Other Important Aspects of Group Work
There are other aspects that are important to discuss in relation to group work. In this chapter, Ill discuss diversity, ethics, and research on the effectiveness of groups.
Being aware of cultural diversity in the group and leading the group so that every member of the group, regardless of culture, is treated with dignity and respect is important. The ACA code of ethics aIDresses cultural diversity in several ways. Concerning informed consent in the counseling relationship it states, Counselors communicate information in ways that are both developmentally and culturally appropriate. It continues by stating, In collaboration with clients, counselors consider cultural implications of informed consent procedures and, where possible, counselors adjust their practices accordingly. In the section on confidentiality and privacy, the code aIDresses counselors being aware and sensitive to cultural meanings of confidentiality and privacy. Concerning the assessment of clients, the code aIDresses multicultural issues with this statement, Counselors select and use with caution assessment techniques normed on populations other than that of the client. Counselors recognize the effects of age, color, culture, disability, ethnic group, gender, race, language preference, religion, spirituality, sexual orientation, and socioeconomic status on test administration and interpretation, and they place test results in proper perspective with other relevant factors.
Singh, Merchant, Skudrzyk and Ingene (2012) prepared a document for the Association for Specialists in Group Work on this topic. They define multicultural as the belief systems and typical daily activities of people from various diverse groups, and denotes that attending to the needs and values of these diverse groups ensures a more vibrant, dynamic, and empowered society overall. Examples of multicultural identities include (but are not limited to): gender identity and expression, race/ethnicity, sexual orientation, religious/spiritual traditions, ability status, migration status, age, and social class.
Singh, et. al. discuss competence in group performing and processing related to group diversity. Group workers demonstrating multicultural competence will: establish group norms to accept, value and respect cultural differences; attend to differences in acculturation levels; avoid stereotyping and labeling; demonstrate just and fair leadership; aIDress overt and covert cultural conflicts in group; respond to language needs; incorporate traditional and spiritual healing methods that are culturally appropriate; use culturally grounded frameworks and techniques as appropriate; and use culturally-appropriate assessment and evaluation tools.
Corey (2008, p. 35) wrote, Becoming a diversity-competent group counselor demands self- awareness and an open stance on your part. You need to be willing to modify strategies to fit the needs and situations of the individuals within your group. It is clear that no one right technique can be utilized with all group members, irrespective of their cultural background. It is important to realize that it takes time, study, and experience to become an effective multicultural group counselor. It is your responsibility as a group counselor to have a general understanding of your members cultural values.
GlaIDing (2008, pp. 223-224) points out three ways that group leaders must make modifications from traditional ways of working with groups to become effective multicultural group counselors. First, they must understand what a culture is. Second, they must modify their theories and techniques to be congruent with the beliefs and behaviors of the cultures represented in the group. Finally, multicultural theories and techniques that facilitate change and growth must be developed.
Holcomb-McCoy & Moore-Thomas (2011, pp. 48-49) discuss issues that may arise when leading a multicultural group. Two of them are especially relevant. The first is when the leader is culturally different from the group members. The culturally different group leader should carefully consider how the leaders cultural background might affect the members behaviors in the group. The members may stereotype the leader based on preconceived notions of how the members believe persons from a particular culture behave. A second issue is when group member hostility arises. When member dissatisfaction or hostility among members occurs, the leader should keep in mind that the problems may be caused by experiences of oppression and marginalization, not by a flaw in the groups process. At the same time, leaders must be aware of the cause for the group members hostility and label it as such for the members. The authors continue by stating, When hostility arises, group leaders must not fail to recognize that cultural differences exist or diminish their importance. Facing differences is difficult but it is necessary. Contrary to what many group leaders believe, recognizing and expressing differences does not cause more conflict. Recognizing and accepting differences creates a feeling of safety for members and in turn promotes personal growth among members.
The importance of being an ethical group counselor goes without saying. In this section, Ill explore the elements of an ethical group counselor.
The ACA code of ethics (2014) is an extensive document covering all aspects of ethics. Section A covers the counseling relationship. Under client welfare, the code of ethics states that the primary responsibility of counselors is to respect the dignity and promote the welfare of clients. Also in section A two statements directly aIDress group work. The first statement aIDresses the need for counselors to select group members whose needs and goals are compatible with the group. The second statement states that counselors should take reasonable precautions to protect clients from physical, emotional or psychological trauma. Many other aspects of the counseling relationship are also covered in section A.
