By Bette J. Freedson, LICSW, LCSW, CGP
Published in FOCUS, the newsletter of the Massachusetts chapter of NASW
Picture yourself leading a group in which you choose the clinical methods that interest you, and serve them up in ways that use your skills, and your personality to affect the objectives of your group. Now, imagine your group members reporting positive psychosocial outcomes–greater resilience, increased ego strength, and improved coping skill. You have just glimpsed the therapeutic richness of growth groups. Growth group settings are filled with a combination of clinical techniques and differential use of Self that draws on the best practices of social work, including dedication to the healing and empowerment of your group members.
In 1942 Gertrude Wilson proclaimed group work as “…a process and a method through which group life is affected by a worker who consciously directs the interaction towards the accomplishment of desirable goals…” (“The National Conference on Social Work, 1942,) In 1949 Wilson and Gladys Ryland published “Social Group Work Practice” which included an “analysis of different programme media, including play and leisure activities, games, dance, music, story telling and dramatics, and arts and crafts, trips and the out of doors…Many of the notions that are familiar today as established nostrums of practice are set out in the book including a discussion of the conscious use of self…”
Studying ideas like these at Boston University School of Social Work (1979-1982,) I became fascinated by group work. At BUSSW, Trudy Duffy, James Garland and Ralph Kolodney consolidated my belief in the power of groups for eliciting change in emotional, cognitive, relational, social, and even physical health dimensions. During fieldwork at Family and Children’s Service of Greater Lynn, under the supervision of group enthusiast Joanne Noyes, LICSW, I began to explore the exciting therapeutic potentials inherent in “differential use of Self” and their applications in groups.
My philosophy about use of Self is expressed well by Heath B. Walters, child Welfare field coordinator at Lewis Clark State College, in his article, “An Introduction to Use of Self in Field Placement.”
“It is the use of self that enables social workers to strive for authenticity and genuineness with the clients we serve, while at the same time honoring the values and ethics we so highly value in social work practice.”
…successful students have not only mastered the skill set taught in social work practice courses, but have also mastered the integration of their social work skills with their authentic selves.
(another)… aspect of use of self is self disclosure. Sharing your own experiences and past problems can often normalize a client’s experience and provide an opportunity for modeling appropriate behaviors and responses. …When you are about to self disclose…ask yourself, “Am I doing this for the client, or is this more related to my own interest?”
Basing my use of Self on these guidelines, I compose groups that borrow from a number of clinical ideas and techniques. In any given group, I might draw from process focus of psychodynamic therapy groups, from the structured format of psycho-educational groups, and/or from the supportive, as well as therapeutic functions of “theme groups.” A discussion of theme groups by Drum and Knott (International Journal of Group Psychotherapy, Oct. 2009, p492) may give you an idea of the format and activities of a growth group.
“These…structured and active group formats…required leaders to attend to group climate-setting tasks, such as developing cohesion, so that self disclosure, …and exploring emotions would occur in a supportive pro-change environment.
Accomplishing these goals required more complex, multi-modal, sequenced change efforts.”
Along such multi-modal lines, I facilitate open-ended groups adopting the role of a clinical chameleon. The complex and fascinating environment of growth groups allows me the latitude to “utilize” (in the spirit of Milton Erickson) my Self, and apply all the clinical skill I can muster, in the interest of providing individual members, and the group, with a broad spectrum of therapeutic experiences.
Here is how it works.
I compose each group with an overarching goal/theme, such as “Stress Management,” “Inspired Coping,” or “Developing the Solid Self in Relationships,” (ego strength based) or, as in my school-based group, the Development of Executive and Social Skills.” Depending on my objective for a given session, I will use my Self differentially. For example, if I determine that process illumination is warranted, I will utilize what I have learned from Irvin Yalom. If psycho-education is in order, I will facilitate a more structured informational session using skills I learned years ago teaching Jr. High School. When my current middle school group is zoning out, I utilize the “zone”, aka meditation, followed by a mild hypnotic suggestion for relaxation. (If you get my drift.)(They edited this out.)
Every group session could include therapeutic doses of CBT, (Self, as cognitive restructurer,) or DBT for ameliorating dysfunctional behaviors, (Self, as proclaimed beneficiary of Marsha Linehan’s work.) I might PRN offer the group an evocative trance experience, (Self, as Ericksonian hypnotist, with story telling occasionally included.) In another session, I might offer a poultice of relaxation a la Herb Benson, (Self, becoming carefully disclosing participant.)
If the group’s dynamic calls for a tincture of non-denominational, secular spirituality, Self can become a fellow traveler into rarified territory. On another night, an experience of image re-association morphs Self into a wanna-be version of Steve Andreas!) On yet other occasions, Self may carefully craft dissociative experiences, in the service of ego integration, a la her mentor, Dr. Jeffrey Zeig.
In summary, growth groups can contain a diversity of clinical strategies and a multiplicity of choices for differential use of Self. Growth groups are therapeutically stimulating, surprisingly entertaining, typically healing, creatively empowering—and almost always, inspirational for all. Within the generative creativity of growth groups, engagement occurs, cohesion emerges, corrective experiences happen– and the clients love it.
Listen to what some clients have told me:
“Group is a time for me to decompress. I do my work better with the guidance and structure of the group.”
“The stress reduction has been amazing for me.
I love the healing circles.”
“Group has helped me to go off anxiety meds I’ve been on for 19 years.”
“I’ve gotten support from the group when I have been a rotten mess.
“As I listen, I can think about feelings I have that I have not been able to express.”
“This group is a mind breath.”
The creativity of growth groups is virtually limitless!
Try it! I think you’ll like it!
Sources and Resources:
Andreas, Steve, “Letting Go of Hate/How to Help Clients Change Unconscious Responses,” Psychotherapy Networker, July/August 2014, pp 59-62.
Drum, David J. and Knott, Eugene J., “Theme Groups at Thirty,” International Journal of Group Psychotherapy, Vol. 59, Number 4, October, 2009.
Freedson, Bette, “Enhance Your Practice and Clients’ Lives with Groupwork, Presentation for Massachusetts Chapter of NASW, Symposium, April 3, 2014.
Hillel I. Swiller, Ph.D, CGP, FAGPA, “Process Groups,” International Journal of Group Psychotherapy, Volume 61, number 2, April 2011.
Smith, M. K. (2004) ‘Gertrude Wilson and social group work’, The Encyclopedia of Informal Education, www.infed.org/thinkers/wilson.htm.© Mark K. Smith 2004.
Sophia Vinogradov, M.D., Irvin D. Yalom, M.D., Group Psychotherapy, Concise Guide to Group Psychotherapy, American Psychiatric Press, 1989.
Irvin D. Yalom, Theory and Practice of Group Psychotherapy, Basic Books, New York, Second Edition.
Zieg, Jeffrey, Ph.D., Founder and Director of the Milton H. Erickson Foundation, Attendance at New York Master Classes, 2011 to Present.