Case Study: Group Therapy

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Group Therapy Case Study

John is the group leader during week three of an eight-week psycho-educational group. Until now, the group has been quiet, but John has been setting the scene by providing them with relevant information. John has been told that his role as leader is to inform the group members of strategies and skills that can be used in order to manage their lives. At the beginning of this week's session, there is a palpable sense of unease. The group members seem highly unsettled and eventually, one of them states: "We are not happy being lectured each week." This outburst surprises John, but he continues on with little acknowledgment of the event. Several minutes pass before another group member states: "Well, if you can't listen to us, maybe we shouldn't listen to you!" Upon this second outburst, it is clear that there is no ignoring the situation at hand. The atmosphere within the group has taken a negative turn, and the present dysfunction must be addressed in order to correct the problem at hand and move forward in a productive manner.

Problems in Functioning

In the situation at hand, the group process and therefore, its functioning, has been disrupted by a disagreement as to how sessions should proceed in terms of communication and content delivery. The facilitator, John, must now work in a manner that can assist the group in accomplishing its objective by diagnosing the problem areas in terms of productive functioning, and utilize his skills as a problem-solving or decision-making entity, intervening to alter the group's operational behavior (Ogrodniczuk and Steinberg 2005, pp.45).

A group like that in the case study can only achieve its purpose if each member of the group feels that they have the open and unhindered capacity to communicate within the group as a whole. When unrest or distrust of the process is presented openly within the group, as is seen in this context, the functionality of the group itself ceases to exist. One of the main attributes of a functioning group counseling session is the presence of a cohesiveness amongst group members, which has long been considered the primary therapeutic factor from which all others flow (Piper 2007, pp. 269). Yalom (2005) notes that all humans are essentially herd animals, with an instinctive need to belong to groups, which is relevant especially in gauging personal development through the interpersonal context of group counseling (Yalom 2005, pp.10). However, true cohesion in a group, which is necessary for prime functioning, is only possible when all the members feel a sense of belonging, acceptance and validation. In viewing this scenario, the validation has been taken out of the equation to the extent that group members feel "dictated to" rather than part of the actual conversation. In noting the shift from open-communication to a teacher-student classroom setting, group members have closed off from the functionality of the group and from each other. A group in which such dynamics remain present will not and cannot function appropriately.

Initial Stages of Group Development

In the initial period of group development and counseling, the group counselor generally attempts to support the open expression of feelings among clients (Bonney and Ginter 1993, pp. 150). In these stages, it is imperative that the group counselor strike a balance between allowing clients to openly express their feelings and providing protection to individuals from undue pressure and intimidation (Clark 2002, pp. 271). Generally, clients who are given opportunities to assess their own readiness for group counseling, to define and evaluate their personal goals, and to develop group norms are less likely to feel hostile as seen in the case study at hand (Ohlsen, Horne and Lawe 1988, 32).

In viewing the study at hand, the initial stages of group development appear to have been handled in the correct manner, as for the first two weeks, the session ran smoothly and without incident. Until this point in time, group members had acted in a manner that would aid in the overall productivity of the group and its mission. However, in viewing the incidents of the third week, one can note the shift in attitudes, which may be attributed to John's leadership strategies. However, one can note that this incident, appearing in the third week of an eight-week course, can still be considered the initial stages of the group, as dynamics have not been fully established. The introduction of John -- and his new style -- into the group in the third week may have further been viewed by group members as an invasion upon the dynamic that had been established in the two sessions prior.

While group members lash out on John for what they deem a dictatorial style of leadership, the question remains as to whether the group's frustrations are actually with John or the result of pent-up frustrations of the past two weeks. While it is noted that the first two sessions ran smoothly, which would indicate the basis for productive initial group development, the leadership styles of the two previous group leaders is never mentioned, which further poses the question of whether group members accepted and actively participated in said sessions, or if they were dictated to as they believe John has done and chose to remain complacent during the initial adjustment period to the group itself.

The Role of Contracting and Group Structure

Behavior contracting is a therapeutic technique in which an agreement is reached with a client, usually in the form of a signed contract, which makes clear the consequences that would follow certain identified behaviors (Carns and Carns 1994, pp. 155). Such contracts may be utilized as adjunct to a behavior modification program or a behavior therapy intervention (Chickering 1977, pp.96). Such contracting takes on an additional dimension within a group structure, as the contract must encompass a common goal of an entire group of individuals rather than a single client.

In creating behavioral contracts within the setting of a group, group members are encouraged to work as a team in order to reach the intended goal. Contracting for behavior change can be an effective method of introducing increased clarity, definition, and task orientation to verbal material that otherwise might remain vague and abstract within a group (Berg, Fall, and Landreth 2006, pp. 221). It can involve the member and the group in a specific process of problem identification and solution, and contracting itself within a group structure can provide identifiable steps, bilaterally agreed upon, to help group members go beyond mere awareness or recognition and into a utilized program for change (Berg, Fall, and Landreth 2006, pp. 223). One of the key factors in the success of behavioral contracting within a group is the ability for each group member to feel free and autonomous enough to both impart and value group input, while at the same time being willing to assume full personal responsibility for carrying out the agreed-upon contract. In the case study at hand, the capacity for these members to exchange ideas freely in moving toward the contracted goal has been hindered by a lapse in communication and a distrust of the leader -- John -- and his methods.

Task and Maintenance Balance in terms of Power Issues

Group counseling essentially provides the framework for teamwork, and in such teams, there are many roles that people perform. Some of these roles relate to helping the group perform its tasks, while others relate to the maintaining of group relationships among members. Additionally, there are dysfunctional roles that may hinder the team, with behavior shifting toward personal agendas rather than team needs, which can be seen in the case study at hand in the group's turning its anger toward John rather than the issues being addressed within the eight-week session. In viewing the maintenance roles and lack of balance in the group at hand, one can see that the group members have moved from being passive followers to aggressors in their resentment of John and unwillingness to move forward with the session. While John, the group leader, is left with the struggle of picking up the pieces in terms of reestablishing a group dynamic that is unified enough to move on.

Such a lapse in task maintenance and balance in this group can be fully attributed to power issues. The group members feel they have lost any semblance of power by allowing the sessions to be led in a manner that dictates information to them rather than value their input and personal contributions. As previously mentioned, the group is now functioning under the notion, "Why should I listen to you if you refuse to listen to me?" In viewing this notion, it becomes clear that the power structure in this group is entirely too volatile. Further, while the use of an impartial leader in such counseling sessions is necessary, the counselor at hand should never be deemed to be in full control of the group, but rather as an unbiased observer who has left the power… [END OF PREVIEW]

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