Skills and Role of the Group Therapist

Group therapy provides a unique and important way for clients to learn about themselves and their relationships, to gain confidence, develop new skills and abilities, and to give and receive support and feedback from others. For many types of problems, group therapy is the treatment of choice. In this article we overview skills and role of the group therapist.

Skills of the therapist

Group therapist’s skills are displayed in different ways and at various stages during the life of the therapy group. Group therapists must be well versed in knowing which skills are at the core of leading an effective group while also ensuring any skills employed are done in a timely and appropriate manner.
 
Interestingly, in the group environment while some of the skills are primarily the responsibility of the therapist, other skills may depend more on the cooperative efforts of group members in conjunction with the group therapist (Gladding, 2003). Some of the specific therapist skills include but not limited to the following:

  • Facilitating: In groups, the therapist facilitates or ensures the smooth and effective progression of group process, interaction between group members and group dynamics. 
     
  • Protecting: This involves safe guarding group members from unnecessary attacks by others in the group. This is a vital skill in group therapy especially at the beginning stages where members are more likely to be combative between one another. 
     
  • Blocking: In blocking the therapist intervenes to stop counterproductive behaviour either verbally or nonverbally. 
     
  • Linking: In linking the therapist points out group members that share the same concerns, and encourages them to work together. 
     
  • Diagnosing: In the group work setting, diagnosis is when the group therapist identifies certain behaviours and categories in which a group member may fit. This is based more on the therapist’s observations and therefore doesn’t necessarily include psychological instruments. For example, a group therapist may notice that the group has a tendency to blame rather than develop constructive ideas. 
     
  • Delegating: In delegating, the group therapist assigns a task to the group or one or more of its members. The idea behind delegation is to share the responsibility group development with the group members. 
     
  • Creativity: because group work is very creative, group therapists need to be skilled in divergent ways of thinking and behaving. With a heightened capacity for creativity group therapists can help themselves and the group to become more productive through innovative ideas and methods of approach in times of crisis and when forming a sense of community within the group. 

Other therapist’s skills

  • Encourage participation of all group members
  • Observe and identify group process events
  • Attend to and acknowledge group member behaviour
  • Clarify and summarise group member statements
  • Open and close group sessions
  • Impart information in the group where necessary
  • Model effective group leader behaviour
  • Ask open ended questions in the group
  • Empathise with group members
  • Confront group member’s behaviour
  • Help group members attribute meaning to the experience
  • Help group members integrate and apply what they learn
  • Demonstrate ethical and professional standards of group practice
  • Keep the group on task and accomplishing shared and individual goals.

Role of the therapist
 
The group therapist is the primary orchestrator of change within the group. While group members also exert an influence, it is the group therapist that creates the therapeutic climate and is responsible for focusing the group on to relevant tasks. The therapist should actively structure group discussion in a way that encourages the members to stay on topic and on task in order to achieve desired outcomes.
 
The therapist’s roles include:

  • Decision to establish a group 
  • Determine setting and size of the group
  • Choose frequency and length of the group sessions
  • Decide on open vs. closed groups
  • Select a co-therapist for the group
  • Formulate policy on the group therapy with other therapeutic modalities
  • Creating a therapy group
  • Formulate appropriate group
  • Select clients who can perform the group task
  • Prepare clients t for group therapy
  • Construction and maintenance of the therapeutic environment
  • Build the culture of the group explicitly and implicitly
  • Identify and resolve common problems (e.g., membership turn over, sub-grouping, conflict)
  • Being aware of individual group members
  • Directing the focus of the group.

Tasks for the Therapist at the Beginning of the Group
 
Group therapists have various tasks to accomplish during the initial sessions of a group. They include: 1/ Dealing with apprehension; 2/Reviewing member’s goals and contracts; 3/ Specifying group rules; 4/ Setting limits and; 5/ Promoting a positive interchange among members.
 
Dealing with Apprehension: Apprehension is synonymous with anxiety. Too much or too little inhibits the performance of the group and its members. A moderate amount of apprehension at the beginning of the group is appropriate as it helps members focus on what they are experiencing in the group while also helping them focus on the task at hand.
 
