Fluent Essays

ALL INFORMATION INCLUDED Yalom Here-and-Now How to Use It The here-and-now refers to the immediate events of the therapeutic hour, to what is happening here (in this office, in this relationship, in the in-betweenness--the space between me and you) and now, in this immediate hour. Does not negate the importance of the patient’s historical past or events of his or her outside life. Why use the here-and-now? 1. Importance of interpersonal relationships - throughout life our surrounding interpersonal environment--peers, friends, teachers, as well as family--has enormous influence over the kind of individual we become. (OUR SELF-IMAGE IS FORMULATED TO A LARGE DEGREE UPON THE REFLECTED APPRAISALS WE PERCEIVE IN THE EYES OF THE IMPORTANT FIGURES IN OUR LIFE) Why use the here-and-now? 2. Therapy is a social microcosm--means that eventually the interpersonal problems of the patient will manifest themselves in the here-and-now of the therapy relationship. Whatever emotions, attitudes, character traits or behaviors have developed within will manifest itself in the patient’s relationship with the therapist, i.e., arrogance, fearful, demanding, seductive, judgmental, etc. Be Authentic and Admit Mistakes According to Yalom, any attempt at covering the error up will only backfire because the client will ultimately sense that you are not being upfront with her/him. Hence, it will have a negative impact on the therapy. Conversely, admitting to the error is setting a positive role model for the client and an indication that he/she matters to you (an important ingredient of a good therapeutic relationship). Grow rabbit ears WHAT DOES THIS MEAN? GROW RABBIT EARS LEARN HOW TO FOCUS ON THE HERE-AND-NOW ● How does the client greet you ● How do they sit ● Inspect surroundings ● How the session begins or ends ● Recount their history ● How do they relate to you ONE MAIN PRINCIPLE: ONE STIMULUS, MANY REACTIONS RABBIT EARS THINK ABOUT THE FOLLOWING IN A GROUP SESSION ● CRYING ● CONFRONTATION ● LATE ARRIVAL ● NON-RESPONSIVE ● JUDGMENTAL ● DEMANDS ATTENTION What To Do When Your Client Is Crying ● Contrary to what you do as a friend (attempt to console and help your friend regain control and stop crying), Yalom recommends that a therapist encourage the client to plunge deeper so as to assist the client in exploring their emotions. ● Yalom eloquently suggests asking the client, “If your tears had a voice, what would they be saying?” REMEMBER EACH INDIVIDUAL HAS A DIFFERENT INTERNAL WORLD AND THE STIMULUS HAS A DIFFERENT MEANING TO EACH. WE MUST PAY ATTENTION TO OUR OWN FEELINGS If you develop a deep knowledge of yourself, eliminate the majority of your blind spots, and have a good base of patient experience, you will begin to know how much of the boredom or confusion is yours and how much is evoked by the patient. (NEED A PERSONAL THERAPIST) FRAME COMMENTS CAREFULLY THERAPISTS MUST PACKAGE THEIR COMMENTS IN WAYS THAT FEEL CARING AND ACCEPTABLE TO PATIENTS. Videos https://youtu.be/CmpetAwVFVI https://youtu.be/oAXJY5c06Mo Yalom Group Session https://youtu.be/PwnfWMNbg48 https://youtu.be/05Elmr65RDg https://youtu.be/eT6B5cyq4LE https://youtu.be/CmpetAwVFVI https://youtu.be/oAXJY5c06Mo https://youtu.be/PwnfWMNbg48 https://youtu.be/05Elmr65RDg https://youtu.be/eT6B5cyq4LE GROUP LEADERSHIP THE MOST EFFECTIVE GROUP DIRECTION IS FOUND IN THE KIND OF LIFE THE GROUP MEMBERS SEE THE LEADER DEMONSTRATING AND NOT IN THE WORDS THEY HEAR THE LEADER SAYING. PERSONALITY AND CHARACTER ● ● Constancy ● Active Listening ● Firm Identity ● Confidence ● Spontaneity ● Integrity ● Trust ● Humor ● Empathy (Shame) ● GROUP LEADERSHIP SKILLS ● Active Listening ● Restating ● Clarifying ● Summarizing ● Questioning ● Interpreting ● Confronting ● Reflecting Feelings ● Supporting ● Empathizing ● Facilitating ● Initiating ● Setting Goals ● Evaluating ● Giving Feedback ● Suggesting ● Protecting ● Disclosing Oneself ● Modeling ● Linking ● Blocking ● Terminating ● Don’t Overwhelm Yourself! Leading Groups - You should not be the center of attention - Vary therapeutic styles with the needs of group members - Model behavior - Leaders can be co-therapists - Ethical issues can arise - -Overriding group agreements - -Informing group members of options - -Prevent enmeshment - -Act in each group member’s best interest - -Handle emotional contagion - - - Leading Groups - Ethical issues can arise (cont) - -Ensure role flexibility - -Avoid role conflict - -Improve motivation - -Overcome resistance - -Defend Limits - Maintain safe therapeutic setting - Substance Use - Boundaries and physical contact - Help cool down affect - Encourage communication within the group - Avoid a Leader-centered group AVOID DOING FOR THE GROUP WHAT IT CAN DO FOR ITSELF! CONFRONTATION HELP CLIENTS SEE AND ACCEPT REALITY SO THEY CAN CHANGE ACCORDINGLY (Miller and Rollnick, 1991) BE MINDFUL TRANSFERENCE - group member projects parts of important relationships from the past into relationships in the present COUNTERTRANSFERENCE - the therapists emotional response to a group member’s transference RESISTANCE - there is an unconscious defense to protect