I don’t know how to handle this Psychology question and need guidance.DQ#1 Challenging Group MembersLiz PI finds that the compulsive talkers are the hardest and most “intrusive in the group” (Beck, Fall, & Landreth, 2013, p. 135). This group member struggles with control and will not allow others to share. If the facilitator does not take control then the group can become discouraged, angry, or withdrawn altogether. The talker “who is allowed “free reign may eventually destroy the group” (How to handle monopolizers and onlookers, 2020, p. 1). It is up to the facilitator to address the avoidant behavior. Therapists need to understand the motivation behind the behavior. Berg (2013) describes this phenomenon as rooted “too early developmental experiences, so awareness is usually deeply hidden, and it is also a compensation for feelings of inferiority” (p. 135).The group member that engages in this behavior is avoiding treatment. This is just one technique that one can use to thwart group progress and divert the group from the task at hand. Avoidance is “considered a maladaptive behavioral response to excessive fear and anxiety” (Hofmann, & Hay, 2018, p. 14). The monopolizer engages in this behavior because it has allowed him/her to feel control “over the environment that is deemed a potential threat” (Hofmann, & Hay, 2018, p. 14).The facilitator should show that a group is a safe place for everybody and in showing that, establish boundaries. In demonstrating clear boundaries and using specific language towards the monopolizer and the group, members can feel heard. They also feel like they belong to this group, and because it is their group, they feel less judged and may not have to hide behind their talking. The facilitator can further process the talking through the group, and members can help provide insight and feedback. The power of the group can help move the monopolizer through their own words. He/she needs to gentle but firm in their expectations and reframing the behavior that is being examined by the group. I have used MI techniques with members of the group who attempted to monopolize/avoid. It is important for the use of “non-directive, client-centered, and other directional or strategic approaches in conjunction with skillful reflective listening” to address the avoidant behavior in the group (Morgenstern, Kuerbis, Houser, Levak, Amrhein, Shao, & McKay, 2017, p. 752). Overall, an “atmosphere and acceptance and safety needs to be created in order to allow for exploration and change to occur” (Morgenstern, & et al., 2017, p. 753).ReferencesBerg, R. C., Fall, K. A., & Landreth, G. L. (2013). Group Counseling : Concepts and procedures: Vol. 5th ed. Routledge.How to handle monopolizers and onlookers. (2020, July). Place: Where You Come to Know.Hofmann, S. G., & Hay, A. C. (2018). Rethinking avoidance: Toward a balanced approach to avoidance in treating anxiety disorders. Journal of Anxiety Disorders, 55, 14–21. https://doi.org/10.1016/j.janxdis.2018.03.004Morgenstern, J., Kuerbis, A., Houser, J., Levak, S., Amrhein, P., Shao, S., & McKay, J. R.(2017). Dismantling motivational interviewing: Effects on the initiation of behavior change among problem drinkers seeking treatment. Psychology of Addictive Behaviors: Journal of the Society of Psychologists in Addictive Behaviors, 31(7), 751–762. https://doi.org/10.1037/adb0000317Julianne SOne challenging behavior that may happen in a group is silence. Silence can be pretty uncomfortable, especially when it a) occurs for an extended period of time or b) is practiced by the entire group in an ineffective way. There are certain circumstances where silence can be productive; however, when it’s (seemingly) never-ending, silence can impede progress (Berg, Landreth, & Fall, 2013). This writer finds silence particularly challenging because it makes engaging the group that much more difficult. Not only is it, quite simply, weird — it also feels like a reflection of group leadership, a signifier of the groups’ ineffectiveness, or an example of non-working relationships. Furthermore, it conveys feelings of awkwardness and apprehension that suggest a lack of comfortability or cohesion in the group (Berg, Landreth, & Fall, 2013). While these things likely aren’t true (at least not entirely), they — and silence — don’t sit well. This writer would likely respond to silence with discomfort; it definitely wouldn’t be a happy experience, nor one that exudes confidence. It would create this situation where this writer chokes up and feels uncertain how to proceed. This is most definitely an area of professional development this writer would need to work on, likely through ongoing experience. Nonetheless, silence would require this writer to hyper-analyze body language and attempt to interpret the function of the behavior on an individual and group level. This writer would need to do her best to pull it together, self-reflect, and address the behavior with all members. For example, this writer would directly acknowledge the silence. If the group were to fall silent for several moments, this writer would re-engage members by questioning, “I see we’ve all fell silent. What does silence mean to everyone?” Perhaps members could then be prompted to take turns answering the question, therefore weaving the behavior into the context of treatment and allowing it to function as a stepping stone towards progress — as opposed to an impediment. Silence isn’t all bad, as it means everyone involved is sharing an experience. So, even