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The caseworker as a change agent in working with groups : a study of how the caseworker uses himself… Pawson, Geoffrey Leslie 1964

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THE CASEWORKER AS A C RANGE A GENT IN WORKING WITH GROUPS . A Study o f how t h e Caseworker uses h i m s e l f as a Change Agent i n a Group o f C l i e n t s , o r R e l a t i v e s o f C l i e n t s , i n t e n groups i n t h e G r e a t e r Vancouver a r e a .  by GEOFFREY LESLIE PAWSON FRANCES DEBORAH POWER BEATRICE ANNE SANDERSON DOUGLAS JAMES SLIGHT  Thesis Submitted i n P a r t i a l F u l f i l m e n t o f t h e r e q u i r e m e n t s f o r t h e Degree o f MASTER OF SOCIAL WORK i n t h e S c h o o l o f S o c i a l Work  Accepted as conforming t o t h e standard r e q u i r e d f o r t h e degree o f M a s t e r o f S o c i a l Work  S c h o o l o f S o c i a l Work 1964  The U n i v e r s i t y  o f B r i t i s h Columbia  J  In  presenting  this  r e q u i r e m e n t s f o r an B r i t i s h Columbia, freely  available  agree that for  i n p a r t i a l f u l f i l m e n t of  advanced degree at I agree that  the  f o r r e f e r e n c e and  p u r p o s e s may  D e p a r t m e n t o r by that  copying or  gain  s h a l l not  be  be  this  a l l o w e d w i t h o u t my  The U n i v e r s i t y o f B r i t i s h C o l u m b i a , V a n c o u v e r 8, C a n a d a .  I  the  of  further this  Head o f  thesis my  I t i s understood thesis  the  s h a l l make i t  copying of  g r a n t e d by  S o c i a l Work  University  study.  his representatives. p u b l i c a t i o n of  the  Library  permission for extensive  scholarly  School of  thesis  for  written  financial  permission.  In presenting  this  r e q u i r e m e n t s f o r an B r i t i s h Columbia, freely  advanced degree a t I agree that  the  a v a i l a b l e f o r r e f e r e n c e and  agree that for  t h e s i s i n p a r t i a l f u l f i l m e n t of  D e p a r t m e n t o r by that  copying or  gain  s h a l l not  School of  be  be  this  a l l o w e d w i t h o u t my  I  further  copying of  g r a n t e d by  of  s h a l l make i t  study.  his representatives. p u b l i c a t i o n of  University  Library  permission for extensive  s c h o l a r l y p u r p o s e s may  the  the  the  this  Head o f  thesis my  I t i s understood thesis  for  written  financial  permission.  S o c i a l Work  The U n i v e r s i t y o f B r i t i s h C o l u m b i a , V a n c o u v e r 8, C a n a d a . Date  //"  S'  ~ 6#  r  In presenting  this  r e q u i r e m e n t s f o r an B r i t i s h Columbia, freely  available  agree that for  t h e s i s i n p a r t i a l f u l f i l m e n t of  advanced degree at I agree that  f o r r e f e r e n c e and  D e p a r t m e n t o r by  be  copying or p u b l i c a t i o n of  gain  s h a l l not  be  Social  this  a l l o w e d w i t h o u t my  Work  The U n i v e r s i t y o f B r i t i s h C o l u m b i a , V a n c o u v e r 8, C a n a d a .  I  further  copying of  g r a n t e d by  of  s h a l l make i t  study.  his representatives.  that  University  Library  permission for extensive  s c h o l a r l y p u r p o s e s may  School of  the  the  the  this  Head o f  thesis my  I t i s understood thesis  the  for  written  financial  permission.  In presenting  this  r e q u i r e m e n t s f o r an B r i t i s h Columbia, freely  advanced degree at I agree that  the  a v a i l a b l e f o r r e f e r e n c e and  agree that for  t h e s i s i n p a r t i a l f u l f i l m e n t of  D e p a r t m e n t o r by that  copying or  gain  s h a l l not  School of  be  be  this  a l l o w e d w i t h o u t my  The U n i v e r s i t y o f B r i t i s h C o l u m b i a , V a n c o u v e r 8, C a n a d a .  I  the  of  make i t  further  copying of  g r a n t e d by  S o c i a l Work  shall  study.  his representatives. p u b l i c a t i o n of  University  Library  permission for extensive  s c h o l a r l y p u r p o s e s may  the  this  Head o f  thesis my  I t i s understood thesis  for  written  the  financial  permission.  ABSTRACT  A p r e v i o u s t h e s i s by K e r r and Kirkham (I963) i n d i c a t e d the e x t e n t t o w h i c h caseworkers worked w i t h groups i n Vancouver. The p r e s e n t s t u d y c o n t i n u e s t h i s i n v e s t i g a t i o n , . f o c u s s i n g on how caseworkers u s e themselves as change agents i n such groups. An i n t e r v i e w s c h e d u l e was used t o o b t a i n f r o m t h e workers t h e nece s s a r y d a t a . T h i s i n f o r m a t i o n was then c l a s s i f i e d a c c o r d i n g t o the purpose and g o a l s o f t h e group, and t h e r o l e of t h e worker, u s i n g t h e c o n c e p t u a l framework o f D r . J . K l e i n as model. The s t u d y r e v e a l e d t h a t each o f t h e groups c o u l d be p l a c e d i n one or t h e o t h e r o f K l e i n ' s t h r e e c a t e g o r i e s : group e d u c a t i o n , s o c i a l group t r e a t m e n t , o r group p s y c h o t h e r a p y . I t was f o u n d t h a t l a c k o f c l a r i t y o f purpose r e s u l t e d i n c o n f l i c t i n g g o a l s , w i t h a consequent c o n f u s i o n i n worker r o l e . Most f r e q u e n t l y , i n e x p e r i e n c e on t h e p a r t o f t h e agency o r worker was t h e cause f o r c o n f u s i o n o f p u r p o s e . I t was seen t h a t a w r i t t e n statement o f purpose c o n t r i b u t e d t o a c l e a r p e r c e p t i o n of g o a l and r o l e . The need f o r caseworkers t o s e t c o n s c i o u s g o a l s f o r each meeting was e s t a b l i s h e d . P a r t i c u l a r a t t e n t i o n was g i v e n t h e g o a l s e s t a b l i s h e d i n t h e f i r s t and f i n a l meetings: planned g o a l s were common f o r t h e f i r s t m e e t i n g , i n c o n s i s t e n c y of a p p r o p r i a t e g o a l s common i n t h e f i n a l m e e t i n g . A n a l y s i s o f t h e d i f f i c u l t i e s on t h e p a r t o f most workers i n t h e i r r o l e i n t h e group, suggest t h e f o l l o w i n g as p o s s i b l e causes: (1) l a c k o f c l a r i t y o f purpose; (2) l a c k o f c l a r i t y o f g o a l s ; (3) l a c k o f knowledge o f group p r o c e s s ; (4) l a c k o f n e c e s s a r y s k i l l s ; and (5) c o n f u s i o n i n p r o f e s s i o n a l i d e n t i t y . I t i s i m p o r t a n t t h a t workers i n t h e p s y c h o t h e r a p y groups s h o u l d have a c l e a r p e r c e p t i o n o f purpose and u n d e r s t a n d i n g o f a p p r o p r i a t e r o l e . Some f i n d i n g s i n r e l a t i o n t o "openended groups" appear which a g e n c i e s s h o u l d t a k e i n t o c o n s i d e r a t i o n when p l a n n i n g such a group. Knowledge and t r a i n i n g i n s o c i a l group work i s o b v i o u s l y v a l u a b l e f o r caseworkers i f they are t o work w i t h groups; and t h e need i s c l e a r f o r f u r t h e r s t u d y t o be u n d e r t a k e n o f caseworkers w o r k i n g w i t h groups.  A CKNOWLED GEMENTS  We w i s h t o e x p r e s s our s i n c e r e thanks t o Mr. Benjamin Chud o f t h e S c h o o l o f S o c i a l Work, f o r h i s encouragement, p a t i e n c e , and a s s i s t a n c e out t h e w r i t i n g o f t h i s t h e s i s .  through-  We a l s o w i s h t o thank  Dr. Leonard C. Marsh, D i r e c t o r o f Research o f t h e S c h o o l o f S o c i a l Work, f o r h i s h e l p w i t h t h e t e c h n i c a l parts of the t h e s i s . To t h e a g e n c i e s and caseworkers who s u p p l i e d t h e i n f o r m a t i o n w h i c h made t h i s s t u d y p o s s i b l e we s i n c e r e l y express our a p p r e c i a t i o n .  i  TABLE:., OF CONTENTS  Chapter 1.  Caseworkers as Change Agents i n w o r k i n g W i t h Groups  Page  B a s i s f o r t h e P r e s e n t Study.; S e l e c t i o n o f t h e P r o b l e m . S e l e c t i o n o f t h e Study P o p u l a t i o n . The Groups. C o n c e p t u a l Framework. Method o f Data C o l l e c t i o n and A n a l y s i s o f M a t e r i a l , C h a p t e r 2.  The Purpose and G o a l s o f t h e Groups  Introduction. Group E d u c a t i o n : Purpose o f t h e groups; G o a l s o f t h e Groups; Summary o f Four Groups. S o c i a l Group Treatment: Purpose o f t h e Groups; Goals of t h e Groups; Summary o f t h e Three Groups. Group P s y c h o t h e r a p y : Purpose o f t h e Groups; Goals o f t h e Groups; Summary o f t h e Three Groups. Summary Chapter 3.  The R o l e o f t h e Caseworker i n t h e Groups  Group E d u c a t i o n : I n t r o d u c t i o n . R o l e o f Worker in: E l ; Eg; E3; and E4. Summary. S o c i a l Group T r e a t ment: I n t r o d u c t i o n . R o l e o f Worker i n : T l ; T2; and T3. Summary. Group P s y c h o t h e r a p y : I n t r o d u c t i o n . Role of Worker i n : T l ; T2; and T3. Summary. Group Pscyhot h e r a p y : I n t r o d u c t i o n . R o l e o f Worker i n : P I ; P2; and P 3 . Summary.,,,, Chapter 4.  15  Summary and F i n d i n g s . Practice.  62  Implications f o r  Introduction. C l a s s i f i c a t i o n . Purpose. G o a l s . R o l e . C o r r e l a t i o n Between Purpose, G o a l , and flole. Implications f o r F r a c t i c e . Suggestion f o r F u r t h e r Study  134  Appendix A. I n t e r v i e w Schedule  152  Bibliography  156  CHAPTER I  CASEWORKERS A3 CHANGE AGENTS IN WORKING WITH GROUPS  The b a s i s o f t h e p r e s e n t s t u d y i s t h e e a r l i e r s t u d y  under-  t a k e n by Ann Margaret K e r r and E l i n o r May Kirkham i n 1963, r e p o r t e d i n t h e M a s t e r t h e s i s e n t i t l e d CASEWORKERS WORKING WITH GROUPS, "A Survey and Assessment o f Casework A g e n c i e s U s i n g Groups o f C l i e n t s and R e l a t i v e s o f C l i e n t s f o r E d u c a t i o n a l and Treatment Work, G r e a t e r Vancouver."  The K e r r - K i r k h a m  thesis  p o i n t e d o u t t h e growing p r a c t i c e o f caseworkers w o r k i n g w i t h groups o f c l i e n t s a n d r e l a t i v e s of c l i e n t s i n s o c i a l a g e n c i e s today.  I t confirmed a s i m i l a r t r e n d o c c u r r i n g i n t h e l o c a l  Vancouver a r e a . The w r i t e r s e s t a b l i s h e d t h a t twenty-one o u t o f e i g h t y two a g e n c i e s canvassed i n t h e a r e a were p r e s e n t l y o p e r a t i n g groups o r p l a n n i n g on d o i n g so i n t h e near f u t u r e .  They  a n t i c i p a t e d t h a t "the r a t e o f employment o f t h i s method i s g o i n g t o i n c r e a s e s i x times more r a p i d l y i n t h e n e x t t w e l v e y e a r s t h a n i t has done i n t h e p a s t t w e l v e y e a r s . "  1  Such a t r e n d has  i m p o r t a n t i m p l i c a t i o n s f o r p r o f e s s i o n a l persons w o r k i n g w i t h  1 K e r r , Ann M a r g a r e t , and Kirkham, E l i n o r May, "A Survey and Assessment o f Casework A g e n c i e s U s i n g Groups o f C l i e n t s and R e l a t i v e s of C l i e n t s f o r E d u c a t i o n a l and Treatment Work, G r e a t e r Vancouver." CASEWORKERS WORKING WITH GROUPS. M a s t e r s T h e s i s , S c h o o l o f S o c i a l Work, U n i v e r s i t y o f B r i t i s h Columbia, 1963, p. 56  - 2 -  groups, as w e l l as f o r t h e t r a i n i n g o f p r o s p e c t i v e s o c i a l  workers,  and i s l i k e l y t o have,a marked e f f e c t on t h e f i e l d o f p r a c t i c e . While the Kerr-Kirkham  t h e s i s s t u d i e s t h e caseworker and h i s ex-  p e r i e n c e w i t h a group o f c l i e n t s , o r r e l a t i v e s o f c l i e n t s , i t was w i t h t h e p r i m a r y g o a l o f d e t e r m i n i n g who t h e caseworkers  were.  No  attempt was made t o examine how t h e workers worked w i t h t h e i r groups. W h i l e t h e r e were a l t e r n a t i v e c h o i c e s f o r f u r t h e r s t u d y , i t seemed t o t h e p r e s e n t w r i t e r s t h a t t h e next l o g i c a l s t e p would be to  e x p l o r e how caseworkers  worked w i t h groups.  The r e s e a r c h e r s  proposed t o do t h i s w i t h i n t h e c o n c e p t u a l framework o u t l i n e d by Dr. Joyce K l e i n i n h e r d o c t o r a l d i s s e r a t i o n , A d u l t E d u c a t i o n and Treatment Groups I n S o c i a l A g e n c i e s , and used by K e r r - K i r k h a m i n t h e i r study.  As a p i c t u r e o f t h e "how" o f t h e s u b j e c t i s ' g a i n e d ,  i t s h o u l d be p o s s i b l e t o d i s c o v e r t h e most e f f e c t i v e s ways o f w o r k i n g w i t h groups, t h e k i n d s o f groups t h a t respond o f t e c h n i q u e s t o which they respond.  and t h e k i n d s  No p r e v i o u s study has been  made i n Vancouver o f how t h e caseworker uses h i m s e l f i n t h e group. S e l e c t i o n of t h e Problem The f o c u s o f t h e p r e s e n t study w i l l be t o attempt from i n t e r v i e w d a t a , how caseworkers  to indicate  work w i t h t h e i r groups.  The  q u e s t i o n s w h i c h t h e p r e s e n t study w i l l seek t o answer a r e : 1.  A r e t h e pupose and g o a l s t h e i r groups t h e same as K l e i n , i e . can t h e group subsumed under t h e t h r e e by K l e i n ?  of t h e workers f o r those p o s t u l a t e d by g o a l s observed be c a t e g o r i e s proposed  2.  I f s o , what r o l e s a r e p l a y e d by t h e workers i n each group?  - 3 -  3.  Are these r o l e s consistent with those p o s t u l a t e d by K l e i n as a p p r o p r i a t e t o t h e s p e c i f i e d group purpose and g o a l ?  The major r e s e a r c h problem t h e n i s t o determine t h e e x t e n t to which the workers' use o f S e l f ( s p e c i f i c r o l e ( s ) ) i s a s s o c i a t e d w i t h t h e g o a l ( s ) o f t h e group.  T h e o r e t i c a l l y , t h e assumption i s  t h a t t h e purpose and group g o a l d e t e r m i n e s worker r o l e ( s ) .  Oper-  a t i o n a l l y , i t i s proposed t o t e s t t h e e x t e n t t o which t h r e e t y p e s o f group s p e c i f i e d by K l e i n ( v i z . group e d u c a t i o n , s o c i a l group t r e a t m e n t , group p s y c h o t h e r a p y ) a r e p o s i t i v e l y a s s o c i a t e d w i t h s p e c i f i e d r o l e s w h i c h K l e i n has p o s t u l a t e d . S e l e c t i o n o f The Study P o p u l a t i o n The  Caseworkers The s t u d y p o p u l a t i o n c o n s i s t s o f t e n o f t h e t w e l v e c a s e -  workers who formed t h e s t u d y group f o r t h e K e r r - K i r k h a m t h e s i s . K e r r - K i r k h a m d i s c o v e r e d t h e r e were twenty-one workers w o r k i n g w i t h t h i r t y - o n e groups between 1959-1963, t h e p e r i o d o f time w i t h w h i c h t h e i r t h e s i s was concerned.  From t h e s e twenty-one w o r k e r s ,  t w e l v e were s e l e c t e d f o r i n t e r v i e w s .  The caseworkers were  employed  by e l e v e n d i f f e r e n t a g e n c i e s , f i v e from a p r o v i n c i a l agency, two from a m u n i c i p a l and f o u r f r o m a v o l u n t a r y agency.  A l l but one o f  t h e workers had p r o f e s s i o n a l t r a i n i n g a t t h e B.S.W. o r M.S.W. l e v e l . The one l a c k i n g a p r o f e s s i o n a l e d u c a t i o n was e x c l u d e d from t h e study.  A l l t h e workers had completed one group work c o u r s e o f t h e i r  2 K e r r , Ann M a r g a r e t and Kirkham, E l i n o r May, "A Survey and Assessment o f Casework A g e n c i e s U s i n g Groups o f C l i e n t s and R e l a t i v e s o f C l i e n t s f o r E d u c a t i o n a l and Treatment Work, G r e a t e r Vancouver, CASEWORKERS WORKING WITH GROUPS, U n i v e r s i t y o f B r i t i s h Columbia, 1963. p.3?.  - 4 -  f i r s t y e a r , b u t "had n o t p a i d t o o much a t t e n t i o n t o i t . " '  F i v e of  the workers had n o t r e a d about group work s i n c e l e a v i n g a s c h o o l of s o c i a l work.  S i x respondents had r e a d about group p s y c h o t h e r a p y .  Three r e s p o n d e n t s took c o u r s e s i n t h e t h e o r y o f groups a f t e r t h e y l e f t a s c h o o l o f s o c i a l work.  One had a t t e n d e d an i n s t i t u t e on  f a m i l y i n t e r v i e w i n g t e c h n i q u e s , and one worker spent s e v e r a l weekends w i t h o t h e r caseworkers l e a r n i n g about groups from a groupworker.^  None o f t h e workers saw themselves as groupworkers when  w o r k i n g w i t h t h e groups.''  I t might be presumed t h a t how t h e  workers saw t h e m s e l v e s and t h e group members might a f f e c t t h e way i n which they f u n c t i o n e d .  N e a r l y a l l of. t h e caseworkers acknow-  l e d g e d t h a t t h e y were a n x i o u s , e x p e c i a l l y i n t h e b e g i n n i n g phases. S e v e r a l workers were s u r p r i s e d a t t h e p r o g r e s s made by i n d i v i d u a l s i n t h e group, and s u r p r i s e d a t t h e f a c t t h e y " d i d n o t have t o do 6 a l l t h e work."  The workers g e n e r a l l y tended t o d i s c u s s t h e i r  groups i n terms o f i n d i v i d u a l s .  A t l e a s t f o u r however, o f t h e  t w e l v e workers t a l k e d o f t h e i r groups i n terms o f group p r o c e s s . Seven elements o f group p r o c e s s were i d e n t i f i e d i n t h e K e r r - K i r k h a m 7 t h e s i s , based on t h o s e suggested by a v a r i e t y o f t h e o r i s t s . The C a s e w o r k e r s Groups Each caseworker i n t e r v i e w e d by K e r r - K i r k h a m , c o n t r i b u t e d 1  3  K e r r and Kirkham, Caseworkers Working W i t h Groups,  4  Ibid.,  5  I b i d . , p.51  6  I b i d . , p.54.  7  Ibid.,  p.48  p.53  p.47  - 5 -  one group t o t h e s t u d y . a time.  A l l t h e groups met f o r n i n e t y minutes a t  Treatment groups met more f r e q u e n t l y , and were s m a l l e r r i n  number o f members, p e r m i t t i n g member t o member r e l a t i o n s h i p s , and member t o worker r e l a t i o n s h i p s . l a r g e r i n membership.  E d u c a t i o n groups were s l i g h t l y  Three e d u c a t i o n groups were open, and t h r e e  c l o s e d , t o new members a f t e r t h e group had met once o r t w i c e . Four o f t h e s i x t r e a t m e n t groups were e q u a l l y b a l a n c e d h e t e r o s e x u a l l y , two t r e a t m e n t groups had o n l y males. e d u c a t i o n groups were a l l f e m a l e .  Three o f t h e  S e l e c t i o n s o f members appeared  t o be on t h e b a s i s o f a common problem and a v a i l a b i l i t y o f members. A l l members o f t h e t r e a t m e n t groups were a s s e s s e d by a c l i n i c a l team b e f o r e t h e y j o i n e d t h e group.  The members o f t h r e e e d u c a t i o n  groups were a s s e s s e d b r i e f l y by a caseworker b u t t h e r e was no assessment made o f t h e o t h e r t h r e e e d u c a t i o n groups, ( o n l y f o u r of t h e s e s i x groups have been used i n t h e p r e s e n t s t u d y ) .  Two  workers w i t h e d u c a t i o n groups saw i n d i v i d u a l members i n casework i n t e r v i e w s as w e l l as i n t h e group s i t u a t i o n .  The r e m a i n i n g f o u r  r e s p o n d e n t s w i t h e d u c a t i o n groups saw members o n l y i n t h e group situation.  A l l s i x workers w i t h t r e a t m e n t groups ( s o c i a l group  t r e a t m e n t , and group p s y c h o t h e r a p y ) , met w i t h group members i n i n d i v i d u a l casework s e s s i o n s as w e l l as i n t h e group) I t s/hould be noted t h a t t h e t w e l v e caseworkers i n d i c a t e d c o n s i d e r a b l e v a r i a t i o n i n t h e c l a s s i f i c a t i o n o f t h e i r groups. Three c l a s s i f i e d t h e i r s as " e d u c a t i o n a l c o u n s e l l i n g , " two as  8  K e r r and Kirkham, Caseworkers Working W i t h Groups,  9  Ibid,  p.47  p.46  - 6 " e d u c a t i o n " , f o u r as " t r e a t m e n t " , two as " t h e r a p y . "  1 0  C o n c e p t u a l Framework The K l e i n c l a s s i f i c a t i o n scheme has been chosen as t h e c o n c e p t u a l framework f o r t h e p r e s e n t s t u d y .  The t y p o l o g y p r o v i d e s  a model i n terms o f purpose, g o a l , and worker r o l e , f a m i l i a r and common concepts t o caseworkers as w e l l as t o group w o r k e r s . I t also provided: 1. 2. 3.  Continuity. P e r m i t s d e t a i l e d a n a l y s i s o f groups i n r e l a t i o n t o the K l e i n c l a s s i f i c a t i o n s . P r o v i d e s an o p p o r t u n i t y t o a n a l y z e worker a c t i v i t y as i t r e l a t e s t o p u r p o s e .  W h i l e t h e r e a r e o t h e r c l a s s i f i c a t i o n s w h i c h might have been used, i t seemed f o r t h e above r e a s o n s t h a t t h e K l e i n  classifications  b e s t s u i t e d t h e purpose o f t h e p r e s e n t s t u d y . K l e i n Typology K l e i n has s t a t e d : " d e f i n i t i o n o f t h e group purpose i s n e c e s s a r y t o guide t h e worker i n s t r u c t u r i n g h e r h e l p i n g r o l e s as change a g e n t . She t h e n knows what l i m i t a t i o n s t o s e t on i n t e r p r e t a t i o n , d i s c u s s i o n , and a c t i o n , and what freedom t o encourage. She can a f f e c t t h e group p r o c e s s t o c a r r y out t h e avowed purpose o f t h e g r o u p . 1 1  K l e i n i s s u p p o r t e d i n t h i s t h i n k i n g by G e r t r u d e W i l s o n who says: "The s p e c i f i c s t a t u s e s and r o l e s o f s o c i a l workers i n group s i t u a t i o n s a r e d e r i v e d from t h e s p e c i f i c purposes o f t h e groups. "-^  10  K e r r and Kirkham, Caseworkers Working W i t h Groups, p.34  11 J . K l e i n , A d u l t E d u c a t i o n and Treatment Groups i n S o c i a l A g e n c i e s , The C a t h o l i c U n i v e r s i t y o f America P r e s s , Washington, D.C., p.94  12 W i l s o n , Gertrude,- "The S o c i a l Worker's R o l e i n Group S i t u a t i o n s , " i n The S o c i a l Group Work Method i n S o c i a l Work E d u c a t i o n , M a r j o r i e Murphy (New York: C o u n c i l on S o c i a l Work E d u c a t i o n , 1 9 5 9 ) . p.135 c i t e d i n A d u l t E d u c a t i o n and Treatment Groups i n S o c i a l A g e n c i e s , The C a t h o l i c U n i v e r s i t y o f America P r e s s , Washington, D.C., p.94 •  -  7  -  K l e i n has c r e a t e d a t y p o l o g y o f t h r e e c a t e g o r i e s : 13 education, therapy. ^ 1  2.  S o c i a l Group Treatment, *lz  and 3 .  Group e d u c a t i o n has as i t s p r i m a r y  of i n f o r m a t i o n t o c l i e n t o r r e l a t i v e g r o u p s . f o c u s e d i n t o two main a r e a s .  1.  Group k_  Group psycho-  goal, the imparting "The knowledge i s  (1) program, p o l i c i e s , p l a n t and  p r o c e d u r e s o f t h e agency, (2) human development, behaviour and s o c i a l adjustment." three  K l e i n f u r t h e r d i v i d e s Group E d u c a t i o n  into  sub-groupings: A. F a m i l y L i f e E d u c a t i o n , h a v i n g as i t s g o a l s the i m p a r t i n g o f knowledge t o presumably h e a l t h y and s t a b l e i n d i v i d u a l s about t h e i r p a r e n t a l and m a r i t a l r o l e s . These a r e preventative groups. ^ 1  B.  O r i e n t a t i o n groups, w h i c h a c c l i m a t e t h e p a t i e n t o r r e l a t i v e t o t h e program, f u n c t i o n s p h y s i c a l p l a n t , and t h e r e a l i t e s of t h e p r o c e d u r e s i n o r d e r t o f a c i l i t a t e f u t u r e r e l a t i o n s h i p s w i t h the i n s t i t u t i o n . When p a t i e n t s ' are i n v o l v e d , t h e o r i e n t a t i o n group has t h e f u r t h e r g o a l o f h e l p i n g t h e p a t i e n t as t h e f i r s t step i n t r e a t m e n t , t o accept t h e r e a l i t i e s o f t h e s i t u a t i o n i n w h i c h he f i n d s h i m s e l f . The o r i e n t a t i o n group aims f u r t h e r t o h e l p him t o e n t e r a new e x p e r i e n c e more r e a d i l y , t o s t a r t c r e a t i n g r e l a t i o n s h i p w i t h o t h e r s and t o p r e v e n t a s t a t e o f normlessness i n t h e t r a n s i t i o n from o u t s i d e w o r l d t o t h e i n s t i t u t i o n .-^  C.  P r e - i n t a k e . These groups have as t h e i r g o a l acquainting the prospective c l i e n t with the p o l i c i e s , f u n c t i o n and p r o c e d u r e s o f t h e agency, and w i t h t h e mutual e x p e c t a t i o n o f the agency and t h e c l i e n t once i t i s agreed t h a t t h e s e r v i c e i s t o be u n d e r t a k e n . The purpose o f i m p a r t i n g t h i s i n f o r m a t i o n i s t o enable t h e p r o s p e c t i v e c l i e n t t o r e a c h a d e c i s i o n as t o whether o r n o t t o a p p l y f o r s e r v i c e s .4-  13 K l e i n , Adult Education A g e n c i e s , p. 132 14  I b i d . , pp. 134-137  and Treatment Groups i n S o c i a l  - 8 -  The second major c l a s s i f i c a t i o n d e l i n e a t e d by K l e i n i s ' " S o c i a l Group Work T r e a t m e n t . ^ 1  1  The purpose o f such a group i s  seen as t h e r e d u c t i o n o f s o c i a l and e m o t i o n a l p r e s s u r e s and t o increase the c l i e n t ' s capacity f o r s a t i s f a c t o r y s o c i a l f u n t i o n ing. ^ 1  W i t h i n t h i s major c l a s s i f i c a t i o n K l e i n s u g g e s t s two sub-  groupings: A.  Group t r e a t m e n t aimed a t m a i n t a i n i n g a d a p t i v e p a t t e r n s i n which the g o a l i s t o h e l p t h e c l i e n t , w i t h i n t h e framework of h i s p a t t e r n o f f u n c t i o n i n g , t o f i n d s o l u t i o n s t o h i s problems and t o improve h i s s o c i a l r e a l i t y . Treatment i s d i r e c t e d towards i n c r e a s i n g t h e ego's integrative capacity. ^ 1  B.  Group t r e a t m e n t aimed a t m o d i f i c a t i o n o f a d a p t i v e p a t t e r n s , t h e aim.- o f t h i s t y p e of group t r e a t m e n t i s t o h e l p t h e c l i e n t handle s p e c i f i c a s p e c t s o f h i s psychos o c i a l s i t u a t i o n w i t h patterns of f u n c t i o n i n g d i f f e r e n t from t h o s e used i n t h e p a s t . I t s g o a l i s t o improve t h e c l i e n t ' s a b i l i t y t o master r e a l i t y s i t u a t i o n s by i n c r e a s i n g h i s u n d e r s t a n d i n g o f h i m s e l f , o f h i s problem and o f h i s own p a r t i n c r e a t i n g them...