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- Herausgeber: John Wiley & Sons
- Kategorie: Fachliteratur
- Sprache: Englisch
A comprehensive and efficient guide for both novice and experienced group leaders, Interactive Group Work helps group leaders to create the conditions across group types and settings that enable group members to support one another.
From group work principles to theories and procedures, this text focuses on group counseling and therapy and explores the shared foundations with psychoeducational and task groups. Through in-depth explanations and real-world examples, it illustrates how groups work and builds knowledge of how to create successful group environments—places where group members interact, grow, change, and achieve their goals. This book goes in depth on how to set the stage for group work and enhance the experience for leaders and clients. A supplemental Instructor's Manual of test questions is available by request from ACA.
*Requests for digital versions from ACA can be found on www.wiley.com
*To purchase print copies, please visit the ACA website
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Seitenzahl: 865
Veröffentlichungsjahr: 2023
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Table of Contents
Cover
Title Page
Copyright Page
Dedication
Preface
Acknowledgments
About the Authors
Part I The Interactive Nature of Groups
Chapter 1 The Social Context of Group Counseling
Interpersonal Relationships, Social Connectedness, and Mental Health
Multicultural Group Counseling and Therapy
Essential Values for Group Work
The Efficacy of Group Counseling and Therapy
Conclusion
Chapter 2 The Interactive Group Environment
Group Process
Power and Group as a Social Microcosm
Norms
Roles
Membership Attitudes
Conclusion
Chapter 3 Group Development Theory
Models
Section 1: Classic Group Development Theories
Section 2: Interactive Group Development Theory
Part II Group Leadership Theories and Foundations
Chapter 4 Focal Conflict Theory
Group Process
Group Members’ Therapeutic Experience
Therapeutic Process
Group Activity Exercise
Conclusion
Chapter 5 General Systems Theory
Essential Concepts: Systems, Subsystems, and Suprasystems
Boundary Functioning
Autonomy
Hierarchy
Therapeutic Process
Conclusion
Chapter 6 The Interpersonal Approach and Group Theory Summary
Theoretical Foundations of the Interpersonal Approach
Essential Themes in Group Counseling and Therapy Theory
Phases of Therapeutic Process
Group Activity Exercise
Conclusion
Chapter 7 Interactive Group Leadership
Trust and Group Boundaries
Developing Effective Interactive Skills
Factors Influencing the Leadership Role
Leadership Functions
Leader Beliefs and Member Attitudes
Leadership Style
Personal Involvement and Technical Skills
Conclusion
Part III Interactive Group Leadership in Action
Chapter 8 Basic Group Leadership Skills and Interventions
Affective, Cognitive, and Behavioral Objectives
Intervention Levels
Intervening: Timing, Balance, and Intensity
Basic Skills and Interventions
Conclusion
Chapter 9 Developing Effective Group Membership Skills
Effective Interpersonal Communication
Teaching Communication Skills
Timing and Teaching of Communication Skills
Communication Problems
Self-Disclosure
Feedback
Feedback and the Interactive Group Environment
Conclusion
Chapter 10 Ongoing Leadership Tasks
Processing
Optimizing the Group’s Facilitative Qualities
Protecting Members From Harm
Unaddressed Societal Dynamics
Ensuring Individual Members’ Chances of Success
Monitoring Group Interaction for Focal Conflicts and Themes
Conclusion
Chapter 11 Intervention Strategies
Obstructing Norms
Interpersonal and Relationship Issues
Problematic Member Roles
Confronting Social Issues
Conclusion
Part IV Real-World Interactive Group Leadership
Chapter 12 Ethical Practice of Group Work
Basic Ethical Principles
Ethical Decision-Making and Models
Professional Organizations and Ethical Standards
Group Ethical Concerns
Ethics and Interactive Group Leadership
Conclusion
Chapter 13 Contemporary Group Research
Research on the Application of Select Group Theories and Skills
Research Linking Group Process and Outcome
Research on the Efficacy of Groups for Specific Populations
Research on Diversity and Inclusive Group Practice
Research Linking Treatment Modality and Outcome
What Works in Groups: A Reflective Exercise
Conclusion
Chapter 14 Introduction to Group Types and Settings
Interactive Therapeutic Factors and Leadership Functions
Group Types
Group Settings
Group Work Online
Manualized Group Work
Conclusion
Chapter 15 Organization and Operation
Planning
Essential Operating Guidelines
Managing Open Groups
Coleadership
Leading Solo
Starting and Ending Group Sessions
Termination
Conclusion
Chapter 16 Becoming a Group Leader
Emotional Challenges
Leaders’ Personal Issues
Knowledge
Experience
Personal Development
Personal Leadership Style
Cultural, Social Identity, and Intersectionality Issues
Being an Anarchist and Orchestrator
Conclusion
References
Index
Technical Support
End User License Agreement
List of Illustrations
Chapter 2
FIGURE 2.1 Dynamics of Norm and Role Development
Chapter 4
FIGURE 4.1 Group Focal Conflict
FIGURE 4.2 Group Focal Conflict Enabling and Restrictive Solutions
FIGURE 4.3 Group Solutional Conflict
FIGURE 4.4 Group Solutional Conflict and Deviant Members
Chapter 5
FIGURE 5.1 Group Systems and Subsystems
Chapter 6
FIGURE 6.1 Developing Interpersonal Schemas
FIGURE 6.2 Interpersonal Theory–Consensual Validation Process
Chapter 7
FIGURE 7.1 Leadership Style Dimensions
FIGURE 7.2 Basic Facilitation Sequence
Chapter 9
FIGURE 9.1 The Cycle of Complete Interpersonal Learning
FIGURE 9.2 The ORAL Model of Feedback Exchange
FIGURE 9.3 Process for Sending Feedback
FIGURE 9.4 Process for Receiving Feedback
FIGURE 9.5 Disclosure-Feedback-Experimentation Cycle
Chapter 14
FIGURE 14.1 Group Types and Objectives
FIGURE 14.2 Psychoeducational Groups and Structured Experiences
Chapter 16
FIGURE 16.1 Supervision of Group Work Model
List of Tables
Chapter 3
TABLE 3.1 Bennis and Shepard’s (1956) Group Development Model
Chapter 4
TABLE 4.1 Examples of Focal Conflict Motives and Their Solutions
Chapter 6
TABLE 6.1 Group Therapeutic Factors
Chapter 7
TABLE 7.1 Basic Group Intervention Skills
Chapter 9
TABLE 9.1 Effective Versus Ineffective Feedback Approaches
Chapter 10
TABLE 10.1 Fundamental Leadership Skills: Objectives
Chapter 15
TABLE 15.1 Group Types and Formats
TABLE 15.2 General Group Planning Guidelines
Guide
Cover Page
Title Page
Copyright Page
Dedication Page
Preface
Acknowledgments
About the Authors
Table of Contents
Begin Reading
References
Index
Technical Support
Wiley End User License Agreement
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Second Edition
Interactive Group Work
Jane E. Atieno Okech
Deborah J. Rubel
William B. Kline
2461 Eisenhower Avenue, Suite 300 | Alexandria, VA 22314 | counseling.org
Copyright © 2024 by the American Counseling Association. All rights reserved. Printed in the United States of America. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the written permission of the publisher.
