Group Facilitation and Counseling

2. Chapter 10 Group Facilitation and Counseling

3. Key Terms • Brainstorm – technique to generate as many ideas as possible for consideration • Emotion-Based – feelings and emotional benefits that drive the behavior change approach • Facilitator – uses group processes to keep members focused on content and guide the flow of a meeting • Ground Rules – set of guidelines for group members • Group Counseling – using group support to find solutions for lifestyle problems

4. Introduction • Group counseling has been found to work effectively and efficiently either as a stand-alone program or in combination with personal counseling • 2 categories of group work: • Facilitating groups – focuses on leading a number of people with a particular goal in mind • Group counseling – provides guidance for working with groups where the objective is behavior change

5. Communication Styles • 3 types of communication styles: • Submissive • Aggressive • Assertive – the most effective style for leading a group

6. Communication Styles

7. Using Questions in a Group • Whether you are facilitating a group towards a common goal, or conducting a group counseling intervention, having an arsenal of questions and knowing when to use them is essential • Appropriately used questions can help keep a group on task and moving toward desired goal • Types of questions will depend on objective

8. Using Questions in a Group • Questions help to encourage participation • Facilitator uses group processes to keep members focused on content and guide the flow of a meeting; designated leader of the group, team or committee • Must evaluate what types of questions are needed to move the discussion forward • Avoid questions that put individuals “on the spot”

9. Types of Questions

12. Facilitating Groups • Role of the facilitator is to use knowledge of group processes to provide structure allowing the group to remain focused on content and work effectively to bring about results • Processes include creating open and inclusive environment using methods that allow group members to interact productively with each other • Content addresses issues under discussion needed to reach the ultimate goals of the group

13. Facilitating Groups • Groups meet for various reasons: • Talk about a concern • Exchange information • Identify issues • Complete a task • Build consensus • Develop plans • Make a decision • Solve problems

14. Facilitating Groups • Desirable characteristics of a group facilitator: • Actively listens and observes • Shows respect and empathy • Appears honest and fair • Accessible • Asks probing questions • Thinks quickly • Assertive • Flexible • Uses humor • Knows a variety of techniques • Energizes the group

15. Preparation • Who? When? Where? Why? • Goals are specific, concrete, positive, realistic, practical, defined • Agenda developed and sent to participants before meeting • Need to consider: • Equipment and supplies • How to solicit input of participants • Identifying support roles • Organization and flow of meeting

16. Preparation • Methods for facilitating the meeting: • Pair-Share • Corners • ORID • Consensus

17. Pair-Share • Process: • Facilitator supplies 1-3 questions for discussion • Participants work with a partner to discuss/answer • Participants share their ideas with the group • Advantages: • Works well with a large group • Provides an opportunity for all participants to discuss their thoughts and feelings • Comments likely to be more concise and coherent

18. Corners • Process: • Post the name of each task in a corner of a room • Participants move to the corner of the task that interests them most • Each corner has specific questions to address • Speaker from each corner reports to whole group • Advantages: • Works well when there are distinct tasks that need to be addressed • Participants are given choice of task

19. ORID • Process: questions should flow naturally from one stage to the next) • Objective Discussion – focus on getting the facts • Reflective Discussion – focus on emotions/feelings • Interpretive Discussion – focus on values, meaning, purpose and significance to group • Decisional Discussion – focus on making a group decision or personal response to the experience • Advantages: • Useful for reflecting on experiences • Invites a variety of perspectives in non-confrontational manner

20. Consensus • Method for making group decisions by encouraging members to share their thoughts, feelings, and suggestions • Group facilitator needs to lead group through 4 stages: • Gathering diverse points of view • Building a shared framework of understanding • Developing inclusive solutions • Reaching closure

21. Consensus • Process: • Explain purpose of discussion • Review values important for good group discussion • Explain that goal is to reach acceptable agreement in a defined time frame • Repeat purpose of discussion • Ask someone to start discussion • “Who would like to begin?” • Group comes to consensus and agrees on course of action

22. Group Management: Beginning a Group Meeting • Use an “icebreaker” • Helps participants to get to know each other • Dispels anxiety • Find areas of commonality • Ex/ treasure hunt, tell interesting story, open-ended questions, humor, interview each other • Set ground rules and review agenda • Always start on time and show respect to those who were on time

23. Icebreaker - Example

24. Ground Rules

25. Group Management: Guiding the Flow of a Group Meeting • Facilitator needs to guide the flow in order to have an effective meeting • Implement specific technique or strategy after the introduction phase • Silence • Facilitator may feel pressure to fill silence • Silence may indicate to group that facilatator does not intend to dominate the discussion • Normally if silence is long enough, someone will take initiative for beginning a discussion

27. Group Management:Closing the Meeting • End may occur at a preset time or after a goal has been achieved • General guidelines for closing a meeting: • Summarize – provide synopsis of what occurred during meeting and highlight challenges and successes • What’s next? – review plans for the future and time/date of next meeting • Thank you – to participants; and congratulate on accomplishments