the group member from the pain of self-examination. BE MINDFUL CONFIDENTIALITY - a group leader must strictly adhere to confidentiality regulations to build trust. Some issues include: use of personal information in a group session, a group leader’s relationships with clients and clients with one another and when group member discusses information from the group beyond its bounds (ethical and legal issues). PROBLEMS FOR NEW GROUP LEADERS ●Initial Anxiety (internal dialogue) ● ○ What do the participants really expect of me? ○ Will I be able to get the group started? How? ○ Will I run out of things to say or do before the end of the session? ○ What if members of the group find out that I really don’t know what I’m doing? ○ Should I take an active role, or should I wait for the group to start on its own? ○ Should I have an agenda, or should I let the group members decide what they want to talk about? ○ Do I possess the cultural competence to lead this group? ○ What if nobody wants to participate? ○ Will the group members want to come back? PROBLEMS FOR NEW GROUP LEADERS (CONT’) ●Self-Disclosure ● ○ Too Little Self-Disclosure ○ Too Much Self-Disclosure ○ Appropriate Self- Disclosure PROBLEMS FOR NEW GROUP LEADERS (CONT’) ●Challenges with Facilitating a Group All group members arriving on time. Setting up and running the session. Variability among group members. Gain full alignment and engagement from group members Documentation of session Keeping outcomes on par, or better ○ DIVERSITY-COMPETENT GROUP COUNSELOR ● Reflect on these questions: ● Are you aware of how your own culture influences the way you think, feel, and act? ● What could you do to broaden your understanding of both your own culture and other cultures? ● Are you able to identify your basic assumption, especially as they apply to diversity in culture, ethnicity, race, gender, class, religion and sexual orientation? ● How prepared are you to understand and work with with individuals from different cultural backgrounds in a group? ● Can you identify any areas of cultural bias that could inhibit your ability to work effectively with people who are different from you MULTICULTURAL COUNSELING COMPETENCIES D.W. SUE, ARRENDONDO, AND MCDACIS (1992) ●Diversity-competent group leaders: ●Beliefs and Attitudes – recognize and understand their own values, biases, ethnocentric attitudes and assumptions about human behavior. ●Knowledge – know specifically about their own racial and cultural heritage and how it affects them personally and professionally. They strive to understand the worldview of their clients. ●Skills/Intervention Strategies – have acquired certain skills in working with culturally diverse populations. Association for Multicultural Counseling and Developments (AMCD) notes: ● -Counselor awareness of cultural values and biases - recognize and understand their own values, biases, ethnocentric attitudes and assumptions about human behavior. -Counselor awareness of client worldview - recognize that a group member’s world view may be different that your own -Culturally appropriate intervention strategies - always must respect the group members religious views, values, beliefs, indigenous practices and languages. RECOGNIZE YOUR LIMITATIONS It is not realistic to expect that you will know everything about the cultural background of all of the group members. RESPECTFUL MODEL recognize multidimensionality of all clients in a comprehensive way R - RELIGIOUS E - ECONOMIC S- SEXUAL P - PSYCHOLOGICAL E - ETHNIC C - CHRONOLOGICAL T - TRAUMA F - FAMILY U - UNIQUE L - LOCATION PROCEDURES FOR OPENING SESSIONS 1. Participants can be asked to briefly state what they want to get from the session. 2. 3. Give members. Chance to express any thought they may have had about the previous session or to bring up for consideration any unresolved issues from an earlier session. 4. 5. Participants can be asked to report on the progress or difficulties they experienced during the week. 6. 7. The group leader may want to make some observations about 8. the previous meeting or relate some thoughts that have occurred to him/her 9. 10. In an open group encourage those members who have been part of the group for a while to share with newcomers what the group has meant to them. 11. PROCEDURES FOR CLOSING SESSIONS ●Group leaders should strive to close the session without closing the issues raised during the session. ●Summarizing can be effective at the end of the session. Summarize group process and their own progress toward their goals. ●Participants can be asked to tell the group how they perceived the session, to offer comments and feedback to other members, and to make a statement about their level of investment in the session. ●Focus on positive feedback. PROCEDURES FOR CLOSING SESSIONS (CONT) ●Allow members to report on homework assignments, insights and how they have applied what they have learned. ●If there were any problems or topics participants would like to discuss, put it on the agenda for the next session. ●Group leaders may want to express their own reactions to the session and make some observations. Good idea to remind