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Historical data identifies that according to Erickson and Maslov, belongingness is an important aspect of individuals.

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Adolescent needs, growth and development are different than adults; therefore, it stands to reason that group therapy needs would also be different.  Treatment facilities cannot simply use the same curriculum and techniques created for an adult population.  Additionally, adolescents have an age range that is diverse and challenging yet allows more flexibility in group modalities.  Group therapy needs to engage youth, be purposeful, be organized, and be systematic to meet the range of needs.   Within a psychoeducational group, the counselor applies strategies that can help promote growth in specific areas where knowledge may be needed or develop skills so clients can address their needs in personal and social areas.

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According to the ASCA Student Standards (2021) the knowledge and skills within the Mindset Standards for this group are as follows:

M1: Belief in the development of the whole self, including a healthy balance of mental, social/emotional and physical well being. Our clients have missed valuable opportunities to develop this level of equilibrium.

Under the behavior standards componenet, learning startegies include B-LS2: Creative approach to learning tasks and problem solving. By allowing for creativity, and alternative means of expression in psychoeducational groups, learning becomes less of a chore and more of an experience.

Under the self-management skills component, B-SMS^: Ability to identify and overcome barriers and B-SMS8: Effective coping skills allow these techniques to be learned in a smaller setting, with unique opportunities to acquire these skills.

Under the social skills component B-SS!: Effective oral and written communication skills and listening skills and B-SS8: Advocacy skills for self and others and ability to assert self when necessary provide opportunities for clients to develop better communication skills for relationship enhancement as well as self-advocacy, which is a key component in adolescent development of behavior.

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This specific type of group is a mandatory group and is included in the services offered when a client is accepted into the facility. There is currently no existing curriculum or program plan in place for psychoeducational groups for adolescents specifically. I am proposing the following schedule to begin a soft implementation, to grow as we gather more data, and as moe counseling staff are available for group sessions.

The group would consist of anywhere between 6 and 12 clients, up to 15. The ratio of counselor to client must be no more than 15 per counselor. This facility is part of a larger organization but is a nonprofit organization. This group addresses adolescents of both genders. Clients need approximately ten (10) hours of psychoeducational sessions to be addressed weekly, with a timeframe of 60 minutes per session.  Currently, psychoeducational groups are not being conducted and were previously facilitated in a different manner, by Behavior Health Technicians.  This is the development of a preliminary plan, which will be evolving, increasing lessons and groups over time, and being facilitated by part-time counselors, who will meet and collaborate weekly to review data collected, add lessons and topics, and adjust programming as needed.

This specific type of group is a mandatory group and is included in the services offered when a client is accepted into the facility. Currently, psychoeducational groups are not being conducted and were previously facilitated in a different manner, by Behavior Health Technicians.  This is the development of a preliminary plan, which will be evolving, increasing lessons and groups over time, and being facilitated by part-time counselors, who will meet and collaborate weekly to review data collected, add lessons and topics, and adjust programming as needed.

The schedule at the facility is structured more during the week than the weekends.  Clients attend school from 8:30am to 12:30pm, Monday through Friday.  Lunch arrives between 12:30pm and 1:15pm, as lunch is provided by the local school district.  From approximately 1:00pm to 2:00pm, there are individual sessions scheduled.  That time frame is also utilized by staff to eat lunch and prepare for process groups.  The facility requires a two (2) hour process group each day from 2:00pm to 4:00pm.  Dinner is at 5:00pm, following by phone calls by clients to family.  Currently, the facility is looking at psychoeducational groups to be held weekdays from 4:00pm to 5:00pm, 6:00pm to 7:00pm, and 7:00pm to 8:00pm, before nighttime schedules begin.  Additionally, psychoeducational groups can be held on Saturdays.  Sundays are structured with religious services in the morning, visitations in the afternoon, with those eligible for services to be out from 10:00am to 4:00pm.  Sundays currently do not have a counselor assigned.  The facility has a final goal of 10 hours of psychoeducational programming each week for each client.  However, logistics and time constraints do not currently allow for this goal to be immediately met.  Counselors can work with no more than 15 clients in a group.  Adolescents work best when groups are smaller, 6-8 clients per group.  The facility can hold up to 32 clients at a time, with the number fluctuating weekly between 25 and 30 clients.

Locations for groups vary depending on size.  There is a classroom available, a conference room that seats up to 8, when not in use, a small area between the cafeteria and offices/dorms which holds up to 10 clients, and the cafeteria, which can realistically hold two small groups of 8 or one large group of 15.  There are also outside areas where groups can be conducted, weather permitting.

