7/3/25

Group Therapy
Monica Whitlock, Ph.D., LMFT
Couple and Family Therapy Program | California School
of Professional Psychology | Alliant International
University

Summer 2025

– Check-in
– Stages of group development
– Practice interviewing client for group
– Use of research
– Multicultural considerations
Agenda – Ethics thoughts
Week 5 – Group Leadership Skills
– Yalom Demonstration
– ACT exercise
– Experiential Groups

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Stages in the
Development of a
Group

How would you decide

if a client is appropriate
for a group?

Stage 1: The Formation Stage

• Pregroup issues:
– Announcing a group and recruiting members
– Rationale for screening group members
Forming a
– Practical matters to consider in forming a group
Group
– Use of a pregroup meeting
– Multicultural considerations in preparing members
– Guidelines for orienting members to a group

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Ask yourself these two questions:

– How can I decide who is most likely to benefit from this group?
– Who is likely to be disturbed by group participation or be a
Selecting negative influence for the other members?
group
members If you are leading an open group, you should ask this question as
well:
– “How might this potential member fit with members already in
the group?”

How would you turn away a person if you thought

either that they were not appropriate for the group
or that the group was not appropriate for them?

Turning away How can you exclude a person from a group

individuals without conveying rejection?
sensitively
What might you do if the person feels rejected
despite your best efforts to avoid conveying
rejection?

Stage 2: Initial or Orientation Stage

– A time for orientation and exploration
Initial Stage of – Characteristics of a group at the initial stage
Group – Primary tasks of stage: inclusion and identity
– Trust: the foundation of a group
– Group leader’s role at the initial stage

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Stage 3: Transition Stage

– A time for dealing with reluctance
Transition
– Characteristics of the transition stage
Stage – Difficult group member or difficult group leader?
– Group leader’s role at the transition stage

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Stage 4: Working Stage

– A time of cohesion and productivity
Stage 4:
– Developing group cohesion
Working Stage – Characteristics of an effective working group
– Group leader’s role at the working stage

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What ideas do you have

for ending your groups?

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Stage 5: Consolidation and Termination Stage

Stage 5: Final
– A time for consolidation and termination
Stage of a – Practical strategies for terminating a group
Group – Group leader’s role at the final stage

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Stage 6: Evaluation and Follow-Up Stage

– Build evaluation into the structure of the group
Stage 6: – Determine measures to assess effectiveness of a group
Postgroup § Objective and standardized measures
Issues § Subjective measures
– Plan follow-up group and individual sessions

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Use of research

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The Role of • Research can help group workers to identify

specific factors that contribute to successful
Research in outcomes.
the Practice of • Accountability is stressed in all settings; thus,
Group Work (1 familiarity with research and evaluation practices
of 2) is essential.

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• Collaboration between practitioners and

The Role of researchers can benefit both parties and the
Research in group work field.
the Practice of – A community-based research paradigm has been proposed.
Group Work (2 • A shift from process research to outcome studies
of 2) has occurred.

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• The current trend is to promote specific

interventions for specific problems based on
Evidence- empirically supported treatments.
Based Practice
• EBP should incorporate three pillars:
in Group Work
– Best available evidence
(1 of 2)
– Clinician expertise
– Client characteristics

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• Critique of EBP:
Evidence- – It is mechanistic and does not consider the relational
dimensions of therapy
Based Practice
– It may not adequately capture the complexity of human
in Group Work change.
(2 of 2) – Third-party payers could use research findings solely as cost-
containment measures rather than to improve services.

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• An alternative to EBP is PBE:

– It involves systematically gathering and using formal client
Practice-Based feedback to inform, guide, and evaluate treatment.
Evidence in – PBE can help therapists assess the value of a group for its
Group Work members throughout the life of the group.
– It aids in evaluation of the group experience during the
termination phase.