members a week before that certain members will be leaving the group. GROUP LEADER COMPETENCE It is good policy for leaders to have a clear theoretical and therapeutic rationale for any technique they use. GROUP LEADER COMPETENCE ●Professional competence is not arrived at once and for all, but is an ongoing developmental process for the duration of your career. The “Best Practice Guidelines” (ASGW, 1998) suggests ways to enhance your level of competence as a group leader involve the following: ○Remain current and increase your knowledge and skill competencies through activities such as continuing education, consultation, supervision, and participation in personal and PD. ○Be open to getting professional assistance for your own personal problems or conflicts that may impair your professional judgement. ○Utilize consultation and supervision to ensure effective practice when you are working with a group for which you need to acquire more knowledge and skill competencies. MODE OF THERAPY – GROUP THERAPY & EFFECTIVE FACILITATION OF GROUPS BY: MARISHA WRIGHT GROUP THERAPY GUIDE What is Group Therapy ⚫ A form of psychotherapy in which a group of individuals meet to discuss a common problem. ⚫ Group therapy is not a free-for-all conversation; rather, the facilitator give the group a set of rules designed to help facilitate conversation, connection, and growth. Benefits of Group Therapy ⚫ Provides benefits that individual therapy may not ⚫ Provides a support network ⚫ Affordable ⚫ Gives you a different perspective ⚫ Provides a safe haven Joining a Group ⚫ Things to consider when looking for a suitable group. ⚪ Open or Close Group ⚪ How many people are in the group ⚪ How alike are group members ⚪ Is it enough ⚪ How much do I share ⚪ What does it look like 3 Primary Goals ⚫ Process Goals – relate to the process of understanding personal concerns and relating to other individuals during a group session and initiate a sense of belonging or relatability through understanding. ⚫ Outcome Goals – relate to behavioral changes that individuals seek to achieve by participating in group. ⚫ Psychoeducational - provide members with information about specific issues. They may also teach healthy coping skills. Primary Types of Groups ⚫ Psychoeducational Groups - educating members about their conditions and providing them with new coping strategies. ⚫ Cognitive Behavioral Groups - attempts to restructure the beliefs a person has that lead to negative or harmful behaviors. ⚫ Skills Development Groups - introducing and improving the skills ⚫ Support Groups – help people cope with significant lige changes ⚫ Interpersonal Process Groups - uses psychodynamic approach to promote positive change. How would these groups fit? ⚫ Anxiety ⚫ Grief/Loss ⚫ Quit Smoking ⚫ Depression ⚫ Anger Management ⚫ Low Self Esteem ⚫ Social Skills ⚫ Divorce PRIMARY GROUPS ⚫ Psychoeducational ⚫ Cognitive Behavioral ⚫ Skills Development ⚫ Support Groups ⚫ Interpersonal Process History of Group Therapy ⚫ The most prominent advocate of group therapy may be Irvin Yalom, author of The Theory and Practice of Group Psychotherapy. Yalom’s research emphasizes the impact group therapy has on people. It also identifies factors that contribute to healing in a group setting. https://www.goodtherapy.org/famous-psychologists/irvin-yalom.html http://amzn.to/2DoYrrl http://amzn.to/2DoYrrl Yalom’s Primary Principles ⚫ Instillation of Hope ⚫ Universality ⚫ Imparting Information ⚫ Altruism ⚫ Corrective recapitulation of the primary family group ⚫ Imitative Behavior ⚫ Interpersonal Learning ⚫ Group Cohesiveness ⚫ Catharsis ⚫ Existential Factors Group Info for Facilitator ⚫ When choosing a group, it can be helpful to consider: ⚫ Group size ⚫ What kinds of issues the group addresses ⚫ How much you wish to share with your group members ⚫ If group therapy should be used along with another type of treatment ⚫ If the group is open or closed ⚫ If the group is process-oriented or psychoeducational Ethics for Group Therapy ⚫ Potential group members have the right to know about the group's rules, goals, and methods when they first meet with the therapist. Rules about confidentiality should be discussed at the beginning. ⚫ All group members must agree to protect the identities of fellow members. They must also keep the content of each session confidential. Unless permission is given, nobody should discuss another member’s personal history with anyone else. ⚫ It is important to remember that confidentiality agreements are not absolute. When are facilitators mandated to disclose? https://www.goodtherapy.org/blog/psychpedia/client-confidentiality 5 Types of Group Therapy 1. Psychotherapy is based on the understanding that the relationships that are built between people are necessary to regulate all aspects of daily living. These groups focus on what members can do in the here and now and help members work together to form a cohesive group in which they can freely share their victories and setbacks in a safe and supportive environment. Therapists that use psychotherapy in a group setting must practice empathy in order for individual group members to communicate freely with each other. These groups help those new in recovery build the interpersonal skills they need in order to effectively communicate with others in a healthy manner. 