Group Stages and Process

EDCO 711

Discussion Assignment Instructions

Throughout this course, students will engage in four discussions with your classmates. These discussions are designed to foster a scholarly community of learning, where participants engage in meaningful dialogue, contribute original insights, and expand their understanding of the coursework through critical reflection and academic discourse.

Discussion Thread: Group Stages and Process

One basic task of a group therapist is to understand the group development stages and process. For this discussion, choose one of the following group stages to discuss and then answer the questions provided.

1. Forming

2. Storming

3. Norming

4. Performing

5. Adjourning

Once you have chosen the group stage you would like to discuss, answer the following prompts :

1. Define the group stage you chose.

2. Discuss what occurs during this stage.

3. Identify the group leader skill needed to navigate this stage.

4. Discuss the difference between group stages and group process.

Thread

Your thread must respond thoughtfully to the provided prompt or case situation for the specific Module: Week. It should reflect doctoral-level analysis, demonstrating a deep understanding of the relevant coursework and theoretical frameworks. Your thread must be well-supported with at least two recent (published within the last three years) scholarly, peer-reviewed sources both must be from a peer-reviewed journal. Resources should be used to support the integration of Scripture, to include biblical commentaries, Chaplain resources, Christian counseling resources, etc. The use of the textbook and the Bible is encouraged, but does not count toward the required two peer-reviewed resources. Each source should be integrated into your thread to support your arguments with evidence-based research, reflecting critical engagement with academic literature.

In addition to scholarly support, your thread should:

· Meet the required word count of at least 400 words of content (not including the references).

· Exhibit a high standard of academic, professional writing, free from grammatical errors.

· Adhere to current APA formatting for citations and references, including correct use of in-text citations, paragraph formation, and reference formatting.

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Videos

https://canvas.liberty.edu/courses/753835/pages/watch-group-dynamics-and-process-group-stages?module_item_id=82809461

Watch: Group 3 Working Stage: EDCO711: Advanced Group Counseling (D04)

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Read: Yalom: Chapters 10 – 12

Yalom, I. D., Leszcz, M. (2020-12-01). The Theory and Practice of Group Psychotherapy, 6th Edition. [[VitalSource Bookshelf version]]. Retrieved from vbk://9781541617568

Chapter 10

In the Beginning

THE WORK OF THE GROUP THERAPIST BEGINS LONG BEFORE the first group meeting. As we have emphasized, successful group outcome is rooted largely in the therapist’s effective performance of the pretherapy tasks: proper group selection and composition, securing a proper setting, and client preparation. In this chapter we consider the birth and development of the therapy group: first, its stages of development, and then the important issues of attendance, punctuality, membership turnover, and the addition of new members.1 As we noted earlier, the added considerations for online group therapy will be addressed in Chapter 14.

FORMATIVE STAGES OF THE GROUP

Every therapy group, with its unique cast of characters and complex interaction, undergoes a singular development. All the members begin to manifest themselves interpersonally, each creating his or her own social microcosm. In time, if therapists do their job effectively, members will begin to identify their own interpersonal styles and will eventually begin to experiment with new behavior. Given the richness of human interaction, compounded by the grouping of several individuals with problematic interpersonal styles, it is obvious that the course of a group over many months or years will be complex and, to a great degree, unpredictable. Nevertheless, group dynamic forces operate in all groups and influence their development, and it is possible to describe an imperfect but nonetheless useful schema of developmental phases. Clinicians and researchers have proposed several models of group developmental stages. All these models share a move toward greater interactional depth and complexity, encompassing four or five main stages.2 We will address the first stages in this chapter and consider termination in the next chapter.

One well-known group developmental theory postulates five stages: forming, storming, norming, performing, and adjourning.3 This simple, rhythmic phrase captures well the range of group development models articulated by diverse researchers and applies to both time-limited and open-ended groups.4 Another leading model describes four stages: engagement, differentiation, interpersonal work, and termination.5 It is best not to think of stages rigidly; as we will discuss later, many group and member factors will impact and influence the group’s development. This developmental sequence requires a group duration of at least ten sessions to unfold. Group development is often accelerated in briefer groups.6 Ongoing groups may return to earlier developmental stages as current members graduate and new ones join.

