yalom group psychotherapy: essential skills for effective group facilitation
DESCRIPTION
The model of group psychotherapy developed by Irvin Yalom is now considered the ‘gold standard’ of group therapy approaches throughout the world. Its focus on the interpersonal relationships and the process underlying them allows the group to become a powerful agent of change. For many therapists, adding group therapy to your suite of services is a wonderful way to augment your practice, as well as provide valuable growth experiences for your clients. However it’s essential that you complete specific training in group therapy as the skills required are different from the skills of individual or couple therapy.June Lake is the leading teacher in Australia of the Yalom group psychotherapy approach and speaks with Australia Counselling about this powerful and effective type of therapy.In this 30-minute interview June also shares:how her passion for working with groups came aboutHow the skills we use in the therapy room different from group facilitation skillsa brief overview of the Yalom group psychotherapy approachthe qualities of an effective group facilitatorspecific skills do group facilitators need to develop to be effectivethe most common mistakes new group facilitators tend to makeJune also speaks about her 5-day intensive Yalom group therapy facilitation training that she runs every year.TRANSCRIPT
Speakers:
Mr Clinton Power Clinical Counsellor & Gestalt TherapistFounder of Australia Counsellingwww.AustraliaCounselling.Com.Au
Psychotherapist, counsellor, master trainer for Counsellors in Addiction InterventionCo-founder and Director of Australian Institute of Counselling in Addictionwww.lakescope.com
www.AustraliaCounselling.Com.Au
“Yalom Group Psychotherapy: Essential Skills for Effective Group
Facilitation”
[START OF VIDEO]
Clinton Power:Hello, this is Clinton Power, founder of the AustraliaCounselling.Com.Au.
It's my great pleasure to be here today with June Lake, who is co-founder and director of the
Australian Institute of Counselling in Addictions since 1997. She is an experienced
psychotherapist, counsellor, interventionist, clinical supervisor, teacher-trainer and consultant,
and she has designed, implemented, and evaluated training programs in the private and
government sectors. As a senior lecturer and trainer at the AICA, June trained hundreds of
counsellors as addiction specialists and is a master trainer nationally for the USA originated and
internationally applied program “Life Management, Relapse Prevention, and Building Health
Relationships.” And I personally know June to be a passionate group facilitator so we titled this
interview “Yalom Group Psychotherapy: Essential Skills for Effective Interpersonal Group
Facilitation.”
So welcome, June.
June Lake:Hello, Clinton, thank you.
Clinton:Well, let’s start by letting us know a little bit about how did your passion for
group therapy come about?
June:In starting this cofounding and beginning the Australian Institute of Counselling in
Addictions, I met three United States Marines from the Navy School of Health Sciences. There
was Ed Lacy, Paul Mullen, and Barry Gillen, three amazing group facilitators and therapists, and
I was just so inspired and motivated that I determined after working with two of them that I
wanted to be just like them. I wanted to be able to make the changes in people’s lives or
facilitate them to make the changes that I saw these 3 men were able to do.
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Clinton: But tell us what was it you saw in those group therapy demonstrations that was
so powerful impacted you in such a big way?
June: It was the skill levels, they were based in theory, they understood what they were
doing, it wasn’t a hit-or-miss, they were just so highly skilled that I knew if they had learned it
I’d be able to learn it too. And I was determined that I would learn it.
Clinton: Wonderful. So let’s talk a little bit about how the skills in the therapy room are
similar and different from group facilitation skills because I understand there are points of
difference. Can you tell us a bit about that?
June: Well, they certainly are. There are points of similarity in terms of micro skills and
there are points of differences in – I think the biggest difference is in group psychotherapy
where instead of just applying the therapists and the client in the interactions, we’ve got client
interaction or group member to group member and we’ve got therapists to client or group
member. And Irv Yalom’s work has a very definite process focus. So we’re actually assisting
clients to self-explore to go in the journey of self-exploration and that’s done through the
interpersonal interactions with the other group members.
