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Group Leadership: Roles, Types and Skills

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Group Leadership: Roles, Types and Skills

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The type of leadership in this group setting will be a combination of Authoritarian, Democratic and Laissez-faire.  Depending on the topic the group may need complete guidance and at that time I will use authoritarian. If it is a group discussion and project that students will individually be doing I may need to guide and then let them figure it out. Those days I will use democratic and possibly Laissez-faire styles. Since it will be with special education students I will never let students be with supervision and will always be flexible based on the needs of the student.

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There are several factors that make for the success of group counseling but the strongest determinant is the skill or effectiveness of the leader of the counseling group which in most cases is the counselor.

"Good" members with poor leadership will still make a failed counseling group but "bad" members can be inspired by good leadership for the success of the group. This is what leadership is in the first place - inspiring followers towards achieving a common vision.

In this article I'll be highlighting the roles of the counseling group leader, the types of group counseling styles and the skills needed by an effective counseling group leader.

Leadership Styles and Types of Leaders in Group Counseling

The three main leadership styles adopted in group therapy are authoritarian, democratic, and laissez-faire leadership. Each of these styles of leadership has its own theoretical background, ideologies, techniques, and impact that all contribute to the success or failure of group therapy.

1. Authoritarian Leadership

The authoritarian leader of group therapy believes that the members of the group do not possess in themselves the solution to their issues and so they must be assisted by an expert.

The leader adopts a directive approach, takes responsibility for every member's action or group outcome, and the group dynamics is leader centred. The leader establishes group roles, defines the course of action, defines the responsibility of every group member (if they have any), explains members' behaviours or issues to them and gives them the solution.

Because group members are only allowed to talk when they are asked questions, the technique used tends to fall into advice-giving and the leader is protected from self-disclosure.

This authoritarian style of group therapy leadership is adopted by psychoanalytic counselors more than any other theoretical background. Flow of communication is back and forth only- from the leader to a member back to the leader.

2. Democratic Leadership

The democratic leader of group therapy believes that the members of the group possess in themselves the solution to their issues but only need facilitation to bring out those solutions.

The leader adopts a non-directive approach, does not take absolute responsibility for the members actions or outcomes, and the group dynamic is group-centered.

All group members agree on the group roles, the course of action to be taken, the responsibilities of all group members, and collectively get more insight into their behaviours or issues as well as come up with solutions.

Because all members are allowed to make contributions throughout the sessions, the techniques used by the counsellor in democratic leadership of group counseling are clarification, synthesis, feedback and evaluation, and the leader has a lot of self-disclosure to do in identifying with the needs of other group members.

The democratic type of group therapy leadership is adopted by counselors who adhere to the humanistic approach of counseling. Flow of communication is both back and forth and side to side -from leader to group members and from group members to group members. The leader seeks to raise other leaders within the group.

3. Laissez-faire Leadership

The third style of leadership in group therapy is laissez-faire leadership. Here there is no leader at all.

The laissez-faire leader of group therapy believes that it is the sole responsibility of the group members to direct themselves in whatever direction they feel necessary while the leader simply assumes the role of another group member.

The leader adopts an uninvolved approach and takes no responsibility for the actions and outcome of the group. All the goals, course of action, distribution of responsibilities, as well as insight into the problems and solutions come from the members, with no intervention of the counselor.

No counseling technique is used in the laissez-faire style of leadership. It is usually an unintended approach adopted by novice counsellors while trying to adopt the non-directive approach or trying to be liked by every member of the group.

8 Roles of Counselling Group Leader/ Group Therapists

1. Initiate the Group

The first role of the counselor or counseling group leader is to initiate or establish the group. This involves gathering other group members and choosing a tentative venue for counseling sessions.

All the activities that are to be done at the initial stage of group counseling should be prepared beforehand so that other members do not gather to meet an unstructured group.

Although the counselor must not come with a final list of activities that will be done from initial session to termination stage since that is a joint responsibility of all members, an agenda for the first day should be prepared by the counselor. Activities that can be done at the initial stage of group counseling include:

introduction of members,

statement of purpose of group,

exploration of individual needs,

setting group goals,

establishment of group rules and roles,

agreement on meeting days and place, and

suggestions and contributions.

This sketch can be employed and expanded by the group leader to set the stage for the initial session.

2. Implementation of Group Rules

Another role of the counselor or leader in group therapy is ensuring the implementation of the group rules. Once the rules have been set and agreed upon by all members, every member should be encouraged and held accountable to stick with them.

This being said, the counselor must not become a nitpicker actively seeking for who is breaking the group rules. Instead the counselor should ensure the rules remain at the back of his mind and he should call back to order anyone going beyond set boundaries.

3. Facilitation of discussion

Facilitation of discussion is the most important of all the roles of the counsellor or group leader in group therapy since this interaction is the most important activity of the counseling group.

The leader must be on the lookout for group members that are becoming withdrawn for whatever reason and try to find out if anything is wrong and possibly resolve them or encourage them to join again in the discussion.

One way the leader can facilitate discussion is through raising relevant open-ended questions or even going off topic for some time to get the environment stirred up again.

4. Follow Up on Assigned Responsibilities

It is also the responsibility of the counselor or group leader in group counseling to follow up on all other leaders who have been assigned with one responsibility of the other.

This includes giving them assistance where necessary, providing them with the resources they may need, setting deadlines for them to ensure the rise up to tasks, and provision of professional coaching in leadership and people management.

The counselor should also evaluate their effectiveness in carrying out assignments to find areas that need to be worked on as well as their strength.

5. Monitoring Adherence to Plan

The counselor or group leader must also be an overseer over all the activities of the therapy group to ensure that they do not drift out of plan.

He or she must continue to visit the goals, strategies and course of action that have been agreed upon by the group to ensure they are not leaving anything behind or getting engaged in frivolities that do not take them towards the goals of the group.

6. Provision of Resources

It is also the responsibility of the group leader or counselor to ensure that all the resources that will be needed for effective group counseling sessions are supplied.

This can either mean the counselor gets/outsources them or assigns a group member to make provision for them. These resources can include television sets for film modelling, books for reading, workbooks for exercises, resource persons and in some cases snacks depending on the group dynamics and nature of the counselling session(s).

7. Creativity and Dynamism

Another role of the counselor in group counseling is to ensure that group counseling sessions are filled with dynamic and creative activities.

One of the challenges that come with group counseling is that with time, some members begin to get bored and uninterested in the activities of the group and withdraw.

This boredom, however, can be minimised through dynamic activities. This can include having special game sessions, having off-topic days to discuss personal life, holding sessions in informal environments like beaches or amusement parks, and it can even get wilder depending on the means available.

Learn how to get ideas continuously.

8. Moderation of Activities

All the roles and responsibilities of the group leader in group counseling can be summarised as moderation of the activities of the group. The counselor must not take over (as in authoritarian leadership style) but also must not be uninvolved (as in laissez-faire leadership style).

Instead he or she should stir up the leadership spirit within every group member so all can work together and be self motivated to achieve the goals of the group.

10 Skills and Qualities of a Group Counselor/Therapist

1. Effective leadership

carrying everyone along in reaching goals

2. Management skills (people and resources)

Management is maximizing available personnel and resources towards the goal

3. Organisation skill

ensuring every session is well planned and implemented

4. Facilitation

stirring up every member to engage in conversation

5. Intervention or Confrontation

calling to order those who want to break group rules

6. Conflict resolution

effectively settling dispute among members

7. Effective communication

relaying information to group members in an understandable way

8. Empathy

ability to understand the feeling of others

9. Professional ethics

maintaining all the ethics of guidance and counselling

10. Knowledge and Competence

ability to contribute productively to the group and have more knowledge about the issue than other group members.

Conclusion

A counselling/therapy group is as good as its leader- the leadership style they use, the roles they assume and the skills they possess.

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Leadership of Group Therapy: Roles, Types & Skills of Group Therapists - Self Discovery Blog

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There are several factors that make for the success of group counseling but the strongest determinant is the skill or effectiveness of the leader of the counseling group which in most cases is the counselor. "Good" members with poor leadership will still make a failed counseling group but "bad" members can be inspired by good ...

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The group will be specifically for the 11th and 12th grade special education students that are in line to graduate. It will give them coping skills and help students find resources needed to continue living a productive life outside of school.

