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This padlet discusses the application of a strengths-based approach to group work with adolescents in residential treatment. Lietz (2007) explains that when group facilitators can incorporate a strengths-based perspective into group work with adolescents in residential care its results in four beneficial outcomes; firstly, the group identifies their own needs; second, the group can then establish a practical group purpose, third, the group can develop specific content that enables them to take ownership in the group; fourth, the group exercises these identified strengths to improve their developmental functioning and self-esteem. This approach has proven to increase individuals' success from the group as they transition back into real life (Lietz, 2007). Moreover, it is consistent with the Canadian Association of Social Workers code of ethics and the services users right to self-determination (CASW, 2005). Strengths-based group work can be applied to a broad range of adolescent groups, including youth who experienced trauma, loss, marginalization, homelessness, addictions, pregnancy, and foster care. When entering into group work with adolescents in residential care, it is crucial to remember that each group has a life of its own, its own culture and unique personality, and therefore, the facilitator must respect and value the life of the group as it emerges (Malekoff, 2008).

https://al-anon.org/newcomers/teen-corner-alateen/

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Unique Needs, Issues and Strengths of Adolescents in Residential Treatment

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Unique Needs, Issues and Strengths of Adolescents in Residential Treatment

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Adolescents in residential care have experienced trauma and loss through the child welfare system's involvement, contributing to an intrinsic condition of orphanhood. The needs of this target group are a direct effect of the trauma and loss they have experienced. Typically, they have experienced losses or trauma such as abuse, family break down, and being taken into care, resulting in serious concerns regarding both their mental health and their future ability to participate in society (Lougheed, 2019; Coholic et al., 2009; Lietz, 2004).
Issues for these adolescents are rooted in the belief that abuse will continue even in the group setting and is further exacerbated by their low self-esteem (Coholic et al., 2009). The behaviours displayed include anxiousness, withdrawal, apprehension, overly watchful, quick tempers, attention deficit, limited social skills, difficulty modulating their effect, poor sense of self, and trouble remaining grounded and present in the moment (Lougheed, 2019; Coholic et al., 2009).

However, despite the challenges in behaviour and adaptive functioning, this target group has numerous strengths. They have an innate ability to go with the flow, to be strong in the face of adversity, to demonstrate resiliency, and the ability to take advantage and use social support from trusting relationships (Lougheed, 2019). They also have a unique outlook on their past experiences as a badge of 'survivor pride' (Coholic et al., 2009, p. 341).

What does this mean for group intervention? Since it is difficult for older children and teens in care to focus for any length of time, the group intervention exercises must be short and straightforward, active and sensory focused, and concrete in their examples (Coholic et al., 2009). Intervention strategies must aim to improve concentration and mindfulness skills, not only to themselves but also to the other group members. Coholic et al. explain that "developing a foundation of attention is essential for the observations of thoughts, emotions and body sensations" (2009, p. 35).

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Appropriate Types of Groups with Adolescents in Residential Treatment

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Appropriate Types of Groups with Adolescents in Residential Treatment

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Firstly, it is essential to note that mandated group therapy for youth is not ideal, although sometimes unavoidable. Coholic et al. proved it is best when participation in the group is voluntary (2009). Voluntary participation ensures that the youth enter the group with a willing heart, which increases the success of participation. Types of groups that are appropriate for this population include holistic-arts based groups, mindfulness-based intervention, cognitive behavioural therapy, psychoeducation or psychosocial, and therapeutic group interventions (Lietz (2004); Coholic (2009); Lougheed (2019)). All of these types of groups have different benefits for youth in residential treatment.

Groups with adolescents could look like psychoeducational groups focusing on social skills training since many youths do not have typical experiences around appropriate social behaviours. However, it must be rooted in a strengths-based approach.

The use of arts-based activities has been well established as a helpful approach to group work. It is especially beneficial at engaging young people who are typically less likely to access supports (Lougheed, 2019). Arts-based groups can make room for the expression of emotions in unique ways that are anti-oppressive and strengths-based. Furthermore, experiencing art can lead youths to use their imaginations and construct new meaning around their past experiences.