Clinton: So tell us a bit about the Yalom approach, can you give us a brief overview? I
understand it’s certainly an extensive approach and if anyone has seen the textbook, it’s
sometimes called the bible of group psychotherapy, it’s an enormous paperweight. But can you
give us a brief summary of the Yalom approach?
June: Yes. Irv Yalom – and you’re right, his theory and practice of group psychotherapy
is the bible and it’s voluminous, I mean it takes ages to get through, but everything about group
is there that you would want to know. His approach is definitely based on process and when
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Irv Yalom talks about process, he’s talking about the nature of relationships between and
among members, and he works primarily with the dynamics that occur as members relate to
one another. So it’s quite a different approach and he’s over time looking to empower group
members so that the power is in the group, and as you and I have said many times, the agent of
change for individuals is the group. The power is in the facilitator’s use of skills rather than
team working one-on-one with members to effect change.
Clinton: Well, I think that in itself is probably a very big statement that the group is the
agent of change, and I guess another point of difference with individual therapy as well?
June: Absolutely. It’s something like I’m not good at math, Clinton, but the figures are
something like when you’re working with the group of eight people there’s the potential for
something like 320 different relationship formulations, so you’re pretty busy as a group
facilitator.
Clinton:Wow, that’s extraordinary. So what are other qualities of an effective group
therapist, can we touch on that?
June: Sure. I believe that the qualities that a therapist needs to begin facilitating, and
let me stress that after extensive training they certainly need to have respect. They need to
have patience, they need to be able to sit with tension and even arouse tension in some
circumstances. They need to be able to accept criticism without getting angry and they
certainly need to be able to look beyond what’s being said in the group in order to move that
group in the direction where healing can be most effective. There’s no point. If you don’t have
respect for your group members, your group members won’t respect you and the potential of
the group – and the potential growth for the individuals will never be realized. It’s essential
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that people have patience if they’re going to be group facilitators because the very best you can
expect the group process is slow and of course it’s very complex. So sometimes you need to
sit with things that are happening over and over again and not jumping too quickly. You will
also need to be able to allow tension to arise in the group because quite often it’s in that
tension where group members will be more inclined to speak the truth. And because of the
different stages that groups go through in the developmental areas when you hit what we call
adolescence and members start to flex their muscles, they start to challenge, they start to
become competitive, angry, you really need to be able to sit with that and use it to promote
growth rather than trying to shut them down. And you need to certainly look beyond what’s
being said if you’re going to work effectively with that group. It’s no use just focusing on the
content.
Clinton: I think what I hear you saying there, June, is that the personal development and
professional development of group facilitators are essential and I’m wondering how important
do you think it is for group facilitators to actually have been a group participant themselves in
the past?
June: Really good question, I think it’s essential, Clinton. I think unless you had the
experience of actually sitting in the group and feeling the emotions that are felt when you’re
receiving feedback, when you’re giving feedback in moments of tension, then there’s two
things that can likely happen: One is you’ll be too fearful to be bold and enthusiastic enough to
interact or intervene in the way that will promote growth and change. Or secondly, because
you’re not being there yourself, there’s a strong likelihood that you’ll start making demands on
group members and wanting them to go there and trying to control the group. And of course if
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a facilitator is doing this, they will actually shut the group down and the potential of the group
will never be realized.
Clinton: So you mentioned that groups go through stages. Do you mind us touching on
what other stages or what others expected developmental stages that a healthy group would
go through?
June: Okay. There are four stages and there are many different terminologies depending
on the modality of therapy where the facilitator comes from. The one I like, because I think it
most aptly describes the stage, is adolescence – I beg your pardon – infancy, adolescence,
maturity, and termination. An infancy parallels what we know in infants, they’re dependent on
the leader, they’re looking for structure, and probably they’re going to keep themselves
relatively safe, they’re not going to rock the boat. When they move into the adolescent phase,
they’re a little more venturous, just like adolescent boys and girls, they’re looking to prove
themselves, they’re looking to prove in the case of families the parents or authority figures
don’t know anything and they want to rock the boat. And unless you allow them to try out
different roles and behaviours in this adolescent phase, they’re probably never going to move
into the maturity stage of the group which is where the real work happens. And then of course
if each time walks through it is going to go into termination or even when one member
terminates the group, you’ll often see regression back to a safer type of group that was seen in
the very all strategies.
