A
TIME-LIMITED PSYCHOTHERAPY GROUP MODEL
FOR DEVELOPING EMOTIONAL INTELLIGENCE:
THE EIPG MODEL FOR COUNSELING CENTERS
Randal Scott Pennington - Psy.D.
ABSTRACT...................................................................................................ii
I.
INTRODUCTION.........................................................................................1
Definitions....................................................................................…......
......10
II. REVIEW OF THE LITERATURE.................................................................12
Emotional
Intelligence............................................................................….....13
Time-Limited Group
Psychotherapy....................................................…….......29
III. ECLECTIC TIME-LIMITED THERAPY MODEL.................................…….....47
IV. THE EMOTIONAL INTELLIGENCE PSYCHOTHERAPY
GROUP MODEL..............................................................................…….......59
V. IMPLICATIONS OF THE EIPG MODEL.........................................……......84
REFERENCES..................................................................................….........91
A. Client Information Handout ..............................................................……..103
B. Ways of Knowing Profile Questionnaire...........................................……....110
C. Multifactoral Emotional Intelligence Scale (MEIS)......................………........113
D. Outcome Questionnaire-45.........................................................……........132
Counseling centers are experiencing increases in the number of students who present with severe psychological and emotional discomforts. The increasing student demands for clinical services poses a challenge for counseling centers with staff limitations, limited resources, and tight budgets. Counseling centers are in a position to consider and to adopt alternative and creative strategies in meeting these demands. Structured, time-limited group psychotherapy is a viable strategy for meeting these demands but continues to be underutilized in counseling center settings. The increasing levels of emotional discomfort among students has moved some writers to challenge counseling centers to dispense "emotional education" and opportunities for students to develop emotional competencies to assist them in managing their emotional lives. The emotional intelligence framework developed by Peter Salovey and John Mayer is incorporated into a model of time-limited group psychotherapy answering the call for counseling centers to provide emotional education while maximizing the benefits of group psychotherapy. The implications of the Emotional Intelligence Psychotherapy Group (EIPG) model are discussed along with ethical issues surrounding multicultural sensitivity and competence in working with students who have different cultural and familial standards for the experiencing and expressing of emotion.
INTRODUCTION
Surveys conducted with university and college counseling center directors during the 1980’s up until the mid 1990’s found most directors agreeing that there were significant increases in the level of psychopathology among students seeking clinical services when compared to previous decades (Stone & McMichael, 1996; O’Mally, Wheeler, Murphey, O’Connel & Waldo, 1990; Bishop, 1990; Bishop, 1991; Pledge, Lapan, Heppner, Kivlighan, and Roehlke, 1998). The increases were seen in the number of cases with eating disorders, substance abuse, affective dyscontrol, pathological gambling, dysfunctional family experiences (alcoholic parents, physical, emotional, and sexual abuse), sexual violence (date rape and sexual assault), moderate to severe levels of depression and anxiety, history of psychiatric treatment or hospitalizations, and high subjective ratings of distress (Pledge et al. 1998; Whitaker, 1996; Dworkin & Lyddon, 1991; Murphy & Archer, 1996). A number of possible explanations may account for these increases. The number of high school seniors enrolling in higher institutions of learning is increasing and some of these students may be ill-prepared for the stress and expectations of college life (Kiracofe, 1993). The demographic profile of students is also changing. Non-traditional students are returning to universities and colleges in increasing numbers due to loss of jobs, changes in career, and divorce (Kiracofe, 1993; Archer & Cooper, 1998). Mental health treatment has also changed over the years with advancement in psychotropic medications and deinstitutionalization policies allowing more students with psychiatric histories to pursue education at the college or university level (Kiracofe, 1993). Archer and Cooper (1998), after reviewing the literature, conclude that:
". . . compared with students in the past, students today arrive on campus with more problems as a result of dysfunctional family situations, with more worries and anxieties about the future and about the serious problems facing them in modern society, with an increased awareness of their own personal demons, and with a greater willingness to seek psychological and psychiatric help" (p. 6).
Whitaker (1996) predicts future college students to be more "troubled on the whole while society continues to be more and more neglectful and harmful to children and adolescents." Stone and Archer(1990) conclude from their review of the literature that there is sufficient evidence from many quarters indicating that the level of psychopathology in students had increased significantly during the 1980’s and would likely continue to increase during the 1990’s. Later survey research supports this prediction although the severity appears to be reaching a plateau (Heppner, Kivlighan, Good, Roehlke, Hills & Ashby, 1994; Pledge et al., 1998).
The growing list of serious student problems and concerns suggests that students are experiencing greater emotional discomfort. Students are likely to experience one or more of the following: (a) the pain of acute or chronic negative affect, (b) fear of feeling, (c) emotional numbing, (d) perplexing emotional reactions, (e) emotional conflict of ambivalence, or (f) experiences associated with "unfinished" or inadequately expressed affect (Mahoney, 1995; McWhirter, 1995; Gold, 1996). McWhirter (1995) has argued for students who present at counseling centers to obtain an emotional education, an opportunity to develop greater emotional knowledge and skills that parallel and support the development of academic intellectual abilities. Robertson and Freeman (1995) had similar ideas when they developed a ten session psychoeducational group model for university men who struggle with the identification and expression of feelings. Male participants in these groups were educated about the positive and adaptive functions of emotions. Each session was devoted to discussing definitions of emotions, their purposes, related vocabulary, homework and exercises that increased awareness of the various emotions. Other examples of counseling center-based interventions intended to address some of the above concerns include psychotherapy groups for "alexithymics" or individuals who are not able to identify, label, or express emotion (Swiller, 1988; Fischer & Good, 1997) and for students who perpetrate verbal and/or physical aggression in response to angry feelings and frustrating situations (Castronovo, 1995).
The increasing demand for student clinical services at counseling centers poses some challenges to administrators, directors, and mental health service providers. Many counseling centers are faced with budget constraints, staff limitations, limited resources, and waiting list problems (Stone & Archer, 1990; Archer & Cooper, 1998; O’ Malley et al., 1990; Fuhriman, Paul & Burlingame, 1986). Many counseling centers address these issues by adopting time-limited philosophies and managed care principles (Burlingame, Fuhriman, Paul, & Ogles, 1989; May, 1988). A popular way for counseling centers to address these issues is to limit the number of individual counseling or psychotherapy sessions allowing more students access to such services (Golden, Corazzini, & Grady, 1993; Fuhriman & Burlingame, 1990). Group psychotherapy has been viewed as second rate treatment compared to individual psychotherapy (Archer & Cooper, 1998; Cooper & Archer 1999) even though empirical data continues to demonstrate little or no difference between outcomes of individual and group psychotherapies. (McKenzie, 1997; Bergin & Garfield, 1994). Group psychotherapy has been touted as a viable method of service delivery to meet the increasing demands (Steenbager, 1992; Fuhriman et al., 1986; Stone & Archer, 1990; McKenzie,1997). Group psychotherapy can assist counseling centers in serving a greater number of students while preserving staff’s clinical time and limited resources.
