PROBLEM BEHAVIORS PROBLEM BEHAVIORS IN GROUPSIN GROUPS

Reference: Cole, Ch.2Reference: Cole, Ch.2

What We Already KnowWhat We Already Know

Individual roles:Individual roles:Use group to serve individual needsUse group to serve individual needs Interfere with group productivity and Interfere with group productivity and

cohesivenesscohesiveness

Individual RolesIndividual Roles

Aggressor – Disapproves of others, Aggressor – Disapproves of others, attacks group or group taskattacks group or group task

Blocker – Negative, resistant, side-tracks Blocker – Negative, resistant, side-tracks group with irrelevant issuesgroup with irrelevant issues

Recognition seeker – Looks for constant Recognition seeker – Looks for constant attentionattention

Self-confessor – Uses group as audienceSelf-confessor – Uses group as audiencePlayboy – Jokes, displays lack of caringPlayboy – Jokes, displays lack of caring

Individual Roles, cont.Individual Roles, cont.

Dominator – Monopolizes, interrupts, sees Dominator – Monopolizes, interrupts, sees every discussion in terms of selfevery discussion in terms of self

Help-seeker – Looks for sympathy, Help-seeker – Looks for sympathy, unreasonably insecure, help-rejecting unreasonably insecure, help-rejecting complainercomplainer

Special interest pleader – Uses group to Special interest pleader – Uses group to sell his/her ideology (political, religious, or sell his/her ideology (political, religious, or social agenda)social agenda)

When problem is occurring, Ask When problem is occurring, Ask yourself:yourself:

When is it a problem?When is it a problem?To whom is it a problem?To whom is it a problem?Why is the problem occurring?Why is the problem occurring?

Why Individual Behaviors OccurWhy Individual Behaviors Occur

Members have inadequate group skillsMembers have inadequate group skillsMembers don’t understand how groups Members don’t understand how groups

should work in therapyshould work in therapyMembers have low moraleMembers have low moraleLeader does not set therapeutic normsLeader does not set therapeutic normsGroup has low level of maturityGroup has low level of maturityGroup task is inappropriateGroup task is inappropriateMembers have personality disordersMembers have personality disorders

Strategies for the Group TherapistStrategies for the Group Therapist

Develop an understanding of the member Develop an understanding of the member with the problem behaviorwith the problem behavior

Ask yourself, “What does this person really Ask yourself, “What does this person really need?”need?”

Ask yourself, “What does the group Ask yourself, “What does the group need?”need?”

Take measures to preserve the group Take measures to preserve the group integrityintegrity

Problem BehaviorsProblem Behaviors

The silent memberThe silent memberThe dominating memberThe dominating memberThe angry or distressed member The angry or distressed member Disruptive or bizarre behavior Disruptive or bizarre behavior The silent group The silent group The apathetic group The apathetic group A group in conflictA group in conflict

Example: MonopolistExample: Monopolist

Harry came into the group angry. He refused to Harry came into the group angry. He refused to listen to the purpose of the group or to listen to the purpose of the group or to participate in the activity. “I’m not going to draw participate in the activity. “I’m not going to draw like I’m in kindergarten. Excuse me, but you girls like I’m in kindergarten. Excuse me, but you girls don’t know anything about alcohol abuse. When don’t know anything about alcohol abuse. When I was in county hospital, they had me doing I was in county hospital, they had me doing paintings & sculptures and what-all. It never did paintings & sculptures and what-all. It never did anything for me…” Five other members listened anything for me…” Five other members listened to this outburst in silence. They had heard to this outburst in silence. They had heard Harry’s routine beforeHarry’s routine before

Monopolist: What to Do?Monopolist: What to Do? What does Harry need?What does Harry need?

Control the groupControl the group Maintain leader/group attentionMaintain leader/group attention Avoid his own hurtful issuesAvoid his own hurtful issues Gain respect Gain respect

What does the group need?What does the group need? Get Harry to be quiet Get Harry to be quiet Let Harry continue, so that they won’t have to reveal Let Harry continue, so that they won’t have to reveal

or discuss their own hurtful issuesor discuss their own hurtful issues How can leader intervene to avoid establishing a How can leader intervene to avoid establishing a

non-therapeutic norm?non-therapeutic norm?

Monopolist, What to Do, cont.Monopolist, What to Do, cont. Harry is playing the role of an aggressor, Harry is playing the role of an aggressor,

devaluing the group and its leadersdevaluing the group and its leaders Best strategy: Ask group “Why are you allowing Best strategy: Ask group “Why are you allowing

Harry to monopolize your group?”Harry to monopolize your group?” Ask specific members, “Why are you silent? Ask specific members, “Why are you silent?

What are you thinking?”What are you thinking?” Encourage members to give Harry feedback by Encourage members to give Harry feedback by

completing the sentence, “When you speak like completing the sentence, “When you speak like that it makes me feel ____________” that it makes me feel ____________”

If the group can be helped to express its If the group can be helped to express its frustration with Harry, then Harry might learn to frustration with Harry, then Harry might learn to control the behaviors that elicit negative feelings control the behaviors that elicit negative feelings from othersfrom others

Problem BehaviorsProblem Behaviors

MonopolistMonopolist The silent memberThe silent member The boring memberThe boring member Help-Rejecting ComplainerHelp-Rejecting Complainer The Self Righteous Moralist (SRM)The Self Righteous Moralist (SRM) Psychotic memberPsychotic member Characterologically difficult membersCharacterologically difficult members

SchizoidSchizoid NarcissisticNarcissistic BorderlineBorderline

From Cole, M. Group dynamics in occupational therapy instructor's manual. Online document, http://www.efacultylounge.com, based on Cole, M. (2004). Group dynamics in occupational therapy, Third edition. Thorofare, NJ: SLACK Incorporated.