In general, groups are first preoccupied with the tasks of member engagement and affiliation, followed by a focus on control, power, status, competition, and individual differentiation. Next comes a long, productive working phase marked by intimacy, engagement, and genuine cohesion. The final stage is termination of the group. There is debate in the field whether group development is linear or cyclical, but most models share the premise that each stage is shaped by and builds upon the success of preceding ones.7 Hence, early developmental failures will express themselves throughout the group’s life. Another premise of development is that threats to group integrity will cause groups to regress from higher levels of function to less mature stages.

As group development unfolds, we see shifts in member behavior and communication. As the group matures, increased empathic, positive communication will be evident. Members describe their experience in more personal and affective and less intellectual ways. Group members focus more on the here-and-now, are less avoidant of productive conflict, offer constructive feedback, are more self-disclosing, and are more collaborative. Advice giving, a telltale sign of group immaturity, is replaced by exploration, and the group grows to be more interactional, more self-directed, and less leader centered.8 This developmental shift to more meaningful work has also been demonstrated repeatedly in reliable studies of task and work groups and correlates significantly with enhanced productivity and achievement.9

There are compelling reasons for you as the therapist to familiarize yourself with the developmental sequence of groups. If you are to perform your task of assisting the group to establish therapeutic norms, and if you are to diagnose group blockage and intervene strategically to encourage healthy development, you must have a sense of both favorable and flawed development. Furthermore, knowledge of a broad developmental sequence will provide you with a sense of direction in the group; a confused and anxious leader engenders similar feelings in the group members. Familiarity with group development is essential to understanding group process and group dynamics. The group therapist must be reliably able to address the fundamental question of why this is happening in this way at this point.

The First Meeting

Despite the trepidation involved in preparing for the launch of the group, the first group therapy session is invariably a success. Clients (as well as neophyte therapists) generally anticipate it with such dread that they are always relieved by the actual event. Any actions therapists take to reduce clients’ anxiety and unease are generally useful. It is often helpful to call members a few days before the first meeting to reestablish contact and remind them of the group’s beginning. Greeting group members outside the room before the first meeting, or posting signs in the hallway directing clients to the meeting room, are easy and reassuring steps to take. Placing a sign on the door identifying it as the group therapy meeting room reduces the risk of a late arrival missing the session over uncertainty about where the group is meeting and whether it is acceptable to enter late.

Some therapists begin the first meeting with a brief introductory statement about the purpose and method of the group (especially if they have not thoroughly prepared the clients beforehand); others may simply mention one or two basic ground rules—for example, honesty and confidentiality. Knowing that most members will be apprehensive, we like to begin with a warm welcome and convey our excitement about starting the group. Some therapists suggest that the members introduce themselves; others remain silent, knowing that invariably some member will suggest that the members introduce themselves. In Western groups, the use of first names is usually established within minutes. Then a very loud silence ensues, which, like most psychotherapy silences, seems eternal but lasts only a few seconds.

Generally, the silence is broken by the individual destined to dominate the early stages of the group, who will say, “I guess I’ll get the ball rolling,” or words to that effect. Usually that person then recounts his or her reasons for seeking therapy, which often elicits similar descriptions from other members. An alternative course of events occurs when a member (perhaps spurred by the tension of the group during the initial silence) comments on his or her social discomfort or fear of groups. This remark may stimulate related comments from others who have similar feelings.

As we stressed in Chapter 5, the therapist, wittingly or unwittingly, begins to shape the norms of the group at its inception. This critical developmental task can be more efficiently performed while the group is still young. The first meeting is therefore no time for the therapist to be passive or inert.10 Group members’ anxiety will be high at the start, and it is helpful to acknowledge and normalize that. Even if the group is off to a very good start with self-disclosure and interaction, there is important work to do: the group leader’s observations about what is happening in the group demystifies group therapy and reinforces pro-group behavior. A member might ask the group leader for clarification.

“This kind of interaction is so welcome but so foreign to me. What is the group’s methodology? The more I can understand it, the more I can work with it,” one client said in the first session of one of my groups (ML). Other group members echoed her comments, and it led to a useful exploration of the work of group therapy. Although hers was an intellectual question, it easily led to exploration of group members’ feelings about group therapy and the back and forth we should expect between the thinking and feeling components of our work together.

The Initial Stage: Orientation, Hesitant Participation, Search for Meaning, Dependency

Two tasks confront members of any newly formed group. First, they must understand how to achieve their primary task—the purpose for which they joined the group. Second, they must attend to their social relationships in the group so as to create a niche for themselves. Ideally, they will forge roles that provide both the comfort and safety necessary to achieve their primary task and personal gratification from the sheer pleasure of group membership. In many groups, such as athletic teams, health-care teams, college classrooms, and work settings, the primary task and the social task are well differentiated.11 In therapy groups, the tasks are confluent—a fact vastly complicating the group experience of socially challenged individuals.

