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Chapter 1

Components of the Pre-Group Meeting

The pre-group meeting is important to set the tone for the group. I try to impress upon the participants the importance of taking the group experience seriously. In this meeting, I cover the group contract, the importance of group goals but also individual goals that each participant will set for herself. After we have discussed the contract and each participant has agreed to abide by it, they sign a copy of the following contract committing to abide by the contract.

Commitment to Contract

I, __________________________, acknowledge that the group counseling contract is important and I commit to following it to the best of my ability. I will be open and honest and participate in the group to achieve the group goals as well as my personal goals. I am agreeing to this contract voluntarily and agree to work hard to make this a successful group.

___________________________________________________ Date and Signature of group participant

I then divide the participants into two groups and allow them 20-30 minutes to share their fears and expectations of the group experience. We then come back together and they share what they discussed in their small groups. The purpose of this is to show them that others have the same apprehensions that they have.

The Group Contract

Goals:

1. An establishment of an intimate community - becoming a cohesive group. This involves cooperation and mutual support. It means that each member trusts the group.

2. Each individual establishes a relationship of some intimacy with each other member of the group. This means that the individual, not only trusts the group as a whole, but also trusts each individual within the group.

3. Diagnose own behavior. Each member will attempt to be cognizant of how she behaves in the group and the purpose of this behavior. What is she attempting to accomplish?

4. Experiment with new behavior. A member may have a behavior or behaviors that she doesn’t like and would like to change. The group gives her an excellent opportunity to experiment with behaving differently. The group can encourage and reinforce the new behavior.

5. Personal goals. Each member must set at least one personal goal that she will strive to accomplish during the group experience. The personal goals will be shared during the initial group meeting.

Interactions:

1. Self-Disclosure. Each member of the group will be expected to disclose herself to the group. This does not mean that the members will air their dirty laundry or necessarily share their deepest and darkest secrets. It means that they will be honest with each other about what they are experiencing in the group setting.

2. Expression of feelings with thought. Each member of the group will be expected to disclose what she is feeling toward the group or toward individuals within the group. This should always be done in a kind and thoughtful way. The purpose is not to hurt anyone but to be honest about what the experience is.

3. Give support to other members. Each member of the group will be expected to support a member who is hurting or struggling with an issue. This can be done with words, a touch or some other behavior.

4. Confront other members. Each member of the group will be expected to confront a fellow member when she believes that the individual is being fake or incongruent in some way. This should not be done in an attacking way but in a spirit of desiring to be helpful.

5. Respond to confrontation. When one is confronted, she should respond to the confrontation, not by explaining the behavior or offering an excuse or argument, but by stating to the confronter how the confrontation affects her thoughts and feelings.

Procedural Rules

1. Deal with the here-and-now. Stay in the present. This doesn’t mean that one never brings up the past, but when doing so, it is related to how it affects the present.

2. Take the initiative. Do not wait for others to speak. When you have something to say or need to work on your goal, it is your responsibility to speak up. You are as responsible as anyone for the success of the group.

3. Speak to individuals. This doesn’t mean that you will never speak to the entire group. It means that you will not pretend to be speaking to the group when you are really speaking to an individual.

4. Own the interaction of others. When someone else is working, be involved by listening and observing. You will be amazed at how much you will gain when observing the interactions of others.

5. Speak for yourself in the group and not for anyone else. You will be tempted to try to explain what someone else means. Don’t give in to the temptation. Everyone is capable of explaining herself.

6. Say it in the group. Do not talk outside of the group about the group, not even to each other. What is said in the group and what happens in the group stays in the group. Everything is confidential.

Etiquette

1. Empathy. Try to understand the other person’s experience as well as possible.

2. Concreteness. Say what you mean as clear and concise as you can. Be specific rather than speaking in generalities.

3. Honesty. Say what you really think and feel rather than what you think the group wants to hear.

4. Respect. Allow the other group members to be who they are rather than whom you want them to be. Accept their thoughts and feelings unconditionally.

Individual Goals

Each group member must clearly define at least one goal that she will work on during the group sessions. This goal can be resolving an issue in her life, improving a skill or gaining a new skill. It doesn’t matter whether it is an interpersonal goal or a goal that relates only to the individual. It will be worked on in relation to the other group members.

For example, in a group several years ago, a lady set the goal of trusting others. She had been devastated by her former husband who left her for a gay relationship. They had a daughter and he left the two of them destitute. Even though this had happened several years before the group, she was still hurt, angry and suspicious of everyone. To protect herself from becoming vulnerable to the group she acted in vengeful ways toward group members. In one session, I asked her if she would be willing to do an exercise with the group. She agreed. I had her lie on

the floor in the center of the group and the group gently lifted her off the floor and above their heads and held her in the air for several seconds and then slowly and gently lowered her back to the floor. We then processed what had happened and how it affected her. This exercise transformed her. From then on she was cooperative and encouraging of other group members. In the last session, she brought a brown paper bag that contained pot holders that she had made for each member. She used different colors in each one and told each member why she used the particular colors for their pot holder. Everyone was in tears, touched by her gift and the thoughtfulness she had put into each one. She had achieved her goal.

