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In this padlet, I will explore a group work intervention for teens who are struggling to cope with mental health issues. I will accomplish this by exploring the issues and needs for youth, the role of the facilitator, the phases of group work, and the benefits of this intervention. This group work design uses an anti-oppressive lens with a focus on the participants' strengths. In order to address where the youth are at developmentally, the use of hands on activities to promote insightful discussion is encouraged.

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"In making the transition to adulthood, adolescents work through a process of self-discovery and realization about who they are and what makes them unique” (McFerran-Skewes, 2004, p.148). It's important to remember, that teenagers have a lot going on at the personal level; between school, family, friends, and trying to find out who they are and who they want to be. Identity formation and authentic self-expression are important developmental tasks at this stage in life (McFerran-Skewes, 2004). Group work can be a good opportunity for adolescents to explore their beliefs, values, and emotions in a safe and accepting space.

Peer pressure is another aspect of teen life that directly impacts their mental health. At this age, its common for peer pressure to be a negative and stressful experience (pressure to use drugs, alcohol, commit crimes etc). Teenagers are dealing with internal struggles of identity, hormones, and emotions but they also have to navigate outside influences from peers. As a facilitator, it’s important to be a positive social role model and provide a space for youth to be open and honest about their struggles with peer pressure. “A good group can function as its own community and promote a sense of solidarity and empowerment among its members” (Northington, 2018, p.14)

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Teenagers are a very diverse population. However, as a whole, they share many strengths that allow them navigate such a transitional time in life. According to a study done by Park & Peterson (2006), this population is known for being very resilient, creative, courageous, and humorous. All of which, can play a positive role in group engagement and discussion. As a facilitator, having discussions around individual strengths can be a great way to promote and foster group cohesion. “The adolescents reported that during group therapy sessions they were more likely to actively participate and engage in group discussion if the session content was based on strengths.” (Harris et al., 2012, p.339)

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For youth, there are many different types of groups that can be used; each having their own benefits and risks. Some groups are therapeutic, educational, focused on skills development, task oriented, online, mandated, or open/closed groups.

For this target population, the most appropriate kind of group would be a peer support group. Better defined as a therapeutic group, with a focus on skill development. In this case, it would be life skills, such as self care and coping skills. Garven et al. describe a successful peer group as one that  "helps shape identity, feelings of belongingness, a sense of meaning and purpose" (2017, p.96)  In order to foster engagement and belongingness, having a group that is closed, unstructured, and tailored to the needs of the participants would be most beneficial. Having a closed group, allows members to start and end together; they don't have to continue meeting new people and retelling their story. The use of activities is also an important factor to incorporate. "If the eyes and hands are occupied, words are able to flow more easily." (Malekoff, 2005, p.151)

As a facilitator, you may want to avoid using online groups as a way to mitigate confidentiality issues. Even though, today’s youth are connected and comfortable with technology; online groups would be difficult to facilitate from an ethical standpoint. The facilitator would have no control over who else is in the room with each youth; meaning the identity of the other youth would be at risk.

Talk therapy groups can also be difficult for youth, as they tend to be in constant movement, both physically and mentally. Malekoff (2005) explains when working with adolescents "a traditional talk therapy group session will not be responsive to their developmental needs and ways of working" (p.151).

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The role of the facilitator in a youth support group is one that is ever changing. "The leader wears many hats, as it were, such as parental, model for identification, limit-setter, educative and resource of information, container and creator of a safe environment, and always, therapeutic." (Aronson & Khan, 2006, p.99) Being flexible and empathetic are very important to facilitating group work for teens, but a good facilitator should also be able to handle a certain amount of resistance and disruptive behavior. "It’s not always easy to hang around to hear the music underneath the static of the words. Yet to work with adolescents one must hang in there." (Malekoff, 2005, p.103)

"The adolescent group therapist is dealing with a room full of egos in the process of developing a sense of identity "  (Aronson & Khan, 2004, p.102) It's important to remember that the youth in the room are still trying to figure out who they are; this means they will most likely test the facilitators boundaries, and sometimes that means working together to accomplish this. As a facilitator, it may seem like a daunting task to take on a group of teens. However, these disruptive behaviours can be great starting points for the facilitator to have discussions around beliefs, values, and communication. The role of the facilitator is really to listen to what is being said and how it's being said, draw on the meaning and purpose to create meaningful discussions for the group. This, will hopefully lead to helpful insight and help create positive change for those involved.