Similarly, mindfulness-based intervention is useful for group work with adolescents in that it helps them sit still, pay attention and focus (Lougheed, 2019). These are skills that many youths generally struggle with, especially those exposed to severe loss and trauma. Therapeutic group work centred around art-based activities that focuses on sharpening mindfulness is ideal and has been receiving burgeoning attention within the helping profession and aligns with a strengths-based group work approach (Lougheed 2019; Lietz, 2004, Malekoff, 2008; Harris, 2012).

https://www.counselorkeri.com/2019/05/21/mindfulness-group-art-activity/

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Discussed here is Malekoff's (2009) 7 principle framework that outlines effective facilitation of group work with adolescents in residential care. Firstly, groups must be formed based on the members' identified needs and wants, not on a label or diagnosis. A question asked during the beginning/contracting phase that demonstrates this principle is, "What would you like to accomplish in this group?" This questioning line is rooted in a strengths-based approach and reiterates to the group that the facilitator is confident in the youths' ability to construct new views of themselves (Lietz, 2004). Secondly, central to a strengths-based approach, the facilitator must welcome the whole person, not just the troubled, hurt or broken parts. The identification of strengths is crucial. Thirdly, the worker must incorporate nonverbal activities as well as verbal ones. For example, the use of art can be a way of expressing emotions in a different way other than words when the right words can be difficult for young people to find. Fourth, facilitators must develop meaningful alliances with the other relevant people in their lives to create a collaborative team of support for youths. The fifth principle is a core value of the strengths-based approach, which states that the facilitator, usually in the middle phase of the group, can decentralize the authority and turn control over to the group encouraging an environment of mutual aid and support between peers. Sixth, the facilitator must have a dual focus on the micro-level of change and the mezzo and macro levels of change. As a facilitator, it is the hope that youths develop these skills so intrinsically that they then go out and change the world in the ways that the world failed them. Good facilitation with adolescents in residential care means weaving in consciousness-raising wherever possible. Lastly, principle seven is that the facilitator must trust the process and development of the group's unique life, personality, and culture. Every one of these principles reiterates the concept of a strengths-based perspective to group work with adolescents in residential treatment.

https://www.mindtools.com/pages/article/improving-group-dynamics.htm

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The majority of the adolescents in residential care have experienced an intersectionality of invasion from various macro, mezzo, and micro-interventions, including educational, criminal justice, child welfare and mental health (Lougheed, 2019; Lietz, 2004). They have endured the loss of family, friends, possible meaningful relationships and connections, home, security, and familiarity. An overall loss of voice and control. Riddled within their stories are issues of power at the macro, mezzo and micro levels that must be considered and addressed within the group setting. Due to the experiences around powerlessness stemming from decisions often out of their control, these youths may be overly accepting of circumstances as they occur (Lougheed, 2019; Lietz, 2004). Although this can be seen as a strength, this can make them susceptible to further control and powerlessness. The facilitator must be aware of these issues of power and address them within the group setting through the decentralization of authority, control and decision-making (Lougheed, 2019; Lietz, 2004; Malekoff, 2008). A collaborative process must take place rooted in the sharing of power. This looks like letting the group select the activities and choosing when to reflect and share openly with other group members. This is accomplished through a democratic process of building consensus, rather than being driven by the facilitator (Lougheed, 2019; Malekoff, 2008).

https://www.dreamstime.com/photos-images/powerlessness.html

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It is common for recruitment to look like referrals through community or government organizations via the agency's childcare workers since youths in residential care do not have the resources to find treatment independently. Social workers refer youths who, in particular, need peer support, improvement with behavioural issues, and with low self-esteem (Coholic et al., 2009). Youth must be voluntary participants for the sake of long-term success. Therefore, before they enter into the group, they must be assessed as to their readiness. This looks like familiarizing the youth with the group, assessing if the youth is in any crisis or breakdown of functioning, and then lastly asking the youth if they want to participate (Coholic et al., 2009).

