Transitioning to Closure

There are several tasks that will need to be accomplished with a member that will be terminating membership of an open group. First, members of the group should fully understand how to give notice and what steps need to be taken in order to appropriately terminate themselves from the group. Second, the member that is leaving will need adequate time to prepare emotionally for their departure. Next, other members of the group should have the opportunity to say goodbye. Different cultures view endings differently, and this should be taken into consideration. Lastly, a final individual session or follow-up call should be discussed and potentially scheduled. The group leader will need to get consent for this final session or phone call. Specifically, the group leader will want to review what the member learned during group counseling and how he will implement those things into his life moving forward. Referrals will be made when appropriate (Corey, Corey, & Corey, 2010).

Third and Fourth Sessions

Checking in with the members of the group kicks off the third session. During the check-in, one of the members, Jesse stated: “I am not feeling very good about myself today.”

Group Leader: “Do you want to tell us why you are not feeling good about yourself today?”

Jesse: “Not really.”

Group Leader: “Jesse we are here for you and we want to support you. We can only support you if you are open and honest with us. Tell us what is going on?”

Jesse: “I used meth over the weekend. I put myself in a vulnerable situation and I relapsed.”

Group Leader: “Ok, do you want to share with us what happened?”

Jesse: “I went out on Saturday night with a few of my friends. We ended up at a party and before I knew it, I was high!”

Group Leader: “Does anyone have anything to say to Jesse?”

Jackie: “Jesse what were you thinking? You should have called me. I told you that I would be here for you if you were ever in a vulnerable situation!”

Jesse: “I know Jackie, I think that deep down I knew that I was going to come across meth if I went out with my friends.”

Jackie: “Why do you think that you put yourself in that situation?”

The group leader’s responsibility was to dig deeper and find out what was bothering Jesse. After further questioning, Jesse opened up and shared to the group that he had relapsed. The members of the group must be willing to share and be open with the group in order to have meaningful interactions with other members (Corey, Corey, & Corey, 2010). Jesse getting honest with the group continues to build group cohesion. Jackie stepping in and offering support shows that group cohesion is getting stronger.

Also during the check-in, another member, Michelle stated, “I was sexually abused as a child.”

Group Leader: “Do you want to share with us what happened?”

Michelle: “When I was 13 years old, my uncle Tom sexually abused me. He used to take care of me when my parents were out of town. He would get drunk and sexually abuse me.”

Group Leader: “I am really sorry to hear that Michelle. How are you feeling right now?”

Michelle: “I’m angry!”

Jackie: “I was also sexually abused as a child, so I can relate. I too was angry. I did not trust men until I finally was able to work through the trauma.”

Michelle: “How were you able to work through the trauma?”

There are many fears that the group members could potentially have including the fear of being vulnerable, the fear of rejection, the fear of self-disclosure, or the fear of being judged (Corey, Corey, & Corey, 2010). Michelle opening up and sharing such a thing shows that she is feeling trusting and comfortable with the group. It is the group leader’s job to make Michelle feel safe, to fully recognize what happened to her, and to assist her in working through the event (Corey, Corey, & Corey, 2010). Depending on how severely Michelle is affected, it might be best to refer her to individual therapy to work through this traumatic event.

The third session closes with homework being given, to complete a Relapse Prevention Plan, which will be due in one week.

During the fourth session check-in, Mike states, “I got wasted at the game on Sunday. Not only did I get wasted, but I also drove home.”

Group Leader: “Wow Mike! That came out of the blue. Do you want to share with the group what happened?”

Mike: “I went to the game with a bunch of guys from work, and they were all drinking. I didn’t want to tell them that I didn’t drink. Therefore, I thought it would be okay to have a couple of beers. Next thing you know, I was wasted. I drove home after the game because I did not want to have to call my wife to come and pick me up.”

Group Leader: “So how are you feeling about yourself right now?”

Mike: “I feel like a loser. I let myself down, I let my wife down, and I let you guys down.”

Group Leader: “Mike we are here to support you and love you. Does anyone else want to say anything to Mike?”

Jesse: “Mike, I am here to support you in anyway that I can. I wish that you would have called me prior to taking that first drink.”

Jackie: “You could have called me Mike. I would have given you a ride home.”

Michelle: “How were you feeling prior to the game? What was going on that you were in a vulnerable place?”

The group leader’s job is to provide a balance between confrontation and support. It is the group leader’s job to support Mike in taking a risk and opening up to the group. Getting him to reflect on his behavior will promote a deeper level of self-exploration (Corey, Corey, & Corey, 2010). The members of the group want to love an support Mike as well. The group leader does a good job getting the members of the group to speak up.

Second Session

Because the group will composed of recently clean and sober adults, it is going to take more than one full session for the level of trust and comfort to be at a place where productive group work will take place (Jacobs, Masson, Harvill, & Schimmel, 2011). During the first part of the second session, the beginning stage will come to an end as the trust and foundation of the group are still being formed. An activity designed for the members to get to know each other individually will be next. The group will break up into dyads, and select a new partner every 10 minutes. Questions asked of each member will include:

  • Why do you want to be clean and sober?
  • What do you expect to get out of the group counseling experience?
  • What is your biggest fear about the group counseling process?
  • What is your level of trust in the group? What is contributing to your trust or mistrust?

