Creating the Group Part 1

previously we talked about individual characteristics that one might want to think about when deciding who to include and who to exclude from a group we also talked about characteristics to think about when constructing a heterogeneous group today we're going to switch gears and creating the group and we're going to talk about considerations like the setting and structure for the group and pre-group meetings so first let's just briefly talk about some of the considerations you might think about in terms of the physical setting for a group first you'll need any room that gives room that gives

you the privacy that you would need and freedom from any outside distractions and it's important that the space be amenable to forming a circle you want all the members of the group to be able to see each other and talk to each other and so you don't want the group set up in such a way so that people have to lean over participate in the group therapy process importantly if the group is going to be recorded or observed you of course want to get written permission from all the members of the group well in advance

you really wouldn't want to spring that sort of request on members at the last minute and you want them well prepared for you want them well prepared for any sort of observations or recordings therapists will also need to determine whether the group is going to be open or closed in a closed group the members that you start with are hopefully the members that you finish with obviously some group members will draw during the first couple of sessions you might allow a new member to join the group but for the most part group membership is going

to remain consistent closed groups also tend to last for a specified period of time for example if you are conducting a group in a school or calling the academic year is going to have a large influence on the duration of your group and because of that your group will likely have a fixed end point brief therapy groups which we'll talk more about in a little bit typically meet weekly for eight months or less longer term closed longer term closed groups are possible but are more difficult because life events happen over the course of many months

people naturally change jobs they move they go through life events that might take them away from group therapy and so if you're going to have a closed group where you're not admitting new members it's important group membership that you know will be stable for example you might be able to conduct a long-term closed group on a military base because the group membership is likely to remain stable open groups on the other hand allow members to join the group even after the group has been meeting for a long has been meeting for a long period of

time open groups may last for several years and when one member leaves the group therapist finds a new member to take that person's place but what about the size of a group it's typically recommended that a therapy group have seven or eight members range of five to nine members although that may change a little bit depending on personal preference in smaller groups of four individuals or less sometimes members disengage and the therapist finds him or herself doing more of an individual therapy with different members of the group as as opposed to group therapy if the

group becomes too large and is more than 10 members there's obviously less time for each individual member of the group to work through their problems and so cohesion may suffer and subgrouping may emerge now you will hear of therapy groups that consist of 20 40 60 even 80 participants but these groups are generally more focused on things like psychoeducation stress reduction and the self-management of illnesses and they focus far less on interpersonal learning learning now what about the duration and the frequency of meetings the sweet spot for the length of a meeting is probably 80

to 90 minutes more than two hours and people are going to be fatigued from the tasks of group therapy in a session that's less than 60 minutes and people probably won't have the time to really work through the themes of that particular session of course depending on the institution that you're in and time constraints associated with that you might need to make some alterations for example in a school setting the length of a group therapy session might be limited to the length of the class in terms of frequency most groups will probably meet weekly although

twice a week might be ideal when possible especially at the beginning of the course of therapy meeting less than once a week will probably harm the dynamics of the group and it will probably be difficult to focus on interpersonal relationships and instead the group may tend to focus on individual crisis situations historically there was a trend at one point of having long marathon sessions that lasted for multiple hours and were sometimes condensed into a long weekend weekend but this has lost a lot of favor and part of the reason for that is probably that the

transfer of learning from the group to the outside world is quite laborious and may take a lot of time for example if somebody in the group is working through a difficult relationship with a important figure in their life the work that is done in group will certainly be relevant to that but it's going to take more than a few sessions for that person to transfer what they're learning in the group to their relationships outside of the group and for that reason having regular meetings over a prolonged period of time to having fewer more intense sessions

may be more helpful now that doesn't exclude the helpfulness of various types of brief therapy brief therapy might be attractive for a number of reasons one of which is financial and so insurance companies and hos are going to favor more cost-effective forms of treatment but also in certain areas given the limited number of mental health professionals the longer a person stays in treatment the less access other people may have to treatment and so cycling people through brief therapy may allow more people access to mental health services access to mental health services but how many sessions

does one need for brief therapy well some will define brief therapy as consisting of 25 sessions others maybe 50 or 60 sessions it will probably depend on their orientation for people who go through inpatient facilities they might only period of a few days or a week and so they might only get one session of group therapy research suggests that the minimum number of sessions that would be effective would be about 12. however it's important to remember that the number of sessions should be related to achieving some sort of specified and so brief therapy might be

more accurately thought of as time efficient therapy of course it's important to remember that not everyone will respond well to the time efficient form of brief therapy and some individuals will need to continue in longer forms of treatment those lines some therapists try to bridge the gap between brief therapy and longer forms of group therapy by incorporating booster sessions after a certain number of weeks after the brief therapy group has ended or by holding a brief therapy group and then allowing members of the group to sign on for another series of sessions but in order

to make sure that brief therapy remains effective here are a few points to consider first it may be important for the group leader to remind the group members that brief therapy is time limited and so the group leader might want to remind the group members and the group members how much time has passed and how many sessions remain in the course of group therapy second leaders might also want to take a more active role in encouraging group members to apply what they've learned in therapy to situations outside the group third group to try and turn

the time limited element of brief therapy into an advantage and draw attention to the time limited element of brief therapy in order to increase efficiency and try to energize the group a little bit fourth group leaders are still going to want to focus on now in brief therapy because that's going to be more powerful than focusing on the there and then and external relationships fifth group leaders might want to incorporate some techniques from other orientations of therapy like cognitive behavioral therapy into the group in order to alleviate the group in order to alleviate symptomatic distress

sixth group leaders need to try to avoid the mistake of cutting out some of the important elements of group therapy specifically pre-group screening and pre-group sessions that are really quite important to building an effective therapy group in fact in group therapy some of the pre-session meetings might be even more important because the therapist can meet with the clients to further define their problems and sharpen their goals for therapy so that they're ready to hit the ground running when they get into the therapy group well throughout this lecture i've made reference a number of times to

pre-session meetings that prepare a client for therapy let's take a little bit of time and focus in on what we might do in pre-group meetings