- -^ 1  The t h i r d major g r o u p i n g t h a t K l e i n d e f i n e s , i s " G r o u p Psychotherapy."  An a n a y l t i c a l l y - o r i e n t e d group t r e a t m e n t aimed a t  p e r s o n a l i t y r e o r g a n i z a t i o n i n an i n d i v i d u a l who has a p s y c h i a t r i c a l l y - d i a g n o s e d emotional problem."-^ C l a s s i f i c a t i o n of Roles As p o i n t e d out e a r l i e r , c e r t a i n r o l e s o f workers a r e conc e p t u a l i z e d as b e i n g most a p p r o p r i a t e t o achievement of s p e c i f i c or p a r t i c u l a r group p u r p o s e s .  K l e i n has r e l a t e d s e l e c t e d r o l e s t o  the t h r e e major g o a l c l a s s i f i c a t i o n s c i t e d above.  14 K l e i n , A d u l t E d u c a t i o n and Treatment Groups i n S o c i a l A g e n c i e s , pp. 134-137  - 9 -  Group E d u c a t i o n R o l e s There a r e f o u r i n number.  They a r e l a r g e l y  f o c u s e d on l e a r n -  i n g about s p e c i f i c s u b j e c t m a t t e r t h r o u g h t h e media o f l e c t u r e s , i n f o r m a t i o n , t a l k , f i l m s , and suggested r e a d i n g s , t h a t i s , knowledge which i s a l r e a d y f a s h i o n e d .  E x p r e s s i o n o f f e e l i n g and t h e  r a i s i n g o f q u e s t i o n s i s s t r u c t u r e d around t h e s u b j e c t m a t t e r . i s m i n i m a l e f f o r t made t o i n v o l v e members i n r e l a t i o n s h i p s one a n o t h e r .  R o l e performance  There  with  o f t h e worker i s p r e d o m i n a n t l y r e -  l a t e d t o m a t e r i a l b e i n g i m p a r t e d r a t h e r than on any development o f 15 intra-member;: Social  relationships.  Group Treatment I n c o n t r a s t t o e d u c a t o r r o l e , t h e worker  engaged i n s o c i a l  group t r e a t m e n t f o c u s e s on t h e development o f p u r p o s e f u l r e l a t i o n s h i p s between h i m s e l f and t h e members, and between members. c o n s c i o u s l y uses h i m s e l f t o a c c o m p l i s h h i s g o a l .  He  As w e l l , he uses  the e x p e r i e n c e s o f members as a medium t o encourage them t o express their feelings  about t h e c o n t e n t .  He h e l p s them a c h i e v e s e l f -  awareness by drawing a n a l o g i e s and p a r a l l e l s between t h e responses and i n t e r - a c t i o n s  o f t h e members.  He l i m i t s and f o c u s e s t h e d i s -  cussions. " 1  Group  Psychotherapy The worker d i r e c t s  h i s e f f o r t s toward t h e u n c o v e r i n g o f  r e p r e s s e d m a t e r i a l and u n c o n s c i o u s c o n f l i c t s .  He u t i l i z e s  trans-  15 K l e i n , A d u l t E d u c a t i o n and Treatment Groups i n S o c i a l A g e n c i e s , p. 132 16  I b i d . , p. 133  - 10 -  f e r e n c e r e l a t i o n s i n t h e i n t e r e s t o f b r i n g i n g about b a s i c in personality.  changes  T h i s f o r m o f t r e a t m e n t i s n o t c o n s i d e r e d t o be a  g e n e r a l aim i n most a g e n c i e s . I t can be presumed t h a t i f t h e caseworkers i n t h e p r e s e n t s t u d y , had d i f f e r e n t i a l purposes and s p e c i f i c g o a l s f o r t h e i r groups, t h e y would t h e n use t h e m s e l v e s d i f f e r e n t i a l l y .  I f their  purposes a r e s i m i l i a r t o t h o s e p o s t u l a t e d by K l e i n , t h e n presumably t h e i r g o a l s and a c t i v i t i e s would a l s o s i m u l a t e h e r s .  I t becomes  i m p o r t a n t t h e n t o examine b r i e f l y some o f t h e i m p l i c a t i o n s w h i c h grow out o f a comparison 'of t h e K l e i n r o l e models.  I n the  E d u c a t i o n a l Groups, i t would be e x p e c t e d t h a t t h e worker w i l l be more a c t i v e t h a n i n ' e i t h e r s o c i a l group t r e a t m e n t o r group psychotherapy.  Her r o l e would be p r e d o m i n a n t l y t h a t o f t e a c h e r , w i t h  t h e members r e l a t i n g more d i r e c t l y t o h e r . Where knowledge and use o f group p r o c e s s would be o f p r i m a r y concern i n b o t h t h e t r e a t ment c a t e g o r i e s , i t would assume f a r l e s s i m p o r t a n c e i n t h e educat i o n groups.  I n c o n t r a s t , f a m i l i a r i t y w i t h program media would be  e s s e n t i a l , n e c e s s a r i l y more e x t e n s i v e , and o f g r e a t e r  significance  i n a c h i e v i n g t h e purpose i n e d u c a t i o n - g r o u p s , w h i l e i t would a secondary c o n s i d e r a t i o n f o r t h e t r e a t m e n t c l a s s i f i c a t i o n s .  I n the  e d u c a t i o n - g r o u p s t h e worker would have meetings w e l l f o c u s e d and w e l l s t r u c t u r e d , w i t h t e r m i n a t i o n dependant on t h e c o n t e n t t o be covered r a t h e r t h a n r e l a t e d t o t h e d e v e l o p m e n t a l r a t e o f group members.  The r e v e r s e would be t r u e o f t e r m i n a t i o n i n t h e t r e a t m e n t  17 K l e i n , A d u l t E d u c a t i o n and Treatment Groups i n S o c i a l A g e n c i e s , p. 137  - 11 -  c l a s s i f i c a t i o n s where i n d i v i d u a l r e a d i n e s s would be t h e d e t e r m i n i n g factor.  R e s p o n s i b i l i t y f o r t h e movement o f t h e group towards t h e  s u c c e s s f u l achievement o f i t s g o a l , r e s t s more h e a v i l y on t h e a c t i v i t y engaged i n by t h e s o c i a l worker i n t h e e d u c a t i o n a l c o n t e x t . I n t h e t r e a t m e n t groups, t h e change agent can depend on c o n s i d e r a b l e a s s i s t a n c e from t h e i n t e r a c t i o n between members t o f a c i l i t a t e movement.-  I n e d u c a t i o n groups t e r m i n a t i o n would n o t i n v o l v e o v e r -  coming r e s i s t a n c e , w h i l e i n t h e s o c i a l group t r e a t m e n t , and group p s y c h o t h e r a p y groups i t would be an i m p o r t a n t c o n s i d e r a t i o n . In  t h e t r e a t m e n t groups t h e workers r o l e i s v i s i b l y  less  a c t i v e , and i n s o c i a l group t r e a t m e n t i s p r e d o m i n a n t l y t h a t o f "enabler."  The main f o c u s i s on t h e e x p r e s s i o n o f t h e f e e l i n g s o f  members, u s i n g program, and t h e members own e x p e r i e n c e t o a i d t h i s expression.  I n ' e d u c a t i o n groups a g a i n t h e r e v e r s e i s t r u e , w i t h  v e n t i l a t i o n p e r m i t t e d o n l y around t h e c o n t e n t .  Since i n s o c i a l  group t r e a t m e n t g o a l s a r e r e l a t e d t o i n t e g r a t i n g ego f u n c t i o n i n g or  t h e changing o f a d a p t i v e p a t t e r n s , l i m i t i n g w i l l be o f g r e a t e r ,  i m p o r t a n c e i n t h e s e groups than i n t h e group psychotherapy.. C l a r i f i c a t i o n , i n s i g h t , and f o c u s i n g on member i n t e r a c t i o n would a l s o be c h a r a c t e r i s t i c o f s o c i a l group t r e a t m e n t . of problems w i l l be o f paramount c o n s i d e r a t i o n .  Partialization  The f o c u s w i l l be  on t h e i n d i v i d u a l member, b u t group p r o c e s s w i l l be t h e most i m p o r t a n t means f o r f a c i l i t a t i n g h i s development. the  Dealing with  d e f e n c e s and r e s i s t e n c e s o f members assumes g r e a t e r  significance  i n t h e s e groups, and demands g r e a t e r knowledge o f i n d i v i d u a l and group development from t h e worker. might make i t d i f f i c u l t  L a c k s i n t h e s e knowledge a r e a s  o r i m p o s s i b l e f o r d e f e n c e s and r e s i s t a n c e s  - 12  t o be d e a l t w i t h a d e q u a t e l y ,  -  p r e v e n t i n g achievement of group g o a l s .  The worker r o l e i n group p s y c h o t h e r a p y has been d e f i n e d that of " s u b s t i t u t e parent."  as  I t i s t h e most p a s s i v e of a l l of t h e  worker r o l e s , i s the l e a s t f o c u s i n g , l i m i t i n g or d i r e c t i v e i n n a t u r e , and has the most e x t e n s i v e p e r s o n a l i t y change as a goal, of any of t h e g r o u p s .  The major r o l e of the s o c i a l worker would be  i n t e r p r e t a t i o n of a s p e c i a l k i n d , namely t h a t of u n c o n s c i o u s material.  I n t e r v e n t i o n i n t o the group p r o c e s s would be m i n i m a l ,  but t h i s f o r m of therapy  i s probably  the most h i g h l y dependant on  member i n t e r a c t i o n of a l l t h e g r o u p s .  I t demands of t h e change  agent, e x t e n s i v e knowledge of i n d i v i d u a l and group dynamics  and  i n essence r e a l l y demands the competence of a p s y c h i a t r i s t . Termination  would depend on members r e a d i n e s s , and the "working  t h r o u g h , " of f e e l i n g s a s s o c i a t e d w i t h t e r m i n a t i n g r a t h e r t h a n on a predetermined  time.  Method of Data C o l l e c t i o n I n o r d e r t o determine t h e r e f o r e , how s u p p o s i t i o n s would be, t h a t i s , how the group p r o c e s s ,  i t was  accurate  c o n s c i o u s l y the workers d i r e c t e d  n e c e s s a r y t o d e v i s e a method b e s t s u i t e d  to gathering pertinent m a t e r i a l .  An i n t e r v i e w s c h e d u l e was  w h i c h would l e n d i t s e l f t o adequate a n a l y s i s . of the s c h e d u l e ,  was  some of t h e s e  devised,  A major advantage  t h a t i t p e r m i t t e d an o p p o r t u n i t y t o meet w i t h  the worker i n a d m i n i s t e r i n g i t . e l a b o r a t e on q u e s t i o n s  I t was  i n " t h e schedule,  therefore possible to t o p i c k up on what o f t e n  proved s i g n i f i c a n t m a t e r i a l and t o get more d e t a i l e d i n f o r m a t i o n than might not have been p o s s i b l e o t h e r w i s e . i n t e r v i e w , i t was  I n the f a c t t o f a c e  p o s s i b l e t o be sure q u e s t i o n s were u n d e r s t o o d ,  making f o r g r e a t e r a c c u r a c y of r e s p o n s e .  - 13 -  Q u e s t i o n s were d e s i g n e d i n t h e s c h e d u l e t o o b t a i n i n f o r m a t i o n from t h r e e d i f f e r e n t meetings w h i c h t h e workers had w i t h t h e i r groups.  The f i r s t , m i d d l e and f i n a l meeting were chosen.  The  m i d d l e meeting was n o t an a r t h m e t i c m i d d l e , but one approximatelyh a l f - w a y t h r o u g h t h e l i f e o f t h e group, which i n t h e workers.mind seemed t o s t a n d o u t .  The purpose i n d o i n g t h i s , was t h e e x p e c t a -  t i o n t h a t t h e workers would p i c k meetings w h i c h had impact and s i g n i f i c a n c e f o r them.  Each meeting c o n t a i n e d q u e s t i o n s as t o t h e  purpose and g o a l s o f t h e worker, and t h e r o l e s he or' she used i n a t t e m p t i n g t o a c h i e v e t h a t purpose.  As i t was n o t f e a s i b l e t o  d e s c r i b e e v e r y .meeting, c o n c e n t r a t i o n was f o c u s e d on t h r e e o f ;t'hem,3,  the  which i t was hoped would g i v e a comprehensive p i c t u r e o f  groups a c t i v i t y from t h e i n i t i a l meeting t o i t s f i n a l one.  From t h e m a t e r i a l t h e w r i t e r s hoped i t would be p o s s i b l e t o d e t e r mine t h e k i n d s o f changes t a k i n g p l a c e i n purposes, g o a l s , r o l e s , and member i n t e r a c t i o n , and how i f a t a l l , t h e s e changes were p u r p o s e f u l l y i n s t i g a t e d by t h e worker. F o l l o w i n g t h e d r a f t i n g o f t h e i n t e r v i e w s c h e d u l e i t was t r i e d out on f o u r workers n o t i n v o l v e d i n t h e p r e s e n t s t u d y , t o test i t s u t i l i t y .  A f t e r some r e v i s i o n s were made i n i t , t h e e l e v e n 18  caseworkers were i n t e r v i e w e d . Method o f Data A n a l y s i s Responses t o q u e s t i o n s p e r t a i n i n g t o group purpose and g o a l s 18  F o r t h e complete i n t e r v i e w s c h e d u l e see Appendix A  - 14 -  are  d e s c r i b e d i n Chapter I I . ' The groups -.are* c l a s s i f i e d a c c o r d -  ing  t o the t h r e e c a t e g o r i e s , o f Group E d u c a t i o n , S o c i a l Group  Treatment, and Group P s y c h o t h e r a p y , u s i n g K l e i n ' s d e f i n i t i o n s as cited earlier. the  S i r n i l i a r i t i e s and d i f f e r e n c e s a r e n o t e d between  p r e s e n t groups under s t u d y , and those of K l e i n as t o group  p u r p o s e s , and g o a l s .  Chapter I I I d e a l s w i t h the R o l e of the Case-  workers as p e r c e i v e d from a n a l y s i s of the i n t e r v i e w s c h e d u l e . The o v e r a l l r o l e of the caseworker i s examined f o r each of t h r e e k i n d s of groups mentioned p r e v i o u s l y .  The r o l e of t h e worker i s  t h e n examined i n each of t h r e e s e p a r a t e meetings, of t h e groups. These r o l e s a r e then r e v i e w e d a g a i n s t K l e i n ' s p o s t u l a t i o n s as t o appropriate r o l e s .  S i r n i l i a r i t i e s and d i f f e r e n c e s between the  c u r r e n t f i n d i n g s and K l e i n ' s model are n o t e d . are  The worker's r o l e s  then d i s c u s s e d i n terms o f ; 1) how the meeting was  started,  2) how the meeting was developed, and 3) how the meeting and t h e groups t e r m i n a t e d . S p e c i f i c examples a r e g i v e n t o a m p l i f y d e s c r i p t i v e l y , the f u n c t i o n s and t a s k s t h e s e workers performed i n t h e i r various roles.  Chapter IV e x p l o r e s t h e u s e f u l n e s s o f t h e  chosen model, and draws some i m p l i c a t i o n s from t h e summaries of Chapter I I and C h a p t e r I I I . included.  I n d i c a t i o n s f o r f u t u r e study a r e  CHAPTER I I  THE PURPOSE AND GOALS OF THE GROUPS  I.  INTRODUCTION I n c o n s i d e r i n g t h e r o l e o f t h e caseworker as a change  agent i n t h e group, i t i s i m p o r t a n t t o study t h e purpose t h e workers s e t f o r t h e i r groups, and how t h e s e a r e r e l a t e d t o t h e i n d i v i d u a l meetings.  The p r e s e n t r e s e a r c h team b e l i e v e t h a t  t h e s o c i a l worker must know and u n d e r s t a n d t h e agency's purpose f o r a group, b e f o r e s e t t i n g t h e g o a l s f o r t h e i n d i v i d u a l meetings. the g o a l s .  The purpose t h e r e f o r e s h o u l d d i r e c t l y  affect  As o u t l i n e d i n c h a p t e r one, t h e i n f o r m a t i o n was  o b t a i n e d from an i n t e r v i e w s c h e d u l e i n a survey o f e l e v e n caseworkers w o r k i n g w i t h g r o u p s .  These caseworkers were t h e same  ones q u e s t i o n e d i n t h e K e r r and Kirkham t h e s i s , w o r k i n g w i t h groups."  "Caseworkers  This t h e s i s w i l l deal w i t h t e n of the  eleven groups.* K e r r and Kirkham used D r . Joyce K l e i n ' s  classification  system f o r d e f i n i n g A d u l t E d u c a t i o n and Treatment Groups i n Social Agencies.  The r e s e a r c h e r s on t h e c u r r e n t study adopted  t h i s as t h e model a g a i n s t w h i c h t o compare t h e s t a t e d purpose . f o r t h e group, t h e g o a l s f o r t h e group, and t h e r o l e o f t h e worker.  * One group d e l e t e d due t o i n s u f f i c i e n t  information.  - 16 -  An i n t e r v i e w schedule was f r o m each worker, who  s e t up i n o r d e r t o e l i c i t  had been concerned w i t h a group, the  following information: (a) the purpose f o r which the group was  set  up.  (b) the g o a l s the worker s e t h e r s e l f a t t h r e e p o i n t s i n the l i f e of the group. (c) the r o l e of the worker as she understood  it,  or p e r c e i v e d i t a t any p o i n t i n t h e work. T h i s c h a p t e r w i l l be concerned w i t h t h e f i r s t two  - purpose and  goals. Dr. K l e i n ' s s t u d y , a n a l y s e d the d i f f e r e n c e between the groups, i n d i c a t i n g t h a t t h e s e may  be d i v i d e d i n t o t h r e e main  categories: 1.  Group E d u c a t i o n  2.  S o c i a l Group Treatment  3.  Group  Psychotherapy  T h i s i s an i m p o r t a n t and u s e f u l d i s t i n c t i o n , and i t i s f o l l o w e d i n the c u r r e n t r e p o r t . The K e r r and Kirkham f i n d i n g s , s u b s t a n t i a t e d by our i n d i c a t e the t e n groups surveyed  s h o u l d be c l a s s i f i e d  own,  as  follows:  In  Group E d u c a t i o n  -  4  S o c i a l Group Treatment  -  3  Group Psychotherapy.  -  3  o r d e r t o a v o i d c o n f u s i o n among the t h r e e s e c t i o n s , the  groups w i l l be c a t e g o r i z e d .  The  Group E d u c a t i o n groups w i l l . b e  -17-  c a l l e d E l , E2, E3, E4, i . e . E l meaning Group E d u c a t i o n Group 1. S o c i a l Group Treatment w i l l be T l , T2,  and T3, w h i l e Group  Psychotherapy  The t h r e e group  w i l l be P I , P2, and P3.  f i c a t i o n s w i l l be d i s c u s s e d under s e p a r a t e s e c t i o n s .  classiEach s e c t i o n  w i l l be concerned w i t h a n a l y s i n g the purpose and g o a l s s e t by the i n d i v i d u a l caseworker II  f o r her group.  GROUP EDUCATION The model a g a i n s t which the purpose o f the group can be  s t u d i e d i s as f o l l o w s :  t  In  E d u c a t i o n means the i m p a r t i n g of knowl e d g e ; t o develop the f a c u l t i e s and powers by i n s t r u c t i o n . E d u c a t i o n groups f o r c l i e n t s , t h e i r r e l a t i v e s o r p r o s p e c t i v e c l i e n t s of s o c i a l agencies are e s t a b l i s h e d p r i m a r i l y to i m p a r t knowledge. The knowledge i s f o c u s e d on two main a r e a s . (1) programme, p o l i c i e s , p l a n and procedures of the agency (2) human development, b e h a v i o u r and s o c i a l a d j u s t m e n t . The manner i n which the worker d i s s e m i n a t e s t h i s knowledge t h r o u g h the use of her s k i l l and u n d e r s t a n d i n g a c q u i r e d i n her p r o f e s s i o n a l l i f e , her r e c o g n i t i o n of c o n s c i o u s and unconscious b e h a v i o u r mechanisms, the s e t t i n g of l i m i t a t i o n s , and her a c t i v e c r e a t i v e guidance, d i s t i n g u i s h e s t h i s e d u c a t i o n group from the c r e a t i v e g u i d ance, d i s t i n g u i s h e s t h i s e d u c a t i o n group from the u s u a l a d u l t work. T h e r a p e u t i c r e s u l t s of such groups, a l t h o u g h i m p o r t a n t , are i n c i d e n t a l t o t h e p r i m a r y purpose of education.i  o r d e r t o use t h i s purpose d e f i n i t i o n i n the most c o n s t r u c t i v e  manner, one must have a w o r k i n g knowledge of t h e member composi1 K l e i n , J.G., A d u l t E d u c a t i o n and Treatment Groups i n S o c i a l A g e n c i e s . A D i s s e r t a t i o n . The C a t h o l i c U n i v e r s i t y o f America P r e s s . Wash. D.C., I 9 6 0 , p.132  - 18 -  t i o n of the surveyed groups.  W i t h t h i s knowledge, p l u s t h e  model, an a n a l y s i s o f t h e group's purpose can be made. As mentioned p r e v i o u s l y t h e r e a r e f o u r groups i n c l u d e d in this section.  E l was a group o f p a r e n t s o f deaf c h i l d r e n  whom t h e agency f e l t c o u l d b e n e f i t t h r o u g h a mutual s h a r i n g of problems.  The caseworker was t o i n t e r p r e t t h e agency's  p o l i c y and s e r v i c e f a c i l i t i e s , as w e l l as h e l p t h e p a r e n t s l e a r n how t o handle t h e i r deaf c h i l d r e n .  A l t h o u g h t h i s group  s t a r t e d out w i t h a t t e n d a n c e by b o t h t h e mothers and f a t h e r s , the f a t h e r s dropped out a t an e a r l y s t a g e . E2 was a group f o r r e l a t i v e s o f p a t i e n t s on t h e p s y c h i a t r i c ward o f a g e n e r a l h o s p i t a l .  The agency f e l t  that  the group would s e r v e as an e x c e l l e n t t o o l f o r e d u c a t i o n on mental i l l n e s s .  Through e d u c a t i n g t h e r e l a t i v e s o f p a t i e n t s  as t o t h e n a t u r e o f t h e d i s o r d e r , p l u s i t s b e h a v i o u r a l manif e s t a t i o n s , t h e y hoped t h e group would g a i n i n c r e a s e d unders t a n d i n g i n t o t h e p a t i e n t ' s problem.  They t h e r e f o r e wished t o  d i r e c t l y i n v o l v e the r e l a t i v e i n the r e h a b i l i t a t i o n of the patient.  The r e l a t i v e s ranged from a mother o r f a t h e r t o an  uncle or cousin.  The a v a i l a b i l i t y o f f a m i l y members determined  who would be a b l e t o a t t e n d t h e group. E3 was a group f o r mothers o f p r e - s c h o o l b l i n d  children.  The caseworker was u n a b l e t o make home v i s i t s t o a l l t h e p a r e n t s , t h e r e f o r e formed t h i s group as a supplement t o c a s e work.  The caseworker f e l t i t was i m p o r t a n t t o s t a y i n c o n t a c t  w i t h t h e s e p a r e n t s as t h e y needed a s s i s t a n c e i n r a i s i n g  blind  - 19  children.  -  S i n c e the c h i l d r e n were of p r e - s c h o o l age,  such as "what w i l l happen t o my were d i s c u s s e d .  problems  c h i l d when he goes t o s c h o o l , "  As t h e r e are few r e s o u r c e s where p a r e n t s  of  b l i n d c h i l d r e n can t u r n t o f o r h e l p , t h i s group of mothers p l a n s t o w r i t e a b o o k l e t on how  t o r a i s e such a c h i l d .  It is  f e l t t h a t t h r o u g h i n f o r m i n g the p a r e n t s of the d i f f i c u l t i e s  of  r a i s i n g a b l i n d c h i l d , and t h r o u g h mutual d i s c u s s i o n among the p a r e n t s on t h i s problem, an e d u c a t i o n a l s e r v i c e can be g i v e n . E4 was  a group of a d o p t i v e p a r e n t s .  meetings were s e t up t o g i v e p a r e n t s , who or who  A s e r i e s of f i v e have adopted c h i l d r e n  a r e i n the p r o c e s s o f a d o p t i n g , a chance t o d i s c u s s t h e i r  problems.  The agency hoped t o s t r e s s the i m p o r t a n t k i n d of  c o n t r i b u t i o n the p a r e n t s , p a r t i c i p a t i n g i n these k i n d s of a r e making t o the knowledge and u n d e r s t a n d i n g families.  The  agency wished  groups,  of a d o p t i v e  t o show i t s c o n t i n u e d i n t e r e s t i n  them, as w e l l as h e l p educate them i n how  t o r a i s e an adopted  child. The purpose of a l l the above f o u r groups i s t o i m p a r t knowledge w i t h i n a s p e c i f i c problem a r e a t o a c l i e n t group. The f o u r caseworkers'  s t a t e d purposes f o r t h e groups w i l l  be s t u d i e s i n o r d e r t o see how  now  and i n what manner they a r e  c o n s i s t e n t t o our model. A)  PURPOSE of the GROUPS The p e r t i n e n t q u e s t i o n t o o b t a i n t h i s i n f o r m a t i o n was:  - 20 -  "What was t h e purpose o f t h e group?" (Note t h e u n d e r l i n e d p o r t i o n s d e a l s p e c i f i c a l l y w i t h t h e purpose o f t h e group) El  I t was a group o f mothers and c h i l d r e n , a l l r o u g h l y t h e same ages, a t t e n d i n g speech and h e a r i n g t h e r a p y f o r treatment because o f h e a r i n g l o s s . Most o f these mothers were i n t e l l i g e n t , b u t had some problem i n a c c e p t i n g t h e h e a r i n g l o s s , so we f e l t i t would be a good i d e a t o have them come t o g e t h e r and d i s c u s s t h e i r problems and h e l p each o t h e r w i t h them.  E2  The group was formed because we f e l t , t h e need on t h e p s y c h i a t r i c ward o f t h e h o s p i t a l t o "have a group o f r e l a t i v e s t o g e t h e r w i t h a i'ocus on t h e r e h a b i l i t a t i o n o r t h e p a t i e n t ahd t o i n v o l v e t h e r e l a t i v e i n t r e a t m e n t . Other aims were community i n t e r p r e t a t i o n c o n c e r n i n g mental i l l n e s s . . . a n d t a l k i n g about t h e i r f e e l i n g s as a r e l a t i v e t o t h e p a t i e n t , and t h e f e e l i n g s t h e r e l a t i v e s had t h e m s e l v e s . . .  E3  ...time s a v e r , we were g e t t i n g more and more p a r e n t s and T d i d n ' t have time f o r home v i s i t s . I t was t o keep c o n t a c t w i t h t h e s e p a r e n t s as they needed h e l p w i t h r a i s i n g b l i n d c h i l d r e n .  E4  The d i s c u s s i o n s e r i e s f o r p a r e n t s was r e g a r d e d by t h e agency as a means o f t h e i r l e a r n i n g more ekntimateiy and d i r e c t l y t h e c h a l l e n g e s and d i f f i c u l t i e s f a c e d by a d o p t i v e p a r e n t s as w e l l as t h e .joys and s a t i s f a c t i o n s o f c r e a t i n g a f a m i l y through a d o p t i o n . I t would a l s o g i v e the p a r e n t s an o p p o r t u n i t y t o share w i t h each o t h e r and t h e agency some o f t h e i r p a r t i c u l a r concerns about a d o p t i o n and t h e ways i n which the p a r e n t - c h i l d r e l a t i o n s h i p s were d e v e l o p i n g .  A l l t h e purposes s t a t e d by t h e caseworkers  a r e f o c u s e d on a  problem common t o t h e members w i t h i n each group.  Although the  problems range from t h o s e c e n t r e d around r a i s i n g a handicapped o r a d o p t i v e c h i l d , t o d e a l i n g w i t h mental h e a l t h r e h a b i l i t a t i o n ,  2  P a r t 1, q u e s t i o n 1, I n t e r v i e w Schedule;  See Appendix A  - 21 -  t h e r e i s a common theme w h i c h runs t h r o u g h a l l the f o u r  groups,  i . e . the v a l u e of the group members s h a r i n g t h e i r problems w i t h each o t h e r . The  caseworkers  e x p r e s s e d i t t h i s way,':  El  ...a good i d e a t o have them come t o g e t h e r and d i s c u s s t h e i r problems and h e l p each o t h e r w i t h them.  E2  . . . t a l k i n g about t h e i r f e e l i n g s as a r e l a t i v e t o the p a t i e n t , and the f e e l i n g s the r e l a t i v e s had t h e m s e l v e s .  E3 . ...they need h e l p w i t h r a i s i n g b l i n d E4  W h i l e i t may  children.  . . . g i v e t h e p a r e n t s an o p p o r t u n i t y t o share w i t h each o t h e r and the agency some of t h e i r p a r t i c u l a r concerns about a d o p t i o n .  not be e v i d e n t i n the statement  p a r t i c i p a t i o n was  by E3 t h a t member  i m p o r t a n t , n e v e r t h e l e s s i t was  implicit.  