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Stage 1= Beginning- The first session will be designated to build a relationship as a whole group. I will introduce myself and have icebreaker games to introduce the group. Since this will be special education students a game to help understand confidentiality will be included. We will create social contact and sign confidentiality agreements. Calendars will be passed out and the group will make covers for their 3-ring binders.
A reminder to follow the social contract and confidentiality at the begging of every group session. (will have them recite "what is said the group stays in the group", before and after the session.s)

Stage 2= Middle- The group will be monitored by the counselor and after each session, an exit ticket or question will be asked to gauge understanding of the lessons. If students are triggered and not participating I will sit with them to work through the issue. This may also require a call home to parents or involve the special ed tracking teacher.

Stage 3= End-
End of class- The counselor will verbally ask and review the lessons after each session. At the end of the class, an exit ticket will be used for understanding. A QR code outside the room will be displayed for any student who wishes to leave a comment or concern without saying so in the group.

After each 9wks- An assessment will be measured and compared. An email will go out to parents to show progress. Students are encouraged to attend the next group session and complete their Transition-Resilience Skills book. A certificate will be issued each quarter for finishing the group program along with a small gift. (gift- journal, fidget, candy bar, tote bag)
Students are encouraged to come to see me throughout the day or email me with any concerns and questions about the group or issues outside of the group.

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American School Counselor Association. (n.d.). ASCA Student Standards: Mindsets & Behaviors for Student Success. https://www.schoolcounselor.org/getmedia/7428a787-a452-4abb-afec-d78ec77870cd/mindsets-Behaviors.pdf

American Counseling Association. (2014). ACA code of ethics.
https://www.counseling.org/resources/aca-code-of-ethics.pdf

Cherry, K. (2022, November 14). 6 leadership styles and frameworks. Verywell Mind. https://www.verywellmind.com/leadership-styles-2795312

Nelson, H. (2019, September 4). Love for the Elementary Counselor
lovefortheelementarycounselor.home.blog/2019/09/04/group-counseling-consent-forms/

Yalom, I.D., & Leszcz, M. (2021). The theory and practice of group psychotherapy. Basic Books.

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Attached is the group action plan for 6 sessions of Transition Resilience Skills Training.

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As a counselor in this group I will:

A.7.a. Advocacy the counselor will advocate for the group and individual as needed.
B.4.a Group Work- remind students about confidentiality
D.1.b. Forming Relationships- working with special education tracking teachers the counselor will be able to provide better insight into students
E.7.c. Technological administration- since students will be using computers for applications and research the counselor will have to ensure it is being properly used for school purposes only.
F.7.a. Counselor educators are responsible for maintaining ethics while creating a curriculum for students and leading a group session while teaching it.

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This is the State of Texas document that goes in detail about school counselors and their roles. On page 7 TEC 33.006 explains the responsibility.

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LEGAL-FERPA & HIPPA in schools (Federal)

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LEGAL-FERPA & HIPPA in schools (Federal)

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As a counselor in this group, I am by law allowed to share information with the special education tracking teacher because they are also involved in the student's educational needs and safety and care. However, just as the students are required to commit to confidentiality so am I. "What is said in the group stays in the group, unless the student is wanting to hurt someone or themselves."

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11.0 FERPA and HIPAA: What Threat Assessment Teams Need to Know

Questions and concerns about the Family Educational Rights and Privacy Act (FERPA) and/or the Health Insurance Portability and Accountability Act (HIPPA) protections often arise as part of the threat assessment planning process. It is critical that threat assessment teams understand how to balance the safety of the school with the privacy of individual students. These laws should not be an impediment to threat assessment and threat management. Threat assessment teams should consult school district legal counsel for guidance on information-sharing.

What is FERPA?

FERPA is a federal law that protects the privacy of student education records. FERPA gives parents certain rights with respect to their children's education records. These rights transfer to the student when he or she reaches the age of 18 or attends a school beyond the high school level. FERPA protects the rights of parents or eligible students to:

Inspect and review education records.

Seek to amend education records.

Consent to the disclosure of personally identifiable information (PII) from education records, except as specified by law.

Who may access FERPA-Protected Education Records?

School officials with a "legitimate educational interest" may access FERPA-protected education records. Such individuals typically include teachers, counselors, school administrators, and other school staff.

The Health or Safety Emergency Exception

FERPA does, however, authorize school officials to disclose information without consent in emergency situations where the health and/or safety of students is at risk. Relevant information can be released to law enforcement, public health, and medical officials.

The U.S. Department of Education (DOE) would not find a school in violation of FERPA for disclosing FERPA-protected information under the health or safety exception as long as the school had a rational basis, based on the information available at the time, for making its determination that there was an articulable and significant threat to the health or safety of the student or other individuals.

Common FERPA Misunderstandings

Information obtained through a school official's personal knowledge or observation is not protected by FERPA and can be disclosed. Specifically, observations, notes, drawings, pictures, anonymous tips, security videos, and all investigating interviews are not protected under FERPA, so a threat assessment team is not violating anyone's rights by collecting such data to drive their assessment and management of a reported threat or concern.

What is HIPAA?

HIPAA protects the privacy and security of individually identifiable health information held by health plans, health care clearinghouses, and most health care providers and their business associates. It is important to remember that confidentiality is held by the patient, not the mental health provider.

In cases where HIPAA applies, the following strategies may assist threat assessment teams in eliminating potential barriers to critical data collection:

Provide information to health and mental health professionals.

Ask about duty to warn or duty to protect.

Ask permission from student and parent to disclose medical records.

The Serious Danger to Self or Others Exception

Medical and mental health providers may disclose protected health information when disclosure:

Is necessary to prevent or lessen a serious and imminent threat to health or safety of patient or others and is to someone reasonably able to prevent or lessen the threat.

May include disclosure to law enforcement, or others who can mitigate the threat and disclosure must be consistent with applicable law and standards of ethical conduct.

Common HIPAA Misunderstandings

Generally, HIPAA does not apply to student health information maintained by a school. While schools and school districts may maintain student health records, these records are in most cases not protected by HIPAA. Rather, student health information maintained at a school would be considered education records which are protected by the Family Educational Rights and Privacy Act (FERPA).

Additional information and guidance regarding the application of FERPA and HIPAA laws can be found in the following resources:

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Behavioral Threat Assessment and Management for Educators and Administrators

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Behavioral Threat Assessment and Management provides a proactive, evidence-based approach for identifying individuals who may pose a threat and for providing interventions before a violent incident occurs. This toolkit introduces the concept of threat assessment and outlines how a threat assessment program functions in a school setting.

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Resources that help understand best practices and guidelines in a group.

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Association for Specialists in Group Work - Our passion is group work

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Resources Cultivating and empowering members with the knowledge, skills, and resources to practice effective, socially just, and ethical group work in a diverse and global society.

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In the group students will learn 6 out of the 11 Yalom's Therapeutic Forces:

Universality by the sharing experiences and learning side by side with the group.
Development of social skills with communicating within the group on a weekly basis.
Imitative behavior by modeling what the counselor is teaching along with seeing other students doing the same thing.
Interpersonal learning with the curriculum specifically helping them learn to advocate for them selves and within the group.
Group cohesiveness will be learned by the weekly group sessions and relationship building throughout the year.
Existential factors will be taught throughout the year in the group with the self advocate learning one's responsibility.

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This is a continuation of discussing group therapy (starting from the introduction).

Dr. Irvin D. Yalom is the guru of group therapy, specifically interpersonal, and is mentioned in many research books and articles. Although Dr. Yalom's textbooks read more like a novel, he makes group therapy and its purpose more relatable and fun in clinical practice than most resources. He was the first person to put a theoretical perspective on group work and believed that all groups had to go through specific phases.

Dr. Yalom is most known for his 11 therapeutic/curative factors that are mechanisms of effecting change in a person with group therapy. It's also important to know the stages of groups were created by psychologist Dr. Bruce Tuckman (1965):

5 Stages or Phases of the Group

In the pregroup phase, the leader will consider the direction and framework of the group:

Stage 1. Forming; the orientation phase. The leader is most active in this stage. Universal norms are discussed such as confidentiality, attendance, and rules of communication and participation are addressed. This is the stage that discusses the time frame/termination of the group.

Stage 2. Storming; the transition phase. Anxiety, ambiguity, and conflict become prevalent as group members test and act-out behaviors to define themselves and the group norms. This stage creates an interpersonal climate where members should feel free to disagree with each other.

