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Chapter 5

Effective Group Therapists

It is important that the group therapist has skills and techniques to lead the group effectively; however, the relationships with the group members individually and with the group as a whole is the most important factor. No matter how skilled the therapist is and how many marvelous techniques she possesses, if she does not build trusting relationships with the group members, the group will fail. The therapist builds trust by exhibiting empathy, respect, genuineness and unconditional positive regard, along with proving that she is skilled in leading groups. With this being said, let’s explore personal characteristics, skills and the basic tasks of the therapist.

Personal Characteristics

These characteristics are drawn from Corey, Corey & Corey (2010, pp. 30-38) and Milsom (2010, pp. 63-65).

Adaptability is very important. You must be willing and able to change directions when something is not working. Behavior of group members cannot always be predicted and you must be flexible enough to adapt when needed.

Belief in the group process is vital. If you do not believe that the group will be effective, then the members will lose confidence in the process. By believing in the process, you can instill hope in the group members.

Enthusiasm may not be necessary, but it certainly is helpful. This doesn’t mean that you must be bubbly all the time, but it does mean that you should exude enthusiasm in whatever manner is genuine for you.

Self-confidence comes from being trained adequately and having the necessary skills. It is important that the group members have confidence in you, which is unlikely unless you possess self-confidence. This involves personal power and the belief that you can bring about change.

Courage is a critical characteristic. This can be demonstrated in a number of ways including being vulnerable, confronting others, acting on beliefs and hunches, being emotionally affected by other group members, being willing to look critically at your life and being honest with the group.

Modeling is one of the best ways to teach desired behaviors. To be an effective therapist, you not only tell the group what is expected but you show the group, through your behaviors, what is expected.

Presence means that you give your full attention to the group throughout the group sessions. You are not distracted by outside forces. Because you are fully present, you are affected by what transpires in the group.

Caring is when you have a sincere interest in the welfare of group members. This involves respecting, trusting and valuing the group members.

Openness means that you do not hide who you are from the group or what you are experiencing; but, you reveal yourself and what you are experiencing to the group. This doesn’t mean that you make the group about you or that you spend time focusing on your problems. It means that you are genuine in the here-and-now.

Stamina is important because leading a group can be physically and emotionally draining. It is important to have a high energy level and to have realistic expectations for the group. If you become discouraged, then stamina wanes.

Self-care is mandatory. You cannot provide care for group members, nor expect them to care for themselves, if you are not modeling self-care. This involves caring for the physical, emotional, intellectual and spiritual components of self.

Self-awareness means that you have an understanding of what you are experiencing at any given point in time. It is unlikely that you will facilitate self-awareness in group members if you are not in touch with what you are experiencing.

Sense of humor allows you to laugh at yourself and keep a balanced perspective. Humor can be used to relieve tension in the group and to make a point.

Skills of the Therapist

These skills are drawn from Corey, Corey & Corey (2010, pp. 38-46), Milsom (2010, pp. 65-70), Jacobs, Masson & Harvill (2009, pp. 121-140) and Gladding (2012, pp. 64-68).

Active Listening involves paying full attention to what the group member is saying verbally but also with her body language. It is noticing the congruencies and/or in-congruencies of the group member. Active listening is essential for effective leadership.

Reflecting is serving as a mirror, conveying the essence of what the group member has communicated but doing so in a way that helps the group member understand her experience better or more clearly. This communicates to the group member that the leader understands what the individual is experiencing.

Clarifying involves focusing on key underlying issues and sorting out confusing and conflicting feelings. Clarifying may be done for the benefit of the speaker or for the benefit of the entire group. Clarifying is also a way for the leader to check her own understanding of the member’s communication.

Summarizing is essentially pulling the important elements of an interaction together into a concise statement. It can be used when the group becomes bogged down and doesn’t know where to go next; or to tighten the focus of the group; or to transition from one topic to another; or, finally, at the end of a session to review what occurred in the session.

Facilitating is opening up clear and direct communication within the group, which helps the group members assume increasing responsibility for the group’s direction. Facilitating can help the group members become more open, create a climate of trust, provide encouragement, challenge members to participate, and help members face controversy and conflict.

Empathizing involves caring and openness. The leader cannot know fully what a group member is experiencing but empathy allows the leader to have a sense of the experience. Empathizing means that the leader can openly grasp a group member’s experience and at the same time maintain separateness. Empathizing builds trust and cohesion and greatly influences the overall climate of the group.

Interpreting involves offering possible explanations for certain behaviors, feelings or thoughts. It can encourage deeper self-exploration and/or provide a new perspective for considering and understanding one’s behavior.

Questioning is asking open-ended questions that lead to a better understanding of a behavior, feeling or thought. It can be used to elicit further discussion, to gain information, to stimulate thinking or to increase clarity and focus.

Linking is finding ways to relate what one member is doing or saying to the concerns of another member. This promotes member to member interaction and raises the level of group cohesion. It also facilitates universality.

Confronting is challenging members to look at discrepancies between their words and actions. It encourages honest self-investigation, promotes full use of potential and brings about awareness of self-contradictions.

Supporting is providing encouragement and reinforcement. It can be used effectively when a member is facing a crisis, facing a frightening challenge, feeling uncertain about a decision or struggling with making a significant change in her life. Supporting can help create an atmosphere that encourages members to continue pursuing difficult goals and a climate of trust.

Blocking is intervening to stop counterproductive behavior in the group. It is used to protect a member from another group member or from herself. The leader should use blocking when there is excessive questioning, probing, gossiping, invading privacy or breaking confidences.

Modeling is demonstrating a desired behavior through actions. Modeling can help establish group norms. The leader can also model commitment to the group by being on time and being prepared; giving appropriate feedback to others; and respect for other group members by being nonjudgmental; as well as other skills and behaviors such as, risk taking, openness, directness, sensitivity, honesty, and enthusiasm.