T h i s common theme i s f u r t h e r s u b s t a n t i a t e d , by such o b j e c t i v e s as e d u c a t i n g each o t h e r and some i n t e r p r e t a t i o n by worker.  the  T h i s i s c o n s i s t e n t w i t h t h e model's " t o l e a r n by  experience, to gain understanding...to circumstances." f o u r purposes,  adapt t o  changing  T h e r e f o r e t h e s e o b j e c t i v e s a r e common t o the and a r e i n tune w i t h the model.  I t i s interest-  i n g t o note t h a t the i n t e r p r e t a t i o n of community r e s o u r c e s a p r i m a r y aim of E2's purpose f o r E l and  caseworker.  T h i s was  was  a l s o i m p l i c i t i n the  E4.  There appears t o be c o n s i d e r a b l e c o n s i s t e n c y between E l , E2 and E4's  purposes and model, l e s s so f o r E3.  T h i s i s because  the worker f o r E3 sees the group as a "time s a v e r " as she unable t o make a s u f f i c i e n t number of home v i s i t s .  was  - 22 -  S i n c e these a r e e d u c a t i o n a l groups, b e l i e v e t h e caseworkers  the researchers  w i l l i n t e r p r e t a great deal to the  group members around t h e i r problems, i . e . mental h e a l t h o r adoption. workers,  As a l l workers i n t h e study were t r a i n e d  case-  i t i s f e l t t h e y would be a b l e t o d e a l w i t h problems  on a t h e o r e t i c a l and p r a c t i c a l l e v e l .  A l l t h e purposes  i n c l u d e d r e f e r e n c e s t o " t a l k about f e e l i n g s " , t o " d i s c u s s p r o blems", t o "share w i t h o t h e r s . . . p a r t i c u l a r concerns." caseworkers  The  t h e r e f o r e f e l t t h e members would v e r b a l i s e f e e l i n g s ,  and t h a t these would have t o be d e a l t w i t h and i n t e r p r e t e d . I t may be argued t h a t i n e d u c a t i o n groups o f t h i s k i n d , t h e r e a r e elements o f t h e r a p y .  There i s no doubt t h a t t h i s i s  so, b u t t h e groups under c o n s i d e r a t i o n had e d u c a t i o n as t h e i r p r i m a r y o b j e c t i v e s . T h i s c o i n c i d e s w i t h t h e model w h i c h s t a t e s : T h e r a p e u t i c r e s u l t s o f such groups, although important, are i n c i d e n t a l to t h e p r i m a r y purpose o f e d u c a t i o n . I t i s t h e r e f o r e i m p o r t a n t t h a t t h e worker d e c i d e s whether the. a c t i v i t y i s aimed p r i n c i p a l l y a t e d u c a t i o n o r t r e a t m e n t , as Dr. K l e i n  states: What t h e change agent i s t r y i n g t o accomplish f o r i n d i v i d u a l s through the group method must be understood by her i n o r d e r t o d e f i n e h e r p u r pose i n w o r k i n g w i t h t h e group.  The  t h e s i s team b e l i e v e t h a t t h e worker, as w e l l as t h e group,  must have a s i m i l a r p e r c e p t i o n o f t h e group's purpose, and t h a t t h e success o f t h e group c o u l d depend upon t h i s p e r c e p t i o n . T h i s statement  cannot be v a l i d a t e d u n t i l t h e caseworkers'  goals  - 23-  f o r t h e i r meetings a r e compared w i t h t h e o v e r a l l group purpose and  model.  3)  GOALS o f t h e GROUPS I t i s now e v i d e n t t h a t t h e f o u r group purposes a r e con-  s i s t e n t w i t h t h e model.  The r e s e a r c h e r s w i l l t h e r e f o r e t u r n t o  the s p e c i f i c g o a l s t h e w o r k e r s s e t f o r t h e m s e l v e s over t h r e e meetings i n t h e group's l i f e .  These t h r e e meetings were:  the  f i r s t meeting, a m i d d l e meeting, and t h e f i n a l m e e t i n g . I n o r d e r t o compare t h e s e g o a l s t o t h e o v e r - a l l group purpose, i t i s i m p o r t a n t  t o u n d e r s t a n d what s p e c i f i c  are i n h e r e n t i n D r . K l e i n ' s statement f o r t h e Group C l a s s i f i c a t i o n (our m o d e l ) . has been a l m o s t u n i v e r s a l l y  She s t a t e s t h a t group accepted  goals Education  education  t o mean work w i t h r e l a t i v e l y  e m o t i o n a l l y h e a l t h y and s t a b l e i n d i v i d u a l s  i n a group.  It is  aimed a t : ...those f a c u l t i e s o f t h e ego u n d i s t u r b e d by c o n f l i c t . I t appeals t o t h e a b i l i t y t o judge, t o l e a r n by e x p e r i e n c e , t o g a i n u n d e r s t a n d i n g , t o p l a n , t o adapt t o changing c i r c u m s t a n c e s . The e d u c a t i o n a l g o a l s f o r t h e c l i e n t group a r e a c h i e v e d t h r o u g h t h e d i s c u s s i o n method w i t h a c t i v e and c r e a t i v e g u i d a n c e and t h e t e a c h i n g o f c o n t e n t on t h e p a r t o f t h e l e a d e r . Thus i t i s hoped t o i n c r e a s e t h e c a p a c i t y o f t h e i n d i v i d u a l t o make c h o i c e s on t h e b a s i s o f some s e l f - u n d e r s t a n d i n g . Any t h e r a p e u t i c r e s u l t s come about as i n c i d e n t a l , and a r e „ not t h e p r i m a r y aim o f t h e e d u c a t i o n a l group. I t i s important  t o note t h a t i n b o t h t h e model statement o f  purpose and t h e statement o f i t s s p e c i f i c g o a l s , D r . K l e i n  3  K l e i n Op.Cit.,  p.47  - 24 -  s t a t e d t h e r a p e u t i c r e s u l t s a r e t h e secondary p r i m a r y aim o f t h e e d u c a t i o n a l g r o u p .  r a t h e r than t h e  P e t e r Neubauer wrote:  S p e c i f i c t e c h n i q u e s s h o u l d be a p p l i e d f o r s p e c i f i c purposes. I n the Educational p r o c e s s t h e r e i s awareness o f i n d i v i d u a l problems and t h e i r e f f e c t on f u n c t i o n i n g , but t h e cause o f a' problem i s n o t sought i n an e d u c a t i o n a l group n o r does one attempt r e s o l u t i o n o f a problem i n t h i s s e t t i n g . 4 If  the combinations  o f e d u c a t i o n and t h e r a p y a r e attempted, i t  may l e a d t o " d i l u t i o n s and c o n f u s i o n s " ^ o f p u r p o s e .  It is  i m p o r t a n t t h e r e f o r e t h a t one d i f f e r e n t i a t e between e d u c a t i o n and  therapy. In order t o e l i c i t the goals of the f o u r  c e r t a i n q u e s t i o n s were put t o them.  caseworkers  The q u e s t i o n s asked f o r  the f i r s t meeting w h i c h were r e l e v a n t t o t h e statement o f g o a l s were: - D i d t h e worker f i n d i t n e c e s s a r y t o e x p l a i n to t h e group t h e r e a s o n why t h e y were t h e r e ? Why was t h i s e x p l a n a t i o n n e c e s s a r y ? What was t h e e x p l a n a t i o n g i v e n t o t h e members? - D i d t h e worker e x p l a i n t o t h e group what t h e y were g o i n g t o do i n t h e f i r s t meeting? What was t h e e x a c t e x p l a n a t i o n g i v e n ? - What d i d t h e worker want t o a c c o m p l i s h . most i n t h e f i r s t m e e t i n g w i t h t h e g r o u p ? " The  q u e s t i o n s f o r t h e middle and f i n a l meeting were i d e n t i c a l :  :  4  Loc. c i t .  5  I b i d . , p.150.  6  see I n t e r v i e w s c h e d u l e , appendix A  - 25 -  - What d i d you want t o a c c o m p l i s h most i n t h i s meeting?' The a n a l y s i s o f t h e m a t e r i a l c o l l e c t e d t h r o u g h t h e s e q u e s t i o n s has been put t o g e t h e r , t h e r e f o r e each q u e s t i o n i s not asked separately i n t h i s  section.  I n answer t o t h e above r e s e a r c h q u e s t i o n s , t h e g o a l s the  worker s e t f o r group E l ( p a r e n t s o f deaf c h i l d r e n ) were as  follows: F i r s t M e e t i n g : A f a i r u n d e r s t a n d i n g o f t h e purpose of t h e group'*' I wanted t o see how t h e y would r e a c t t o t h e i d e a o f t h e group, and perhaps get some i d e a o f what f u t u r e meetings s h o u l d be, what our g o a l s h o u l d be. M i d d l e M e e t i n g : I had no p a r t i c u l a r g o a l . I had asked them i n t h e b e g i n n i n g , as I was d o i n g at a l l m e e t i n g s , i f t h e y had any concerns w h i c h t h e y wished t o d i s c u s s . F i n a l M e e t i n g : I wanted t o make s u r e t h a t t h e s e mothers u n d e r s t o o d what was happening between t h e c l i n i c and t h e i r p a r e n t ' s group because t h i s had been t h e main t o p i c of concern t h r o u g h o u t a l l t h e m e e t i n g s . . . t o t r y and c l a r i f y f o r them as much as I c o u l d what s t a g e t h e c l i n i c was and what p o i n t t h e i r group was a t as compared t o the c l i n i c . The worker i n group E l had a v e r y i n t e r e s t i n g problem. the  Although  purpose o f t h e group had been e x p l a i n e d t o a l l members  t h r o u g h i n d i v i d u a l c o n t a c t s , she f o u n d i n t h e f i r s t  meeting  " t h a t some o f them had t h e i d e a t h a t t h i s was g o i n g t o be an a c t i o n group t o d e v e l o p more r e s o u r c e s w h i c h wasn't t h e purpose  7  see I n t e r v i e w S c h e d u l e , appendix A.  * U n d e r l i n e d p o r t i o n s of statements d e a l s p e c i f i c a l l y goals.  with  - 26 -  at  all."  The w o r k e r f o u n d i t n e c e s s a r y t o e x p l a i n  g r o u p many t i m e s why members p e r c e i v e d group f o r s o c i a l "those meetings one  t h e y were t h e r e .  action  t o meet once a week.  perceived  of their  the group's purpose.  I t was  not u n t i l  s t e p s t o remedy what a p p e a r e d - t o be  great  deal  that the t o t a l  p o i n t where t h e a g e n c y  It  with this  clarified  g r o u p due  i s interesting  deaf  conception  to t h e group's i d e a consistent fore,  members.  On  The w o r k e r ' s for E l definitely group's p e r c e p t i o n social action  undertook action for  T h e r e was  o f t h e g r o u p , up u n t i l i t s position.  a the  The w o r k e r  herself  goals  ranged from  The w o r k e r ' s  had  problem.  of purpose t o accommodating her  stat-  ideas  g o a l s were n o t  t o t h e members, influenced  there-  by member  g o a l s were s e c o n d a r y t o t h o s e o f t h e  h i n d s i g h t , t h e worker  have p l a n n e d a  t h e members *  in social  clear.  g r o u p p u r p o s e had b e e n  The w o r k e r ' s  original  t o note, i n comparing the t h r e e  as she had t o a d a p t  the worker's  and  to the i n t e r p r e t a t i o n  of purpose.  concern.  would  said  to the success of  f o r the i n d i v i d u a l meetings, t h a t t h e worker i n g h e r own  own  children.  t h e agency  a gap  p u r p o s e was  of f u z z i n e s s i n goals  difficulty  The w o r k e r  as t h e g o a l ,  o f them, r e p r e s e n t e d a b a r r i e r  group,  o f what t h e  became more i m p o r t a n t t o them," t h a n t h e  . What t h e w o r k e r  this  a result  as t h e g r o u p p u r p o s e , t h e y f o r m e d t h e i r  c e n t e r e d around the problems  perception  As  to the  f o r group E l s t a t e d ,  "I  programme." over-all  p u r p o s e and t h r e e  had an e d u c a t i o n a l  focus..  o f i t s f u n c t i o n was  instead  of education.  sets  of g o a l s  However, t h e  different.  Dr. K l e i n  They  states:  wanted  - 27 -  Lack o f c l a r i t y as t o purpose p r e v e n t e d a p p l i c a t i o n o f t h e worker's a p p r o p r i a t e s k i l l s and knowledge t o c a r r y out t h e agency aim f o r t h e group, w i t h o u t d i l u t i o n s and confusions. The caseworker's e f f e c t i v e n e s s i n E l was d i r e c t l y a f f e c t e d by t h i s i n t e r p r e t a t i o n problem.  T h i s w i l l be d i s c u s s e d i n g r e a t e r  d e t a i l i n Chapter t h r e e , where t h e caseworker's r o l e i n t h e group w i l l be a n a l y s e d . The g o a l s w h i c h t h e worker s e t f o r t h r e e meetings o f group E2 ( r e l a t i v e s o f p s y c h i a t r i c p a t i e n t s ) were a s . f o l l o w s : F i r s t Meeting:_ What I wanted t o seek^was group i n t e r a c t i o n . I wanted them t o l i k e me and to l i k e t h e group.. I wanted t o r e l i e v e a n x i e t y , t o be an a c c e p t i n g p e r s o n t o them, to a c c e p t them, t o g i v e them a good group experience. M i d d l e M e e t i n g : I n t e r a c t i o n . I wanted t o g e t the members t o i n t e r a c t w i t h each o t h e r , t o support each o t h e r , t o perhaps c l a r i f y f o r each o t h e r , t o a c c e p t each o t h e r , t o unders t a n d each o t h e r , t o be a group. F i n a l Meeting:  Group i n t e r a c t i o n .  The caseworker f o r E2 had a c o n s i s t e n t g o a l o f group i n t e r a c t i o n for  a l l three meetings.  He s t r e s s e d a b e n e f i c i a l group ex-  p e r i e n c e , and t r i e d t o f o s t e r a h i g h degree o f member p a r t i c i p a tion.  T h i s c o i n c i d e s w i t h D r . K l e i n ' s statement t h a t t h e  worker "uses h e r knowledge and s k i l l c o n s c i o u s l y t o a f f e c t t h e group p r o c e s s . "  The worker, f o r E2 wants t o c l a r i f y i s s u e s  t h r o u g h d i s c u s s i o n as w e l l as t o g e t members t o i n t e r a c t , support and a c c e p t each o t h e r .  This i s t h e r e f o r e p r i m a r i l y  e d u c a t i o n a l i n f o c u s as t h e worker's main g o a l f o r h i m s e l f and  - 28 -  the group members i s t o i m p a r t knowledge.  I t i s interesting to  n o t e t h a t t h i s was t h e o n l y caseworker who s t a t e d e x p l i c i t l y t h a t he wished h i s members " t o be a group." I n o r d e r t o d i s c u s s t h e g o a l s o f t h e worker f o r E3 ( b l i n d c h i l d r e n ' s p a r e n t s ) , i t i s important  t o s t r e s s t h i s was  an open ended group, w h i c h had been i n e x i s t e n c e f o r t h i r t e e n years.  The p r e s e n t worker had been a c t i v e w i t h t h e group f o r  approximately  seven y e a r s .  Therefore  she d i d n o t have a f i r s t  meeting w i t h a s p e c i f i c purpose statement, b u t she d i d say t h a t a t a f i r s t m e e t i n g f o r a new member h e r g o a l was: ...to g e t t h e f e e l i n g she i s not a l o n e w i t h her l o a d and t h a t t h e r e a r e o t h e r people w i t h t h i s l o a d who have s u r v i v e d . I a l s o want t o g i v e them (new members) f a c t u a l i n f o r m a t i o n , but t h e b i g g e s t emphasis i s on t h e f e e l i n g of b e l o n g i n g . . . M i d d l e M e e t i n g : There was n o t h i n g d e s i r e d t o be a c c o m p l i s h e d . As t h i s group i s s t i l l  i n progress  specifically  t h e r e was no f i n a l m e e t i n g .  However, when a member does l e a v e , " t h e r e i s a c o n s i d e r a b l e resistance to termination." T h i s was t h e o n l y worker who s t a t e d i n t h e o v e r - a l l group purpose t h a t t h e group was s e t up as a "time s a v e r . " o t h e r words, c o n t a c t s were not p o s s i b l e w i t h a l l p a r e n t s t h e r e was a group.  In  unless  I t was n o t e d t h a t a l t h o u g h t h e group was t o  r e p l a c e casework c o n t a c t s , t h e e d u c a t i o n a l purpose was more h e a v i l y s t r e s s e d t h a n a t h e r a p e u t i c one.  T h i s i s seen i n t h e  worker s a y i n g " I want t o g i v e them f a c t u a l i n f o r m a t i o n , " w h i l e s t i l l e m p h a s i s i n g mutual s h a r i n g o f problems among t h e members.  - 29 -  I t has a l r e a d y been shown t h a t any t r e a t m e n t a s p e c t s i n an e d u c a t i o n a l group a r e i n c i d e n t a l , r a t h e r t h a n t h e p r i m a r y objective. The g o a l s which t h e worker of E4 ( a d o p t i v e p a r e n t s ) set  f o r the t h r e e meetings were: F i r s t M e e t i n g : I wanted t o put them a t ease, and see t h e y were c l e a r on the purpose, and t o make c l e a r t h e group was t h e i r s and t h e y c o u l d f o l l o w whatever p a t t e r n t h e y c h o s e . . . t o s e t a good c l i m a t e where everyone would be a b l e to more i n t o d i f f i c u l t a r e a s . To get enough of a b e g i n n i n g so d i s c u s s i o n would become p r o v o c a t i v e y e t not t h r e a t e n i n g . M i d d l e M e e t i n g : To open t h e doors t o more i n t i m a t e d i s c u s s i o n , namely the d i s appointment about not h a v i n g t h e i r own c h i l d r e n , and why they f i n d i t h a r d t o e x p l a i n t o t h e c h i l d he i s adopted. F i n a l M e e t i n g : I wanted t o make i t p o s s i b l e f o r p e o p l e who needed h e l p t o come back f o r i t , and f o r t h e r e s t , r e a s s u r e them, to h e l p them over t h e i r s e l f - d o u b t , g i v e them c o n f i d e n c e f o r the f u t u r e , by summarising the accomplishments a t t h e end.  T h i s group was h i g h l y s t r u c t u r e d and h e l d o n l y f i v e m e e t i n g s . A programme was p l a n n e d f o r each meeting w i t h i n w h i c h t h e r e a h i g h degree of worker f l e x i b i l i t y cuss a c e r t a i n r e l e v a n t problem.  was  i f members wanted t o d i s -  B r o c h u r e s were sent out p r e -  v i o u s t o the f i r s t meeting t o e n l i s t i n t e r e s t e d p e r s o n s .  The  t h e s i s team b e l i e v e s t h a t t h i s had a d i r e c t b e a r i n g on the r e s u l t i n g c o n s i s t e n c y of a t t e n d a n c e by the members s i n c e t h e y were w e l l i n f o r m e d as t o the purpose and g o a l s of t h e group sessions. The worker promoted group p a r t i c i p a t i o n t h r o u g h d i s -  - 30 -  c u s s i o n , and d i d a g r e a t d e a l o f i n t e r p r e t a t i o n around t h e problems o f a d o p t i o n .  She a l s o i n t e r p r e t e d t h e agency's f u n c -  t i o n i n t h i s f i e l d , and t r i e d t o h e l p t h e members use t h i s r e s o u r c e , as w e l l as o t h e r s .  Her main f u n c t i o n was t o i m p a r t  knowledge. I t i s i n t e r e s t i n g t o n o t e t h a t t h e worker f o r E4 f i t s t h e c r i t e r i a w h i c h Dr. K l e i n s e t s up as i n h e r e n t i n f a m i l y l i f e e d u c a t i o n groups 1.  The g o a l s a r e w e l l thought out i n advance, w i t h i n t h e f u n c t i o n o f t h e agency.  2.  The groups a r e seen as p r e v e n t i v e work and/or seen as an o p p o r t u n i t y t o make known t h e work o f t h e agency, and,  3.  The s o c i a l worker draws upon h e r s o c i a l work knowledge and e x p e r i e n c e s w i t h i n d i v i d u a l s and groups. She has a sound f o u n d a t i o n o f knowledge o f i n d i v i d u a l growth and development t h a t she has obtained, i n a d d i t i o n , basic p r i n c i p l e s of l e a r n i n g from t h e f i e l d of education. She uses her knowledge and s k i l l c o n s c i o u s l y t o a f f e c t t h e group p r o c e s s .  4.  The worker i s c o n s c i o u s of t h e e f f e c t on t h e s e group members o f confused e t h n i c , c u l t u r a l o r s o c i a l s t a n d a r d s , and/or l a c k of knowledge o f c h i l d development. She i s aware t h a t t h e f a m i l y l i f e e d u c a t i o n group does n o t seek t o modify a d o p t i v e p a t t e r n s , but t o help these parents, t h r o u g h f r e e i n t e r c h a n g e , t o change a t t i t u d e s and f e e l i n g s about f a m i l y l i f e ^ on t h e b a s i s o f t h e p r e s e n t e d m a t e r i a l s . ;  * I n c l u d e d under c a t e g o r y o f F a m i l y L i f e E d u c a t i o n a r e members of p a r e n t e d u c a t i o n , c h i l d development, and m a r i t a l r e l a t i o n s groups who a r e presumed t o be c o m p a r a t i v e l y e m o t i o n a l l y h e a l t h y and s t a b l e i n d i v i d u a l s s e e k i n g a d d i t i o n a l i n f o r m a t i o n and unders t a n d i n g about t h e i r p a r e n t a l and m a r i t a l r o l e s , p.132 8 K l e i n Qp. G i t . , pp.132-133  - 31 -  Of a l l t h e groups surveyed i n t h i s c a t e g o r y , E4 was t h e b e s t example o f an e d u c a t i o n a l group. C)  SUMMARY OF.4 SROUPS I n comparing t h e purposes as s t a t e d by t h e caseworkers t o  t h e model, i t i s c l e a r t h a t a l l f o u r groups had a p r i m a r i l y educational function.  These a r e c o n s i s t e n t w i t h t h e s p e c i f i c  o b j e c t i v e s t h a t D r . K l e i n s t a t e d were i m p l i c i t i n t h e model. I n a n a l y s i n g and comparing t h e g o a l s set- by t h e c a s e workers f o r t h e t h r e e meetings t o t h e model, t h e r e a r e some interesting findings.  Three caseworkers had c o n s i s t e n t s e t s of  g o a l s w h i c h adhered t o t h e i r o v e r - a l l group purpose.  These  were a l s o r e l e v a n t t o t h e model's e x p l i c i t and i m p l i c i t The workers were f r o m groups E2, E3 and E4.  goals.  The f o u r t h worker,  from group E l , had an e d u c a t i o n a l f o c u s f o r her group, w h i c h was not a c c e p t e d by t h e members.  Therefore her i n d i v i d u a l  group g o a l s were n o t c o n s i s t e n t w i t h h e r own group and t h a t o f t h e model.  purpose  T h i s was due t o t h e members' p e r c e p - .  t i o n o f t h e worker's g o a l as secondary i n i m p o r t a n c e t o t h e development  o f r e s o u r c e s f o r deaf c h i l d r e n ' .  I t must be noted t h a t workers i n E l and E4 had c l o s e d groups w h i l e t h e workers i n S2 and E3 had open-ended g r o u p s . R e p e t i t i o n o f t h e group's purpose i n t h e open-ended groups (E2, E3) was o n l y n e c e s s a r y when a new member e n t e r e d t h e group.  Worker f o r E4 d i d n o t have t o r e s t a t e t h e group's p u r -  pose, s i n c e i t was c l e a r l y o u t l i n e d i n t h e b r o c h u r e s e n t t o  - 32 -  the i n t e r e s t e d p e o p l e p r i o r t o the group s e s s i o n s .  Worker f o r  E l c o n s t a n t l y r e s t a t e d t h e group's purpose due t o t h e members' f a u l t y perception  of i t .  I t t h e r e f o r e becomes apparent t h a t  •the s u c c e s s of any one group depended on t h e c l e a r  perception  of purpose by b o t h worker and member. I t i s i n t e r e s t i n g t o note t h a t Dr. K l e i n s t a t e s t h e group she c l a s s i f i e d under E d u c a t i o n u s u a l l y met from two t o t e n t i m e s . I n t h e p r e s e n t s t u d y , t h e groups s u r v e y e d met f o r a minimum of f i v e sessions  (E4) and a maximum of t h i r t e e n y e a r s ( E 3 ) .  As p r e v i o u s l y s t a t e d , E4 c o i n c i d e d d i r e c t l y w i t h t h e model d e f i n i t i o n f o r t h i s category.  T h i s seems t o be due t o t h e f a c t  t h a t i t was a c l o s e d group w i t h a w e l l - s t r u c t u r e d programme f o r the f i v e s e s s i o n s .  The worker f o r E4 s t a t e d t h a t t h e r e s u l t s  of t h i s group were e x t r e m e l y p o s i t i v e .  The o t h e r t h r e e c a s e -  workers were u n a b l e -to g i v e d e f i n i t e answers as t o t h e e f f e c t i v e ness of t h e group upon t h e members.  One can t h e r e f o r e  t h a t t h e e f f e c t i v e n e s s of an e d u c a t i o n a l  group i s d i r e c t l y a f f e c t e d  by: the number of group  sessions,  the s t r u c t u r e of t h e a c t i v i t y or programme, the purpose of the group as  perceived  by b o t h worker and member, and the c o n s i s t e n c y  state  o f t h e worker's g o a l s  t o the o v e r - a l l group purpose.  - 33 --  III  SOCIAL GROUP TREATMENT S o c i a l group t r e a t m e n t i s t h e second, o f t h e t h r e e c l a s s -  i f i c a t i o n s s e t out by Dr. K l e i n .  Her e l a b o r a t i o n on t h i s t y p e  of group reads as f o l l o w s : S o c i a l Group Treatment - These a r e groups i n the s o c i a l work agency which have been s u g g e s t ed as t h e method o f t r e a t m e n t c h o i c e . Here a s o c i a l worker i s i n v o l v e d i n w o r k i n g w i t h a number o f c l i e n t s c o l l e c t i v e l y , f o r each o f whom she had a t e n t a t i v e p s y c h o s o c i a l d i a g n o s i s - and t r e a t m e n t p l a n . A d i a g n o s i s i s made o f t h e group b e f o r e t h e c l i e n t i s i n v i t e d o r r e q u i r e d by d o c t o r ' s p r e s c r i p t i o n t o j o i n . The s o c i a l worker c o n s c i o u s l y a f f e c t s t h e group p r o c e s s and makes use o f h e r knowledge o f i n d i v i d u a l b e h a v i o u r s and,the dynamics o f b o t h t h e group and each i n d i v i d u a l as an a i d t o treatment i n t h e group s i t u a t i o n . S o c i a l group treatment i s used a l o n e , o r i n c o m b i n a t i o n w i t h casework a t v a r i o u s s t a g e s o f t h e p r e s e n t i n g problem so t h a t t h e e f f e c t o f t r e a t m e n t i s t o reduce s o c i a l and e m o t i o n a l p r e s s u r e s and t o i n c r e a s e the c l i e n t ' s c a p a c i t y f o r s a t i s f a c t o r y s o c i a l functioning. S o c i a l group t r e a t m e n t o b j e c t i v e s s h o u l d p a r a l l e l those o f i n d i v i d u a l casework t r e a t m e n t , r e m a i n i n g w i t h i n t h e a r e a o f t h e worker's competence w i t h i n d i v i d u a l s and groups, agency purpose, and m u t u a l l y agreed upon g o a l s . Only a c a r e f u l assessment o f t h e c l i e n t ' s s i t u a t i o n w i l l enable t h e worker t o u n d e r s t a n d (1) whether t h e group t r e a t m e n t aim i s i n t h e s u p p o r t i n g and m a i n t a i n i n g o f , o r t h e changing a d a p t i v e p a t t e r n s c l a s s i f i c a t i o n , and (2) how t h i s g o a l can be reached - i n d i v i d u a l l y o r t h r o u g h a group s e r v i c e , o r c o m b i n a t i o n t h e r e o f . ' The t h r e e groups i n c l u d e d under t h i s s e c t i o n ( T l , T2, T3)  9  K l e i n , Op. C i t . , p. 134  - 34 -  w i l l be a n a l y s e d i n terms o f t h e above model.  Again i t i s  i m p o r t a n t t o u n d e r s t a n d t h e membership c o m p o s i t i o n o f t h e g r o u p s . A l l t h e groups were conducted i n t h e same p s y c h i a t r i c T l was a group f o r male a d o l e s c e n t s .  setting.  S i n c e t h i s was an  e x c e p t i o n a l l y l a r g e agency, t h e a d o l e s c e n t s were s p r e a d t h r o u g h out  it.  