American Counseling Association2461 Eisenhower Avenue, Suite 300Alexandria, VA 22314
Publisher | Carolyn C. Baker
Digital and Print Development Editor | Nancy Driver
Senior Production Manager | Bonny E. Gaston
Copy Editor | Joan Flynn
Cover and text design by Bonny E. Gaston
Library of Congress Cataloging-in-Publication DataNames: Atieno Okech, Jane E., author. | Rubel, Deborah J., author. | Kline, William B., author.Title: Interactive group work / Jane E. Atieno Okech, Deborah J. Rubel, William B. Kline.Description: Second edition. | Alexandria, VA : American Counseling Association, [2023] | Includes bibliographical references and index. |Identifiers: LCCN 2023008774 | ISBN 9781556203978 (paperback)Subjects: LCSH: Group counseling. | Group psychotherapy.Classification: LCC BF636.7.G76 A76 2023 | DDC 158.3/5—dc23/eng/20230503LC record available at https://lccn.loc.gov/2023008774
Dedication
We dedicate this book to our current and former students who continue to inspire us to learn and grow from their education, supervision, and practice of group work.
For our practitioner readers, we hope that our book will stimulate your ongoing growth and development as group leaders.
Lastly, we hope that our book will encourage counselor educators and supervisors to broaden their perspectives about conceptualizing group process and the roles of group leaders.
Preface
Over 20 years ago, we (Jane Okech and Deborah Rubel) had front row seats for the creation of a seminal book on group counseling and therapy. Our major professor, William (“Bill”) Kline, had not only taken on the formidable task of launching our careers as researchers and counselor educators but also signed a contract to create a book that would expand and improve upon prior texts used in training group counselors and therapists. We watched, listened, and learned as Bill guided us through our own group training and also as he labored to communicate his distinct, pure, disciplined, and incredibly useful vision of the potential and reality of groups and group leadership to us, to the other students, and to the reading audience. We were privileged to experience leading groups and receiving supervision for these groups in a way that was thoroughly consistent with Bill’s teaching and writing and authentic to Bill as a person, group leader, and scholar. For both of us, this experience was life changing and instilled a lifelong belief in the potential of groups and how they should be structured and led.
As we (Jane Okech and Deborah Rubel) moved on to our own counselor education careers we used Bill’s book in both our beginning and advanced group classes. Sometimes it was difficult to fit the content into our institutions’ existing group counseling course structures because the book was so direct and focused on group-specific conceptualization and intervention. Often, we chose to add separate readings to address areas commonly overlooked in group coursework. At times, we toyed with using other texts but always found them filled with information that was not useful or systematic and lacking in information that assisted in the conceptualization of groups and group interventions.
When we used Bill’s text, we found that our courses, once liberated from old structures, became highly effective as the foundation for budding group counselors. As I (Deborah Rubel) taught advanced group counseling to doctoral students who had already learned about group work, I received feedback that the book revolutionized the way they thought about groups and assisted them in integrating the bits of disparate information from past learning into a useful approach across group types. As time wore on, we and our master’s- and doctoral-level students continued to find the text useful, unique, and substantial.
After a few years, Bill’s book went out of print. We and our students still had access to the book in the form of used copies and PDF files, but we pondered why the book had not been used more often and how we could potentially update it and reintroduce it to a larger audience. Thoughts, meetings, plans, plan revisions, outlines, jobs, kids, aging parents, and COVID-19 all happened. Some of these challenges (or “delays”) became opportunities as the world of helping and helping in groups shifted in unimaginably dramatic ways, even as it stayed, at its core, essentially the same. This book, in collaboration with Bill and the American Counseling Association, is the culmination of these experiences over time.
Like the first edition, this second edition presents principles, theories, and procedures to help readers develop their understanding of group interaction and begin their practice of group work. Experienced leaders will learn about new ideas that can invigorate and improve their practice, as well as be challenged to “try on” new perspectives and procedures. Novice leaders and students will be challenged to view group work as a distinct and uniquely powerful evidence-based mode of counseling and therapy that stands apart from individual counseling. Both experienced and novice group leaders will find that the perspectives and procedures offered are different from, and offer additional benefits over, what they have learned in their training in individual counseling and therapy.
The perspectives on group work that have guided the preparation of this second edition vary from the perspectives present in most group counseling and therapy texts. First, the principles, theory, and procedures presented here place the group process at the center of group work. This perspective views the quality of group members’ interactions within the group process as the most critical determinant of member change. The centrality of group process and quality of member interactions have several critical implications for group leaders’ roles, responsibilities, and actions (which lead to the second set of differences). The centrality of group process and quality member interactions is emphasized most often in counseling and therapy groups but is also significant to psychoeducational and work groups.