A national survey of 148 college and university counseling centers found that (92%) of the respondents were actively utilizing group psychotherapy, but that only a fraction (less than 20%) of their clients were involved in any type of group treatment (Golden et al., 1993). Counseling centers may not be realizing the potential benefits of group psychotherapy (Golden et al., 1993; Burlingame & Fuhriman, 1987; Stone & Archer, 1990). Counseling centers often have settings and cultures favoring individual psychotherapy, making it a challenge to create and implement group psychotherapy. When university counseling center staff are open to and optimistic about group psychotherapy, then the group psychotherapy service delivery option can be as effective, if not more than individual psychotherapy (Archer & Cooper, 1998; Crosby & Sabin, 1995).
The most frequently offered type of psychotherapy group in counseling centers is the time-limited, structured topic groups where group leaders have a specific planned agenda (Golden et al., 1993). These groups may also be labeled "focus" (McKay & Paleg, 1992; May 1988) or "common theme" (Andrews, 1995) groups. Time-limited groups were predicted to be the main service delivery option in the future for most counseling centers (Fuhriman et al., 1986) although the literature continues to demonstrate individual psychotherapy as the most common treatment modality used (Golden et al., 1993).
The aim of most time-limited structured groups is to teach group participants knowledge and skills they can use to prevent future developments of psychological or emotional problems (Andrews, 1995). These groups do not try to "undo" anything in the participants, but simply provide opportunities for them to develop knowledge and skills they did not have before. The consensus of the literature highly recommends that counseling centers promote time-limited group therapy modalities in order to serve greater number of students seeking clinical services (Archer & Cooper, 1998; Stone & Archer, 1990; O’Malley et al., 1990; Fuhriman et al., 1986; Burlingame & Fuhriman, 1990). For many years, most counseling centers operated on principles of managed care (Archer and Cooper 1998) by holding costs down and offering services to greater numbers. By utilizing time-limited psychotherapy groups more frequently and effectively, counseling centers can achieve this aim more readily than limiting individual psychotherapy sessions (Hoyt, 1995; Budman, Demby, Redondo, Hannan, Feldstein, Ring, & Springer, 1988; Spitz, 1996; Steenbarger & Budman, 1996).
The primary mission of most universities and colleges is educational and mental health counseling centers should provide psychological health education programs relating to emotional problems (Arnstein, 1990). Counseling centers are often seen as emotional remediators rather than developers (Slimak, 1992). The purpose of this dissertation is to present a time-limited group psychotherapy program with an educational component designed to help students develop emotional knowledge and competencies enabling them to cope more effectively with future developments of psychological or emotional discomforts (Salovey, Bedell, Detweiler, & Mayer; 1999). The model will focus on the development of mental abilities to: (a) perceive, appraise, and express emotion, (b) assimilate basic emotional experiences into mental life, (c) understand and reason with emotion, and lastly (d) manage and regulate emotion adaptively (Mayer & Salovey, 1990; Salovey & Mayer, 1997. The model does not restrict group membership based on diagnostic categories (e.g. depressive or ADHD groups), or narrow themes such as "loneliness" or "anger management," thereby making it flexible and inclusive.
The proposed model is a modification of the Eclectic Time-Limited Therapy (ETLT) Model developed by Fuhriman, Paul, and Burlingame (1986). The ETLT model originally was a conceptual framework for the individual psychotherapy treatment modality, however, the philosophy and concepts also apply to group psychotherapy. ETLT model is an eclectic ten session model which can be adapted to any theoretical orientation of the group therapist. The model was developed primarily to reach a larger number of students and address the waiting list problems (Fuhriman et al., 1986). The ETLT model will be a template for the time-limited psychotherapy group model proposed herein and the agenda of the group will be provided by the "emotional intelligence" framework by Salovey and Mayer (Salovey & Mayer 1990; Mayer & Salovey, 1997).
The concept of emotional intelligence has gained considerable attention since the publication of Daniel Goleman’s popular best seller, Emotional Intelligence (Goleman, 1995). Emotional intelligence (EI) is a conceptual framework for understanding individual differences in the abilities to: (a) perceive, appraise, and express emotion accurately in self and others; (b) assimilate emotion and thought; (c) understand, analyze, and reason with emotions; and (d) regulate emotions in self and others adaptively (Salovey & Mayer, 1990; Mayer & Salovey, 1997). Although there are other competing definitions of emotional intelligence in the literature (Payne, 1986; Goleman, 1995; Bar-On, 1997), Salovey and Mayer’s definition is more narrowly defined and accepted in the psychological community (Sternberg,1997; Sternberg, 2000) and, therefore, will be used for the rest of this dissertation. Salovey and Mayer (Mayer & Salovey, 1997) define emotional intelligence as " . . . the ability to perceive accurately, appraise, and express emotion; the ability to access and/or generate feelings when they facilitate thought; the ability to understand emotion and emotional knowledge; and the ability to reflectively regulate emotions in ways that promote emotional and intellectual growth" (p.10).
Recently, the concept of emotional intelligence has seen a proliferation in the literature with application to various domains of life including parenting and child care, (Gottman, 1997; Shapiro, 1997; Myers, 1997; Taylor, Parker, & Bagby, 1999), business management, leadership, and organizational behavior (Cooper & Sawaf, 1997; Simmons & Simmons, 1997; Abraham, 1999; Morand, 2000), work environment and professional careers (Weisinger, 1997), self-help and self-improvement (Epstein, 1998; Steiner & Perry, 1997; Ryback, 1997), bereavement and oncology nursing (Stanely, 2000), and education (Salovey & Sluyter, 1997; Greenspan, 1989; Greenspan 1997; Stone-McNown & McCormick; 1999). A few authors have applied the concept to the individual psychotherapy treatment modality (Greenspan, 1997; Segal, 1997; DeBeauport, 1996; Payne, 1986; Taylor, 1990). A review of the existing literature cites no examples where Salovey and Mayer’s (Salovey & Mayer, 1990; Mayer & Salovey, 1997) theory of emotional intelligence has been incorporated into any conceptual psychotherapy group model. This dissertation fills this gap by outlining a theoretical and practical model which incorporates emotional intelligence theory into the conceptual Eclectic Time-Limited Therapy model developed by Fuhriman and colleagues (Fuhriman et al., 1986).
Chapter Two of this dissertation presents literature reviews in two critical areas. First, a review of the historical roots of emotional intelligence and its current conceptualization is presented. Second, a review of the literature on time-limited group psychotherapy is examined with particular attention paid to group selection, time-limits, group structure, group composition, group preparation, group process, and group termination.
Chapter Three spotlights the Eclectic Time-Limited Therapy (ETLT) model by Fuhriman and colleagues (Fuhriman, et al., 1986) and is delineated so as to provide a template for the proposed psychotherapy group model. Modifications of the model are provided by McKenzie’s (1997) "generic model of group psychotherapy" and by Andrews (1995) common theme group psychotherapy model.
Chapter Four outlines the Emotional Intelligence Psychotherapy Group (EIPG) model which is based on the synthesis of the literature reviews in Chapter Two. The EIPG model assists students in managing their emotional life more effectively so as to enhance their learning potential while they pursue their educational goals. The EIPG model includes an evaluation component that monitors client change over the course of the group. The Multifactor Emotional Intelligence Scale (MEIS) (Mayer, Salovey, & Caruso, 1997) and the Outcome Questionnaire-45.2TM (OQ-45.2) (Lambert, Hansen, Umpress, Lunnen, Okiishi, & Burlingame, 1996) and their respective uses are highlighted in the chapter.
Chapter Five presents a discussion about the implications of the Emotional Intelligence Psychotherapy Group (EIPG) model for counseling centers and students. Ethical considerations for the group also are examined with regard to cross cultural sensitivity and competency as it relates to different cultural norms for the expression of emotion.
