Group Counselling

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Keith Tudor

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  • Professional Skills for Counsellors

    The Professional Skills for Counsellors series, edited by Colin Feltham, covers the practical, technical and professional skills and knowledge which trainee and practising counsellors need to improve their competence in key areas of therapeutic practice.

    Titles in the series include:

    Counselling by Telephone

    Maxine Rosenfield

    Time-Limited Counselling

    Colin Feltham

    Long-Term Counselling

    Geraldine Shipton and Eileen Smith

    Client Assessment

    Stephen Palmer and Gladeana McMahon (eds)

    Counselling, Psychotherapy and the Law

    Peter Jenkins

    Contracts in Counselling

    Charlotte Sills (ed.)

    Counselling Difficult Clients

    Kingsley Norton and Gill McGauley

    Learning and Writing in Counselling

    Mhairi MacMillan and Dot Clark

    Counselling and Psychotherapy in Private Practice

    Roger Thistle

    Referral and Termination Issues for Counsellors

    Anne Leigh

    The Management of Counselling and Psychotherapy Agencies

    Colin Lago and Duncan Kitchin

    Copyright

    View Copyright Page

    Epigraph

    No man is an island, entire of itself; every man is a piece of the continent, a part of the main.

    John Donne (1624) Devotions, XVII

    No individual is self-sufficient; the individual can exist only in an environmental field. The individual is inevitably, at every moment, a part of some field. His behavior is a function of the total field, which includes both him and his environment.

    Fritz Perls (1973) The Gestalt Approach and Eye Witness to Therapy

    I am because we are

    African proverb

    Dedication

    In memory of Margaret Proctor, FBPsS Principal Educational Psychologist, ILEA generous Godmother and enlightening witness (1914–1997)

    Acknowledgements

    Although writing is often a lone and isolated task, writing a book especially about groups is not possible without the experience, help and support of a number of people. My heartfelt thanks and acknowledgements go: to past and present clients, supervisees and trainees with whom I have been and continue to be privileged to work and who consistently remind me about the resilience, potential and aspiration of the individual and collective human condition; to Jenny Robinson, a valued colleague, who – and whose radical therapeutic work – deserves more recognition; to friends and colleagues for their help through discussion and research – Kevin Brown, Mike Fitter, Colin Lago, Adrienne Lee, Fiona Purdie, Val Smith and Ian Stewart – who, for me, formed a conceptual group matrix around this book; to Colin Feltham for his constructive editing; to Susan Worsey at Sage for her support and patience; to Jo and Simon Browes for their secretarial and design skills; and, finally and mostly, to Louise Embleton Tudor, my most valued colleague, best friend and life partner who, as ever, provides both support and constructive criticism and whose love and understanding contributes to my immediate facilitative environment and who, with Saul and Raiya, forms my most immediate family group.

    Appendix 1, ‘Best Practice Guidelines for Groupwork’, © ACA. Reprinted with permission. No further reproduction authorized without written permission of the American Counseling Association.

    Every effort has been made to trace the copyright holders, but if any have been inadvertently overlooked, the publishers will be pleased to make the necessary arrangements and acknowledgement at the first opportunity.

  • Appendix 1: Best Practice Guidelines for Groupwork

    Association for Specialists in Group Work (ASGW) Best Practice

    Guidelines

    Approved by the ASGW Executive Board, 29 March 1998

    Prepared by Lynn Rapin and Linda Keel, Co-Chairs, ASGW Ethics

    Committee

    The Association for Specialists in Group Work (ASGW) is a division of the American Counseling Association whose members are interested in and specialize in groupwork. We value the creation of community; service to our members, clients, and the profession; and value leadership as a process to facilitate the growth and development of individuals and groups.

