Clinical Social Work in Groups, Essay Example

Forming and establishing relationships in clinical social work in groups is vital to all stages of the process. During the first stage of formation the group members and the leader learn how to communicate to each other. The leader must establish the appropriate climate and encourage participation. The leader guides the group members to anticipate the process and learn to be allowed to honestly participate and permit the leader to monitor and guide the process. The successful relationships are even more important during the separation and termination phase of clinical social work in group settings.

The transitional stage can be difficult as the members deal with resistance; anxiety and conflict with the leader helps the members deal with working through their weaknesses. The termination phase involves many factors for the workers and members of the group. Anxiety and denial along with regression often occurs. The group members may experience a fight or flight feeling.  During the final stage of termination the members may take advantage of this time through summarizing and integrating the entire group experience. The leader can aid in consolidating the learning experience by developing specific contracts for home assignments to help the members feel a sense of continuity and continual working towards goals for life. They should be encouraged to evaluate the process also to help solidify the lessons learned for life.

Termination as a Transitional Stage

Transition/Member

Helping members transition back into the real world and the acknowledgement of the continued work they will be doing with the help of their group work is especially important (Jacobs, Masson and Harvill, YEAR). This part of the process is the capstone of the therapy. During transition members should be guided to realize the gains and crystallize the personal individual achievements. Leaders can mentor members to promote the internalization of the group therapy experience. Helping members to realize termination is an end but rather a time to embrace their experiences and realize the meaningful work which they have processed and worked through.

The ending phase and the transition of the member to be able to face their future life demands equipped with the necessary tools and resources which therapy has provided is the ultimate goal of termination. The members may develop a network for accountability and continued personal relationships. If members have dealt with addiction problems they will need a new social network to assist in keeping sober. Therefore, if relationships have developed during the group therapy, the members have a unique bond which may benefit them as they face the challenges and demands of entering life again.

Departure/Worker Departure

Depending on the time frame of the groups the worker may leave the group. This may be due to many factors such as work reassignment, logistical problems, or an illness. Workers will ideally have developed trust among the group and this can be detrimental to the members. The best way to accomplish this is with a planned transfer to another worker (Northen and Kurland, 2001). The worker should introduce to the group of a planned departure and transfer. In an ideal situation the announcement will allow time for the members to adjust and work through their emotions. Typically members will express concern for the future process and the new worker. As time progressed they will process the information and may turn to anger or resentment.

The members may also idealize the current worker; worrying about the new worker and how they will accept them. If the worker has established a close relationship among the group, the members will eventually work through the emotions of the worker’s departure based on the close relationship. The worker’s acceptance and verification of the members feelings will help alleviate the various negative emotions the members will experience. The loss of a worker among a group of members with serious psychosocial problems can be traumatic and must be handled with empathy and skill (Northen and Kurland, 2001). Members may benefit from the transition between workers as this can be an opportunity to learn coping skills.

Group Termination

The decision to terminate a group may result from several factors. The group may have completed the time allotment or the goals may have been achieve. The group will also have to be able to function independently and without the support of the group. Resources for community assistance will be instrumental in the members after group termination. Some groups may terminate due to internal personal conflict or the realization that the group is not functioning properly.

Members should be informed and given a set time and schedule working towards the termination. Workers should search for clues that the group should terminate (Northen and Kurland, 2001). Time frames for discussing termination should be considered based on the group dynamics. The notice should be neither too early nor too late. This can cause extra stress and worry; interfering with the goals and objectives of the group as a whole and the members individually.

Factors in Termination Phase for Workers and Members

Anxiety

Members will usually become anxious over a worker departure. Separation anxiety will also occur with group termination. As the members become familiar with each other they will fear life without the support they have experienced. A successful group will view the members as family members. The feeling of losing a family member will create anxiety and often the members may resist the termination.

Denial

Members may deny the termination of the group as a coping mechanism. The members in denial will ignore the notice of termination and simply behave as if it were not going to happen (Northen and Kurland, 2001). Workers should look for clues of member denial such as silence, subject changing or antisocial behavior. Exaggerated independence or a higher level of functioning will also alert the worker that group members are experiencing denial.