Second, although this text positions group leaders as important to group members’ learning, change, and therapeutic success, the group leader’s impact is characterized throughout as a less direct change and therapeutic agent. The role of a leader is characterized more as a builder and steward of optimal group conditions for change than as a purveyor of group techniques. This differs from most texts. It means that group leaders are responsible for creating and maintaining a learning, change-promoting, and therapeutic environment. This environment supports teaching members communication skills and other tools necessary for interpersonal learning and structures and supports interactions so that members learn from one another and change as desired. This perspective holds that members’ interactions, not the individual therapeutic technique of the group leader, provide the medium for learning, change, and growth.
Another set of beliefs that inform this text is a systems perspective and the view that helping groups are social systems. From this perspective, the environment in which the group exists, the composition of the group, the group’s goals, the internal and external communication boundaries of the group, and members’ issues are all intertwined. As part of the environment within which all groups operate, the sociopolitical realities of power and differences in culture, race, gender, sexual orientation, socioeconomic class, religion, primary language of communication, national origin, immigration status, and age, among others, affect leadership and member interactions. The implications of systemic interrelatedness include the replication and display of individual, familial, societal, and cultural dynamics within the group and the potential for growth or harm to result.
Finally, this text is grounded in the belief that the principles of group dynamics and theories specific to group should inform leaders’ actions. This belief implies that leader actions and interventions are severely limited when they are not informed by theoretically based conceptualizations of group interaction. Principles of group dynamics and theories specific to group offer new and experienced group leaders information about group-as-a-whole functioning, when to intervene, which intervention to use, and why an intervention may not have been effective. Surprisingly, this emphasis on group-specific theory is relatively uncommon.
This second edition differs from the first edition in several ways. Updated perspectives on diversity and social justice, current research on group efficacy and process, and updated professional frameworks are included and integrated into all aspects of the text. In particular, attention to accreditation standards will enable training programs to utilize this text as a comprehensive resource for entry-level and advanced group coursework. Additionally, extra care is taken in this text to apply the systemic perspective, foundational concepts of group dynamics, and group-specific theory to a variety of settings and group types, including online settings and populations of relevance to counselors.
Organization and How to Use This Book
This updated text includes four parts with several chapters in each part. Each chapter is relevant to both novices and more experienced group leaders. If you are just learning, use the learning outcomes for novice leaders outlined at the start of each chapter to guide your reading and learning efforts. If you are more advanced, use the advanced leaders’ learning outcomes to deepen your learning and application of concepts.
The information in Part I helps new and experienced leaders understand groups as human phenomena that occur naturally in a social context, have shared interactive and environmental characteristics, and develop over time. Learning can be directly supported by reflection, discussion, and writing about current group membership and leadership experiences. Learning can also be enriched through reflection, discussion, and writing on recalled past informal and formal group experiences, on group interaction in movies or training videos, or on written group interaction scenarios.
Part II explains three group-specific theories—focal conflict, group general systems, and interpersonal—that each contribute to a comprehensive, integrated, and useful framework for understanding groups and group leadership. The chapters emphasize the types of understanding that are critical to counseling and therapy groups but are also useful to understanding psychoeducation and task groups. Learning for novice group leaders can be best extended through applying the concepts to group interaction in training videos that use facilitated groups. Learning for more advanced group leaders may be facilitated by viewing video recordings of their own groups and applying the concepts, preferably in the context of supervision.
In Part III, this theoretical framework is translated into concrete leadership and membership skills, ongoing leadership tasks, and intervention strategies for moving groups and group members forward through common challenges. Again, these skills, tasks, and intervention strategies are directly applicable to counseling and therapy groups but also adaptable to psychoeducation and task groups. Novice and advanced group leaders will benefit from extending their learning of these skills, tasks, and interventions by applying the concepts to group interaction in video recordings.
The first two chapters in Part IV integrate all of the foundational learning into the “real world” of groups through a discussion of professional ethical issues. Novice group leaders can support their learning by analyzing group work cases to identify potential ethical dilemmas and apply ethical decision-making models. More advanced group leaders should regularly process the concepts of ethical group work during group planning and supervision.
Part IV also summarizes current research on the effectiveness of groups, introduces readers to common types of groups and settings, describes how groups should be organized and operated, and discusses the importance of leadership personal development and style to the function of the group. It may be helpful to read Chapter 14 on group types and settings earlier in learning—for example, after reading Part I—to become familiar with the broad, real-life world of groups before revisiting it later to deepen understanding of how interactive group leadership is used across group types and settings.
Acknowledgments
We want to express our gratitude to Maya Jamaleddine for her careful literature review and for reviewing all book chapters during the early stages of this project. We also thank Carolyn Baker for her support, patience, and dedication to our success in publishing our second American Counseling Association book. We extend our sincerest congratulations and well wishes to her as she embarks on her retirement journey. Lastly, we thank all the peer reviewers and the staff at ACA Publications for their dedication in helping us publish a book that we are proud of.
About the Authors
Jane E. Atieno Okech, PhD, is a professor of counselor education and supervision and vice provost for faculty affairs at the University of Vermont. Professor Okech’s scholarship primarily focuses on the advancement of proficiencies in the practice of group psychotherapy and clinical supervision with diverse populations. Her scholarly publications in group work and counselor education in general have received multiple professional accolades, including the 2015 Outstanding Article and 2017 Article of the Year awards by the Association for Specialists in Group Work for her collaborations with Drs. Rachel Vannatta, Asher Pimpleton-Gray, and Julia Champe. Professor Okech also received the 2019 Counselor Education and Supervision Publication of the Year award from the Association for Counselor Education and Supervision for her collaboration with Dr. Rubel. She was designated a fellow by the Association for Specialists in Group Work in 2018 and is executive editor of The Journal for Specialists in Group Work.