    The Association for Specialists in Group Work recognizes the commitment of its members to the Code of Ethics and Standards of Practice (as revised in 1995) of its parent organization, the American Counseling Association, and nothing in this document shall be construed to supplant that code. These Best Practice Guidelines are intended to clarify the application of the ACA Code of Ethics and Standards of Practice to the field of group work by defining Group Workers’ responsibility and scope of practice involving those activities, strategies and interventions that are consistent and current with effective and appropriate professional ethical and community standards. ASGW views ethical process as being integral to group work and views Group Workers as ethical agents. Group Workers, by their very nature in being responsible and responsive to their group members, necessarily embrace a certain potential for ethical vulnerability. It is incumbent upon Group Workers to give considerable attention to the intent and context of their actions because the attempts of Group Workers to influence human behavior through group work always have ethical implications. These Best Practice Guidelines address Group Workers’ responsibilities in planning, performing, and processing groups.

    Section A: Best Practice in Planning
    A.1. Professional Context and Regulatory Requirements

    Group Workers actively know, understand and apply the ACA Code of Ethics and Standards of Practice, the ASGW Professional Standards for the Training of Group Workers, these ASGW Best Practice Guidelines, the ASGW diversity competencies, the ACA Multicultural Guidelines, relevant state laws, accreditation requirements, relevant National Board for Certified Counselors Codes and Standards, their organization's standards, and insurance requirements impacting the practice of group work.

    A.2. Scope of Practice and Conceptual Framework

    Group Workers define the scope of practice related to the core and specialization competencies defined in the ASGW Training Standards. Group Workers are aware of personal strengths and weaknesses in leading groups. Group Workers develop and are able to articulate a general conceptual framework to guide practice and a rationale for use of techniques that are to be used. Group Workers limit their practice to those areas for which they meet the training criteria established by the ASGW Training Standards.

    A.3. Assessment
    • Assessment of self: Group Workers actively assess their knowledge and skills related to the specific group(s) offered. Group Workers assess their values, beliefs and theoretical orientation and how these impact upon the group, particularly when working with a diverse and multicultural population.
    • Ecological assessment: Group Workers assess community needs, agency or organization resources, sponsoring organization mission, staff competency, attitudes regarding group work, professional training levels of potential group leaders regarding group work; client attitudes regarding group work, and multicultural and diversity considerations. Group Workers use this information as the basis for making decisions related to their group practice, or to the implementation of groups for which they have supervisory, evaluation, or oversight responsibilities.
    A.4. Program Development and Evaluation
    • Group Workers identify the type(s) of group(s) to be offered and how they relate to community needs.
    • Group Workers concisely state in writing the purpose and goals of the group. Group Workers also identify the role of the group members in influencing or determining the group goals.
    • Group Workers set fees consistent with the organization's fee schedule, taking into consideration the financial status and locality of prospective group members.
    • Group Workers choose techniques and a leadership style appropriate to the type(s) of group(s) being offered.
    • Group Workers have an evaluation plan consistent with regulatory, organization and insurance requirements, where appropriate.
    • Group Workers take into consideration current professional guidelines when using technology, including but not limited to Internet communication.
    A.5. Resources

    Group Workers coordinate resources related to the kind of group(s) and group activities to be provided, such as: adequate funding; the appropriateness and availability of a trained co-leader; space and privacy requirements for the type(s) of group(s) being offered; marketing and recruiting; and appropriate collaboration with other community agencies and organizations.

    A.6. Professional Disclosure Statement

    Group Workers have a professional disclosure statement which includes information on confidentiality and exceptions to confidentiality, theoretical orientation, information on the nature, purpose(s) and goals of the group, the group services that can be provided, the role and responsibility of group members and leaders, Group Workers’ qualifications to conduct the specific group(s), specific licenses, certifications and professional affiliations, and address of licensing/credentialing body.

