Terry Joel Norris

Group Counseling City University July 2004

Children Impacted by Alcohol Group Counseling

Session 1: Session 2: Session 3: Session 4: Session 5: Session 6: Has your family connections been deeply impacted by alcohol abuse? Roles in the Family of Alcohol Impacted Families Feelings Bingo Alcohol and the Family: Breaking the Chain What can you do? Wrapping it Up!

Session 1: Attendance Ice Breaker

Has your family connections been deeply impacted by alcohol abuse?

Have students pair-up and share the following: A hobby or activity I do well, favorite food, favorite television show or movie, favorite family member other than parents or siblings, and my biggest worry about being in this group. Have students come back together after 10 minutes or so and introduce their partner. Session Goals Establish rules to run the group to include respect (and all it means, waiting ones turn to speak, no name calling, making light of other peoples statements, etc.), right to pass without commenting, and confidentially (and the exceptions, ie. talking about your own problem with others outside the group without mentioning other members and the leaders responsibility report certain things to outside authorities to protect the members of the group from harming themselves or others.) Allow the group to develop some cohesion. Students will begin to associate certain parts of their behavior with being a member of a family that is impacted by alcoholism. Facilitative Factors Introduce the survey by asking a question to the group such as, Has anyone been hurt by somebody elses drinking? Rationale The group needs to become accustomed to one another in order to share their feelings with the group. The rules need to be established to protect everyones rights and feelings. The survey/questionnaire suggests situations that may have occurred to the students and give the group some topics to talk about together.

Terry Joel Norris Process Questions

Group Counseling City University July 2004

What are your concerns about being in this group? What rules should our group have to make everyone comfortable? Activities Icebreaker (described above) Survey (attached) Stages The students need to establish trust with other members of the group and understand that the group is safe secure place. Members need to understand that their experiences with the family member who has a drinking problem is not unique to them, that many other people have this problem and it causes them similar pain. EALRs Communication 3.2 Work cooperatively as a member of a group Predicted Leadership Skills Establish rules, secure respect for all, provide for open safe discussions, plan activities that allow students to develop trust with group. Commentary Alcohol abuse is very common and causes tremendous problems for children in interpersonal relationships of all sorts. Students need to understand that there are commonalities of behavior of children of alcoholics.

Has your Life Been Affected By Someone Else's Drinking?

There is help for young people whose lives have been affected by someone else's drinking. Sometimes, the active drinking has stopped, or the active drinker may not live with us anymore. Even though the alcohol may be gone, and the alcoholic gone or recovering, we are still affected. The following twenty questions are to help you decide whether or not alcohol has impacted your life.

1. Do you believe no one could possibly understand how you feel? 2. Do you cover up your real feelings by pretending you don't care? 3. Do you feel nobody really loves you or cares what happens to you? 4. Do you tell lies to cover up for some one else's drinking or what's happening in your home? 5. Do you stay out of the house as much as possible because you hate it there? 6. Are you afraid or embarrassed to bring your friends home? 7. Has someone's drinking upset you? 8. Are holidays and gatherings spoiled because of drinking or others' reactions to the drinking?

Terry Joel Norris

Group Counseling City University July 2004

9. Are you afraid to speak up sometimes for fear it will set off a drinking bout or start another fight? 10. Do you think the drinker's behavior is caused by you, other members of your family, friends, or rotten breaks in life? 11. Do you make threats such as, "If you don't stop drinking and fighting, I'll run away"? 12. Do you make promises about behavior, such as, "I'll get better grades," "go to church," or "keep my room clean" in exchange for a promise that the drinking and fighting stop? 13. Do you feel that if your mom or dad loved you, she or he would stop drinking? 14. Do you ever threaten or actually hurt yourself to scare your parents into saying "I'm sorry," or "I love you"? 15. Do you or your family have money problems because of someone else's drinking? 16. Are mealtimes frequently stressful or delayed because of drinking or fighting? 17. Have you considered calling the police because of the abusive behavior in your home? 18. Have you refused dates because your date may find out

about the drinking or fighting? 19. Do you think your problems would be solved if the drinking stopped? 20. Do you ever treat people (teachers, schoolmates, teammates, etc.) unjustly because you are angry at someone else for drinking too much? If you answered yes to some of these questions, the Drinking Support Group may be able to help you and help you help others. Copyright Al-Anon Family Group Headquarters, Inc. 2000 Is Someone's Drinking Getting to You? (S-20)

Terry Joel Norris Session 2: What role(s) do you fill? Attendance Session Goals

Group Counseling City University July 2004

Students will review rules and the names of other members of the group with a short activity such as trying to recall all the names of the group. Students will understand the different roles family members of alcoholics often play in a dysfunctional family by reading pages 49 to 64. Facilitative Factors The counselor will need to assist the partners come up with a useful definition of their assigned role. Rationale The students need to understand the roles many people fall into when they come from a family affected by alcohol if they are ever to climb out and lead more healthy functional lives. Process Questions With what role or roles can you identify? What roles do you see other members of your family playing? Activities The students will recall everyones name in turn; the fastest person receives a piece of candy. The students will pair off, each group will read about particular roles, and then present their information to the group as a whole. After each group has presented their information the entire group will discuss their experience with that role. The roles are: the Responsible One, the Adjuster, the Placater, and the Acting-Out Child. Stages Students will increase their self-awareness and learn information about their family situation and how alcohol affects their interaction. They will also continue to develop trust with the group.