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– AGPA

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Multicultural Group
Therapy

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Group • Multicultural group work entails:

– Appreciating diversity in all forms
Counseling in a
– Challenging the culturally encapsulated view of a group’s
Multicultural structure, goals, techniques, and practices
Context – Examining ourselves as contextual/cultural beings
(1 of 3) – Assuming nontraditional roles

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Group • Guidelines:
– Learn more about your own cultural background
Counseling in a
– Identify your basic assumptions about diversity
Multicultural
– Adopt a self-in-relation perspective
Context – Respect individual differences and recognize that all
(2 of 3) encounters are multicultural

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Group • Guidelines:
– Identify universal concerns and common ground
Counseling in a
– Allow clients to teach you how best to serve them
Multicultural
– Prepare clients for the group experience and teach them to
Context adapt their group work to their everyday lives
(3 of 3) – Be flexible in applying methods

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How can we hold space

for difference while
challenging injustice?

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Becoming a • Address the following three areas of the

multicultural counseling competencies:
Diversity- – Beliefs and attitudes
Competent – Knowledge
Group Leader – Skills and intervention strategies

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• Become aware of your biases and values

Tips for • Try to understand the world from the member’s
Increasing vantage point
Diversity • Gain a knowledge of the dynamics of oppression,
Competence racism, discrimination, and stereotyping
(1 of 2) • Study the traditions and values of the members
of your group

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Tips for
• Learn general knowledge, but avoid stereotyping
Increasing
• Be open to learning from your members
Diversity
Competence • Recognize that diversity can enhance the group
process
(2 of 2)

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• Confronting • Empathizing • Protecting

• Reflecting • Facilitating • Disclosing
feelings oneself
• Clarifying
• Supporting • Modeling
• Summarizing
• Empathizing • Linking
• Questioning
Group • Facilitating
• Interpreting
• Blocking
Leadership • Active
• Initiating
• Terminating
listening
Skills • Restating • Setting goals
• Evaluating
• Confronting
• Reflecting • Giving
feelings feedback
• Suggesting
• Supporting

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Tying together loose ends, identifying common themes, and

providing a picture of the directional trends of a group session.
a. Do you use summarizing as a way to give more direction to a
Summarizing session?
b. Do you tie together various themes in a group?
c. Are you able to identify key elements of a session and present
them as a summary of the proceedings at the end of a session?

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Explaining the meaning of behavior patterns within the framework

of a theoretical system.
a. Can you present your interpretations in a tentative way, as a
hunch or a hypothesis?
b. Are your interpretations dogmatic and authoritarian? Do you
have a need to convince members of what you see as “truth”?
Interpreting c. Do you have a tendency to rescue members from difficult
feelings too quickly through the use of interpretations?
d. Are you conscious of appropriateness and timing in making
interpretations?
e. Do you encourage members to provide their own meaning of
their behavior?
f. Do you invite other members to make interpretations?

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Offering some form of positive reinforcement at appropriate times

in such a way that it has a facilitating effect.
a. Do you recognize the progress that members make?
b. Do you build on the strengths and gains made by members?
Supporting c. Do you make use of positive reinforcement and
encouragement?
d. Does your support allow and encourage members to both
express and explore their feelings? Or does your support tend to
bolster members and aid them in avoiding intense feelings?

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Challenging members in a direct way on discrepancies and in such a

manner that they will tend to react nondefensively
a. How do you confront members? What are the effects of your
confrontations, generally?
b. What kind of model do you provide for confronting others with
care and respect?
Confronting c. As a result of your confrontations, are members encouraged to
look at discrepancies in a nondefensive manner?
d. Do you confront people about their unused strengths?
e. Are you sensitive to the timing and appropriateness of your
confrontations?
f. Are your confrontations related to specific behavior rather than
being judgmental?

