purpose for the group, and to provide an opportunity for the leader to address fears and apprehensions. Orientation can take place prior to the initial group session, or if that is not possible, during the first group session. It is important that group members receive some instruction about this new situation.
• Minimal use of family-of-origin and early life experiences: While the antecedents for current issues, problems, and concerns have some aspects that can be rooted in the past, psychoeducational groups do not emphasize this, nor do they use much session time for this kind of exploration. If these early experiences emerge during sessions, they are accepted but not examined in depth or explored to the extent they would be in psychotherapy groups.
• Process and process commentary: Group process is always present and is a valuable source of information for the leader as to what the group is needing, is resisting, and is unable or unwilling to speak about openly. While there may not be sufficient time to teach members how to accept and use process commentary, group leaders should make use of process to understand the group as a whole and to intervene and respond and not dismiss it as not being a valuable resource for psychoeducational groups.
• Emotional and intellectual capacity of group members: Psychoeducational groups can address issues, problems, and concerns for a wide variety of target audiences. These audiences and potential members can have a wide range of both emotional and intellectual capacities, as psychoeducational groups are suitable for all types of age ranges, from children to the elderly.

All planning and implementation for these groups must have a core concern to care for the group members, which dictates that all proposed techniques, strategies, interventions, and activities be suitable for the capacities of group members. When screening is possible and done, the leader can gauge their capacities in advance. Otherwise, leaders can use some basic demographic and background information to make inferences for planning.

Group Planning: Structuring and Organizing a Group

Groups seem to run best when there has been some organizing and structuring of the group in advance. There are three primary concerns: the purpose and goal(s), the target audience, and structural concerns.

Information Gathering

Information gathering includes needs assessment, purpose for the group, the target audience, and research findings about the condition, issue, or concern that will be the focus for the group (DeLucia-Waak & Kalodner, 2005; Kalodner & Coughlin, 2004). Questions explored during the needs assessment focus on identifying the extent to which a group experience would be beneficial. Are there sufficient numbers of people who could or would use the services of a group formed around a particular topic? The purpose for the group is derived from the needs assessment that has identified a deficiency, lack of information, or a needed upgrade or development of skills that would increase efficiency and productivity, and so on. The target audience is also identified during this process, along with available information gathered, such as ability, educational levels, and so on. Basic background information that can be helpful in planning for most psychoeducational groups include age of participants, educational level(s), the presenting issue, and if they are voluntary or involuntary group participants.

Target Audience Characteristics

Gather information about the basic characteristics of the target audience, such as age, educational level, the present condition or problem or concern, medication effects, and if there are significant past traumas. Other information that may be helpful includes personality and intellectual assessment, family history, and health history. If possible, gather information about members’ culture and diversity characteristics, including but not limited to place of national origin, socioeconomic status, religion, primary language, disability, gender identity, and the like. This information is fundamental to your planning.

Age is important, especially when forming groups for children or adolescents and when there may be a wide range of ages for group members. The importance of age for children and adolescents will be discussed in later sections. Adult groups can have a wide variety of member ages, and this can either be enriching or can cause difficulties. The latter can be especially troubling if one or more members transfer their feelings about other personal relationships on the basis of age alone, respond to bias or stereotyping, and/or assume they should be treated a particular way because of their age(s). On the other hand, a group that has a variety of ages can be enriching when members learn from each other, wisdom and lessons from experience are passed on, new perspectives are gained, and bias and stereotyping are debunked. The most important point is for the leader to be aware of the ages of target group members and the potential for trouble or enhancement.

Educational levels of group members can be a significant factor, because you will have to gear your presentations so that all levels can understand and ensure that the material is not too complex for them to grasp. The ideal situation is that group members have similar educational levels, such as all high school graduates. However, the reality may be that members will have a range of levels. What is very important for your planning is to know what these levels are, as this will make a difference in materials selected, homework assignments, and the amount and depth of material presented and can have an impact on instructional methods.