THE EMOTIONAL INTELLIGENCE
PSYCHOTHERAPY GROUP MODEL
Student motivations for requesting psychotherapy from counseling centers typically involve wanting some kind of relief from emotional discomforts that impede their ability to enjoy interpersonal relationships, to perform adequately in class, and to get satisfaction from life. Many students present with increasing severity of emotional discomforts where they experience one or more of the following (a) the pain of acute or chronic negative affect, (b) fear of feeling, (c) emotional numbing, (d) perplexing emotional reactions, (e) emotional conflict or ambivalence, and (f) painful experiences associated with "unfinished business" or inexpressed affect (Mahoney, 1995; Gold, 1996). Generally speaking, most universities and colleges primarily focus their education efforts on developing students’ cognitive or academic intelligence. Steenbarger (1992), McWhirter (1995), and Robertson and Freeman (1995), have articulated compelling reasons for the need to educate individuals about the adaptive functions of emotions and how they can assist individuals in having more satisfactory relationships and in developing an overall well sense of being. Salovey and Mayer’s emotional intelligence framework can provide students with a framework for better understanding themselves, those around them, and the circumstances they face (Salovey & Mayer, 1990; Mayer & Salovey, 1995; Mayer & Salovey, 1997; Mayer, Salovey, & Caruso, 2000; Mayer, Caruso, & Salovey, 1999; Salovey, Bedell, Detweiler, & Mayer, 2000; Salovey, Hsee, & Mayer, 1993; Mayer, DiPaolo, & Salovey, 1990; Mayer & Salovey, 1993; Mayer & Geher, 1996; Salovey & Mayer; 1994; Salovey, Mayer, Goldman, Turvey & Palfai, 1995). The following sections will outline the Emotional Intelligence Psychotherapy Group (EIPG) design which is a hybrid of Eclectic Time-Limited Therapy model (Fuhriman, et al., 1986), common-theme group model (Andrews, 1995; MacKay & Paleg, 1992), and MacKenzie’s (1997) "generic model of time-limited group psychotherapy." The content material of the EIPG model is provided by Salovey and Mayer’s model of emotional intelligence.
Screening and Pregroup Preparation
The EIPG model employs a number of psychological, behavioral, and interpersonal exclusion and inclusion criteria. For this time-limited approach, clients are excluded if they present with any one of the following: (a) severe depression requiring medication, (b) anger as main affect, (c) acute psychosis or recent psychotic episode, (d) borderline personality disorder, or (e) organic psychotic disorder (Fuhriman et al., 1986). When the exclusion criteria have been successfully applied, the following inclusion criteria are used: (a) ability to form a satisfactory relationship(s) in the past or present, (b) evidence of good premorbid adjustment, (c) the ability to establish an early and positive relationship with the therapist conducting the intake interview, (d) the ability to arrive at a mutual set of therapeutic expectations, and (e) the ability to perceive a personal problem in a circumscribed manner and remain focused in describing it (Fuhriman et al., 1986).
When the therapist determines the client appropriate for the EIPG program, he or she prepares the prospective participant for the group by reviewing the purposes of the group, the group structure, the ground rules, and the expectations for the roles of participant and therapist. The participant is given "The Client Information Handout" (Appendix C) to take home and to review before coming to the first session.
Time and duration
The EIPG model is both structured and time-limited. The group provides enough time for dispensing psychoeducational material and provides sufficient time for symptom reduction. The group meets weekly for an hour and a half for ten consecutive weeks within the beginning and ending of the university semester term. The student class schedules often influence the starting time of the group and consequently, most groups are to be conducted in the late afternoon (Golden et al., 1993).
Group participants are strongly encouraged to arrive at least five minutes before group time so they can fill out a questionnaire (Outcome Questionnairetm 45.2 ) that monitors symptom distress, interpersonal conflict, and social role performances. This questionnaire is described in the last section of this chapter. Therapists must start and end the group on time. Only under unusual circumstances should group time be extended (MacKenzie, 1997). The time-limited nature of the group is consistently referred to throughout treatment. At each session, the therapist advises the participants of the session number and the number of sessions remaining. Therapeutic attention to session number and the number of remaining sessions encourages participants to take personal responsibility for his or her treatment and speeds up the psychological work done in the group.
Structure of the group
The group is designed to be a closed group that meets for one and one half hours each week for ten weeks. The group consists of six to eight members. Groups with more than eight members run the risk of each client not obtaining sufficient opportunities for role playing, asking questions, and sharing experiences. Group composition of more than eight members runs the risk of the group becoming more like a class, minimizing the therapeutic potential of the interpersonal interactions among the group members. This group model incorporates dispensing psychoeducational material with group therapy processes commonly found in cognitive-behavioral group psychotherapies.
Group participants receive knowledge and opportunities for skill building in a cumulative manner. Participants who attend all group sessions will benefit by enhancing their knowledge and skill in emotional intelligence. Sessions two through nine are similar in structure, with the first 25-30 minutes spent on a brief check-in with participants and a didactic presentation on the various aspects of emotional intelligence. The remaining group time is devoted to psychological work with two or three group participants presenting their concerns.
The therapist bears the responsibility for presenting the psychoeducational material each week. He or she stimulates group discussion and facilitates problem solving during the psychological work portion of the group. The therapist is highly active in maintaining focus on group participants’ focal aims and in adhering to the time element of the treatment modality.
Goals
The goal of the EIPG model is to educate and train participants in being emotionally intelligent so they can enhance their learning potential in school, in their interpersonal relationships, and in the way they cope with emotional discomforts. Participants will be given a framework which they can use to help them better understand themselves, those around them, and their circumstances. The objectives for the group model include (a) providing accurate information about the adaptive functions of emotions; (b) assisting group participants in identifying feelings and expressing them appropriately, particularly the negative or toxic feelings (anger, sadness, etc.); (c) educating about emotions and their respective meanings; and (d) identifying helpful and adaptive mood or emotion regulation strategies in managing unpleasant or toxic feelings and enhancing pleasant feelings.
Ground rules
The EIPG model adopts the ground rules developed by MacKenzie (1997), outlined for most time-limited groups. The participant is given a copy of "The Client Information Handout" (see appendix A), containing the ground rules and expectations for the group during pregroup preparation. The material is reviewed again during the first group session. The ground rules cover confidentiality, attendance and punctuality, socializing with other group participants, contact between sessions, and the use of mood altering substances.
The therapist emphasizes the need for each group participant not to discuss outside of the group those things discussed within the group time. If group participants have a compelling need to share their group experience with people close to them, they are advised not to attach names or specific group details to the conversation. The therapist reminds the group of the limits of confidentiality. A breach in confidentiality will be made and the authorities notified if the therapist has reasonable suspicion that a participant poses a danger to him or herself or to others.
Attendance and punctuality are important in the EIPG model for several reasons. The dispensing of psychoeducational material is done in each session in a sequential manner. Group participants who miss a session are likely to feel left behind and this may slow the group process for the other participants. If participants know in advance that they will miss a session, they are strongly encouraged to share that information with the group. If participants are unable to attend due to unexpected circumstances, they are encouraged to notify the therapist.