It is also helpful and sometimes necessary after each session for the group therapist to deal with misunderstandings that may arise due to anxiety due to apprehension. For example, if a client is berating themselves in front of the group for being defensive about their sexuality then the therapist may address this by saying “I hear you are concerned about the question that Tom asked regarding your sexuality. I wonder what feelings got in the way of your handling of Tom’s question”. Such an observation and invitation will give the client a chance to deal with their emotions, especially their apprehension about opening up in front of the group.
 
Reviewing Goals and Contracts: Goals are specific objectives that both the individual and the group strive to achieve. The therapist as group leader should make the group goals clear to all group members at the commencement of the group therapy. As well as group goals, the therapist should clarify individual goals of every group member and ascertain if these goals are in line with the group goals. This is normally done at the screening stage.
 
A thorough way of clarifying group and individual goals is to have the group therapist restate the purpose of the group at the beginning of each session and have each member elaborate on their goals. Some group therapists choose to ask their members to formulate a contract indicating an agreement between the group members and the therapist of what will be done, when and by whom. A written contract, while not done by all group therapists, can help members to specify how and when they aim to make the necessary changes in relation to their goals (Gladding, 2003).
 
Specifying Group Rules: Rules serve as guidelines for how the group will run and are established both before and during the group therapy process. It is beneficial to involve group members in the formation and establishment of group rules as it helps to promote group cohesion and compliance to the rules formulated. It is important to ensure there is a logical and accepted rationale behind each rule rather than having rules set and enforced in an arbitrary manner.
 
Rules should also be stated in a positive rather than negative way. For example, “no physical violence” is better expressed as “members will respect the physical and psychological space of others at all times”. One rule that is usually agreed upon but at the same time can also be difficult to enforce is confidentiality.
 
Confidentiality in the group context is an explicit agreement between each group member and the group therapist to ensure that what is said in the group will remain between the group members and group therapist and not be discussed by any group member with anyone outside the group. It is to be noted that confidentiality is the cornerstone of ethical practice of psychotherapy (Gladding, 2003).
 
Confidentiality is sometimes violated either intentionally or unintentionally. To avoid this, the therapist should at the beginning of the group therapy process, encourage a discussion to identify ways that confidentiality could be violated and then clarify how such instances can be avoided. The group should agree at the beginning of the group therapy process on possible consequences for breaking confidentiality.
 
Group therapists have additional responsibilities regarding confidentiality for example protecting group members’ files, or computer records. When breaches of confidentiality occur, they will disrupt the functioning of the group through promoting distrust among group members (Gladding, 2003). Therefore it is crucial that the group rules or procedures be in place to deal with such things if/when they occur.
 
Setting Limits: Limits are the boundaries the group sets around behaviours of group members. They determine what will be accepted and what will not be accepted in the group. Such limits are set both explicitly and implicitly in group settings. Explicitly, these limits take the form of rules regarding acceptable behaviours and procedures.
 
When group members violate the limits, the group corrects them. Implicit limits are more subtle and involve such actions as attention of the leader to a particular member or the verbal reinforcement or discouragement of certain content topics. Skilled group therapists use their power of facilitating and setting limits in both direct and indirect ways. The leader can use non-verbal cues such as eye contact to encourage or suppress dialogue in areas where they want to set a limit (Gladding, 2003).
 
Promoting a Positive Interchange among Members: Promoting positive interchange among members of a group is initially the task of the group therapist. If positive interchanges among group members can be facilitated, the group atmosphere will be enhanced and the group members will begin to share openly with one another. If a positive tone is not created, the group members may drop out, close up, or attack one another. The group therapist can establish a positive tone by the following:

  • Being enthusiastic
  • Holding discussion on topics that are relevant to group members
  • Shifting the focus when the topics are irrelevant or interesting to only a couple of members
  • Cutting off, redirecting and/or resolving any hostile or negative interactions 

Another way to promote a positive interchange within the group is to use interactive journal writing. In this process, members keep logs on their thoughts, feelings, impressions and behaviours within the group and exchange them. This type of process can help facilitate group cohesiveness, trust, altruism, catharsis, hope and self-understanding (Gladding, 2003).
 
References:

  • Gladding. G.T. (2003) Group Work: A Counselling Speciality (4th ed.).New Jersey: Prentice Hall.

Source: www.mentalhealthacademy.com.au