Fears and Expectations of the Group Experience

As the members break into small groups to discuss their fears and expectations of the group experience, they learn that their particular fears are common to most everyone in the group. Probably the most common fear is the fear of conflict. They fear that group members will get into arguments with each other and that hurtful things will be said. Most of them express that they do not like conflict and avoid it at all costs. They fear that they will be pulled into conflicts in the group. I assure them that conflict might occur but that it can be resolved in ways that make it a positive experience rather than a hurtful or harmful one. Conflict can bring the group closer together if it is handled healthily. I point out that we don’t want to create conflict for the sake of conflict but we don’t want to avoid it if it naturally occurs.

Another common fear is that they will reveal things about themselves that they will regret later because it will be used against them by group members or will be told outside the group. Yalom & Leszcz (2005, p. 297) wrote, “One of the most basic and pervasive fears of individuals entering a therapy group: the horror of having to reveal oneself and to confess shameful transgressions and fantasies to an alien audience. What’s more, members imagine a critical, scornful, ridiculing, or humiliating response from the other members.” Corey, Corey & Corey (2010, pp. 187-188) wrote, “It is the choice of members to determine what and how much they share. When they recognize that they are responsible for what they tell others about themselves, participants tend to be less fearful of self-disclosure.” First, I assure them that they will not be forced to reveal anything that they don’t choose to reveal. Next, I try to assure them that if they are attacked by anyone in the group because of what they disclose, I will do all that I can to assist them in protecting themselves and resolving the issue created by the revelation. Finally, I state that I cannot guarantee that everything will be held in confidence, because I don’t have control of what members do outside of the group. However, I point out that everyone has promised to abide by the group contract which states that everything that is said and that happens in the group is confidential.

A third fear is that they will be judged by group members. I assure them that they will be judged by the other group members but this is not necessarily a negative thing. Most, if not all members of the group, will judge each other positively. My experience is that even when someone reveals something that she thinks is horrible, other group members respond in very positive ways toward the person. The more vulnerable one becomes in the group, the more positively this one is judged, is my observation. However, as Corey, Corey & Corey (2010, p. 189) pointed out some members may have early memories of being judged in groups and may need to move slowly in overcoming this fear.

A final fear that I’ll mention is the fear that the individual will not like group therapy and therefore will emotionally and behaviorally withdraw. I cannot guarantee that this will not occur; but, I can assure the person that usually if the effort is made and the contract is kept, it will be a positive experience. I can also promise the person, that if she reaches a point where she

can no longer tolerate the group experience, she can withdraw. No one is forced to stay in the group against her will.

Other fears are expressed but these are the most common ones that I hear. It is important that the therapist discuss the fears with the group members and address the fears as honestly and positively as possible. Greason (2010, p. 124) wrote, “In time, group members begin to realize that voicing their fears actually helps them deal with core interpersonal issues.”

Questions to Ponder

1. What do you find most challenging about the group contract? Why? If you could change the group contract, how would you change it?

2. As you consider participating in a group, what is the personal goal(s) that you set for yourself?

3. What is your greatest fear of participating in a group? Why is this frightening for you?

Chapter 2

Sessions

I only lead closed groups, meaning that members do not rotate in and out of the group. It is important to set ahead of time how many sessions a closed group will have and how long each session will last. As stated in the preface, my groups have eleven sessions. Each group session lasts 90 – 120 minutes. In the first session, we discuss the personal goals of the participants; in sessions two through ten we work on the personal goals and in the final session we share what we have learned and how we’ll take our learning into the future outside of the group.

Session 1

Individual goals are important to keep the group from floundering. Without goals, members may have difficulty progressing in the group (Corey, Corey, & Corey, 2010, p. 147). In session one, each member of the group is expected to share what her personal goal or goals are. The goal(s) must be realistic, attainable, concrete, measureable and congruent with the group goals. As each group member shares her goal(s), I coach her in stating the goal(s) in a way that meets the above criteria. I ask questions such as, “How will you know when you have achieved your goal(s)?” “How will the group recognize when you have reached your goal(s)?” “What specific steps will you take in the group to meet your goal(s)?” “What are the possible stumbling blocks to your reaching your goal(s)?” “When you achieve your goal(s), what positive difference will it make in your life?” “How can the group help you reach your goal(s)?”