Several simultaneous concerns are present in the initial meetings. Members, especially if not well prepared by the therapist, search for the rationale of therapy; commonly, they may be confused about the relevance of the group’s activities to their personal goals in therapy. The initial meetings are often peppered with questions reflecting this confusion. Even many weeks later, members may wonder aloud, “How is this going to help? What does all this have to do with solving my problems?”

At the same time, the members are attending to their social relationships: they size up one another and the group. They search for viable roles for themselves and wonder whether they will be liked and respected or ignored and rejected. Although clients ostensibly come to a therapy group for treatment, social forces impel them to invest energy in a search for approval, acceptance, respect, or domination. To some, acceptance and approval appear so unlikely that they defensively depreciate the group by mentally derogating the other members and by reminding themselves that the group is unreal and artificial. Clients with a dismissive attachment style may reject group engagement and dismiss others who may be eager for engagement. Many members are particularly vulnerable at this time as the push and pull for engagement and belonging is strongly activated.12

In the beginning, the therapist is well advised to keep one eye on the group as a whole, and the other eye on each individual’s subjective experience in the group. Members wonder what membership entails. What are the admission requirements? How much must one reveal or give of oneself? At a conscious or near-conscious level, they seek the answers to questions such as these and maintain a vigilant search for the types of behavior that the group expects and approves. Most clients crave both a deep, intimate one-to-one connection and a connection to the whole group.13 Occasionally, however, a member with a very tenuous sense of self may fear losing his or her identity through submersion in the group. If this fear is particularly pronounced it may impede engagement. For such individuals, differentiation trumps belonging.14

Not only is the early group puzzled, testing, and hesitant, but it is also dependent. Overtly and covertly, members look to the leader for structure and answers as well as for approval and acceptance. Many comments and reward-seeking glances are cast at you as members seek to gain approval from authority. Your early comments are carefully scrutinized for directives about desirable and undesirable behavior. Clients appear to behave as if salvation emanated solely or primarily from you, if only they can discover what it is you want them to do. There is considerable realistic evidence for this belief: you have a professional identity as a healer, you host the group by providing a room or the online platform, you have prepared the members, and you charge a fee for your services. All of this reinforces their expectation that you will take care of them. Some therapists respond to the narcissistic stimulation of this idealization in ways that compound this belief.15

The existence of initial dependency thus stems from many sources: the therapeutic setting, the therapist’s behavior, a morbid dependency state on the part of the client, and, as we discussed in Chapter 7, the many irrational sources of the members’ powerful feelings toward the therapist. Among the strongest of these is the need for an omniscient, all-caring parent or rescuer.16

The content and communicational style of the initial phase tends to be relatively stereotyped, resembling the interaction occurring at a cocktail party or similar social encounters. Problems are approached rationally; clients suppress irrational aspects of their concerns in the service of support, etiquette, and group tranquility. Thus, at first, groups may endlessly discuss topics of apparently little substantive interest to any of the participants. These cocktail party issues, however, serve as a vehicle for the first interpersonal exploratory forays. The content of the discussion is less important than the unspoken process: members size each other up and attend to such matters as who responds favorably to them, who sees things the way they do, whom to fear, whom to respect.

In the beginning, therapy groups often spend time on symptom description, previous therapy experience, medications, and the like. The members often search for similarities. They are fascinated by the notion that they are not unique in their distress, and most groups invest considerable energy in demonstrating how the members are similar. This process often offers considerable relief to members (see the discussion of universality in Chapter 1) and provides part of the foundation for group cohesiveness. These first steps set the stage for the later deeper engagement that is a prerequisite for effective therapy.17 This early-stage comfort should not be confused with the more durable and difficult-to-attain group cohesion to follow.

Giving and seeking advice is another characteristic of the early group: clients seek advice for problems with spouses, children, employers, and so on, and the group attempts to provide some practical solutions. This guidance is rarely of functional value but serves as a vehicle through which members can express mutual interest and caring. It is also a familiar mode of communication that can be employed before members understand how to work fully in the here-and-now.

