Running Effective Groups With Children & Adolescents

1. Running Effective Groups With Children & Adolescents

2. A Primer on Group Therapy:Yalom’s Therapeutic Factors • Installation of Hope • Patients’ belief in the efficacy of the group mode • Things will improve during course of therapy • Universality • Disconfirm patient’s feelings of uniqueness • See commonalities in each other, relief

3. Yalom’s Therapeutic Factors • Imparting Information • Didactic instruction • Direct advice • Examine misconceptions • Altruism • Learning to give of one’s self • Seeing the benefit in doing so

4. Yalom’s Therapeutic Factors • Imparting Information • Didactic instruction • Direct advice • Examine misconceptions • Altruism • Learning to give of one’s self • Seeing the benefit in doing so

5. Yalom’s Therapeutic Factors • Corrective recapitulation of primary family group • Correctly resolve early family conflicts • Group symbolically resembles original family • Development of socializing techniques • Basic social skills • Both direct (role play) and indirect (feedback)

6. Yalom’s Therapeutic Factors • Imitative behavior • Group members imitate behavior of other members and therapist (vicarious-spectator) • Helps patients try new behaviors • Interpersonal learning • Diminish parataxic distortions • Form rewarding relationships

7. Yalom’s Therapeutic Factors • Group cohesiveness • Increases tolerance of disagreement • Facilitates feedback and disclosure • Catharsis • Strong emotional component • Cognitive component promotes change (necessary) • Existential factors • Face ultimate concerns of existence: death, isolation, freedom, and meaninglessness

8. Co-Therapist Model • Advantages • Reduce chance of burnout • Shared attention, greater observational range • Infrequent cancellation due to illness • Explore reactions together • Sensitivity to countertransference • Split roles – provocative v. nurturing • Help maintain objectivity

9. Co-Leadership Model (cont) • Disadvantages • Lack of synchronization • Competition and rivalry • Lack of trust in other’s competence • Different theoretical orientation • Openly siding with members against leader

10. Working with Children and Adolescents • Legal considerations • Clarify what you can and cannot keep confidential • Be aware of your legal responsibility to report abuse or suspected abuse of minors • Secure written consent of parents or guardians

11. Practical Considerations • Frequency and Duration • With children and adolescents it may be better to meet more frequently and for a shorter period of time to suit their attention span. • If meeting in a school setting, meeting times should correspond to regularly scheduled class periods (if possible) • Group Size • elementary school children: 3-4 people • adolescents: 6-8 people • Setting • Will the site provide privacy? • Will there be enough room for all students?

12. Practical Considerations (cont) • Communicate expectations • Set rules and follow through with firmness • Preparation • Avoid insisting on “covering your agenda” • Parental involvement • Meet with or write to parents about the group, if appropriate

13. Screening Process • Define the following areas: • Population (age, gender, etc.) • Frequency and Duration • Length • Size • Open v. Closed • Who will be present? • What information do you want to collect? • What information do you want to impart?

14. Working with Children and Adolescents • Strategies in the Group • Self-Disclosure • Direct child to express how affected by incident rather than allow them to reveal everything about it • Emphasize confidentiality • Use language that is developmentally tailored to convey importance of privacy • Encourage parents to avoid asking questions that could lead to breach

15. Working with Children and Adolescents • Strategies in the Group (cont) • Maintain neutrality • Avoid siding with children or adolescents against their parents or a particular institution • Use appropriate exercises and techniques • Even though their unwillingness to participate may stem from a lack of understanding, children and adolescents have the same rights to not participate in exercises they see as inappropriate

16. Working with Children and Adolescents • Strategies in the Group (cont) • Listen and remain open • Encourage young people to express themselves in their own words • Be aware of preconceived labels and diagnoses that subtly influence your interactions • Prepare for termination • Let children know that the termination point is not far off well before your group ends • This enables children to express their sadness (or other feelings related to termination)

17. Working with Reluctant Adolescents • Explain the rationale of the group in jargon-free language • Allow members to express reactions to being sent to a group • Go with resistance – Don’t go against resistance • Avoid getting defensive • Be clear and firm with your boundaries

18. Key Points – Child Groups • Get the support of administrators • Communicate the importance of confidentiality in their language • Not all children are ready for group therapy • Some structure is important • Think about methods for evaluating outcomes

19. Key Points – Adolescent Groups • Understand and respect resistance • Role-playing techniques can often be creatively used in adolescent groups • Find ways to involve parents • Co-leadership models are especially useful in facilitating an adolescent group