    A.7. Group and Member Preparation
    • Group Workers screen prospective group members if appropriate to the type of group being offered When selection of group members is appropriate, Group Workers identify group members whose needs and goals are compatible with the goals of the group.
    • Group Workers facilitate informed consent. Group Workers provide in oral and written form to prospective members (when appropriate to group type): the professional disclosure statement; group purpose and goals; group participation expectations including voluntary and involuntary membership; role expectations of members and leader(s); policies related to entering and exiting the group; policies governing substance use; policies and procedures governing mandated groups (where relevant); documentation requirements; disclosure of information to others; implications of out-of-group contact or involvement among members; procedures for consultation between group leader(s) and group mem-ber(s); fees and time parameters; and potential impacts of group participation.
    • Group Workers obtain the appropriate consent forms for work with minors and other dependent group members.
    • Group Workers define confidentiality and its limits (for example, legal and ethical exceptions and expectations; waivers implicit with treatment plans, documentation and insurance usage). Group Workers have the responsibility to inform all group participants of the need for confidentiality, potential consequences of breaching confidentiality and that legal privilege does not apply to group discussions (unless provided by state statute).
    A.8. Professional Development

    Group Workers recognize that professional growth is a continuous, ongoing, developmental process throughout their career.

    • Group Workers remain current and increase knowledge and skill competencies through activities such as continuing education, professional supervision, and participation in personal and professional development activities.
    • Group Workers seek consultation and/or supervision regarding ethical concerns that interfere with effective functioning as a group leader. Supervisors have the responsibility to keep abreast of consultation, group theory, process, and adhere to related ethical guidelines.
    • Group Workers seek appropriate professional assistance for their own personal problems or conflicts that are likely to impair their professional judgement or work performance.
    • Group Workers seek consultation and supervision to ensure appropriate practice whenever working with a group for which all knowledge and skill competencies have not been achieved.
    • Group Workers keep abreast of group research and development
    A.9. Trends and Technological Changes

    Group Workers are aware of and responsive to technological changes as they affect society and the profession. These include but are not limited to changes in mental health delivery systems; legislative and insurance industry reforms; shifting population demographics and client needs; and technological advances in Internet and other communication and delivery systems. Group Workers adhere to ethical guidelines related to the use of developing technologies.

    Section B: Best Practice in Performing
    B.1. Self Knowledge

    Group Workers are aware of and monitor their strengths and weaknesses and the effects these have on group members.

    B.2. Group Competencies

    Group Workers have a basic knowledge of groups and the principles of group dynamics, and are able to perform the core group competencies, as described in the ASGW Professional Standards for the Training of Group Workers. Additionally, Group Workers have adequate understanding and skill in any group specialty area chosen for practice (psychotherapy, counseling, task, psychoeducation, as described in the ASGW Training Standards).

    B.3. Group Plan Adaptation
    • Group Workers apply and modify knowledge, skills and techniques appropriate to group type and stage, and to the unique needs of various cultural and ethnic groups.
    • Group Workers monitor the group and progress toward the group goals and plan.
    • Group Workers clearly define and maintain ethical, professional, and social relationship boundaries with group members as appropriate to their role in the organization and the type of group being offered.
    B.4. Therapeutic Conditions and Dynamics

    Group Workers understand and are able to implement appropriate models of group development, process observation and therapeutic conditions.

    B.5. Meaning

    Group Workers assist members in generating meaning from the group experience.

    B.6. Collaboration

    Group Workers assist members in developing individual goals and respect group members as co-equal partners in the group experience.

    B.7. Evaluation

    Group Workers include evaluation (both formal and informal) between sessions and at the conclusion of the group.

    B.8. Diversity

    Group Workers practice with broad sensitivity to client differences including but not limited to ethnic, gender, religious, sexual, psychological maturity economic class, family history, physical characteristics or limitations, and geographic location. Group Workers continuously seek information regarding the cultural issues of the diverse population with whom they are working both by interaction with participants and from using outside resources.

    B.9. Ethical Surveillance

    Group Workers employ an appropriate ethical decision making model in responding to ethical challenges and issues and in determining courses of action and behavior for self and group members. In addition, Group Workers employ applicable standards as promulgated by ACA, ASGW; or other appropriate professional organizations.