28. Group Management:Follow-Up • Follow-up activities may include: • Maintain contact with members through websites, email, etc. • Review the accomplishments and concerns of the meeting with colleagues • Write thank you notes • Provide minutes to participants • Provide information about the meeting to people who were absent

29. Group Counseling • Intended to elicit behavior change r/t nutrition issues • Facilitator needs to provide a group atmosphere that encourages curious exploration and consideration of behavior modification alternatives • AND review of the evidence regarding facilitating health and food behavior change identified 3 studies showing group counseling to be more effective than individual counseling • Weight loss study by Renjilian et al. showed group counseling sessions produced more weight loss than individual treatment • Advantages of combining group counseling and one-on-one

30. Group Counseling: Advantages • Emotional support – clients feel as though they are not alone; feel accepted and special • Group problem solving – motivate each other to change through coping strategies and problem-solving together; “two heads are better than one” • Modeling effect – clients learn by observing accomplishments of others • Attitudinal and belief examples – group members may re-evaluate their own belief systems as they observe others

31. Group Counseling: Disadvantages • Individual responsiveness – some people do not easily share in a group setting • Group member personalities – dynamics are influenced by individual personalities; some members may dominate or monopolize • Possibility of poor role models – can create additional burdens for counselor to counteract • Meeting the needs of all group members – needs may vary widely; age, gender, ethnic background differences, health problems can be challenging

32. Group Process • First session is crucial • Group personality evolves early on • Plan interactive and fun activities • Principal objective is to address participants’ concern of feeling accepted and being acknowledged as worthy • Composition of groups can be: • Open groups • Closed groups

33. Group Process • Open groups • Support groups • Participants encouraged to participate • No commitment to a set number of sessions • Participants generate the topics and share their own experiences • Leader’s role is to facilitate the process • Works well in WIC, diabetes clinics, dialysis units

35. Group Process • Closed groups • Do not accept new members after the first or second session • Allow for greater bonding • More suitable environment for behavior change to take place • Members feel a sense of belonging and acceptance • Counselor guides group on a “journey of self-discovery and shared problem solving”

36. Group Process • 6 steps for development of cohesive, well-functioning groups: • Establish an open, warm environment and productive leader-participant relationships • Balance facilitator-generated and group-generated information • Design problem-solving strategies • Provide the opportunity for group members to practice new skills • Use positive role models and pacing to keep the group motivated • Ask for evaluation and feedback

37. 1) Establish an open, warm environment & productive leader-participant relationships • Facilitators need to: • Show empathy • Appear warm/genuine • Use effective body language • Use relationship-building responses • Show attentive behavior • Radiate positive energy • Stay focused on group members • Establish ground rules (can be formal or informal)

38. 2) Balance facilitator-generated and group-generated information • Facilitators have a list of tasks identified as essential for clients to understand, but this will fall on deaf ears if group members have their own concerns on their minds • Facilitator may want to ask participants in the 1st session to identify their pressing needs • Ex/ a person with diabetes may be concerned about amputations d/t complications and may have trouble focusing on other issues such as glucose monitoring

39. 3) Design problem-solving strategies • Counselor should provide many opportunities for group problem-solving, rather than tell the group what to do • Likability of advice giver affects acceptance of advice • Group counseling provides ideal setting for self disclosure coupled with group problem-solving

42. 4) Provide the opportunity for group members to practice new skills • Divide members into small groups to rehearse new skill developed from previous step • The new skill should be something the members can use before the next group session so members can report back on their experience • Ex/ modify a recipe, measuring portion sizes, interpreting a food label, analyzing blood glucose records

43. 5) Use positive role models and pacing to keep the group motivated • Spend time reviewing successes of group members to provide model for other members • Successful members inspire other members • However, members may exhibit counterproductive or disruptive behaviors • Scapegoating, personal attacks, side jokes, unrelated stories, gossiping • Counselor needs to block these members from disrupting the group process • Focus on blocking the behavior, not on the person

46. 6) Ask for evaluation and feedback • Facilitator should elicit feedback from group throughout the counseling process or after trying new activities or strategies • Ex/ “Since we began meeting, what did you find particularly useful?”

47. Ending • Bring closure to the session • Provide a summary • Encourage the power of group support to have a continuing effect • Ask members to think about the journey of change and address the next chapter of the journey • Summarize evolution of group and ask participants to share their stories

48. Practical Considerations for Successful Groups • Allow adequate time for organization • Plan for adequate meeting time • Select a comfortable meeting room and location • Ideal group size for closed groups is 8-12 • Contemplate collecting fees or refundable deposits before the 1st meeting • Appraise target group needs for selecting a meeting time

49. Practical Considerations for Successful Groups (cont’d) • Consider composition issues of the potential group • Interview prospective group members • Group leaders should remain the same • Be responsible • Plan sessions carefully • Consider refreshments • Call members who miss meetings

50. Evaluation of Group Interactions • Facilitating group meetings can be rewarding and challenging • Mentor is beneficial; can sit in and provide feedback • Written evaluations from members can supply useful information