During this session, one of the members, John stated: “I am uncomfortable being with groups and I really do not want to be here.”

In response to this statement, this writer herein described as Group Leader stated: “John, tell me more about why you are uncomfortable being with a group?”

John: “I do not know the other members of this group. Why would I want to open up and share with complete strangers?”

Group Leader: “If you got to know the other members of the group, would you feel comfortable being in this group and would you want to be here?”

John: “I guess so.”

Group Leader: “Does anyone else have anything to say to John?”

Jackie: “You and I have had several conversations and I feel comfortable opening up to you. I have learned from you and I think that you are an important member of this group.”

Michelle: “I think that you are an important member of this group and I too am glad that you are here.”

Group Leader: “What do you think about that John?”

John: “Wow, I had no clue. Knowing that other members of the group like me makes me feel more comfortable already.”

It is important here to get John to open up and express how he is feeling and what he is thinking. This will promote group cohesion and trust will start to be established if the facilitator can get him to share (Corey, Corey, & Corey, 2010). Getting other members of the group involved in the discussion helps John see that he is an important part of the group and it makes him feel more comfortable.

Checking in with all of the group members closes the session.

Group Sessions and Phases

In this section of the paper, the writer will describe several group sessions. The first session is the beginning stage of the counseling group and includes an icebreaker exercise. The second session includes a dyad and moves into the working stage. The third and fourth sessions describe check-ins, problems that are uncovered during the check-ins, and rationale for how the problems were addressed. Finally, the transition to closure is described.

First Session

One of the goals of the initial meeting will be further screening of the members. Further screening of group members will include additional assessment of each member’s readiness for the group experience, confirmation that each member wants to stay clean and sober, confirmation that each member is not suicidal, homicidal, or full of rage, and to determine if each member a good “fit” in the group (Berg, Landreth, & Fall, 2013).

The first part of the initial session will be to establish the rules of the group. The rules of the group are as follows:

  1. Attend sessions regularly and be on time. There will be three 3-hour sessions per week. I will be respectful of their time and start and finish on time. My expectation is that the members reciprocate.
  2. Make a commitment to complete sixteen weeks with the group. Sixteen weeks gives the group sufficient time for the group to form cohesion and for trusting relationships to form (Corey, Corey, & Corey, 2010).
  3. Maintain confidentiality. Maintaining confidentiality is imperative to the development of the group. Each member must understand and be on board with the importance of keeping discussions of the group confidential. Discussing what happens in the sessions to other people outside of the sessions is discouraged and talking about group members to non-members is strictly prohibited. This gives members peace of mind and it builds trust amongst the group members (Berg, Landreth, & Fall, 2013).
  4. Listen attentively to other group members. Each member is expected to listen attentively while the focus is on other members of the group.
  5. Be open, honest, and clear when discussing issues. Each member of the group can only expect to get out of the group what he is willing to invest. The group is most likely to develop the strongest if the members of the group are willing to be open, honest, and clear when discussing issues (Berg, Landreth, & Fall, 2013).
  6. Set concrete goals for personal development. The members of the group will see a greater benefit from the group experience if they are actively seeking positive change. Putting goals down on paper dramatically increases the odds of obtaining the desired result (Berg, Landreth, & Fall, 2013).

The ice-breaker activity that will be used is called Two Truths and a Lie. Each member of the group will write down two truths and one lie about themselves. When it is each member’s turn, they will tell the group all three and the group has to guess which one is the lie. This is a fun way to break the ice and for the members of the group to get to know each other. This exercise gives the members the opportunity to start connecting and for trust to start being formed.

It is important for the group leader to understand how the members of the group are feeling at all times. This is the best way for to stay on the same page. Therefore, the members of the group will then be given an opportunity to express their fears and their expectations of the group. The fears and expectations will be addressed appropriately prior to closing the first session.

Selection and Deselection Criteria

The screening questions serve many purposes and are vital to forming an appropriate group. When it comes to the selection of members of a group, “Deselection criteria” is normally emphasized more than selection criteria (Delucia, 2006). The goal of the screening process is to identify group members whose needs and goals line up with the goals of the group (Corey, Corey, & Corey, 2010). Another goal of the screening process is to determine if a particular individual should be included in this particular group at this particular time with this particular group leader (Corey, Corey, & Corey, 2010).