Members’ present conditions or illnesses play a role for all of the factors mentioned under educational level. Leaders should be familiar with the various effects the conditions or illnesses can have on individuals, with particular emphasis on degree of attention span that can be expected; the extent of cognitive functioning or impairment; the effect on affective functioning and expression such as mood swings and inappropriate expressions of feelings; effects on relationships and so on. Careful planning will prevent the leader and/or members from experiencing the frustration and discouragement that can result when planned materials and activities cannot be used or are introduced and members cannot use them effectively.

The effects of medication(s) are also important, especially when they may impair members’ attention, participation, and learning. Sedating effects, tranquilizing effects (or their lack when prescribed medication is not taken), stimulating effects that produce hyperactivity, and lack of pain reduction are some effects that can impact members and their learning. For example, a member who can ordinarily concentrate on the material presented can find that medicating effects prevent him from doing so. Some common effects of medication are known, and knowing what medications members are taking can help you plan to work around any effects that may exist.

Some members may have more than one condition or illness, or there can be another associated illness or condition in addition to the major or presenting one. For example, depression can be a condition associated with the aftereffects of a heart attack. Medications can also cause other associated conditions, and these too can play a role in members’ participation. While the focus for the group may be one condition or illness, the leader should also be aware that there may be others that will also impact some members and the group. Leaders can prevent becoming frustrated by understanding these possible effects and gearing the planning for this potential.

Significant past traumas can be of vital importance in understanding members’ reactions and participation, as the current conditions or illness can trigger some old memories, projections, and transference, especially when these were not resolved earlier. Group leaders will not be able to anticipate much of what could trigger these distressing old memories. However, leaders can review planned use of materials and activities for possible triggers to try and reduce the likelihood of past traumas emerging for one or more group members. Once traumatic memories have been triggered, it becomes the leader’s responsibility to work with the members at the moment and to consult with a supervisor or other professionals after the session or to refer the member.

Other Member Information

Other background information that can be helpful with planning the group can be a part of the intake session(s). This information may already be available in members’ files, so it becomes important to review all available information. Ideally, the following information would be available: personality and intellectual assessments, family history, health history, and cultural and diversity characteristics. This background information can guide you in selecting instructional strategies, choosing information consistent with members’ abilities to absorb and understand, helping to anticipate some possible behavior problems, giving information and guidance that is helpful and useful, realizing members’ limitations and constraints, and reducing the possibility of unconsciously imposing the leader’s values or having an expectation that group members will have the same values in common with the leader.

Structural Group Factors

Structural factors include membership criteria and selection; if the group is to be open or closed; the duration, frequency, number of sessions, and length of sessions; the size of the group and whether homogenous or heterogeneous; location concerns; assessment plan; and developing group rules.

Membership criteria and selection are desirable but not always feasible, as many groups are composed of members who are mandated to attend. Most authors and researchers describe the optimum characteristics for successful membership, but these tend to focus on inner characteristics that can be difficult or impossible to assess, even with a personal interview. Riva, Wachtel, and Lasky (2004) and Piper and McCallum (1994) propose that the following group member characteristics be used when selecting group members: a moderate ability to tolerate frustration; moderate social ability; commitment to change; psychological-mindedness; and an expectation that the group will be beneficial.

Leaders of many psychoeducational groups will not be able to select group members or to screen out people who may be unsuitable. The membership may be predetermined by the organization, and participants may be ordered or forced to attend. However, knowing this in advance of the group allows the group leader to become emotionally prepared to deal with possible resentment, resistance, and defiance.

The decision about whether the group is to be open, and new members are constantly added, or a closed group, in which no new members are added after ...

Table of contents

• Cover
• Title
• Copyright
• Contents
• Preface
• Section I Getting Started
• Section II Encouraging Productivity
• Section III Trouble Shooting/Problem Solving
• Section IV Closure
• References
• Appendix A: A Sample Psychoeducational Group Plan
• Appendix B: Effective Group Leader Behaviors and Attitudes
• Appendix C: Behaviors and Attitudes of Effective Group Members
• Appendix D: Leader Development: Emotional Sensitivity or Emotional Susceptibility?
• Index