Due t o t h i s i s o l a t i o n , t h e s t a f f f e l t t h e group would  be an e x c e l l e n t o p p o r t u n i t y f o r t h e boys t o d i s c u s s mutual problems.  The caseworker found i t e x t r e m e l y d i f f i c u l t t o work  w i t h t h e s e c l i e n t s on a one-to-one b a s i s , t h e r e f o r e , she had as a prime o b j e c t i v e , t h e p r e p a r a t i o n o f t h e group members f o r casework i n t e r v i e w s .  The caseworker a l s o i n t e r p r e t e d t h e  h o s p i t a l ' s p o l i c i e s and s e r v i c e s . T2 was a group f o r c h r o n i c s c h i z o p h r e n i c s who had been h o s p i t a l i z e d f o r more t h a n f i v e y e a r s .  The caseworker's main  o b j e c t i v e was t o h e l p them r e t u r n t o t h e community.  T h i s was  t o be done by r e m o t i v a t i n g t h e p a t i e n t s t h r o u g h d i s c u s s i o n o f problems and e n a b l i n g them t o share common c o n c e r n s .  This  group was composed o f b o t h a d u l t males and f e m a l e s . T3 was a p r e - d i s c h a r g e group s e t up t o p r o v i d e r e a l i t y o r i e n t e d d i s c u s s i o n s about f e e l i n g s , a t t i t u d e s and problems t h a t t h e p a t i e n t s had. A l l t h e members were men.  Each  member u s u a l l y l e f t t h e group a f t e r a p p r o x i m a t e l y s i x t o e i g h t weeks. the the  The worker's main o b j e c t i v e was t o work t h r o u g h some o f  problems t h a t t h e p a t i e n t s would f a c e a f t e r d i s c h a r g e t o community. I t i s i n t e r e s t i n g t o n o t e t h a t t h e i d e a f o r s e t t i n g up  - 35 -  the groups came f r o m t h e caseworkers, and t h e y i n s t i g a t e d  them.  They a l l had a common purpose o f d i s c u s s i n g problems i n a r e a l i t y o r i e n t e d manner, which would h e l p t h e i n d i v i d u a l release h i sfeelings,  and share them w i t h o t h e r s .  patient  The f o c u s  was " t o reduce s o c i a l and e m o t i o n a l p r e s s u r e s and t o i n c r e a s e the  c l i e n t ' s capacity f o r satisfactory  s o c i a l functioning."-'-  0  T h e r e f o r e t h e main purpose was t r e a t m e n t . W i t h t h i s background o f t h e t h r e e surveyed g r o u p s , the t h e s i s team w i l l now t u r n t o t h e caseworkers' s t a t e d purposes, and see i f t h e y a r e c o n s i s t e n t w i t h t h e model. As i n t h e case o f t h e e d u c a t i o n groups, t h e i m p o r t a n t q u e s t i o n asked o f t h e caseworkers i n t h i s g r o u p i n g was: "What was t h e purpose o f t h e g r o u p ?  1 1  (Note t h e u n d e r l i n e d p o r t i o n s d e a l s p e c i f i c a l l y w i t h t h e purpose of. t h e group) A)  PURPOSE o f t h e GROUP Tl  Worker found casework w i t h a d o l e s c e n t s d i f f i c u l t because t h e y were h o s t i l e and s u s p i c i o u s . We found i t e a s i e r t o put them i n t o a group and l a t e r b r i n g them i n f o r casework.... i t was a group i n w h i c h t h e y c o u l d a c t out and b r i n g t h e i r problems up f o r d i s c u s s i o n . They were i s o l a t e d and on t h e i r own i n t h e c e n t r e and were brought t o g e t h e r . . . t o d i s cuss mutual problems w i t h no a d u l t s around.  T2  To r e s o c i a l i s e t h e p a t i e n t s t o endeavour t o h e l p them l i v e i n t h e community. To r e m o t i v a t e the p a t i e n t t o a c c e p t t h e t h e r a p y and t r e a t m e n t .  10  Loc. c i t .  11  P a r t I , Q u e s t i o n I , I n t e r v i e w Schedule, see Appendix A.  - 36 -  To u n i v e r s a l i s e t h e i r problems i n a c c e p t i n g mental i l l n e s s . T3  I t i s b a s i c a l l y to provide a r e a l i t y oriented d i s c u s s i o n about f e e l i n g s a t t i t u d e s and problems t h a t a number of p a t i e n t s have. To e s t a b l i s h a sense of s h a r i n g , b e l o n g i n g , and a c c e p t ance t h a t comes t h r o u g h group p a r t i c i p a t i o n . To a s s i s t i n e s t a b l i s h i n g a b a l a n c e o r check... f o r i n d i v i d u a l s on some of t h e i r v a r i o u s distorted feelings, fears, etc. ?  From t h e above d e s c r i p t i o n i t w i l l be seen t h a t t h e t h r e e groups are  c o n s i s t e n t w i t h t h e model.  psychosocial diagnosis  cind  Membership was based on a  treatment p l a n .  As K l e i n emphasises  t h a t the o b j e c t i v e s i n t h e group s h o u l d p a r a l l e l t h o s e of i n d i v i d u a l casework t r e a t m e n t , a t l e a s t two of t h e t h r e e workers seem t o have g i v e n - c o n s i d e r a t i o n t o t h i s p o i n t .  They e x p r e s s e d  t h i s when t h e y s a i d : Tl  We found i t e a s i e r t o put them i n t o a group and l a t e r b r i n g them i n f o r casework.  T2  ...remotivate the p a t i e n t to accept-the t h e r a p y and t r e a t m e n t .  The t h i r d worker, i n group T3, p l a c e d emphasis upon "group participation."  T h i s i s i m p o r t a n t s i n c e t h e r e i s the ever  p r e s e n t danger t h a t t h e caseworkers may f u n c t i o n on a oneto-one b a s i s even i n a group s i t u a t i o n .  To t h e e x t e n t t h a t  a worker i s concerned w i t h group p a r t i c i p a t i o n , t h i s  pitfall  might be a v o i d e d . A l l caseworkers w i s h e d t o "reduce s o c i a l and e m o t i o n a l p r e s s u r e s and t o i n c r e a s e t h e c l i e n t ' s c a p a c i t y f o r s a t i s 12 factory social functioning." 12  K l e i n , Op. c i t . ,  p.134  - 37 -  Tl  . . . i t was a group i n w h i c h they c o u l d a c t out and b r i n g t h e i r problems up f o r d i s c u s s i o n .  T2  To r e s o c i a l i s e the p a t i e n t s t o endeavour t o h e l p them l i v e i n the community.  T3  To a s s i s t i n e s t a b l i s h i n g a b a l a n c e or check... f o r i n d i v i d u a l s on some of t h e i r v a r i o u s distorted feelings, fears, etc.  The  above i m p l i e s a h i g h degree of i n t e r p r e t a t i o n of  f e e l i n g s , and f a l l s n e a t l y i n t o s t e p w i t h the i d e a t h a t  "the  s o c i a l worker...makes use of her knowledge of i n d i v i d u a l s beh a v i o u r and the dynamics of b o t h t h e group and each i n d i v i d u a l as an a i d t o treatment  i n the group s i t u a t i o n , " ^ f o r 1  t h i s knowledge, t h e worker may a c t i n g as a n e g a t i v e f o r c e . " " ^ entrance  be u n a b l e t o prevent  "without  the group  T h i s i s . i m p o r t a n t s i n c e member  i n t o the group i s based on a p s y c h o s o c i a l d i a g n o s i s ,  which i m p l i e s t h a t a l l the members w i l l be m a n i f e s t i n g some degree of p s y c h o p a t h o l o g y .  Hence the s t a t e d group purposes are  c o n s i s t e n t w i t h the model.  Once a g a i n i t becomes n e c e s s a r y  t e s t the c o n s i s t e n c y of the purpose of t h e group w i t h t h e  to goals  s e t by the worker f o r the t h r e e m e e t i n g s . B)  GOALS of the GROUP T h i s s e c t i o n w i l l concern i t s e l f w i t h the  o b t a i n e d from the i n t e r v i e w schedule the g o a l s f o r the f i r s t ,  13  K l e i n , Op.  14  Ibid,  p.68  cit.,  a middle,  p.134  information  i n o r d e r t o determine  and f i n a l meeting i n  - 33 -  the group's l i f e .  The  questions  w h i c h were r e l e v a n t t o t h e  asked  statement  f o r the f i r s t  of goals  meeting  were:  - D i d the worker f i n d i t necessarjf t o e x p l a i n t o t h e g r o u p t h e r e a s o n why t h e y were t h e r e ? Why was t h i s e x p l a n a t i o n n e c e s s a r y ? What was t h e e x p l a n a t i o n g i v e n t o t h e members? - D i d t h e w o r k e r e x p l a i n t o t h e g r o u p what were g o i n g t o do i n t h e f i r s t m e e t i n g ? What was t h e e x a c t e x p l a n a t i o n g i v e n ?  they  - What d i d t h e w o r k e r want t o a c c o m p l i s h most i n the f i r s t meeting with the g r o u p ? ^ 1  For the  middle  and  final  m e e t i n g s t h e r e was  o n l y one  question  namely: - What d i d y o u want t o a c c o m p l i s h this meeting? "  most i n  1  The  a n a l y s i s of the m a t e r i a l c o l l e c t e d  has  been put  together,  through  t h e r e f o r e each q u e s t i o n  these  questions  i s not  asked  separately i n this section. The for  answers o b t a i n e d  group T l  r e g a r d i n g the  goals  s e t by  the  ( a d o l e s c e n t s ) were as f o l l o w s :  F i r s t M e e t i n g : • I t was n o t a g r o u p f o r them t o l e a r n how t o f u n c t i o n w i t h e a c h o t h e r b u t t o l e t them see an a d u l t as a n o r m a l l i k e able person... The w o r k e r w o u l d i n t e r p r e t b e h a v i o u r p r o b l e m s and t h e members seemed t o r e a l i s e t h a t some a d u l t s can j u d g e t h i n g s b e t t e r t h a n t h e m s e l v e s . . . t o p o i n t why they were h e r e , a n d t h a t t h e y were n o t b e i n g punished Middle  Meeting: They had b e e n t r y i n g t o m a n i p u l a t e the worker i n t o doing s p e c i a l f a v o u r s . . . . I had t o e x p l a i n t o them t h a t t h e w o r k e r can  15  Interview  Schedule,  See  Appendix  A.  16  Interview Schedule,  See  Appendix  A.  Underlined  portions deal s p e c i f i c a l l y  with  goals.  worker  - 39 -  be k i n d and on t h e i r s i d e but must l i m i t them and d i s c i p l i n e them.  still  T h i s group has not t e r m i n a t e d , t h e r e f o r e , i t i s not p o s s i b l e t o d i s c u s s the g o a l s f o r the f i n a l m e e t i n g . I t i s i n t e r e s t i n g and i m p o r t a n t t o note t h a t the concept of " c o n s c i o u s l y a f f e c t i n g the group process," '' 1  i n the f i r s t m e e t i n g .  7  was not e v i d e n t  T h i s w i l l be seen from the worker's  statement t h a t : Tl  I t was not a group f o r them to l e a r n how , t o f u n c t i o n w i t h each o t h e r but t o l e t them see an a d u l t as a normal l i k e a b l e person.  I n t h i s case, t h e worker i s not e n c o u r a g i n g member p a r t i c i p a t i o n , but appears t o be e n c o u r a g i n g a one-one r e l a t i o n s h i p .  This  might w e l l be because of her own g o a l of moving t h e group members i n t o casework i n t e r v i e w s .  I t happens a g a i n i n the  m i d d l e meeting where the worker s t a t e s : I had t o e x p l a i n t o them t h a t the worker can be k i n d and on t h e i r s i d e but must s t i l l l i m i t them and d i s c i p l i n e them. The worker used the,group as a t o o l t o c r e a t e the a c c e p t a n c e of the casework t h e r a p y , by t r y i n g t o decrease t h e r e s i s t a n c e t o a d u l t a u t h o r i t y , and t r e a t m e n t  i n the a d o l e s c e n t s .  She a l s o  used her t h e o r e t i c a l knowledge t o i n t e r p r e t b e h a v i o u r a l p r o b l e m s . W i t h the e x c e p t i o n of t h e worker's l a c k of f o c u s i n group p r o c e s s , t h e r e appears t o be c o n s i s t e n c y w i t h t h e model i n a l l other respects.  17  K l e i n Op.  I t s h o u l d be e v i d e n t t h a t u n l e s s t h e r e  c i t . , p.134  - 40 -  i s a c l e a r d e f i n i t i o n of t h e group purpose t o g u i d e t h e worker i n s t r u c t u r i n g her h e l p i n g r o l e s as change agent, r o l e w i l l appear.  conflict  T h i s i s seen i f t h e caseworker c o n t i n u e s t o  t h i n k of her l e a d e r s h i p of t h e group i n terms of a one-to-one effort. the  T h i s c o u l d a l s o cause a c o n f u s e d i n d e n t i f i c a t i o n w i t h  s o c i a l work p r o f e s s i o n .  T h i s w i l l be d i s c u s s e d f u r t h e r i n  Chapter t h r e e when the worker's r o l e i n the group w i l l  be  analyzed. The g o a l s which t h e worker s e t f o r t h r e e meetings of group T2 ( c h r o n i c s c h i z o p h r e n i c s ) were as f o l l o w s : F i r s t M e e t i n g : I wanted t o a c c o m p l i s h t h r o u g h d i s c u s s i o n , t h e o p p o r t u n i t y o f g e t t i n g frja know the p a t i e n t s . To e x p l a i n t h e f u n c t i o n of t h e group even though t h e y wouldn't u n d e r s t a n d . The group had been e x p l a i n e d to them i n d i v i d u a l l y . . . . f o r them t o a c c e p t i t i s i m p o r t a n t . . . . 1 t o l d them t h e y c o u l d d i s c u s s a n y t h i n g or t a l k on any s u b j e c t . :  M i d d l e M e e t i n g : There was no g o a l . I t was a c c e p t e d t h a t t h e y d i s c u s s what t h e y wished a c c o r d i n g t o t h e i r own needs and demands. L a s t M e e t i n g : The worker wanted t o t r a n s f e r h i s group t o a n o t h e r t h e r a p i s t t h e r e f o r e ••"The . main purpose was t o i n f o r m the group t h a t t h e y were b e i n g t r a n s f e r r e d t o a n o t h e r worker, l e t thern know what was g o i n g on and a s s u r e them t h a t the new worker was no different. T h i s meeting was not a f i n a l meeting i n t h e u s u a l sense o f t h e group's l i f e , but i t was as f a r as t h e worker was c o n c e r n e d . The members were f e l t t o have s u f f i c i e n t s t r e n g t h s t h a t a r e a l i t y o r i e n t e d group would be h e l p f u l t o them.  Klein  a m p l i f i e s upon t h i s i n her d e f i n i t i o n of s o c i a l group t r e a t m e n t  - 41 -  aimed a t t h e m o d i f i c a t i o n o f a d a p t i v e p a t t e r n s : The a i m o f t h i s t y p e o f t r e a t m e n t i s t o h e l p t h e c l i e n t handle s p e c i f i c a s p e c t s of h i s p s y c h o s o c i a l s i t u a t i o n w i t h p a t t e r n s o f f u n c t i o n i n g d i f f e r e n t from those used i n t h e p a s t . I t s g o a l i s t o improve t h e c l i e n t ' s a b i l i t y t o master ' r e a l i t y s i t u a t i o n s by i n c r e a s i n g h i s u n d e r s t a n d i n g o f h i m s e l f , o f h i s problems, and of h i s own p a r t i n c r e a t i n g them.... I t s t r e n g t h e n s t h e ego's a b i l i t y t o a s s e s s r e a l i t y , t h e r e b y r e d u c i n g a n x i e t y and t h e use o f d e s t r u c t i v e d e f e n s e s . I t d e a l s w i t h c o n s c i o u s and p r e - c o n s c i o u s m a t e r i a l i t does n o t attempt t o r e o r g a n i z e t h e basic personality s t r u c t u r e . " 1  The g o a l o f m a s t e r i n g r e a l i t y s i t u a t i o n s i s e x c e p t i o n a l l y i m p o r t a n t f o r t h e c l i e n t , who i s a p a t i e n t , s i n c e u n l e s s he i s a b l e t o c o n f r o n t r e a l i t y , he cannot be expected t o l i v e i n t h e community. T h i s t r e a t m e n t group, appears t o be one i n which t h e worker had some d i f f i c u l t i e s w i t h member c o m p o s i t i o n .  That i s  t o s a y , t h a t w i t h a group o f s c h i z o p h r e n i c s t h e r e was a problem i n e x p l a i n i n g " t h e f u n c t i o n o f t h e group, even though t h e y didn't understand."  He l e f t a g r e a t d e a l up t o t h e group, i n  terms o f group d i s c u s s i o n .  Where the group c o n s i s t s o f people  who "do n o t u n d e r s t a n d " t h e r e i s v e r y l i t t l e doubt t h a t t h e worker-tmust p l a y t h e c e n t r a l r o l e .  The worker's  i n d i c a t e h i s major g o a l s : ... t o r e s o c i a l i z e ... t o r e m o t i v a t e the p a t i e n t t o accept the therapy and t r e a t m e n t .  18-  K l e i n , Op. c i t . , p.136  own words  - 42 -  Because the caseworker s t a t e d t h a t " i t was i m p o s s i b l e t o s t r u c t u r e a meeting f o r s c h i z o p h r e n i c s " i t i s d i f f i c u l t t o speak of h i s g o a l s e x c e p t i n t h e most g e n e r a l k i n d s o f t e r m s . I t would appear t h e degree of p a t h o l o g y discussion d i f f i c u l t .  i n t h i s group makes  There i s a s h a r p c o n t r a s t between t h e  group j u s t d e s c r i b e d and t h e p r e - d i s o h a r g e  group w h i c h i s  d e a l t w i t h below. A pre'rdischarge group's p r i m a r y f o c u s i s t o " o f f e r h e l p i n handling d i f f i c u l t i e s  w h i c h a r i s e ' i n the p r o c e s s of d i s -  charge f r o m t h e h o s p i t a l and r e t u r n t o f a m i l y and  community.""''^  I t g i v e s t h e members a p r o t e c t e d s o c i a l . e x p e r i e n c e where they can work w i t h o t h e r s on t h e i r problems of s o c i a l  relationships.  The group s e r v e s as a b r i d g e between the p r o t e c t i v e n e s s o f t h e i n s t i t u t i o n , and the more demanding  s o c i a l l i f e of the  community.  The g o a l s w h i c h t h e worker of T3 ( p r e - d i s c h a r g e group) s e t f o r the t h r e e meetings were: F i r s t " M e e t i n g : I wanted t o o r g a n i z e t h e s e f e l l o w s t o f a c e t h e problems they •• would meet on r e l e a s e . To g i v e them support i n h a n d l i n g them. M i d d l e M e e t i n g : As n e a r l y a l l of the t e n members o f t h e group had a l o t o f c o n f u s i o n or d i f f i c u l t y around t h e idea of the adult r o l e , r e s p o n s i b i l i t y and m a t u r i t y , worker wanted t o b r i n g t h i s up f o r d i s c u s s i o n , . . . t o show how f u n c t i o n i n g w i t h i n t h e group and c l i n i c can be c a r r i e d out i n t o t h e community.  19 Konopka, G i s e l a . S o c i a l Group Work: A H e l p i n g ' P r o c e s s . N.J., P t e n t i c e - H a l l , I n c . , Englewood C l i f f s . 19o3, p.273  - 43 -  F i n a l M e e t i n g ( f o r t h o s e who were l e a v i n g the group.) I n the l a s t meeting. I t r y t o g i v e each p e r s o n g o i n g out a sense t h a t t h e y have w i t h i n themselves the s t r e n g t h s and a b i l i t y t o f a c e problems and s t r e s s e s . I t r y t o h e l p them t o see how t h e y can c a r r y over the t h i n g s t h e y l e a r n i n the c l i n i c out i n t o the community. I t r y t o m o b i l i z e them t o go. The  caseworker had a c o n s i s t e n t g o a l of m o b i l i z i n g the member's  s t r e n g t h s t o d e a l a d e q u a t e l y w i t h the problems t h e y would f a c e on r e t u r n i n g t o the community. Konopka's g o a l of " h a n d l i n g f a m i l y and  This i s s i m i l a r to G i s e l a  d i f f i c u l t i e s . . . f r o m the h o s p i t a l . . .  community."  T h i s was  the o n l y caseworker who  •group p a r t i c i p a t i o n was  one  e x p l i c i t l y states that  of h i s p r i m a r y g o a l s .  e v i d e n t i n a l l of t h e t h r e e meetings s u r v e y e d .  This  1  was  Note t h a t  the  worker s a i d : T3  I wanted t o o r g a n i z e  these f e l l o w s . . .  . . . t o show how f u n c t i o n i n g w i t h i n t h e group and c l i n i c can be c a r r i e d out i n t o the community. As t h i s group i s an open-ended one, involved.  When a member was  t o h e l p them see how  t h e r e i s no f i n a l meeting  ready t o l e a v e , the worker " t r i e d  t h e y can c a r r y over the t h i n g s t h e y l e a r n  i n the c l i n i c out i n t o the community." i s o b v i o u s l y i n v o l v e d i n a g r e a t d e a l of The  o v e r - a l l impression  I n t h i s group the worker individualization.  i s t h a t t h i s worker comes c l o s e s t t o t h a t  w h i c h i s p e r c e i v e d by K l e i n , as l e a d e r s h i p f o r t h i s type of t r e a t m e n t group.  He shows awareness of b o t h the i n d i v i d u a l  the group, and g i v e s e v i d e n c e of c o n s c i o u s l y a f f e c t i n g the group p r o c e s s t h r o u g h r e a l i t y o r i e n t e d d i s c u s s i o n s .  and  - 44 -  C)  SUMMARY o f t h e TREATMENT GROUPS The t h r e e c a s e w o r k e r s ' purposes appear c o n s i s t e n t w i t h  t h a t o f t h e model.  The one a r e a w h i c h was not e x p l i c i t l y ex-  p r e s s e d was t h a t o f " c o n s c i o u s l y a f f e c t i n g t h e group p r o c e s s . " ^ S i n c e K l e i n p l a c e s a g r e a t d e a l o f emphasis on a f f e c t i n g t h e group p r o c e s s , there-seems t o be some c o n f u s i o n as t o whether the  caseworker i s a i m i n g towards a one-to-one, o r a one-to-  group r e l a t i o n s h i p .  The e x c e p t i o n seems t o have been I n  group T.3j where t h e worker gave e v i d e n c e o f h a v i n g a knowledge of  group dynamics, and was concerned w i t h a f f e c t i n g t h e group  process. In  T h i s w i l l be e x p l o r e d f u r t h e r i n C h a p t e r t h r e e . a l l t h r e e groups t h e r e was a h i g h degree o f i n d i v i d -  u a l i z a t i o n and as K l e i n says " . . . t r e a t m e n t o b j e c t i v e s s h o u l d p a r a l l e l t h o s e of i n d i v i d u a l casework t r e a t m e n t . " T h i s t h e r e f o r e i m p l i e s i n t e r p r e t a t i o n o f f e e l i n g s and problems by t h e worker, u s i n g t h e t h e o r e t i c a l knowledge a t t h e i r command. I t i s i m p o r t a n t t o c o n s i d e r t h a t t h e caseworker I s t r a i n e d t o work on a one-to-one b a s i s .  I t I s , therefore,- n o t  s u r p r i s i n g t h a t emphasis w i l l be p l a c e d on i n d i v i d u a l  treat-  ment, even i f t h e t r e a t m e n t i s o c c u r i n g w i t h i n a group.  Since 21  "groups a r e t h e b a s i c e x p r e s s i o n s o f human r e l a t i o n s h i p s , " i t i s an e x c e l l e n t o p p o r t u n i t y f o r t h e s o c i a l - worker to' a s s e s s the  adequacy o f a c l i e n t ' s s o c i a l f u n c t i o n i n g . 20  K l e i n , Op. c i t . , p.134  21  Konopkia, Op. c i t . , p. v l  T h i s concept  - 45 -  of s o c i a l f u n c t i o n i n g i s common t o a l l s o c i a l work methods i . e . casework, group work and community o r g a n i z a t i o n . implies a helping or enabling  It  r o l e f o r t h e s o c i a l worker who  s h o u l d t h e r e f o r e be a b l e t o t r a n s f e r i t from an i n d i v i d u a l t o a group s i t u a t i o n . treatment.  This i s the primary objective of s o c i a l  However, i n r e a l i t y , i t i s d i f f i c u l t f o r many  caseworkers t o handle a group s i t u a t i o n . to personal dynamics. portant  group  T h i s i s due n o t o n l y  b i a s e s b u t a l s o t o l a c k o f t r a i n i n g i n group Therefore, i n conclusion,  i t i s e x c e p t i o n a l l y im-  t h a t t h e 'caseworker, .who h a s , o r has not f o r m a l  i n g w i t h groups, d e f i n e h i s a c t i v i t y and d e s c r i b e  train-  t h e purpose  and depth o f t r e a t m e n t t h a t he, as a change agent, hopes t o - . undertake.  Only w i t h t h i s c l e a r d e f i n i t i o n o f purpose can  the caseworker "be p r e p a r e d t o d e a l w i t h t h e dynamics o f t h e group. '"^ IV  GROUP PSYCHOTHERAPY There a r e innumerable d e f i n i t i o n s o f group p s y c h o t h e r a p y ;  K l e i n e x p l a i n s i t as f o l l o w s : An a n a l y t i c a l l y - o r i e n t e d group t r e a t m e n t aimed a t p e r s o n a l i t y r e o r g a n i z a t i o n i n an . i n d i v i d u a l who has a p s y c h i a t r i c a l l y diagnosed e m o t i o n a l problem'. I t i s cond u c t e d under p s y c h i a t r i c s u p e r v i s i o n , by a p e r s o n p r o f e s s i o n a l l y t r a i n e d t o handle i n d i v i d u a l unconscious m a t e r i a l , fantasy dreams, f r e e a s s o c i a t i o n and t r a n s f e r e n c e i n depth beyond t h e scope o f t h e u s u a l S o c i a l Work T r a i n i n g . L i k e i n d i v i d u a l  22  K l e i n , Op. c i t . , p.68  - 46 -  p s y c h o t h e r a p y , aimed a t p e r s o n a l i t y r e o r g a n i z a t i o n , i t i s not i n c l u d e d i n the s e l e c t i o n o f t r e a t m e n t aims i n s o c i a l a g e n c i e s except under v e r y r a r e c i r c u m s t a n c e s . 23 I t i s g e n e r a l l y conceded t h a t s o c i a l workers a r e n o t t r a i n e d t o engage i n p s y c h o t h e r a p y .  K l e i n makes i t c l e a r t h a t  i t i s o n l y "under v e r y r a r e c i r c u m s t a n c e s " t h a t s o c i a l choose t h i s form o f t r e a t m e n t .  agencies  I n a p s y c h i a t r i c s e t t i n g the  s o c i a l worker may i n d e e d be used as a p r o f e s s i o n a l person i n such a group.  Whether one agrees w i t h t h e i d e a t h a t s o c i a l  workers s h o u l d o r s h o u l d n o t be doing p s y c h o t h e r a p y , t h e f a c t remains, t h a t i n t h i s s t u d y t h r e e workers were f o u n d t o be engaged i n one o r o t h e r c a p a c i t y i n t h i s t y p e o f group. I n o r d e r t o a n a l y z e t h e groups i n c l u d e d under t h i s s e c t i o n , i t i s i m p o r t a n t t o l o o k a t t h e member c o m p o s i t i o n o f each one.  There a r e t h r e e groups - two o f w h i c h were  i n t h e same p s y c h i a t r i c agency. P I , P2, and P 3 .  conducted  They w i l l be d e s i g n a t e d as  A l l groups were l e d by a t r a i n e d p s y c h i a t r i s t  o r p s y c h o l o g i s t w i t h a caseworker a c t i n g i n t h e r o l e o f cotherapist. P I was a group composed o f a d o l e s c e n t s and young a d u l t s of b o t h s e x e s .  The main purpose  o f t h i s group was t h e r e s o l u -  t i o n o f a u t h o r i t y and p a r e n t a l c o n f l i c t s , as w e l l as on-thejob problems.  P2 was a group o f a d u l t s - a l s o o f b o t h  The p r i m a r y purpose was t o r e s o l v e p a r e n t a l c o n f l i c t s  23  K l e i n , Op. c i t . ,  p.137  sexes. through  - 47 -  the group d i s c u s s i o n s .  B o t h groups sought t o e s t a b l i s h a  f a m i l y atmosphere w h i c h would be used t h e r a p e u t i c a l l y f o r t h e s o l u t i o n o f t h e above problems and c o n f l i c t s .  Each i n d i v i d u a l  was i n t e n s i v e l y a s s e s s e d by a c l i n i c a l team b e f o r e j o i n i n g e i t h e r group.  I t i s i n t e r e s t i n g t o note t h a t t h e p s y c h i a t r i c  agency where t h e s e two groups were h e l d , s e r v e s b o t h c h i l d r e n and a d u l t s on an o u t - p a t i e n t  basis.  