Running Head: CPSY688 MIDTERM1.

CPSY688 Midterm

Alyssa Heggen

Ball State University

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1. Please assess the strengths and weaknesses of the Yalom text from a multicultural perspective.

In Irvan Yalom’s book The Theory and Practice of Group Psychotherapy (2005), it

seems that Yalom is conscious to go into great detail regarding every aspect of group therapy.

Each chapter is thoroughly dedicated to a building block of what it takes to conduct effective

interpersonal group therapy. However, there is little mention of multicultural perspective in his

framework of group therapy. In the very beginning of his book, when discussing the therapeutic

factor, universality, Yalom does discuss how cultural differences can have an impact on the

growth and dynamics of group therapy. Specifically, he cautions group therapists to be aware of

feelings of exclusion that cultural minorities may feel in a group that is predominantly

Caucasian. Yalom suggests that individuals from different cultures may have varying feelings

towards the therapeutic aspects of self-disclosure, interaction with the group, and affective

expression. In terms of self-disclosure, in his article “Multicultural Counseling: From Diversity

to Universality” (1996), C.H. Patterson suggests that it isn’t that some individuals from various

cultures are unable to self-disclose, rather they are reluctant to self-disclose with others who they

are unfamiliar with or who are outside of their culture group. This contributes to the challenge of

building universality within the group that was discussed by Yalom. A definite strength in

Yalom’s text is that he provides novel group therapists with a task the group can collectively

work on to overcome such cultural differences. Specifically, Yalom suggests that rather than

focusing on absolute cultural differences, that the group should begin focusing on “transcultural”

responses to life experiences and tragedies that all human beings experience, regardless of

culture. I think this is something that all groups must overcome regardless of the type of

members that compose the group in order to build group cohesion. For instance, a group could be

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composed of all African American or Caucasian members, but they still may have different

backgrounds, family life, or ways of living, all of which can create various prejudgments in the

early stages of group therapy before they have had the opportunity to get to know one another.

Although Yalom suggests that the group should work collectively to overcome such

individual differences, he does not suggest that group therapists dismiss cultural differences

altogether. Here, Yalom argues that often times mental health professional lack the knowledge

and awareness of multicultural factors that allow them to work well with diverse clients. One

way Yalom suggests to achieve this cultural understanding is to gain awareness of where their

client(s) stand in terms of how much they identify with their culture of origin. However, Yalom

fails to go into detail regarding these various levels of acculturation. According to Ann Vernon

(2009), there are four types of acculturation; integration, assimilation, separation, and

marginalization. A cultural minority who is integrated has blended their culture of origin with the

dominant cultural practices. Assimilation means that a cultural minority has replaced their

culture of origin with the dominant culture they live in. Separation refers to rejecting the

dominant culture they live in and solely practicing their culture of origin, whereas

marginalization refers to rejecting both their culture and the dominant culture. What type an

individual finds themselves associating with can greatly affect an individual and how they

interact with the group. I think it’s important that group therapists understand their client’s

identification with their culture in order to effectively work through therapy.

I think it would have been beneficial for Yalom to provide case study examples of

various multicultural issues that often arise in group counseling. Yalom’s text is filled with a

wide variety of case examples that Yalom has personally experienced throughout his years as a

group therapist. However, there are not any that discuss multicultural issues. In the Corey video

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that was presented in class, the group therapists demonstrated a multicultural issue that arose

very early in the group process. Here, a minority member felt that she could not fully express her

thoughts and feelings because she was afraid of being judged by other members from dominant

cultures. As Yalom suggested, this can be a critical factor when working on universality and

group cohesion. I thought that Corey and Corey did a great job at working through the issue

immediately so the group members may learn from the experience and grow stronger as a group

because of it. Another aspect that Yalom failed to discuss is that some minority groups prefer a

structured environment where the therapist is viewed as the expert that offers advice and

solutions to problems. An individual who holds such beliefs might struggle in an interpersonal

group setting that is focused on the here-and-now because such groups don’t evolve around the

therapist, but instead the relationships within the group and the understanding of one’s

interpersonal skills (Patterson, 1996). To conclude, it is evident that Yalom (2005) wrote this

book to provide a comprehensive understanding of the most recent research and practice of

group therapy. Although Yalom doesn’t completely exclude multicultural aspects from his text,

there is still opportunity for him to provide more regarding multicultural perspective than he has

originally included.