As group members work on their goals, many times they will realize that another goal is more relevant and they change their goal(s). This is okay in the early sessions, but I encourage them to settle on a goal as soon as possible and to stick with it.

Corey, Corey & Corey (2010, p. 147) gave an excellent list of general goals: Become aware of one’s interpersonal style.
Increase awareness of what prevents intimacy.
Learn how to trust oneself and others.

Become aware of how one’s culture affects personal decisions.
Increase self-awareness and thereby increase the possibilities for choice and action. Challenge and explore certain early decisions (most likely made in childhood) that may no

longer be functional.
Recognize that others have similar problems and feelings.

Clarify values and decide whether and how to modify them. Become both independent and interdependent.
Find better ways to resolve problems.
Become more open and honest with selected others.

Learn a balance between support and challenge. Learn how to ask others for what one wants. Become sensitive to the needs and feelings of others. Provide others with helpful feedback.

By the end of the first session, each member should have a goal that is realistic, attainable, concrete, measureable and congruent with the group goals. If a member does not have a goal, this is the first item of business in the second session. I close this session, as I do every session, by being certain that everyone is okay with what has transpired in the group and that there is no unfinished business. I remind the members about confidentiality.

Sessions 2 - 10

I use a number of different theories in these sessions, depending on the situation. In the following paragraphs, I’ll share the theories that I use and how I might use them. I’ll put the name of the theory in bold print so they’ll be easily recognizable. I begin sessions 2 - 10 by asking if anyone has anything to report to the group, particularly pertaining to any insight they received this week that came as a result of last week’s session or of any progress they made on their goal this week. I close each session by being certain that everyone is okay with what has transpired in the group and that there is no unfinished business. I remind the members about confidentiality.

I may use Adlerian theory if a group member is struggling with inferiority or if they are struggling with family issues. I might have them recall early childhood experiences and then look for a theme or connection between these memories and to consider if their early childhood influences the present problem especially related to the person’s style of life. I ask her to consider how this style of life will hinder or help her in reaching her goal. I might also have her do a family sculpting to gain a better understanding of how her family functioned and to gain a perspective of relationships between family members. As the member shares, I encourage others to respond to what is shared by giving feedback, sharing similar experiences, or challenging the thinking of the speaker. Group members are often amazed at how childhood experiences affect how they respond to situations presently. They are able to see how being in the here-and-now doesn’t deny the past but connects it to the present.

I may use Gestalt Therapy to bring a member back to the present if she has regressed to the past; or to help a member resolve a conflict between two alternatives, or to help a member do inner child work. I may use the empty chair technique or repeating something over and over until insight is gained or exaggerating a behavior. Anytime a member needs insight into resolving her problem, I am likely to use Gestalt therapy. I encourage others to respond to what is being shared by giving feedback, sharing similar experiences, asking questions, or challenging the speaker. Some members become aware that they are out of touch with the here-and-now and cannot express what they are presently experiencing. I work with these members asking them to share what they are thinking about being in this place, with these people, in this encounter with me, right now. I ask them to pay attention to their emotions and to share these as they are aware of them. I also ask them to notice any body sensations and to share these as they become aware of them. I point out any unconscious behaviors they might be doing and encourage them to pay attention to these and learn what the behaviors are telling or showing them. In this session,

group members begin to learn the difference between here-and-now and there-and-then. They begin to see the relevance of the present and why focusing on it is more powerful and beneficial than focusing on the past. They also gain an understanding of experiencing over against talking about an experience.

Person Centered Therapy is helpful when one is hurting emotionally and needs the group to not only hear the pain but to empathize with the hurting member and give her unconditional positive regard. I encourage others to respond to what is being shared by giving feedback and sharing similar experiences. I discourage challenging the speaker or giving advice. This may create difficulty for many members because they want to solve the problem, so they come up with all kinds of advice for the person who is struggling. I emphasize that each group member can work on empathy, attempting to make statements or ask questions that will help them better understand the experience of the speaker, rather than trying to solve the problem for the individual.

I use Rational Emotive Behavior Therapy, especially Ellis’ ABC model, when one’s beliefs are getting in the way of her reaching her goal. I remind her that any belief that does not create a positive outcome is irrational. The individual may have difficulty accepting that her belief is irrational. I encourage her to talk about what she believes about the achieving of her goal and encourage the other group members to listen for irrational beliefs as do I. When someone hears an irrational belief they are encouraged to dispute it. Through this process of stating beliefs and having the irrational ones disputed, members are able to change beliefs about themselves, others and the achieving of their goals.

Reality Therapy is helpful when a member is having a difficult time achieving her goal perhaps due to a weak plan of action. I especially emphasize the WDEP method. I ask the member to use the WDEP method to analyze her goal and what she is doing to achieve it. Is her goal really what she wants to accomplish? If not, does it need to be altered in some way? Is she doing what she needs to be doing to accomplish the goal? If not, what does she need to do differently? Other group members are encouraged to assist in the tweaking of the goal or the plan of action.

