Group Counseling This Work Explores

Group Counseling

This work explores group counseling and examines what group counseling actually is and what the purpose of group counseling is. Secondly, this work examines ethics in counseling and specifically those ethics of the Christian counselor in maintaining Biblical principles in counseling and what the ethical requirements of the Christian counselor are. Findings in this work include the important and key role of the group leader or facilitator in keeping the interactions and communications positive in order to avoid harm to group members.

GROUP COUNSELING

This work will first compare/contrast views on what current literature states on group counseling in what it is and what it is not within professional view of group counseling. Attention will be given to ethical considerations including how professional codes of ethics are congruent or incongruent with biblical principles of group counseling. Specifically related will be the function of this information to the current understanding of the writer of how a therapist will function in the role of group counselor. Additionally this work will include how this will affect the therapist and the implications for decisions regarding educational training and preparation as well as the setting and context of where and how counseling will take place, the type of clients that will be worked with and how the writer views this in affecting personal, family and church life.

METHODOLOGY

The method of research conducted in this work is of a qualitative nature through an extensive review of academic and professional peer-reviewed literature in this subject area.

KEY TERMS and DEFINITIONS

AACC - American Association of Christian Counselors

ASGW - Association for Specialists in Group Work

BACKGROUND to the STUDY

The work of Stockton, Morran and Krieger (2004) states, in the work entitled: "Research and Best Practices for Training Group Leaders" that group counseling and psychotherapy originated in 1905 with Joseph Pratt, a physician, who "used a group of 'class' format to assist patients with tuberculosis. Throughout the remainder of the 20th century, groups emerged as an increasingly popular mode of intervention in psychotherapy and counseling settings." (Stockton, Morran, and Krieger, 2004) Group methods are popular in use today "across a wide variety of settings to assist clients who present with a diverse range of goals and concerns," (Stockton, Morran and Krieger, 2004) Group counseling is an approach to treatment that is considered to have the same relevant effectiveness as individual counseling. There are various methods used in the group counseling therapy and there are very few studies to provide solid evidence of the direction the group leader should take however, preliminary findings do state that positive interaction with the group leader and the members of the group is vital to successful intervention. Group counseling is known to have benefits including:

1) Learning to communicate more comfortably and effectively;

2) Identification and exploration of inner feelings;

3) Gaining feedback from others;

4) Learning to express oneself and act on one's own behalf;

5) Being honest with self and others;

6) Gaining sensitivity to the ways that others communicate;

7) Learning about intimacy; and (8) Experimentation with new ways of relating. (What is Group Counseling, 2007)

I. COMPARE/CONTRAST CURRENT VIEWS on GROUP COUNSELING

The work of Riva, Wachtel and Lasky entitled: "Effective Leadership in Group Counseling and Psychotherapy" published in the Handbook of Group Counseling and Psychotherapy (2004) states that group counseling and psychotherapy "has been consistently been found to be effective with a broad range of problem areas and clients." Stated to be an essential component in the effectiveness of therapeutic groups is "the leadership."(Riva, Wachtel and Lasky, 2004) the group leader's role is a vital one "in both the dynamics of the group and the outcomes of its members." (Riva, Wachtel, and Lasky, 2004) There is much yet unknown about effective facilitation of group counseling leadership yet, "several leadership characteristics and behaviors are correlated with group effectiveness." (Riva, Wachtel, and Lasky, 2004) it is related that "The American Counseling Association Code of Ethics and Standards of Practice (1997) set as a criterion the need for group counselors to 'select group members whose needs and goals are compatible with the goals of the group, who will not impeded the group process, and whose well-being will not be jeopardized by the group experience." (Riva, Wachtel, and Lasky, 2004) the selection methods are "highly subjective and based on leader intuition." (Corey and Corey, 1997; as cited in Riva, Wachtel and Lasky, 2004) in a national survey of 75 group leaders, it is related that these leaders "almost exclusively used clinical judgment to determine whether the client possessed some specific behavior or characteristic that would be beneficial for group membership." (Riva, Wachtel and Lasky, 2004) it is related that the procedure most commonly used for making the decision of who would participate in and was appropriate for this participation in a group "was whether the person fit the specific group theme." (Riva, Wachtel and Lasky, 2004) Riva, Wachtel, and Lasky (2004) state that: "In other words, rather than selecting members because of specific personality characteristics that would increase the likelihood for them and other group members of having a successful group experience, a person with an eating disorder would be referred to an eating-disorder group." (Riva, Wachtel, and Lasky, 2004) Additionally related by Riva, Wachtel, and Lasky is that there are two areas that have received attention and support in "the selection of criteria literature" which are the:

