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11/28/2010

Psycho-educational Groups for Adolescents


Leslie G. Kelly, MA LPCC UNM Center for Rural & Community Behavioral Health

So you want to start a group..


Is it possible? What are the goals? Who should be in it? Who shouldnt be in it? Single leader or co-leader?

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What kind of model?


Manualized interventions Issue focused Skill focused Open ended Closed Mandatory vs. voluntary Size?

Stages of Group Development


Forming - anxiety, tentativeness, limited sharing Storming struggles w/power & control issues Norming - or intimacy where a working process

takes shape
Performing- this is the work phase Adjourning- issues of group termination

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Kinds of groups:

Divorce/blended families Girls issues Boys issues Anger management Problem solving Grief and loss Drug/alcohol

What are the Therapeutic Factors?


Universality Altruism Instillation of Hope Imparting Information Corrective recapitulation of primary family experience Imitative Factors Cohesiveness Existential Factors Catharsis Interpersonal Learning-input Interpersonal Learning-output Self-understanding

Source:Yalom&Leszcz, 2003

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Why is Cohesion the most considered the most central therapeutic factor?
Studies have shown it is important in explaining client

improvement
Helps groups withstand conflicts with less discouragement

and alienation
It encourages and enhances development of other therapeutic

factors.

Evidence-Based Principles Related to Cohesion: Use of Group Structure


Principle One Conduct pre-group preparation that sets

treatment expectation, defines group rules, and instructs members in appropriate roles and skills needed for effective group participation Principle Two- The group leader should establish clarity regarding group processes in early sessions since higher level of early structure are predictive of higher levels of disclosure and cohesiveness later in the group
Source: Burlingame et al., 2002

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Use of Group Structure (cont)


Principle Three: Composition requires clinical judgment to

balance intrapersonal (individual member) and intra-group (amongst group members) considerations.

Source: Burlingame et al., 2002

Evidence-based Principles related to Cohesion: Verbal Interaction


Principle Four: The leader modeling real-time observations, guiding

effective interpersonal feedback, and maintaining a moderate level of control and affiliation may positively impact cohesion Principle Five: The timing and delivery of feedback are pivotal consideration for leaders as they facilitate the relationship-building process. These important considerations include developmental stage of the group (for example, challenging feedback is better received after the group has developed cohesiveness) and the differential readiness of individual members to receive feedback ( members feel a sense of acceptance)
Source: Burlingame et al., 2002

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Evidence-based principles related to cohesiveness: Establishing and Maintaining an Emotional Climate


Principle six: The group leaders presence not only effects

the relationship with individual members but with all group members as they vicariously experience the leaders manner of relating. Thus, the leaders management of his or her own emotional presence in the service of others is critically important. For instance, a leader who handles interpersonal conflict effectively can provide a powerful positive model for the group as a whole

Source: Burlingame et al., 2002

Establishing and maintaining an emotional climate (cont)


Principal Seven : A primary focus of the group leader should

be on facilitating group members emotional expression, the responsiveness of others to that expression, and the shared meaning derived from such expression.
Source: Burlingame et al., 2002

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Leader Interventions
Executive Function Caring Emotional Stimulation Meaning-Attribution Fostering Self-Awareness Establishing Group Norms

Reducing Adverse Outcomes


Group Pressures possible positive and negative catalysts Record Keeping Confidentiality Dual Relationships Monitoring members

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Ending Group
Time limited groups Open-ended groups Premature terminations Ending rituals Group leader departure

Small group activity


Get in groups of three If you have done a group share two thing you remember that worked well and two that didnt work so well. How would you change things next time. If you havent done a group but want to, talk about what it would look like, how many, what model, how to promote, screen, closed/open, how long, co lead or one leader, any other ideas about how to run the group or its content. Report back

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Bag of tricks:
Ice breakers, name games, check ins, discussion leads etc. Food and drink go a long way Try and meet in a comfortable place or not formal setting Have a back up plan Embrace silence Know you will make mistakes Let members participate in group structure if appropriate

For resources please email me at:

lekelly@salud.unm.edu 505-934-9518

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