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International Centre for Certification and Education of Addiction Professionals (ICCE)

The Universal Treatment Curriculum for Substance Use Disorders (UTC)

Curriculum 4

Basic Counseling Skills


for Addiction Professionals
MODULE 5GROUP COUNSELING:
BASIC SKILLS

Important
Group

counseling is not the same thing as


doing individual counseling in a group setting!
Using individual counseling skills in group may
not always be effective
The needs of the group as a whole must be
balanced with the needs of individuals in the
group
Group counseling includes good facilitation
skills that enable the group to do most of the
work
5.2

Group Counseling: Motivational


Enhancement

Motivational enhancement techniques used in a group setting can


Provide social support and encouragement for group members
Encourage self-disclosure as a result of feedback and
empathic regard
Develop the capacity for reflective listening and comment by
peers that promote discrepancy as well as ambivalence in
peers, and
Allow group members to act as agents of change by helping
each other, through a peer-based process, to strengthen their
motivation and commitment to change

5.3

Module 5 Learning Objectives


Describe

the process of preparing clients for

groups
Describe at least 2 basic issues or tasks for each
typical group phase
Describe a basic way to structure a group session
List at least 3 ways to avoid leader-centered
groups
Demonstrate ways of managing disruptive
behavior in groups
5.4

Pre-group Meetings With Clients


Clarify

expectations

Of the client
Of the treatment program

Set

up basic ground rules


Explore the advantages of group therapy
Correct any misconceptions about groups

5.5

Assessing and Matching Clients to


Groups
Consider:

The clients characteristics, needs, preferences,


stage of change, and stage of recovery
The programs resources
The nature of the group or groups available

5.6

Special Considerations
Not

all clients are right for a group:

Clients with co-occurring mental disorders (e.g.,


severe depression; anxiety) may not be able to
function well in a group setting
Clients with a co-occurring personality disorder may
need a group with very strict boundaries to avoid a
negative group experience or to avoid negatively
affecting other group members

Each

client must be assessed for his or her own


individual needs in treatment
5.7

Special Considerations (continued)


Not

all clients are right for a group:

Clients who have experienced trauma, especially


sexual abuse, may need a homogeneous group
Clients in the throes of a life crisis may require more
concentrated attention than groups can provide
Clients who choose not to participate in group
therapy should not be criticized or penalized

5.8

Preparing Clients for Group Work


Screen

clients for appropriateness

Assess ability to function in group


Assess stage of change
Assess willingness to participate

5.9

Preparing Clients for Group Work


(continued)
Provide

information:

How group counseling compares with other group


experiences clients may have had
The benefits of group counseling, or how group might
specifically help the client
How the group is structured
The kinds of issues the group addresses

5.10

Preparing Clients for Group Work


(continued)
Recognize

and affirm clients expectations

Ask about expectations


Correct any misconceptions
Affirm positive expectations
Address and reframe fears

5.11

Preparing Clients for Group Work


(continued)
Group

agreements

Attendance requirements
Expectations of confidentiality
Whether physical contact is okay
Use of substances
Minimum participation requirements
The counselors punctuality

5.12

Goals of Preparation
Establish

a preliminary alliance between client and


counselor
Gain a clear mutual understanding about the
client's expectations
Offer information and instruction about the group

5.13

Goals of Preparation (continued)


Deal

with initial client anxiety about joining a


group
Present and gain acceptance of a group
agreement

5.14

Small-Group Exercise: Preparing


Clients for Groups
Resource

Page 5.2: Potential Group Members:


Client Profiles
Resource Page 5.3: Types of Groups
For each of your three assigned clients:
Which group is most appropriate?
Why?
How will you prepare the client for the group?

For

one client, develop a role-play demonstrating


preparing the client for group
5.15

General Types of Groups: Static Versus


Revolving Membership
Static

membership groups keep the same


membership throughout the life of the group with
no new people joining
Revolving membership groups have people come
and go, join and leave, and the group continues
on despite the changing membership

5.16

General Types of Groups: TimeLimited Versus Ongoing


Time-limited

groups have a set number of


sessions (an education group is a good example)
Ongoing groups have no specific end date

5.17

General Types of Groups: ContentOriented Versus Process-Oriented


Groups
Content-oriented

groups focus on identified


topics for each session (for example: education
or skills-training groups)
Process-oriented groups focus on the
interaction between group members and
counselors and are here and now focused,
with no specific topic identified for each session

5.18

Your Agencys Groups


Membership:

static or revolving?
Timeline: Time-limited or ongoing?
Focus: Content-oriented or process-oriented?