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2. How does the “use of self” fit into your theoretical orientation as it relates to group leadership and development? (Please note that you will need to identify and explain your theoretical perspective, as well as your model of group development to answer this question.)

As a counselor, I have chosen to align my theoretical framework with solution-focused

therapy. As a solution-focused counselor, my ultimate goal is to listen to the client and provide

alternative perceptions to their presenting problem so that they may redefine and normalize their

problems, and thus begin to find exceptions and solutions to such issues. Metcalf (1998), in his

book Solution Focused Group Therapy, describes it best when he describes solution-focused

counselors as “facilitators” who allow clients to view themselves as the expert of their own life.

Here, Metcalf suggests that individuals have the potential and resources to solve their own

problems, but have simply gotten stuck focusing on the problem and thus, forgotten such

alternative solutions or ways of behaving. I find a group setting to be particular beneficial for

practicing solution-focused therapy because it provides individuals with feedback and

perceptions from a variety of people besides solely the counselor. Further, it will ensure that all

points of view are being considered besides what the counselor values and considers most

important. While practicing this theory in a group setting, it is important that I am conscious of

both my professional knowledge and self-knowledge. As suggested in class, self-knowledge is

equally important as professional knowledge. Yalom (2005) expands on this idea when he

explains that a group leader’s personal reactions and feelings within the group can serve as

invaluable data and should be used as such appropriately. Here, Yalom is suggesting that not

only do you use your professional skill set, but also your own reactions to how the group is

working. I think awareness of my own past experiences and how I view them are going to be

extremely important while working with clients. One of the reasons why I wanted to become a

counselor, and why I chose solution-focused as my theoretical framework, is because I have had

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my fair share of trials and tribulations throughout my life. However, I have learned from these

experiences and my life is better because of them. I want others to realize their potential to grow

and learn from their experiences as well. With that said, it is also important that as counselor I

am also open to new perceptions and ways of viewing the problem besides my own views,

values, and beliefs. This will not necessarily be an easy task; however, taking this risk will allow

me to learn about myself through interacting and working with my clients. Thus, it will provide a

mutually beneficial therapy experience.

When it comes to conducting a solution-focused group, I find myself supporting the

group development theory that was discussed in Yalom (2005) and in class, which consists of

five stages of forming, storming, norming, performing, and adjourning. It is important that I am

aware of the developmental sequence of the group in order to guide and facilitate the group to an

optimal level of functioning and interacting. Similarly, Yalom suggests that it is the group leader

that shapes the norms of the group in the beginning. Because of this, it is important that I am

especially active in leading group discussion, while also being attuned to every member’s

subjective experience. Once again, I find my personal feelings and reactions to how the group is

progressing to be very valuable here. As a group leader, I am also willing to pave the way for

deep discussion; this includes expressing my own feelings and self-disclosing when appropriate.

To conclude, as a counselor, I strongly believe that I cannot help others effectively work through

their problems and experiences unless I have successfully come to understand and learn from my

own problems and experiences. It’s important that am always conscious of my preconceptions

and be aware of other’s as well, thus allowing for continual growth and learning throughout my

counseling career.

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3. Describe a group that you would like lead with a specific population in the future. Discuss how the following ethical issues are relevant to facilitating this particular group: 1) Psychological Risk to Members, 2) Sensitivity to Diversity, 3) Awareness of my own values/biases/experiences, 4) Competence to work with specific group, and 5) Confidentiality and its Limits. Finally, choose four of Yalom’s therapeutic factors that would be important with this group and describe your rationale for choosing these particular factors