Another thing to consider is whether or not you will facilitate alone or if you will have a cofacilitator. Malekoff (2006) suggests cofacilitation, "never go it alone" (p.103). Having two facilitators, allows for more connections to be made and it gives the facilitator some one to debrief with.

Facilitating a youth support group, is really about fostering healthy coping mechanisms and listening to the youth from a  non-judgmental perspective. It's about being a safe person, who is reliable and supportive. A peer support group can act as a social support system for youth, for some this will be the only support system available to them. Having a support system can directly impact ones mental health, in a positive manner. It can aid in eliminating feelings of loneliness and helplessness.

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“Social work often takes place with the most disadvantaged groups in society - those who are most likely excluded from power and influence” (Lindsay & Orton, 2014, p. 110) In order to empower and build rapport with clients, it’s important to facilitate group work in an anti-oppressive way. As a facilitator, there are ways to help shift the power from you to the group. Malekoff (2006, p.97) explains that one must look at group work from the “I am working with groups” perspective and not the “I am running a group” perspective. It’s about recognizing the power, skills, and capacity that individuals and groups hold.

Working with teens, automatically puts you in a position of power. Whether you like it or not, they will see you as an authority figure. One way to mitigate this is to be careful of the words you use. It important to speak in a way that is easy to understand, but also be careful not to patronize. It’s about finding the middle ground between “baby talk” and jargon.

Another way to mitigate issues of power, is to be curious about what they say and do, from a non-judgemental perspective. It’s OK to be vulnerable, and tell them you don’t know what that slang word means. This really helps to shift the power, because now they are in a position to teach you something.

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When planning a peer support group for teens struggling with their mental health, you will need to find teens who are interested and willing to participate. One way, might be to recruit teens from local schools, other social programs, or from the agency you work with.

The size of group is also something to consider, while you may be inclined to accept anyone that is willing to join your group, it’s important to remember that “the size of the group will have an impact on how it is experienced, both by the members and by the leaders” (Lindsay & Orton, 2014). A peer support group for this age group (12-17) , should include both activities and discussions about personal topics. This means you don’t want the class to be too big, as some may not feel safe enough to share such things; but, you also don’t want it to be too small, as you won’t have enough people for activities. You should also aim to have an even number rather than an odd number for activities. For this type of group, I would aim for 6-8 youth. However, “most groups experience a certain amount of drop-out” (Lindsay & Orton, 2014). In order to plan for this, it might be wise to start with 8-10 youth.

The ideal setting would be an open concept room, which has comfortable seating and tables to do activities on, and maybe a white board to help with visuals. This may be a classroom in a school or a room in a community center. It would be important to access a space where the volume of the youth isn’t restricted; like at a library.

You can be very creative when planning activities, however, it’s important to keep in mind that while you may think certain activities are a good idea; it really depends on the interests of the group. With youth, activities like art, music creation, hikes, journaling, poetry, and games, are all great for engagement and group cohesion. As mentioned before, getting youth busy with their hands is always a great way to get their brains thinking. Because it feels so casual during activities, this is when youth engage in the most insightful discussions (Malekoff, 2006).

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Beginning and Middle Phases of Group Development

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Beginning and Middle Phases of Group Development

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In the beginning phase of a group, there are a number of issues that may arise. For example, there may be member who experiences anxiety in groups when they have to introduce themselves. It may be wise to choose an alternative way to do introductions; as there might be some participants who struggle with self-esteem and may find it difficult to talk about themselves. Pelech et al. (2016) suggest using a buddy system as a way to do introductions. Each member finds a partner, learns a few fun things about them, and introduces their partner to the group.