Socializing with other group participants outside of the group is strongly discouraged. Such social contacts or relationships may make it more difficult for those involved to maximize the therapeutic benefit from the group interaction. Participants are advised that if such social contacts are made or maintained, they are to bring it to the awareness of the therapist and other group participants. Then the therapist and other participants can take the effect of the social contact into account during the group process. The therapist secures commitments from each participant to uphold this ground rule.
Group participants are advised that there will be no contact between the therapist and any group participants during the course of the group. Matters of personal safety are an exception to this rule. Participants are strongly encouraged to not have other treatments occurring at the same time of the group except for medication management.
Group participants are advised not to consume drugs or alcohol prior to attending group sessions. If the behavior or presentation of a group member suggests the use of mood altering substances, he or she is asked to leave the session. No food, drinks, or smoking is allowed during any session.
Starting of the group and succeeding sessions
The EIPG program is a cognitive-affective-behavioral ten session program outlined briefly in the following paragraphs with particular attention given to session goals, main concepts, and interventions used. The therapist is strongly encouraged to keep the group process as close as possible to the proposed guidelines outlined here.
The therapist begins the first session of the group by introducing him or herself to the group and by reviewing the EIPG program, with attention given to the time, duration, group structure, group process, goals and ground rules for the group. After reviewing this information, the therapist elicits any questions, if any, from group members about what has been said.
The therapist then initiates the "go-around" by having the group participants introduce themselves and share their reasons for being in the group and what they hope to gain from the group experience. Group members are invited to ask questions of the speaker at the conclusion of his or her introduction before moving on to the next person. If the client is too vague, the therapist or other group members may ask for more specific communication or concrete examples of problems or goals. If a group participant is taking up too much time, the therapist thanks him or her for sharing and suggests that it is time to hear from the next group participant. The therapist ends the introduction phase by summarizing the themes shared by the group participants. This initial go-around process should take 20-30 minutes.
After the initial go-around, the therapist introduces Artz’s (1994) "Ways of Knowing Profile" questionnaire to the group. The questionnaire introduces the notion that feeling is a "way of knowing that we use to discern and judge how and what we value" (Artz, 1994, p. 22). The questionnaire incorporates Solomon’s (1976, 1989) view of feelings as evaluative judgments about individual’s experience. The questionnaire provides a succinct introduction to how feelings work in concert with other intellective processes (thinking, intuiting, and sensing). Group participants are instructed to read the printed directions on the questionnaire carefully and to proceed filling out the questionnaire. The form generally takes 10-15 minutes to fill out. When participants are finished, the therapist introduces the acronym "TIFS" (Thinking, Intuiting, Feeling, and Sensing) and reviews what each of these four active and reflective mental processes are, as described by Artz (1994). The acronym will be referred to throughout the group experience. The therapist, using a dry erase board or chalk board, writes on the board "TIFS" in a vertical fashion with the letter "T" at the top. Cognitive and emotional restructuring group interventions during all sessions will refer to the TIFS acronym on the board. The therapist will maintain each participant’s TIFS profile in a group chart.
The first session concludes with the therapist orienting the group participants to the construct of "emotional intelligence" by providing a handout which depicts the four branches of Mayer and Salovey’s model of emotional intelligence and the mental abilities contained therein. Participants are educated briefly about each of the branches and the mental abilities within as depicted in the model. Participants are given a homework assignment to think about their problems or concerns and the feelings associated with them and to be ready to present them to the group.
Table 4.1 outlines Sessions Two and Three and the corresponding abilities of emotional intelligence that are covered during that respective session.
Table 4.1
Session coverage of Perception, Appraisal, and Expression of Emotion Branch
_____________________________________________________________
Session II • Ability to identify emotion in one’s physical states, feelings, and thoughts.
• Ability to identify emotions in other people, designs, artwork, etc., through language sound, appearance and behavior.
Session III • Ability to express emotions accurately, and to express needs related to those emotions.
• Ability to discriminate between accurate and inaccurate, or honest versus dishonest expressions of feeling.
_____________________________________________________________
Session two begins with a brief check-in by the participants and the presentation of psychoeducational material on what constitutes feelings, emotions, and thoughts, and facilitates the view that feelings and emotions are functional and adaptive. Participants are encouraged to suspend their beliefs and attitudes about the appropriateness of experiencing feelings and emotions and expressing them to others. Each participant is given his or her "Perceiving Emotions" subtest results of the Multifactor Emotional Intelligence Scale (MEIS). This scale is described in the last section of this chapter. The therapist explains what the subtest measures and responds to any questions from the participants about their performance on this subtest.
Participants are educated about the powerful influences family and culture can have on how one relates to emotion. Family and culture influence how one feels and communicates those feelings. Some familial and cultural influences teach individuals not to trust themselves or their feelings and not to talk about them. Some individuals may learn to override, to become numb, or to over react to their feelings. The consequences of not being able to trust feelings, talk about them, or feel them, can result in emotional or physical difficulties such as psychosomatic illness, stress, tension headaches, or ulcers (Lazarus & Lazarus, 1994; Segal, 1997) A group discussion about the development of feeling vocabularies is initiated.
The rest of the group time is devoted to two or three participants presenting their concerns. Cognitive and emotional restructuring techniques are used by the therapist while discussing participants’ critical incidents. The TIFS acronym is put on the board and the focus of participants’ critical incidents is on thoughts, feelings, and sensing. Key questions used by the therapist include: "What thoughts are you having about this experience?", "Can you describe what you are feeling?", "What is it like?", "What would you like to change?", "What physical signals are you receiving as you are having this emotional experience?", and "Where in your body is this experience located?" (Artz, 1994). The therapist initiates problem solving by enlisting help, advice, etc. from the group participants. The "Intuition" segment of TIFS is closely related to problem solving. The therapist writes the original thoughts, feelings, and sensing information on the board next to their respective letters. Alternative thoughts and felt meanings are enlisted from the participant and the group. Each of these is inserted in place of the original thought or feeling. The process outlined in this session is the same for sessions three through nine.
Session three’s didactic information is gleaned from the remaining two abilities of the "Perception, Appraisal, and Expression of Emotion" branch of emotional intelligence. Group participants are instructed to use the following formula provided by Amerslav (1992) and fill in the blanks when communicating with others:
I feel __________ (your feeling)
when you __________ (an action)
because __________ (your reason) (p. 8)
Expressing wants or needs associated with those feelings effectively follows an assertive script that has three basic components. First, the situation is described in factual terms. There is no blaming, no attacking, and no use of pejorative language. Second, in communicating feelings to others, use "I" statements. Last, be specific about what the wants or needs are. This includes the whats, wheres, and whens. Participants are encouraged to ask for a behavioral change from others rather than an attitude change. Participants are given the homework assignment to utilize the formula previously mentioned in communicating their feelings to friends, family, and associates. Participants are also asked to monitor how they feel when they utilize this formula and to share their experiences with the group in the next session.
When the didactic material has been presented, as in session two, the group will now focus on the TIFS for each participant who elects to use group time to discuss his or her issues or concerns. The formula is written on the board next to the TIFS acronym to assist participants in verbalizing their feelings and thoughts.
Session four begins by introducing the "Emotional Facilitation of Thinking" branch of the emotional intelligence framework. Table 4.2 provides the list of abilities covered in this branch. Each participant is given his or her results of the "Assimilating Emotions" subtest of the MEIS. The therapist reviews what this subtest measures and responds to any questions from the participants about their individual performances on the test.