if the silence is awkward and stems from a non-working relationship amongst group members, it still means everyone’s involved in the same behavior and can, at the very least, relate in that way — it’s somewhere to start. Despite the challenges and discomfort associated with the behavior, silence can be flipped as a tool and used to further group work.ReferencesBerg, R., Landreth, G. L., & Fall, K. A. (2013). Group counseling: Concepts and procedures. New York: Routledge.DQ#2 SilenceLiz PSilence in group therapy is not silent at all. There is so much that is said without words. It is “gestures, unspoken words, unverbalized feelings, facial expressions, and the group atmosphere” (Berg, Fall, & Landreth, 2013, p. 126). Silence is powerful and everybody feels it. Members are thinking about either the silence itself, how to end it, or thinking about what was just said – processing. Silence even if considered superficial at first, is not. Instead, it speaks to the cohesiveness of the group, topic or question that was posed which hung in the air, and unspoken feelings. This can even help the group bond. Though, it is up to the facilitator to foster this after processing a period of silence. Typically, after the silent period, groups feel more open to process who they felt and what they thought. This can become a powerful lesson, “silence can emerge due to normal feelings of anxiety related to the beginning of a new experience” (Berg, Fall, & Landreth, 2013, p. 128). Then, it is therapeutic to process what that awkwardness looked like and sounded like in their heads. The clients may have look at their hands intently, scanned the group to see if they can make eye contact with someone they began forging a relationship with, make faces as they stare at the floor, cough, play with their hair, stretch, and clear their throats, cross/uncross their legs. All of these things show and speak to how uncomfortable they were and in their minds questioning the purpose of the group, wondering how long it has been, wondering who will speak up, and thinking about ‘should I say something?’ Silences are filled with “texture and feeling and can have therapeutic, neutral, or destructive effects on the therapeutic relationship. While there are silences that feel awkward, indifferent, or even hostile, there are also silences that feels comforting, affirming, and safe” (Back, Bauer-Wu, Rushton, & Halifax, 2009, p. 1114). Silences can be invited or the result of a heavy question/topic that the group is not ready to explore at that moment and processing this later can begin group healing and growth. However, silence can also be interpreted as “judgment, disapproval, or withholding” (Back, & et al, 2009, p. 1115). Therefore, processing this practice is important.Theoretical learning in groups is important as the educational component is the piece that will teach clients how to cope and understand their illness/disease. Though, sometimes the group needs to sit in the processing moment of the group. Examining the process is powerful, and offers insight as to the here and now. Silence included. A lot of what happens “in the group is really based upon where the clients are at, and tapping into that is more important than teaching something that was planned” (Wendt, & Gone, 2018, p. 15).I have used silence in both groups and individual sessions. However, I am careful with which groups I use this with. It is not because I am not comfortable with silence, it is the nature of the group that I am concerned with. In groups that have new members on a weekly basis, different group dynamics each month makes for an unbalanced use of silence. Some members are new and not comfortable with the process in general, while others have been attending for months and are familiar with the format and people. Therefore, I use it less in these types of groups versus specialty groups with the same members present throughout the program. ReferencesBack, A. L., Bauer-Wu, S. M., Rushton, C. H., & Halifax, J. (2009). Compassionate silence in the patient-clinician encounter: a contemplative approach. Journal of Palliative Medicine, 12(12), 1113–1117. https://doi.org/10.1089/jpm.2009.0175Berg, R. C., Fall, K. A., & Landreth, G. L. (2013). Group Counseling : Concepts and procedures: Vol. 5th ed. Routledge.Wendt, D. C., & Gone, J. P. (2018). Complexities with group therapy facilitation in substance-use disorder specialty treatment settings. Journal of Substance Abuse Treatment, 88, 9–17. https://doi.org/10.1016/j.jsat.2018.02.002WGloria MInvoking silence in a group for a therapeutic setting, in general, can be used for specific and beneficial reasons. Never less silence is not something that I intend to use as an everyday or even common practice. One reason behind this preference is due to the belief that therapy is entirely based on talking and working through psychological problems. Silence is a part of this overall process in terms of therapists using silence to facilitate reflection expressions of feelings, to encourage responsibility, to avoid interruptions, or even to convey empathy to the speaker (Ladany, Hill, Thompson & O’Brien, 2004). Silence is often useful to reflect on your own thoughts before speaking and this is the most essential aspect of the concept. You can never take something back once it is said, and in therapy communication is vital. As a professional you never want to give advice that is not sound and silence can help eliminate those possibilities by allowing the therapists enough