Regression

Members who suddenly seem to have lost previously mastered goals signals to the worker that regression in response to termination is occurring. Members will attempt to convince the worker that they are not better and they still need therapy, the worker and the group. The worker must exercise caution and not misinterpret these behaviors as the member’s failure but rather recognize the regression model at work.

Fight or Flight

It is a normal human response to experience fight or flight syndrome in an emergency situation. For members of a group they will experience this due to the anxiety and worry. They will experience a feeling of “I’ll leave you before you leave me” (Northen and Kurland, 2001, p. 419). As trust has been established, the members who have not experienced this before will feel a true emergency situation. Workers should recognize this and work towards engaging the members to remain in the group until the planned termination date.

Recapitulation

Accepting the termination of a group is also a dynamic of an individual’s reaction to separation and termination. Members may experience a sense of loss which is normal. This process is helpful to the member as they summarize their time in the group and evaluate the processes and achievements they have made. Although there are negative feelings towards termination, there are also positive feelings of accomplishment. Workers can foster this sense of accomplishment to help members through the separation and termination.

Graduation Effect

Members may experience the feeling and sensation of reflection and feel empowered by their progress. A feeling of happiness and gratitude for the learning process will resemble graduation from a course or school. The sensation of a task accomplished. Members will be able to see the positive and negative feelings and realize these as building blocks for moving forward with their lives.

Evaluation

Purpose

Workers need to evaluate the group as the end nears. The purpose of the group should be a main factor in the evaluation. The worker can use any method they choice; questionnaire or interview.  The members should be questioned on the experience value, what was liked and disliked about the group, how they perceived the worker and how the group could be better (Jacobs, Masson, and Harvill, YEAR).

The closing stage is important in summarizing the group experiences. This is a time of assessing the growth and changes made by the individual group members. Reviewing the group’s purpose should focus on how the members perceive the group’s success. The members and worker have a responsibility to share their own personal observations of progress and confidence in the growing ability of the members to get along without the group (Northen and Kurland, 2001).

The ongoing process of evaluation is important to the continued success of the group process. Evaluating how the group did will assist in the next group’s success. For the worker to understand their styles and methods in relation to how the group evaluates the process is important for continued methodology and outcomes. Maintaining high morals and ethics in the group process is important and continual evaluation will help keep these principals in the forefront of the process. Workers should use research and documented processes for group structures.  Clearly stated expectations and the critical importance of worker/member/group relationships are important in the model development (Northen and Kurland, 2001).

Method and Instrumentation

Records are a means of evaluation. Accurate record keeping is important in the evaluation of individuals and the group as a whole. The records will contain important information about the members and their progression in therapy. The worker will keep records to include the dates, times, location, members present and notes on the participation and outcomes of the meeting.  Records document the event and provide historical information in teaching other workers the processes.

Individual summaries are also of use in evaluation purposes. Workers will keep individual summaries on the members to include an assessment of the member, their needs, problems and strengths in psychosocial functioning, mental and physical health and the impact of the group on that functioning (Northen and Kurland, 2001). These summaries are collected after the first interview and periodically throughout the group process.

There are scales which are useful to workers and the evaluation process. Goal attainment scaling, client satisfaction, Global Assessment Scale and the Group Climate Questionnaire are a few examples. These and others are useful in the evaluation of the group’s results. It is important to use these instruments in a way which is not counterproductive to the outcome of the individuals and the group.

Understanding Outcomes

The purpose of evaluations and the understanding of the outcomes are beneficial to the relevance of the group processes. The workers are responsible for ensuring that no danger or risks are threatening the members. This research is vital to the continuing teaching of workers and their effectiveness in leaving groups. This is important for preventing problems to specific individuals participating in the group process.

Summary

Group separation and termination is a part of the entire clinical social work group process. Workers and members each have a participatory role to the group. The worker is responsible for ensuring the process and particularly the successful termination of a group. Helping members through the emotional factors of termination is vital to success of the members entering the real world again. Evaluation and understanding of the outcomes is important not only for the members but for research and continued teaching opportunities for workers.

Works Cited

Jacobs, Ed E., Robert L Masson, and Riley L. Harvill. Group Counseling. 6th ed. Belmont, CA: Thomson Books, 2009. Print.

Northen, Helen, and Roselle Kurland. Social Work with Groups. 3rd. New York: Columbia University Press, 2001. Print.