TABLE 4.2
Session coverage of Emotional Facilitation Branch
_____________________________________________________________
Session IV • Emotions prioritize thinking by directing attention to important information.
• Emotions are sufficiently vivid and available that they can be generated as aids to judgment and memory concerning feelings.
Session V • Emotional mood swings change the individual’s perspective from optimistic to pessimistic, encouraging consideration of multiple points of view.
• Emotional states differentially encourage specific problem
approaches such as when happiness facilitates inductive reasoning and creativity.
_____________________________________________________________
Next, the therapist presents psychoeducational material about the positive functions of emotions (Leeper, 1948, Salovey & Mayer, 1990, Mayer & Salovey, 1997). Psychoeducational material on emotional attunement is dispensed so participants can enhance their ability to make sense of incoming sensory information, can help one another become aware of a wider range of choices, and can better empathize with others.
The therapist educates the participants about the utility of being able to access or generate emotions to assist thinking processes. An exercise using music helps illustrate this principle. To create a sad mood, the therapist plays some music from a tape or CD depicting sad moods or emotions. Examples may include "How?" by John Lennon or "While My Guitar Gently Weeps" by the Beatles. The song "How?" is particularly effective in generating a sad mood as it discusses the implication of suppressing emotions and not allowing them to color and enrich one’s own life and interpersonal relationships. The therapist ends the exercise by playing a song that generates happy mood states. Examples include the theme song from the movie, "Rocky" or Handel’s "Arrival of the Queen of Sheba." Participants are encouraged to think about how they use music to enhance their thinking and regulate their feelings.
The participants are given a homework assignment to monitor and chart their emotions as they occur. Participants are to be aware how they use music. They are to note the situation they are in, the emotion they feel, and the thoughts they are thinking during that moment. Van Buren (1997) suggests the following basic emotions to monitor and chart: anger, sadness, fear, disgust, surprise, calmness, jealousy, and happiness. The rest of the session is devoted to participants’ issues and concerns using the TIFS format and cognitive and emotional restructuring techniques.
Session five begins by reviewing the homework exercise from the previous week. The therapist listens and notices how, when, and why participants use music. This provides an opening for the therapist to present psychoeducational material about how emotional mood swings can change an individual’s perspective. Such emotional mood swings may provide participants opportunities to consider multiple points of views. Such perspectives may range from optimism to realism to pessimism. Participants are informed about how certain emotional states enhance certain problem solving strategies. Happy or elevated states generally enhance inductive or creative problem solving strategies. On the other hand, depressive states generally enhance problem solving strategies requiring deductive reasoning tasks. The therapist then guides the group to focus on participants’ critical incidents and the use the TIFS tool.
Table 4.3 lists the abilities in the "Understanding and Analyzing Emotion; Employing Emotional Knowledge" branch. Psychoeducation about the ability to label emotions and to recognize various groupings or families of similar emotions is given. For example, pessimism, hopelessness, disappointment, and dejection are emotions that fall under the category of the "Sad-Depressed-Discouraged" (Artz, 1994). Genial, clever, agreeable, hearty, and jovial are emotions that can be subsumed under the "Playful-Joking-Witty" family of emotions (Artz, 1994). Psychoeducation about the similarities and differences of the various emotions and their respective families is presented.
TABLE 4.3
Session coverage of Understanding and Analyzing Emotions; Employing Emotional Knowledge
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Session VI • Ability to label emotions and recognize relations among the words and the emotions themselves, such as the relation between liking and loving.
• Ability to interpret the meanings emotions convey regarding relationships, such as that sadness accompanies a loss.
Session VII • Ability to understand complex feelings: simultaneous feelings of love and hate, or blends such as awe, as a combination of fear and surprise.
• Ability to recognize like-transitions among emotions, such as the transition from anger to satisfaction, or from anger to shame.
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In addition to the ability to label emotions and to recognize the similarities and distinctions between emotions, the ability to determine the meaning of emotions is also discussed. Lazarus and Lazarus (1994) describe emotions as having distinctive dramatic plots that define what we believe is happening to us. Lazarus and Lazarus write:
In order to understand how an emotion comes about, we must study the plotline that distinguishes it from other emotions. . . .If we understand the personal meanings that underlie our own emotions, we will be in a better position to accept these emotions in ourselves, control them so that they do not interfere with our relationships with those we care about and be more skillful in managing our lives" (p. 6, 8).
The therapist provides psychoeducational material about the various emotions and their distinctive plots. Examples of emotions and their respective plots may include: anger and the perception of a demeaning offense against the self, guilt and having transgressed a personal moral imperative, or sadness with the plot of an irrevocable loss that we know can not be restored (Lazarus & Lazarus, 1994). Other emotions may include anxiety, shame, envy, jealousy, relief, hope, happiness, pride, love, gratitude, and compassion (Lazarus & Lazarus, 1994). The therapist may want to select only those emotional discomforts shared by the group. The therapist also educates participants about how emotions emerge only under certain circumstances, or operate under certain "laws of emotion" (Frijda, 1988). The rest of the session is devoted to critical incidents and the use of the TIFS tool.
Session seven begins with a review of the participants’ performance on the MEIS "Understanding Emotions" subtest. The therapist discusses what the subtest measures and answers any questions from the participants about their performance. Didactic information is presented on how feelings are sometimes complex and contain blends of feelings. To illustrate how one can think about feelings, blends of feelings, and the simultaneous experience of feelings, the therapist initiates an exercise designed by Van Buren (1997) with the following instructions to the participants:
Take a piece of paper and make a grid with horizontal and vertical lines.
You should wind up with a page of boxes. Write a list of possible emotions across the top. Do the same thing down on the left side of the grid. Now fill in the grid by writing the two intersection emotions in each box. For example, in one box, you might write "happy" (from the left ‘y axis’ of the grid) and "sad" (from the top, ‘x axis’ of the grid). Think about what it means to be happy about feeling sad. In what kind of situation might you be happy about feeling sad? Do the same with the rest of the grid.
Participants are advised to use the following emotions: anger, sadness, fear, disgust, surprise, calm, jealousy, and happiness in their grid. This exercise will take up to 20-25 minutes of the group time. After the participants complete the grid, the therapist initiates a discussion about some of the intersections in the grid. The rest of the session is devoted to participants’ issues or concerns and the TIFS protocol.
Session eight presents the final branch of the model, "Reflective Regulation of Emotions to Promote Emotional and Intellectual Growth" as seen in Table 4.4. Results of the MEIS subtest, "Managing Emotions", are reviewed with the participants. The therapist responds to questions from the participants about their performance on this subtest.
TABLE 4.4
Session coverage of the Reflective Regulation of Emotions to Promote Emotional and Intellectual Growth Branch
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Session VIII • Ability to stay open to feelings, both those that are pleasant and those that are unpleasant.
• Ability to reflectively engage or detach from an emotion depending upon its judged informativeness or utility.
Session IX • Ability to reflectively monitor emotions in relation to oneself and others, such as recognizing how clear, typical, influential, or reasonable they are.
• Ability to manage emotion in oneself and others by moderating negative emotions and enhancing pleasant ones, without repressing or exaggerating information they may convey.