time to reflect on those issues prior to advising their client. Knowing when to use silence and breaks in between client disclosures is vital as well. For instance, when working with highly anxious individuals gaps of silences can be perceived as judgment towards their last statement or disapproval of what they’ve just disclosed. Any short period of elaboration can be viewed as a negative response to abused and anxious members, and that is why I believe that some prompt should be given prior to silence or breaks in the communication flow of therapy. For instance, once the client stops speaking, the therapists can immediately follow with “Yes, that is a very understandable reaction to a situation” before taking a pause for the simple reason of reassuring the client that their views and behaviors are understandable even if not favorable. I use silence in new situations all of the time and I find it especially helpful to keep my foot out of my mouth. For instance, when a girlfriend of mine spoke about infidelity within her past relationships I first responded stating that many times in life hardships and unfaithfulness will come with many relationships especially in this generation of adolescents. I stopped to briefly observe her reactions to this statement and when I noticed a smile appear I perceived that as her decoding my statement as a co-sign for her to continue in the relationship as if these infidelities are acceptable. That is when I calmly looked at her and continued speaking stating “but that is unacceptable no matter what reason he gave, you deserve trust and it is clear that this mistake has altered the trust within your relationship by the way in which you treat him now” which I find to be a good follow up response. It is essential to have breaks and while they help I do not see myself depending on them in therapy. Silence is also beneficial for eliciting responses from the crowd. The silence after prompting the group with questions pertaining to their life experiences and reactions to those experiences can allow the uncomfortable source of eliciting a response from any client. Although this can easily backfire, some research has shown the benefits of sitting in silence in anticipation of a response to a question because after a certain interval of time (approx. 30 seconds in complete silence) someone will muster up the courage to answer, and typically other members will respond to their input as well. References Ladany, N., Hill, C. E., Thompson, B. J., & O’Brien, K. M. (2004). Therapist perspectives on using silence in therapy: A qualitative study. Counseling and Psychotherapy Research, 4(1), 80-89.DQ#3 To Terminate a Difficult Group Member or not? Liz, there should be a set of steps or protocols that are followed before terminating a member of the group. Certainly, there are situations that would require this to occur earlier than in others, like abuse towards the group. However, understanding the ‘why’ the behavior is manifesting in the group and the ‘how’ to effectively deal with the behavior is imperative.Firstly, the group facilitator should analyze the situation to fully understand and process what is happening. This should be something that is also discussed in a clinical team meeting or with a colleague. This helps the facilitator explore both the “client and therapist perspectives on whether termination is warranted and the client-therapist dyad to examine specifics of the group interactions” (Westmacott, Hunsley, Best, Rumstein-McKean, & Schindler, 2010, p. 428). Identifying the anger helps the therapist assess the “etiology and treatment” (Bright, 2009, p. 277). Bright (2009) categorizes anger as “deliberate, anger avoidance, passive aggression, paranoia, sudden anger, shame-based anger, excitatory anger, habitual anger, moral anger, or resentment/hate” (p. 277). Additionally, feedback helps with the identification of the above, and treatment planning strategies to address the anger. However, if the verbal attack is “directed at a person and is abusive in nature, the group leader needs to take direct action in stopping the behavior. Abusive behavior should not be permitted in groups any more than it should in families” (Berg, Fall, & Landreth, 2013, p. 137).Secondly, the facilitator may need to examine their own reactions and feelings towards the group and the particular member that is disrupting the group. These dynamics of transference could be contributing to the issue. And, this too needs to be examined closely by the facilitator. When there is a co-facilitator, feedback is more specific to interactions that the other facilitator may not have noticed. For instance when a facilitator is working with men in an anger management group, “it can almost invariably be assumed that the issues are related to personal control and, by extension, a need to control the situation; and members who have a high need for situational control typically feel threatened and anxious about exploring their personal issues carefully for fear that they will ‘lose control of self’ “(Berg, Fall, & Landreth, 2013, p. (131). This may or may not be related to the facilitator. The hostile group member that is acting out in anger may not know how to show feelings of frustration without escalating to verbal abuse, and the therapist should use “interventions that are direct because those with highly focused special interests often do not perceive and respond to normal social cues that group members might offer” (Berg, Fall, & Landreth, 2013, p. 134).If