Hey there , all you curious and studious therapists out there . Welcome to our podcast here at Licensure Exams . I'm Dr Linton Hutchinson and this is my co-host , stacey Frost , and we have a fun topic to explore with you today . Are you ready to dive into the wonderful world of group therapy ?
I sure am , linton . I've really been looking forward to this . All week .
We talk so much about individual therapy and all the different theoretical approaches that you can use to work with clients in a one-on-one setting , but there are really several therapy modalities that you need to know about as you're preparing for your exam Couples , family and , of course , our topic today , group therapy .
Yes , group therapy , very true . Group therapy is like a box of chocolates and you never know exactly what will happen next . And while each group is unique , there are certain dynamics that tend to exist in all groups .
Dr Curry and his wife , marriage and family therapist , mary Ann , have been involved in leading groups for many years and developed a theory of group development that we're going to talk about today . Stacey , have you ever taken a group class with Corey ?
Why yes , I did , Linton , and as I remember , you were in the class too .
Oh yeah God , it was so long ago , I just slipped my mind .
You're starting to scare me a little bit , linton . It was only last year sometime , so I guess that you'll need a refresher on this , yeah , I guess so . Ah , okay . So Corey's model consists of a series of stages forming the group the initial stage of group , the transition stage , the working stage and the final stage .
Right , so come back to me now . Finally , it's essential for you , as a therapist , to understand what goes on in each and every one of these stages , so that you can determine the best course of action to take with the group at any given time . So let's start with the first stage forming the group .
This is where all the group members come together for the very first time .
Yes , and we all know how awkward that can be . It's like a middle school dance , where nobody knows who to talk to or what to say .
Or that very first date you ever had , gweny , my first love , I think . We ended up playing chess in their basement and her father just happened to come down over and over because it was something that he needed .
I see , well , maybe he was just interested in how that chess game was going .
Right , it could be , but it's really important for the therapist to focus on creating a safe and trusting environment during the group formation stage Early on . Group members will look to you for direction .
It would be best if you reviewed some basic housekeeping items like how confidentiality is handled in group settings , the purpose of the group and clarifying their role and method of conducting group sessions .
Absolutely . And what about the group members Linton ? What are they experiencing in this stage ?
Well , in that first stage , they're feeling anxious , uncertain , or you may find them even resistant to joining the group .
So , moving on to the second stage , the initial stage of group , this is really the beginning of the group , when the group members are starting to get to know each other and they're figuring out how they fit into the group picture . So everyone is assessing their comfort level and determining how much to share .
And I really like how Dr Corey put it when he said that the initial stage is akin to the first few days one spends in a foreign land having to learn the rudiments of a new language and different ways of expressing oneself .
Yes , this is definitely the stage of discovery . You see a lot of small talk and superficial interactions . As people are testing the waters , it's important for you to encourage open communication and help the group members establish trust and support among each other .
And although maybe tempting , as the group leader , to try to rush through the awkwardness and make everyone feel like one big , happy family who's working toward a common goal , it's actually really important to let the group members feel that awkwardness , which sounds really counterintuitive , right . Doesn't sound like something you should do . So why is it important ?
Because it's through feeling this anxiety and uncertainty that the group members start to find common ground and develop trust .
Well , that sounds pretty tricky . Kind of reminds me of the counseling technique therapeutic silence where you sit back and wait for the client to talk . Tell the truth now . You compassionate therapist out there want to continue to rescue whenever you sense your client is starting to feel really antsy and uncomfortable and anxious . Don't do it .
Exactly , and of course , there is a balance to be struck . So you don't want to let the group stay in the initial stage forever , but it's important to give them time and space to establish their own group dynamic .
Absolutely . And that brings us to the next stage , the transition stage . This stage can be characterized by some conflicts arising as group members start to push boundaries and test the group's norms and rules , and it's up to the therapist that's you to guide the group through the stage by addressing conflicts and helping them work towards resolution .
Yes , and in this stage we also see anxiety , defensiveness and resistance , and all of these reactions are normal and they're part of the group process . So you can think of it kind of like the group's natural growing pains as the members start to open up and share deeper thoughts and feelings .
And one of the group leaders tasks at this point is really to remain sensitive and non-judgmental . The leader has to strike a balance and gently encouraging group members to share , but not pushing too hard if they really aren't ready .
Right , and talking about resistance is not always verbal , such as . I don't want to talk about that anymore . Sometimes resistance manifests as hostile behaviors on the other end of the spectrum , as passive , aggressive behavior .
So this is one of those times where you really put on your detective hat as a therapist , because understanding resistance is really crucial , because if you don't recognize it and work with it , then the group is going to get stuck . Yeah , it gets stuck .