One of the issues with forming groups for adolescents in residential treatment is their potential to move placements and thus discontinue participation. This is mitigated by allotting only 6-week block groups. This seems to be a manageable commitment for youths in residential care (Coholic et al., 2009). If the youths decide that the 6-week program was beneficial for them, they are welcome to join another 6-week program. Research suggests that it is most effective if groups are comprised of 4-6 boy/girl homogenous gatherings similar in age (Coholic et al., 2009). This helps to increase openness and relatability, thereby increasing group cohesion. The smaller the group, the more opportunity for intimate reflection among peers.

A possible layout for a 2-hour session comprises a 'primer' or 'icebreaker' activity, which provides a signal to start the group. It is meant to be short and fun and tends to the youths' behaviours such as anxiousness, lack of attention, or excitement (Coholic et al., 2009). A quick note about starting the group; merely launching the group right into group work has not been an effective strategy because there is not release of pent up energy and emotions from their week that they are bringing with them into the group (Coholic et al., 2009). From there, the facilitator can guide the group into the middle phase or ask the group members to pick their activity of choice, with a break mid-way for a snack and end with a closing exercise. Examples of types of activities include; videos educating the youths on mindfulness, drawing and painting to music, practicing short mindfulness meditations, short movement activities (e.g., mindful walking, awe walks) and then drawing or painting while reflecting on those activities, and purposeful fun games the youths choose (Lougheed, 2019).

https://www.postermywall.com/index.php/posterbuilder/copy/6f80e2c16ac12041759cbf6816b1f474

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Beginning Stage of Group Development:

Adolescents in residential treatment come into groups in a state of anxiousness of the unknown. There is a tension between trust and distrust, and a want to approach the group but also to avoid it. Youth are generally wary of the group, slowly dipping their toes into the conversation, all the while giving themselves the space to draw back if necessary (Malekoff, 2014).

What needs to happen is an orientation of the worker to the group, members to the worker, members to other members, and the group must establish the norms, values and patterns of communication (Malekoff, 2014). Along with that, the purpose of the group needs to be discovered. At this stage, the group members rely heavily upon the facilitator's leading; however, a strengths-based approach would say that they should determine their own purpose. The facilitator can lead them to discuss "what do they want to get out of the group," helping them identify connections and commonalities. The members will look at the facilitator to establish group norms through the worker's verbal and non-verbal actions. Once the group has "reduced anxiety, increased trust, growing commitment, clarity of purpose, and establishment of norms," they are ready for the middle phase.

Middle Stage of Group Development:

At this point, the youths in the group are still trying to find their place in the group through exploring, testing, sizing each other up, vying for power, competing, and determining their status (Malekoff, 2014). A unique aspect of the middle stage is that the youths start to understand the group's meaning for themselves. They start to take ownership through identifying their personal goals, and they see the group can help them with that. As a result, they become less dependent on the facilitator and more dependent on other group members, opening themselves up to more and taking more risks. The group becomes something important to them, and they see the experience as unique (Malekoff, 2014).

In the middle phase, youth in residential treatment will begin to test the facilitator to see how committed they are to accept them. This needs to happen in order for them to gain trust and ultimately respect the similarities and differences among group members (Malekoff, 2014). This is when subgroups may form between youths' as they find other members they like to 'hang out' with. In this stage, cohesiveness is still being developed, but the youths learn how to share openly even amid arguments, confrontations and testings.

Ending Stage of Group Development:

At this point in the group process, youth will start to identify individual skills development and maybe expressing good 'self-talk' about how they will apply what they have learned outside the group. Communication is free-flowing and easy to participate in. However, many mixed emotions arise in the ending phase of the group. There are many positives, reminiscing, evaluating how the group met their goals and yet, some might feel anxious at the impending loss of the group and its support (Makeloff, 2014). Some issues that could arise are regression in behaviours to communicate that members are not 'healed enough' to leave the group. Some may react in a 'flight' response and stop attending the group, effectively leaving the group before the group can leave them. Or an outright denial of termination altogether (Makeloff, 2014).