    Section C: Best Practice in Group Processing
    C.1. Processing Schedule

    Group Workers process the workings of the group with themselves, group members, supervisors or other colleagues, as appropriate. This may include assessing progress on group and member goals, leader behaviors and techniques, group dynamics and interventions; developing understanding and acceptance of meaning. Processing may occur both within sessions and before and after each session, at time of termination, and later follow up, as appropriate.

    C.2. Reflective Practice

    Group Workers attend to opportunities to synthesize theory and practice and to incorporate learning outcomes into ongoing groups. Group Workers attend to session dynamics of members and their interactions and also attend to the relationship between session dynamics and leader values, cognition and affect.

    C.3. Evaluation and Follow-Up
    • Group Workers evaluate process and outcomes. Results are used for ongoing program planning, improvement and revisions of current group and/or to contribute to professional research literature. Group Workers follow all applicable policies and standards in using group material for research and reports.
    • Group Workers conduct follow-up contact with group members, as appropriate, to assess outcomes or when requested by a group member(s).
    C.4. Consultation and Training with Other Organizations

    Group Workers provide consultation and training to organizations in and out of their setting, when appropriate. Group Workers seek out consultation as needed with competent professional persons knowledgeable about group work.

    Appendix 2: Group Counselling: Q-Sort Research*

    Information to Clients

    Aim of the exercise:

    To sort 60 statements about group counselling/therapy into your own rank ordering.

    Instructions:

    Enclosed with this is a list of 60 statements about the therapeutic factors of groups and seven envelopes. Please sort the statements into the seven envelopes marked:

    • Most helpful to me in the group (2 statements)
    • Extremely helpful to me in the group (6 statements)
    • Very helpful to me in the group (12 statements)
    • Helpful to me in the group (20 statements)
    • Barely helpful to me in the group (12 statements)
    • Less helpful to me in the group (6 statements)
    • Least helpful to me in the group (2 statements).

    Then, within each envelope rank each statement in the order of helpfulness by writing a number (1–60) on the statement. Thus in the ‘Most helpful to me in the group’ you will have statements ranked 1 and 2, in the ‘Extremely helpful to me in the group’ you will have statements ranked and marked 3, 4, 5, 6, 7 and 8 and so on through the envelopes until you have ranked all the statements. You will probably find it easiest to sort the statements into the seven groups, then make any necessary adjustments in terms of the numbers of statements in each group, and then rank-order and number them and put them in the envelopes.

    I am also enclosing a sheet of paper asking you to write your comments on the pre- and post-group time as well as what, if anything, happens outside the group, and any other comments you have about your experience of group counselling/therapy

    With thanks for your consideration.