Monopolist, characteristicsMonopolist, characteristics

Anxious with silenceAnxious with silenceResponds to everyone’s commentsResponds to everyone’s commentsDecreased ability to empathize with othersDecreased ability to empathize with othersUnaware of impact on othersUnaware of impact on othersDiscusses tangential issues in irrelevant Discusses tangential issues in irrelevant

detaildetailMay assume the role of interrogatorMay assume the role of interrogatorMay tearfully describe his or her own crisisMay tearfully describe his or her own crisis

The Silent MemberThe Silent Member Dreads self-disclosureDreads self-disclosure PerfectionisticPerfectionistic Fears failureFears failure Dreads being center of attentionDreads being center of attention May be conflicted about aggressionMay be conflicted about aggression Maintains control thru silenceMaintains control thru silence May be avoiding display of feelingsMay be avoiding display of feelings May feel incapable of expressing self in ways May feel incapable of expressing self in ways

other group members have doneother group members have done What are your reasons for being silent?What are your reasons for being silent?

Silent Member: Therapeutic Silent Member: Therapeutic InterventionsInterventions

Comment on non-verbal behaviorsComment on non-verbal behaviorsAsk process questions like: “What is the Ask process questions like: “What is the

ideal question that I could ask you today to ideal question that I could ask you today to get you involved in therapy?”get you involved in therapy?”

Help member learn about self thru his or Help member learn about self thru his or her behaviorsher behaviors

Get member to explain why it is so hard Get member to explain why it is so hard for him or her to speak in groupfor him or her to speak in group

The Boring MemberThe Boring Member

Massively inhibitedMassively inhibitedLacks spontaneityLacks spontaneity ““Safe” – Does not take risksSafe” – Does not take risksAgrees with majorityAgrees with majorityCould be dependent, silent (not aware of Could be dependent, silent (not aware of

feelings)feelings)May have a core dependent self and May have a core dependent self and

dread rejection/abandonmentdread rejection/abandonment

Therapeutic InterventionsTherapeutic Interventions If you as leader are bored by this person, so is If you as leader are bored by this person, so is

the groupthe group Group tolerates this behavior better than other Group tolerates this behavior better than other

problem behaviors, because it seldom disrupts problem behaviors, because it seldom disrupts the groupthe group

Use self as data to give member feedbackUse self as data to give member feedback Replace boredom with curiosityReplace boredom with curiosity Ask “How can I find the real, dynamic person Ask “How can I find the real, dynamic person

behind this boring shell?”behind this boring shell?” Inquire gradually over several sessions, Inquire gradually over several sessions,

encourage other members to do the sameencourage other members to do the same

Help-Rejecting ComplainerHelp-Rejecting Complainer

Variant of the monopolistVariant of the monopolist Seeks therapist attentionSeeks therapist attention Implicitly or explicitly asks for help, then rejects itImplicitly or explicitly asks for help, then rejects it Problems sound impossible to solve and takes Problems sound impossible to solve and takes

pride in thispride in this May belittle problems of othersMay belittle problems of others Usually blames others for own problemsUsually blames others for own problems Highly conflicted about dependencyHighly conflicted about dependency Mistrusts authorityMistrusts authority

HRC: Vicious CycleHRC: Vicious Cycle

Member Complains

Therapist& Group

Offer Help

Member Requests

Help

Member Rejects

Help

HRC: Therapeutic InterventionsHRC: Therapeutic Interventions

Do not express your anger and frustration. Do not express your anger and frustration. Why?Why?

Use empathy and self disclosure about Use empathy and self disclosure about hopelessness of situationhopelessness of situation

Do not continue to offer helpDo not continue to offer helpGive support for HRC to choose to accept Give support for HRC to choose to accept

or reject helpor reject helpUse feedback only when trust is Use feedback only when trust is

establishedestablished

Self Righteous Moralist (SRM)Self Righteous Moralist (SRM)

Invokes guilt and blameInvokes guilt and blameBlames and judges other membersBlames and judges other membersDoesn’t care about being likedDoesn’t care about being likedUsually appears self assured and calmUsually appears self assured and calmWill not admit to being wrong Will not admit to being wrong Feels shame on deeper levelFeels shame on deeper levelCreates maladaptive cycle, similar to HRCCreates maladaptive cycle, similar to HRC

SRM: Therapeutic InterventionsSRM: Therapeutic Interventions

Get group to give SRM feedback on how Get group to give SRM feedback on how behavior makes them feelbehavior makes them feel

Discuss consequences of behavior on Discuss consequences of behavior on relationships with othersrelationships with others

Use empathy to develop trustUse empathy to develop trustLook at pattern of behavior outside group Look at pattern of behavior outside group

and consequences for SRMand consequences for SRMDon’t tell him he’s right. Why?Don’t tell him he’s right. Why?

Psychotic MemberPsychotic Member

Persons who are psychotic should not be Persons who are psychotic should not be included in a groupincluded in a group

If member becomes psychotic, he or she is If member becomes psychotic, he or she is unable to benefit from group treatment, unable to benefit from group treatment, according to Yalomaccording to Yalom

Irrational and illogical members take up vast Irrational and illogical members take up vast amounts of group energy, and may bring group amounts of group energy, and may bring group process to a stopprocess to a stop

Such members should be removed from the Such members should be removed from the group until their psychosis comes under controlgroup until their psychosis comes under control

SummarySummaryUse interpersonal learning as guideUse interpersonal learning as guideTherapist judgment as to how much Therapist judgment as to how much

feedback members are ready to acceptfeedback members are ready to acceptUse group feedback to facilitate self Use group feedback to facilitate self

understandingunderstandingAlways protect integrity of group firstAlways protect integrity of group first