Clinton: Well, let’s talk about what are some of the specific skills that therapists need to
be to facilitate a group, and I think you’ve touched on a few of this already. One that’s standing
out to me, June, is certainly the ability to be out to hold tension and certainly as a group moves
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into adolescence, you know, imagining you will also need to be out to tolerate criticism and
people getting upset and angry with you. Tell us more about some of those skills.
June: Well, all of those that you just mentioned are vital. I think the most specific skills,
Clinton, you need to be able to differentiate between process and content. And we’re
socialized as a society to focus on content, what’s being said, and a perfect example of this is
one I like to use because we’ve come over late to it is the family Christmas table where ten or
twelve members of the family come together and they range from 5 to perhaps 85 and Uncle
Harry is holding cotton reminiscing as he loves to do and tell the stories about Christmas he’s
gone and his experiences and people hear this year-in, year-out, they know it off by heart,
they’re tired but Little Mary sits there and says, “Uncle Harry, you haven’t stopped talking since
we sat down.” And of course everyone says, “Mary, be quiet, don’t be rude to Uncle Harry!”
You see, he’s called the process that everyone is sitting bored to death listening to the content.
So you need to be able to differentiate between process and content. You need to strike a
balance between maintaining the group, keeping the group working, and achieving the task of
the groups. So we look very closely at facilitators acquiring the ability to differentiate between
functional and non-functional roles, and we call them behaviours and roles; those that are the
functional and those that are non-functional.
There’s also the list of Irv Yalom’s security factors or I think he calls them therapeutic
factors now. And there are those happenings that occur, the experiences that come up in the
group as group members go about interacting with one another and have the potential for
healing. You also need to know the stages that you just asked me about and let me say every
word that comes out of a facilitator’s mouth is not an intervention. We interact as facilitators
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as well depending on the stage of the groups. So in order to intervene at a crucial, at critical
point, something that has the potential to hum the development of the group and the growth
of the members in the group, you’ll also need to know when to intervene and to intervene
effectively at each of those four stages because they’re quite different.
So there’s a whole range of skills. You need to know what the process elements are. It’s
no good just understanding that process is about the nature of relationships and there’s people
interact, they’re the dynamics that we work with. You need to know what those process
elements are.
Clinton: So I guess, what I’m taking from that, June, is if you want to be a facilitator,
your want is not for the light of heart but also that it’s obviously important to have really
specific and extensive training in group facilitation skills. These are often not skills that are
taught in a regular counselling or psychotherapy degree.
June: Right, they’re specialized. They’re specialized skills, Clinton, they do need
specialized training. I think that because groups are cost-effective there’s a tendency to think
well throw them into group, but it’s a whole lot more than this. Just as such amazing abilities to
create growth and healing that needs to be in the hands of somebody that’s trained.
Clinton: So what are some of the most common mistakes you see perhaps beginner
group therapists make?
June: I think it’s concentrating. You know, when you knew and I remember those days I
intently listened to every word that was being said because somehow I thought that if I heard
everything and I do listen intently still but I was missing the process, I was so focused on what
was being said and of course that was in order to solve the problem. And I think that neophyte
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facilitators get caught into that. And that’s understandable, the desire to look intelligent, know
what you’re doing and bring about some change in probably group members. I think also that
unless you have a really good knowledge of how groups maintain and develop, that for instance
when they hit that second stage and it’s fire in Brimstone then there’s a tendency for untrained
facilitators to go into some sort of control to be either in facilitator-initiated transferential
energy or part of transferential energy, and of course you’re just supporting the members in
acting out more.
So I think there’s a lot of traps for new facilitators and I think it can be helped when they
co-facilitate with somebody with a little bit more experience or they’re trained and they have a
sense of mastery and direction about what they’re doing. I think they can let go of some of the
nerves then.