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The focus for session eight surrounds the abilities to stay open to any emotional experience, those that are unpleasant as well as pleasant ones, and to know when it is adaptive to engage or to detach from such emotional experiences. To help participants understand the familial and cultural influences on emotional management skills, participants are encouraged to think or write about how feelings were handled in their families. The following questions are used to facilitate this exercise: (a) How did your family members manage feelings? (b) Were feelings always out in the open, as they are in some families, or was it hard to tell what was going on? (c) How does your own style of managing feelings compare with others in your family? (d) Are there gender differences in the family? Discussion about the answers to these questions is encouraged. After the discussion, the group continues with participants’ critical incidents and TIFS protocol.
Session nine presents psychoeducational material on the last two abilities of the "Reflective Regulation of Emotions to Promote Emotional and Intellectual Growth" branch: the abilities to think about emotions and how to regulate them in oneself and others, and then manage the emotions in a way that doesn’t distort the information they convey. This session focuses on participants learning emotional regulation strategies. Greenberg and Pavios’ (1997) list of four emotion regulating strategies is useful psychoeducational material to share with participants. The list includes attention regulation strategies (focusing on their present sensory experience of internal and external reality rather than thoughts), breathing regulation (focusing on breathing brings attention to current sensations, clears mind of ruminations, and helps regulate breathing), muscular relaxation (facilitates the relaxation response), and "self-soothing" strategies (developing compassion and self empathy by engaging in behaviors such as going for a walk, taking a hot bath, working out, listening to music or whatever is helpful for someone to manage toxic or bad feelings (Greenberg & Pavio, 1997). The rest of session is devoted to participants’ critical incidents and the TIFS protocol.
The format for the tenth and final session is similar to the first. The therapist revisits the goals of the EIPG program and summarizes the progress that has been made. Participants are reminded that the work is not complete and that they are expected to apply the learning from the group to life outside of the group. The therapist initiates a final go-around by asking each participant to take five to seven minutes and speak to each member of the group to say their good-byes. This last go-around provides each participant an opportunity to say things to others in the group about an advice or an insight that was helpful. This reminds the participants that therapy groups are generally filled with ideas, suggestions, and advice. The therapist responds to the group as a whole and provides supportive feedback and challenges each member to continue the pursuit of developing his or her emotional intelligence.
Criteria for measuring client change
Group therapists are strongly encouraged to incorporate outcome evaluation protocols into their practice (Harris & Kranz, 1991; McCallum, Piper, & Morin, 1993; Sack, Graham, & Simmons, 1995; Spitz, 1996; MacKenzie, 1997). Outcome evaluation protocols using standardized instruments sensitive to client change over short periods of time help therapists monitor client change and fine tune the delivery of their clinical services (Wells, Burlingame, Lambert, Hoag, & Hope, 1996; Ogles, Lambert, & Masters, 1996; Crego, 1990; Bieschke, Bowman, Hopkins, Levine, & MacFadden, 1995). The Outcome Questionnaire (OQTM-45.2) (Lambert, Hansen, Umpress, Lunnen, Okiishi, & Burlingame, 1996 ) and the Multifactor Emotional Intelligence Scale (MEIS) (Mayer, Salovey, and Caruso, 1997; Mayer, Caruso, and Salovey, 1999) are instruments with adequate psychometric properties and are appropriate for this time-limited modality.
The Outcome Questionnaire (OQtm-45.2) is designed for a busy service setting such as a counseling center. The OQtm-45.2 is a self administered, self report instrument designed to be used on a repeated basis to measure client change over the course of treatment and at termination (Lambert, Hansen, Umpress, Lunnen, Okiishi, & Burlingame, 1996). The OQtm-45.2 provides a global score and three corresponding subscale scores, Distress (SD) scale, Interpersonal Relations (IR) scale, and Social Role Performance (SR) scale.
The Symptom Distress scale has items that tap into depression and anxiety symptoms and substance abuse problems. Sample items include, "I feel stressed at work/school," "I have difficulty concentrating," and "I feel something is wrong with my mind."
The Interpersonal Relations scale includes items that assess problems with family life, marriage, and friendships. Isolation, feelings of inadequacy, withdrawal or conflict are of interest in this scale. Sample items include, "I get along well with others," "I feel lonely," "I have trouble getting along with friends and close acquaintances."
The Social Role Performance scale measures the client’s level of dissatisfaction, conflict, or distress in his or her employment, family roles, and leisure life. The scale also attempts to measure positive feelings and satisfaction as well as problematic symptoms. Sample items include, "I find my work/school satisfying," "I am not working/studying as well as I used to," and "I feel angry enough at work/school to do something I may regret."
The OQtm 45.2 offers several critical items that can alert the group therapist to suicide potential ("I have thoughts of ending my life"), drug and/or alcohol abuse ("After heavy drinking, I need a drink the next morning to get going" and "I have trouble at work/school because of drinking or drug use"), and violence at work or school ("I feel angry enough at work/school to do something I may regret"). These critical items, when endorsed by participants, can help the therapist be aware of these problems and make sound clinical decisions about the participants.
Administering the OQtm 45.2 has four distinct advantages in a counseling center setting. The OQtm 45.2 is (a) brief (45 items) and suitable for repeated measurement on a weekly basis, (b) solid psychometrically, (c) sensitive to change over short periods of time, and (d) inexpensive (Lambert, Okiishi, Finch, & Johnson, 1998). The OQtm 45.2 scores can be calculated and put into a formula to determine whether or not the change was clinically significant (Lambert et al, 1996). Normative data for the OQtm 45.2 for counseling centers is available to compare client’s progress (Ogles, Lambert, & Masters, 1996).
Empirical research on the emotional intelligence construct is accumulating (Davies, Stankov, & Roberts, 1998; Martinez-Pons, 1997; Schutte, Malouff, Hall, Haggerty, Cooper, Golden, & Dorneim, 1998, Bar-On, 1997; Mayer, Caruso, & Salovey, 1999; Mayer, DiPaolo, & Salovey, 1990; Mayer & Gehere, 1996; Mayer, Salovey, & Caruso, 1997; Salovey, Bedell, Detweiler, & Mayer, 2000; Salovey, Mayer, Goldman, Turvey, & Palfai, 1995). Much of the research cited above is based on Salovey and Mayer’s 1990 model of emotional intelligence. The Multifactor Emotional Intelligence Scale (MEIS) (Mayer, Salovey, & Caruso, 1997) is an instrument based on the revised model of emotional intelligence (Mayer & Salovey, 1997). The MEIS is an instrument available in computer software format or paper-pencil test format. The MEIS contains twelve ability measures of emotional intelligence divided into four branches of abilities including (a) perceiving, (b) facilitating, (c) understanding, and (d) managing emotion (Mayer, Caruso, & Salovey, 1999; Mayer, Salovey, & Caruso, 1997). The perceiving of emotion branch consists of tasks that measure emotional perception in faces, music, designs, and stories. The facilitation branch contains two tests that measure synesthesia judgment and feeling biases. The understanding emotion branch has four tests that examine the understanding of emotion. Managing emotion branch has two tests which measure emotion management in self and others. The MEIS is administered before and after group treatment. The pretest is administered after the initial intake session with the therapist and before the EIPG group begins. A typical person will take forty-five to seventy-five minutes to complete the MEIS (Caruso, personal communication, June 14, 2000). Test results will be incorporated into the EIPG group experience in a piece by piece fashion based on the session number and the branch of emotional intelligence covered. For example, sessions two and three cover the first branch of emotional intelligence, "Perception, Appraisal, and Expression of Emotion." The MEIS is again administered after the EIPG group experience is completed. It is hypothesized that improvements will be noticed in various abilities of emotional intelligence.