Stage 3. Norming; the cohesiveness phase. Members develop group-specific standards (cohesiveness) and therapeutic alliance forms such as disapproving late-arriving members, or the level of anger/conflict that will be tolerated.

Stage 4. Working; the performing phase. During this stage, individual growth and team productivity, and effectiveness occur. Members experiment with new ideas or behaviors and egalitarianism develops.

Stage 5. Adjourning; the termination phase. The closure for the group as a whole or the individual that left. The primary task is to discuss and review actual outcomes and achievements, explore feelings of what worked (and what didn't), and any feelings of loss. Introducing new concerns or initiatives is not appropriate.

To remember the stages of groups, the best mnemonic I could think of was; I had to form a storm in the north (norm) and then work or adjourn. Another reason for knowing the group stages is for documentation and understanding how to gauge the group productivity plus strengths and weaknesses.

Relating these processes/terms were overall very useful for remembering key points and measuring the group dynamics.

Dr. Yalom's Therapeutic Forces in Groups

1. Instillation of Hope: encouragement that recovery is possible by sharing stories and information.

2. Universality: recognition of a shared experience and knowing a person's problems are not unique.

3. Imparting of Information: teaching about problems and learning factual information about treatment options.

4. Altruism: helping and supporting others by experiencing the ability to help another person can build self-esteem. It helps to develop adaptive coping mechanisms.

5. Simulation of the primary family: identifying & changing the dysfunctional patterns or roles one played in the primary family.

6. Development of social skills: learning new ways to talk about feelings, observations, and concerns.

7. Imitative Behavior: modeling another's manners & recovery skills.

8. Interpersonal Learning (modeling, vicarious learning): finding out about themselves & others from the group. Yalom also describes 3 important concepts with interpersonal learning; 1. The importance of interpersonal relationships, 2. The corrective emotional experience, and 3. The group is a social microcosm.

9. Group Cohesiveness (belonging): the feeling of belonging to the group, and valuing the group.

10. Catharsis: the release of emotional tension i.e. a burst of crying. Express emotions in a safe environment.

11. Existential Factors (risk, responsibility): Learning to take responsibility for one's own actions.

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This is a continuation of discussing group therapy (starting from the introduction). Dr. Irvin D. Yalom is the guru of group therapy, specifically interpersonal, and is mentioned in many research books and articles. Although Dr. Yalom's textbooks read more like a novel, he makes group therapy and its purpose more relatable and fun in clinical practice than most resources.

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I know this resource says for substance abuse and I am working on a school setting, but I like it. It explains the characteristics of what a good leader/counselor should have within a group. Not just the roles or style a counselor should use.

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Interventions

Interventions may be directed to an individual or the group as a whole. They can be used to clarify what is going on or to make it more explicit, redirect energy, stop a process that is not helpful, or help the group make a choice about what should be done. A well‐timed, appropriate intervention has the power to

Help a client recognize blocks to connection with other people

Discover connections between the use of substances and inner thoughts and feelings

Understand attempts to regulate feeling states and relationships

Perceive the effect of substance abuse on one's life

Notice meaningful inconsistencies among thoughts, feelings, and behavior

Perceive discrepancies between stated goals and what is actually being done

Any verbal intervention may carry important nonverbal elements. For example, different people would ascribe a variety of meanings to the words, "I am afraid that you have used again," and the interpretation will vary further with the speaker's tone of voice and body language. Leaders should therefore be careful to avoid conveying an observation in a tone of voice that could create a barrier to understanding or response in the mind of the listener.

Avoiding a leader‐centered group

Generally a counselor leads several kinds of groups. Leadership duties may include a psychoeducational group, in which a leader usually takes charge and teaches content, and then a process group, in which the leader's role and responsibilities should shift dramatically. A process group that remains leader‐focused limits the potential for learning and growth, yet all too often, interventions place the leader at the center of the group. For example, a common sight in a leader‐centered group is a series of one‐on‐one interactions between the leader and individual group members. These sequential interventions do not use the full power of the group to support experiential change, and especially to build authentic, supportive interpersonal relationships. Some ways for a leader to move away from center stage:

In addition to using one's own skills, build skills in participants. Avoid doing for the group what it can do for itself.

Encourage the group to learn the skills necessary to support and encourage one another because too much or too frequent support from the clinician can lead to approval seeking, which blocks growth and independence. Supporting each other, of course, is a skill that should develop through group phases. Thus, in earlier phases of treatment, the leader may need to model ways of communicating support. Later, if a client is experiencing loss and grief, for example, the leader does not rush in to assure the client that all will soon be well. Instead, the leader would invite group members to empathize with each other's struggles, saying something like, "Joanne, my guess is at least six other people here are experts on this type of feeling. What does this bring up for others here?"

Refrain from taking on the responsibility to repair anything in the life of the clients. To a certain extent, they should be allowed to struggle with what is facing them. It would be appropriate, however, for the leader to access resources that will help clients resolve problems.

Confrontation

Confrontation is one form of intervention. In the past, therapists have used confrontation aggressively to challenge clients' defenses of their substance abuse and related untoward behaviors. In recent years, however, clinicians have come to recognize that when "confrontation" is equivalent to "attack," it can have an adverse effect on the therapeutic alliance and process, ultimately leading to failure. Trying to force the client to share the clinician's view of a situation accomplishes no therapeutic purpose and can get in the way of the work.

A more useful way to think about confrontation is "pointing out inconsistencies," such as disconnects between behaviors and stated goals. William R. Miller explains:

The linguistic roots of the verb "to confront" mean to come face to face. When you think about it that way, confrontation is precisely what we are trying to accomplish: to allow our clients to come face to face with a difficult and often threatening reality, to "let it in" rather than "block it out," and to allow this reality to change them. That makes confrontation a goal of counseling rather than a particular style or technique. . . [T]hen the question becomes, What is the best way to achieve that goal? Evidence is strong that direct, forceful, aggressive approaches are perhaps the least effective way to help people consider new information and change their perceptions ( CSAT 1999b, p. 10).

Confrontation in this light is a part of the change process, and therefore part of the helping process. Its purpose is to help clients see and accept reality so they can change accordingly ( Miller and Rollnick 1991). With this broader understanding of what interventions that "confront" the client really mean, it is not useful to divide therapy into "supportive" and "confrontative" categories.

Transference and Countertransference

Transference means that people project parts of important relationships from the past into relationships in the present. For example, Heather may find that Juan reminds her of her judgmental father. When Juan voices his suspicion that she has been drinking, Heather feels the same feelings she felt when her father criticized all her supposed failings. Within the microcosm of the group, this type of incident not only relates the here‐and‐now to the past, but also offers Heather an opportunity to learn a different, more self‐respecting way of responding to a remark that she perceives as criticism.

The emotion inherent in groups is not limited to clients. The groups inevitably stir up strong feelings in leaders. The therapist's emotional response to a group member's transference is referred to as countertransference. Vannicelli (2001) describes three forms of countertransference:

Feelings of having been there. Leaders with family or personal histories with substance abuse have a treasure in their extraordinary ability to empathize with clients who abuse substances. If that empathy is not adequately understood and controlled, however, it can become a problem, particularly if the therapist tries to act as a role model or sponsor, or discloses too much personal information.

Feelings of helplessness when the therapist is more invested in the treatment than the client is. Treating highly resistant populations, such as clients referred to treatment by the courts, can cause leaders to feel powerless, demoralized, or even angry. The best way to deal with this type of countertransference may be to use the energy of the resistance to fuel the session. (See "Resistance in Group," next section.)

Feelings of incompetence due to unfamiliarity with culture and jargon. It is helpful for leaders to be familiar with 12‐Step programs, cultures, and languages. If a group member uses unfamiliar terms, however, the leader should ask the client to explain what the term means to that person, using a question like, "'Letting go' means something a bit different to each person. Can you say a little more about how this relates to your situation?" ( Vannicelli 2001, p. 58).

When countertransference occurs, the clinician needs to bring all feelings associated with it to awareness and manage them appropriately. Good supervision can be really helpful. Countertransference is not bad. It is inevitable, and with the help of supervision, the group leader can use countertransference to support the group process ( Vannicelli 2001).