1) Interpersonal; and 2) Intrapersonal characteristics of potential group members. (Riva, Wachtel and Lasky, 2004)

Pre-group preparation is held by many practitioners to be a vital part of the development of cohesion within a group and is also associated with satisfaction among the group members as well as decreasing the risk that members will drop out of the group. This preparation can be utilized for addressing procedural information and in assisting group members understand the manner in which the group will function. This is especially critical when the group consists of a combination of members who have never taken part in group counseling. While there is not a standard model for group preparation, the work of Riva, Wachtel and Lasky (2004) suggests a four-step model as follows:

One - Identify needs, expectations, and commitment of client;

Two - Challenge any myths or misconceptions;

Three - Convey information; and Four - Screen the individual for 'group fit'.

The work of Burlingam, Furhriman and Johnson (2001) provide a description for pre-group preparation "as one of their six empirically supported principles regarding the therapeutic relationship." (Riva, Wachtel, and Lasky,2004) Burlingame, Furhriman, and Johnson 20010 state the "pregroup preparation sets treatment expectations, defines group rules and instructs member in appropriate roles and skills needed for effective group participation and group cohesion." (as cited in Riva, Wachtel, and Lasky, 2004) Also highlighted in the work of Riva, Wachtel and Lasky (2004) is the fact that research greatly supports the perspective of group leaders being "crucial in the development of a positive group climate and that for group members, a supportive relationship with the leader is necessary for client change." The reason cited for this is that when members of a group hold a "favorable view of their leaders" these individuals are much more likely to make progress of a substantial nature.

Riva, Wachtel and Lasky (2004) report the work of Dies (1994) who reviewed 135 studies and states conclusion that: "Group members favor and seem to benefit more from a positive style of intervention, and that as leaders become more actively negative, they increase the possibility that the participants will not only be dissatisfied, but also potentially harmed by the group experience." (as cited in Riva, Wachtel and Lasky, 2004) the use of structure by the leaders is another aspect of group counseling noted in the work of Riva, Wachtel and Lasky who state that: "...structure is conveyed when the group leader discusses the norms of the group. Some typical norms include the importance of attendance and what member should do if they're unable to attend, how communication occurs and clear norms about confidentiality and its limits." (2004) Group leaders also help to structure the group through introduction of group themes and through providing intervention in communications that are of a destructive nature between members in the group. The group leader further holds to light the positive interactions, which take place and provides a sense of safeness in assisting members gain and understanding regarding their behaviors and their actions. The work of James P. Trotzer (2004) entitled: "Conducting a Group: Guidelines for Choosing and Using Activities" states that "Structured group activities have many labels but are distinguished from leadership skills, functions, or roles by characteristics that make them entities unto themselves, with specific traits that define their nature." While some refer to tem as "procedures, techniques, human relations, or communication activities, exercises and even catalysts...the traits that offer a working definition of the nature of these are as follows:

1) Group activities have specific instructions and parameters that give group members a format and focus for interaction;

2) Materials and props (pencils, paper, paint, music, etc.) may typically be used in the conduction of the activity; and 3) Activities can be standardized and adapted with a minimum of alteration for use across groups and members so that a common framework can be replicated. (Trotzer, 2004)

The main feature of activities are:

1) Technical; and 2) Mechanical and have "...parameters and directions that make them merely tools." (Trotzer, 2004)

Categorization of the activities of a group are on the basis of:

1) focus; and 2) types of communication involved and may be intrapersonal or interpersonal with communication that is verbal or nonverbal in nature. Intrapersonal activities are for the purpose of enhancing communications between individuals in the group and are 'nonverbal' activities. All activities of the group are within one of the following categories:

Verbal Interpersonal Activities;

Non-Verbal Intrapersonal Activities; and Non-Verbal Interpersonal Activities. (Trotzer, 2004)

Some activities may be characterized by nonverbal and verbal activities with the example given being: "...where a member first does a self-assessment task, nonverbally, alone and then verbally discloses what was experienced or learned." (Trotzer, 2004)