Deborah J. Rubel, PhD, is a professor of counselor education and supervision at Oregon State University. Dr. Rubel’s recent scholarship focuses on examining and critiquing qualitative approaches to research, describing mental health stigma and bias in counseling/counselor education, and promoting group work. She received the 2019 Counselor Education and Supervision Publication of the Year award from the Association for Counselor Education and Supervision (ACES) for her collaboration with Dr. Okech. She was designated a fellow by the Association for Specialists in Group Work in 2017. Currently, she serves as the chair of the ACES Social Justice and Human Rights Committee.
William “Bill” Kline, PhD, is a retired counselor educator and counselor. During his career, he focused on group work and qualitative research, publishing in both areas. His professional service included numerous terms on the editorial boards of Counselor Education and Supervision (CES) and The Journal for Specialists in Group Work. He also served as editor and then as associate editor for qualitative research for CES. He received the Eminent Career Award and was later designated a fellow by the Association for Specialists in Group Work.
Part IThe Interactive NATURE of GROUPS
Chapter 1The Social Context of Group Counseling
Outcomes
Level 1 Outcomes
After reading this chapter, entry-level students and practitioners should be able to:
Describe how human reliance on relationships is connected to the value of group work.
Communicate how change occurs in group work and how these changes can impact individuals’ lives.
Recount the origins and evolution of group counseling and therapy.
Identify the core values of group counseling and therapy in a socioculturally and sociopolitically diverse world.
Articulate the importance of group work in a socioculturally and sociopolitically diverse world.
Level 2 Outcomes
After reading this chapter, advanced-level students and practitioners should also be able to:
Explain a theoretical basis that connects human reliance on relationships to the value of group work.
Compare and contrast how change occurs in group work and how change occurs in individual helping relationships.
Critique the origins and evolution of group work in light of our changing society.
Justify the shift in the core values of group work in light of our rapidly changing world.
Explain the connection between the needs of a socioculturally and sociopolitically diverse world and the potential of group work.
Group membership defines our lives as humans. The instant we are born we gain membership in groups, starting with membership in the family group that consists of our primary caregivers and siblings. These group memberships evolve and multiply over time to include those associated with friends, school, community, and work or profession, among others. We are also born into a society where our positionality with respect to a multitude of social identities, such as race, ethnicity/culture, gender, age, sexual orientation, ability status, and religion, is defined and nurtured from birth. Potentially, we may become members or leaders of helping groups, such as task, psychoeducational, counseling, and therapy groups. Our intersecting identities and these multiple memberships shape the roles we play in our lives and sculpt our relationships with other individuals and groups. We often refer to ourselves in terms of the roles we play. We may identify as someone’s child or sibling, partner, spouse, parent, or friend or as a counselor or therapist, a researcher, a fan of a sports team, a member of a political party, or an advocate for a social cause. We, the authors of this book, are human beings, too—an Asian American biracial woman, a Black woman, and a White man. We are multifaceted human beings with several intersecting identities. Because we are human beings, we are a part of many groups—for example, a race, a gender, a sexuality, a family, an extended family, friendship groups, a profession, and groups of people who share similar passions and problems. We are connected in some way to all who live in the world with us, all who have preceded us, and all who will follow.
Interpersonal Relationships, Social Connectedness, and Mental Health
The social connectedness that results from effective communication and mutual relationships forms a foundation for mental health. Social connection includes a sense of closeness and belonging, and this develops in relationships ranging from acquaintanceship to intimate relationships (R. M. Lee & Robbins, 2000). If we are able to interact effectively with others, we are likely to get our social needs met and to develop a satisfactory social connection to our primary groups and to the world. Effective interactions with others contribute to our sense of personal value, self-esteem, and belonging. When we are not able to interact effectively, we may become lonely, we may lose our sense of social connection or belonging, and our identity may suffer. Ineffective interactions with others may also lead to very real difficulties in educational environments and the workplace, to a diminished view of our own personal worth, and to lowered self-esteem.
Many theorists representing a broad range of views (e.g., Bugental, 1965; Freud, 1921/1948; Fulmer, 2018; Maslow, 1970; Rogers, 1961; Schutz, 1966; N. Thomas et al., 2015) have described relationships as essential in meeting core human needs. Bugental (1965) discussed rootedness and relatedness as core existential needs and suggested that individuals are motivated to develop a sense that they are a part of humankind and involved in authentic relationships with others. Freud (1921/1948) held that individuals have a basic psychological need for affiliation. Maslow (1970) maintained that individuals need to experience a sense of belonging as well as have a need for love and intimate relationships. Rogers (1961) held that individuals develop a sense of self-worth in the context of their relationships and strive to gain acceptance from others. Rogers also stressed that, as individuals age, their “need for positive regard from others increases. Such needs include being loved by others, being emotionally and/or physically touched, and being valued and cared for” (Sharf, 1996, p. 220). Finally, Schutz (1966) identified three essential interpersonal needs—inclusion, control, and affection—that can be satisfied only in relationships with others. All these theorists supported the essential need of individuals to be in connected relationships in which they feel valued and accepted.
The literature affirms that an individual’s ability to effectively self-disclose in relationships plays a significant role in the effectiveness of their social functioning and sense of well-being (Davis & Franzoi, 1987). Effective self-disclosure leads to connectedness, which leads to a sense of well-being and mental health (Davis & Franzoi, 1987; Jourard, 1964). Neuroscientists such as Matthew Lieberman (2013) also have contended that human brains are wired for connection, which serves as the core foundation for modern neurobiology studies. Without a sense of connectedness, individuals may become lonely, may lack a clearly defined sense of identity, and may not feel they belong in society (Lieberman, 2013).