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Odyssey House | Houston Treatment Center | Cenikor

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The problem for this specific population is identifying appropriate psycho educational groups that are required as part of the treatment. All clients participate in five (5) two-hour process group sessions each week, which are predominately addressing SUD and related issues such as triggers, effects of addiction, warning signs, recovery process and other related areas. Since the facility only accepts adolescents ages 13 through 17 the age group is static.

Informed consent is obtained upon entry into the facility.  Psychoeducational groups are important in the recovery process as information and participation promotes success in recovery for the adolescents as they learn about issues that are related to not only chemical dependency but other areas of concern.  Clients with a substance use disorder have often neglected other areas of growth and learning or missed out on valuable information.

Information from the data collected generated a list of possible topic areas and a survey was generated.  Clients were asked to pick 6 of their top areas they would like to see addressed in psychoeducational groups.  There was also an option to add an idea should a client or clients have strong feelings about a particular topic. Clients vehemently verbalized that they received a plethora of information regarding their substance use disorder and related or associated issues.  Clients indicated that they had many other needs that needed to be met.    Given that these are adolescents, at differing ages, educational experiences, even languages, clients completed the surveys slightly differently than requested.  Clients chose anywhere from 3 topics to 8 topics.  However, there was overall consistency in topic choosing, and 6 main topics were generated, with two (2) additional topics to add once programming begins.

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The styles of leadership that are most common include an Autocratic leadership, a

Democratic leadership, and a Lasseiz-faire leadership. There are many other types

of leadership, 8 overall. The autocratic leader has complete control of the group process. The group makes no decisions and this style of leader manages every aspect of the group.

A Democrat leader asks, is a facilitator and takes comments or input from the group members. This type of leadership allows the group to feel as they are invested in the outcome. Members recognize they are

stakeholders and that they are being heard. Ultimately the group leader in this

case, helps guide and shape the direction of the group.

The Laissez-faire type of leader provides some guidance to group members, but really allows the group to make the

decisions and guide the direction of the group. The first and last of these groups are not conducive to a positive adolescent group experience. Therefore, the

psychoeducational group would be based on a Democratic leadership style to allow

the participant to be a part of the group and actively engaged with a

leader/counselor facilitating, shaping and guiding behavior. I'd like to mention that

transactional leadership is a model that you may often see when working with

adolescence which chooses rewards and punishments to motivate individuals.

However, this is a completely inappropriate model for working with adolescence

with SUD and mental health issues and increases the risk of problem behaviors, nger and conflict

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This group is a small group focusing on adolescents with primary SUD.  The specific population identified for psychoeducational groups is an at-risk population, consisting of adolescent males and females between the ages of 13 and 17. The population has a primary identification as an individual with a substance use disorder and many have a co-occurring mental health diagnosis, and some clients also have disabilities. As this is the make-up of the population of the residential treatment facility, data is derived from the intake, the initial SUD assessment and/or Comprehensive Individual/Intake assessment which generates needs assessment data.  Based on the information provided by the facility, clients would be spending as little as 30 days or as long as 90 days with the average client spending 45 to 60 days per treatment. This information indicates that the group will be structured but open as clients come and go weekly.

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The adolescent treatment facility has a core set of rules for group conduct and behavior. These rules are similar amongst individual groups, but slight variations can occur, based on the individuals. For example, I encourage participation within my groups, but provide the right to pass. I encourage clients to speak to me separately if they are uncomfortable, and many will write a note or statement as part of their participation. Art activities and projects do not require neatness nor talent, just enthusiasm and participation.

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One of the best advantages of this type of group is that clients are able to identify with other adolescents with similar issues. In addition to substance use disorder, clients who have felt in isolation find others with family issues. anger issues, problems with daily stressors, communication at home and in relationships and other areas. Universality is the most recognized therapeutic factor for psychoeducational groups.

Clients also experience Installation of hope in that they are able to recognize, though activities and speakers that recovery is possible, and relapsing is not failure. Additionally, clients recognize that there are future opportunities.

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When working with adolescents, be prepared!

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When working with adolescents with substance use disorder there are several risk and safety issues that can arise.  Primarily, the facilitating counselor needs to be aware of each client’s needs, triggers and any trauma related issues.  I recommend a one (1) page sheet completed for each client that can give necessary background data for part-time counselors who do not have their own client base.  Additionally, clients have safety plans when they are high-risk addressing issues such as suicide ideation, self-harm, homicidal tendencies and history of elopement.  This sheet should also be provided.  Divisions of clients into smaller groups needs to be purposeful, as clients are of varying age, have varying issues, and can even belong to rival groups.  Although there are some aspects that are likely not something written in a folder or on an assessment, counselors need to be observant and prepared.

