Thursday, October 31, 2013

Role Play/Diversity

I am having a really difficult time with this blog/journal format, as I always have in many of my classes. I kept trying to write the diversity ones but have had trouble collecting my thoughts. I will try and get that one up over the weekend. I will also try to add some extra ones throughout November to make up for the ones I've missed.


Researched Group Role Play

Though I am not playing the group leader in my role play, I decided to do a write-up of the role of a group leader in solution focused group therapy for our handout. So I have been doing a lot of research on group leader characteristics and techniques anyway. I was able to find most of what I needed in the Corey chapter, as he gives a lot of information about the proper functions and characteristics of a SF group leader. Though it's not a specific SF technique, the role of the leader appears important to the creation of an environment conducive to the SF process, so I think it's worth exploring a little on the handout. I also used the section to talk about the use of compliments as Corey describes.

I tried to do some more research into the linguistic-construction of reality ideas that permeate SF literature, but I haven't found anything too deep yet in the types of places I research. I probably keep looking and expand my search outside of SW/counseling lit because I was a linguistics major for about 20 minutes, and Sapir-Whorf things are interesting to me. I think the idea of a linguistic construction of reality is interesting, however I am skeptical that brief therapy in the solution focused style can really change that kind of framework in a short period of time. I wonder if changing someone's construction of reality at the linguistic level is a more realistic goal for psychodynamic therapy since language is so tied to early development, but I understand how the theory guides the SF framework.

 I created my character based on some of the kids I worked with during my first field at a high school, and didn't do a lot of research around that initially. I hadn't put too much thought into race or ethnicity at first, I just had a 14-year-old girl in mind, but I decided that since we wanted to show diversity in our role play, I would make her multiracial so that I would have to do more research about SFT with different cultures and populations. My general sense of preparedness around diversity is summed up in the Socratic idea of the truly wise person being the one who admits that s/he knows nothing. I'm not saying I know nothing, but I think in therapy it's good to refrain from making assumptions about something or someone you don't know a lot about. My general approach to working with people different from me is to ask genuine questions to improve my understanding of them and their framework, and to practice cultural humility in my day to day life. Research can help too I suppose but talking to people is most important. I will talk more about this in relation to the diversity blog prompt soon.



Thursday, October 10, 2013

Transference and Modeling

In light of the topic of psychodynamic group therapy, I've been thinking about transference, and how it relates to the skill of modeling. Yalom writes about the inevitability of transference in the group, and how this isn't a bad thing, but something to be therapeutically utilized. In this chapter Yalom goes into detail about the kind of resistances that can develop in the group because of negative transference reactions, and how the therapist can use these opportunities to model a particular behavior in order to influence the client. Mr. Price talked about this as well, and how he uses modeling and transference to help clients repair the schemas (or whatever he called it, lol CBT term) they developed about attachment figures and relationships.


This technique can only work if the therapist can hold it together in the face of hostile clients and not let their own bruised emotions get in the way. These are the situations that scare me a little bit, because I worry that I won't be able to keep calm and rational in the face of hostility from clients. I score pretty highly on neuroticism scales and deal with depression on and off, and am just the kind of person who is easily batted around by negative emotions. Because of this, I have to be aware of my struggles with emotional stability and continue to work on them. Only by dealing with my own problems can I authentically model that behavior to clients.


Thursday, October 3, 2013

Group Leaderships Cont. + CBT Presentation

The presentation on Cognitive Behavioral Group Therapy got me thinking about "Questioning," one of the skills from the leadership self assessment. Dr. 2343 talked a bit about Socratic questioning in CBT, and how it differs from the types of questioning used in other models like SFBT. He reinforced that in CBT, the questions should be aimed at maladaptive thought patterns and ways of thinking. This differs from the line of questioning in something like SFBT, where the questions are more...pragmatic? And goal oriented. I've been thinking a lot about how carefully questions need to be formed in order to achieve what your therapeutic model is trying to achieve. This is obvious, but easier said than done, especially when you're having to come up with questions off the cuff in a real group. I think if I had the chance to really practice with one therapeutic model like CBT it would come naturally, but at this point in my learning I still have to think a lot about what I'm going to say.


Thursday, September 19, 2013

Group Leadership Assessment Week #1

Completing the Group Leadership Assessment reminded me a bit of filling out my self-assessments for field last year. I had to reflect on many of the skills mentioned in the group leadership assessment, such as: active listening; reflecting, clarifying, and summarizing; evaluating; empathizing; and interpreting. The field assessment focused on general relational skills, not group work. Fortunately I was able to work on a lot of these skills with groups during my field placement.


I'm good at reflecting, clarifying, summarizing, active listening - anything that you get a lot of practice with in individual work. I spent most of my time at field doing individual work, and I had a lot of practice in the relational and listening skills. Sometimes I worry that I'm not a great listener in daily life, because I can be kind of absent minded and daydreamy, but when I can focus on a client without too many distractions, it's not a problem. Active listening in groups is more difficult, because I want to focus exclusively on the person who is speaking, but I also have to be aware of the behavior of the other people present. This is why it can be good to have a cofacilitator; I can worry less about missing something.


Facilitating a group is probably the skill I'm least comfortable with. Even though I had more practice than most of my classmates during field, I didn't get a lot of group-specific guidance from my supervisor, and we didn't cover it very much during class last year. I worked on facilitation mostly through trial and error and practice, and discussion with my cofacilitators. Additionally, most of the groups I facilitated were psychoeducational, and I was encouraged to focus on that, not really on group member interactions, and the use of the group dynamic to facilitate change. That is something I'd like more practice with in final field, potentially.