a client was confrontational towards other members of the group, I would assess and discuss this with team members and maybe even pull this client aside to discuss the behavior. This could help me gauge more of what the client was aware of on an individual basis. I also may even ask a colleague to help co-facilitate the group to help me see what else is occurring in the group. This also adds a different dynamic to the group, therefore, could also change the behaviors within the group. I would try to change factors on my end before terminating a member, being that this is an anger management group and the client is in my group for a reason. I would not allow abusive behaviors in the group and would terminate treatment if that was evidenced. And, if I decided that the patient needed to terminate group treatment, I would recommend another level of care with a specific referral to ensure continued treatment.ReferencesBerg, R. C., Fall, K. A., & Landreth, G. L. (2013). Group Counseling : Concepts and procedures: Vol. 5th ed. Routledge.Bright H. (2009). Handbook of anger management: Individual, couple, family, and group approaches. Primary Care Companion to The Journal of Clinical Psychiatry, 11(5), 277. https://doi.org/10.4088/PCC.09bk00821Westmacott, R., Hunsley, J., Best, M., Rumstein-McKean, O., & Schindler, D. (2010). Client and therapist views of contextual factors related to termination from psychotherapy: a comparison between unilateral and mutual terminators. Psychotherapy Research: Journal of the Society for Psychotherapy Research, 20(4), 423–435. https://doi.org/10.1080/10503301003645796Courtney C When working with a challenging client within the group setting, this writer can imagine that a natural first instinct may be to consider termination. However, as professional counselors, we must take certain aspects into consideration prior to deciding to terminate a client. When dealing with ethical issues, this writer always likes to first consult the ACA Code of Ethics for direction. According to the ACA, counselors should select members whose needs and goals are compatible with the goals of the group, and who will not impede the group process (ACA, 2014). Clearly, if a client is being confrontational toward others, they are impeding the group process and their needs would not be considered compatible with the goals of the group. A client such as this would likely benefit from more individualized care, as this writer does not feel that they would be ready to interact within the group setting. The ACA also states that in a group setting counselors should take reasonable precautions to protect clients from physical, emotional, or psychological trauma (ACA, 2014). As a result, this writer finds that it would be appropriate to terminate such a client as a means of protecting the other group members. As there are many personalities within a group setting, it is a possibility that a confrontational client’s outburst could trigger another client to experience mental health symptoms such as anxiety or panic. Overall, this writer finds that this would be disruptive to the group while putting other clients at risk of harm. It should be noted that this writer would not simply terminate treatment with a group member solely due to the request of other clients without first following proper ethical codes.Once deciding to terminate group therapy with a difficult client, this writer finds that challenges may arise in deciding the best way in which to terminate therapy without upsetting the client. If the client is confrontational, there is always a risk that the client could become angry or violent. Berg, Landreth, & Fall discuss the proper way in which to terminate a client from group therapy, and this writer agrees with their statements (Berg, Landreth, & Fall, 2013). According to the authors, both the individual and the group are equally important (Berg et al. 2013). As such, the authors state that the decision to terminate a group member depends on whether the group is able to react to the individual in an appropriate way (Berg et al. 2013). In this scenario, two group members have stated they will leave the group if the client remains in the group; at this point, this writer thinks the authors would also find it reasonable to terminate the confrontational client. As for the most appropriate way in which to inform the client they are being terminated, the text suggests speaking with the client after the session is over to discuss not continuing with the group at this time (Berg et al. 2013). It is suggested that the client should be recommended for individual counseling, with the possibility of joining another group at a later time (Berg et al. 2013). This writer finds this to be a great, non-confrontational way in which to terminate a client from group therapy. Rather than placing blame on the client, simply suggesting they attend individual sessions first implies that the client is not ready for a group setting, leaving the option open for attending groups in the future. This way, the information is conveyed to the client in a caring way, rather than seeming punitive.ReferencesAmerican Counseling Association. (2014). ACA Code of Ethics. Alexandria, VA: Author.Berg, R. C., Fall, K. A., & Landreth, G. L. (2013). Group Counseling : Concepts and Procedures: Vol. 5th ed. Routledge.
Requirements: Each must be 450 words or more, with 2 references or sources each with one example, total responses 6.
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