Resistance in Group

Resistance arises as an often unconscious defense to protect the client from the pain of self‐examination. These processes within the client or group impede the open expression of thoughts and feelings, or block the progress of an individual or group. The effective leader will neither ignore resistance nor attempt to override it. Instead, the leader helps the individual and group understand what is getting in the way, welcoming the resistance as an opportunity to understand something important going on for the client or the group. Further, resistance may be viewed as energy that can be harnessed and used in a variety of ways, once the therapist has helped the client and group understand what is happening and what the resistant person or persons actually want ( Vannicelli 2001).

In groups that are mandated to enter treatment, members often have little interest in being present, so strong resistance is to be expected. Even this resistance, however, can be incorporated into treatment. For example, the leader may invite the group members to talk about the difficulties experienced in coming to the session or to express their outrage at having been required to come. The leader can respond to this anger by saying, "I am impressed by how open people have been in sharing their feelings this evening and in being so forthcoming about really speaking up. My hope is that people will continue to be able to talk in this open way to make our time together as useful as possible" ( Vannicelli 2001, p. 55).

Leaders should recognize that clients are not always aware that their reasons for nonattendance or lateness may be resistance. The most helpful attitude on the clinician's part is curiosity and an interest in exploring what is happening and what can be learned from it. Leaders need not battle resistance. It is not the enemy. Indeed, it is usually the necessary precursor to change.

It would be a serious mistake, however, to imagine that resistance always melts away once someone calls attention to it. "Resistance is always there for a reason, and the group members should not be expected to give it up until the emotional forces held in check by it are sufficiently discharged or converted, so that they are no longer a danger to the safety of the group or its members" ( Flores 1997, p. 538).

When a group (rather than an individual) is resistant, the leader may have contributed to the creation of this phenomenon and efforts need to be made to understand the leader's role in the problem. Sometimes, "resistance can be induced by leaders who are passive, hostile, ineffective, guarded, weak, or in need of constant admiration and excessive friendliness" ( Flores 1997, p. 538).

Confidentiality

For the group leader, strict adherence to confidentiality regulations builds trust. If the bounds of confidentiality are broken, grave legal and personal consequences may result. All group leaders should be thoroughly familiar with Federal laws on confidentiality (42 C.F.R. Part 2, Confidentiality of Alcohol and Drug Abuse Patient Records; see Figure 6-2 ) and relevant agency policies. Confidentiality is recognized as "a central tenet of the practice of psychotherapy" ( Parker et al. 1997, p. 157), yet a vast majority of States either have vague statutes dealing with confidentiality in group therapy or have no statutes at all. Even where a privilege of confidentiality does exist in law, enforcement of the law that protects it is often difficult ( Parker et al. 1997). Clinicians should be aware of this legal problem and should warn clients that what they say in group may not be kept strictly confidential. Some studies indicate that a significant number of therapists do not advise group members that confidentiality has limits ( Parker et al. 1997).

One set of confidentiality issues has to do with the use of personal information in a group session. Group leaders have many sources of information on a client, including the names of the client's employer and spouse, as well as any ties to the court system. A group leader should be clear about how information from these sources may and may not be used in group.

Clinicians consider the bounds of confidentiality as existing around the treatment enterprise, not around a particular treatment group. Clients should know that everyone on the treatment team has access to relevant information. In addition, clinicians should make it clear to clients that confidentiality cannot be used to conceal continued substance abuse, and the therapist will not be drawn into colluding with the client to hide substance use infractions. Clinicians also should advise clients of the exact circumstances under which therapists are legally required to break confidentiality (see Figure 6-2 ).

A second set of confidentiality issues has to do with the group leader's relationships with clients and clients with one another. When counseling a client in both individual therapy and a group context, for example, the leader should know exactly how information learned in individual therapy may be used in the group context. In almost every case, it is more beneficial for the client to divulge such information than for the clinician to reveal it. In an individual session, the therapist and the client can plan how the issue will be brought up in group. This preparation gives clients ample time to decide what to say and what they want from the group. The therapist can prompt clients to share information in the group with a comment like, "I wonder if the group understands what a hard time you've been having over the last 2 weeks?" On the other hand, therapists should reserve the right to determine what information will be discussed in group. A leader may say firmly, "Understand that whatever you tell me may or may not be introduced in group. I will not keep important information from the group, if I feel that withholding the information will impede your progress or interfere with your recovery."

Still other confidentiality issues arise when clients discuss information from the group beyond its bounds. Violations of confidentiality among members should be managed in the same way as other boundary violations; that is, empathic joining with those involved followed by a factual reiteration of the agreement that has been broken and an invitation to group members to discuss their perceptions and feelings. In some cases, when this boundary is violated, the group may feel a need for additional clarification or addenda to the group agreement. The leader may ask, both at the beginning of the group or when issues arise, whether the group feels it needs additional agreements in order to work safely. Such amendments, however, should not seek to renegotiate the terms of the original group agreement. See Figure 6-2 for helpful information on confidentiality and the law.

Figure 6-2. Confidentiality and 42 C.F.R., Part 2

Confidentiality is both an ethical and a legal issue. Federal law (Title 42, Part 2 or 42 C.F.R., Part 2, Confidentiality of Alcohol and Drug Abuse Patient Records) guarantees strict confidentiality of information about all people receiving substance abuse prevention and/or treatment services. Clients should be fully informed regarding issues of confidentiality, and group leaders should do all they can to build respect for confidentiality and anonymity within groups.

There are six conditions under which limited disclosure is permitted under the regulations. These exceptions are

The group member has signed a Release of Information document that allows the group facilitator to communicate with another professional and/or agency.

A group member threatens imminent harm to him‐ or herself, and the group facilitator believes that the client may act on this threat.

A client threatens imminent harm to another named person, and the group facilitator believes that there is a reasonable likelihood that the client will act on the threat.

A medical emergency requires that a client's drug and alcohol status be revealed in order to ensure that the client gets appropriate medical attention.

A client is suspected of child neglect and/or abuse, as defined by the laws of the State in which the substance abuse treatment services are being provided.

A direct court order mandates the release of specific information related to a client's history and/or treatment. However, an authorizing court order alone does not compel disclosure-for example, if the person authorized to disclose confidential information does not elect to make the disclosure, he or she cannot be forced to do so unless there is a valid subpoena (i.e., the subpoena has not expired) or other compulsory process introduced that would then compel disclosure. An appropriate judge issues a court order. It specifies the exact information to be provided about a particular client and is properly signed and dated.

More detailed discussions of confidentiality can be found in TIP 25, Substance Abuse Treatment and Domestic Violence ( CSAT 1997b); TIP 8, Intensive Outpatient Treatment for Alcohol and Other Drug Abuse ( CSAT 1994a); TAP 13, Confidentiality of Patient Records for Alcohol and Other Drug Treatment ( Lopez 1994); and TAP 18, Checklist for Monitoring Alcohol and Other Drug Confidentiality Compliance ( CSAT 1996).

Source: Consensus Panel.

Because a group facilitator generally is part of the larger substance abuse treatment program, it is recommended that the group facilitator take a practical approach to exceptions. This practical approach is to have the group facilitator discuss the potential application of the exceptions with the program director or member of the program staff who is the lead on the confidentiality regulation.

Biopsychosocial and Spiritual Framework-Treating the Whole Person

Substance use disorders include a wide range of symptoms with different levels of associated disability. Clients always bring into treatment vulnerabilities other than their alcohol or illicit drug dependencies. Group interventions may be needed to resolve psychological problems, physical ailments, social stresses, and perhaps, spiritual emptiness or bankruptcy. In short, successful treatment for substance use disorders should address the whole person, including that person's spiritual growth.

While the group experience is a powerful tool in the treatment of substance use disorders, it is not the only tool. Other interventions, such as individual therapy, psychological interventions, pharmacological supports, and intensive case management, may all be necessary to achieve long‐term remission from the symptoms of addictive disorders.

For example, people who are homeless with a co‐occurring mental disorder have three complicated sets of problems that require a continuous and comprehensive care system-one that integrates or coordinates interventions in (1) the mental health system, (2) the addiction system, and (3) the social service system for homeless persons. In group therapy, each condition should be regarded as a primary interactive problem; that is, one in which each problem develops independently but contributes to both of the others ( Minkoff and Drake 1992).

One model offered for treating homeless persons with substance use disorder is a modified training group designed to accommodate a large number of members whenever a traditional small group is not possible. In this model, participants meet in a large group with the clinician and then break into smaller groups to discuss, practice, or role‐play the particular topic.