With the goals of the screening process in mind, the writer developed sixteen questions. First, personal information is gathered. Second, the writer wants confirmation that the individual has admitted that he is a substance abuse addict along with his drug of choice(s). Next, the writer wants confirmation that the individual is planning to stay clean and sober. It is important that group members want recovery. If they do not want recovery, then this is not the right group for them at this moment in time. Additionally, does the individual have any mental health conditions? If they do have mental health conditions, which do they have? Mental health disorders are common amongst substance abuse addicts and it will be important for the group facilitator to know what he is dealing with. The group facilitator also needs to know if an individual is suicidal, homicidal, experiences episodes of rage, or has experienced recent trauma. If so, he is probably not a good fit for this group (Corey, Corey, & Corey, 2010). He needs a different level of care than can be provided at the group level. Next, is he in the midst of an extreme crisis? If he is in the midst of an extreme crisis, group counseling is probably not a good fit for him at this very moment in time (Corey, Corey, & Corey, 2010). Next, is he highly paranoid or have an extreme case of anxiety? A person with anxiety or extreme paranoia might not be a good fit for a group-counseling environment (Corey, Corey, & Corey, 2010). The group facilitator will want to know if an individual has been to treatment for his substance condition. If so, which treatment center? How long was he in treatment? And what was his discharge date? This information will tell more about the social class of the individual, what kind of treatment he was provided, and how severe his substance condition is. Is he in a transitional sober living environment or is he planning on moving into a sober living environment? This will tell if he is in a different environment than he was in when he was actively in his addiction. Depending upon which sober living home he is in, the other members of the household will be in recovery, there will be drug testing, and there will be rules and policies, which need to be followed. If a person is in a transitional sober living home, it usually means that he is more willing to go outside of his comfort zone to change his life. Living in a sober living home is an indication that he is taking the next step towards lifelong recovery. Is he willing to commit to sixteen weeks? The individual must commit to at least sixteen weeks with the group. Sixteen weeks is long enough for the members to build trust and for significant behavioral changes to take place (Corey, Corey, & Corey, 2010). The individual must be open, willing, and committed to doing homework when assigned. Work outside of the group is imperative to the group counseling process. Is a person willing to explore difficult issues in his life and is he willing to learn new techniques to handle these situations? This is a gauge of a person’s willingness. Is the individual willing to support other members of the group? This is a group and the members must be supportive of each other to achieve the best possible outcome.

The final step of the screening process will be a one-on-one interview with one of the group counselors. Actually having a conversation with each potential group member is the best way to dig deeper on some of the screening questions, connect, and determine whether or not he might be a good fit for the group.

Group Goals

There are many goals that I can think of that individuals with a substance condition might have. However, I have narrowed the list down to five goals:

  1. Each member will confront difficult issues in his life and learn a technique to handle the issues more effectively.
  2. The members of the group will provide a supportive network for the other members of the group. Members of the group will support each other by listening, caring, opening up.
  3. The members of the group will learn more effective ways to handle difficult social situations. Difficult social situations will be discussed during the sessions.
  4. Each member will complete a relapse prevention plan and share it with the group.
  5. Members of the group will provide constructive feedback to other members of the group.

Session Structure

            Because of the intense nature of the substance condition and because the members will still be early in recovery, there will be three sessions per week. A group of well-functioning adults of higher intelligence will have the ability to stay present during group counseling sessions for longer periods of time. (Corey, Corey, & Corey, 2010). Therefore, the group will meet for three-hour sessions. The initial commitment required for membership of the group will be 16 weeks. 16 weeks gives the group enough time for the members to form trusting relationships and for group cohesiveness to form. (Corey, Corey, & Corey, 2010). Members will have the opportunity to continue their membership with the group for an indefinite period time if they choose to do so. Missing meetings will be acceptable with either a valid excuse or if it is planned in advance.

Group Selection

The group approach to counseling with adults with a substance condition has been proven to be not only cost-effective, but also powerful and successful. The group approach gives members of the group an experience that cannot be replicated by individual counseling. One reason why group counseling is so effective is because of therapeutic forces, like the instillation of hope, altruism, universality, and group cohesiveness. Another reason why group modalities are effective is due to their success in treating conditions that are associated with addiction, like bipolar, depression, and anxiety. (Treatment, 2005

Population and Participant Number

The people considered as members for this group will include adults, male or female, with a substance condition. The only requirement for membership will be that the individuals are over the age of 18 and they have a substance condition. The type of individuals that will be attracted to this group will be of the middle to upper socioeconomic status, above average intelligence, and most will have at least some college education. For an ongoing group, eight members might be ideal. (Corey, Corey, & Corey, 2010). However, because it is an open group and members are welcome to join at anytime, the number of people in the group will range from six to ten at any given time.

In this post I will discuss group counseling with regards to a group composed of adults with a substance condition. I will discuss the group type and where the members will come from. I will discuss why I chose to select the group that I did. I will discuss the member population type and number of participants in the group. I will also discuss the session structure and the goals of the group.

Group Type – Adults with a Substance Abuse Condition

            The group that I plan to facilitate will consist of adults with a substance abuse condition. The members of this group will typically be adults referred from treatment centers. After going to treatment for 30-120 days, group counseling will be the next step in the recovery process. An open group is one where new members are welcome to join at anytime. (Cherry, n.d.). It is best for a person with a substance condition to join a group immediately after being discharged from treatment. Since people are discharged from treatment centers everyday, this will be an open group. Also, having members of the group that are in different stages of recovery is a good thing. This allows people that are new in recovery to be exposed to people that have been clean and sober for a longer period of time. This will give them hope. (Cherry, n.d.) Members of the group will also be referred by transitional sober living facilities.