What needs to happen for the group is an acknowledgement of the end with a discussion around identification of progress made and how to carry onto life after the group taking with them what they accomplished here (Makeloff, 2014). Members may need help in transitioning out of relationships with other group members and with the facilitator. The facilitator's role is to help the group evaluate its experience; did they reach their goal? What needs to be accomplished still so that termination can happen? Are the youths ready for life outside the group? What outside resources would help the youth's transition outside the group (Makeloff, 2014)? The facilitator must contact other supporters in the youth's lives, such as staff, social workers, and family members, who may need to be involved post group (Makeloff, 2014). Lastly, the facilitator must understand how ending the group will impact themselves and process through any sense of loss or regret of unfinished work.

http://www.aleanjourney.com/2011/04/stages-of-high-performance-teams.html

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Group Dynamics: Subgroups, Roles and Conflict

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Group Dynamics: Subgroups, Roles and Conflict

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Now that group work dynamics at various stages with adolescents in residential treatment have been discussed, one must consider the roles, subgroups, and conflicts that emerge. Simply, subgroups in group work with adolescents in residential care form based on whom they like to 'hang out' with at the moment (Malekoff, 2014). This is usually the most evident during the middle phase of the group. Harris et al. (2012) identified in their interviews with youths coming out of a strengths-based treatment group that youths bonded more closely to other members who encouraged them and pointed out their strengths.

Adolescents in residential treatment exhibit most of the same roles as any other group, including; the listener or quiet one, the follower, popularity contest winner, and the monopolizer (Schmid, 2019). A role that particularly stands out in the literature is the scapegoat. Malekoff (2014) suggests why the scapegoat comes up in group work with adolescents in residential treatment; for example, youths who are confused about their sexual identity will arouse fears in other members to determine who will be accepting of them and who will not. As Shulman (2012) suggests, these members will project their own negative emotions about themselves onto other people in the group, which can be troublesome for group cohesion. Malekoff (2014) cautions that the removal of the scapegoat is always the last resort. The facilitator should skillfully encourage a change in behaviour by pointing out the pattern to the group and the scapegoat without criticizing them for expressing their feelings in this way.

Group work with adolescents in residential treatment could have many points of conflict. Lietz (2004) explains potential points of conflict, including; youth coming and going from different placements affecting group cohesion, peer dynamics that are complicated by group members living together, and highly structured living conditions, which may reduce feelings of empowerment. This is why it is essential to have norms established because it is the norms that will determine how conflict is expressed, managed, and resolved (Malekoff, 2014). The facilitator might have to model these norms and nudge the group along in the conversation. This looks like discussing potential disappointments, figuring out how to prevent this from happening in the future (problem-solving), and offering forgiveness (dealing with its effects in the moment) (Malekoff, 2014). This is all a part of sophisticated learning that prompts youths to develop psychosocial skills, teamwork skills, and conflict resolution skills.

https://www.shutterstock.com/search/group+dynamics

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There are many benefits for applying a strengths-based approach to group work with adolescents in residential treatment. Unique to youths is their high value of peer relationships. Most of these youths do not have typical experiences around peer relationships and do not know whom to function within them. Being a part of a group where youths can exchange personal stories and receive validation of strengths from peers helps foster self-esteem and confidence in themselves (Lietz, 2004; Coholic et al., 2009). When a group can incorporate treatments infused with strengths and mindfulness, the result is increased feelings of optimism, better emotional regulation, and even improved sleep hygiene (Lougheed, 2019). Arguably, a vital benefit to a strengths-based approach to group work with youths in care is the toolbox they walk away with to apply in the real world. It is emphasized that for youth ageing out of the child welfare system, these kinds of peer connections are vital in setting the right expectations for future connections out in the world. Youths ageing out of care who can be mindful of their emotions will also be more likely to seek future social supports, having received the benefits of participating in group work (Lougheed, 2019).