Although the ability to self-disclose effectively is important in developing essential connections with others, effectively communicating one’s experiences to others is challenging. For some, this is complicated by a variety of barriers, the development of which can also be traced to relationships. Fears that may originate from inadequate or damaging relationships with families of origin or peers may limit what individuals feel safe to disclose. Even when self-disclosure and connection are desired, patterns of behavior established over time in unhealthy environments—for example, avoidance or aggression—may prevent or limit connections. Similarly, lack of modeling and reinforcement in formative relationships may result in a lack of communication skills. These limitations to appropriate and effective self-disclosure restrict the capacity of an individual for intimate involvement with others. Individuals who hear messages from significant authorities in their lives (e.g., teachers, priests, counselors, caregivers, political leaders) that they are inferior or do not have value in society may begin to internalize such messages or develop anger and resentment toward those who harbor such values and beliefs.
Individuals who have not witnessed effective self-disclosure or listening skills may become discouraged if their attempts at connecting are ineffective. Thus, to build authentic and healthy relationships, acquire a sense of social connectedness, and develop a clear sense of identity, individuals must resolve those interpersonal issues that influence how they communicate and respond to the communications of others. Individuals may also need to acknowledge the impact of sociocultural factors and systemic oppression on how they experience themselves and their relationships with people in general, with their own primary identity groups, and with groups that have contributed to their marginalization. The resolution of interpersonal issues in all these contexts is a crucial prerequisite for mental health, and adequately resolving interpersonal issues is a critical part of improving mental health.
Interpersonal Relationships
Historical and contemporary research both support the idea that individuals learn how to view themselves and others, and how to act in relationships, from interactions in their families as well as in social, educational, and occupational groups. Foundational theorists such as Sullivan (1953), Bowen (1966), and Kernberg (1976), despite their varied perspectives, contended that family-of-origin experiences shape the roles that individuals assume and the way in which they fill those roles. From the perspective of these theorists, experiences with significant others shape how individuals interact with others and influence their choices about forming relationships and interacting with others throughout their lives.
Relationship patterns formed in their family of origin define the behaviors and roles that individuals perform in all their relationships. This means that individuals’ interactions, with some variation, are relatively consistent between home, work, school, and other social-cultural contexts. For example, an individual who suppresses the expression of their anger at home probably suppresses it at work and with their friends. An individual who believes they need to please others to be acceptable in their family is likely to work hard to please their friends, their peers at work or at school, and their employers or teachers.
Learning how to be in a relationship is a result of the experiences individuals have in their family of origin or in their primary family grouping. At times, the “rules” families have about how to be appropriate, acceptable, and noticed create self-perceptions and relationship behaviors that cause pain and limit the extent to which individuals are able to be fulfilled in their relationships. Family rules that forbid the expression of painful emotions severely limit how openly family members can share their feelings to gain support from other family members. Later in life, individuals who have grown up operating by these rules are not likely to know how to ask for or receive the support offered in more fulfilling relationships. Conversely, many families have rules that lead to self-perceptions and relationship behaviors that are fulfilling and allow individuals to develop and prosper. These families provide a nurturing environment in which it is safe to be vulnerable, share emotions, openly seek support, and experience acceptance.
Individuals who experience problems in their relationships are often dissatisfied with their lives and less mentally healthy than individuals who do not experience relationship problems. When individuals who experience relationship problems become members of counseling or therapy groups, they have an opportunity to identify their relationship problems, to identify the origins and impact of these on their current relationships, and also to gain insight into self-perceptions that lead to unfulfilling relationships. The primary goals of group counseling and therapy are to help group members learn effective ways to make fulfilling interpersonal connections, change their limiting self-perceptions, and acquire the interpersonal skills and behaviors necessary to develop healthy relationships.
Group Interaction as a Reflection of Social-Cultural Context
The social issues present in the social-cultural context of counseling and therapy groups invariably appear in group interaction. Most commonly, these issues emerge when members treat each other according to stereotypes (Miles et al., 2021; Okech et al., 2016). Examples include a female member accusing a male member of not valuing the expression of emotions, a male member accusing a female member of not being able to make rational decisions, a cisgender group member telling a member who identifies as gender nonbinary to choose a “side,” or a member suggesting that another member has limited intelligence because of race. Other occasions in which stereotyping occurs are less blatant but just as demeaning. For example, group members may treat another member very carefully (e.g., making sure a member understands what is going on or does not have hurt feelings) or patronize a member because of assumptions about how to get along with “that kind of person.” Such careful or patronizing treatment is a subtle demonstration of stereotyping that limits member participation and learning and stymies the relationships the targeted member can develop with other group members. Members are often unaware that their long-held stereotypes of others limit the choices they make about their treatment of others. Many members are unaware that they inadvertently cause others pain (Okech et al., 2015). Perhaps most tragically, these members are totally unaware of how their stereotypes severely limit their opportunities for satisfying relationships and what they can learn from those whom they stereotype.
The clearest manifestation of social-cultural issues emerging in the group context occurs when there is an open expression of bigotry or intolerance. Although the open expression of prejudice is appalling and immediately damaging to the group, it is only a more blatant expression of the same limiting beliefs usually expressed more subtly (Miles et al., 2021). In all cases, members bring the biases they acquire in their social environments into the counseling and therapy groups they attend. Regardless of how they are expressed, biases disrupt interpersonal interactions within the group and delay the group’s progression toward cohesion as overt and covert conflicts (Okech et al., 2016). Assuming counseling or therapy groups will be “cultural islands” free of intolerance and bigotry is an enormous mistake.
Social Issues and Social Responsibility
Leaders who understand that groups are social microcosms, inevitably reflecting the dynamics of the social-cultural contexts within which they exist, should expect that sociocultural issues will emerge within their groups. Leaders who witness social and cultural issues emerging in their counseling and therapy groups are responsible for identifying and confronting these issues. Confronting social issues is a fundamental aspect of a leader’s role and social responsibility. At a minimum, leaders who are sincere about helping members make productive changes in their lives are concerned about the social issues that cause members pain and limit their potential for growth. Such leaders are also invested in creating a group culture that encourages members to directly address sociocultural concerns and to work on understanding each other and resolving conflict.
