Therapeutic and Counselling Groups

The main purpose of all counselling and therapeutic endeavours is to bring about change. When a person joins a counselling group, it is usually to learn new ways of being, interrelating, and interacting. In a therapeutic small group the specific goals for each member can be varied but would include the expectation that change will occur (Conyne, 1997b).

In both types of groups it is expected that members will become more functional and less distressed. Often groups are called by names that indicate their purpose. For example, both therapists and counsellors run communication groups, assertiveness groups, life-skills groups, and decision-making groups.

The general goals of these respective groups are to improve communication skills, to increase assertiveness, to provide experience in life skills, and to allow experience in a decision-making process.

If the theme of the group is self-awareness, then one goal for the group members would be to become more aware of various aspects of themselves – how they behave in different situations, how they react to certain stimuli, and how others react and behave in return.

A second goal would be for the members to use this new awareness to gain a better understanding of themselves and, based on this understanding, to effect some change in their behaviour directed at achieving or eliciting more productive outcomes.

Immediately the question arises, “What happens in groups that enable members to change?” Or, as Kottler (1994a) asks “What is this magic that cures people of their suffering?” (p. 50).

Perhaps the magic, in part, is based on the phenomenon described by Kurt Lewin who is credited with the observation that “it is usually easier to change individuals formed into a group than to change any one of them separately” (Rosenbaum & Berger, 1975, p. 16).

In commenting on the value of groups, Finlay (1999) states “Groups hold individuals’ sense of personal and social identity. Through action and interaction, participants acquire skills, attitudes, and ways of behaving as they respond to the expectations of others and adopt different roles” (p. 26).

Although a person does not experience the same one-to-one attention in a group as she or he would receive during individual counseling or therapy there are other factors that contribute to the success of groups as a therapeutic modality.

Rudestam (1982) discusses five elements that he considers to be advantages of using groups to facilitate bringing about change.

First, Rudestam likens a group to a “miniature society” in which members can lose their feelings of alienation and, temporarily at least, experience feelings of belonging, thus meeting one of the basic needs of humankind (Maslow, 1968). Within the group setting, members can experience every-day life situations such as peer pressure, social influence, and the need to conform.

In this microcosm of society, members can relate their behaviour in the group to their behaviour in social groups outside the group. When these experiences occur in a learning environment, such as a group, the changes that occur are usually transferable to the outside world (Posthuma, 1972; Waldinger, 1990).

The second element in favour of the group-treatment setting is the opportunity to be among others with whom common problems can be shared. It offers the chance to learn new skills and behaviours in a supportive environment. Through group interaction one can receive feedback and caring, experience trust and acceptance, and learn new ways of relating to others.

Because most groups comprise a cross-section of members of society at large, this affords each group member opportunities to cope with give-and-take situations similar to those existing in the world outside. In one-to-one therapy the client experiences only one other point of view and one source of feedback, that of the therapist.

Even though such viewpoints and feedback may be valid, they are limited in breadth and experience by virtue of coming from only one person (Ferencik, 1992). In a group the client may experience several points of view and varied feedback (Echabe & Castro, 1999)… all of which can be presented in different ways. By evaluating this assortment of information, the group member is able to select what he feels could be of personal value and assistance.

Hopefully, because of this mixture, group members will get a broader view of themselves, and become more aware of the subtle nuances of their behaviour. Also, the integration of information is likely to produce a combination of supportive and confrontive messages that can soften any good-bad or right-wrong dichotomies. The more supportive feedback serves as a sort of cushion for the more confrontive.

In essence, this multifeedback situation creates an environment in which members are more receptive and feel less need to be defensive and block out negative feedback (Campbell, 1992). They are more apt to listen, to take in, and to consider what they hear and hence benefit from the process. Conversely, it is also true that there is strength in numbers.

It is easier to disregard feedback that comes from one source only with a “what-does-he-know?” attitude. However, it is close to impossible to ignore feedback from five or more persons if they share the same perceptions and are all giving the same messages or information.

Third, the individual is able to observe the problems, struggles, behaviours, interaction styles, and coping mechanisms of the others in the group.  He is then able to use this information as a yardstick for comparing his own behaviours.  From this a group member can assess his own abilities and disabilities and consider possibilities for personal change.

Closely linked with the third advantage is the fourth, which is facilitation of the individual growth process. The support of the group can be an enhancing factor in self-exploration and introspection (Lieberman, 1990b; Posthuma & Posthuma, 1972).  Feeling, caring, and respect from others can go a long way in promoting the self-confidence necessary to attempt new and different ways of behaving.

The final advantage of the group format for both counselling and therapy is the obvious one of economics.  Having several clients meet together with a group leader rather than meeting individually with a therapist or counsellor saves time and money (Davies & Gavin, 1994).

References

• Campbell, L.F. (1992). An interview with Arthur M. Horne. Journal for Specialists in Group Work, 17, 131-143.
• Conyne, R.K. (1997b). A developing framework for processing experiences and events in group work. Journal for Specialists in Group Work, 22, 167-174.
• Davies, P.L., & Gavin, W.J. (1994).  Comparison of individual and group/consultation treatment methods for preschool children with developmental delays.  American Journal of Occupational Therapy, 48, 155-161.
• Echabe, A.E., & Castro, J.L.G. (1999). Group discussion and changes in attitudes and representations. Journal of Social Psychology, 139, 29-43.
• Ferencik, B.M. (1992). The helping process in group therapy: A review and discussion. Group, 16, 113-124.
• Finlay, L. (1999). When action speaks louder: Groups in occupational therapy. Groupwork, 11, 19-29.
• Kottler, J.A. (1994a). Advanced group leadership. Pacific Grove, CA: Brooks/Cole.
• Lieberman, M.A. (1990b). Understand how groups work: A study of homogeneous peer group failures. International Journal of Group Psychology, 40, 31-52.
• Posthuma, B.W., & Posthuma, A.B. (1972). The effect of small-group experience on occupational therapy students. American Journal of Occupational Therapy, 26, 415-418.
• Posthuma, B.W. (1972). Personal development and occupational therapy. American Journal of Occupational Therapy, 26, 88-90.
• Rosenbaum, M., & Berger, M.M.(1975). Group psychotherapy and group function (Rev. ed.). New York: Basic Books.
• Rudestam, K.E. (1982). Experiential groups in theory and practice. Monterey, CA: Brooks/Cole.
• Waldinger, R.J. (1990). Psychiatry for medical students (2nd ed.). Washington, DC: American Psychiatric Press.