https://bohatala.com/the-benefits-of-working-in-a-group/

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The end of a group can signal many different emotional responses to the members and the facilitator (Pelech et al., 2016). Potentially, everyone has devoted the last six weeks to form deep, emotional, trusting relationships. For youths, specifically, this can manifest in many different ways. Malekoff (2014) explains four possible ways youths outwardly express the internal emotional turmoil they are experiencing towards the group's ending. Firstly, there is a shift in how the youths view their relationship with the facilitator, either increased dependence or exclusion. For some, any gains in independence from the facilitator slowly deteriorate as the youths are not ready to lose this relationship. Conversely, youths may further exclude the facilitator to protect themselves from the impending abandonment they feel is inevitable with the group's ending. Secondly, the youths could exhibit regression in behaviour, upsetting the group rules and norms in the hopes the facilitator postpones ending the group. Thirdly, any acknowledgement of positive experiences is clouded over to ease the pain to deny its benefits. Lastly, some youths initiate a flight response where they abandon the group before the group can abandon them. Again, these youths come from traumatic backgrounds, and the ending of the group could elicit painful memories from the past. It takes a skillful facilitator to walk the group through the ending phase sensitively.

It is good practice to evaluate the effectiveness of the group with the youths. This can help reiterate gains made, strengths identified, and renew their sense of self-actualization. Reminding the group of their purpose, to add strategies to their toolbox as they move on in life, and demonstrating that you are confident in their ability to apply these tools will make all the difference for life after the group. Furthermore, facilitators must partner with other supports within the youths' lives so that a follow-up can occur post group (Makeloff, 2014).

https://www.edsurge.com/research/guides/crossing-the-finish-line-stories-on-student-success-and-what-colleges-are-doing-to-get-there

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The group work process can be both a trigger and beautifully rewarding process, especially when trying to organize a group of adolescents who have no basis for building trust or functioning within a structured setting. As Pelch et al. (2016) discuss, facilitators must learn to be self-reflective to help better the group discuss their feelings, bond over experiences, take risks by expressing their opinions, and grow into emotionally competent citizens. Youths in residential care feel the safest to do so when encouraged to identify strengths in themselves and other members. This allows youths to work with peers to learn from each other's success and failures is a unique experience that cannot be recreated in an individual therapy session (Harry et al., 2012). And finally, a strengths-based perspective must be the root of group work with adolescents in residential care as it has been increasingly promoted throughout the literature as providing the best outcomes and benefits for its group members (Coholic, 2009; Harris et al., 2012; Lietz, 2004; Lougheed, 2019; Malekoff, 2014).

https://uplandsoftware.com/eclipseppm/resources/blog/focus-on-your-project-strengths/

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Coholic, D., Lougheed, S., & Lebreton, J. (2009). The helpfulness of holistic arts-based group work with children living in foster care. Social Work With Groups, 32(1), 29–46. https://doi.org/10.1080/01609510802290966

Harris, N., Brazeau, J., Clarkson, A., Brownlee, K., & Rawana, E. P. (2012). Adolescents' perspectives on strengths-based group work and group cohesion in residential treatment for substance abuse. Journal of Social Work Practice in the Addictions, 12(4), 333–347. https://doi.org/10.1080/1533256x.2012.728485

Lietz, C. (2007). Strengths-based group practice: Three case studies. Social Work With Groups, 30(2), 73–87. https://doi.org/10.1300/j009v30n02_07

Lougheed, S. C. (2019). Strengths-based creative mindfulness-based group work with youth aging out of the child welfare system. Social Work with Groups, 42(4), 334–346. https://doi.org/10.1080/01609513.2019.1571762

Malekoff, A. (2007). A Flexible Organizing Framework for Group Work with Adolescents. Social Work with Groups, 30(3), 85–102. https://doi.org/10.1300/j009v30n03_06

Malekoff, A. (2014). Group work with adolescents, third edition: Principles and practice. Guilford Publications.

Pelech, W., Basso, R., Lee, C.D. & Gandarilla, M. (2016). Inclusive group work. New York, N.Y.: Oxford University Press.

Schmid, J. (2019). Roles in groups [Web page]. Retrieved from Lecture Notes Online Website:             https://learn.viu.ca/d2l/le/content/156556/viewContent/1773137/View

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