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When counseling adolescents the American Counseling Association indicates that counselors must present the ethical responsibilities that consist of protecting the clients, yet still being collborative with the parents and guardians. Confidentiality is a legal requirement and one of the most important aspects of counseling. Counselors are required to balance responsibilities and protect adolescents from harm. Although counselors collaborate with parents and guardians, it is important to recognize adolescent autonomy. Parents are still requird to consent for treatment, unless the minor is married, they are enlisted, or they are seeking treatment for substance use disorder or an STD. Additionally, clients must be willing to accept the service, and consent.

The ethics and guidelines are attached, but it is important to note that the ethics and guidelines for an LCDC are actually more strict.

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Overall, the variety of studies available across different populations, ethnicities, and even countries offer evidence of similar issues, indicating that this area of group therapy is a necessary component in the treatment of adolescents with substance use disorders and co-occurring mental health disorders.  A good, cohesive group can help motivate others who are reluctant to participate, to be less passive.  Comfort with peer group also impacts group dynamics, as does the ability to speak freely.  It is important for treatment to not just focus on the substance use disorder but take a more holistic approach and look at other issues impacting adolescents.  This is the importance of an effective psychoeducational group program.

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Please see attached document

American Counseling Association (2014) ACA Code of Ethics

Thomas, R.V. & Pender, D.A. (2008) Association of

specialists in group work: Best practice guidelines

2007 revisions. The Journal for Specialists in Group

Work. 33:2 111-117

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Group dynamics helps leaders and members understand how the individuals are interacting with each other. Based on the style of group, and the idea that although the group is structured, it remains open, there is truly never an ending or adjournment. Upon initial establishment, the group will likely be in the forming stage very briefly if at all as clients are already participating in process group therapy daily. The concept of this style of group will be new.

There may also be some moments of conflict and disagreement as psychoeducational groups are being implemented, which is a different dynamic and make-up than process groups.

Most likely, the psychoeducational groups will have a structure, expectations that are established, and clients will work together and understand their responsibilities, which is a blending of the norming and performing stages of group.

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Attached please find a copy of my action plan. I welcome any feedback, so thank you.

Melissa L. Knop, LCDC

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(a) A licensee shall not discriminate against any client or other person on the basis of gender, race, religion, age, national origin, disability, sexual orientation, or economic condition.

(b) A licensee shall maintain objectivity, integrity, and the highest standards in providing services to the client.

c) A licensee shall:

(1) in addition to complying with any other applicable reporting requirements, promptly report to the department any suspected, alleged, or substantiated incidents of abuse, neglect, or exploitation committed by oneself or another licensee under this subchapter;

(2) unless otherwise prohibited by law, promptly report to the department violations of Texas Occupations Code, Chapter 504 (relating to Chemical Dependency Counselors), or rules adopted under the Act, including violations of this subchapter by oneself or another licensee;

(3) recognize the limitations of the licensee's ability and shall not offer services outside the licensee's scope of practice or licensure or use techniques that exceed the person's license authorization or professional competence; and

(4) make every effort to prevent the practice of chemical dependency counseling by unqualified or unauthorized persons.

d) A licensee shall not engage in the practice of chemical dependency counseling if impaired by, intoxicated by, or under the influence of chemicals, including alcohol.

(e) A licensee shall uphold the law and refrain from unprofessional and unethical conduct. In so doing, the licensee shall:

(1) comply with all applicable laws, regulations, and orders;

(2) not make any claim, directly or by implication, that the person possesses professional qualifications, licensure, or affiliations that the person does not possess;

(3) include, as applicable, their current credentials when signing all professional documents;

(4) not mislead or deceive the public or any person; and

(5) refrain from any act that might tend to discredit the license or profession.

(f) A licensee shall:

(1) report information fairly, professionally, and accurately to clients, other professionals, the department, and the general public;

(2) maintain complete, accurate, and appropriate documentation of services provided;

(3) not submit or cause or allow to be submitted to a client or third party payer a bill for services that were not provided or were improper, unreasonable, or medically or clinically unnecessary, with the exception of a missed appointment for which notice has been given that a charge will be assessed, and as permitted by law concerning third party billing; and

(4) provide responsible and objective training and supervision to interns and subordinates under the LCDC, CCS, or CTI's supervision. This includes properly documenting supervision and work experience and providing supervisory documentation needed for licensure.