    • Helping others has given me more self-respect.
    • Putting others' needs ahead of mine.
    • Forgetting myself and thinking of helping others.
    • Giving part of myself to others.
    • Helping others and being important in their lives.
    • Belonging to and being accepted by a group.
    • Continued close contact with other people.
    • Revealing embarrassing things about myself and still being accepted by the group.
    • Feeling alone no longer.
    • Belonging to a group of people who understand and accept me.
    • Learning I'm not the only one with my type of problem; ‘We're all in the same boat.’
    • Seeing that I am just as well off as others.
    • Learning that others have some of the same ‘bad’ thoughts and feelings I do.
    • Learning that others had parents and backgrounds as unhappy or mixed up as mine.
    • Learning that I'm not very different from other people gives me a ‘welcome to the human race’ feeling.
    • The group's teaching me about the type of impression I make on others.
    • Learning how I come across to others.
    • Other members honestly telling me what they think of me.
    • Group members pointing out some of my habits or mannerisms that annoy other people.
    • Learning that I sometimes confuse people by not saying what I really think.
    • Improving my skills in getting along with people.
    • Feeling more trustful of groups and of other people.
    • Learning about the way I relate to other group members.
    • The group's giving me an opportunity to learn to approach others.
    • Working out my difficulties with one particular member in the group.
    • The therapist's suggesting or advising something for me to do.
    • Group members suggesting or advising something for me to do.
    • Group members telling me what to do.
    • Someone in the group giving definite suggestions about a life problem.
    • Group members advising me to behave differently with an important person in my life.
    • Getting things off my chest.
    • Expressing negative and/or positive feelings towards another member.
    • Expressing negative and/or positive feelings towards the therapist.
    • Learning how to express my feelings.
    • Being able to say what was bothering me instead of holding it in.
    • Trying to be like someone in the group who is better adjusted than I.
    • Seeing that others could reveal embarrassing things and take other risks and benefit from it helps me to do the same.
    • Adopting mannerisms or the style of another group member.
    • Admiring and behaving like my therapist.
    • Finding someone in the group I can pattern myself after.
    • Being in the group is, in a sense, like reliving and understanding my life in the family in which I grew up.
    • Being in the group somehow helps me to understand old hang-ups that I had in the past with my parents, brothers, sisters, or other important people.
    • Being in the group is, in a sense, like being in a family, only this time a more accepting family.
    • Being in the group somehow helps me to understand how I grew up in my family.
    • The group is something like my family – some members or the therapist being like my parents and others being like my relatives. Through the group experience I understand my past relationships with my parents and relatives (brothers, sisters etc.).
    • Learning that I have likes or dislikes for a person for reasons which may have little to do with the person and more to do with my hang-ups or experiences with other people in my past.
    • Learning why I think and feel the way I do (that is, learning some of the causes and sources of my problems).
    • Discovering and accepting previously unknown or unacceptable parts of myself.
    • Learning that I react to some people or situations unrealistically (with feelings that somehow belong to earlier periods in my life).
    • Learning that how I feel and behave today is related to my childhood and development (there are reasons in my early life why I am as I am).
    • Seeing others getting better is inspiring to me.
    • Knowing others have solved problems similar to mine.
    • Seeing others have solved problems similar to mine
    • Seeing that other group members improve/d encourages me.
    • Knowing that the group has helped others with problems like mine encourages me.
    • Recognising that life is at times unfair and unjust.
    • Recognising that ultimately there is no escape from some of life's pain and from death.
    • Recognising that no matter how close I get to other people, I must still face life alone.
    • Facing the basic issues of my life and death, and thus living my life more honestly and being less caught up in trivialities.
    • Learning that I must take responsibility for the way I live my life no matter how much guidance and support I get from others.

    *Based on Yalom (1995).

    Group Counselling – before, after and outside the Group
    • I am interested in your thoughts and feelings about the time you spend with people before the group. Please write as much or as little as you want.

      Some questions you may consider – Do you come for this time or aim to come for the starting time of the group at 7.30pm? What is the purpose of this time for you? What, if any value does it have? Has this time changed over the time you've been in the group?

    • I am interested in your thoughts and feelings about the time you spend with the group after I have left. Again, please write as much or as little as you want.

      Some questions you may consider – Do you stay on after the group, if so how regularly and for how long? Does this depend on anything and if so what? What's different about this time compared to the time in the group (7.30–9.30pm)? Are there particular therapeutic factors (e.g. the 60 statements) which are more relevant or pertinent to this time? Has any of this changed over the time you've been in the group?

    • I am also interested in any contact you have with group members, or indeed as a group, outside the group.

      Some questions – Do you have any contact with any group member/s outside the group? Is this one or two particular people or with anyone in the group and if so how often? What is the nature and purpose of this contact? Has it changed over the time you've been in the group?

    • Any other comments about your experience of group counselling/ therapy

    With thanks

    Keith Tudor

    Appendix 3: A Simple Group Contract

    Using the parallel with legal contracts, Steiner (1971) outlines four basic requirements for contracts:

    • Mutual consent – which, in turn, involves a request for treatment, an offer of treatment and an acceptance of treatment.
    • Valid consideration – that is, the benefit to both parties, for instance, a service for a fee.
    • Competency – that both parties are competent to agree to the contract and to fulfil their side of it. This is especially important in the case of working with minors or people whose mental facilities are impaired for some reason and will almost certainly involve a third party (see Chapter 6) such as a parent or legal guardian (also see Vanwynsberghe, 1998).
    • Lawful object – that the object or outcome of the contract is legal and not illegal.