In the beginning the group needs direction and structure. The leader’s support and presence promote safety and create a secure base for group members. The leader can bolster the client’s therapeutic alliance by building safety and trust and offering a road map for what lies ahead. A silent, aloof leader will cause members high levels of avoidable, antitherapeutic anxiety. This phenomenon occurs even in groups of psychologically sophisticated members. In a training group of psychiatry residents led by a silent, nondirective leader, the members grew anxious during their first meeting and expressed fears of what could happen in the group and who might become a casualty of the experience. One member spoke of a recent news report of a group of seemingly “normal” high school students who beat a homeless man to death. Their anxiety lessened when the leader commented that they were all concerned about the harmful forces that could be unleashed as a result of joining this group of seemingly “normal” psychiatry residents. Wilfred Bion, a British analyst, long ago described the primitive unconscious group forces that operate beneath and alongside the more rational and conscious group forces.18

The Second Stage: Conflict, Dominance, Rebellion

If the first core concern of a group is with “in or out,” then the next is with “top or bottom.”19 In this second, “storming” stage, the group shifts from preoccupation with acceptance, approval, commitment to the group, definitions of accepted behavior, and the search for orientation, structure, and meaning to a preoccupation with dominance, control, and power. The conflict characteristic of this phase, among members or between members and leader, is what gives it its “stormy” character. Each member attempts to establish his or her preferred amount of initiative and power. Gradually, a hierarchy of control—a social pecking order—emerges.

Negative comments and intermember criticism are more frequent in this stage than in the first, and members often appear to feel entitled to a one-way analysis and judgment of others’ experiences. As in the first stage, members give advice, but in the context of a different social code; social conventions are abandoned, and members feel free to make personal critiques about other members’ behavior or attitudes. It is a time of “shoulds” and imperatives in the group, a time when the locker-room court is in session. Members make suggestions or give advice not as a manifestation of deep acceptance and understanding—sentiments yet to emerge in the group—but in the service of jockeying for status and position.

The struggle for control is part of the infrastructure of every group. It is always present: sometimes quiescent, sometimes smoldering, sometimes in full conflagration. If there are members with strong needs to dominate, control may be the major theme of the early meetings. A covert struggle for control often becomes more overt when new members are added to the group, especially new members who do not “know their place” and, instead of paying obeisance to the older members in accordance with their seniority, make strong early bids for dominance.

The emergence of hostility toward the therapist is inevitable in the development of a group. Many observers have emphasized an early stage of ambivalence toward the therapist coupled with resistance to self-examination and self-disclosure. Hostility toward the leader has its source in the unrealistic, indeed magical, attributes with which clients secretly imbue the therapist. Their expectations are so limitless that they are bound to be disappointed by any therapist, however competent. Gradually, as group members recognize the therapist’s humanity and concern for them, reality sets in and their hostility dissipates. The group therapist must attend to managing and containing conflict without responding defensively or, worse, hostilely, to group members’ challenges. It is easier for the group leader to stay grounded if he or she understands that such conflict generally emerges from natural group developmental forces.20

This is by no means a clearly conscious group process. The members may intellectually advocate a democratic group that draws on its own resources, but nevertheless, on a deeper level, crave dependency and attempt first to create and then destroy an authority figure. Group therapists refuse to fill the traditional authority role: they do not provide answers and solutions; they urge the group to explore and to employ its own resources. The members’ dependency cravings linger, however, and it is usually only after several sessions that the group members come to realize that the therapist will frustrate their yearning for the ideal leader.

Yet another source of resentment toward the leader lies in the gradual recognition by each member that he or she will not become the leader’s favorite child. During the pretherapy session, each client comes to harbor the fantasy that the therapist is his or her very own therapist, intensely interested in the minute details of that client’s past, present, and fantasy world. In the early meetings of the group, however, each member begins to realize that the therapist is no more interested in him or her than in the others. Seeds are thus sown for the emergence of rivalrous, hostile feelings toward the other group members. Echoes of prior issues with siblings may emerge, and members begin to appreciate the importance of peer interactions in the work of the group.21

These unrealistic expectations of the leader and consequent disenchantment are by no means a function of a childlike mentality or psychological naïveté. The same phenomena occur, for example, in groups of professional psychotherapists. In fact, there is no better way for the trainee to appreciate the group’s proclivity both to elevate and to attack the leader than to be a member of a training or therapy group and to experience these powerful feelings firsthand. (We will discuss the training role of experiential learning in Chapter 16.)