Solution Focused Therapy is helpful when a member is discouraged that she isn’t making any progress or is having difficulty believing that she can accomplish her goal. I use the rating scale to help her see the progress she has made; or the exception question to help her see times in the past when she has succeeded; or the miracle question to help her gain a clearer vision of how she will know when she has been successful. I encourage the other members to assist the one working by using the exception question and the miracle question and helping the member focus on her successes rather than her failures.

I use Narrative Therapy to encourage a member who is especially quiet to share a feel- good story about her life. After she shares the story I encourage group members to respond by sharing how the story touched them. This can encourage the quiet member to feel better about sharing in the future. Then I ask other members to share personal stories of their successes in childhood, adolescence and/or adulthood. I encourage the other members to ask them questions about these stories and to praise them for their accomplishments. I ask the one sharing to think about skills and strengths that she used to accomplish these successes and to talk about ways that she can use these strengths and skills to accomplish her goal. I encourage the other members to make suggestions of how she might use her strengths and skills.

Mindfulness Therapy can be helpful for one struggling with anxiety, depression or chronic pain. By paying attention to her present experience and noticing how it changes as she focuses

on it, the person can realize that no sensation is permanent. This can give her hope that she can achieve a state of calm or happiness instead of the anxiety or depression she is presently experiencing. I assist the member by leading her in the following mindfulness exercise: “I want you to get in a comfortable position and begin to relax. You may close your eyes or you may leave them open. It’s your choice. You might notice your breathing, feeling the air as you inhale and as you exhale. As you focus on your breathing, you can allow this focus to take you deeper into relaxation. Now you might scan your body to notice where your discomfort is located. Begin to focus on it. You are not trying to change it. You are merely noticing it. If your mind wanders, it’s okay. Gently nudge it back to focusing on the discomfort. As you continue to focus, notice what changes occur. Maybe the sensation of discomfort changes to a different sensation or maybe it intensifies or diminishes. You are not trying to control it. You are merely noticing it. If your mind wanders, it’s okay. Gently nudge it back to focus. Now I’m going to be quiet so that you can totally focus on the sensation.” After a couple of minutes, I close the exercise by saying, “You might shift your attention from the sensation to your breathing, noticing the air as you breathe it in and then as you exhale. Take three breaths, noticing the air coming in and going out and then you may bring your attention back to this room.”

After the exercise, we process what happened. As this member shares and others respond, we notice how the sensation changed and she did nothing but notice it. We talk about what ramifications this has for our lives and for our goals and how we can use this exercise in the future. If anyone has chronic pain, high blood pressure or some other physical symptom that they want to work on, depending on how much time we have, we might work. The group can participate by doing the exercise with the individual or by thinking positive thoughts for the person while she works.

Positive Psychology is useful if a member has a goal pertaining to becoming grateful, optimistic or self-confident. If someone has the goal of becoming more grateful, I’ll ask the member to think of three individuals toward whom she feels gratitude because of something the person did for her. I ask her to share about one of the individuals and to share a specific act of kindness from this person. Then I have her imagine how she might use the memory of this individual to help her achieve her goal. For example, she might hear this person giving her encouragement or see this person giving her the thumbs up. Other group members can make suggestions of how the person can use the memory of this person. Also, the entire group might gather around this person and shout words of encouragement that the individual can take with her. If the person is working on optimism, I will ask her to share some of her pessimistic beliefs and then ask group members to point out how these can be changed to optimistic beliefs and still be as true as the pessimistic beliefs. If the person wants to become more self-confident, I will ask her to talk about her successes or I might have her sit in the center of the group and ask group members to share their positive beliefs about this person. I stress that they must be honest.

Session 11

I begin session 11 by asking if anyone has anything to report to the group, particularly pertaining to any insight they received this week that came as a result of last week’s session or progress they made on their goal this week.

In this final session the members share what they have learned about themselves, how they have reached their goals and how they will apply what they have gained through the group experience. I also allow time for the members to express any concerns they have and to answer

any questions they have. I want them to leave the group feeling good about the experience and being pleased with what they accomplished.

Questions to Ponder

1. Answer the following questions related to your goal. How will you know when you have achieved your goal(s)? How will the group recognize when you have reached your goal(s)? What specific steps will you take in the group to meet your goal(s)? What are the possible stumbling blocks to your reaching your goal(s)? When you achieve your goal(s), what positive difference will it make in your life? How can the group help you reach your goal(s)?

2. What do you think are the advantages and disadvantages of using different counseling theories as appropriate in each session rather than sticking with one theory throughout the group experience?