Clinton: And just another point, June, I mean is it necessary to have a co-facilitator or
can you still be just as effective running a group on your own?
June: I like that, Clinton. It’s much easier on your own, you don’t have to consider the
rhythms of the other person. I think what I see, I do a lot of clinical supervision of health
professionals and what I see so much around, not just New South Wales but other states when
I’m working, is I see a lot of shared facilitation versus co-facilitation.
Co-facilitation is like marriage and members will always try and split and divide and a
strong echoing in situation they’re unable to do this. Shared facilitation is something quite
different, it’s where the two facilitators decide who’ll do what. It has its place and particularly
in psychoed groups or something like that, but in the process group it’s never as effective as
echoing process.
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Clinton: So, June, I’m aware that you’re under a training, a week-long training in group
facilitation, tell us a little bit about that.
June: Well, it probably covers most of the things that we’ve been talking about but
obviously a whole lot more, what I can say in a few minutes is not what we can do in five
intensive days. It’s a five-day program, mornings are devoted to theory, afternoons to actually
putting into practice what they have learned that morning and accumulative over the five days
because the training group is co-facilitated.
One of the facilitators will coach each member individually as they co-facilitate with
whoever is co-facilitating the training group. It’s a very, very effective way of learning because
you’re not just relying on yourself, you’ve got a co-facilitator and you’ve got another
professional beside you that’s just coaching you, allowing you to say things but being there as a
sort of a backstop if they needed.
Clinton: Wonderful. I – sorry, go ahead.
June: I try and do two training programs a year in Sydney, so far I haven’t managed one
but we do have one commencing on the 28th of June and that’s a Friday so it runs Friday,
Saturday, Sunday, Monday, Tuesday which is the 2nd of July. And I’ve done this, Clinton,
because therapists, as you know particularly in private practice, find it difficult to take five days
Monday through Friday, of course they cannot fit in a Saturday and a Sunday and only three
days out. And this is being held at Mary Mackillop Place in North Sydney, only run generally
8:30 to 4: 30.
Clinton: Wonderful. Now, I’ve done, June, this training a number of years ago and I can
certainly testify it certainly is intense in a good way, and one of things I love about your
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training, June, was just the way we did the intense theory in the morning but then going into
group and actually living it, actually experiencing what it likes to be a member or to be
facilitator. I mean, there really is no – there’s no better way to learn and actually doing it and
no theory can kind of capture that.
June: Oh, I’m so pleased to hear you say that because it’s my belief. That’s how I
learned to be a group therapist, and it’s for the last 20 odd years it’s how I thought I was to be
amazing group therapist.
Clinton: And I think for many therapists, it’s also a wonderful way to augment your
common practice so to become – to do training in group and then to be off of that as another
service to your client is certainly very beneficial in terms of being out of the current clients and
new clients into groups, so I hope that the therapists watching it will consider that as part of
they kind of practice as something beneficial for your own practice and for your clients.
June: Look, I can’t underscore what you’re saying strongly enough. It’s not just a matter
of keeping the ball rolling because it’s what everyone needs to do, if they’re in private practice
they need to generate business and it’s one way to do that. But more importantly, so often the
therapy that occurs in the post therapy room between the therapist and the client goes so far
and then to be able to put them in a group of seven or eight or nine people and have them look
at how they come across to other people, how they’re received. It is just added growth for
them and to me it’s like completing the therapy.
Clinton: Yes, it’s something that always surprises me. It shouldn’t surprise me but just
to work with the client individually and then have them come into group and just see them
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have such a different experience because of the multiple perceptions and feedback coming
towards and it absolutely is a huge growth experience.
So, June, thank you so much for giving up your time today to speak to the Australia
Counselling community. It’s been a pleasure as always to speak with you, and I hope we can
connect again sometime.
June:I’d love that, Clinton, thank you.
Clinton:Thanks, June, and all the best!
June:Bye bye now.
Clinton:Bye bye!
[END OF VIDEO]
Visit http://www.australiacounselling.com.au for more information and resources for
therapists and counsellors.
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