The work of DeLucia-Waack and Fauth (2004) entitled: "Effective Supervision of Group Leaders: Current Theory, Research, and Implications for Practice" states that "the essence of supervision for group leaders is to help them remove the 'logs' (e.g. anxiety, insufficient skills, limited awareness of self or group process) from their own eyes so that they might intervene more effectively (i.e. help group members to take the specks out of their eyes as well)." This framework is based upon Luke 6:41-44 in the New Testament of the Bible. It is related that the Association for Specialists in Group Work's (ASGW) Professional Standards for the Training of Group Workers (2000) "specifies a minimum level of 1 hours a week of planning time for group leaders" whether this is on an individual basis or with a co-leader. Research in this area stresses the importance of supervision of group leaders because "without supervision, group therapists were not able to identify mistakes and generate new plans of action; instead they became stuck in a cycle of repeated ineffective interventions." (DeLucia-Waack and Fauth, 2004) the work of Rapin (2004) entitled: Guidelines for Ethical Practice and Legal Practice in Counseling and Psychotherapy Groups" states the fact that "ethical dilemmas and choice points occur in every phase of group counseling, and psychotherapy planning, performing, and processing. Group facilitators need to navigate an ethical course while providing for the therapeutic needs of group members." This is specifically true for Christian Counselors, which is dealt with in the following section of this work.

II. AACC CODE of ETHICS

The American Association of Christian Counselors AACC Code of Ethics is designed "to assist AACC members to better serve their clients and congregants and to improve the work of Christian Counseling worldwide. This code is stated to be a "...comprehensive, detailed and integrative synthesis of biblical, clinical, systemic, ethical and legal information." (AACC Code of Ethics, 2004) Stated as the reason it is created in this manner is because "vaguely worded, content limited and overly generalized codes are insufficient for the complexities of the modern, 21st century counseling environment. A more comprehensive and behavior-specific ethical code is needed for Christian counselors because of: (1) the mounting evidence of questionable and incompetent practices among Christian counselors, including increasing complaints of client-parishioner harm; (2) the largely unprotected legal status of Christian counseling, including the increasing state scrutiny, excessive litigation, and unrelenting legalization of professional ethics; and more positively; (3) the vitality and growing maturing of Christian counseling -including its many theories and controversies - indicating the need for an overarching ethical-legal template to guide the development of biblical and empirically sound Christian counseling models." (AACC Code of Ethics, 2004) This Code have four influences:

1) the Bible (Old and New Testament);

2) Accepted standards of counseling and clinical practice from Christian counseling and the established mental health disciplines;

3) Code of ethics from other Christian and mental health professions; and 4) Current and developing standards from mental health and ministry-related law." (AACC Code of Ethics, 2004)

The following are the 'Biblical-Ethical Foundations of the AACC Ethics Code:

First Foundation: Jesus Christ -- and His revelation in the Old and New Testaments of the Bible -- is the pre-eminent model for Christian counseling practice, ethics, and caregiving activities.

Second Foundation: Christian counseling maintains a committed, intimate, and dedicated relationship with the world-wide church, and individual counselors with a local body of believers.

Third Foundation: Christian counseling, at its best, is a Spirit-led process of change and growth, geared to help others mature in Christ by the skillful synthesis of counselor-assisted spiritual, psycho-social, familial, bio-medical, and environmental interventions.

Fourth Foundation: Christian counselors are dedicated to Jesus Christ as their 'first love,' to excellence in client service, to ethical integrity in practice, and to respect for everyone encountered.

Fifth Foundation: Christian counselors accord the highest respect to the Biblical revelation regarding the defense of human life, the dignity of human personhood, and the sanctity of marriage and family life.

Sixth Foundation: The biblical and constitutional rights to Religious Freedom, Free Speech, and Free Association protects Christian counselor public identity, and the explicit incorporation of spiritual practices into all forms of counseling and intervention.