I'm good at looking for patterns in abstract stuff, so I like linking in groups - taking something one person said and drawing connections to what others have said. I had a lot of practice blocking in my groups, because my clients were high schoolers and they like to talk over each other and derail the conversation. I'm less comfortable with confronting because I worry about pushing people before they are ready and putting them on the defensive.




Thursday, September 12, 2013

Blog #2 - In the Beginning

In reading Yalom's chapters on group formation and the beginning phase, the bit that stuck out the most to me was the importance of group cohesiveness as a mechanism for change. I knew that group cohesiveness was important but I never thought of it as analogous to the therapeutic relationship (I don't know why, it's kind of obvious once it's spelled out for you). Yalom states that both the client-therapist relationship in individual therapy and group cohesiveness in group therapy create the same conditions necessary for growth and change, such as: opportunities for inter- and intrapersonal exploration, catharsis and risk taking. In both of these settings it is important for the client to feel that their emotional experience is validated and accepted, and this can come from the therapist or group members. Yalom mentions that some clients find acceptance by group members more meaningful than acceptance by therapists because they aren't getting paid to do it. This is one of the advantages that group work has over individual work.

Reading about the importance of group cohesiveness just underscored everything that comes later in the book about forming groups. It's clear to me now that since cohesiveness is so important, ensuring that it is developed and maintained is just as important as planning curricula or activities for a group. I will always keep this in mind. I think learning to recognize good group cohesiveness or encourage it along is something difficult and abstract in practice that I can only learn from experience.

I found Yalom's exploration of client selection methods interesting; especially coming from my psychology background. I've studied a bit about psychological assessment and I love the idea of a pre-therapy group meeting in order to assess possible members' goodness of fit by watching them socially interact in real time. It's very psych. I don't know how feasible it would be in real life though, since I imagine we don't get too much power over client selection in the real world. Yalom's pragmatic advice of having exclusion criteria rather than inclusion criteria and focusing on behaviors that could disrupt group cohesiveness is what I'll be keeping in mind. When I was at my field placement at Akins, we met briefly with students who were interested in our groups individually so that we could talk to them and get a "feel" for whether they are "group appropriate." These were nebulous concepts that my supervisor never concretely explained. Basically I was to look out for kids who seem like they might be disruptive or flaky, or if they seemed to be at a level of emotional or cognitive development incongruent with other group members. It was a murky, trial and error thing, and I imagine it's something you develop a instinct for after years of practice.





Friday, September 6, 2013

Blog #1

Hi, I'm Megan. I graduated from UT Austin in 2012 with a Bachelor of Arts in Psychology. I also have a Certificate in European Studies which means I took too many German classes in college. Deutschland Uber Alles. Just kidding, but really if you can get past the obsession with rules, purity and self-loathing it's a wonderful country.

I'm a second year clinical student and I'm interested in mental health, psychological disorders, counseling and psychotherapy. I've worked, interned, and volunteered at a psychiatric hospital, counseling clinics, a sex education program, and a science lab full of snakes and spiders where people studied anxiety disorders. I love psychology and have made many a buck volunteering to be experimented on by the fine researchers at UT's Psychology Department during my time in undergrad.

My first year field placement was at Akins High School ~ Student Support Services. I started co-facilitating a few different support groups pretty early in my internship, so I think I had a lot more opportunities to work with groups than other students in my year. For most of my time at Akins I facilitated or co-facilitated two closed groups each week. The groups took place during school hours and had about 3-12 students depending on the group. The groups were support and psychoeducational in nature and included: Anger Management, managing anxiety and depression, LGBTQ support, and healthy relationships. I liked planning and running most of the groups, especially the depression and anxiety one because of the heavy emphasis on mental health.

Because of my experiences I don't have much fear about working with groups of teenagers. I'm still nervous about working with adults or children in groups (or individually) because I've never done that before. I do find individual work more nerve-wracking than group work, because I feel like there's more pressure on me. I find groups to be more laid back than individual sessions, at least in my limited experience. I hope to learn more tools and strategies for working with groups and individuals, and I'm excited to read the Yalom book. I have an old edition from the '70s that I picked up at Half Price Books once on a whim (because that's the kind of person I am). I'm sure I will be comparing editions and snickering at outdated stuff because I am incredible nerd and that's the sort of thing I do for fun.

On the reading...

It appears that most of the participants chose to study group work because they tried it and enjoyed it or felt like they were good at it. That's always the best reason to learn something useful, right? It's also good to feel like you're good at something. I imagine a lot of the study participants expected their groups to go horribly, and were surprised at skills they didn't know they had. That was my experience at Akins.

A secondary reason appears to be because of the career benefits of having advanced group work skills. The article's introduction discusses the growing emphasis on group work in today's budget-limited world, and social work education's concurrent shift toward generalist education with less advanced instruction in group work or other areas. This has apparently led to less student's graduating with advanced study of group work at a time when we need practitioners with those skills more than ever. Quite the conundrum, but certainly not the only problem with social work education in North America. I'm not quite sold on the "generalist" education. I feel like I've learned a little of everything, but I still know nothing. I wish we had more opportunities for advanced study of group work (and other specializations).

I think this implies that social work schools should give students more opportunities to experience group work (or force them to). I think a lot of people would find that if they try it, they'll like it. Making students do group work during first field like UT does (all CSWE accredited school's might require it for all I know) is a good strategy. I think the idea of group work puts off a lot of people because it feels more like public speaking than casework or individual therapy, and almost everyone is afraid of public speaking. I just had to be forced to do groups a few times before it quit being scary and started being fun.

I like working with groups and individuals. I get bored easily so I hope I get to do lots of both in my career as a therapist.