Another issue might be, if the group worker does not have a thorough discussion surrounding confidentiality; this may lead to members feeling uncomfortable talking about their personal lives. "Without members' openness and authenticity in a group, it will be difficult to reach therapeutic goals" (Pelech et al, 2016, p.122). In order to avoid this, Pelech et al. recommend creating a written contract that includes the  rules around confidentiality, and have one for each member to sign (2016, p.123).

In peer support groups, it is common for conflict to arise in the middle phase. During discussions, members sometimes get into disagreements about their opinions, beliefs, or values. Contrary to popular belief, conflict can actually be a good thing in group work; as long as it's handled appropriately. During conflict, members should be encouraged to explore their feelings and thoughts, in a safe and respectful manner. "Conflicts can also lead to greater commitment, cohesion, communication, and cooperation and can revitalize stagnant groups" (Zastrow, 2009, p.166)

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Members have a space to explore their feelings, thoughts, and experiences. They have access to a safe group and environment.

Members have a support system, to which they can lean on in times of need. They know how and where to find them. Its a reliable source of support.

Members will work on goals; some that are tailored to their needs and some that are for the group as a whole. This fosters skills such as, teamwork, problem-solving, and respect for others.

Members can decrease feelings of depression and anxiety, by socializing, working towards and completing goals. Also, by learning healthy coping strategies like self-care, expressing and exploring feelings, and being compassionate to oneself and others.

Members will have access to new resources and information. They may create new, healthy connections in their community.

Members may gain new insights into their communication styles, which may help in relationships outside of group. Peer groups are a great place for youth to learn and practice how to be critically reflexive or "in tune" with ones emotions and thoughts. Groups are a good place for youth to practice communication skills.

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"Termination is a necessary and critically important phase of group development, since it sets the tone for learned skill transfer to various other experiences in the natural environment of members" (Mayadas & Glasser, 1981, p.194) In a peer support group, many of the skills learned are from each other and a result of their lively discussions and insights. This exchange of knowledge and skills, gives the group purpose, which can lead to their learnings feeling more meaningful then if they were taught skills from the facilitator on a white board. In the end phase of groups, it's a good idea to have a discussion with the group about what they got out of the group, how they feel leaving the group, and what they didn't like about it.   Gathering the groups thoughts, can help the members solidify their learnings and help them to take it with them. It might be a good idea, to make a list and have a copy for each participant to take home.

For the facilitator, the end phase is also about examining goals and outcomes of the group and individuals. This can be difficult for a facilitator, because it can feel like a failure if the goals were not reached. But reaching goals, isn't the only way to determine if the group was successful. For example, a youth may have not met their goal of being physically active 3 times a week as a way to decrease anxiety; but their group experience was transformational because they became more comfortable talking in groups, which will in turn benefit their school and personal life. Participant surveys can be used as a tool to get better insight into how effective the group was for each individual. The use of open ended questions in the survey can also promote further discussion.

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After careful review of youth as a target population, group phases, dynamics, and processes; I conclude that a peer support group with a focus on strengths and skill development would be the most efficient approach to address mental health issues. Working from a strengths-based perspective with youth, can have a positive impact on members' self-esteem and sense of belonging. It allows youth to see the power, strength, and resilience they hold. Within a peer group, they are able to see these strengths with the help of other youth; rather than having an adult tell them how great they are. A peer support group helps youth develop their identity, learn new coping strategies, and make healthy connections.

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Aronson, S. & Kahn, G. (2004) Group interventions for treatment of psychological trauma. American Group Psychotherapy Association.

Garven, C, Gutirez, M, & Maeda, G. (2017) Handbook of Social Work with Groups. (2nd Ed) Guilford Publications.

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Park, N. &  Peterson, C. (2006) Moral competence and character strengths among adolescents: The development and validation of the Values in Action Inventory of Strengths for Youth, Journal of Adolescence, Volume 29, Issue 6, Pages 891-909,

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

Zastrow, C.H. (2009). Social work with groups, 7th ed. Brooks/Cole: Belmont, CA.