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– Universality - Members recognize that other members share similar feelings, thoughts and
problems
– Altruism - Members gain a boost to self concept through extending help to other group
members
– Instillation of hope - Member recognizes that other members’ success can be helpful and they
develop optimism for their own improvement
– Imparting information - Education or advice provided by the therapist or group members
– Corrective recapitulation of primary family experience - Opportunity to reenact critical family
dynamics with group members in a corrective manner
The – Development of socializing techniques - The group provides members with an environment
that fosters adaptive and effective communication
Therapeutic – observation
Imitative behavior - Members
of Group expand
members’ their personal
self-exploration, knowledge
working and
through skills
and through
personal the
development
Factors | – Cohesiveness - Feelings of trust, belonging and togetherness experienced by the group
members

Definitions – Existential factors - Members accept responsibility for life decisions

– Catharsis Members release of strong feelings about past or present experiences
– Interpersonal learning- input - Members gain personal insight about their interpersonal impact
through feedback provided from other members
– Interpersonal learning- output - Members provide an environment that allows members to
interact in a more adaptive manner
– Self-understanding - Members gain insight into psychological motivation underlying behavior
and emotional reactions
(Yalom and Leszcz, 2005)

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Ethical and Professional

Issues in Group Practice

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• Members need enough information about a

group to be able to make informed choices.
• Educate members about their rights and
responsibilities.
Rights of • Informed consent needs to be an ongoing
Group process, not a one-time event.
Participants • Confidentiality is essential but not absolute.
• Freedom to leave a group
• Freedom from coercion and undue pressure

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– The client poses a danger to others or self.

– A minor, elder, or dependent adult is victim of abuse or
• Exceptions to neglect.

confidentiality – The client needs to be hospitalized.

– The information is made an issue in a court action.
– The client requests a release of record.

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Social Media and Group Work present

confidentiality and privacy considerations:
– There is an increased risk of breach of confidentiality when
Social Media members of a counseling group engage in social media.
and Group
– Ground rules regarding members’ online behavior need to be
Work part of informed consent.

– Educate members about how to share their experience with

others outside the group in an appropriate way.

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• Protecting members from psychological risks in

More Ethical groups
Concerns in • Ethics of group leaders’ actions
Group Work • Subgrouping and out-of-group contact

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• Be aware of how your values influence your group

interventions
• Assist members in finding answers that are most
congruent with their own values
Impact of the • Use “ethical bracketing” to keep your personal values
Leader’s separate from your work with group members
Values on the • Find ways to manage value conflicts between you
and the members
Group
• Recognize that much of group members’ exploration
involves clarifying their values
• Monitor any members who may attempt to impose
their values on other members

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• Addressing spiritual and religious values in group

work involves sensitive, controversial, and
Religious and complex concerns.
Spiritual • To help members with these concerns, be aware
Values in of your own spiritual or religious attitudes,
Group beliefs, values, and experiences.
Counseling • Some group members may feel that their needs
are not being met if their religious or spiritual
concerns are ignored.

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• Become aware of your cultural values

Ethical Issues • Come to know and challenge your biases;
confront stereotypes
in Multicultural
• Promote sensitivity and competence in
Group addressing all forms of diversity
Counseling
• Invite members to share their pain from the
social injustices they have encountered

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• Transcend cultural encapsulation and avoid

Ethical Issues imposing your worldview on members
in Multicultural
• Recognize differences among and within groups
Group
• Align the values of the group process with the
Counseling cultural values of your members

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• Have a rationale for all techniques

Uses and • Avoid misusing techniques to impose your
agenda
Misuses of
• Use techniques to foster self-exploration and
Group self-understanding
Techniques
• Modify techniques based on members’ cultural
and ethnic backgrounds

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• Ethical issues in training group workers:

Training of
– Combining experiential and didactic approaches in training
Group – Informed consent
Counselors – Importance of professionalism of group trainer

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• Group leaders are:

Liability and – subject to civil penalties if they fail to do right or actively do
wrong to their members.
Malpractice – on firmer ground legally if they follow accepted standards
and practices of others in their profession.

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• Group leaders should:

– keep up to date with state laws that pertain to their
professional practice,
Liability and
– take preventative measures to avoid malpractice suits,
Malpractice – maintain reasonable, ordinary, and prudent practices, and
– follow the spirit of the ethics codes of their professional
organization.

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Adapted from Yalom, I. D., & Leszcz, M.

(2021). The theory and practice of group
psychotherapy (6th ed). Basic Books.

and
Sources
Corey, Gerald. (2023). Theory & Practice of
Group Counseling (10th ed). Cengage.

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