Leaders must recognize that group members live in environments where there are devastating social issues, such as religious and cultural bigotry, intolerance of differences, racism, ageism, and sexism. These socially exhibited attitudes and beliefs significantly influence what individuals can be and limit their opportunities to have social relationships that could contribute to their well-being. These realizations have three important implications for the work of group counselors and therapists. First, the leaders’ responsibility to proactively identify and confront these issues during group interaction is critical. Second, leaders must help members learn not only how to confront and cope with the tyranny of social issues but also how to help others outside the group confront these issues. Finally, group counselors and therapists must find a meaningful way to confront social and cultural issues in their own lives.
The Critical Need for a Multicultural Perspective
Individuals from diverse cultures, races, religious practices, and worldviews populate the earth we live on. These diverse perspectives enrich us all because they offer alternative perspectives and variety; each of us becomes richer in our experiences when we embrace and respect diversity. Treating others with respect, and valuing the development of common understanding and acceptance, completes a cycle of relationships that increases the possibility that social systems will come nearer to nurturing all individuals and their potential. The entire world is interconnected through global economies and political movements; impacted by global pandemics and sociopolitical changes; and intractably influenced by social media, international education, and cultural movements. Developing a multicultural perspective in one’s work is therefore imperative.
Multicultural Group Counseling and Therapy
In a sense, all group counseling and therapy is multicultural and requires the engagement of diverse perspectives. Each group member represents diverse communities and the diverse qualities, identities, histories, experiences, and circumstances of their families. Later discussion will describe various ways to compose groups and the advantages and disadvantages of composing groups of people who are alike or different in some way (see Chapter 14). At this point, prospective leaders should understand that there is diversity in even the most homogeneous groups. Leaders who assume the presence of diversity even when members appear and behave similarly are most likely to develop an effective group environment.
Assuming diversity means that leaders presume that each member differs from the others in meaningful ways. Leaders who assume diversity always strive to help members confront and answer the question “How can we work together in a way that benefits us all?” Confronting this question means acknowledging members’ differences and finding a common ground for members working together in the group. Confronting and acknowledging diversity means members’ differing histories, identities, experiences, and perspectives can benefit all group members. For example, men and women can gain insight into their own relationships by listening to others’ perspectives on intimacy and gender roles. Individuals who struggle with emotions and those who are comfortable with emotions can learn to empathize with those who are different and to respect the ways in which others express themselves. Spontaneous members and members who are more measured in their interactions can learn ways to interact with each other. Cisgender, heterosexual group members can learn about the dynamics of cisgender gay and lesbian relationships or those of nonbinary, gender-nonconforming, or transgender group members. In each of these examples, members learn tolerance and respect for different perspectives and identities, experience alternative ways to interact, and broaden their perspectives about others.
Change
From a group counseling and therapy perspective, three fundamental beliefs are useful guides for counselors and therapists. These pertain to how individuals develop relationship problems, how they maintain those relationship problems, and how they can best change how they relate to others. The first belief is that individuals form and enact their personalities in relationship to others. The second is that because of their relationships, individuals develop a pattern of “acceptable” interpersonal behaviors that they believe are appropriate to use in their relationships. The third belief is that because individuals form self-perceptions and interpersonal behaviors in relation to others, they are more likely to change how they interact with others and in relation to their self-perceptions. This is what makes group work such a powerful tool for interpersonal change.
Interpersonal Learning and Group Interaction
From as early as 1905, literature on group membership has described the powerful impact of group members on one another and of group dynamics within the group (I. D. Yalom & Leszcz, 2020), allowing members to learn from their here-and-now interactions. Bloch and Crouch (1985) analyzed factors previously identified by research as crucial for achieving therapeutic goals in therapy groups. One of these factors, interacting with one another, was found to be the most crucial in helping members achieve therapeutic success. In other words, members profited most from their interactions with each other, not from their interactions with the group leader. The idea of members profiting from their interactions with other members may be foreign to group counselors and therapists who have been trained in traditional, individual-oriented approaches to counseling and psychotherapy. As a result of their clinical training, they may perceive themselves to be the primary agent of change in their work with clients.
From our perspective as authors, effective group leaders are those who can successfully create environments that promote effective member interaction. When members interact effectively, they experience the profound power of group interaction to influence their interpersonal behavior. When leaders recognize that their goal is to establish and maintain conditions that allow interpersonal learning, the way they lead groups often changes dramatically. Members who participate in groups that demonstrate necessary conditions and emphasize interpersonal learning become intensely engaged and acutely aware of their relationships with each other. This awareness can often lead to significant changes in how members relate to each other and to people outside their groups.
The Relevance of Change in Group Interaction to Real Life
Because members participate in counseling and therapy groups to deal with relationship problems, they eventually enact their relationship issues in the here and now of group interaction. Ultimately, group members realize the way they interact with others in group is very similar to how they interact in relationships outside group. Additionally, the social-cultural context of the group has a significant impact on the interpersonal dynamics and interpersonal issues with which a group may grapple. Group members’ beliefs and values regarding, for example, their socioeconomic status, racial identity, gender identity, political views, and sexual orientation are likely to emerge in group in both overt and covert ways. Inevitably, members will also see how their perceptions of others and their interactions in their group relationships are related to early experiences in their family of origin and their social-cultural context.
When members become aware of the behaviors and perceptions that create problems in their relationships with others in group, change is possible. Group members who become aware of what they do to cause relationship problems are then able to make different choices about interacting with other group members. A reflective and introspective process allows group members to examine the personal beliefs and values underlying their behaviors and interpersonal patterns. Eventually, members can apply those changes they make to improve their relationships with other group members to improving their relationships outside group.
Issues can arise, however, when members do not transfer what they learn in group to their out-of-group relationships or when members believe that their interpersonal patterns within the group are untransferable and unrelated to how they engage outside the group. Leaders who are sensitive to this transfer of learning involve members in fine-tuning their behavior changes in group and in making thoughtful decisions about when and how to use their new interpersonal behaviors outside group. When considering the relevance of group interaction to “real life,” new leaders and members must recognize that relationship behaviors in group correspond with relationship behaviors outside group. Group leaders also should recognize the need for and value of a conscious decision-making process for transferring what members have learned in group to their out-of-group relationships, so members have no doubt about the relevance of in-group changes to real-life situations.