    Updating Steiner's requirements in terms of British contract law, four elements create a legal ‘simple contract’ (as distinct from a contract by deed or a contract under seal): agreement, clarity, legality and valid consideration and, bearing in mind that some counsellors draw up written agreements with their clients, dates and signatures. The content of a written, legal counselling contract may be considered thus:

    • An introduction, outlining the purpose of the contract.
    • The definitions of terms, including any ambiguous terms such as ‘getting better’
    • The responsibilities of parties to the contract, including other parties, for example parents when working with children and other group members when working with groups
    • A description of what is to be delivered
    • Any issues as regards copyright – this may be relevant to any writing and publication of material about clients.
    • The delivery of service specified.
    • Agreed terms of payment
    • An agreed disputes procedure – or access to an identified complaints or disputes procedure.

    In the light of their empirical findings from studying group confidentiality and the law, Roback et al. (1996) suggest a model for an ‘informed consent’ form which includes a clear outlining of ‘risks’:

    • The legal and professional position on the counsellor's obligation or choice to report any disclosure of child abuse. All counsellors, including group counsellors, need to be clear where they stand on this in terms of the law, their professional associations and codes of ethics and practice, any requirements arising from the setting of their work, for example in primary care, and morally (see BAC, 1997, especially B.3.3 and B.3.4).
    • The risk of disclosure of any ‘secrets’ by other members of the group.
    • The implications of telling other people outside the group of group members' secrets, including the possibility of legal action.
    • The risk of expulsion from the group.

    This model also proposes a signed and witnessed declaration of acceptance of the terms, conditions and risks of group counselling (see Roback et al., 1996, pp. 134–5).

    Appendix 4: Training Courses in Groupwork

    These are listed in terms of specialist courses leading to UKCP registration and other training courses in groupwork.

    This is not intended as a comprehensive list. It is based on entries in and a brief survey of courses – of a minimum duration of one year, part time – listed in the BAC's (1995) Directory of Training Courses. Details of other group-work training courses may be sent to the author at Sage Publications for inclusion in future editions/publications.

    Specialist Training Courses in Groupwork Leading to UKCP Registration

    In addition to these there are organisations currently seeking membership of the UKCP with a view to having their groupwork training accepted as leading to UKCP registration, including Cambridge Group Work (Diploma in Group Analysis) and Goldsmiths' College, London University (Diploma in Group Psychotherapy).

    Other Courses in Groupwork
    Organisation:Cambridge Group Work
    Course:Introductory General Course
    Duration:1 year, part-time
    Qualification:Advanced Diploma in Group Work/Advanced Diploma in Educational Studies (University of Cambridge Institute of Education)
    Duration:3 years, part-time
    Contact:CGW Administrator, 4 George Street, Cambridge CB4 1AJ
    Organisation:Group Analysis North
    Course:Manchester Course in Group Psychotherapy
    (recognised by the IGA as equivalent to its Introductory General Course in Group Work)
    Duration:1 year, part-time
    Course:Advanced Learning in Group Psychotherapy
    Duration:1 year, part-time
    Course:Diploma in Dynamic Psychotherapy
    Duration3.5 years, part-time
    Contact:Group Analysis North (address above)
    Organisation:The Institute of Group Analysis
    Course:Introductory General Course in Group Work
    Duration:1 year, part-time
    Contact:IGA (address above)
    Organisation:Minster Centre
    Qualification:Diploma in Integrative Group Psychotherapy
    (post-qualification)
    Duration:2 years, part-time
    Contact:Minster Centre, 1 Drakes Court Yard, 291 Kilburn High Road, London NW6 7JR
    Organisation:Westminster Pastoral Foundation
    Qualification:Diploma in Groupwork Skills
    Duration:1 year, part-time
    Contact:WPF (address above)

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