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Appendix A
Client InformationHandout
Client Information Handout
Information Regarding Group Therapy
Introduction
This information sheet is intended for people who are about to begin Group Therapy of who are considering it as a possible treatment. It is useful when starting Group Therapy to have some general ideas about how groups help people and how to get the most out of the experience. Group Therapy is different from individual therapy because many of the helpful events take place between the members and not just between the leader and the members. That is one reason why it is important that all of the members have a general introduction before beginning. Please read this material carefully and feel free to discuss any part of it with your group leader. The issues raised in this handout are also useful to talk about during the first few sessions in the group.
Do groups really help people?
Group therapy is widely used and has been a standard part of treatment programs for the last 40-50 years. Sometimes is used as the main or perhaps the only treatment approach. This is especially true for outpatients. Sometimes it is used as part a treatment approach that may include individual therapy, medications, and other activities. Group therapy has been shown in research studies to be an effective treatment. Studies that have compared individual and group approaches indicate that both are about equally effective. The difference with groups, of course, is that a group has to form, and the members need to get to know each other a bit, before it can be of the greatest benefit. Most people have participated in some types of nontherapy groups, for example, as part of school, church, or community activities. Therapy groups will have many of the same features. The difference is that in a therapy group, the leader has a responsibility to ensure that the members stay focused on their treatment goals and that everyone participates in this.
How Group Therapy Works
Group therapy is based on the idea that a great many of the difficulties that people have in their lives can be understood as problems in getting along with other people. As children we learn ways of getting close and talking to others and ways of solving issues with others. Often, these early patterns are then applied in adult relationships. Sometimes these ways are not as effective as they might be, despite good intentions. Very often, symptoms such as anxiety or unhappiness, bad feelings about yourself, or a general sense of dissatisfaction with life reflect the unsatisfactory state of important relationships. Sometimes such symptoms result in interpersonal issues such as withdrawal or irritability. Groups offer an opportunity to learn more about these "interpersonal" patterns no matter how they got started.
There are many different kinds of groups. Some groups are designed to provide the members with information about some topic, such as eating disorders; others focus on a particular skill, such as assertiveness. Some groups are quite structured and may use a written manual, for example, cognitive-behavioral groups, whereas others focus on understanding more about yourself and the nature of your important relationships. No matter what kind of group you are in, this information sheet is designed to let you know about how groups work and how you can get the most from your experience.
Common Myths About Group Therapy
1. While it is true that groups offer an efficient way of treating several people at once, Group Therapy is not a cheaper or second-rate treatment in the sense that it has less power to help people than other treatments. As mentioned above, studies show that most of the "talking therapies" are about equally effective.
2. Some people are concerned that a therapy group will be liked a forced confessional where they have to reveal all of the details of their life. This is not the case. Groups will progress at their own rate as members become more familiar with each other and can trust each other. In general, groups talk about the patterns in relationships and the meanings these have for them. For this it is often not necessary to know specific details. Members will find their own level of comfort regarding how much they want to disclose about their personal lives. Details about where you live or work, even your last name, are not necessary for effective involvement in the group.
3. Some people worry that being in a room with other people with difficulties will make everyone worse. This idea of "the blind leading the blind" is understandable, but in practice people find that the process of talking about their problems is very helpful. Indeed, finding that others have had similar problems can be reassuring. Many Group Therapy clients are surprised to find that they have something to offer other people.
4. Some of the media presentation of groups suggests that people will lose control in groups and become so upset they can’t function or maybe get so angry that they will be destructive. Very seldom is there any chance of this happening, and the group therapist will be alert and responsible to encourage the group if it gets too slow or to dampen things down if the tension gets too high.
5. When people picture being in a therapy group, they sometimes find themselves concerned that they may be rejected or excluded by the other group members, sometimes the fear is that they will be judged harshly by the other members, and sometimes they are afraid that they may lose their sense of themselves and be carried along by the group where they don’t wish to go. All of these fears are perfectly understandable, and indeed, almost everyone experiences them to some extent when they enter a new social group situation. It is good to talk about these sorts of fears early in the group so that they can be understood and then put behind you.
How to Get the Most out of Group
1. The more you can involve yourself in the group, the more you will get out of it. In particular, try to identify the sorts of things you find upsetting or bothersome. Try to be as open and honest as possible in what you say. Group time is precious; the group is a place to be working on serious issues, not just passing the time of day. Listen hard to what people are saying, think through what they mean, and try to make sense of it. You can help others by letting them know what you make of what they say and how it affects you. Many of the issues talked about in groups are general human matters with which we can all identify. At the same time, listen hard to what others say to you about your part in the group. This process of learning from others is an important way to gain from group experience. It takes time to appreciate how much a group can help you. So it is important that you commit yourself to come to a few sessions of the group before deciding if it’s worthwhile for you. Discuss with your therapist before the group starts what the expectations are in terms of the length of your particular group.
2. One way of thinking about group is to view it as a "living laboratory" of relationships. It is a place where you can try out new ways of talking to people, a place to take some risks. You are a responsible member of the group and can help to make it an effective experience fore everybody. A good way to think about how a group can help people is this. Consider a person risking a different way of talking about personal matters, getting some response from the other members that it sounds all right, and then trying to make sense of the experience.
3. Do your best to translate your inner reactions into words. Group is not a "tea party" where everything has to be done in a socially proper fashion. It is a place to try and explore the meaning of what goes on and the reactions inside that get stirred up.
4. Remember that how people talk is as important as what they say. As you listen to others and as you think about what you yourself have been saying, try to think beyond the words to the other messages being sent. Sometimes the meaning of the words does not match the tone of voice or the expression on the face.
5. Because the group is a place to learn from the experience itself, it is important to focus upon what is happening inside the group room between the members and between each member and the leader. Often, understanding these relationships throws new light on outside relationships. Many people have found helpful to think about themselves in terms of the things they know and don’t know about themselves, and the things others know and don’t know, The diagram below outlines this. One of the tasks in group is to try to make the box called "public knowledge" larger by three main methods: first, to talk about things that you normally keep hidden about yourself or speaking about your thoughts concerning others (self-disclosure); second, to listen to what others are saying about what might be your blind spots (receiving feedback); and third, to listen hard and think hard so that you can understand more about yourself (personal insight).
SELF
| Things
I do know about myself |
Things
I do NOT know about myself |
||
G R O U |
Things
others do know abo |
PUBLIC
KNOWLEDGE |
feedback
BLIND SPOTS |
P |
Things
others do NOT know about me |
self-
disclosure HIDDEN SELF |
Insight
UNKNOWN SELF |
Common Stumbling Blocks
1. It is normal to feel anxious about being in groups. Almost everyone experiences it to some extent. One way of dealing with this is to talk about it at an early point in the group. This is a good model of the usefulness of talking about important issues so that they can be clarified wand the anxiety related to them reduced.
2 It is the role of the leader to encourage members to talk with each other and to help keep the group focused on important tasks. The leader is not there to supply ready answers to specific problems. One of the things you will experience in group is learning to benefit from the process of talking with other people and not just getting pat answers.
3. Try hard to put into words the connection between how you are reacting or feeling and what is happening between you and other people both in the group and outside. It is all right to be emotional. This process of trying to understand reactions or symptoms in terms of relationships is important.
