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Interpersonal group work 2

See the earlier blog post "Interpersonal group work 1" for comments and handouts particularly orientated to pre-group assessment.  It's usually time very well spent, orientating would-be participants to what interpersonal process groups are likely to involve.  This both speeds up the time it takes new group members to start engaging helpfully in group interactions, and reduces drop-out rates.  Participants who know roughly what the group is going to be like, why the experience is relevant to what they want to change in their lives, and how they can best engage with the group to gain most benefit, are likely to be participants who get most from the group experience.  Below I've listed various handouts that can be relevant in this orientation process.

Our life stories: needs, beliefs & behaviours, page 1 & page 2 - here is a two page handout (printed out at 2 Powerpoint slides to a page) that I use a lot, especially when working with long term personality patterns.  The blog post "Our life stories: needs, beliefs & behaviours" gives a fuller explanation.  Although a bit "complicated", this "map" can be helpful in clarifying, for would-be group participants, where it might be most helpful for them to focus when working in the group.  The ideas aren't at all original, although this particular way of presenting them is my own.  I point out that a triangle of frustrated needs, dysfunctional beliefs, and outdated unhelpful behaviours probably made sense and may even have served them well, when the pattern developed in childhood/adolescence (e.g. in relation to "past people", slide 4), but that the triangle may well not be serving them well now (in relation to "current people" in their lives, and possibly with "therapist or group" too).  I tend to encourage work at all corners of the triangle - clarifying healthy needs, challenging dysfunctional beliefs, and exploring more functional behaviours.

What it's usually helpful to talk about in the group - research shows that explaining to would-be group participants what the group focuses on, how it works, and why it's relevant for them, reduces subsequent drop-out rates and helps participants engage in the group more quickly and more productively.  The already described assessment questionnaires are useful here.  This "What it's usually helpful to talk about in the group" leaflet is a further step in this orientation process. 

Therapeutic factors - here are the 12 therapeutic factor categories that Irvin Yalom describes in his seminal book "The theory and practice of group psychotherapy".  Typically interpersonal factors, catharsis and group cohesiveness are rated very highly.  There is considerable variation though - with the type of group studied, with how long  the group has been meeting for, and with the participant's level of functioning and personality style. 

Group facilitator style & outcome - Lieberman, Yalom & Miles's major early group research profoundly affects the way I facilitate groups and the way I teach group facilitation.  Key facts are illustrated by this six-slides-to-a-page Powerpoint handout - also available as a PDF handout.  These slides highlight particularly the importance of "caring" and of "meaning attribution" in how one facilitates groups.  The slides also remind us that group therapy is not "neutral" - some facilitators were found to run groups where almost all participants benefited and none seemed to experience a negative outcome.  With other facilitators, participants were lucky if they managed to leave the group unscathed psychologically.

Communication scales - a handout from Carkhuff & Berenson's adaption of the classic Rogerian person-centred triad highlighting key interpersonal qualities in close relationships.

Honesty, transparency & confrontation - this interesting 3 page handout describes the emotion-focused therapist Les Greenberg's comments on honesty/authenticity in therapeutic relationships.  His remarks however are also very relevant to other close relationships that are basically supportive but sometimes run into difficulties e.g. couples, families, and friendships. 

Self-concealment scale & related references - this is an interesting questionnaire I use occasionally to highlight the health risks of being to "self-concealing" and "private".  It links in with the overall benefits of intimacy and interpersonal trust.  It links too with the importance of clients feeling they can be really open in the therapeutic relationship.

Experiencing scale - this scale assesses seven levels of emotional and cognitive involvement with one's ongoing (internal) experience.  Primarily tested in person-centered therapy - but also for other therapies such as group therapy and CBT - it has been found that being more emotionally engaged with therapy tends to be associated with better subsequent outcomes.

Although I currently call the interpersonal process groups I run here in Edinburgh "Opening Up", they used to have the rather clunky title "Relationships & emotional intelligence".  This is still a pretty good description of what the groups focus on, and below are half a dozen handouts more specifically on emotions and emotional intelligence.

Emotions & feelings - this six Powerpoint slides to a page handout discusses definitions, components, types and functions of emotions.

Emotions are like a ‘radar system' - this pair of Powerpoint slides, that I print out as a two-slides-to-a-page handout, introduces the idea of emotions as an evolutionarily adaptive system.  I use the metaphor of emotions as a 'radar & rapid response system' - normalising emotions and conceptualising emotional problems as inappropriate levels of activation in a basically adaptive system.   

Emotions, ‘arriving' & ‘leaving' - this pair of Powerpoint slides handout introduces a simple model of 'arriving' (understanding what one is feeling) and 'leaving' (acting from or processing the feelings).  The ideas are based on the work of Les Greenberg, Robert Elliott and others. 

Emotions, awareness & regulation - again a pair of Powerpoint slides based largely on the work of Greenberg and colleagues.  The handout both looks at aspects of emotions and introduces a metaphor of wading into a river as a way of considering over- and under-regulated emotions.

Emotions as different rooms in a house, page 1 & page 2 - here are four Powerpoint slides that I usually print out as a handout with two slides per page.  Page 1, with ideas from Antonio Damasio, looks at the changes emotions produce in body and brain.  Page 2, partly inspired by John Teasdale, suggests that different emotions produce such different mind-body states that it may sometimes be helpful to view humans as possessing a series of different "minds" rather than just one.  I then introduce the metaphor of humans as "houses" with a collection of different mind-body "rooms" that we move between. 

Understanding our reactions: self monitoring - this is an assessment form that can be used to self-monitor or to complete within a therapeutic session.  It looks at experiences of strong emotional reactions and asks a series of questions that can clarify the source of the emotion (leading to ideas about appropriate responses).

And finally here are a couple of handouts, below, used to encourage group participants to reflect on what they're experiencing.  "Meaning attribution" has been highlighted as a key process that group facilitators should focus on by the Lieberman, Yalom & Miles research mentioned earlier.

Reflection sheet and background - I ask all group participants - including myself as facilitator - to fill in a reflection sheet in the last 10 minutes or so of each session.  I then copy or scan the reflection sheets, and all participants get copies of all sheets in time to look through before the next meeting.  This can enrich the group and the learning process in all kinds of interesting ways.


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