P3 was a group o f young a d u l t s - o f b o t h sexes - who had common problems o f e p i l e p s y .  The main o b j e c t i v e was t o  t r y and r e s o l v e - t h r o u g h t h e group - some o f t h e p s y c h o s o c i a l problems w h i c h a r e caused by t h i s p h y s i c a l h a n d i c a p . Since the b a s i s of psychotherapy i s r a t h e r  well-defined,  b o t h i n t h e l i t e r a t u r e and i n p r a c t i c e , i t was e x p e c t e d t h a t the purposes and g o a l s o f t h e t h r e e groups would be s i m i l a r t o one a n o t h e r and t o t h a t w h i c h i s p r e s e n t e d i n t h e model. A)  PURPOSE o f t h e GROUPS I t s h o u l d be n o t e d t h a t t h e two groups, conducted w i t h -  i n t h e same agency ( P I , P 2 ) , had f o r m a l s t a t e m e n t s o f purpose w h i l e t h e t h i r d group d i d n o t .  I t i s presupposed t h a t t h e s e  f o r m a l i z e d s t a t e m e n t s were w r i t t e n , by t h e p s y c h i a t r i s t o r p s y c h o l o g i s t and n o t t h e caseworker. The p e r t i n e n t q u e s t i o n put t o t h e workers o f t h e groups was:  - 48 -  "What was t h e purpose o f t h e group?" ^ (note t h e u n d e r l i n e d p o r t i o n s d e a l • s p e c i f i c a l l y w i t h t h e purpose.) The f o r m a l statement f o r group P I ( a d o l e s c e n t s ) was as follows: 1. To h e l p t h e c l i e n t s u n d e r s t a n d t h e i r problems and t h e i r r e a c t i o n s t o t h e s e problems by a showing o f e x p e r i e n c e s and emotions i n an a c c e p t i n g and p r o t e c t i v e environment. 2. To encourage t h e members t o v e r b a l i z e t h e i r f r u s t r a t i o n s regarding peer and parental r e l a t i o n s h i p s through i d e n t i f i c a t i o n of the t h e r a p i s t s (conscious or u n c o n s c i o u s ) as s u r r o g a t e p a r e n t s and f e l l o w members as s i b l i n g s . 1  '  3. To enable t h e members t o e x p e r i e n c e a v a r i e t y of i n t e r p e r s o n a l r e l a t i o n s h i p s t h r o u g h t h e medium o f t h e group. 4. To b r i n g d i r e c t i o n and f o c u s t o p r a c t i c a l problems i n assuming a d u l t r e s p o n s i b i l i t i e s . In  o r d e r t o h e l p s e t t h e c l i m a t e and t o h e l p each member t o under-  s t a n d t h e g e n e r a l purpose o f t h i s group, t h e w r i t t e n purpose g i v e n t o t h e members was as f o l l o w s : The purpose o f t h e group i s t o a l l o w each member f r e e d i s c u s s i o n o f thought and f e e l i n g s . The o b j e c t i s f o r group members t o h e l p each o t h e r come t o a b e t t e r u n d e r s t a n d i n g of how t o d e a l w i t h r e l a t i o n s h i p problems w h i c h a r i s e from day-to-day, a t home, a t s c h o o l , on t h e job o r g e n e r a l l y i n any s o c i a l s i t u a t i o n . The t h e r a p i s t s e f f o r t s a r e d i r e c t e d a t f a c i l i t a t i n g t h i s p r o c e s s o f f r e e communi c a t i o n w i t h due r e g a r d f o r t h e comfort and s e c u r i t y o f each group member.  24  P a r t I , Q u e s t i o n I , I n t e r v i e w S c h e d u l e , see Appendix A  - 49 -  The above i s a s i m p l i f i e d statement of t h e f o r m a l agencypurpose, t h e r e f o r e t h e two c o i n c i d e . The Formal Statement f o r group P2 (young a d u l t s ) was as f o l l o w s : 1. To h e l p t h e c l i e n t s u n d e r s t a n d t h e i r problems w i t h i n t h e p r o t e c t i o n o f t h e group, t h e r e b y r e c e i v i n g h e l p and guidance from t h e t h e r a p i s t and group members.  '  2. To v e r b a l i z e p e r s o n a l f r u s t r a t i o n s w i t h i n t h e group c o n t e x t , t o d e v e l o p new i n s i g h t s i n t o b e h a v i o u r and g e n e r a l l y broaden t h e c l i e n t s unders t a n d i n g o f h i m s e l f and o t h e r s . 3. The group w i l l be used as t h e t o o l t o b u i l d and?or i n t e n s i f y t h e a b i l i t y o f the c l i e n t t o form and m a i n t a i n , need f u l f i l l i n g relationships. The caseworker's own p e r c e p t i o n o f purpose f o r P2 was: The main o b j e c t i s t r e a t m e n t . They c o u l d d i s c u s s what t h e y wanted t o . One r u l e was t h a t e v e r y t h i n g i n t h e group was c o n f i d e n t i a l and n o t t o be t a k e n out o f t h e group. Hence, t h e above purpose sums up t h e p r e v i o u s f o r m a l i z e d s t a t e ment i n one word - t r e a t m e n t , as the' p r i m a r y a i m . The caseworker f o r group P3 ( e p i l e p s y ) d i d not have a w r i t t e n statement o f purpose f o r t h e group b u t h e r own r e s p o n s e t o q u e s t i o n I of t h e i n t e r v i e w s c h e d u l e c l e a r l y s t a t e d t h e purpose o f t h e m e e t i n g s . P3  I n t h e hope t h a t p s y c h o t h e r a p y would a l l e v i a t e n o t o n l y t h e s e i z u r e problem . among t h e p a t i e n t s b u t d e a l w i t h o t h e r p s y c h o s o c i a l problems as w e l l , t h a t were p r e c i p i t a t i n g t h e s e i z u r e s t h a t had no apparent b e a r i n g . '  - 50 -  ... t h e y c o u l d h e l p one a n o t h e r w i t h t h e i r t r o u b l e s , and u n d e r s t a n d i n g t h a t o t h e r p e o p l e have t r o u b l e s t h a t a r e u p s e t t i n g t o them ... may h e l p them l e a r n more a b o u t t h e m s e l v e s and provide help f o r other people. All- three formalized ception all  groups are  statements,  of the  treatment  as  i n agreement w i t h t h e  well  as  the  This  i s seen i n the  p o s e s t a t e m e n t s where s u c h p h r a s e s as understand t h e i r  problems,"  and  need f u l f i l l i n g  "to form  ...  ...  The  i n d i v i d u a l worker's  g r o u p ' s p u r p o s e were c o n s i s t e n t objective.  model.  per-  w i t h the  over-  underlined  pur-  "to help  the  client  "to v e r b a l i z e f r u s t r a t i o n , " r e l a t i o n s h i p s , " were common  to a l l workers. All primary  g r o u p s had  aim  a male and  female t h e r a p i s t .  of psychotherapy i s to provide  a  the  group s e s s i o n ,  therapists family  were e n c o u r a g e d .  a t m o s p h e r e was As  the  the  but  goals  the  of  a  social•worker  questions  co-therapist,  will  be  three  e i t h e r the  preconscious material team t h e n  the  i n a l l the groups are  group  j u s t how  further discussed  oriented  group.  i n Chapter  three.  secure,  personality goals  be  .stated  their  own,  psychologist.  handle  e f f e c t i v e the  i n a psychotherapy  the  not  p s y c h i a t r i s t or  a reality  the  purposes.  b a s e d on  meetings w i l l  i s trained to  on  material  c r e a t i o n of a  t h e s i s team assumes t h a t  workers f o r the  the  Since  the  of the  conscious  r e l a t i o n s h i p s towards  Therefore  inherent  purposes  reorganization, by  transferrence  the  corrective  e x p e r i e n c e t h r o u g h d i s c u s s i n g u n c o n s c i o u s and in  Since  conscious level,  social This  the  or thesis  worker i s  therapy  role  as  - 51 -  B)  GOALS o f t h e GROUP  D e s p i t e t h e d i f f e r e n c e s i n t h e s e t h r e e groups as compared t o t h e o t h e r two group c l a s s i f i c a t i o n s , t h e r e s e a r c h e r s used the same q u e s t i o n s t o e l i c i t i n f o r m a t i o n . q u e s t i o n s about t h e t h r e e meetings,  I n answer t o t h e  t h e g o a l s f o r t h e worker o f  group P I ( a d o l e s c e n t s ) were as f o l l o w s : F i r s t Meeting: We had a s p e c i f i c agenda and we suggested t h a t we go t h r o u g h , p o i n t by p o i n t . We e x p l a i n e d t h a t i n d i v i d u a l e x p e r i e n c e s on t h e j o b and at s c h o o l s h o u l d be d i s c u s s e d h e r e . ...we wanted t o g a i n t h e i r t r u s t and . a sense o f f a m i l i a r i t y and s e c u r i t y . * At l e a s t we wanted them t o t r u s t t h e t h e r a p i s t , t o p r o v i d e them w i t h a s t r u c t u r e and t o r e a l i z e t h a t they wouldn't be p r e s s u r e d i n d i v i d u a l l y into producing. I n t h e middle meeting t h e r e was no s p e c i f i c g o a l f o r t h e group. However, t h e i n f o r m a t i o n o b t a i n e d from t h e i n t e r v i e w schedule i n d i c a t e d t h a t t h e group was moving towards t h e groups' a l i z e d statement  o f purpose.  form-  The caseworker expressed i t as  follows: T h i s was t h e f i r s t m e e t i n g where-the group e x p r e s s e d u n d e r s t a n d i n g t h a t t h i s was a c o h e s i v e f a m i l y group ... The members d i s c u s s e d p a r e n t a l f i g u r e s ... and t h e y moved from t h i s t o t h e d i f f i c u l t y o f g e t t i n g c l o s e t o people ... t h e meeting was t e r m i n a t e d on t h e theme, what t h e p r e s e n t s i t u a t i o n was and would t h i s f a m i l y group make up f o r what they had lost.  .* u n d e r l i n e d p o r t i o n s i n d i c a t e t h e s p e c i f i c g o a l s f o r each meeting.  -  52  -  F i n a l M e e t i n g : We wanted t o show t h e . group t h a t t h e a s s o c i a t i o n , as i t was, was t e r m i n a t i n g . We would not be meeting a g a i n . We wanted the group t o a c c e p t t h i s r e a l i t y . Through examining t h e above s t a t e m e n t s , t h e r e s e a r c h e r s found the caseworker's g o a l s f o r t h e t h r e e meetings t o be c o n s i s t e n t w i t h t h o s e of the model.  The t h e r a p i s t s aimed a t s t r u c t u r i n g  a group s i t u a t i o n where t h e members would f e e l enough s e c u r i t y and t r u s t t o be a b l e t o d i s c u s s t h r e a t e n i n g m a t e r i a l .  I n the  m i d d l e meeting t h e worker s a i d "the group e x p r e s s e d u n d e r s t a n d i n g t h a t t h i s was a c o h e s i v e f a m i l y group."  T h i s i s i n complete  accordance w i t h t h e f o r m a l i z e d purpose s t a t e m e n t , as w e l l as i n h e r e n t i n the model, w h i c h speaks of " p e r s o n a l i t y r e o r g a n i z a t i o n " t h r o u g h t h e p r o f e s s i o n a l h a n d l i n g of i n d i v i d u a l unconscious m a t e r i a l .  I t i s i n t e r e s t i n g t o note t h a t t h i s  infers  t h a t t h e members u n d e r s t o o d t h e purpose of t h e group. As t h e g o a l s f o r t h e meetings depend on member p a r t i c i p a t i o n , t h e s h a r i n g of problems was encouraged.  I t i s evident  i n a n a l y z i n g the three g o a l s , that the t h e r a p i s t s played a f a i r l y active interpretive role. s t a t e m e n t s as "we t o show...."  T h i s i s seen t h r o u g h such  s u g g e s t e d . . . , we e x p l a i n e d . . . , or we  The use o f t h e word "we"  t h e r a p i s t s worked c l o s e l y t o g e t h e r .  wanted  a l s o suggests the  I t further indicates that  the caseworker i s i d e n t i f y i n g w i t h the p s y c h i a t r i s t as a therapist. The g o a l s t h e worker s e t group P2 follows:  ( a d u l t s ) were as  I n the f i r s t m e e t i n g , i t was hoped t o move d i r e c t l y  - 53 -  toward t h e purpose, t h e t h e r a p i s t had o u t l i n e d f o r t h e members. T h i s was d e s i g n e d by t h e worker t o s e t t h e p a t t e r n f o r f u t u r e m e e t i n g s , i n an e f f o r t t o c r e a t e a t h e r a p e u t i c environment. T h i s was e x p r e s s e d as f o l l o w s : A f t e r the t h e r a p i s t explained the r u l e s he s a t back and w a i t e d f o r t h e group t o d e c i d e what t h e y were g o i n g t o do.... The worker d i d t r y t o b r i n g out f e e l i n g s but r e c e i v e d l i t t l e r e s p o n s e . . . . I don't t h i n k we ever t o l d t h e group what t h e y were g o i n g t o do, h i s (the t h e r a p i s t ' s ) i n i t i a l standards of p r a c t i c e d i d n ' t • allow this. M i d d l e M e e t i n g : The o n l y p l a n s e t up, was i n t h e f o r m a t i o n o f t h e group and a f t e r t h a t i t was s i m p l y t o d i s c u s s f e e l i n g s around members and t h e m s e l v e s . I t was hoped t h a t t h e members would v e r b a l i z e and demonstrate f e e l i n g s t o t h e group by s p e c i f i c examples from everyday l i f e . At t h i s p o i n t t h e y a r e b e g i n n i n g t o t a l k about f e e l i n g s and f e e l i n g s a r e b e g i n n i n g t o be demonstrated. L a s t M e e t i n g : The l a s t t h r e e . m e e t i n g s were t o t r y and g e t t h e group t o e x p r e s s t h e i r f e e l i n g s about termination . In  t h e f i r s t m e e t i n g , t h e worker s t a t e d t h a t t h e members had a  . c i i f f e r e n t purpose f o r t h e t h e r a p i s t t h a n what he i n t e n d e d . l a c k o f c l a r i t y r e s u l t e d i n some c o n f u s i o n as t h e worker  said:  Any q u e s t i o n s d i r e c t e d a t t h e t h e r a p i s t were r e t u r n e d t o t h e group and he s t a t e d t h a t a l l he wanted t o do was a c t as an o b s e r v o r . The members c o n s t a n t l y t r i e d to draw t h e t h e r a p i s t i n t o t h e convers a t i o n but q u i c k l y r e a l i z e d t h i s c o u l d n ' t be done. T h i s c o n f u s i o n was a l s o apparent i n t h e worker's "I  This  statement,  don't t h i n k we ever t o l d t h e group what t h e y were g o i n g  - 54 -  to  do...."  Even t h o u g h t h e p s y c h o t h e r a p y g r o u p s have  formalized  purposes and g o a l s ,  the  therapists'  can  still  ed  differ.  o f them, and t h a t  I t was e v i d e n t t h a t  i n t h e way t h e t h e r a p i s t This  group  organization the that  main  of f e e l i n g  ipation  T h e r e i s no s p e c i f i c expression.  This  feelings,  members  then f o r c e d  The g o a l s  t o use the  environment i s  content structure  A h i g h d e g r e e o f member a fairly  " t h e worker  beyond  partic-  passive  d i d n o t happen i n t h e f i r s t  but received l i t t l e  progress-  Personality r e -  created  i s encouraged, which i n d i c a t e s  the therapists.  that  wished.  c o i n c i d e s w i t h t h e model.  where t h e c a s e w o r k e r s t a t e s ,  the  as the meetings  through a t h e r a p e u t i c a l l y  goal.  t o note  o f t h e members,  ( a s s e e n i n t h e m i d d l e one) t h e members began  group  for  perception  i ti s interesting  strictly  role  meeting,  d i d t r y t o b r i n g out  r e s p o n s e . . . . " . R e s i s t a n c e by  t h e worker  into  a more p a s s i v e  s e t by t h e w o r k e r f o r g r o u p P3  role.  (epilepsy)  were a s f o l l o w s : First  Meeting: The p u r p o s e was s t a t e d t o t h e members, a s an o p p o r t u n i t y f o r people t o discuss u p s e t t i n g f e e l i n g s w h i c h may be c a u s i n g p o o r s e i z u r e c o n t r o l , f a m i l y problems etc.  M i d d l e M e e t i n g ... t o have t h e g r o u p accept the absence o f the t h e r a p i s t ( p s y c h i a t r i s t ) and f o r t h e c a s e w o r k e r t o t a k e o v e r . . . . We hoped v i a d i s c u s s i o n t o a s s u r e t h e group t h a t t h e D o c t o r c o u l d be a b s e n t o c c a s i o n a l l y a n d t h a t they- c o u l d s t i l l accomplish something because we n e e d t o have t h i s happen r a t h e r than j u s t d i s c o n t i n u e the group. Since t h i s  group  is still  continuing,  t h e r e has b e e n no  final  - 55 -  meeting. The  worker's group g o a l s  psychotherapeutic uished  aims.  c o i n c i d e w i t h t h e model's  However, t h e s e g o a l s  can be  disting-  f r o m P I a n d P2, b e c a u s e i n t h e m i d d l e m e e t i n g , t h e c a s e -  worker took over as the s o l e t h e r a p i s t .  Since  t a k e on t h e r o l e o f t h e r a p i s t i n s e v e r a l  o f t h e group  it  s e t f o r these  would t h e r e f o r e  follow that  w o u l d depend on h e r . it  the goals  t h e worker d i d sessions, sessions  E v e n i t t h e y were s e t b y t h e p s y c h i a t r i s t ,  w o u l d be i n t e r e s t i n g t o s e e how she i n t e r p r e t e d t h e s e t o  the  g r o u p , a n d w h e t h e r o r n o t h e r s o c i a l work o r i e n t a t i o n  influenced  this  i n Chapter  Three.  C)  SUMMARY o f t h e PSYCHOTHERAPY All  two  This w i l l  be f u r t h e r  statements  discussed  GROUPS  t h e groups' purposes a r e c o n s i s t e n t ,  written  model. her  interpretation.  both with the  (PI and P 2 ) , as w e l l as t h a t  E v e n t h o u g h P3 d i d n o t have t h i s  written  of the  statement,  p u r p o s e f o r t h e g r o u p was c o m p l e t e l y p s y c h o t h e r a p e u t i c  in  content. The  goals  set f o rthe three  ment w i t h t h e m o d e l . This  A l l aimed a t p e r s o n a l i t y  i s seen i n t h e great  individual  contributions  unconscious m a t e r i a l . pretation  meetings a r e a l l i n agree-  r e l i a n c e the t h e r a p i s t s placed to the discussion,  The b r i n g i n g  Despite  this,  on  e s p e c i a l l y around  to the fore  of the unconscious material  of the p s y c h i a t r i s t .  reorganization.  and i n t e r -  i s the area  o f competence  i t i s i n t e r e s t i n g t o note  - 56 -  t h a t some o f t h e g o a l s i n t h e three group purposes were s i m i l a r t o those h e l d i n g e n e r a l  s o c i a l work p r a c t i c e .  T h i s i s seen  i n t h e f o r m a l i z e d statements ( P I , P2) where r e f e r e n c e s made t o "understand p r o b l e m s . . . v e r b a l i z e  were  frustrations...and  enable members t o p a r t i c i p a t e . . . . " A case can t h e r e f o r e be made f o r a s o c i a l worker w o r k i n g w i t h a p s y c h o t h e r a p i s t  i n an  " i n t e r p r e t i v e c a p a c i t y , " w h i c h i s i n accordance w i t h h e r p r o f e s s i o n a l competence and s k i l l s .  I t . i s when t h e worker t a k e s  over as t h e s o l e p s y c h o t h e r a p i s t  (P3)> t h a t c o m p l i c a t i o n s can  arise.  D r . K l e i n s t a t e s i t t h i s way: A w e l l - t r a i n e d caseworker would n o t . attempt t r e a t m e n t o f t h e f o r c e s o f t h e unconscious i n psychotherapeutic situ a t i o n s where b a s i c r e o r g a n i z a t i o n o f p e r s o n a l i t y p a t t e r n s was i n v o l v e d , w i t h o u t s p e c i a l and p r o l o n g e d p r e p a r a t i o n under p s y c h i a t r i c s u p e r v i s i o n . I n c o n t r a s t , many caseworkers do not r e a l i z e t h a t t h e y may n o t be competent t o handle t h e complex and p o w e r f u l f o r c e s of t h e group w i t h o u t a d d i t i o n a l t r a i n i n g and s u p e r v i s e d e x p e r i e n c e . They a r e . l i k e l y t o be unaware o f t h e d e s t r u c t i v e as w e l l as c o n s t r u c t i v e p u i s s a n c e a t work i n groups.25  I t i s t h e r e f o r e e x c e p t i o n a l l y i m p o r t a n t t h a t t h e caseworker understand h i s f u n c t i o n i n the group. b e t t e r a b l e t o employ h i s own  I f he does, he w i l l be  p r o f e s s i o n a l s k i l l s , and w i l l be  a b l e t o i d e n t i f y w i t h h i s own p r o f e s s i o n , r a t h e r than t h a t of psychiatry. SUMMARY OF CHAPTER TWO A l l t h e purpose s t a t e m e n t s , o f t h e t h r e e group c l a s s 2$ K l e i n , J.G. A d u l t E d u c a t i o n and Treatment Groups i n S o c i a l A g e n c i e s . A d i s s e r t a t i o n . The C a t h o l i c U n i v e r s i t y o f A m e r i c a P r e s s . Wash.,.D.C., I 9 6 0 , p.61  - 57 -  i f i c a t i o n s , were c o n s i s t e n t w i t h t h e model.  C o n f u s i o n -only-  r e s u l t e d , when t h e caseworker's p e r c e p t i o n o f t h e group's purpose, d i f f e r e d from t h a t of t h e members.  This i s s p e c i f i c -  a l l y seen i n E l and P2. I n b o t h the group e d u c a t i o n and s o c i a l t r e a t m e n t groups, the caseworkers f o r m u l a t e d t h e purpose s t a t e m e n t s .  I n the group  p s y c h o t h e r a p y groups, t h e p s y c h i a t r i s t o r p s y c h o l o g i s t d e f i n e d the group's purposes i n f o r m a l i z e d s t a t e m e n t s . former groups, the caseworker was  T h e r e f o r e i n the  seen as the p r i m a r y change  agent, w h i l e .in t h e l a t t e r , she was e i t h e r a c o - t h e r a p i s t or recorder.  She would t h e n be a secondary change agent,  sub-  o r d i n a t e t o the p s y c h i a t r i s t . The purposes of t h e t e n groups d i f f e r e d on one main objective - that of treatment.  I n the group e d u c a t i o n groups,  e d u c a t i o n was t h e p r i m a r y o b j e c t i v e , t h e r a p e u t i c r e s u l t s b e i n g incidental.  I n s o c i a l group t r e a t m e n t and group  t r e a t m e n t was t h e p r i m a r y aim.  psychotherapy,  The main d i f f e r e n c e , between the  two, i s t h a t p s y c h o t h e r a p y d e a l s p r i m a r i l y w i t h u n c o n s c i o u s m a t e r i a l ' w h i l e s o c i a l group t r e a t m e n t d e a l s w i t h p r e - c o n s c i o u s and c o n s c i o u s m a t e r i a l .  I t i s t h e r e f o r e extremely important  t h a t t h e caseworker be aware of the depth of t r e a t m e n t , t h a t she as a change agent can p r o f i t a b l y hope t o u n d e r t a k e . A c l e a r l y d e f i n e d purpose d i r e c t l y a f f e c t s the statement . of g o a l s .  I f t h e caseworker i s c l e a r as t o t h e purpose of t h e  group, she w i l l be c l e a r e r as t o the g o a l s of t h e i n d i v i d u a l meetings.  I t t h e r e f o r e f o l l o w s , t h a t f a u l t y p e r c e p t i o n of  - 58 -  purpose w i l l in E l .  T h i s was seen  T h i s was a l s o c h a r a c t e r i s t i c of a l l t h e psychotherapy-  groups.  I n t h e f o r m a l i z e d purpose statements  caseworkers treatment ual  cause an i n c o n s i s t e n t s e t of g o a l s .  ( P I , P2), t h e  s t r e s s e d s i m i l a r aims t o those o f s o c i a l group  i . e . v e r b a l i z a t i o n , e n a b l i n g , e t c . When t h e i n d i v i d -  meeting g o a l s were s p e l l e d o u t , they were p r i m a r i l y  psychotherapeutic i n nature. the caseworker's  Confusion therefore r e s u l t e d i n  own p e r c e p t i o n o f f u n c t i o n i n t h e group i . e .  r e c o r d i n g and i n t e r p r e t a t i v e r o l e w i t h i n t h e s o c i a l worker's a r e a o f competence, o r a c o - t h e r a p i s t d e a l i n g w i t h material.  unconscious  I f t h e . r o l e . i s the l a t t e r , i t leads t o i d e n t i f i c a t i o n  with the p s y c h i a t r i c f i e l d .  T h i s i s s t i l l a problem w i t h i n t h e  s o c i a l work p r o f e s s i o n and needs f u r t h e r study and c l a r i f i c a t i o n . In  t h e group e d u c a t i o n groups t h e g o a l s were e a s i l y de-  f i n a b l e , s i n c e t h e caseworker was w o r k i n g w i t h i n a s p e c i f i c problem a r e a e.g. mental h e a l t h r e h a b i l i t a t i o n o r adoption., In  t h e s o c i a l group t r e a t m e n t groups t h e g o a l s were more  diffuse.  T h i s was due t o t h e t r e a t m e n t  o b j e c t i v e , as t h e worker  r e l i e d a g r e a t d e a l upon i n d i v i d u a l member c o n t r i b u t i o n s t o the d i s c u s s i o n s .  T h e r e f o r e , t h e r e were u s u a l l y no s e t g o a l s  for  allowing f o r greater f l e x i b i l i t y  t h e meetings,  problem areas o r . c o n f l i c t s .  i n discussing  I n t h e group psychotherapy  groups,  the g o a l s were aimed at. p e r s o n a l i t y r e o r g a n i z a t i o n through a c o r r e c t i v e experience. for  T h e r e f o r e , t h e members were r e s p o n s i b l e  t h e d i s c u s s i o n c o n t e n t , and t h e p s y c h i a t r i s t was r e s p o n s i b l e  - 59 for i t s interpretation.  There was no s e t g o a l s f o r t h e m e e t i n g s ,  and i f p r e s e n t , t h e caseworker had l i t t l e o r n o t h i n g t o do w i t h s e t t i n g them. The  educatiorygrpups'.'were  Klein's classifications.  t h e most c o n s i s t e n t w i t h D r .  I t was i n t h e s o c i a l group  treatment  groups where t h e g o a l s , e x p l i c i t l y , d i f f e r e d f r o m the model on some p r i m a r y o b j e c t i v e s . T h i s was e s p e c i a l l y seen i n t h e g o a l o f " c o n s c i o u s l y a f f e c t i n g t h e group p r o c e s s . "  Only one  worker (T3) had t h i s as a p r i m a r y o b j e c t i v e . The o t h e r two r e l i e d on i n d i v i d u a l i z a t i o n o f members i n t h e group i . e .  P2  p l u s s c h i z o p h r e n i c s . As p r e v i o u s l y mentioned, i n the psychot h e r a p y groups t h e r e were some s o c i a l work g o a l s i m p l i c i t i n the purpose s t a t e m e n t s .  I t i s i m p o r t a n t t o remember t h a t many  s o c i a l work o b j e c t i v e s p a r a l l e l those o f o t h e r h e l p i n g p r o f e s s i o n s i . e . p s y c h i a t r y , b u t t h a t t h e methods o f employing these s k i l l s a r e d i f f e r e n t .  Therefore t o avoid confusion, the  g o a l s i n a t h e r a p y group must be p r i m a r i l y  psychotherapeutic  i n n a t u r e , w i t h any s o c i a l work components b e i n g secondary t o the main treatment  o b j e c t i v e . Only w i t h t h i s c l e a r statement o f  purpose can t h e r e s p e c t i v e p r o f e s s i o n s ( s o c i a l work and p s y c h i a t r y ) , u t i l i z e t h e i r own s k i l l s i n d e a l i n g w i t h t h e members problems. As a r e s u l t o f these f i n d i n g s based on t h e purpose and. g o a l s o f t h e meetings w i t h i n t h e t h r e e c l a s s i f i c a t i o n s , t h e r e s e a r c h e r s b e l i e v e s o c i a l group treatment t o be t h e most amenable type o f group f o r a s o c i a l worker t o a c t as a change  - 60 -  afcent.  T h i s i s f u r t h e r s u b s t a n t i a t e d by t h e f a c t  that such :  t h i n g s as a p s y c h o s o c i a l d i a g n o s i s , casework t r e a t m e n t o b j e c t i v e s t o p a r a l l e l group o b j e c t i v e s ^ a n d t h e use of t h e r o r e t i c a l knowl e d g e a r e e x p l i c i t i n t h i s type of group's p u r p o s e .  