Essential Values for Group Work
Helping people become more satisfied in their relationships with others is the core objective for group counseling and therapy. This objective can be translated, if necessary, into such terms as promoting mental health, increasing the effectiveness of interpersonal behaviors, improving boundary functioning, bettering social adjustment, changing limiting cognition, developing congruence, increasing self-acceptance, or ameliorating developmental issues. Counselors and therapists can also express the foundational value of group work, which is that effective and fulfilling relationships are necessary for optimal functioning and mental health.
Leaders who understand that group interaction mirrors interaction occurring in the social and cultural environment outside the boundaries of their groups also see the relevance of group work to improving society as a whole. Among the things members should learn in groups are how to be sensitive to the needs of others, how to accept and live with differences, how to communicate to ensure more complete understanding, and how to deal productively with conflict. Thus, each member who leaves a group with these learnings can contribute to the quality of their social and cultural environment. Similarly, issues in the broader society/culture have a powerful impact on individuals’ lives, both limiting and defining possibilities for interpersonal connection, personal development, and life satisfaction. Leaders who are concerned about members leading satisfying lives cannot ignore the social and cultural conditions that limit the possibilities for group members outside counseling and therapy groups.
The Efficacy of Group Counseling and Therapy
The first description of group counseling and therapy as a formal practice appeared in an article by Joseph Pratt in 1906. This article described the powerful influence that group interaction had on group members. Pratt’s ideas have evolved continuously since the publication of his accounts. At present, there continues to be overwhelming support for group counseling and therapy and an ever-growing need for group interventions.
The Accounts of Pratt, Trigant Burrow, and Lewis Wender
The pioneers of group therapy learned about the power of group interaction to improve individuals’ lives through happenstance, challenging circumstances, and inquisitiveness. As mentioned, Pratt (1906) was the first to write about the curative effects of group interaction. He used groups due to overwhelming practical demands and stumbled on the discovery that group interaction had a powerful influence on those who participated. Another pioneer, Trigant Burrow (1928), was curious how loneliness affected individuals and so explored how relationships with others influenced a person’s psychiatric issues. Lewis Wender (1936), by contrast, faced the practical issues of applying individually focused psychoanalytic therapeutic interventions to hospitalized psychiatric patients. He discovered that group interaction was productive because of some essential dynamics present in group interactions.
On July 1, 1905, as a result of being overwhelmed with a constant stream of new patients, Pratt began treating tuberculosis patients in groups (MacKenzie, 1992; Pratt, 1906). Pratt’s Emmanuel Church Tuberculosis Class was a group of 25 members who met weekly at Massachusetts General Hospital for socializing and education. Members of the class represented many racial identities and religious sects. Pratt noted that the members, although different in many ways, shared the common bond of their disease. Of the tuberculosis patients in Pratt’s classes, many of whom had been given no hope, 75% recovered.
On April 30, 1928, Burrow presented a paper at the Phipps Psychiatric Clinic at Johns Hopkins Hospital (MacKenzie, 1992). Burrow initiated his work with groups because of his interest in exploring the effects of isolation. He believed that many psychiatric problems were related to how individuals interacted with others in their communities. To study problems in community living, Burrow examined the here-and-now interactions of individuals in groups. He concluded that interventions designed to address “mental disorder and insanity, in industrial disorders and crime” (Burrow, 1928, p. 206) should focus extensively on how individuals relate to each other. He also reached the conclusion that interpersonal relationships play a critical role in the development and enactment of psychopathology.
In 1936, Wender published a paper that described the practical realities of making efficient psychotherapeutic interventions with an inpatient population. Using a psychoanalytic frame of reference, Wender faced the issues of time, cost, patients’ unsuitability for analytic procedures, and the difficulties he perceived in establishing productive transference relations. Wender determined that analytic procedures were unsuitable for his situation and that he needed to devise a therapeutic program that could overcome the limitations of analytic procedures. After extensively applying group therapeutic interventions in his setting, Wender identified several essential “dynamics” that operated in group psychotherapy: intellectualization, patient-to-patient transference, and catharsis in the family. Essentially, Wender was the first to articulate what are now called group therapeutic factors.
The contributions of Pratt (1906), Burrow (1928), and Wender (1936) were the products of accidental discovery, curiosity, and practical demands. Pratt accidentally discovered the powerful effects of group interaction. Burrow advanced concepts that describe the role of group interaction in the development and amelioration of psychopathology. Wender was the first to identify some of the critical group therapeutic factors. Each of these contributions plays a significant role in current conceptualizations of the purposes and applications of group counseling and therapy.
The Evolution of Group Work
The practice of group work dramatically expanded in the 1940s in response to the overwhelming needs of military personnel after World War II (Rutan, 1993; Scheidlinger, 1993). During the mid-1940s, group therapy grew dramatically in terms of theory and practice. “The group therapists of those days did the best they could through trial and error and by incorporating their dyadic psychotherapy skills in a group setting” (Rutan, 1993, p. xvii). Although the group therapists during this time were relatively unsophisticated, they recognized that something powerful was taking place in their groups (Rutan, 1993; Scheidlinger, 1993).
In the 1950s, therapists continued to recognize the power of their groups to heal members; however, numerous debates emerged. One of the first, which occurred between individually oriented therapists and group therapists, focused on the relative efficacy of individual versus group therapy. Individual therapists, most of whom were analytically oriented, argued that group therapy offered only superficial treatment (Rutan, 1993). They argued in particular that group therapy diluted transference and that group therapy patients could thus make only superficial changes. This argument ended when group therapy consistently demonstrated that group interaction actually enhanced transference (Rutan, 1993). Subsequent debates occurred between group therapists over theory and the most effective group therapy techniques (Rutan, 1993; Scheidlinger, 1993). Despite these debates, by the end of the 1950s, the literature recognized group therapy as a powerfully effective and versatile form of treatment.
