Group Therapy (TIP 41)
Chapters 3-5
Stages of Treatment and Process Issues
Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC, NCC
Executive Director, AllCEUs
Module 3 Goal and Objectives
Goal:
Provide an overview of how to match clients with groups, depending on clients’ readiness to change and their ethnic and cultural experiences.
Objectives:
~ Match clients with substance abuse treatment groups.
~ Assess clients’ readiness to participate in group therapy.
~ Determine clients’ needs for specialized groups.
Matching Clients With Groups
~ The client’s characteristics, needs, preferences, and stage of recovery
~ The program’s resources
~ The client’s ethnic and cultural experiences
Clients Who May Be Inappropriate
~ Clients who refuse to participate
~ Clients who cannot honor group agreements
~ Clients in the throes of a life crisis
~ Clients who cannot control impulses
~ Clients whose defenses would clash with the dynamics of the group
~ Clients who experience severe internal discomfort in groups
Primary Placement Considerations
~ Women
~ Adolescents
~ Level of interpersonal functioning
~ Motivation to abstain (if an addiction group)
~ Stage of recovery
~ Expectation of success
Preparing the Group for New
Members
~ Integrate new clients into the group slowly, letting them set their own pace.
~ Be aware of signs of transference and countertransference between
◦ Clinician and clients
◦ Clients and other clients
~ Watch for signs of increased participation and comfort
Module 4 Goal and Objectives
Objectives:
~ Distinguish the differences between fixed and revolving membership groups.
~ Prepare clients for groups.
~ Describe the tasks for each of the three phases of group development.
Fixed Membership Groups
~ Members are prepared and stay together for a long time.
~ Membership is stable.
~ Groups are either:
◦ Time limited. Members participate in a specified number of sessions and start and finish together.
◦ Ongoing. New members fill vacancies in a group that continues over a long period.
Revolving Membership Groups
~ New members enter a group when they become ready for its services.
~ Groups must adjust to frequent, unpredictable changes.
~ Groups are either:
◦ Time limited. Member attends a specified number of sessions, starting and finishing at his or her own pace.
◦ Ongoing. Member remains until he or she has accomplished his or her specified goals.
Pregroup Interviews
~ Begin as early as the initial contact between the client and the program.
~ Strive to:
•Form a therapeutic alliance between the leader and the client.
•Reach consensus on what is to be accomplished in therapy.
•Educate the client about group therapy.
•Allay anxiety related to joining a group.
•Explain the group agreement.
Preparation Meetings
~ Explain how group interactions compare with those in self-help groups.
~ Emphasize that each person may be at a slightly different place in recovery
~ Let new members know they may be tempted to leave the group at times.
~ Recognize and address clients’ therapeutic hopes.
Group Agreements
~ Establish the expectations that group members have for one another, the leader, and the group.
~ Require that group members entering a long-term fixed membership group commit to the group.
~ Inspire clients to accept the basic rules and increase their determination and ability to succeed.
Elements in a Group Agreement
~ Communicating grounds for exclusion
~ Confidentiality
~ Physical contact
~ Use of mood-altering substances
~ Contact outside the group
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