Each group has a client leader, and the clinician circulates among the groups to ensure that the topic is understood and that discussion is proceeding. The clinician does not participate in the groups. Researchers describing this model note that because the clinicians step back from assuming leadership roles in the groups, the clients become empowered to take group sessions in the necessary direction and demonstrate feelings and insights that might not occur in a group formally led by a clinician ( Goldberg and Simpson 1995).

It is well known that 12‐Step programs are an important part of many therapeutic programs ( Page and Berkow 1998). While 12‐Step programs have a proven record of success in helping people overcome substance use disorders, there is a basic conflict inherent in them that group therapists need to reconcile. In the 12‐Step program, people are urged to cede control to a higher power. Yet, in group, the clinician is prompting clients to take control of their emotions, behavior, and lives.

As a result, some researchers have stated that it is "impossible to integrate psychotherapy and AA approaches dealing with addictions without compromising one approach or the other" ( Page and Berkow 1998, pp. 1-2). Another researcher has argued that "the AA approach is consistent with existential philosophy" because both stress that people should accept their "human limitations and security‐seeking behaviors" ( Page and Berkow 1998, p. 2). Although the literature currently has few straightforward discussions of spirituality and its role in the dynamics of group therapy, most clinicians would agree that the spiritual well‐being of the client is essential to breaking free of substance abuse.

When clients join self‐help groups, they sometimes hear from individuals who strongly oppose the use of any medication. Some people in 12‐Step programs erroneously believe, for example, that the use of pharmacological adjuncts to therapy is a violation of the program's principles. They consequently oppose methadone maintenance, the use of Antabuse, or the use of medications needed to control co‐occurring disorders.

Clinicians should be prepared to handle these misapprehensions. One way to help would be to refer apprehensive clients to the pamphlet, The AA Member-Medications and Other Drugs: A Report from a Group of Physicians in AA ( Alcoholics Anonymous World Services 1984). It stresses the value of appropriate medication prescribed by a physician who understands addictive disorders and reassures clients that such use of medication is wholly consistent with AA and Narcotics Anonymous' 12‐Step programs (more information can be found at AA's Web site: www.aa.org).

Many clients enrolled in a process group for persons with substance use disorders are likely participating in a 12‐Step program or other self‐help groups as well. On occasion, apparently conflicting messages can be an issue. For instance, many people with addiction histories try to use AA and its jargon as material for resistance. Such problems can readily be managed, provided the therapist is thoroughly familiar with the self‐help group. Matano and Yalom (1991) strongly recommend that group leaders become thoroughly familiar with AA's language, steps, and traditions because misconceptions about the program, whether by the client or therapist, can raise barriers to recovery.

Recent research has clearly demonstrated the ability of self‐help groups to improve outcomes ( Tonigan et al. 1996). Research also has shown that clients receiving mental health services as well as participating in 12‐Step meetings have an even better prognosis ( Ouimette et al. 1998). Marilyn Freimuth's research on integrating group psychotherapy and 12‐Step work has shown that "if mere co‐participation in psychotherapy and 12‐Step groups supports a client's recovery, it is reasonable to expect that a more integrated approach will provide further benefits" ( Freimuth 2000, p. 298). Both activities "support abstinence and emotional growth" ( Freimuth 2000, p. 301). Together, the two modalities supply multiple relationship models, potentially of immense value to the client.

Some suggestions for maximizing the therapeutic potential of participation in both process and 12‐Step groups follow:

Orientation should prepare new group members who are also members of 12‐Step groups for differences in the two groups. A key difference will be the fact that members interact with each other. Such "cross talk" is discouraged at 12‐Step meetings. "The new psychotherapy group member may need to be told that the topic of conversation is much wider than the 12‐Step meeting's focus on addiction and recovery, and that it includes feelings and reactions toward other group members" ( Freimuth 2000, p. 300; see also Vannicelli 1992).

During early recovery, it is particularly important to avoid making the 12‐Step program's encouragement of "unquestioning acceptance" a focus of analysis in group therapy. Too critical an interpretation offered too early may disrupt the 12‐Step program's status as an "ideal object," belief in which "is critical to maintaining early abstinence" ( Dodes 1988; Freimuth 2000, p. 305).

Sometimes clients experience "splitting"-seeing "the [12‐Step] program as the all‐good parent and all others, including the therapist/group as the all‐bad/ambivalent object." Later, the split may be just the opposite ( Freimuth 2000). The group leader should be attuned to this potential and should be prepared to work through these perceptions and the feelings underlying them. Further, when the process group is perceived as the "less than" modality and the client enthusiastically quotes insights from a 12‐Step group, the therapist should watch for possible countertransference and bear in mind the benefits the client is receiving from both programs.

Sponsors of 12‐Step members may distrust therapy and discourage group member from continuing in treatment. The leader should be prepared to respond to a variety of potential issues in ways that avoid appearing to compete with the self‐help group. For example, if a client says, "In my AA group, they say I don't need to be here. As long as I'm not drinking, my life is fine." The therapist might acknowledge the importance of continued sobriety, but remind the client of depression experienced before the onset of heavy drinking.

Group leaders should beware of their possible biases against 12‐Step groups that may be based on inaccurate information. For example, it is not true that the 12‐Step philosophy opposes therapy and medication, as AA World Service pamphlets clarify. It also is a misconception that 12‐Step programs encourage people to abdicate responsibility for substance use. AA, however, does urge people with addiction problems to attend meetings in the early stages of recovery, even though they may still be using alcohol or illicit drugs. Finally, some clinicians believe that 12‐Step programs discourage strong negative emotions. On the contrary, "there is no unilateral discouragement of negative affects within [12‐Step] program philosophy; only when anger threatens sobriety is it considered necessary to circumvent negative feelings" ( Freimuth 2000, p. 308).

The following vignette illustrates a typical intervention intended to clarify and harmonize appropriate participation in 12‐Step and process groups:

The group leader knew that Henry, who was well along in recovery but new to group, had not expressed his anger at Jenna for having cut him off for the third time. When asked how he experienced Jenna, he simply replied that according to the program you are not to take another person's inventory. The leader took the opportunity to say that in group therapy it is important to consider one's feelings about what others say and do even if [the feelings] are negative. Expressing one's own feelings is different from focusing on another's character (taking his inventory) ( Freimuth 2000, p. 308).

No matter what the modality, however, group therapy is sure to remain an integral part of substance abuse treatment.

Addressing life issues

Substance abuse affects every aspect of life: home, family, friends, job, health, emotional well‐being, and beliefs. As clients move into recovery, the wide range of issues they should face may overwhelm them. Leaders need to help clients rank the importance of the challenges, taking care to make the best possible use of the resources the client and the leader can bring to bear.

Naturally, clients will vary in their ability to address many concerns simultaneously; capacity for change also is variable. For example, some individuals with cognitive impairments will have a much harder time than others engaging in a change process. In the early stage of treatment, such clients need simple ideas, structures, and principles.

As the client moves forward, the clinician can keep in mind the issues that a client is not ready or able to manage. As this process goes on, the leader should remember that the client's priorities matter more than what the leader thinks ought to come next. Unless both client and leader operate in the same motivational framework the leader will not be able to help the client make progress.

No matter what is missing-even if it is a roof over the client's head-it is possible to engage the client in treatment. A client never should be told to come back after problems other than substance abuse have been resolved. On some front, constructive work can always be done. Of course, this assertion does not mean that critical needs can be ignored until treatment for substance abuse is well underway. The therapist should recognize that a client preoccupied with the need to find a place to sleep will not be able to engage fully in treatment until urgent, practical needs are met.

Life issues facing the client provide two powerful points of therapeutic leverage that leaders can use to motivate the client to pursue recovery. First, group leaders should be aware that people with alcoholism and other addictions will not give up their substance use until the pain it brings outweighs the pleasure it produces. Consequently, they should be helped to see the way alcohol and drugs affect important areas of their lives. Second, early in treatment, group leaders should learn what is important to each client that continued substance abuse might jeopardize. For some individuals, it is their job. For others, it is their spouse, health, family, or self‐respect. In some cases, it might be the threat of incarceration. Such knowledge can be used to encourage, and even coerce, individuals to utilize the tools of treatment, group, or AA ( Flores 1997).