Seventh Foundation: Christian counselors are mindful of their representation of Christ and his church and are dedicated to honor their commitments and obligations in all social and professional relations. (AACC Code of Ethics, 2004)

Section I-540 deals with "Working With Couples Families and Groups" and states that: "Christian counselors often work with multiple persons in session -- marriage couples, families or parts of families, and small groups -- and should know when these forms of counseling are preferred over or used as an adjunct to individual counseling. In these relationships we will identify a primary client -- the group as a unit or the individual members -- and will discuss with our client(s) how our differing roles, counseling goals, and confidentiality and consent issues are affected by these dynamics." (AACC Code of Ethics, 2004)

Section I-541 relates to: "Safety and Integrity in Family and Group Counseling" and states that: "Christian counselors will maintain their role as fair, unbiased, and effective helpers in all marital, family, and group work. We will remain accessible to all persons, avoiding enmeshed alliances and taking sides unjustly. As group or family counseling leaders, Christian counselors respect the boundary between constructive confrontation and verbal abuse, and will take reasonable precautions to protect client members from any physical, psychological, or verbal abuse from other members of a family or group." (AACC Code of Ethics, 2004)

Section I-542 relates to "Confidentiality in Family and Group Counseling" and states that: "Christian counselors do not promise or guarantee confidentiality in family and group counseling, but rather explain the problems and limits of keeping confidences in these modes of therapy. We communicate the importance of confidentiality and encourage family or group members to honor it, including discussion of consequences for its breach. Christian counselors do not share confidences by one family or group member to others without permission or prior agreement, unless maintaining the secret will likely lead to grave and serious harm to a family member or someone else." (AACC Code of Ethics, 2004)

Section I-543 deals with "Avoiding and Resolving Role Conflicts" stating that: "If and when Christian counselors are asked to perform conflicting roles with possible unethical consequences (i.e.: pressure to keep "secrets" or called to testify as an adverse witness in a client's divorce), we will clarify our therapeutic, neutral, and meditative role and/or decline to serve in a conflicted capacity, if possible. Some counselors will contract for professional neutrality at the beginning of professional relations, securing client agreement not to have oneself or one's records subpoenaed or deposed in any legal proceeding." (AACC Code of Ethics, 2004)

Specific ethical standards are set out for Christian Counselors and the first of which is "Do No Harm." (AACC Code of Ethics, 2004) it is critically important that the Christian counselor affirm the "God-given dignity" of all individuals, which includes the unborn, the living, and the dying. The AACC code of ethics relates that all individuals are the creation of God and are "in fact, the crown of His creation - and are therefore due the rights and respect and ordered logic that this fact of creation entails." (AACC Code of Ethics, 2004) What this really boils down to is that regardless of the harmful attitudes of actions of the individual in counseling care, the counselor is required and charged with the duty of responding to the individual in a manner of "loving care." (AACC Code of Ethics, 2004) This might be particularly complex and difficult in some cases where a man has beaten his wife and children in a drunken rage or where a member of the congregation has sexually assaulted someone perhaps even his own children. However, the counselor is required and bound by the code of ethics as well as by the law of God to treat this individual in a manner that conveys the unconditional and unchanging love of God. This example of God's love must necessarily be reflected in the counselor in his or her interactions with this individual.

Section 1-111 of the AACC Code of Ethics (2004) relates the unavoidability of conflicts among clients in counseling and states that "In fact, conflict and resistance are often a central dynamic of the helping process." (AACC Code of Ethics, 2004) in the event that a counselor comes under a temptation to respond to these conflicts inappropriately, the counselor "shall seek out consultative and restorative help" in order to regain self-control and avoid harming the client. If self-control being regained is not possible, it is the responsibility of the counselor to make a referral in the best interest of the client. Section 1-120 of the AACC Code of Ethics (2004) addresses the situation wherein the client is participation in harmful action and states that the responsibility of the counselor is to "refuse to condone, advocate for, or assist with the harmful actions of clients, especially those that imperil human life from conception to death." In other words, should a woman have had an extramarital affair and become pregnant, it is not acceptable for the counselor to agree with or approve of an abortion, even if this might save the woman's marriage and this is reiterated as well in Section 1-122 relating to abortion. Section 1-121 expresses clearly, that the counselor must refuse to "condone, advocate for, or assist with the suicidal, homicidal, or assaultive abusive harm to self or others by clients." (AACC Code of Ethics, 2004) the many Sections of rules and regulations within the AACC Code of Ethics are simply Biblical principles reiterated as the counselor must not condone any type of behavior that is against the principles as set out in the Old and New Testament of the Bible. This is not assuming laws relating to eating of foods and the like but in relation to the Ten Commandments and the principles of brotherly love as set out in the New Testament