5.19

Phases of Group Development


Beginning

phase
Middle phase
End phase

5.20

Beginning Phase Issues and Tasks


Introducing

members and facilitators


Establishing/reviewing a group agreement
Providing a safe, cohesive environment
Establishing norms
Initiating the work of the group

5.21

Middle Phase Issues and Tasks


Balancing

content and process


Noticing and rolling with resistance
Keeping the group focused
Modeling a healthy interactional style
Facilitating rather than running or directing the
group

5.22

End Phase Issues and Tasks


Putting

closure on the experience


Examining the impact of the group on each
person
Acknowledging the feelings triggered by
departure
Giving and receiving feedback about the group
experience and each members role in it
Completing any unfinished business
Exploring ways to carry on the learning
5.23

Break
15 minutes

5.24

Structuring a Group Session


What

is intentionality in counseling?

5.25

Structuring a Group Session


(continued)
Intentionality

means:

Selecting helping behaviors and specific strategies


with a clear purpose and direction in mind
Having a clear objective in mind for a session and not
allowing the session to take on its own momentum
(while being appropriately flexible)

5.26

Structuring a Group Session


(continued)
By

structuring a group session:

The facilitator ensures that important aspects of the


work are protected
Group members know what to expect from a session
Beginning and ending rituals are established

5.27

Structuring a Group Session


(continued)
Opening

and welcome

Check-in
Review

group norms and rules


Active work
Summary and homework
Closing

5.28

Opening and Welcome


Greet

each participant warmly


Start the session ON TIME!
Beginning on time sends the message that the work
of the group is important
A late group leader sends the message that the
group is not important and conveys a lack of respect
for participants time
Waiting for late group members reinforces lateness
and conveys lack of respect for group boundaries
and participants

5.29

Opening and Welcome (continued)


Introduce

new members
Make announcements
Opening ritual

5.30

Check-in
Review

of last session
Homework follow up
How are you all feeling today?

5.31

Active Work
The

heart of the session


Content-oriented or process-oriented, depending
on type of group

5.32

Summary and Homework


Summarize

the work of the group or ask the


group to summarize
Give or reinforce homework assignments
Affirm the work of the group
Ask the group for any other affirmations
Check in with participants if necessary

5.33

Closing
Closing

ritual

For example: Asking group members what was


learned that they are taking away from the group

5.34

Leader-centered Groups
Content-oriented

group

For example: Psycho-educational groups


Leader becomes a teacher

A process

group that remains leadercentered:

Limits the potential for learning and growth


May include one-on-one counseling in the group
Does not use the full power of the group to support
experiential change or to build authentic, supportive
interpersonal relationships

5.35

Group Facilitation
The

practice of supporting a groups process


rather than creating or directing it

5.36

Group Facilitation (continued)


Avoid

doing for the group what it can do for itself:

Turn questions back over to the group


Ask a group member to direct a comment to another
group member
Dont always be the one to break a silence
Ask the group to comment on process

5.37

Group Facilitation (continued)


Teach

participants to support one another:

Model support in early stages of group


Teach specific skills
Reinforce and affirm participants support of one
another
Dont rush in to offer support to a participant in the
later stages of group

5.38

Emotional Contagion
Anothers

sharing can stir frightening memories


and intense emotions in listeners
Emotional contagion can overwhelm group
members and the group process

5.39

Emotional Contagion (continued)


To prevent

or counter emotional contagion, the


facilitator needs to:
Protect individuals
Protect boundaries
Regulate emotionality

5.40

Protect Individuals
Guard

the right of each member not to be


involved in emotional discussions:
Make it clear that each group member has a right to
private emotions and feelings
When the group pressures a member to disclose
information, remind the group that members need
reveal information about themselves only at levels
with which they are comfortable

5.41

Protect Boundaries
Clarify

that each client is responsible for


managing his or her own feelings in the face of
the groups power and deciding what he or she
will and wont share

5.42

Modulate Emotionality
Keep

emotionality at a level that enables the work


of the group to continue

Example:
Weve

been expressing some intense feelings here


today.To prevent us from overload, it might be valuable
to stop what were doing and try together to understand
whats been happening and where all these powerful
feelings come from

Source: Yalom, I. D. (1995). The theory and practice of group psychotherapy. 4th ed. New York: Basic
Books. p. 350.

5.43

Small-Group Demonstrations:
Instructions
Decide:

In what phase of development is your group?


What portion of a group session will you
demonstrate?

Select

a facilitator
Select client roles from Resource Page 6.2
Prepare an 8- to 10-minute group role-play
Be creative!
5.44

Issues in Group Management


Handling

conflict in group (Resource Page 6.8)

Unhealthy interactions
Covert conflicts
Displaced anger

Managing

subgroups (Resource Page 6.9)

Make covert alliances overt


Reframe what the group is doing
Rearrange
5.45

Issues in Group Management


(continued)
Responding

to disruptive behavior (Resource

Page 6.10)
Talkative or interrupting clients
Clients who flee a session
Coming in late or absence
Silence
Tuning out
Focusing only on others
5.46

Small-group Presentations:
Issues in Group Management
Instructions
Read

your assigned Resource Page


Select a facilitator
Select client roles from Resource Page 5.2
Create a presentation and a demonstration roleplay

5.47

Lunch
60 minutes

5.48

Small-Group Exercise: Issues


in Group Management

Presentations
5.49