Incorporating faith

While spirituality and faith may offer to some the hope, nurturing, sense of purpose and meaning, and support needed to move toward recovery, people obviously interpret spiritual matters in diverse ways. It is important not to confuse spirituality with religion. Even if clients are not religious, their spiritual life is important. Some clinicians mistakenly conclude that their own understanding of spirituality will help the client. Other clinicians err in the opposite direction and are overly reluctant to address spiritual beliefs. Actually, a middle ground is preferable. The leader should explore the importance of spiritual life with the group, and if the search for spiritual meaning is important, the clinician can incorporate it into group discussions.

For clients who lack meaningful connection to anything beyond themselves, the group may be the first step toward a search for meaning or a feeling of belonging to something greater than the self. The clinician's role in group therapy simply is to create an environment within which such ego‐transcending connections can be experienced.

Management of the Group

Handling conflict in group

Conflict in group therapy is normal, healthy, and unavoidable. When it occurs, the therapist's task is to make the most of it as a learning opportunity. Conflict can present opportunities for group members to find meaningful connections with each other and within their own lives.

Handling anger, developing empathy for a different viewpoint, managing emotions, and working through disagreements respectfully are all major and worthwhile tasks for recovering clients. The leader's judgment and management are crucial as these tasks are handled. It is just as unhelpful to clients to let the conflict go too far as it is to shut down a conflict before it gets worked through. The therapist must gauge the verbal and nonverbal reactions of every group member to ensure that everyone can manage the emotional level of the conflict.

The clinician also facilitates interactions between members in conflict and calls attention to subtle, sometimes unhealthy patterns. For example, a group may have a member, Mary, who frequently disagrees with others. Group peers regard Mary as a source of conflict, and some of them have even asked Mary (the scapegoat) to leave so that they can get on with group work. In such a situation, the therapist might ask, "Do you think this group would learn more about handling this type of situation if Mary left the group or stayed in the group?" An alternative tack would be, "I think the group members are avoiding a unique opportunity to learn something about yourselves. Giving in to the fantasy of getting rid of Mary would rob each of you of the chance to understand yourself better. It would also prevent you from learning how to deal with people who upset you."

Conflicts within groups may be overt or covert. The therapist helps the group to label covert conflicts and bring them into the open. The observation that a conflict exists and that the group needs to pay attention to it actually makes group members feel safer. The therapist is not responsible, however, for resolving conflicts. Once the conflict is observed, the decision to explore it further is made based on whether such inquiry would be productive for the group as a whole. In reaching this decision, the therapist should consider the function the conflict is serving for the group. It actually may be the most useful current opportunity for growth in the group.

On the other hand, as Vannicelli (1992) points out, conflicts can be repetitive and predictable. When two members are embroiled in an endless loop of conflict, Vannicelli suggests that the leader may handle the situation by asking, "John, did you know what Sally was likely to say when you said X?" and "Sally, did you know what John was likely to say when you said Y?" "Since both participants are likely to answer, 'Yes, of course,' the therapist would then inquire what use it might serve for them to engage in this dialogue when the expected outcome is so apparent to both of them (as well as to other members of the group). This kind of distraction activity or defensive maneuver should come to signal to group members that something important is being avoided. It is the leader's task to help the group figure out what that might be and then to move on" ( Vannicelli 1992, p. 121).

Group leaders also should be aware that many conflicts that appear to scapegoat a group member are actually displaced anger that a member feels toward the therapist. When the therapist suspects this kind of situation, the possibility should be forthrightly presented to the group with a comment such as, "I notice, Joe, that you have been upset with Jean quite a bit lately. I also know that you have been a little annoyed with me a since couple weeks ago about the way I handled that phone call from your boss. Do you think some of your anger belongs with me?"

Individual responses to particular conflicts can be complex, and may resonate powerfully according to a client's personal values and beliefs, family, and culture. Therefore, after a conflict, it is important for the group leader to speak privately with group members and see how each is feeling. Leaders also often use the last 5 minutes of a session in which a conflict has occurred to give group members an opportunity to express their concerns.

Subgroup management

In any group, subgroups inevitably will form. Individuals always will feel more affinity and more potential for alliance with some members than with others. One key role for the therapist in such cases is to make covert alliances overt. The therapist can involve the group in identifying subgroups by saying, "I notice Jill and Mike are finding they have a good deal in common. Who else is in Jill and Mike's subgroup?"

Subgroups can sometimes provoke anxiety, especially when a therapy group is made up of individuals acquainted before becoming group members. Group members may have used drugs together, slept together, worked together, or experienced residential substance abuse treatment together. Obviously, such connections are potentially disruptive, so when groups are formed, group leaders should consider whether subgroups would exist.

When subgroups somehow stymie full participation in the group, the therapist may be able to reframe what the subgroup is doing. At other times, a change in the room arrangement may be able to reconfigure undesirable combinations. On occasion, however, subtle approaches fail. For instance, adolescents talking among themselves or making obscene gestures during the session should be told factually and firmly that what they are doing is not permissible. The group leader might say, "We can't do our work with distractions going on. Your behavior is disrespectful and it attempts to shame others in the group. I won't tolerate any abuse of members in this group."

Subgroups are not always negative. The leader for example may intentionally foster a subgroup that helps marginally connected clients move into the life of the group. This gambit might involve a question like, "Juanita, do you think it might help Joe if you talked some about your experience with this issue?" Further, to build helpful connections between group members, a group member might be asked, "Bob, who else in this group do you think might know something about what you've just said?"

Responding to disruptive behavior

Clients who cannot stop talking

When a client talks on and on, he or she may not know what is expected in a therapy group. The group leader might ask the verbose client, "Bob, what are you hoping the group will learn from what you have been sharing?" If Bob's answer is, "Huh, well nothing really," it might be time to ask more experienced group members to give Bob a sense of how the group works. At other times, clients tend to talk more than their share because they are not sure what else to do. It may come as a relief to have their monolog interrupted ( Vannicelli 1992, p. 167).

If group members exhibit no interest in stopping a perpetually filibustering client, it may be appropriate to examine this silent cooperation. The group may be all too willing to allow the talker to ramble on, to avoid examining their own past failed patterns of substance abuse and forge a more productive future. When this motive is suspected, the leader should explore what group members have and have not done to signal the speaker that it is time to yield the floor. It also may be advisable to help the talker find a more effective strategy for being heard and understood ( Vannicelli 1992).

Clients who interrupt

Interruptions disrupt the flow of discussion in the group, with frustrating results. The client who interrupts is often someone new to the group and not yet accustomed to its norms and rhythms. The leader may invite the group to comment by saying, "What just happened?" If the group observes, "Jim seemed real anxious to get in right now," the leader might intervene with, "You know, Jim, my hunch is that you don't know us well enough yet to be certain that the group will pay adequate attention to your issues; thus, at this point, you feel quite a lot of pressure to be heard and understood. My guess is that when other people are speaking you are often so distracted that it may even be hard to completely follow what is going on completely" ( Vannicelli 1992).

Clients who flee a session

Clients who run out of a session often are acting on an impulse that others share. It would be productive in such instances to discuss these feelings with the group and to determine what members can do to talk about these feelings when they arise. The leader should stress the point that no matter what is going on in the group, the therapeutic work requires members to remain in the room and talk about problems instead of attempting to escape them ( Vannicelli 1992). If a member is unable to meet this requirement, reevaluation of that person's placement in the group is indicated.

Contraindications for continued participation in group

Sometimes, clients are unable to participate in ways consistent with group agreements. They may attend irregularly, come to the group intoxicated, show little or no impulse control, or fail to take medication to control a co‐occurring disorder. Though removing someone from the group is very serious and should never be done without careful thought and consultation, it is sometimes necessary. It may be required because of a policy of the institution, because the therapist lacks the skills needed to deal with a particular problem or condition, or because an individual's behavior threatens the group in some significant and insupportable way.

Though groups do debate many issues, the decision to remove an individual is not one the group makes. On the contrary, the leader makes the decision and explains to the group in a clear and forthright manner why the action was taken. Members then are allotted time to work through their responses to what is bound to be a highly charged event. Anger at the group leader for acting without group input or acting too slowly is common in expulsion situations, and should be explored.

Managing Other Common Problems

Coming late or missing sessions

Sometimes, addiction counselors view the client who comes to group late as a person who, in some sense, is behaving badly. It is more productive to see this kind of boundary violation as a message to be deciphered. Sometimes this attempt will fail, and the clinician may decide the behavior interferes with the group work too much to be tolerated.