The members are never unanimous in their attack on the therapist. Invariably, some champions of the therapist will emerge from the group. The lineup of attackers and defenders may serve as a valuable guide for the understanding of characterological trends useful for future work in the group. Generally, the leaders of this phase, those members who are earliest and most vociferous in their attack, are heavily conflicted in the area of dependency and have dealt with intolerable dependency yearnings by reaction formation. These individuals, initially considered counterdependents, may also have an avoidant and dismissive attachment style and are inclined to reject prima facie all statements by the therapist.22 Some may even entertain the fantasy of unseating and replacing the leader.

For example, approximately three-fourths of the way through the first meeting of a group for clients with bulimia, I (IY) asked for the members’ reflections on the meeting: How had it gone for them? Disappointments? Surprises? This is generally an effective process intervention that causes the group members to reflect on their experience. One member, who was to control the direction of the group for the next several weeks, commented that it had gone precisely as she had expected; in fact, it had been almost disappointingly predictable. The strongest feeling that she had had thus far, she added, was anger toward me, because I had asked one of the members a question that evoked a brief period of weeping. She had felt, at that moment, “You’ll never break me down like that!” Her first reactions were very predictive of her behavior for some time to come. She remained on guard and strove to be self-possessed and in control at all times. She regarded me not as an ally but as an adversary, and was sufficiently forceful to lead the group into a major emphasis on control issues for the first several sessions.

If therapy is to be successful, counterdependent, dismissive members must at some point experience their flip side. This entails recognizing and working through deep dependency needs buried beneath the assertiveness and fear of rejection and unresponsiveness. They need to experience some comfort with belonging and asking for help. The challenge in their therapy is first to understand that their counterdependent behavior often evokes rebuke and rejection from others; only then can their wish to be nourished and protected be experienced or expressed.

Some members invariably side with the leader and they must be helped to investigate their need to defend the therapist at all costs, regardless of the issue involved. Occasionally, clients defend you because they have encountered in their past a series of unreliable care providers, and they misperceive you as extraordinarily frail; others need to preserve you because they fantasize an eventual alliance with you against other powerful members of the group. Beware that you do not inadvertently transmit covert signals of personal distress to which the rescuers appropriately respond.

Many of these conflicted feelings crystallize around the leader’s title. Are you to be referred to by professional title (“Dr. Jones”) or, even more impersonally, as “the group instructor” or “the counselor,” or by first name? We always address this issue in the preparation process and invite clients to use our first names. We link the use of first names to our wish for a flattened hierarchy in the group and to remind clients that each member of the group carries therapeutic impact and responsibility. Some members will immediately use the therapist’s first name or even a diminutive of the name before inquiring about the therapist’s preference. Others, even after the therapist has wholeheartedly agreed to proceeding on a first-name basis, still cannot bring themselves to mouth such irreverence and continue to bundle the therapist up in a professional title. One client, a successful businessman who had been consistently shamed and humiliated in childhood by a domineering father, insisted on addressing me (ML) as “the Doctor,” because he claimed this was a way to ensure that he was getting his money’s worth. Another member also addressed me as “the Doctor” as a way to distance herself from me because, in her experience, closeness and familiarity with older men were a setup for exploitation and sexual abuse. Establishing a formal distance helped her to manage her negative transference. Later, when she began to call me by my first name, as all the other group members did, it was a big step for her, representing both greater trust and liberation from the past.

Although we have posited disenchantment and anger with the leader as a ubiquitous feature of small groups, the process is by no means constant across groups in form or degree. The therapist’s behavior may potentiate or mitigate both the experience and the expression of rebellion. What kind of leader evokes the most negative responses? Generally, it is those who are ambiguous or deliberately enigmatic; those who are authoritative yet offer no structure or guidelines; or those who covertly make unrealistic promises to the group early in therapy.23

This developmental stage is often difficult and personally unpleasant for group therapists. For your own comfort, you must learn to discriminate between an attack on your person and an attack on your role in the group. The group’s response to you is similar to transference distortions in individual therapy in that it is not directly related to your behavior. Its source in the group must be understood from both an individual psychodynamic and a group dynamic viewpoint. The power of multiple critical voices can be daunting even to a seasoned therapist, but it is essential that the leader explore and understand the criticism without being defensive, hostile, or blaming. If you feel you have missed the mark in your approach, own the error and repair it.24 In so doing you model that everyone in the group can be the focus of feedback: no one and nothing is off limits.25 Keep in min