4. Many group members find themselves experiencing a sense of puzzlement or discouragement after the excitement of the first few group sessions. Please live through this stage. It almost always occurs, and it reflects the fact that it always takes groups some time to develop their full benefit for the members. Once the group has lived through this, it is in a much stronger position to be helpful.
5. From time to time in the group you may find yourself having negative feelings of disappointment, frustration, or even anger. It is important to talk about these reactions in a constructive fashion. Many people have difficulty with managing these sorts of feelings, and it is a part of the group’s task to examine them. Sometimes these negative feelings may be toward the leader. It is equally important that these also be talked about.
6. Try hard to apply what you learn in group to outside situations. Many group members have found it very useful to talk to the group about how they might go about applying what they are learning, and then to try it outside in their personal lives and report back to the group about how it went. Studies have shown that the more you can do this, the more therapy becomes "real" and the more you will get out of it. Many people report that keeping a regular personal journal is helpful in keeping on track with important issues between sessions. Remember that the rest of the world does not necessarily run the same way as a therapy group. Try out your ideas in the group first to test if your plans are will thought out.
7. Many people come to therapy groups because things have not been going well in their lives. There is a temptation to take the first advice you may hear and decide to make a big change. Please wait so that you have a chance to think about your ideas and talk about them in the group before making important life decisions.
Group Expectations
1. Confidentiality: It is very important that things that are talked about in the group do not get talked about outside. You may, of course, want to discuss your experience with people close to you, but even then it is important not to attach names or specific information to the talk. In our experience it is extremely uncommon for there to be any important break in confidentiality in therapy groups. Please be sure that you don’t talk about others, just as you don’t want them to talk about you outside the group.
2. Attendance and punctuality: It is very important that you attend all sessions and arrive on time. Once a group gets going, it functions as a group, and even if just one member is absent, it is not the same. So both for your sake and for the sake of all the members, please be a regular attendee. If, for some reason, it is impossible for you to make a session, then call in advance and discuss it with your therapist or at least leave the information. In that way the group will know you are not coming and won’t find itself waiting to get down to work until you arrive. For outpatient groups, it is useful for the group to spend some time periodically talking about major absences such as trips or vacations and discuss how to plan for these as a group.
3. Socializing with other group members: It is important to think of groups as a treatment setting and not as a replacement for other social activities. Group members are strongly advised not to have outside contacts with each other. The reason for this is that if you have a special relationship with another group member, that relationship interferes with getting the most out of the group interaction. The two of you would find yourselves having secrets from the group or not addressing issues because of your friendship. If you should have some outside contact with group members, then it is important that this be talked about in the group so that the effects of such contact can be taken into account. You are asked to make a commitment to report such contacts within the group. (Note: Some group that deal with learning and applying social skills may encourage members to practice together.)
4. Contact between group sessions: The therapist does not general expect to have contact with group members outside of the group itself, unless it is something very urgent. All such contacts will be considered as part of the larger frame of the group experience, and the therapist may bring this material back into the group sessions. It is generally advisable not to engage in any other regular therapy while in the group with the exception of seeing your doctor for medication management. Any concerns or plans about seeing other therapists need to be discussed with the group leader before the group begins
5. Alcohol or drugs: Groups are places for sensitive personal discussions. It is important that you not come to a session under the influence of alcohol or drugs except prescription medicines. This is not to say that it is good or bad to use alcohol or drugs, but only that they get in the way of making the most of the group experience. As a general rule, you will be asked to leave the session if your behavior is significantly affected. No food, drinks, or smoking is allowed in the group room. These tend to be distractions from the work of the group.
Appendix B
Ways of Knowing Profile
"Ways of Knowing" Profile
On the scoring sheet, please rank each of the four statements in each of the 10 questions in order of their importance to you (4,3,2,1), so that 4 most closely describes you and 1 least describes you. You may find it difficult to choose between some of the statements in some of the questions, and may wish to assign the same value to two or more statements--but this is not an option. In each of the 10 questions, only one statement may receive the value of 4,3,2, or 1.
1. My approach to forming knowledge and understanding is
a. _____ based on looking at the facts
b. _____ based on logic and reason
c. _____ based on my feelings and emotions
d. _____ based on my immediate intuitive reaction or response
2. I would describe myself as
a. _____ concerned with accuracy, with getting things right
b. _____ interested in investigating and learning more about the things I come across
c. _____ liking things that can be dramatized or vividly pictured
d. _____ liking to jump into things and/or take some risks
3. Information is mostly likely to catch my attention if it is
a. _____ reliable, stable, and properly standardized
b. _____ known for its proven excellence because it has been thoroughly researched
c. _____ creatively and attractively presented
d. _____ able to help me gain a deeper personal understanding
4. My approach to learning is
a. _____ learning by doing
b. _____ learning by thinking things through
c. _____ learning by getting involved with others
d. _____ learning through sudden insight, through having "ah-ha" experiences
5. I like to
a. _____ be careful with details and keep things in order
b. _____ think about all kinds of ideas and theories
c. _____ be conscious of and sensitive to what is going on with the people around me
d. _____ use my imagination to come up with new ways of doing things
6. In my approach to accomplishing a task I am
a. _____ careful about details, and make sure that I do everything that is required
b. _____ reasonable, and think about how best to work my way toward my goal
c. _____ guided by how I feel about the task, and have to feel like doing it
d. _____ challenged and engaged if the task requires me to find solutions to
problems.
7. In general, I would describe myself as
a. _____ concrete and practical
b. _____ inquiring and comparative
c. _____ responsive and able to put myself in other people’s shoes
d. _____ able to create new ideas and experiences out of what is offered
Copyright © Sibylle Artz/Trifolium Books. Permission to reproduce this page is granted.
8. When I work with documented materials, I look for
a. _____ a clear, concise arrangement of information
b. _____ evidence to show that the information provided is accurate and well
researched
c. _____ a tasteful composition and a pleasing synthesis of knowledge
d. _____ material that suggests several different ways of approaching the subject matter
9. I like to
a. _____ stick with things, and follow through until all is properly completed
b. _____ analyze things into their component parts so that I can understand how they all work together
c. _____ respond to beauty and do artistic things
d. _____ try different things in different situations, play with things to see how they work
10. Mostly, I like to
a. _____ deal with concrete things in a hands-on fashion and know what outcomes will be produced
b. _____ check things out to make sure that they are correct, proven, reasonable, and true
c. _____ deal with people rather than things
d. _____ be inventive and come up with new and different approaches
How to Score Your "Ways of Knowing" Profile
1. Add all the values you placed in the "a" section of each question. Transfer this total to the category entitled Sensing in the space provided below.
2. Add all the values you placed in the "b" section of each question. Transfer this total to the category entitled Thinking in the space provided below.
3. Add all the values you placed in the "c" section of each question. Transfer this total to the category entitled Feeling in the space provided below.
4. Add all the values you placed in the "d" section of each question. Transfer this total to the category entitled Intuiting in the space provided below.
The overall total of your scores taken together must equal 100. If that is not the case, it is likely that you have made an error in addition, or have inadvertently given the same value to two statements on one of the questions.
These totals taken in order of highest to lowest constitutes your personal "Ways of Knowing" Profile.
Scoring
a. ________ Sensing
b. ________ Thinking
c. ________ Feeling
d. ________ Intuiting
Copyright © Sibylle Artz/Trifolium Books. Permission to reproduce this page is granted.