Silence

A group member who is silent is conveying a message as clearly as one who speaks. Silent messages should be heard and understood, since nonresponsiveness may provide clues to clients' difficulties in connecting with their own inner lives or with others ( Vannicelli 1992).

Special consideration is sometimes necessary for clients who speak English as a second language (ESL). Such clients may be silent, or respond only after a delay, because they need time to translate what has just been said into their first language. Experiences involving strong feelings can be especially hard to translate, so the delay can be longer. Further, when feelings are running high, even fluent ESL speakers may not be able to find the right words to say what they mean or may be unable to understand what another group member is saying about an intense experience.

Tuning out

When the group is in progress and clients seem present in body but not in mind, it helps to tune into them just as they are tuning out. The leader should explore what was happening as an individual became inattentive. Perhaps the person was escaping from specific difficult material or was having more general difficulties connecting with other people. It may be helpful to involve the group in giving feedback to clients whose attention falters. It also is possible, however, that the group as a whole is sidestepping matters that have to do with connectedness. The member who tunes out might be carrying this message for the group ( Vannicelli 1992).

Participating only around the issues of others

Even when group members are disclosing little about themselves, they may be gaining a great deal from the group experience, remaining engaged around issues that others bring up. To encourage a member to share more, however, a leader might introduce the topic of how well members know each other and how well they want to be known. This topic could be explored in terms of percentages. For instance, a man might estimate that group members know about 35 percent about him, and he would eventually like them to know 75 percent. Such a discussion would yield important information about how much individuals wish to be known by others ( Vannicelli 1992).

Fear of losing control

As Vannicelli (1992) notes, sometimes clients avoid opening up because they are afraid they might break down in front of others-a fear particularly common in the initial phases of groups. When this restraint becomes a barrier to clients feeling acute pain, the therapist should help them remember ways that they have handled strong feelings in the past.

For example, if a female client says she might "cry forever" once she begins, the leader might gently inquire, "Did that ever happen?" Clients are often surprised to realize that tears generally do not last very long. The therapist can further assist this client by asking, "How were you able to stop?" ( Vannicelli 1992, p. 152).

When a client's fears of breaking down or becoming unable to function may be founded in reality (for example, when a client has recently been hospitalized), the therapist should validate the feelings of fear, and should concentrate on the strength of the person's adaptive abilities ( Vannicelli 1992).

Fragile clients with psychological emergencies

Since clients know that the group leader is contractually bound to end the group's work on time, they often wait intentionally until the last few minutes of group to share emotionally charged information. They may reveal something particularly sad or difficult for them to deal with. It is important for the leader to recognize they have deliberately chosen this time to share this information. The timing is the client's way of limiting the group's responses and avoiding an onslaught of interest. All the same, the group members or leader should point out this self‐defeating behavior and encourage the client to change it.

Near the end of a session, for example, a group leader has an exchange with a group member named Lan, who has been silent throughout the session:

Leader: Lan, you've been pretty quiet today. I hope we will hear more about what is happening with you next week.

Lan: I don't think you'll see me next week.

Further exploration reveals that Lan intends to kill herself that night. In view of the approaching time boundary, what should the leader do?

In such a situation, the group leader has dual responsibilities. First, the leader should respond to Lan's crisis. Second, the incident should be handled in a way that reassures other group members and preserves the integrity of the group. Group members will have a high level of anxiety about such a situation. Because of their concern, some group leaders are willing to extend the time boundary for that session only, provided that all members are willing and able to stay. Others feel strongly that the time boundary should be maintained and that the leader should pledge to work with Lan individually right after the session. Whatever the decision and subsequent action, the leader should not simply drift casually and quietly over the time boundary. The important message is that boundaries should be honored and that Lan will get the help she needs. The group leader can say explicitly that Lan's needs will be addressed after group.

Figure 6-3 shows that group leaders should be prepared to deal not only with substance abuse issues, but with co‐occurring psychiatric concerns as well.

Anxiety and resistance after self‐disclosure

Clients may feel great anxiety after disclosing something important, such as the fact that they are gay or incest victims. Often, they wonder about two possibilities: "Does this mean that I have to keep talking about it? Does this mean that if new people come into the group, I have to tell them too?" ( Vannicelli 1992, p. 160).

To the first question, the therapist can respond with the assurance, "People disclose in here when they are ready." To the second, the member who has made the disclosure can be assured of not having to reiterate the disclosure when new clients enter. Further, the disclosing member is now at a different stage of development, so the group leader could say, "Perhaps the fact that you have opened up the secret a little bit suggests that you are not feeling that it is so important to hide it any more. My guess is that this, itself, will have some bearing on how you conduct yourself with new members who come into the group" ( Vannicelli 1992, p. 160 & p. 161).

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6 Group Leadership, Concepts, and Techniques

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This chapter describes desirable leader traits and behaviors, along with the concepts and techniques vital to process groups-though many of the ideas can apply in other types of groups. Most of the ideas seem perfectly logical, too, once they are brought to mind.

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Consent form:
I could not get on the SAISD employee counselors website and find a group counseling consent form. However, I did find this on the web and added some info to fit my needs.
The form explains what will be covered in the group along with confidential expectations for the group.

Expextionation and ground rules- will be a group discussion created during the first meeting. The rules will be posted in the room and considered to be a live document and student-signed. (much like Capturing Kids Hearts contract)

https://lovefortheelementarycounselor.home.blog/2019/09/04/group-counseling-consent-forms

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The following ASCA Mindset and Behaviors will be addressed and mastered throughout the school year:

Category 1: Mindsets Standards
M 1. Belief in the development of the whole self, including a healthy balance of mental, social/emotional, and physical well-being

M 2. Sense of acceptance, respect, support, and inclusion for self and others in the school environment

M 3. Positive attitude toward work and learning

M 4. Self-confidence in the ability to succeed

M 5.Belief in using abilities to their fullest to achieve high-quality results and outcomes

M 6. Understanding that postsecondary education and lifelong learning are necessary for long-term success

Category 2: Behavior Standards
Learning Strategies
B-LS1. Critical thinking skills to make informed decisions
B-LS2. Creative approach to learning, tasks, and problem-solving
B-LS3. Time management, organizational, and study skills
B-LS4. Self-motivation and self-direction for learning
B-LS5. Media and technology skills to enhance learning
B-LS7. Long- and short-term academic, career, and social/ emotional goals
Self-Management Skills
B-SMS 1. Responsibility for self and actions
B-SMS 2. Self-discipline and self-control
B-SMS 3. Independent work
B-SMS 5. Perseverance to achieve long-and short-term goals
B-SMS 6. Ability to identify and overcome barriers
B-SMS7. Effective coping skills
B-SMS10. Ability to manage transitions and adapt to change
Social Skills
B-SS 1. Effective oral and written communication skills and listening skills
B-SS 3. Positive relationships with adults to support the success
B-SS 6.  Effective collaboration and cooperation skills
B-SS 8. Advocacy skills for self and others and ability to assert self, when necessary
B-SS 9. Social maturity and behaviors appropriate to the situation and environment

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ASCA School Counselor Standards and Competencies

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ASCA School Counselor Standards and Competencies

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Attached is the full document for counselors to review standards and competencies for their roll as School Counselor.

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Selection:
Since the group is for special education students in 11th and 12th grade only, the counselor will get a list of students from the office and discuss it with the special education department head. After the sections of students are found, the counselor will approach the principal and go over the curriculum, consent and what students are available to attend based on the department head's suggestion.

Teacher Communication:
Once students are chosen and the curriculum is approved, the counselor will let the homeroom and tracking teachers first and provide names and calendar info. (this will give the counselor support from these primary teachers) After communication with the primary teachers, the counselor will send out an email to the facility with the information about the new group being created.

Parent & Student Communication:
The first contact will be a written consent form to the parent along with a follow-up phone call from the counselor. Then monthly emails with topics covered and google forms for any comments or concerns.

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Student Sign-up:
Each 11th & 12th-grade special education student will be handed a flyer/consent form and talked to by the tracking teacher at the beginning of the school year. Followed up by a phone call from Counselor to get the list of students participating.