EALRs Communication 2.3 use effective delivery 3.2 work cooperatively as a member of a group 4.2 seek and offer feedback Troubleshooting Predicted Leadership Skills The counselor will continue to develop trust and control the group to ensure safety and respect. He will instruct the students about the roles family members of alcoholics often take. Commentary Students need to understand the common roles that family members of alcoholics often take in order for them to take efforts to change themselves. Black, Claudia. Children of alcoholics: As youngsters-adolescents-adults: It will never happen to me!. Ballantine Books, New York 1981

Terry Joel Norris

Group Counseling City University July 2004

Session 3: Roles in the Family of Alcohol Impacted Families Attendance Session Goals Students will continue to learn about the roles family members of alcoholics often take by watching a video. Facilitative Factors The counselor will maintain a quiet learning environment during the video and facilitate appropriate questions after the video. Rationale The students need to deeply understand the behavior of the roles. Process Questions How does what you saw in the video compare with what your home life? Activities Watch a 25 minute video and discuss what each role(s) of the member can relate to. Stages Students will become aware of how others behavior impact their own. EALRs Communication 1.1 focus attention 1.2 listen and observe to gain and interpret information 1.3 check for understanding by asking questions and paraphrasing Predicted Leadership Skills The counselor will need to encourage discussion and notice individual members comfort level and address it as needed.

Commentary These roles are paramount to many of the issues children of alcoholics have as children and as adults. The students need to understand the roles they play in order to change their behavior and live a more emotionally health life.

Nelson, C., Ivanhoe Communications, and Films for the Humanities (Firm). Alcohol and the family breaking the chain, videocassette (25 minute). Films for the Humanities, Princeton, NJ c. 1990

Terry Joel Norris

Group Counseling City University July 2004

Session 4: Attendance

Alcohol and the Family: Breaking the Chain

Session Goals Students will understand that they have feelings towards family members that drink that are common to other people in the same situation. Facilitative Factors Maintain respectful safe setting and plan meaningful activities. Remind students that the last session will be two weeks away. Rationale The students will understand that it is ok for them to have feelings about their family members drinking and that is good to express them. Process Questions How do you feel about your family members drinking? How do you feel about other family members? Mom, dad, brother, sister? Activities Students will then play Feelings Bingo to associate the feelings towards some of the situations that were listed in the survey from lesson one. See attached instructions and bingo worksheet.

Feelings Bingo
Feelings Bingo: this activity is designed for affective-based counseling groups. It is a useful activity for groups that have established rapport and trust, therefore should not be used until the 3rd or 4th group session. Directions: 1. Ask students to brainstorm feelings related to group subject (ie, divorce, loss, etc.); leader should make a list of them, preferably on a chalk/white board, poster paper, etc. Be sure to focus on feelings, as opposed to thoughts or actions. Brainstorm at least 20 feelings. Leader can reference a feelings poster or chart, or pass out a list of feelings if needed.

2. Distribute a feelings bingo card to each group participant. 3. Have group members fill in one feeling per square, either selecting feelings from those listed (preferrably) or identifying additional related feelings. This should be an individual activity; leader should request members honor confidentiality and not discuss or copy from others. 4. Leader will facilitate discussion by:

Asking for a volunteer to share one feeling he/she has selected Discuss the feeling with the group, linking and relating as appropriate Do this for as many feelings as the group can process, possibly extending over two to three 45 minute session.

Stages What have you learned about yourself? Whats your role? EALRs
Health and Fitness 3.4 Understand how emotions influence decision making.

Predicted Leadership Skills Counselor will maintain respectful and supportive climate. He will also ask probing questions in order to bring students feelings to the surface. Commentary Family members of alcoholics often have closed off their feelings and do not talk about the drunken pink elephant in the living room. It is one of the most valuable lessons for a family member to learn. They need to be able to talk about their feelings and behaviors before they can make positive changes.

Terry Joel Norris

Group Counseling City University July 2004

_______________________________s Feelings Bingo Card

Session 5: What can you do? Attendance Session Goals The students will begin to write a letter about their experiences and feelings to themselves. Facilitative Factors The counselor will provide writing materials assistance in spelling, grammar, punctuation, et cetera, and motivation to place their thoughts and feelings on paper. Rationale Writing is a positive release for the students feelings and may lead the student to change some unhealthy behaviors they may be doing. Process Questions How do you feel when (use situations from the survey)? Activities The students will write a letter to themselves about a situation they have recently felt strongly and include a description of their feelings and their response to them. Stages Students will identify their feelings about their alcoholic family member (and their actions when intoxicated) and behaviors that are associated with them. EALRs
Writing 2.2 write for different purposes 2.3 write in a variety of forms Health and Fitness 3.4 Understand how emotions influence decision making.