5 Types of Group Therapy ⚫ 2. Cognitive Behavioral group therapy is another popular type of group therapy in drug treatment is cognitive therapy groups. As its name suggests, these particular groups use cognitive behavioral therapy and other similar therapy styles that will help newly recovering addicts identify patterns of behavior that have kept them stuck in their substance abuse. ⚫ Therapists in cognitive therapy groups work with clients to control their thought processes and their addictive behaviors and help give them the tools to cope with the stressors and triggers they encounter in a more proactive fashion and without having to resort to the use of drugs and alcohol. 5 Types of Group Therapy 3. Interpersonal group therapy is yet another popular psychodynamic option that drug and alcohol rehab facilities use to help addicts address and overcome addictive behaviors. This form of addiction group therapy focuses on an addict’s deficits in both regulating their own behavior and any defects in character the addict may possess. Dynamic group therapy gives clients the supportive environment to examine the common issues that are shared within the group. This cohesiveness allows each member to overcome feelings of isolation and shame, as well as establish a safe environment with the goal of learning how to effectively control their emotions and feelings and achieve abstinence. 5 Types of Group Therapy ⚫ 4. Support Groups - Perhaps the most common, effective, and popular type of group therapy outside of an intensive treatment program are mutual self-help support groups such as Alcoholics Anonymous. Many drug and alcohol treatment facilities base their programs and services on 12-step philosophy, and active participation within these groups is paramount in helping the individual overcome their addiction. ⚫ These self-help groups are made up of people who share a common condition and a common goal. Outside of residential treatment, AA groups are self-run and offered in large groups, small groups, and other meeting types. These meetings are free of charge and focus on mutual support and the achievement of abstinence. http://www.aa.org/ 5 Types of Group Therapy ⚫ Network Therapy - A big indicator of success in sobriety is the presence of a substantial support network comprising of family and friends who are fully supportive of a person’s decision to lead a recovery-based lifestyle. Network therapy involves using the social network of the newly recovering addict in a group format to provide support for behavioral change and relapse prevention. ⚫ 5. Skills development groups focus on introducing and improving the skills that members need to cope with certain mental health conditions. These groups may incorporate aspects of psychoeducational groups. https://www.firststepsrecovery.com/need-sober-support-group-early-recovery/ https://www.firststepsrecovery.com/need-sober-support-group-early-recovery/ https://www.ncbi.nlm.nih.gov/books/NBK64214/ https://www.goodtherapy.org/learn-about-therapy/types https://www.psychologytoday.com/us/blog/how-do-life/201404/how-i-begin-and-end-counseling-session https://belmontwellness.com/psychoeducational-handouts-quizzes-group-activities/ https://www.ncbi.nlm.nih.gov/books/NBK64211/ https://www.goodtherapy.org/learn-about-therapy/modes/group-therapy https://www.goodtherapy.org/learn-about-therapy/modes/group-therapy https://nationalcounsellingsociety.org/find-counsellor/types-of-therapy/ https://work.chron.com/top-eight-attributes-effective-counselor-22250.html videos https://www.youtube.com/watch?v=CmpetAwVFVI https://www.youtube.com/watch?v=7R_-KBmU5g0 https://www.youtube.com/watch?v=PwnfWMNbg48 https://www.youtube.com/watch?v=crgvtIZqs0k Group Therapy _________________________________ DATE: ____________________ · Present to the class about the Therapy – info sheet is due before presentation · Present to the class about your specific therapy · Provide the class a cheat sheet about the therapy, i.e., who founded the therapy, what are the highlights, what is the therapy typically used for, techniques mainly used, etc. · Facilitate a group session · Ice Breaker · Find a group therapy activity that can be used with your therapy · Activity can be either team building, ice breaker, or group therapy technique · How you added the Here And Now method in your session · Utilize procedures for opening and closing the session · Acknowledge members in the group verbally and non-verbally · Utilize some group leadership skills · Create a Lesson Plan – Due on day of presentation · Materials Needed for Session · Objectives · Purpose of Group · Group Rules · Group Discussion/Directions · Ice Breaker/Activity · Summary of the Session · Grading Rubric · Info Sheet on Therapy · Lesson Plan · Facilitating the Group Session – how you facilitated the group and used the Here and Now method · Group leader reflective journal · Group member reflective journal Group Therapy 2