And there's a lot of different reasons why group members may be reluctant to talk about and explore their own personal issues . It might be a good , old-fashioned defense mechanism protecting the client from anxiety or pain . It could be a fear of change and the unknown .
It could be a fear of losing control , fear of intimacy , fear of rejection , issues with authority figures which will be you , or it could even be related to depression . As you uncover the underlying reasons for the group members' resistant attitudes and behavior , that's when you start to get to the good stuff .
This is when the group can really turn a corner , gaining insight and awareness .
And as the group moves through the transition stage , members may take on certain roles within the group dynamic and some common roles that we see are the monopolist and this is the client who dominates the conversation . They hardly let anybody else get a word in . So , as a therapist , you're going to need to gently intervene .
So they always interrupt you too , huh .
Yes , exactly like that , Lyndon . They always interrupt , so your job is going to be gently now , lyndon . I'd like for you to open up space for others to share . Then you can have the silent member , and this client participates really very little if at all .
So drawing out quiet members requires real sensitivity and you can invite them to share , but , as we mentioned earlier , you shouldn't push too hard and then you have the clown . So this is the person in the group who uses humor to lighten the mood , and this isn't necessarily bad , but too much joking can cover up real issues .
And then we've got another example is the distractor , and this group member is always going to try to steer the conversation off topic . So as the therapist , your job is to redirect the discussion back to the important issues .
So , stacy , have you got all your Christmas decorations up yet ?
No , are you kidding ? It's not even Thanksgiving yet .
Well .
I'm waiting till the end of the month . How about you ?
Well , I thought I'd be the distractor right there and get us off topic for a bit .
Oh , yes , yes , I do see your tree back there and got some other ornamentation going on , yeah , so you can see how easily you would be able to get off course talking about really completely unrelated .
Definitely , With this stage you also see pairings and allegiance forming with different members . Two group members may develop a stronger connection and want to talk privately before or after sessions . Our few members may band together and seem to have an us versus them mentality .
Good point . So , with that in mind , your job as the group leader is to maintain healthy boundaries around these subgroups , and the goal is really to build an inclusive , collaborative environment . So let's move on to the fourth stage now , the working stage . This is really the heart of the therapy process , right here .
Absolutely yes . By now the group has moved past the initial awkwardness and resistance stage . They've built trust , cohesion and a sense of belonging . Group members are more willing to take risk , give each other feedback and explore their deeper issues .
Yes , exactly , and you , as the therapist , are going to be taking more of a background role here and you're going to be allowing the members to interact and support each other and you might step in occasionally to offer insights , some reflections and guidance where it's needed , but really , for the most part , you're going to be taking a backseat and letting the
group process kind of continue to unfold . Naturally .
This is where the real breakthroughs and the aha moments tend to happen . Group members have worked through most of their earlier anxiety about being in the group and they seem more secure in sharing their intense emotions . Cohesion is really strong during the stage and at this point , group members all share a common bond .
Now , as rewarding as this working stage can be , it's not without its challenges . Strong emotions will arise as people open up about trauma , grief , insecurity and their inner pain .
And as the group therapist , the leader you need to strike a balance between allowing some productive venting while also keeping things from escalating into pure chaos . So if multiple members get highly escalated at once , that's when you may need to intervene with some calming techniques .
And expect conflicts to come up during this working stage . Part of your role is to teach healthy communication and conflict resolution skills . When done right , working through disagreements can bring the group to an ever deeper level of understanding and trust .
Yes , which eventually brings us to the last stage , the final stage . This is when the group prepares to disband and everyone will start to go their separate ways .
That's such a bittersweet stage , isn't it , stacy ?
Yeah yeah , see you .
On one hand , it's so gratifying to see how far members have come in their journey of growth and healing , but of course it's natural to feel some sadness about saying goodbye after going through this intense experience together .
And , as the therapist , you really want to optimize this termination stage by preparing the group and helping them process the transition in a healthy way . The final stage is a time to resolve unfinished business and review the progress and strengths that each group member has found during the therapeutic process .
A follow-up session can also be planned to help the group members transition from having the support of a structured group sessions to being on their own and creating their new support systems . Follow-up sessions can also be helpful in reinforcing what group members learn during the group process as well .
Well , that brings us to the final stage of this episode , so here's a quick recap of Corey's view on group development . There are five main stages forming initial , transition , working and final and the key is to recognize what's happening in each stage so that you know how to guide the group effectively .
Now you , as the group leader , sometimes have different roles to play , so encouraging participation , addressing conflicts , allowing vulnerability and teaching communication skills , but through it all , from start to finish , in the group , you are providing a safe space for self-discovery .
Well , stacey , up there .
And Linton down there .
Well , this wraps up today's presentation . We've got more in store for you about group therapy , different techniques and different theories . That will be something you'll want to stay tuned for . So until next time , remember it's in there .