A group that I would like to implement in the future would be a group for adolescent girls

focusing on peer pressure and relational aggression in a middle school setting. Middle school is

often a difficult time for girls because their bodies are maturing, there is an increased desire to

connect with peers, and assert independence. This is even more pronounced with images in the

media of the ideal feminine body image and seeking of romantic relationships. Because of all

these changes, belonging in a peer group is particularly important for adolescent girls. Having a

strong connection with peers has been found to increase confidence and protect against isolation

and victimization in the school setting (Letendre, 2007). When there is struggle maintain such

power and control in relationships, girls have turned to various forms of aggression. However,

unlike their male counterparts who have turned to physical aggression, girls exert relational

aggression in the form of name-calling, harassing, and spreading rumors. Such forms of

relational aggression have been found to be just as detrimental as physical forms of aggression,

often resulting in feelings of loneliness and depression (Letendre, 2007). Unfortunately, it seems

that many negative coping skills have been developed to help girls maintain connection and a

sense of identity with other girls. I think it is particularly important to implement this group

because it will allow struggling adolescent girls to realize that peer relations and relational

aggression is something experienced by all girls in school and can only be changed once they

themselves change their behavior and begin to assert themselves in more appropriate, non-

aggressive ways.

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By implementing this group in a school setting, there are certain psychological risks that

must be understood by the group members before beginning. To start, there are going to be

members within the group who have been aggressed, the aggressor, and sometimes, have been

both. This is particular important because there may be conflict already present among members

before the group actually begins. Further, members within the group may disclosure some very

personal experiences. Sharing such strong experiences may elicit strong emotions from members

other than the one sharing. There may be experiences that other members can relate too, which in

turn, will also result in a strong emotional reaction. These psychological risks are very similar to

the limits of confidentiality in this group setting. Similar to individual therapy, all members

within the group are given informed consent. That is, they realize what the group entails, how it

will be conducted, and any risks that may result from involvement in the group. In addition,

every group member will have confidentiality explained to them in an individual session.

Confidentiality is incredibly important with this group for two reasons. The first reason is that

group therapy is different from individual therapy because there is the possibility of other group

members breaking confidentiality and sharing information to people outside the group. Members

within the group must be aware of this and be willing sign a confidentiality contract that commits

them to keeping information shared within the limits of this group only. Further, this group will

be conducted with minors in a school setting. Before students can become a part of this group,

parental permission must be given. In addition, the students within the group must also realize

that there will be limits to confidentiality; if someone is hurting them, if they are hurting

themselves, or if someone else is in immediate danger. Communicating all the above is going to

be detrimental in the formation of this group. It’s important that each and every member

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understands these psychological risks and limits of confidentiality, and be willing to adhere to

them.

It’s also important that the group therapist and the members of the group be aware and

understanding of individual and cultural differences. According to Joan Letendre (2007), the

consequences that adolescent girls experience as a result of relational aggression are

compounded when they are a part of a minority group, are of low socio-economic status, or live

in an urban area because such girls have experienced increased hardships and marginalization

because of their group status. Letendre (2007), in her discussion of forming adolescent girl peer

group therapy, went on to emphasize the importance of ensuring that every girl is recognized and

affirmed within the group. This is particularly true of girls from diverse backgrounds who may

have varying feelings towards gender expectations, communication styles, ways of handling

conflict, and managing friendships. Because of this, an important goal of my group would be to

model acceptance and understanding of those from different backgrounds or cultures. I believe

this could be a very therapeutic factor within the group because it allows the members to learn

different perspectives and ways of understanding situations and experiences that they are being

confronted with among their peers in the school setting.

As the leader of the group, there are several things I also must consider while leading this

group. To start, I am a woman who has had the same experiences as the adolescent girls in the

group. For that reason, I think it’s important that I am aware of my own experiences, my feelings

towards such experiences, my feelings towards the group members and the experiences they

share within the group. It is discussed in Yalom (2005) that the relationship is often considered

the “curative” factor in therapy, which means I must be open, honest, and attuned to every

member’s feelings and experiences within the group. However, it is important that when I

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express my feelings, I do so with appropriate reason and timing. Here, Yalom also discusses the

difference between objective countertransference and subjective countertransference,

emphasizing that when expressing my thoughts and feelings, I must be cautious that they are

clearly objective and beneficial for the individual or the group. As suggested by Yalom (2005), I

also think that disclosing some of my personal experiences of relational aggression when I was

their age will help bring group cohesion and acceptance of sharing such vulnerable experiences.