(g) In any publication, a licensee shall give written credit to all persons or works that have contributed to or directly influenced the publication.

(h) Licensees shall respect a client's dignity, and shall not engage in, or permit their employees or supervisees to engage in, any action that may injure the welfare of any client or person to whom the licensee is providing services. The licensee shall:

(1) make every effort to provide access to treatment, including advising clients about resources and services, taking into account the financial constraints of the client;

(2) remain loyal and professionally responsible to the client at all times, disclose the counselor's ethical code of standards, and inform the client of the counselor's loyalties and responsibilities;

(3) not engage in any activity that could be considered a professional conflict, and shall immediately remove oneself from such a conflict if one occurs;

(4) terminate any professional relationship or counseling services that are not beneficial, or are in any way detrimental to the client;

(5) always act in the best interest of the client;

(6) not abuse, neglect, or exploit a client;

(7) not engage in a sexual, personal, or business relationship with a client or a member of the client's immediate family (including any client receiving services from the licensee's employer) for at least two years after the client's services end;

(8) not request a client to divulge confidential information that is not necessary and appropriate for the services being provided;

(9) not offer or provide chemical dependency counseling, supervision, or related services, nor meet with a client, in settings or locations which are inappropriate, harmful to the client or others, or which would tend to discredit the profession of chemical dependency counseling; and

(10) refrain from using any method or engaging in any conduct that could be considered coercive or degrading to the client or another, including, without limitation, threats, negative labeling, or attempts to provoke shame or humiliation.

(i) A licensee shall protect the privacy of all clients and shall not disclose confidential information without express written consent, except as permitted by law. The licensee shall remain knowledgeable of and obey all state and federal laws and regulations relating to confidentiality of chemical dependency treatment records, and shall:

(1) inform the client, and obtain the client's consent, before tape-recording the client or allowing another person to observe or monitor the client;

(2) ensure the security of client records;

(3) not discuss or divulge information obtained in clinical or consulting relationships except in appropriate settings and for professional purposes which clearly relate to the case, to the extent authorized by law;

(4) avoid invasion of the privacy of the client;

(5) provide the client his/her rights regarding confidentiality, in writing, as part of informing the client in any areas likely to affect the client's confidentiality; and

(6) ensure the data requested from other parties is limited to information that is necessary and appropriate to the services being provided and is accessible only to appropriate parties.

(j) A licensee shall inform the client about all relevant and important aspects of the professional relationship between the client and the licensee, and shall:

(1) in the case of clients who are not their own consenters, inform the client's parent(s) or legal guardian(s) of circumstances that might influence the professional relationship;

(2) not enter into a professional relationship with members of the counselor's family, close friends or associates, or others whose welfare might be jeopardized in any way by such relationship;

(3) not establish a personal relationship with any client (including any individual receiving services from the licensee's employer) for at least two years after the client's services end;

(4) neither engage in any type or form of romantic or sexual behavior with a client (including any individual receiving services from the licensee's employer) for at least two years after the client's services end nor accept as a client anyone with whom they have engaged in romantic or sexual behavior; and

(5) not exploit relationships with clients for personal gain.

(k) A licensee shall treat other professionals with respect, courtesy, and fairness, and shall:

(1) refrain from providing or offering professional services to a client who is receiving chemical dependency treatment and/or counseling services from another professional, except with the knowledge of the other professional and the consent of the client, until treatment and/or counseling services with the other professional ends;

(2) cooperate with the department, professional peer review groups or programs, and professional ethics committees or associations, and promptly supply all requested or relevant information, unless prohibited by law; and

(3) ensure that the person's actions in no way exploit relationships with supervisees, employees, students, research participants or volunteers.

(l) Prior to providing treatment and/or counseling or substance abuse services, a licensee shall inform the client of the licensee's fee schedule and establish financial arrangements with a client. The counselor shall not:

(1) charge exorbitant or unreasonable fees for any service;

(2) pay or receive any commission, consideration, or benefit of any kind related to the referral of a client for services;

(3) use the client relationship for the purpose of personal gain, or profit, except for the normal, usual charge for services provided; or

(4) accept a private professional fee or any gift or gratuity from a client if the client's services are paid for by another funding source, or if the client is receiving treatment from a facility where the licensee provides services (unless all parties agree to the arrangement in writing).