Suggesting is offering advice and information, direction and ideas for new behaviors. Suggesting should always enhance a group member’s movement toward making her own decisions. It should never be done in a way that tells the group member what she should or should not do.

Initiating includes helping members focus on their personal goals, assisting members when they are stuck, helping members identify and resolve conflicts, using techniques to enhance member work and helping members assume responsibility for themselves. Initiating can help prevent needless group floundering and increase the pace of group process.

Evaluating is appraising the ongoing group process. It is a crucial leadership skill. Evaluating should be an ongoing process with the leader continuously paying attention to the changes taking place in the group from session to session and the internal and external forces influencing the progression of the group.

Terminating involves knowing when and how a group session should end, when and how an individual should exit the group and when and how the group should end. Prior to the ending of the group, the leader should prepare members to assimilate, integrate and apply in-group learning to everyday life.

Seeing all these skills in a list may be overwhelming for you. Learning all these skills may seem impossible. You cannot learn them all at once but like anything else you become proficient one step at a time. Think back to when you learned to write your ABC’s. Twenty-six different shapes multiplied by two because you had to learn capital and small letters. Add to this learning how to print and also write in script. But over time and hours of practicing you learned and now you are proficient at writing. The same will be true about learning how to be a skilled group leader.

Basic Tasks of the Therapist

Before discussing the basic tasks of the therapist, I want to emphasize, as I did at the beginning of this chapter, that everything the therapist does must be consistent with a positive, healthy relationship between the therapist and the group member. No amount of skills and techniques can replace an accepting, concerned therapist-group member relationship. With this being said, let’s look at the basic tasks of the therapist as suggested by Yalom & Leszcz (2005, pp. 117-200).

Creation and Maintenance of the Group

The leader must set the time and place for the meetings. Most groups meet once or twice a week. I like the weekly format with each session lasting about two hours. There is no magic in this formula. Each leader must decide what works best for her and for the group. The group can meet anywhere that is accessible provided that it is comfortable and provides privacy for the group members. The room should be large enough for the group to move around and do physical activities, should these be needed. It should also be large enough so that the members can sit in a circle without a table or other obstacles in the way.

She must select and prepare the group members for the group experience. In selecting group members, she should avoid individuals who may not be able to handle the group experience. Yalom & Leszcz (2005, p. 234) stated, “Clients will fail in group therapy if they are unable to participate in the primary task of the group, be it for logistical, intellectual, psychological, or interpersonal reasons.” There is no magical formula for selecting group members. Deciding who is not suitable for the group is probably easier than deciding who is suitable.

The therapist must “recognize and deter any forces that threaten group cohesiveness. Continued tardiness, absences, subgrouping, disruptive extra-group socialization, and scapegoating all threaten the functional integrity of the group and require the intervention of the therapist.” (Yalom & Leszcz, 2005, p. 118). A member consistently being tardy or absent must be confronted by the leader. The member should explore what is going on and if this cannot be addressed, then the member should be removed from the group. Subgrouping is usually harmful because the members of the subgroup transfer their allegiance from the group goals to the subgroup goals; loyalty becomes a major and problematic issue (Yalom & Leszcz, 2005, p. 347).

The disruptive extra-group socialization usually occurs by the subgroup or leads to a subgroup being formed. Scapegoating usually cannot occur unless the leader is involved. When a leader is too insecure to take criticism, then blaming a group member for any failures of the group becomes a possibility. All of these are issues that must be addressed by the therapist as they occur. They must be resolved or the group will fail.

Building a Group Culture

I find the group contract to be very important in helping to build the group culture. It establishes the behavioral rules that will guide the interactions of the group. It informs the members of the expectations. Because the norms of a therapy group are radically different from the norms of social interactions, the group members must be aware of what the expected norms are.

Corey, Corey & Corey (2010, pp. 150-152) gave a comprehensive list of explicit norms that are common in many groups:

Members are expected to attend regularly and to show up on time.
Members are encouraged to be personal and share meaningful information.
Members are expected to give feedback to one another.
Members are asked to express thoughts and feelings rather than talking about problems in a

detached and intellectual manner.
Members are encouraged to focus on here-and-now interactions within the group. Members are expected to bring into the group personal problems and concerns that they are

willing to discuss.
Members are encouraged to provide therapeutic support.
Members are expected to challenge other members to look at themselves.
Members are expected to really hear what others are saying to them and to seriously

consider these messages - particularly ones that are repeated consistently.
Focusing on the Here-and-Now
Yalom & Leszcz (2005, p. 142) wrote, “The therapist has two discrete functions in the here-

and-now: to steer the group into the here-and-now and to facilitate the self-reflective loop (or process commentary).” To carry out these two functions, the therapist must help the group process what is said or done but also the meaning behind what is said or done. What do the words or deeds say about the individual’s relationship to the group member being addressed and to the group as a whole? The therapist must “help the group members make cognitive sense of what is happening. When used effectively, here-and-now processing serves as a catalyst to deepen interaction among group members and move members toward their personal goals.” (Greason, 2011, p. 117).

Corey, Corey & Corey (2010, p. 151) gave a good list of questions that the therapist might use to steer the group toward a here-and-now focus. What is it like to be in this group now? With whom do you identify in here? What are some of the things that you might be rehearsing

to yourself silently? Who in this room are you most aware of? The therapist might also ask the members to share what they think and feel about what is going on in the group at any particular moment.

Questions to Ponder

1. What will be the most difficult task for you as group leader in creating and maintaining the group? Why?

2. Which one of the Coreys’ list of norms would be most difficult for you to enforce as the group leader? Why?

3. Why do you think it is important to have a here-and-now focus in the group rather than talking about the past or future?