Being able to relate and work with adolescent girls is not something that every therapist

would feel comfortable. It takes time to build trust with adolescent girls because they often think

that no one else can understand how they feel. Although I may not have experienced every life

situation every adolescent girl has experienced, I have gone through many myself. Further, lack

of experience in every situation does not mean that I won’t be able to have empathic

understanding for these girls and an open mind to their thoughts and feelings. In fact, working

with adolescent girls is a passion of mine. I have worked a lot with adolescent girls in both a

clinical and school setting and feel confident in my skill set at this point to implement this type

of group in a middle school setting.

In the next section, I will discuss four therapeutic factors which I believe will be

incredibly important for this group of adolescent girls.

Universality: According to Yalom (2005), many individuals begin therapy with the notion that

no one else will have, nor understand, the problems, fears, and/or insecurities they face. This

could not be truer for adolescent girls, who often assume that no one could possibly understand

what they go through every day. Adolescent girls are very self-conscious of their appearance and

behavior, often striving to “fit in” as best as they possibly can at their school to ensure

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friendships and control over their peers (Letendre, 2007). For this reason, universality is going to

be a significant component for this group. It’s going to be important that the members of the

group realize that many of them have very similar insecurities and fears in terms of peer

relationships and fitting in at school. Further, my experience working with adolescent girls has

demonstrated that simply realizing that nearly everyone has had some experience with bullying

will bring a sense of relief for many young girls. Yalom (2005) supports this notion and suggests

that group therapists aim at disconfirming beliefs of uniqueness in the early stages of group

therapy.

Altruism: Altruism, or the act of giving for no personal benefit, is going to be a therapeutic

factor that provides healing and growth for many members in the group. Yalom has suggested

that often times, individuals in the group more readily accept suggestions, feedback, or advice

from other members than from the group leader. I expect this theory to hold true for adolescent

girls who often find it easier to confide in peers than adult figures. Further, there may be some

members within this group who experience guilt for their past aggression on peers. Simply

listening to other members, relating to their fears, and offering support could be a simple act of

altruism that can have lasting change on their behavior. They may see that it’s much easier to be

kind than to compete with one another for social status.

Development of socializing techniques: Because this group is specifically for adolescent girls

in a school setting, particular attention will be paid to social skills. Letendre (2007) calls for

programs that teach and empower young girls to develop healthy relationships and assertiveness

skills that will help them work through life challenges effectively. Further, one of the main goals

of the group is to learn and understand the impact relational aggression can have on individuals

and their peer relationships. To supplement this goal, it is going to be important that members in

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this group learn and practice appropriate problem solving techniques to deal with relational

aggression. Having students who have all aggressed or are aggressors themselves interacting and

working together is going to contribute a lot of new socializing techniques.

Group cohesiveness: Finally, Yalom (2005) suggests that positive relationships are essential to

a positive outcome in therapy and is a precondition for other therapeutic factors to work

effectively in the group. Similar to universality, I find that group cohesiveness is going to be

important to develop early on in the group in order for the adolescent girls to begin fully working

on the topic of relational aggression. In order for this group to succeed, I expect there to be a lot

of self-disclosure and therapeutic conflict among the members while discussing relational

aggression. By nature, girls seek and thrive off of connectedness and relating to others (Letendre,

2007). However, it will be the makeup of the group that determines how much cohesiveness is

demonstrated early on. This may be a therapeutic factor takes time, or is strong in some sessions,

while lacking in other sessions.

To conclude, conducting a group for adolescent girls in a school setting is going to take a

lot time and preparation. However, through the research, it is evident that there is a need for such

programming (Letendre, 2007). Working through the conflict experienced among girls in school

will hopefully provide members of the group with a new understanding and respect for their

peer, in addition to appropriate social skills to work through future conflict and relational

aggression.

Works Cited

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Letendre, J. (2007). 'Sugar and spice but not always nice': Gender socialization and its impact on

development and maintenance of aggression in adolescent girls. Child & Adolescent

Social Work Journal, 24, 353-368. doi:10.1007/s10560-007-0088-7

Patterson, C. H. (1996). Multicultural counseling: From diversity to universality. Journal of

Counseling & Development, 74, 227-231.

Vernon, A. (2009). Counseling children & adolescents. Denver, CO: Love Publishing

Company.

Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy. New

York, NY: Basic Books.