Predicted Leadership Skills The counselor will continue to maintain a warm caring environment that will motivate students to share their feelings with others and more importantly themselves. Commentary

Terry Joel Norris

Group Counseling City University July 2004

The students will learn to express their feelings and associate behaviors with those them.

Session 6: Attendance

Wrapping it Up!

Session Goals The students will begin to think about changing unhealthy behaviors associated with their feelings towards the drinking problem. Facilitative Factors The counselor will maintain respectful climate and assist the students in closing their ties with the group. He will also assist the students with another letter about changing their behavior. Rationale Students need to learn how to recognize change unhealthy behaviors. Process Questions What have you learned about yourself? How are you going to use your new insight to make your life better? Activities The student will write another letter that defines a new healthier behavior that the she will replace the unhealthy behavior she identified in the first letter. The group will discuss their experience in the group and how they feel about it and how they feel about it ending. Stages The student will reach closure about her experience in group and take away new skills that will her to live a healthier life and more able to deal with alcoholism in their family. EALRs
Writing 2.2 write for different purposes 2.3 write in a variety of forms Health and Fitness 3.4 Understand how emotions influence decision making.

Terry Joel Norris Predicted Leadership Skills

Group Counseling City University July 2004

The counselor will need to guide students through their loss of group and motivate them to continue with at least thinking about their feelings if not writing about them. Commentary Children of alcoholics need to learn to express their feelings and identify patterns of behaviors that are associated with their alcoholic family member.

Comparing students from substance abusing and dysfunctional families: Implications for counseling, Buelow, George. Journal of Counseling and Development, January 1995, Proquest July 11, 2004
This article took a survey of college students in a required freshmen health class. The survey asked about family background, specifically use of chemical substances. It also asked about the students impressions of their family and how it relates to drug use, whether they believed their family was dysfunctional or functional with chemical dependent parents or nondependent functional families. It then asked about the coping skills of the student after they have entered college. The study found that students from dysfunctional homes with chemically dependent parents were less able to cope with changes or stress than those from functional homes with dependent parents and far less than those with functional families nondependent parents. The latter two groups were both in the normal arrange of coping ability, however, the functional non-using families were still more able than the functional dependent parents. This article underlines the impact of chemical dependency on the future of the children from dependent parents. Statistical data is a positive addition to further support the need for counseling to children of chemically dependent parents. This has been a terribly wide spread problem for what must be an immeasurable amount of time.

Terry Joel Norris

Group Counseling City University July 2004

Letter writing as a tool to increase client motivation to change: Application to an inpatient crisis unit, Tubman, J., Montgomery, M., and Wagner, E. Journal of Mental Health Counseling, Oct. 2001, vol. 23, is.4 The article speaks to the diversity of problems that letter writing may help to address. Crisis counseling is particularly emphasized in the article. It also mentions some of the drawbacks or limitations to letter writing in these situations.

Clients that have gone through a loss of a loved one have written letters to them telling them things they wished they told them before they died. Addicts have written goodbye letters to their drug of choice. Any number of issues can be addressed in this manner. The authors suggest that letter writing offers the client a way to recognize their own problems and the ability to overcome their ambivalence towards them. They also mention some of the drawbacks. Time and resource limitations may inhibit this procedure when the client was in crisis. Trying to stabilize a client quickly may preclude the time to use letter writing therapy. Also, when the client returns to their unhealthy lifestyle the letter writing may lose its utility with out the continual support of therapy.

The utility of letter writing in a school setting would be more useful since it avoids two of the weak points. School counseling group sessions tend not to be critical interventions that can continue some contact over a longer period of time. Further more, letter writing fits well with the over all goals of schools.

Group counseling strategies for rural at-risk high school students. Bauer, S., Sapp, M., and Johnson, D. The High School Journal Dec 1999/Jan 2000 The authors tested the effectiveness of a cognitive-behavioral counseling as opposed to supportive counseling. Cognitive-behavioral counseling was predicted to be more effective in an academic setting than supportive counseling. The cognitive-behavior counseling was much more structured than the other. Both groups consisted of a single gender to isolate that variable and to improve comfort level for the participants. Grade point average, selfesteem level, number of detentions, and academic self-concept were measured before and after the counseling sessions. The researchers did not find a difference of effective performance between gender groups. The cognitive-behavioral model out performed the supportive model in self-esteem and academic self-concept, while the supportive model decreased the number of detentions more. Both had a similar impact on raising grade point average. Overall, the authors stated that a link between at-risk students and adult school staff are important to improve their performance. Furthermore, the cohesion between members in a group counseling setting is more effective than that between a single student and a staff member. At-risk students are an exceptionally needy group of students that require an inordinate amount of help to succeed in school. These students also tend to have the fewest resources to cope with academic requirements. These counseling strategies begin to address these needs of this group.