Section B of the code covers confidentiality and privacy. It states that counselors protect the confidential information of prospective and current clients. Counselors disclose information only with appropriate consent or with sound legal or ethical justification. Also in section B, the following statement is made specifically for group work. In group work, counselors clearly explain the importance and parameters of confidentiality for the specific group. Thomas and Pender (2007) state that group workers should have a professional disclosure statement which
includes information on confidentiality and exceptions to confidentiality. Many other aspects of confidentiality and privacy are also covered in section B of the ACA code of ethics.
Section C of the code covers professional responsibility. In this section, boundaries of competence are covered. It is stated that counselors practice only within the boundaries of their competence, based on their education, training, supervised experience, state and national professional credentials, and appropriate professional experience. Another point made in this section pertains to treatment modalities. It states that counselors should use techniques/procedures/modalities that are grounded in theory and/or have an empirical or scientific foundation. It continues by stating that when counselors use developing or innovative techniques/procedures/modalities, they explain the potential risks, benefits, and ethical considerations of using such techniques/procedures/ modalities. Thomas and Pender (2007) state that group workers should be aware of personal strengths and weaknesses and be able to articulate a rationale for the techniques that are used.
Section D of the code covers relationships with other professionals. AIDressing this section Thomas and Pender (2007) state that professional development is important. Group workers should remain current and increase knowledge and skill competencies. They should seek consultation and/or supervision regarding ethical concerns. They should seek appropriate professional assistance for their own personal problems or conflicts. If they do not have all the knowledge and competencies that they need to work with a particular group, they should seek consultation and supervision. They should also keep abreast of group research and development.
Section E of the code covers evaluation, assessment and interpretation. While this section speaks primarily to counselors evaluating, assessing and interpreting results of evaluation and assessment instruments to the client, Thomas & Pender (2007) stress that group workers should actively assess their knowledge and skills related to the groups they are offering, as well as assessing their values, beliefs and theoretical orientation and how these impact the group members. They also state that group leaders should assess needs and resources in the community and use this information to make decisions related to their groups.
The ACA code of ethics covers many other points of ethical concerns. I have tried to call attention to the ones that directly affect group counselors. You can find the entire code on the ACA website at www.counseling.org. Every group leader should consult this web site. Thomas and Pender also discuss other issues related to ethics. You can find their work at www.asgw.org. I encourage you to read and be familiar with both of these documents. Jacobs, Masson & Harvill (2009, p. 442) make the best statement concerning the ethics of group leaders when they write, The most frequent unethical practice in group counseling occurs when untrained or ill-trained leaders conduct groups.
The Effectiveness of Groups
Roback (2000) states that there is ample evidence of the effectiveness of group treatments. Many people have been helped. The three major dynamics which include the leader, the group and the group member are typically associated with positive outcomes. However, they may also create negative outcomes. The leader may create negative outcomes through negative intervention styles, misapplication of technical skills and harmful relationships with the group. The group may help create negative outcomes by low cohesion and hurtful social interactions. Group members with severe character pathology are more likely to have a negative outcome.
Yalom and Leszcz (2005, p. 232) state that group therapy produces significant benefit to its participants. The results of the research are clear that group therapy is as effective or more effective than individual therapy. In 32 studies, group therapy was more effective 25% of the
time and in the other 75% it was as effective as individual therapy. Group therapy is also more efficient.
Erford (2010, pp. 309-315) states that hundreds of studies over the past 50 years indicate that group therapy is very effective. He draws several conclusions from the research. Group work is more effective than individual therapy when ten or fewer sessions are conducted. The research indicates that structured groups are more beneficial than unstructured groups. A lack of structure leads to client difficulties with interpersonal fears, cognitive distortions, subjective distress and premature termination. Pre-group training has been shown to boost treatment outcome, interpersonal interactions and attendance. Effective leaders have been shown to nurture a sense of hope and display positive personal characteristics. The research indicates that nearly 50% of all group work casualties are produced by a leadership style which involves high stimulus input, intrusiveness, confrontation and challenge.
This chapter has touched the surface in the areas of diversity, ethics and research. I would encourage you to do further study in these areas.
Questions to ponder
1.Is it important to be aware of diversity in the group? If so, why? If not, why not?
2.If you were to summarize ethics in one sentence, what would it be?
3.The research shows that group therapy is as effective as individual therapy. Do you agree
or disagree? Why?