Forms/Surveys:
All forms will be collected and put in students' files. (participation and confidentiality)

A google form/survey will be used as a pre and post-assessment survey every 9 weeks. (one to the parent and one to the student)

Participation:
Even though this is not a graded participation group, it will fully voluntary on the student's part and backed by the parent. Students will have a chance to sign up for the group every quarter (9weeks). Once the groups start at the beginning of the 9weeks, no new members will be allowed until the beginning of the next 9 weeks. Each quarter will be a new set of group goals.

Attendance:
Though the group is not mandatory, but once a student is signed up it is a commitment to attend for the full 9 weeks.

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Nonnegotiable-
1. No sharing confidential information (what is said in the group stays in the group)
2. No put downs
3. Speaker-Listener (Active listening)

Social Contract and group rules- Living contract posted in room with every participants signature.
Students will come up with a contract and agree to it. Counselor will help guide and make sure students understand when the work Respect is written, they also write what that means. (example- encourage each other, don't talk over someone, be kind, share, no yelling, ect)

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The SAISD website for counseling states the school counselors are dedicated and ethical.

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The Guidance and Counseling Department for the San Angelo Independent School District is an integral part of the complete education process. Our department strives to provide a systematic approach to assist and empower all students in acquiring the skills needed to be academically successful and college/career ready, while also providing assistance for those in need of special services. SAISD school counselors work collaboratively with school staff, students, parents and the community to plan, implement and evaluate a developmental counseling program Our primary goal as is to support the social, emotional, academic and career growth and development for all students. The Guidance and Counseling program shall consist of:

A Guidance Curriculum to help students develop social and academic skills needed to be successful in school and beyond.

A Responsive Services component to intervene on behalf of any student whose immediate personal concerns or problems place the student's educational, personal, social or career development at risk.

An Individual Planning system to guide students as they make social, emotional and academic goals. Counselors aide students in monitoring progress, and work in conjunction with students, teachers and parents to build academic plans based on interests and career objectives.

Indirect Student Services to support the efforts of teachers, staff, parents and the community in promoting the personal, social, educational and career development of all students

SAISD Counselors hold a professional certificate in School Guidance and Counseling issued by the Texas Education Agency. Our counselors are dedicated and ethical professionals, who work diligently to grow students by meeting with them through whole class guidance, small group sessions, and individually. Our purpose is to build positive relationships, help create a safe and inviting environment for students and parents, and collaborate with all stakeholder for the benefit of students.

If you have any questions regarding the counselor or counseling services, please contact your campus.

Contact Information

Rebecca Cline
Director of Assessment and Counselors
T: (325) 947-3838 x741

Raelynn Cajas
Administrative Assistant
T: (325) 947-3838 x744

14 Reasons Why We Care
Things to think about if YOU or someone you care about is in a crisis. Multiple organizations came together to create this flyer to support our families and youth in a time of crisis. The flyer provides positive reinforcers and resources to help support families.

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Guidance and Counseling - San Angelo Independent School District

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The Guidance and Counseling Department for the San Angelo Independent School District is an integral part of the complete education process. Our department strives to provide a systematic approach to assist and empower all students in acquiring the skills needed to be academically successful and college/career ready, while also providing assistance for those in need of special services.

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Per the TEA school counselors follow:
ASCA's Code of Ehtics- Item A.12.f.
School counselors are evaluated and aligned by TEC33.005 State Law- TEA, 2018, page 5

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2. Where can I find information on school counselors serving special education students? When serving special education students, certified school counselors can:
For assistance with serving special education students contact your local Regional Education Service Center staff specialist. 3. Where can I find information on school counselors and multi-tiered system of supports (MTSS)?School counselors play a vital role in the MTSS framework. For information on the school counselor role in MTSS, visit the American School Counselor Association (ASCA) position statement: The School Counselor and Multitiered System of Supports. School counselors should be team members, under the guidance of a campus instructional leader who is directing the MTSS effort. The following are examples of how an MTSS framework may require the district's leadership:
4. What is The Texas Model for Comprehensive School Counseling Programs? 6. How can I find information on conferences, training, workshops, newsletters, and other information relevant to school counselors? Below are three professional development organizations that provide professional development for school counselors: 7. Does a parent have an unrestricted right of access to the school counseling records of his or her minor child? 10. Where can I find the list of appropriate school counseling duties on which a school counselor must spend at least 80 percent of their total work time, per SB 179 and TEC 33.006? 13. Where can I find information about graduation requirements, credits, and transcripts? 14. How can I use data in my school counseling program? 16. Is a school district or open-enrollment charter school required to have a school counselor on staff?
Certain provisions of the Texas Education Code (TEC) require that students of a district or charter school receive services from school counselors (e.g., TEC, Sec. 33.007(a), (b), and (c)). As a result, a district or charter school must have access to a school counselor to provide services to students in such situations.
The Texas Model has extensive information and resources on using data in school counseling. You can find guidance on how to use data in Sections II (pg. 38-40), III (pgs. 57-72), and IV (pgs. 106-114). In addition, the ASCA publication, Making Data Work, 4th Edition gives school counselors a step-by-step plan on how to use data in their program.
The state graduation requirements webpage provides information about Texas high school graduation requirements. Additional questions on these three topics can be sent to the Curriculum Standards and Student Support Division at curriculum@tea.texas.gov
Page 119 of the Texas Model has a list of appropriate school counseling duties (that are components of a counseling program developed under TEC 33.005) on which a school counselor must spend at least 80 percent of their total work time unless otherwise prescribed by local school board policy.
Texas Attorney General Opinion No. JC-0538 states the following: Generally, all student records are available to parents. Only under very narrow and unusual circumstances may a minor child's school counseling records be withheld from a parent. Under the Federal Family Educational and Privacy Rights Act, a public school may withhold a minor child's counseling records from a parent only if the records are kept in the sole possession of the counselor, are used only as the counselor's personal memory aid, and are not accessible or revealed to any other person except a temporary substitute for the counselor. Within this circumscribed category, state law permits the counselor to withhold a minor child's records only if the counselor is a "professional," as defined in section 611 .001(2) of the Health and Safety Code, and further, if the counselor "determines that release" of such record "would be harmful to the patient's physical, mental, or emotional health." If the counselor does not fall within the category of licensed professional under section 611 .001(2) of the Health and Safety Code, section 26.004 of the Education Code prevails, and the parent "is entitled to access to all written records" of the school district "concerning the parent's child, including . . . counseling records."
Visit TEA's Counseling, Advising, and Student Supports webpage for all Texas school counseling information, as well as to sign up for the school counseling newsletter. In addition, you can contact the counselor specialist at your Education Service Center for further resources.
The Texas Model for Comprehensive School Counseling Programs, Fifth Edition, (Texas Model) is a guide for creating, implementing, and evaluating a comprehensive school counseling program, aligned to the statutory requirements established in TEC 33.005. The Texas Model is a "resource to help students benefit from high-quality and effective comprehensive school counseling programs. It aligns with Texas state law governing the work of school counselors" (TEA, 2018, page 5). You can download a free copy of the Texas model by clicking here. "The multi-tiered system of supports (MTSS) framework can be considered the umbrella for other support systems, such as data-based individualization (DBI), response to intervention (RTI), and positive behavior intervention and supports (PBIS). MTSS encompasses career, academic, behavioral, and mental health supports for all students" (Tier Network, 2020). School Counselors cannot make Special Education Eligibility Determinations under 19 TAC 89.1040. The determination must be made by a licensed specialist in school psychology (LSSP), educational diagnostician, or other appropriately certified or licensed practitioner with experience and training in the area of the disability or a certified professional for a specific eligibility category.

provide a comprehensive school counseling program in accordance with Chapter 33 of the Texas Education Code to all students including special education students

serve on the Multi-Tiered System of Supports (MTSS)

MTSS can involve the re-allocation of resources such as federal, state, and local funds;

MTSS can involve the shifting of staff duties and responsibilities;

MTSS can involve decision making that impacts the entire school district;

MTSS involves supervision (fidelity of implementation);

MTSS involves buy-in from administration;

MTSS can involve a shift in current instructional practices (i.e. the inclusion of students in the general education setting who were served in a special education setting previously);

MTSS involves professional development;

MTSS involves support provided to staff by the instructional leader;

MTSS involves collaboration (common planning, aligning of curriculum, dialogue among staff, etc.); and

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2. Where can I find information on school counselors serving special education students? When serving special education students, certified school counselors can: For assistance with serving special education students contact your local Regional Education Service Center staff specialist. 3. Where can I find information on school counselors and multi-tiered system of supports (MTSS)?