In the 1960s and 1970s, major advances occurred in the applications of psychoanalytic theory and object relations theory to group therapy (Scheidlinger, 1993). Also, during this period, Whitaker and Lieberman (1964) presented a new theory that continues to contribute significantly to the practice of group counseling and therapy. At the same time, various applications of group therapy developed and became highly popular. In particular, encounter groups and variants such as T-groups and sensitivity training groups emerged as vehicles for personal growth.
One of the foremost advocates of encounter groups was Carl Rogers (1970), who stated, “For more than thirty-five years, individual counseling and psychotherapy were the main focus of my professional life. But nearly thirty-five years ago I also experienced the potency of the changes in attitudes and behavior which could be achieved in group. This has been an interest of mine ever since” (p. v). Many authors echoed Rogers’s enthusiasm during the 1970s (Schutz, 1973).
Unfortunately, many practitioners of encounter and related “growth” groups were insufficiently trained and incautious about using provocative group interventions and activities, which often led to members having adverse experiences in their groups. These groups “challenged and embarrassed the professional group work field because many people began to equate those controversial and at times even harmful group enterprises with group therapy” (Scheidlinger, 1993, p. 5). To clarify the difference between the abuses of group work and competent practice, practitioners recognized the need to professionalize group work.
Group work practitioners in 1973 formed the Association for Specialists in Group Work (ASGW). Like the American Group Psychotherapy Association (AGPA), which was founded in 1942, ASGW seeks to advance professionalism in group work. Both organizations contribute to group work knowledge and practice through their journals: the International Journal of Group Psychotherapy, published by AGPA, and The Journal for Specialists in Group Work, published by ASGW.
In 1994, AGPA, which has developed standards for clinical membership and ethical practice, supported certification for group therapists who meet stringent standards for training and experience. Certification and recertification of group psychotherapists is currently managed by the International Board for Certification of Group Psychotherapists.
ASGW, now a division of the American Counseling Association (ACA), has made substantial contributions to the professionalization of group workers in the fields of counseling and psychotherapy. For example, it has defined standards for training, practice, and multiculturalism in group work. Guiding documents include Multicultural and Social Justice Competence Principles for Group Workers (ASGW, 2012), Professional Standards for Training Group Workers (ASGW, 2000), and Best Practice Guidelines (R. V. Thomas & Pender, 2008).
In the field of psychology, the recognition of group work was slower to develop. In 1991, the American Psychological Association formed the Group Psychology and Group Psychotherapy division, which in 1996 began publication of the journal Group Dynamics (Gladding, 1999).
Since the 1970s, group therapy has seen continued growth and development. Dies (1993) pointed out that new group paradigms, such as time-limited therapy groups and self-help groups, have replaced the encounter movement of the 1970s. Scheidlinger (1993) described the growth of the group therapy movement since the 1970s as “an unprecedented growth spurt” (p. 9). Evidence of the continued growth in group work includes the increasing presence of group research in psychotherapy and counseling literature (I. D. Yalom & Leszcz, 2020) and the increased presence of group treatments in inpatient, outpatient, community, school, and “virtually all human service facilities” (Scheidlinger, 1993, p. 9). The substantial evidence of the effectiveness of group work interventions fuels the ongoing rapid expansion of group work.
Since 2000, group work has expanded exponentially with an increasing emphasis on practices that are effective across diverse racial and cultural groups (Kivlighan et al., 2019, 2021; Okech & Rubel, 2007; Rubel & Okech, 2018). For years group work has been criticized for not keeping up with the needs of racial minority groups (Bemak & Chung, 2004; Rubel, 2006). The practice has also expanded in its provision of treatment to specialized groups of clients who present with specific concerns, such as anger management or addictions, or who are in sexual offender treatment programs and the like. Treatment programs have expanded from unstructured counseling groups to structured and manualized psychoeducational groups (M. J. Galinsky et al., 2008). Even more recently, the trend toward evidence-based group work has influenced how practitioners in counseling and allied fields think about their work and the field (Muskat et al., 2010; Pollio & Macgowan, 2010). The call for evidence-based counseling has resulted in more focus on assessment of interventions and group outcomes, as well as how group work is taught and supervised in academic programs preparing counselors and therapists for practice (Hollenbaugh & Goodrich, 2021). Diversity-focused and evidence-based group practice are at the front lines of the continuing evolution of group counseling and therapy training and practice. In fact, the proliferation of manualized treatment is directly linked to the call for evidence-based group counseling practices (Burlingame et al., 2013; Miles & Paquin, 2013).
Research on the Efficacy of Group Counseling and Therapy
H. S. Bernard and MacKenzie (1994), in describing the 15 years of psychotherapy research prior to 1994, reported that approximately 85% of individuals involved in group psychotherapy did better than individuals in control groups. They went on to state that the results were “essentially the same whether the psychotherapy [was] delivered in an individual or group format” (H. S. Bernard & MacKenzie, 1994, p. viii). I. D. Yalom (1995) and I. D. Yalom & Leszcz (2005, 2020) concurred that a significant amount of evidence supports the efficacy of group therapy. Piper (1993) also made the point that reviews of the outcome literature during the past decade have confirmed the general effectiveness of group therapy and its similar efficacy to that of individual therapy.
In 1993, Dies summarized 40 years of research in group psychotherapy, finding that the literature showed continued growth in the confidence that group treatments were effective. This confidence followed from meta-analytic studies of group research, surveys, comprehensive reviews of outcome studies, and studies that demonstrated the effectiveness of group interventions with specific client groups (e.g., depressed, bulimic, or sexually abused clients; Dies, 1993). Authors generally have agreed that group treatment is both effective and cost-efficient (H. S. Bernard & MacKenzie, 1994; Dies, 1993; Piper, 1993; Scheidlinger, 1993; I. D. Yalom & Leszcz, 2020).