CHAPTER I I I  THE ROLE OF THE CASEWORKER IN  THE GROUPS  GROUP EDUCATION Chapter two d i s c u s s e d t h e purpose and g o a l s o f t h e t e n groups b e i n g s t u d i e d i n t h i s t h e s i s .  I n Chapter t h r e e , t h e  f o c u s w i l l be on t h e r o l e o f t h e worker.  I t has been hypo-  t h e s i z e d t h a t t h e purpose o f t h e group w i l l determine how t h e worker uses h i m s e l f t o h e l p t h e members.  The K l e i n  class-  i f i c a t i o n s h o u l d be u s e f u l i n d i s t i n q u i s h i n g between t h e v a r i o u s t y p e s o f groups and t h e a c t i v i t y t h a t may be e x p e c t e d o f t h e worker.  That i s t o say, d i f f e r e n c e s may be e x p e c t e d i n t h e  worker's r o l e i n e d u c a t i o n as compared t o t r e a t m e n t o r psychotherapy groups. The p r i m a r y r e s p o n s i b i l i t y o f t h e s o c i a l worker i n any e d u c a t i o n group w i l l be t o t e a c h o r i m p a r t knowledge t o t h e members.  The i n f o r m a t i o n t h a t i s s u p p l i e d t o t h e group w i l l be  c o r r e l a t e d t o t h e purpose f o r w h i c h t h e group was formed.  In  t h i s r o l e , t h e worker i s e x p e c t e d t o be i n f o r m e d on t h e s u b j e c t b e i n g d i s c u s s e d and a c t i v e i n t h e d i s s e m i n a t i o n o f knowledge. In  t h e group d i s c u s s i o n s t h e r e f o r e , t h e worker w i l l be e x p e c t e d  to  assume a c e n t r a l p o s i t i o n as a d i s c u s s i o n l e a d e r .  - 62 -  Since the education  o f t h e members i s t h e p r i m a r y  focus  of t h e worker's r o l e , t h e t r e a t m e n t a s p e c t w i l l be s e c o n d a r y . Group i n t e r a c t i o n s w h i c h a r e so i m p o r t a n t  i n therapy  groups w i l l  not be used as a t o o l t o i n c r e a s e t h e s o c i a l a d j u s t m e n t o f i n d i v i d u a l members. cohesive  The r e l a t i o n s h i p s between members and  group bonds, w i l l n o t be f o s t e r e d as p a r t o f t h e  worker's e d u c a t i o n a l f o c u s . the d i s c u s s i o n of emotionally  I n encouraging questions  and l e a d i n g  charged t o p i c s , t h e emphasis  w i l l be on l e a r n i n g and i n c r e a s i n g t h e knowledge o f t h e groupas-a-whole, r a t h e r t h a n p u r p o s e f u l l y changing i n d i v i d u a l behaviour  patterns. To a c c o m p l i s h  t h i s e d u c a t i o n a l f o c u s t h e s o c i a l worker  has a t h i s d i s p o s a l a wide range o f communication media. i n c l u d e l e c t u r e s , i n f o r m a l d i s c u s s i o n s and v i s u a l a i d s .  These Lectures  w i l l be u s e f u l i n p r e s e n t i n g a f o r m a l t o p i c t h a t w i l l be e a s i l y u n d e r s t o o d and r e a d i l y a c c e p t e d by t h e members.  In discussing  an e m o t i o n a l l y charged s u b j e c t however t h e l e c t u r e does n o t a l l o w f o r s u f f i c i e n t o u t l e t o f f e e l i n g about t h e t o p i c .  This  w i l l be p a r t i c u l a r i l y t r u e i f t h e audience i s l a r g e . The  d i s c u s s i o n group i s u s e f u l i n overcoming t h e im-  p e r s o n a l approach o f t h e l e c t u r e .  I n s i t u a t i o n s , where t h e sub-  j e c t b e i n g communicated, i s t h r e a t e n i n g t o t h e members, t h e s m a l l e r i n t i m a t e group s e t t i n g s w i l l a i d t h e s o c i a l worker i n t r a n s m i t t i n g 'this i n f o r m a t i o n . techniques,  Through t h e use of d i s c u s s i o n  t h e members a r e encouraged t o ask q u e s t i o n s .  p e r s o n a l f e e l i n g s o f t h e group around t h e t o p i c under  The  consider-  - 63 a d i t i o n are discussed.  A s p e c t s o f t h e problems a r e d e v e l o p e d  and where p o s s i b l e , s o l u t i o n s o r a l t e r n a t i v e s w i l l be p r e s e n t e d as p a r t o f t h e e d u c a t i o n a l theme o f the m e e t i n g .  Books, a r t i c l e s ,  f i l m s and o t h e r media are u s e f u l supplements t o any d i s c u s s i o n . They may be used as a source o f r e f e r e n c e as w e l l a s an a i d i n helping t o r e i n f o r c e the information, that i s being The  s o c i a l worker may u s e any o f t h e s e t e c h n i q u e s  transmitted.  t o increase  the knowledge o f t h e p a r t i c i p a n t s , on t h e s u b j e c t t h e y a r e  dis-  cussing. The to impart  worker i s t h e r e f o r e a c t i v e and uses many knowledge t o t h e members.  techniques  K l e i n includes the use of  communication media, member p a r t i c i p a t i o n , and the  expression  of f e e l i n g s around problems as p a r t o f t h e workers f o c u s i n education type groups. ROLE o f WORKER i n GROUP E I The  worker i n group E l (deaf c h i l d r e n ) was v e r y a n x i o u s  about h e r r o l e i n t h e group. experience  I n d e s c r i b i n g t h e f i r s t meeting she  " I was v e r y i n s e c u r e b e f o r e I went i n and i t kept  g e t t i n g worse." and  first  a t l e a d i n g a d i s c u s s i o n group and i t p r o v e d v e r y  threatening f o r her. stated:  T h i s was t h e c a s e w o r k e r s  A c e r t a i n amount o f a n x i e t y i s u n d e r s t a n d a b l e  commonly e x p e r i e n c e d  of u n f a m i l i a r c l i e n t s .  by a s o c i a l worker e n t e r i n g a group Her f e e l i n g s however became so o v e r -  whelming t h a t t h e worker was u n a b l e t o c o n t a i n them and the group members became aware o f t h e caseworker's a n x i e t y . "They were a l l aware o f how I f e l t . "  She s t a t e d :  This i s a l s o true of t h e  - 64 -  m i d d l e meeting:  " I was u n c o m f o r t a b l e i n t h e group w h i c h was  o b v i o u s t o everyone."  The s o c i a l work d i s c i p l i n e t e a c h e s  c o n t r o l o v e r a worker's p e r s o n a l f e e l i n g s , t o a v o i d a f f e c t i n g the  c l i e n t , who i s s e e k i n g h e l p .  T h i s i s a c o n d i t i o n t h a t was  n o t i c e a b l y l a c k i n g i n t h i s worker. The a n x i e t y o f t h e caseworker caused h e r t o assume a v e r y p a s s i v e r o l e i n group E l .  T h i s was i l l u s t r a t e d i n t h e f i r s t  meeting when a m a r r i e d c o u p l e became h o s t i l e o v e r t h e avowed purpose o f t h e group.  They were a t t e m p t i n g t o form a s o c i a l  a c t i o n committee and were n o t c o n t e n t t o s i m p l y use t h e group for  d i s c u s s i o n purposes.  The h o s t i l e r e a c t i o n l e d t o g r e a t e r  i n s e c u r i t y on t h e p a r t o f t h e worker and t h i s r e s u l t e d i n further passivity. worker was s t i l l  I n l a t e r meetings t h e p a s s i v e r o l e o f t h e  evident.  w i t h o u t guidance.'  She s t a t e d :  "The group c a r r i e d on  They were v e r y v o c a l and i n t e r p r e t e d t h e  m a t e r i a l t h e y d i s c u s s e d w i t h o u t any h e l p . " The worker i n an e d u c a t i o n a l group i s e x p e c t e d t o h e l p the  members r e l a x and f e e l a t ease.  This w i l l f a c i l i t a t e the  f l o w o f i n f o r m a t i o n i n t h e group and i s a c c o m p l i s h e d t h r o u g h s u p p o r t , acceptance and t h e o t h e r p r i n c i p l e s o f t h e s o c i a l work d i s c i p l i n e . s t a t e d however:  The worker i n t h e i n i t i a l and m i d d l e meeting " I r e l i e d on t h e group f o r s u p p o r t . "  a f o c u s uncommon t o any s o c i a l work method.  This i s  The e d u c a t i o n a l  r o l e o f t h e worker was l i m i t e d by h e r a n x i e t y .  The caseworker  appeared so t h r e a t e n e d by t h e group s i t u a t i o n t h a t she became dependent upon t h e members she was t r y i n g t o h e l p .  - 65 -  The o v e r - a l l a c t i v i t y o f t h e worker was d e s c r i b e d i n t h e following  statement: " I t r i e d t o e x p l a i n t o them about the purpose o f t h e group.... I n general I played a p r e t t y passive r o l e . . . a n d I r e l i e d on t h e group f o r s u p p o r t . They were a l l q u i t e v o c a l . . . a n d t h e group i n t e r p r e t e d most o f t h e m a t e r i a l they d i s c u s s e d . I might have g i v e n a b i t o f i n t e r p r e t a t i o n o r c l a r i f i c a t i o n from time t o t i m e . The members d i d most o f the d i s c u s s i o n and t r i e d t o make t h e worker c o m f o r t a b l e . "  D i s c u s s i o n t e c h n i q u e s a r e a v a i l a b l e t o any s o c i a l worker i n h i s work w i t h c l i e n t s . for  These i n c l u d e opening  the subject  d i s c u s s i o n by g i v i n g a g e n e r a l o u t l i n e o f t h e problem under  consideration.  Once t h e members u n d e r s t a n d  worker w i l l encourage them t o p a r t i c i p a t e .  the t o p i c , the By d e v e l o p i n g t h e  t o p i c o f t h e c o n v e r s a t i o n , f o c u s i n g t h e d i s c u s s i o n and r a i s i n g s a l i e n t i s s u e s , p a r t i c i p a t i o n i s encouraged. to  When members b e g i n  i n t e r a c t , t h e n t h e r o l e o f t h e s o c i a l worker w i l l i n c l u d e  c l a r i f y i n g i s s u e s , i n t e r p r e t i n g f e e l i n g s and summarizing t h e content of t h e meeting. D i s c u s s i o n techniques are very important t o education groups.  Since the d i s c u s s i o n i s p r i m a r i l y o r i e n t e d t o help the  members u n d e r s t a n d  a s u b j e c t t h a t i s s i g n i f i c a n t t o them, t h e  opening  remarks o f t h e s o c i a l worker w i l l f o c u s t h e group on a  topic.  The a b i l i t y o f t h e worker i n g u i d i n g , f o c u s i n g o r  i n t e r p r e t i n g t h e d i s c u s s i o n w i l l h e l p t h e members l e a r n about the s u b j e c t .  Once t h e t o p i c has been c o n s i d e r e d from v a r i o u s  -  66  -  p o i n t s of v i e w the worker w i l l summarize the c o n t e n t of t h e meeting.  T h i s w i l l h e l p c l a r i f y t h e v a r i o u s i s s u e s t h a t have  been r a i s e d and p r e s e n t t h e members w i t h an o r g a n i z e d a n a l y s i s of t h e d e l i b e r a t i o n . The worker i n E l began t h e d i s c u s s i o n i n the f i r s t meeting  by o u t l i n i n g t h e purpose of t h e group.  As s t a t e d  earlier,  t h i s was i m m e d i a t e l y a souce o f i r r i t a t i o n f o r two members who d i s a g r e e d w i t h t h e purpose as s t a t e d by the caseworker.  The  r o l e of t h e d i s c u s s i o n l e a d e r emphasized the need f o r h a v i n g the  members u n d e r s t a n d t h e t o p i c t h a t w i l l be d i s c u s s e d .  In  group E l , t h e a n x i e t y o f t h e worker d i d not a l l o w her t o e l a b o r a t e upon t h e opening remarks, and the h o s t i l e r e a c t i o n she e n c o u n t e r e d l e d t h e caseworker t o remain s i l e n t .  I n the m i d d l e  and f i n a l m e e t i n g s , t h e worker was a g a i n r e s p o n s i b l e f o r i n i t i a t i n g the d i s c u s s i o n . the  T h i s was a c c o m p l i s h e d by summarizing  c o n t e n t o f the p r e v i o u s week, as i l l u s t r a t e d by t h e worker's  comments i n d e s c r i b i n g the m i d d l e meeting: summary o f l a s t weeks d i s c u s s i o n .  " I gave a s h o r t  They h e s i t a t e d f o r a moment  but e v e n t u a l l y someone would s t a r t t h e d i s c u s s i o n . "  The worker  due t o her d i s c o m f o r t assumed v e r y l i t t l e r e s p o n s i b i l i t y i n h e l p i n g t h e members t o i n t e r a c t . In  t h e m i d d l e and f i n a l meetings o f t h e group the r o l e  of the worker c o n t i n u e d t o be a p a s s i v e one.  The worker s t a t e d :  " I might have g i v e n a b i t o f i n t e r p r e t a t i o n f r o m t i m e t o t i m e . G e n e r a l l y t h e group handled, t h e d i s c u s s i o n . "  There does not  -  67 -  seem t o be any i n d i c a t i o n o f t h e worker u s i n g h e r p o s i t i o n i n t h e group t o educate t h e members.  T h i s r o l e was n o t c l e a r l y  u n d e r s t o o d by t h e caseworker and t h e expected a c t i v i t y o f t h e discussion leader d i d not m a t e r i a l i z e . S i n c e a group i s composed o f i n d i v i d u a l s who a r e i n t e r a c t i n g t o g e t h e r t h e s o c i a l worker w i l l be r e s p o n s i b l e f o r handling various reactions that occur.  I f these d i f f i c u l t i e s  a r e n o t d e a l t w i t h t h e y may remain a s o u r c e o f i r r i t a t i o n f o r b o t h t h e i n d i v i d u a l members o r t h e group as-a-whole.  This i s  p a r t i c u l a r i l y t r u e i f t h e r e a c t i o n i s c e n t e r e d around e m o t i o n a l l y charged i s s u e s t h a t t h e members a r e d i s c u s s i n g . I n an e d u c a t i o n a l group t h e c o n c e n t r a t i o n w i l l be on l e a r n i n g r a t h e r t h a n d e v e l o p i n g t h e s o c i a l adjustment o f t h e i n d i v i d u a l member.  The i n t e n s i t y o f i n d i v i d u a l r e a c t i o n s a r e  e x p e c t e d t h e r e f o r e t o be l e s s t h a n t h e r a p y groups and w i l l be h a n d l e d from an i n t e l l e c t u a l o r e d u c a t i o n a l frame o f r e f e r ence.  That i s , t h e worker w i l l use t h e i n d i v i d u a l r e a c t i o n s  t o h e l p c l a r i f y i s s u e s f o r t h e group as-a-whole r a t h e r t h a n c o n c e n t r a t i n g on b e h a v i o u r p a t t e r n s . The caseworker, i n group E l , was p r e s e n t e d w i t h ' h a n d l i n g t h e problem o f t h e h o s t i l i t y o f a m a r r i e d c o u p l e . A l a c k o f c l a r i t y around t h e group purpose seemed t o be t h e c e n t r a l issue producing t h i s h o s t i l i t y .  There was no attempt on t h e  worker's p a r t t o reduce t h e f r u s t r a t i o n t h e s e two people experienced.  The worker l e f t t h e r e s o l u t i o n o f t h i s  conflict  up t o t h e group which r e s u l t e d i n a l i g n i n g t h e members a g a i n s t  - 68 -  this hostile pair.  The worker s t a t e d :  "Many p e o p l e wanted  t h i s group and o p e n l y opposed t h i s c o u p l e . "  Eventually the  u n r e s o l v e d c o n f l i c t caused t h e two members t o drop o u t o f t h e group. The r o l e o f t h e worker was d e s c r i b e d i n t h e i n t e r v i e w as f ollows,-,: " I found t h a t some o f them thought t h i s was t o be a s o c i a l a c t i o n group... One c o u p l e - i n p a r t i c u l a r was most h o s t i l e . . . I t r i e d t o e x p l a i n about t h e purpose o f t h e group b u t I l e t t h e members h a n d l e t h i s h o s t i l i t y w h i c h worked v e r y w e l l . . . They dropped out a f t e r awhile." Thus f a r t h e f o c u s has been upon t h e r o l e o f t h e worker i n opening and d e v e l o p i n g a d i s c u s s i o n i n an e d u c a t i o n t y p e group.  T h i s s t u d y a l s o u n d e r t o o k t o i n v e s t i g a t e t h e worker's  r o l e i n t e r m i n a t i n g a group m e e t i n g .  T e r m i n a t i o n o f a group  meeting i n an e d u c a t i o n a l group i s g e n e r a l l y n o t t o o d i f f i c u l t . The e m o t i o n a l i n v o l v e m e n t o f t h e members i s l i m i t e d as compared t o t r e a t m e n t groups and t h e development o f c o h e s i v e bonds i s n o t encouraged.  The s o c i a l worker i n t h e f i n a l p o r t i o n o f t h e  meeting would be expected t o summarize  the discussion.  Salient  p o i n t s would be c l a r i f i e d b u t t h e worker would be c a r e f u l n o t t o open new a r e a s o f c o n c e r n .  The summary, would i n v o l v e an  element o f t i m i n g so t h e meeting i s n o t c o n c l u d e d on a t h r e a t ening subject.  The emphasis i n t h e workers c l o s i n g remarks  will  be on t h e p o s i t i v e accomplishments o f t h e group. I n t h i s group t h e meetings were brought t o a c l o s e v e r y  - 69 -  abruptly.  The t h r e e meetings o f group E l were t e r m i n a t e d by t h e  deaf c h i l d r e n coming i n t o t h e room.  The c h i l d r e n had been i n  s c h o o l and f o l l o w i n g c l a s s e s proceded i m m e d i a t e l y t o where t h e i r p a r e n t s were m e e t i n g .  T h i s was a v e r y d i s r u p t i v e e n d i n g t o t h e  s e s s i o n and any summary o r i n t e r p r e t a t i o n t h e worker c o u l d have made became i m p o s s i b l e . T h i s would a l s o be t r u e o f any i n t e n s e or p a r t i c u l a r i l y m e a n i n g f u l d i s c u s s i o n t h a t was i n p r o c e s s during t h i s time.  The caseworker d i d n o t summarize o r t e r m i n a t e  the meeting i n any way.  T h i s p r o c e s s was l e f t t o the c h i l d r e n  as i l l u s t r a t e d by t h e f o l l o w i n g statement: c u s s i o n g o i n g u n t i l t h e c h i l d r e n came.  "We kept t h e d i s -  The p a r e n t s knew t h e  t i m e and a l l o f us were e x p e c t i n g them." T e r m i n a t i o n o f t h e group i t s e l f r e q u i r e s s i m i l a r to t h o s e o f c l o s i n g t h e i n d i v i d u a l group m e e t i n g s .  skills  Ideally  the members a r e made aware o f t h e f i n a l meeting date u s u a l l y several sessions before termination.  T h i s a l l o w s t h e group t o  e x p r e s s t h e i r f e e l i n g s about t h e problem and t o p r e p a r e themselves emotionally to disband. to  The r o l e o f t h e worker w i l l be  h e l p each member reduce h i s dependancy upon t h e group by  s l o w l y s e v e r i n g t h e c o h e s i v e bonds t h a t have d e v e l o p e d . worker may be expected t o summarize t h e p o s i t i v e  The  achievements  of t h e group and o u t l i n e t h o s e areas i n w h i c h more u n d e r s t a n d ing  i s r e q u i r e d by t h e members. T e r m i n a t i o n o f e d u c a t i o n a l groups i s r e l a t i v e l y s i m p l e  as compared t o t r e a t m e n t g r o u p s .  T h i s i s due t o t h e e m o t i o n a l  attachments o f t h e members b e i n g m i n i m i z e d as o u t l i n e d  earlier.  -  70  -  I t i s o f t e n - . f a c i l i t a t e d by t h e members b e i n g aware o f t h e e x a c t number o f s e s s i o n s they a r e expected t o a t t e n d .  A summary  i s p a r t i c u l a r l y a p p r o p r i a t e i n t h i s type o f group s i n c e t h e s e s s i o n s have been s t r u c t u r e d around a p a r t i c u l a r s u b j e c t . d i f f i c u l t y o f s e v e r i n g group a t t a c h m e n t s and p r e p a r i n g members f o r t e r m i n a t i o n i s t h u s The  individual  minimized.  worker i n group E l does n o t i n d i c a t e t h a t t h e s u b j e c t  of t e r m i n a t i o n was d i s c u s s e d p r i o r t o t h e f i n a l m e e t i n g . states:  The  She  " I t o l d them t h i s was t h e f i n a l meeting and t h e y gener-  a l l y accepted  it.  I t o n l y l a s t e d twenty m i n u t e s . "  s t a t e s t h a t she c o n t i n u e d  The worker  t o m a i n t a i n h e r p a s s i v e r o l e and d i d  not attempt t o f o c u s t h e members i n any way'.  The group meeting  was l a t e i n g e t t i n g s t a r t e d which r e s u l t e d i n t h e c h i l d r e n coming t o t h e room e a r l i e r than u s u a l .  There was no r e s i s t a n c e  noted by t h e caseworker and t h e d i s b a n d i n g r e l a t i v e l y simple  o f t h e group was a  process.  ROLE o f WORKER i n GROUP E2 I t has been o u t l i n e d t h a t t h e worker i n e d u c a t i o n a l groups i s expected t o be a c t i v e i n t r a n s m i t t i n g knowledge t o t h e members.  The worker i n group E2 ( r e l a t i v e s o f p s y c h i a t r i c  p a t i e n t s ) s t a t e d t h a t i n t h e f i r s t meeting he e x p e r i e n c e d a n x i e t y due t o t h e r e l u c t a n c e o f t h e members t o i n t e r a c t . worker s a i d :  The  " I remember I had some a n x i e t y m y s e l f because  t h i s was my f i r s t group and t h e p r o d u c t i o n was a l i t t l e  slow."  These f e e l i n g s however d i d n o t I n t e r f e r e w i t h h i s r o l e i n t h e group. members.  He was v e r y v e r b a l and i n t e r a c t e d e a s i l y w i t h the  - 71  -  The a c t i v i t y o f t h e worker i n t h e i n i t i a l and m i d d l e meetings was aimed p r i m a r i l y a t e d u c a t i n g t h e group members about t h e p r o b l e m o f m e n t a l p a t i e n t s r e t u r n i n g t o t h e community.  The caseworker was knowledgeable on t h e s u b j e c t and a c t i v e -  l y i n t e r p r e t e d t h e m a t e r i a l t o t h e group. by t h e statement:  This i s i l l u s t r a t e d  "We o f f e r e d i n f o r m a t i o n from a v a r i e t y of  s o u r c e s t o t h e r e l a t i v e s t o a f f e c t an u n d e r s t a n d i n g o f t h e problem."  The e d u c a t i o n a l f o c u s o f t h e worker's r o l e was concent  rated a t three l e v e l s :  firstly,  t o attempt t o h e l p t h e group  u n d e r s t a n d t h e problems t h a t would be encountered by t h e p a t i e n t ; s e c o n d l y , t o i n t e r p r e t t h e u s e f u l n e s s o f t h e member i n r e l a t i o n t o h e l p i n g t h e s i c k r e l a t i v e s ; and l a s t l y , t o t r y t o e x p l a i n  i the community's a t t i t u d e toward t h e inmate and how t h i s would e f f e c t t h e f a m i l i e s o f t h e group members.  Since the m a t e r i a l  under d i s c u s s i o n was o f such an e m o t i o n a l c h a r a c t e r , t h e worker encouraged an e x p r e s s i o n o f f e e l i n g .  "Another purpose was t o  have t h e r e l a t i v e s t a l k about' t h e i r f e e l i n g s t o h e l p a l l a y any shame, g u i l t , f e a r o r resentment."  T h i s f o c u s was. p r e s e n t i n  a l l three meetings. R e l a t i o n s h i p was t h e t o o l t h e caseworker used t o h e l p develop v e r b a l i n t e r a c t i o n among t h e members i n d i s c u s s i n g various subjects.  The worker s t a t e d i n t h e m i d d l e meeting:  " I wanted t o g e t t h e members t o i n t e r a c t w i t h each o t h e r , t o s u p p o r t each o t h e r , t o c l a r i f y f o r each o t h e r , t o a c c e p t each o t h e r , t o u n d e r s t a n d each o t h e r , t o be a group." o f a c t i v i t y i s common t o t r e a t m e n t g r o u p s .  This kind  I n consciously  - 72 -  f o s t e r i n g group bonds, t h e caseworker i n d i c a t e d t h a t t h e r a p y and e d u c a t i o n a l r o l e s o v e r l a p p e d . i n the f i n a l  meeting o f t h e group.  T h i s was i n c r e a s i n g l y e v i d e n t The members began t o d i s -  cuss each o t h e r and p r e s e n t e d p e r s o n a l e x p e r i e n c e s t o t h e group for  discussion.  The caseworker encouraged t h i s s o r t o f d e l i b -  e r a t i o n by h e l p i n g to. c r e a t e a c l i m a t e i n which t h e members c o u l d b r i n g up p e r s o n a l e x p e r i e n c e s . T h i s f o c u s o f t h e worker's r o l e was n o t expected i n e d u c a t i o n a l g r o u p s . The o v e r - a l l r o l e o f t h e caseworker was d e s c r i b e d as follows: "I offered information of various k i n d s , and as I would t a l k I would use t h e c o l l e c t i v e pronoun we... I t r i e d t o s u p p o r t t h e group members around t h e i r a n x i e t i e s and t r i e d t o get them t o v e r b a l i z e t h i s . . . " The d i s c u s s i o n t e c h n i q u e s o f s o c i a l workers has been d i s cussed e a r l i e r . ing  The caseworker i n group E2 was a c t i v e i n i n i t i a t -  t h e d i s c u s s i o n o f t h e group i n t h e f i r s t m e e t i n g .  There was  no s p e c i f i c t o p i c t h e worker wanted t o d i s c u s s and t h i s was left  up t o t h e members.  The w o r k e r s a i d :  "We w i l l  t a l k about  you as r e l a t i v e s and what you can do t o h e l p t h e p a t i e n t when he r e t u r n s t o t h e community.  I l e t them go where t h e y wanted,  i t was a v e r y u n s t r u c t u r e d group."  The members d i d n o t b e g i n  i n t e r a c t i n g i m m e d i a t e l y and t h e worker was f o r c e d t o suggest a t o p i c t h a t was o f i n t e r e s t t o a l l o f t h e group. In  t h e m i d d l e and f i n a l  meetings o f t h e group t h e members  - 73 assumed t h e r e s p o n s i b i l i t y ' o f i n i t i a t i n g t h e d e l i b e r a t i o n s . The worker p u r p o s e l y a r r a n g e d t o be s e v e r a l minutes l a t e i n e n t e r i n g t h e m e e t i n g and t h e d i s c u s s i o n was u s u a l l y w e l l underway a t t h i s p o i n t .  He s t a t e d i n t h e i n t e r v i e w :  " I would come  t o t h e o f f i c e and prepare t h e room f o r t h e m e e t i n g and t h e n I would go t o t h e ward.  Frequently  I would be t h e l a s t t o e n t e r  and t h e y would be d i s c u s s i n g amongst t h e m s e l v e s . "  While t h i s  may be an u n u s u a l way o f f u n c t i o n i n g i t appears t o have been e f f e c t i v e i n t h i s group. Guidance, i n t e r p r e t i n g and developement o f t h e d i s c u s s i o n have p r e v i o u s l y been e l a b o r a t e d  upon i n c o n s i d e r i n g t h e worker's  role i n continuing the discussion.  The worker s t a t e d :  "Gener-  a l l y t h e group responded v e r y w e l l once they s t a r t e d t a l k i n g . I was v e r y r e l a x e d and c a s u a l d e s p i t e my a n x i e t y .  I generally  j u s t t r i e d t o keep t h e members t a l k i n g and where n e c e s s a r y h e l p e d them u n d e r s t a n d a p o i n t o r two." I n t h e m i d d l e and f i n a l meetings t h e caseworker c o n t i n u e d t o be a c t i v e .  The worker a l l o w e d  t h e group t o d e v e l o p - t h e  d i s c u s s i o n w i t h o u t guidance and o n l y i n t e r j e c t e d s t a t e m e n t s concerned w i t h c l a r i f y i n g i s s u e s .  I n t e r a c t i o n s o f t h e members  were c o n t i n u e d w i t h o u t d i f f i c u l t y a t t h i s s t a g e . i l l u s t r a t e d by t h e workeri.. d i r e c t i o n they wished.  "The group was a l l o w e d  t o go i n any  I t was s t a r t e d by them and my r o l e was  t o i n t e r p r e t any p e r t i n e n t m a t e r i a l . active."  T h i s was  I was u s u a l l y p r e t t y  The p a t t e r n o f a l l o w i n g t h e members t o develop t h e  d i s c u s s i o n w i t h o u t g u i d a n c e f r o m t h e worker was c a r r i e d , on t h r o u g h o u t t h e l i f e o f t h e group.  - 74  -  As a r e s u l t o f t h e caseworker t e n d i n g t o s h i f t between e d u c a t i o n a l and t r e a t m e n t  he was f o r c e d t o handle a p e r s o n a l  s i t u a t i o n w i t h one member i n t h e group.  A v e r y obese woman  began d i s c u s s i n g h e r a s s o c i a t i o n w i t h A l c o h o l i c s Anonymous. The worker s t a t e d : group.  " T h i s was v e r y u p s e t t i n g f o r t h e whole  I handled t h i s by s i m p l y l e t t i n g h e r t a l k and g e t t i n g i t  out o f h e r system.  When she t a l k e d t o o l o n g o r t o o much I would  d i v e r t t h e i n t e r a c t i o n t o one o f t h e o t h e r members."  The  m a t e r i a l b e i n g d i s c u s s e d i n t h e group was c e n t e r e d around t h e p e r s o n a l e x p e r i e n c e s o f t h e members.  Helping the i n d i v i d u a l  was a p r i m a r y concern and t h e woman was encouraged t o d i s c u s s her f e e l i n g s . this  The t r e a t m e n t i m p l i c a t i o n s were v e r y o b v i o u s i n  situation. The  expectations of the d i s c u s s i o n leader i n terminating  a m e e t i n g have been o u t l i n e d e a r l i e r . . The worker i n t h e f i r s t m e e t i n g o f group E2 s t a t e d : i t ' s eight o'clock."  " I n c l o s i n g I'suggested;  "Well  I would comment g e n e r a l l y on t h e d i s c u s s i o n  and s u g g e s t , we can c a r r y on f r o m t h i s p o i n t n e x t week."  The  comments o f t h e worker were designed t o o r g a n i z e t h e d i s c u s s i o n i n t o meaningful  concepts.  By s t a t i n g t h e p o s i t i o n a t w h i c h the;,  group would b e g i n t h e f o l l o w i n g week, i t a l l o w e d the members t o a s s i m i l a t e t h e d i s c u s s i o n as w e l l as g i v i n g time t o p r e p a r e f o r the n e x t  meeting.  I n t h e m i d d l e meeting a member t e r m i n a t e d t h e s e s s i o n . T h i s was a c c o m p l i s h e d  by t h e member s u g g e s t i n g t h a t t i m e was up  and by making a move t o l e a v e .  The o t h e r members f o l l o w e d t h e  - 75 -  suggestion. of  There i s no i n d i c a t i o n o f r e s i s t a n c e ^ and a c c e p t a n c e  t h i s s i t u a t i o n was r e g i s t e r e d by t h e members.  The worker had  completed h i s summary and was about t o suggest t h e meeting d i s band. . He s t a t e d : i t down.  One woman l o o k e d a t h e r watch s a y i n g ; 'Well i t ' s t h e  end o f t h e h o u r . ' In the  " I f i n i s h e d commenting and was about t o shut  No one o b j e c t e d . "  t e r m i n a t i n g t h e f i n a l s e s s i o n o f t h e group, n e i t h e r  members n o r t h e worker was aware t h a t t h e group was d i s -  banding.  The caseworker was g o i n g on h o l i d a y and c a r e f u l l y  e x p l a i n e d t o the members upon h i s r e t u r n t h e group would r e convene.  There had been a b s o l u t e l y no p r e p a r a t i o n f o r t e r m i n a t i o n .  S i n c e t h e group bond had been so c a r e f u l l y f o s t e r e d and p l a y e d such an i m p o r t a n t a s p e c t o f t h i s worker's r o l e , one may wonder about t h e e f f e c t s on t h e members.  A f t e r h i s r e t u r n the c a s e -  worker c o n t a c t e d each member i n d i v i d u a l l y t o e x p l a i n t h a t t h e group would n o t be r e - e s t a b l i s h e d .  He s t a t e d :  " I t o l d them  I would g e t i n t o u c h w i t h them a f t e r my v a c a t i o n , w h i c h I d i d . No one was e s p e c i a l l y u p s e t about s t o p p i n g t h e group."  In this  case t h e l i f e o f t h e group came t o an end i n an u n u s u a l way. The p o s i t i v e a s p e c t o f i t was t h a t t h e worker u n d e r s t o o d t h e need t o e x p l a i n t h i s t o each i n d i v i d u a l i n t h e group.  It is  d i f f i c u l t t o e s t i m a t e what t h e l o s s o f t h e group and o f t h e worker r e a l l y meant t o t h e members. ROLE o f t h e WORKER i n E3 The caseworker i n group E3 ( b l i n d c h i l d r e n ' s p a r e n t s )  - 76 s t a t e d h e r o v e r - a l l r o l e i n t h e group was v e r y a c t i v e .  The  worker was f o r m e r l y a t e a c h e r and t h i s h e l p e d t o i n f l u e n c e t h e d i d a c t i c r o l e t h a t was assumed.  She s t a t e d :  " I wanted t o g i v e  them f a c t u a l i n f o r m a t i o n so they c o u l d d i s c u s s t h e problem o f blindness r a t i o n a l l y . " was c e n t e r e d  The emphasis o f t h e worker's a c t i v i t y  on i m p a r t i n g knowledge.  The i n f o r m a t i o n t h a t she  o f f e r e d was t h e r e s u l t o f seven y e a r s e x p e r i e n c e  of working  w i t h b l i n d c h i l d r e n and was o b v i o u s l y v e r y knowledgeable on t h e subject. The  group d i s c u s s i o n was t h e p r i m a r y t o o l t h e worker used  i n t r a n s m i t t i n g her i n f o r m a t i o n .  F i l m s were used t o supplement  t h e d i s c u s s i o n on s e v e r a l o c c a s i o n s .  These h e l p e d t h e members  f o c u s more c l e a r l y on v a r i o u s i s s u e s t h a t were i m p o r t a n t f o r them t o u n d e r s t a n d . gard.  Books a l s o h e l p e d t h e worker i n t h i s r e -  Pamphlets, t e x t s and v a r i o u s w r i t t e n l e c t u r e s were made  a v a i l a b l e t o members, who f e l t t h a t i n f o r m a t i o n would h e l p them w i t h t h e i r p a r t i c u l a r problem. o t h e r a g e n c i e s were a r r a n g e d  Where a p p r o p r i a t e , o u t i n g s t o  t o h e l p t h e members d e v e l o p a more  complete p i c t u r e o f t h e f a c i l i t i e s a t t h e i r d i s p o s a l .  I n each  case t h e e d u c a t i o n a l v a l u e o f t h e s u p p l e m e n t i n g media were clearly  evident. The  development o f r e l a t i o n s h i p and group bonds•among t h e  members was an i m p o r t a n t  aspect  o f t h e caseworker's a c t i v i t y .  T h i s was seen as a method o f showing t h e members t h a t t h e y belonged t o something w o r t h w h i l e .  The caseworker had been i n  c o n t a c t w i t h many o f t h e group p a r t i c i p a n t s o v e r s e v e r a l y e a r s and had an i n t i m a t e r e l a t i o n s h i p w i t h them.  This f e e l i n g of  - 77 -  i n t i m a c y was encouraged between t h e members and c o n s c i o u s l y f o s t e r e d by t h e s o c i a l w o r k e r .  She s a i d :  "The p s y c h i a t r i s t  who s t a r t e d t h i s group t h i r t e e n y e a r s ago thought t h e members would h e l p s u p p o r t each o t h e r . long.  We want them t o f e e l t h e y be-  A l l o f us show a mother she i s n ' t a l o n e w i t h h e r l o a d .  We a l l can h e l p h e r . "  The p r i m a r y f o c u s o f t h e workers,.-role  i n t h e group was e d u c a t i o n a l i n t e a c h i n g t h e mothers how t o d e a l w i t h problems e x p r e s s e d by t h e i r b l i n d c h i l d r e n .  Treat-  ment however was o f major concern and c o n s c i o u s l y d e v e l o p e d by the w o r k e r . A development o c c u r s i n t h e group meeting w h i c h changes the o v e r - a l l r o l e o f t h e s o c i a l worker f r o m group l e a d e r t o caseworker.  The i n t e n s i v e p a r t o f t h e group d i s c u s s i o n o c c u r e d  b e f o r e t e a was s e r v e d , two t h i r d s o f t h e way t h r o u g h t h e meeting.  A t t h i s p o i n t t h e members broke up i n t o s m a l l i n f o r m a l  groups.  The caseworker c i r c u l a t e d t h r o u g h t h e s e groups and  t a l k e d t o members on a one-to-one b a s i s .  She s t a t e d :  "We  d i s c u s s v e r y e a r n e s t l y and v e r y o r g a n i z e d u n t i l t e a and t h e n t h e y chat u n t i l t h e c h i l d r e n come.  I work my way around t h e  groups w h i c h g i v e s me a good chance t o d i s c u s s problems i n d i v i d ually."  Treatment on an i n f o r m a l casework b a s i s was s u p p l e -  mented by group e d u c a t i o n f o r h e l p i n g t h e c l i e n t . I n d e s c r i b i n g her o v e r - a l l r o l e i n t h e group t h e c a s e worker s t a t e d : " I may r e a d an a r t i c l e t o t h e group on b l i n d c h i l d r e n . I a c t as d i s c u s s i o n l e a d e r and t h e  - 7a members r e s p o n d by f o l l o w i n g t h e discussion leader. I t r y to discuss something t h a t i s p e r t i n e n t t o a new member... I t r y t o make them c o m f o r t a b l e and t h e worker b r i n g s p e o p l e who a r e a l o n e i n t o t h e group." I t has been shown t h a t t h e s o c i a l worker i n e d u c a t i o n a l groups i s expected t o i n i t i a t e t h e d i s c u s s i o n and t h a t t h i s may be a c c o m p l i s h e d by a s h o r t i n t r o d u c t i o n o f t h e s u b j e c t s caseworker i n group E3 c a r e f u l l y chose, t h e t o p i c . of s u b j e c t was g u i d e d b y t h e p e r s o n a l problems b e i n g by members i n the group.  F o r example:  The  The c h o i c e experienced  "One member was having  d i f f i c u l t y w i t h h e r b l i n d baby c o n f u s i n g day and n i g h t .  By  d i s c u s s i n g t h i s w i t h t h e group t h e o t h e r mothers t o l d h e r how t o handle t h i s . "  The worker began t h e meeting by r e a d i n g a  s h o r t a r t i c l e t h a t was a p p r o p r i a t e t o t h e p r o b l e m .  This  a l l o w e d t h e o t h e r members t o f o c u s upon t h e s u b j e c t and t o b e g i n f r o m a common frame o f r e f e r e n c e . t h i s same g e n e r a l p a t t e r n was u s e d .  I n t h e m i d d l e meeting  The worker read an a r t i c l e  on t o i l e t t r a i n i n g c h i l d r e n and r e l a t e d t h i s t o t h e c o m p l i c a tion involved with blind children;  I t was n o t u n r e a s o n a b l e  t o assume t h a t t h i s was a s u b j e c t o f concern t o a l l t h e members. The worker was a c t i v e as a l e a d e r i n g u i d i n g t h e d i s cussion.  When a new member e n t e r e d t h e group, t h e caseworker  would d i r e c t q u e s t i o n s t o t h e mother t o i n v o l v e h e r i n t h e discussion.  This technique  was a l s o used i n o b t a i n i n g i n f o r m -  a t i o n about a . p a r t i c u l a r t o p i c from any member. stated:  The worker  "With new members a t t h e b e g i n n i n g I asked them  q u e s t i o n s t o make sure they a r e i n v o l v e d .  W i t h p a r e n t s who  -  7  9  -  have something, i m p o r t a n t t o c o n t r i b u t e I may a s k a q u e s t i o n i f t h e y don't speak." I f an i n d i v i d u a l r a i s e d any i s s u e s t h a t needed t h e worker's c l a r i f i c a t i o n o r i n t e r p r e t a t i o n t h e caseworker would ask t h e group-as-a-whole t o c o n s i d e r t h e problem.  By a s k i n g q u e s t i o n s  about t h e t o p i c t h e many a s p e c t s o f t h e s u b j e c t were s t u d i e d . The w o r k e r s a i d :  " E v e n t u a l l y i f t h e members d i d n ' t  t h e t o p i c t h e n I would.  crystallize  U s u a l l y one member would see t h e l i g h t  and come up w i t h an answer t h a t was g e n e r a l l y a c c e p t a b l e . a l l t r i e d a t l e a s t t o agree upon t h e p r o s and cons."  We  The  development o f t h e d i s c u s s i o n was e v i d e n t i n t h i s r o l e , t h r o u g h the use of questions.  T h i s h e l p e d t h e caseworker m a i n t a i n  guidance o f t h e d i s c u s s i o n and ensured p a r t i c i p a t i o n . I n group E3 one mother demonstrated c o n s i d e r a b l e r e s i s t a n c e t o t h e group.  The r o l e t h e worker assumed i n t h i s case d i s p l a y s  q u a l i t i e s o f b o t h t h e casework and groupwork method. come t h i s r e s i s t a n c e t h e worker s a i d : v i s i t s on a s t r i c t l y casework b a s i s . she must a c c e p t t h e c h i l d ' s b l i n d n e s s .  To o v e r -  " I made s e v e r a l home I t r i e d t o show h e r t h a t I f she c o u l d a c c e p t  the group she c o u l d a c c e p t t h e h a n d i c a p . "  S i n c e t h e group was  d e s i g n e d t o educate t h e members about b l i n d c h i l d r e n t h e i r a t t e n d a n c e a t t h e meetings would h e l p them b o t h u n d e r s t a n d and a c c e p t t h e problem.  When t h e member agreed t o come f o r one  s e s s i o n t h e worker a r r a n g e d t o p r o v i d e a r i d e t o t h e meeting i n an e f f o r t t o . s u p p o r t h e r .  The group made h e r v e r y welcome and  she was warmly i n t r o d u c e d t o t h e o t h e r members. stated:  The worker  " I t p r o v e d t o be a v e r y m e a n i n g f u l m e e t i n g .  Since t h i s  - $0 -  time she has been a. v e r y r e g u l a r a t t e n d e r . " t o h e l p t h e member accept a handicap f u l l y deal with i t .  The group was u s e d  and t o l e a r n how t o s u c c e s s -  T h i s was a c c o m p l i s h e d  t h r o u g h a warm  a c c e p t i n g group e x p e r i e n c e . T e r m i n a t i o n o f t h e group meetings occured when t h e b l i n d c h i l d r e n o f t h e p a r e n t s came i n t o t h e room.  The members were i n  s m a l l i n f o r m a l groups a t t h i s p o i n t and were e x p e c t i n g t h e children.  T h i s was i l l u s t r a t e d by t h e worker:  "The p a r e n t s  knew t h e t i m e o f s t o p p i n g and u s u a l l y a r r a n g e d f o r someone t o p i c k them up.  The u s u a l p a t t e r n was f o r t h e mothers t o w a i t  e x p e c t a n t l y f o r t h e c h i l d r e n t o come. e i g h t e e n c h i l d r e n demolished  When t h e y a r r i v e d , t h e  the place."  The i n h e r e n t  difficulty  o f t h e c h i l d r e n i n t e r r u p t i n g a d i s c u s s i o n o r summary was minimi z e d i n t h i s group.  The i n t e n s e group d i s c u s s i o n was completed  by t e a time as e x p l a i n e d e a r l i e r .  The l a t t e r p a r t o f t h e meet-  i n g was spent d i s c u s s i n g problems i n f o r m a l l y .  The worker d i d  not t r y t o summarize t h e content o f meetings.  S i n c e t h e meet-  i n g s were s e v e r a l weeks a p a r t t h e worker d i d n o t p l a n a program ahead o f t i m e . changed.  The t o p i c s developed  as t h e needs o f t h e members  One cannot h e l p b u t note t h e d i f f e r e n c e between t h e  c h i l d r e n a r r i v i n g i n E l as compared t o E3. The group i t s e l f has n o t been t e r m i n a t e d .  The members  a u t o m a t i c a l l y l e a v e t h e agency however when t h e i r c h i l d  reaches  s c h o o l age. T h i s p r o c e s s was seen by t h e s o c i a l worker as a g r a d u a t i o n and t h e members move i n t o another agency and group. The r o l e o f t h e worker i n a c h i e v i n g t h i s t r a n s i t i o n was v e r y active.  She accompanied t h e group members t o t h e new agency  and f o r m a l l y i n t r o d u c e d them.  I f any r e s i s t a n c e was  encounter-  - 81 -  ed t h e worker handled t h i s t h r o u g h casework i n t e r v i e w s . She stated:  "The t r a n s i t i o n i s s i m p l e .  They see p a r e n t s o f l a s t  y e a r and r e a l i z e they have some p l a c e t o go. I may have t o see some o f them i n d i v i d u a l l y . " understand  The worker h e l p e d t h e members  t h a t t h e i r c o n n e c t i o n t o the group was over by  c r e a t i n g a t r a n s i t i o n i n t o a new agency and group.  T h i s gave  the members something c o n c r e t e t o r e l y upon d u r i n g t h i s p e r i o d . ROLE o f t h e WORKER i n GROUP E4 The worker i n group E4 ( a d o p t i v e p a r e n t s ) attempted t o m a i n t a i n an e n t i r e l y e d u c a t i o n a l r o l e i n h e r work w i t h the group. She  stated:  " I t was d e c i d e d t h a t t h e d i s c u s s i o n s e r i e s would  have an e n t i r e l y e d u c a t i o n a l r a t h e r than t h e r a p e u t i c emphasis." The h e l p g i v e n t o t h e c l i e n t s was expected t o be most b e n e f i c i a l i f t h e worker c o n c e n t r a t e d on t e a c h i n g t h e p a r e n t s about t h e problem o f a d o p t i o n .  The caseworker had c o n s i d e r a b l e  experience  i n t h i s f i e l d and a c t i v e l y i n t e r p r e t e d h e r knowledge t o t h e group.  T h i s was a c c o m p l i s h e d  by s t r u c t u r i n g a s e r i e s o f meet-  i n g s each week around s p e c i f i c a s p e c t s o f t h e a d o p t i o n p r o b l e m . The members were encouraged t o d i s c u s s t h e s u b j e c t and t h e caseworker g u i d e d i n t e r p r e t e d and expanded on t h e m a t e r i a l p r e s e n t e d t o t h e group. As a r e s u l t o f t h e e d u c a t i o n a l f o c u s t h e r e was no attempt t o encourage t h e development o f r e l a t i o n s h i p between t h e members. The worker-member bond was kept v e r y f o r m a l . suggested  The agency had  t h a t c e r t a i n people would b e n e f i t f r o m an a d o p t i o n  group and these i n d i v i d u a l s were c o n t a c t e d by t e l e p h o n e .  The  -coworker s t a t e d : to  "We  t o l d them, t h e group was p r i m a r i l y s e t up  d i s c u s s problems around a d o p t i o n .  They were welcome t o come  i f they wished." E a r l i e r i t was n o t e d t h a t a s o c i a l worker s h o u l d h e l p a member t o f e e l as c o m f o r t a b l e as p o s s i b l e .  The worker i n group  E4, i n the i n i t i a l m e e t i n g , g r e e t e d each member a t t h e door. T h i s was d e s i g n e d t o c r e a t e a c l i m a t e i n w h i c h t h e group couldinteract freely.  The caseworker was v e r b a l i n t h e meetings and  was r e s p o n s i b l e f o r d e v e l o p i n g t h e d i s c u s s i o n i n such a way as to  i n c l u d e as many members as p o s s i b l e . S i n c e t h e meetings were so f o r m a l l y s t r u c t u r e d , t h e worker  did of  n o t a c c e p t any s u g g e s t i o n s from the members about t h e c o n t e n t the d i s c u s s i o n .  A w r i t t e n summary o f each s u b j e c t t o be  d i s c u s s e d by t h e group was g i v e n t o t h e members.  T h i s was an  e x c e l l e n t s o u r c e o f r e f e r e n c e as w e l l as a b a s i s from w h i c h t o begin.  The worker s t a t e d :  "Any s u g g e s t i o n s t o b r i n g i n e x t r a  s p e a k e r s or f i l m s was n o t t o l e r a t e d .  The s e r i e s was s e t up t o  d i s c u s s s p e c i f i c problems and changes would have meant e x t e n d i n g the  series."  The e d u c a t i o n a l f o c u s of t h e worker's a c t i v i t y  vividly illustrated i n this situation.  Her o v e r - a l l r o l e  was  was  d e s c r i b e d as f o l l o w s : "The worker g u i d e d t h e d i s c u s s i o n . . . I was t h e d i s c u s s i o n l e a d e r . . . F e e l i n g around i s s u e s were d i s cussed and many a n x i e t i e s were c l a r i f i e d . . . By a c t i v e l y p a r t i c i p a t i n g the group was h e l p e d to i n t e r a c t . " The a c t i v i t y of t h e i n i t i a l meeting was i n s t i g a t e d by t h e caseworker.  She s t a t e d , t h e purpose of t h e group by s a y i n g :  - 83 -  " T h i s i s a d i s c u s s i o n group, anyone e x p e c t i n g a l e c t u r e w i l l disappointed."  From t h i s b e g i n n i n g , t h e worker expanded on  comments by e x p l a i n i n g how  the s e r i e s was  s u b j e c t s t h a t would be d i s c u s s e d . any m i s c o n c e p t i o n s an u n d e r s t a n d i n g meetings.  s t r u c t u r e d and  This technique  be her  the  clarified  on the p a r t of the members.and gave t h e group of t h e i r p o s i t i o n and r o l e e x p e c t a t i o n i n t h e  '  I n the m i d d l e and f i n a l s e s s i o n s of the group t h e c u s s i o n was  dis-  s t a r t e d by the c a s e w o r k e r , p r e s e n t i n g a summary of t h e  previous meeting.  The  s e r i e s was  s t r u c t u r e d i n such a way  as  t o have each s u b j e c t d e v e l o p from the f o r m e r d i s c u s s i o n . F o l l o w i n g her summary the caseworker would l e a d i n t o ;the s u b j e c t t h a t was  t o be d i s c u s s e d a t t h e m e e t i n g .  T h i s gave t h e members  a chance t o r e c a l l the f o r m e r s e s s i o n s as w e l l as t o p r e p a r e f o r the p r e s e n t d i s c u s s i o n . The  a b i l i t y t o m a i n t a i n g u i d a n c e i n a d i s c u s s i o n has been  d e s c r i b e d and was n o t e d t o r e q u i r e c o n s i d e r a b l e s k i l l . techniques  The  of h a n d l i n g a d i s c u s s i o n were c l e a r l y i l l u s t r a t e d  the worker.  The f i r s t meeting was  opened by a c o n c i s e statement  of t h e group's purpose and t h e t o p i c t o be d i s c u s s e d was lined.  out-  When the worker attempted t o i n v o l v e the members how-  ever, she was said:  by  "Who  rephrased  met  with silence.  would l i k e t o s t a r t ?  To overcome t h i s the worker There was  the q u e s t i o n and s t i l l no r e p l y .  no r e p l y .  I  At t h i s p o i n t . I  threw out a h y p o t h e t i c a l q u e s t i o n and from t h e r e the d i s c u s s i o n was  away."  The use of r e p h r a s i n g i d e a s and a t t e m p t i n g  t o make  - 84 -  the  d i s c u s s i o n as u n d e r s t a n d a b l e as p o s s i b l e a r e a l l t e c h n i q u e s  used by a d i s c u s s i o n l e a d e r . The worker i n group E4 seems t o have used h e r s e l f appropr i a t e l y i n b r i n g i n g the meetings t o a c l o s e . m i d d l e s e s s i o n s she.summarized  I n the f i r s t  t h e d i s c u s s i o n v e r y c o n c i s e l y and  o u t l i n e d the t o p i c t o be c o n s i d e r e d t h e f o l l o w i n g week. was i l l u s t r a t e d by the s t a t e m e n t : by a summary.  "The  consent."  This  s e s s i o n was t e r m i n a t e d  I o u t l i n e d t h e d i s c u s s i o n n e x t week.  appeared t o agree by s i l e n t  and  The group  The worker d i d n o t appear  t o meet any r e s i s t a n c e i n c l o s i n g the meetings which i s not u n u s u a l f o r t h i s t y p e o f group.  The members d i d not become  e m o t i o n a l l y i n v o l v e d t o any e x t e n t and dependency upon t h e group was not encouraged.  T h i s f a c i l i t a t e d the c l o s i n g of t h e m e e t i n g .  The members were aware of t h e number of s e s s i o n s t h e group would be o p e r a t i n g and a c c e p t e d t e r m i n a t i o n o f t h e group from the beginning meeting. the  The worker s t a t e d :  group was t o end and a c c e p t e d i t .  itself  "They knew when  I d i d not n o t i c e any  r e s i s t a n c e a t a l l . " The d e f i n i t e s t r u c t u r e and t e r m i n a t i o n date was h e l p f u l i n ending t h e group.  The worker made use of t h e  l a s t session i n order to gather together the various ideas cussed and p r e s e n t e d them t o t h e group i n a c r y s t a l l i z e d  dis-  form.  The c o n s e c u t i v e n a t u r e o f t h e t o p i c s w h i c h were c o v e r e d by t h e group f a c i l i t a t e d such a summary.  T h i s i s i l l u s t r a t e d as f o l l o w s :  "By b r i n g i n g t o g e t h e r a l l t h e i d e a s , we hoped t o g i v e them a c l e a r and t o t a l p i c t u r e of what t h e y had been d i s c u s s i n g . "  The  worker a g a i n demonstrated a p p r o p r i a t e use o f s e l f i n t h e conc l u d i n g meeting of t h i s  e d u c a t i o n a l group.  SUMMARY OF GROUP EDUCATION The r o l e o f t h e worker i n e d u c a t i o n groups has been shown t o be a c t i v e i n t h e d i s s e m i n a t i o n o f knowledge.  Educating the  members i s t h e p r i m a r y f o c u s o f t h i s group and t h e use o f v i s u a l aids, books and other,media may be used t o f a c i l i t a t e t h i s p u r pose.  The members a r e encouraged t o e x p r e s s f e e l i n g s around  e m o t i o n a l l y charged s u b j e c t s and t h e worker i s e x p e c t e d t o encourage p a r t i c i p a t i o n .  S i n c e t h e aim o f t h e group i s educa-  t i o n t h e use o f r e l a t i o n s h i p and group i n t e r a c t i o n t o enhance t h e p e r s o n a l f u n c t i o n i n g o f i n d i v i d u a l members, w i l l be secondary.  T h i s p l a c e s t h e worker i n t h e c e n t r a l p o s i t i o n i n t h e  group. Group E l was i n c o n s i s t e n t w i t h t h e o t h e r t h r e e groups i n c o n s i d e r i n g t h e o v e r - a l l r o l e o f t h e worker.  The a n x i e t y o f t h e  worker combined w i t h a l a c k o f c l a r i t y about t h e r o l e t h a t was expected, r e s u l t e d i n p a s s i v i t y .  This l i m i t e d the f l o w of i n f o r -  m a t i o n t o t h e members and p r e v e n t e d t h e caseworker from h e l p i n g the group develop t h e d i s c u s s i o n .  This is.contrasted with the  o t h e r t h r e e workers i n t h i s c l a s s i f i c a t i o n who a l l participated  actively  i n t h e i n t e r a c t i o n s o f t h e members i n i m p a r t i n g  knowledge. The o v e r l a p p i n g o f t h e e d u c a t i o n a l and t h e t r e a t m e n t f o c u s of t h e caseworker's r o l e becomes e v i d e n t i n groups S2 and E3. I n t h e former group, t h e worker a c t i v e l y encouraged a r e l a t i o n s h i p between t h e members and problems o f t h e i n d i v i d u a l s were d i s c u s s e d i n t h e group i n an e f f o r t t o h e l p t h e members concerned.  - 86 -  I n group E3 however, an o r g a n i z e d group d i s c u s s i o n emphasizing the e d u c a t i o n a l r o l e o f t h e worker l a s t e d u n t i l t e a was s e r v e d . A t t h i s p o i n t t h e caseworker d i s c u s s e d problems i n d i v i d u a l l y w i t h t h e members on an i n f o r m a l one-to-one b a s i s . A l l f o u r caseworkers  i n the educational c l a s s i f i c a t i o n  were r e s p o n s i b l e f o r i n i t i a t i n g t h e d i s c u s s i o n . T h i s may have been a c c o m p l i s h e d  by a s h o r t statement  as e v i d e n c e d i n t h r e e o f  the groups o r by r e a d i n g an a r t i c l e p e r t i n e n t t o t h e needs o f the members.  The l a t t e r was t h e case i n group E3.  C o n s i d e r a b l e v a r i a t i o n was p r e s e n t i n a l l f o u r groups as t o t h e t e c h n i q u e used by t h e worker i n c o n t i n u i n g o r d e v e l o p i n g the s u b j e c t under d i s c u s s i o n . I n group E l t h e caseworker once the meeting was s t a r t e d , became p a s s i v e and r e l i e d upon t h e members to maintain the d e l i b e r a t i o n .  I n group E2 t h e worker a c t i v e l y  p a r t i c i p a t e d and h e l p e d t h e group develop t h e content o f t h e meeting.  T h i s was a l s o t r u e o f group E4 b u t t h e use o f f o r m a l  d i s c u s s i o n t e c h n i q u e s were more e v i d e n t i n t h i s worker's r o l e . A n o t h e r t e c h n i q u e was used by t h e worker i n E 3 .  This involved  the use o f q u e s t i o n s t o c o n s i d e r t h e v a r i o u s a s p e c t s o f t h e problem t h e members were d i s c u s s i n g .  The worker saw t h e i m p o r t -  ance o f c r y s t a l l i z i n g i d e a s w h i c h would be u s e f u l t o t h e members i n handling d a i l y problems. There were v a r i a t i o n s i n t h e ways i n w h i c h t h e meeting o f t h e f p u r groups were t e r m i n a t e d .  Group E l concluded  i n g t h e entrance o f t h e deaf c h i l d r e n i n t o t h e room.  follow-  When t h e  c h i l d r e n a r r i v e d , t h e meeting came t o an abrupt e n d i n g .  This  - 87 -  t y p e o f t e r m i n a t i o n was a l s o e v i d e n t i n group E3.  The d i f f e r -  ence, however, was t h a t t h e group had c o n c l u d e d its.; d e l i b e r a t i o n s and t h e members were g a t h e r e d i n s m a l l i n f o r m a l groups awaiting the a r r i v a l of the b l i n d c h i l d r e n . The t e r m i n a t i o n o f t h e meetings i n group E2 came about when t h e worker announced t h a t t i m e was up.  L i t t l e resistance  was n o t e d and t h e p r o c e s s was a c c o m p l i s h e d w i t h r e l a t i v e ease. T h i s was a l s o t r u e o f group E4. suggestion  of t h e worker t o end, and r e s i s t a n c e was n o t .evident  i n concluding The  The members a c c e p t e d t h e  these meetings.  study r e v e a l e d t h a t t h e t e r m i n a t i o n o f t h e l i f e o f  t h e s e f o u r groups and t h e r o l e o f t h e worker i n b r i n g i n g t h i s about took as many forms as t h e r e were g r o u p s .  E l abruptly  d i s b a n d e d f o l l o w i n g a f i n a l m e e t i n g w h i c h l a s t e d twenty m i n u t e s . The members had n o t been p r e p a r e d f o r t h i s t e r m i n a t i o n b u t t h e worker s t a t e d t h a t they a c c e p t e d i t w i t h o u t m a n i f e s t i n g any resistance. I n group E2 t h e members d i s b a n d e d f o l l o w i n g t h e h o l i d a y of t h e caseworker.  T h i s had n o t been planned and t h e t e r m i n a -  t i o n o f t h e group was n o t d i s c u s s e d d u r i n g t h e m e e t i n g s . caseworker however c o n t a c t e d this situation.  The  each member i n d i v i d u a l l y t o e x p l a i n  The worker i n group E4, on t h e o t h e r hand,  i n d i c a t e d c a r e f u l planning of t h i s process.  The f i n a l m e e t i n g  was used t o summarize t h e d i s c u s s i o n s e r i e s and t h e v a l u e s dserived from t h e meetings were f o c u s e d f o r t h e members.  - 88 -  Group E3 has n o t been t e r m i n a t e d .  I n d i v i d u a l members  a u t o m a t i c a l l y l e a v e t h e agency when t h e c h i l d r e n r e a c h age.  school  The caseworker f a c i l i t a t e d t h e t e r m i n a t i o n by i n t r o d u c i n g  t h e member concerned t o t h e new agency and group w i t h w h i c h he would be a s s o c i a t e d .  Any r e s i s t a n c e t o t h i s p r o c e s s was o v e r -  come t h r o u g h casework i n t e r v i e w s .  - 89 SOCIAL GROUP TREATMENT S o c i a l t r e a t m e n t groups a r e formed t o h e l p i n d i v i d u a l s a d j u s t more a d e q u a t e l y t o t h e c o n d i t i o n s i n w h i c h t h e y l i v e . The  s o c i a l environment  o f t h e member may range f r o m t h e g e n e r a l  community t o t h e c l o s e d doors o f a mental h o s p i t a l . ing  By c r e a t -  a p r o t e c t i n g and a c c e p t i n g group c l i m a t e , t h e members w i l l  b e g i n t o i n t e r a c t and e x p r e s s problems t h e y a r e f a c i n g i n e v e r y day l i f e s i t u a t i o n s .  Treatment  t h e r e f o r e i s t h e major  purpose  of t h e group and t h e a c t i v i t y o f t h e worker i s expected t o h e l p f a c i l i t a t e t h e i n t e r a c t i o n s o f t h e members i n a c h i e v i n g t h i s therapeutic focus. The worker w i l l be a c t i v e as t h e d i s c u s s i o n l e a d e r i n t h i s t y p e o f group.  The m a t e r i a l t h a t w i l l f o r m t h e c o n t e n t o f  each meeting w i l l be p r i m a r i l y d e r i v e d f r o m t h e l i f e e x p e r i e n c e s of t h e members.  T h i s a l l o w s t h e worker t o i n c r e a s e t h e aware-  ness o f t h e members i n d i s c u s s i n g i n d i v i d u a l problems and t o :  r e l a t e t h e s e d i f f i c u l t i e s back t o t h e group as a whole.  It  w i l l require c l e a r understanding of d i s c u s s i o n techniques i n e n c o u r a g i n g t h e members t o d i s c u s s t h e s e e m o t i o n a l l y charged issues without f e e l i n g threatened.  The a b i l i t y t o b e g i n t h e  d i s c u s s i o n on some m e a n i n g f u l t o p i c and t h e n t o e l a b o r a t e and d e v e l o p t h e s u b j e c t so i t i s u n d e r s t a n d a b l e and m e a n i n g f u l t o t h e members, r e q u i r e s c o n s i d e r a b l e s k i l l . The r e l a t i o n s h i p between t h e worker and t h e i n d i v i d u a l members, w i l l h e l p t o a c h i e v e t h i s t r e a t m e n t f o c u s .  The worker  c o n s c i o u s l y f o s t e r s c o h e s i v e group bonds and d e v e l o p s a purposef u l : r e l a t i o n s h i p w i t h t h e i n d i v i d u a l i n t h e group.  This w i l l  - 90 -  f a c i l i t a t e t h e e x p r e s s i o n o f p e r s o n a l f e e l i n g s and b u i l d s a sense o f s e c u r i t y f o r t h e members.  The r e l a t i o n s h i p bonds  of t h e members w i l l h e l p t o reduce t h e i r a n x i e t y around t h r e a t ening t o p i c s .  T h i s w i l l a i d i n t h e d i s c u s s i o n o f t h e problems  t h e members a r e f a c i n g . An e d u c a t i o n a l component o f a workers, r o l e i s e v i d e n t i n t r e a t m e n t groups.  The s o c i a l worker i n e n c o u r a g i n g t h e use o f  p e r s o n a l e x p e r i e n c e s h e l p s t h e i n d i v i d u a l s become more aware o f t h e i r problems.  T h i s i s a c c o m p l i s h e d by p o i n t i n g out s i m i l a r -  i t i e s and d i f f e r e n c e s i n t h e i r r e a c t i o n s t o those of other i n d i v i d u a l s i n t h e community.  S i n c e t h e group i s u s u a l l y  d e s i r o u s o f i n c r e a s i n g t h e i r s o c i a l achievement they a c c e p t i n f o r m a t i o n i n l e a r n i n g t o handle p e r s o n a l In  this  problems.  such a group t h e worker would be expected t o be v e r y  a c t i v e and i n t h e c e n t r e o f group i n t e r a c t i o n .  His a c t i v i t y  w i l l be c e n t e r e d on h e l p i n g i n d i v i d u a l members, c l a r i f y t h e i r f e e l i n g s and u n d e r s t a n d i n g , a b o u t s o c i a l environment. for  t h e i r r e l a t i o n s h i p t o the  K l e i n , summarizes t h e r o l e o f t h e worker  t h i s c l a s s i f i c a t i o n i n t h e f o l l o w i n g manner: "In t h e s e groups t h e l e a d e r uses m a t e r i a l f a s h i o n e d from t h e p e r s o n a l e x p e r i e n c e s of t h e members and encourages them t o e x p r e s s t h e i r f e e l i n g s " about t h e c o n t e n t . Through t h e c o n s c i o u s use o f h i m s e l f , he enables t h e members t o form p u r p o s e f u l r e l a t i o n s h i p s w i t h him and w i t h one a n o t h e r . By drawing a n a l o g i e s and p a r a l l e l s between t h e responses and i n t e r a c t i o n s o f t h e members, he h e l p s them a c h i e v e some s e l f - a w a r e n e s s . He s e t s l i m i t s and f o c u s e s t h e d i s c u s s i o n . " 1  1 K l e i n , J.G., A d u l t E d u c a t i o n and Treatment Groups i n S o c i a l A g e n c i e s . A D i s s e r t a t i o n . The C a t h o l i c U n i v e r s i t y o f A m e r i c a P r e s s . Wash., D.C., I960, p.87  -91 -  ROLE  o f WORKER i n GROUP T l I t w i l l be seen f r o m Chapter 2, t h a t t h r e e groups a r e  c a t a g o r i z e d as b e i n g t r e a t m e n t t y p e s .  Group T l ( a d o l e s c e n t s )  was formed t o h e l p t h e members a c c e p t t h e h o s p i t a l r o u t i n e more successfully. and guarded. secretive.  I n t h e f i r s t m e e t i n g t h e members were v e r y c a u t i o u s The worker s t a t e d :  "They were f r i g h t e n e d and  They d i d n o t know e x a c t l y why t h e y were t h e r e . "  In  an e f f o r t t o overcome t h i s r e a c t i o n t h e worker assumed a c e n t r a l p o s i t i o n i n the group.  She i n t e r p r e t e d t h e purpose o f t h e  group t o t h e members and encouraged them t o d i s c u s s t h e i r p e r s o n a l f e e l i n g s around t h i s  topic.  The development o f a r e l a t i o n s h i p was e v i d e n t f r o m t h e very outset.  By a c c e p t i n g t h e v e n t i l a t i o n o f f e e l i n g s t h a t  d e v e l o p e d i n t h e i n i t i a l s e s s i o n , t h e worker showed t h e members her  willingness to help.  out  t h e i r problems and two o f them brought o u t examples o f  punitive treatment.  She s t a t e d :  "Group members brought  Through a c c e p t a n c e and u n d e r s t a n d i n g I  showed t h e group my d e s i r e t o h e l p them." ing  T h i s b e g i n n i n g meet-  h e l p e d t o e s t a b l i s h a p o s i t i v e r e l a t i o n s h i p w h i c h was e v i d e n t  i n t h e l a t e r meetings o f t h e group. R e l a t i o n s h i p s between t h e worker and members, h e l p e d t h e group a c c e p t t h e l i m i t s imposed by t h e h o s p i t a l . i l l u s t r a t e d by t h e caseworker:  This i s  " I t r i e d t o e x p l a i n why t h e group  needed a p r o t e c t i v e environment and why l o c k e d doors were nece s s a r y on a ward.  I t was n e c e s s a r y t o show them t h a t punishment  and l i m i t s were n o t synonymous.  T h i s d i d n ' t go over i n t h e f i r s t  - 92 week." the  The concept o f u n d e r s t a n d i n g l i m i t s was a g a i n p r e s e n t i n  middle meeting.  Two o f t h e members had l e f t t h e h o s p i t a l  w i t h o u t p e r m i s s i o n and t h e worker i n t e r p r e t e d t h e reason why t h i s wasn't a l l o w e d .  The worker e x p l a i n e d t o a l l t h e members  t h a t she would t a k e measures t o ensure t h i s d i d n ' t happen a g a i n . The worker s t a t e d :  "A s h o r t time l a t e r a p a t i e n t was k i l l e d f  when he l e f t t h e h o s p i t a l w i t h o u t l e a v e .  A l l o f us agreed t h a t  I had been r i g h t i n s t o p p i n g t h e members."  The p o s i t i v e use o f  l i m i t s was p a r t o f t h e t r e a t m e n t r o l e o f t h e worker w h i c h was n e c e s s a r y i n h e r work w i t h a d o l e s c e n t p a t i e n t s .  I t h e l p e d them  see why r u l e s were n e c e s s a r y and how i t was u s e f u l f o r them as individuals. Due t o t h e age o f t h e p a t i e n t s i n T l and t h e i n t e n s i v e r e l a t i o n s h i p t h a t was f o s t e r e d by t h e c a s e w o r k e r , t r a n s f e r e n c e elements were e v i d e n t i n t h e group. to t h e worker as "Mom." the  She state;d:  Each a d o l e s c e n t r e f e r r e d "They used my p o s i t i o n i n  group t o d i s c u s s problems and seek a d v i c e .  would a r b i t r a t e i n arguments and f i g h t s . "  On o c c a s i o n I  T h i s i n d i c a t e d how  c o m p l e t e l y t h e members i d e n t i f i e d t h e worker a s a mother  image.  T r a n s f e r e n c e was n o t encouraged by t h e caseworker, a l t h o u g h she was w e l l aware o f t h e mechanism a t work i n t h e group. The worker used h e r r o l e t o a c t i v e l y i n t e r p r e t v a r i o u s b e h a v i o u r p a t t e r n s t o t h e members.  S i n c e t h i s group had  o r i g i n a l l y been a c o n s i d e r a b l e problem t o t h e s t a f f on t h e h o s p i t a l wards, t h e worker c o n c e n t r a t e d t h e d i s c u s s i o n s around these a c t i v i t i e s .  She s t a t e d :  "We d i s c u s s e d t h e i r s h o r t c o m i n g s  -  i n the h o s p i t a l .  93  -  V a r i o u s s u g g e s t i o n s f r o m t h e group have helped'  w i t h t h e i r b e h a v i o u r problems."  The worker used t h e s e e x p e r -  i e n c e s i n t h e group as a p o s i t i v e l e a r n i n g p r o c e s s . F o r example the  members complained about t h e l a c k o f adequate J r e c r e a t i o n .  To overcome t h i s t h e worker s t a t e d :  "The group was shown how  to approach t h e d i r e c t o r f o r h e l p r a t h e r t h a n j u s t c o m p l a i n i n g . They r e c e i v e d a few e x t r a p r i v i l e d g e s . "  The s o c i a l worker  a t t e m p t e d t o b r i d g e t h e gap between f r u s t r a t i o n and p o s i t i v e a c t i o n , t o i n c r e a s e t h e u n d e r s t a n d i n g i n t h e members. The o v e r - a l l r o l e o f t h e worker was summarized as f o l l o w s for  the interview: "The worker a c t e d as t h e d i s c u s s i o n l e a d e r and t o o k o v e r each m e e t i n g . . . I was v e r y f i r m and s e t l i m i t s on t h e a d o l e s c e n t b e h a v i o u r and e x p l a i n e d why t h i s was n e c e s s a r y . . . I always t r i e d t o l e t them see how t h e b e h a v i o u r here r e l a t e d t o t h e ward o r t h e community. T h i s needed i n t e r p r e t a t i o n and I s u p p o r t ed, y e t l i m i t e d t h e members." I t has been s t a t e d t h a t t h e worker i n t h e s o c i a l t r e a t m e n t  groups, i s e x p e c t e d t o be t h e d i s c u s s i o n l e a d e r and w i l l  structure  the  m e e t i n g around t h e p e r s o n a l problems o f t h e members.  Once,  the  i n t e r a c t i o n s have s t a r t e d and p e r s o n a l a t t i t u d e s become  e v i d e n t t h e worker w i l l use t h i s m a t e r i a l t o l e a d i n t o more r e v e a l i n g problems.  The d i f f e r e n c e i n a t r e a t m e n t group as  compared t o an e d u c a t i o n a l group, i s t h e i n d i v i d u a l  orienta-  t i o n and t h e c o n c e n t r a t i o n on u n d e r s t a n d i n g ;the p e r s o n a l problems of  t h e members.  - 94 -  The worker i n t h e f i r s t m e e t i n g o f T l met w i t h a veryr e s e r v e d , with-drawn group o f a d o l e s c e n t s . " I immediately  The worker s t a t e d :  took over and t r i e d t o f i n d o u t why t h e a d o l -  e s c e n t s thought they were h e r e .  I o u t l i n e d why t h e group was  n e c e s s a r y and what we hoped t o a c c o m p l i s h . "  This  clarification  o f agency and member purpose was v e r y i m p o r t a n t t o t h e g r o u p . I t h e l p e d c l a r i f y t h e group's f e e l i n g s and t h e members were a b l e to  express what they wanted f r o m t h e m e e t i n g s .  p a r t o f t h i s s e s s i o n t h e worker remarked:  During the f i r s t  " I don't know e v e r y -  t h i n g and I am n o t t o o f a m i l i a r w i t h groups."  Since the adoles-  cents were h a v i n g d i f f i c u l t i e s around a u t h o r i t y and l i m i t s , e x p l a n a t i o n was v e r y a c c e p t a b l e .  this  I t h e l p e d t h e members see t h e  caseworker as an i n d i v i d u a l and t o v e r b a l i z e t h e i r f e e l i n g s about the problems t h e y f a c e d i n t h e h o s p i t a l . By t h e m i d d l e meeting t h e members were i n t e r a c t i n g v e r y freely.  The d i s c u s s i o n s were i n t r o d u c e d by t h e caseworker  summarizing o f t h e p r e v i o u s m e e t i n g .  through*c  The caseworker would then  comment on a s u b j e c t p e r t i n e n t t o t h e i s s u e , under c o n s i d e r a t i o n ^ . T h i s was i l l u s t r a t e d as f o l l o w s . happened l a s t week.  "The worker summarized what  " O c c a s i o n a l l y I would g i v e them some  i n f o r m a t i o n w h i c h was d i s c u s s e d . " i n the f i n a l s e s s i o n of the group.  T h i s r o l e was a g a i n  evident  I n t h i s m e e t i n g however t h e  worker s t a r t e d t h e d i s c u s s i o n by o u t l i n i n g t h r e e a r e a s t h a t needed t o be c l a r i f i e d . to  I t was s t a t e d :  " I f i r s t o f a l l wanted  i n t e r p r e t the t r a n s f e r s of the patients w i t h i n the h o s p i t a l .  A l s o , C h r i s t m a s v a c a t i o n was c l o s e and many people were l e a v i n g  - 95 -  w h i l e others would s t a y .  T h i s needed i n t e r p r e t i n g .  For those  j p e o p l e r e t u r n i n g home, what t o e x p e c t f r o m f a m i l i e s was i m portant."  T h i s m a t e r i a l was v e r y m e a n i n g f u l t o t h e members  and t h e y a c t i v e l y c o n t r i b u t e d t o t h e d i s c u s s i o n . I n s t u d y i n g t h e r o l e o f t h e worker i t i s i m p o r t a n t t o i n v e s t i g a t e t h e ways i n w h i c h t h e change agent encouraged . member p a r t i c i p a t i o n i n t h e group.  I n t h e f i r s t meeting o f  group T l t h e worker encouraged t h e p a r t i c i p a t i o n o f t h e members t h r o u g h t h e use o f a c c e p t a n c e . f o l l o w i n g remarks:  T h i s was i l l u s t r a t e d by t h e  "The members responded t o t h e worker by  b r i n g i n g up t h e p e r s o n a l problems t h e y had on t h e ward."  The  worker a l l o w e d t h e s e a d o l e s c e n t s t o v e r b a l i z e t h e i r f r u s t r a t i o n s . The caseworker c o n t i n u e s :  "The r e s t o f t h e s e s s i o n was s p e n t  c l a r i f y i n g t h e m i s c o n c e p t i o n s . " The worker has used h e r s e l f t o c r e a t e a s i t u a t i o n where t h e members f e l t f r e e t o i n t e r a c t . T h i s f a c i l i t a t e d p a r t i c i p a t i o n i n t h e d i s c u s s i o n which was t h e aim o f t h e caseworker as d i s c u s s i o n l e a d e r . I n t h e m i d d l e and f i n a l meetings o f t h e group t h e members eagerly entered i n t o the d i s c u s s i o n s . the w o r k e r ' s s t a t e m e n t :  T h i s was i l l u s t r a t e d by  "They w a i t e d f o r me t o s t a r t i t b u t  t h e y were b u b b l i n g w i t h t h i n g s t o s a y . "  Due t o t h i s t y p e o f  r e a c t i o n , l i m i t s had t o be imposed upon t h e ' g r o u p .  O n l y one  p e r s o n a t a t i m e was a l l o w e d t o speak and t h e worker m a i n t a i n e d control.  Therefore f o c u s i n g t h e d i s c u s s i o n proved  difficult  s i n c e each member wanted t o b r i n g up a d i f f e r e n t p o i n t o f v i e w . The worker a t t e m p t e d t o d e v e l o p t h e d i s c u s s i o n b u t she s a i d :  - 96 -  " I t was v e r y d i f f i c u l t t o m a i n t a i n a f o r w a r d d i r e c t i o n . t o be s t r i c t o r we jumped a l l o v e r . "  Understanding  I had  of her r o l e  as d i s c u s s i o n l e a d e r was e v i d e n t b u t d i f f i c u l t y was e x p e r i e n c e d i n adequately m a i n t a i n i n g t h i s p o s i t i o n i n t h e group. An i n t e r e s t i n g and i m p o r t a n t a s p e c t o f group p r o c e s s i s i n t h e a r e a o f t e s t i n g t h e worker as t o l i m i t s .  T h i s was  i l l u s t r a t e d i n t h e members' r e q u e s t f o r a c e r t a i n boy t o be a l l o w e d t o j o i n t h e group.  I t was s t a t e d :  "The worker e x p l a i n -  ed t h a t t h i s t h i r t e e n y e a r o l d boy would not be a b l e t o f u n c t i o n i n t h e group.  I e x p l a i n e d t h i s s e v e r a l ways, t o no a v a i l . "  F i n a l l y t h e worker gave i n t o t h e p r e s s u r e o f t h e group and she i n v i t e d t h i s member, a l t h o u g h i t was a g a i n s t h e r b e t t e r judgement.  The boy a r r i v e d a t t h e f o l l o w i n g s e s s i o n and caused  a d i s t u r b a n c e t h a t t h e w o r k e r e j e c t e d him from t h e room.  such The  members a c c e p t e d t h i s a c t i o n a s i l l u s t r a t e d by t h e statement: "They asked why I had n o t done t h i s sooner."  They now seemed  t o u n d e r s t a n d t h e v a l i d i t y o f t h e o r i g i n a l l i m i t t h a t was s e t , but had u s e d t h i s as a means o f t e s t i n g t h e a u t h o r i t y o f t h e worker.  The p o s s i b l e harm done t o t h e t h i r t e e n y e a r o l d boy and  the image o f t h e worker i n t h e group c o u l d have been c o n s i d e r able. The i n d i v i d u a l r e a c t i o n s o f t h e members and t h e i r p e r s o n a l i n v o l v e m e n t i n t h e group was q u i t e e x t e n s i v e . any t r e a t m e n t group.  This i s true of  The p r o c e s s o f t e r m i n a t i n g a meeting t h e r e -  f o r e w i l l be d i f f i c u l t .  The members'come t o r e a l i z e what an  i m p o r t a n t r o l e t h e group p l a y s i n t h e i r l i v e s .  There a r e  - 97 -  m a n i f e s t a t i o n s o f dependency.  T h i s has come about t h r o u g h t h e  development o f i n d i v i d u a l and group bonds and p e r s o n a l i n v o l v e ment i n t h e group.  The c l o s i n g o f a meeting may be v e r y t h r e a t -  e n i n g as i t may be seen as a f o r m o f r e j e c t i o n , and t h i s i s o f t e n v i g o r o u s l y opposed by t h e g r o u p .  This r e a c t i o n w i l l tend to  become more predominant as t h e d i s c u s s i o n o f i n d i v i d u a l problems develops i n t e n s i t y .  The meetings may t h e r e f o r e become i n c r e a s -  i n g l y more d i f f i c u l t t o t e r m i n a t e w i t h t h e development o f cohesion i n the l a t e r meetings.  The s k i l l o f t h e s o c i a l worker  i n s u c c i n c t l y summarizing t h e t o p i c o f d i s c u s s i o n , r e l a t i n g t h i s t o t h e environment i n w h i c h t h e members f u n c t i o n , and h e l p i n g the of  group a c c e p t t h e c l o s i n g o f t h e m e e t i n g , w i l l a i d t h e p r o c e s s termination. In the i n i t i a l  meeting o f group T l t h e r e was c o n s i d e r a b l e  resistance to termination.  The meeting was a new and e n j o y a b l e  e x p e r i e n c e away f r o m t h e r o u t i n e o f t h e h o s p i t a l f o r t h e members. The worker d i d n o t attempt t o summarize the c o n t e n t o f t h i s s e s s i o n and t h e meeting c l o s e d when t h e t i m e was up. p l i s h t h i s t h e worker s a i d : the  To accom-  " I was r i g i d i n c l o s i n g t o h e l p  members keep a r o u t i n e . "  The caseworker f e l t t h a t t h i s  was a way o f h e l p i n g t h e i n d i v i d u a l s a c c e p t l i m i t s and r e s p o n s ibility.  The members asked i f t h e y c o u l d c o n t i n u e t h e s e s s i o n  beyond t h e hour b u t t h e worker m a i n t a i n e d t h e l i m i t In  l a t e r meetings t h e d i s c u s s i o n around t e r m i n a t i o n be-  came e x t e n s i v e .  The p a t i e n t s would b r i n g up v a r i o u s t o p i c s o f  d i s c u s s i o n a t t h e end o f t h e m e e t i n g . to  she had s e t .  summarize f o u n d d i f f i c u l t y ,  The caseworker i n t r y i n g  s i n c e t h e members would i n t e r r u p t  - 9a i n an e f f o r t t o p r o l o n g t h e s e s s i o n . the  worker said:  next meeting."  To handle t h e s e r e a c t i o n s  " I i n s i s t e d t h a t new t o p i c s be k e p t f o r t h e The worker was aware o f t h e r e s i s t a n c e t h e group  d i s p l a y e d and c a r e f u l l y e x p l a i n e d t h e l i m i t the  meeting.  she s e t i n c l o s i n g  G r u d g i n g l y t h e group would a c c e p t t h i s  situation  as i n e v i t a b l e and under t h e i n s i s t a n c e o f t h e worker t h e meeting concluded. T e r m i n a t i o n o f t h e group i t s e l f would be even more d i f f i c u l t than t e r m i n a t i n g t h e group meeting i n any t y p e o f t h e r a p y group.  The members have been encouraged t o i d e n t i t y w i t h t h e  group and c o n s i d e r a b l e e m o t i o n a l i n v e s t m e n t i s u s u a l l y p r e s e n t . T h i s has been d i s c u s s e d e a r l i e r .  The r o l e o f t h e worker i n t h i s  p r o c e s s w i l l be t o h e l p t h e members r e l i n q u i s h t h e i r on t h e group.  dependency  Over a p e r i o d o f s e v e r a l weeks t h e problem o f  t e r m i n a t i o n w i l l be t h e p o i n t o f d i s c u s s i o n and e m o t i o n a l f e e l i n g s around t h i s problem e x p r e s s e d .  The s o c i a l worker w i l l be  expected t o summarize t h e p r o g r e s s o f t h e group..:...- This i s n o t u n l i k e t h e s i t u a t i o n i n t h e e d u c a t i o n t y p e group d i s c u s s e d e a r l i e r i n t h i s paper.  The major d i f f e r e n c e i n t e r m i n a t i n g a  t r e a t m e n t group w i l l be t h e d i f f i c u l t y  experienced i n severing  i n d i v i d u a l a t t a c h m e n t s t o t h e group. I n t h e f i n a l meeting o f T l t h e members t e r m i n a t e d v e r y p a s s i v e l y as t h e y were unaware t h a t t h i s was t h e f i n a l  session.  The meeting was f o c u s e d on h e l p i n g t h e members p r e p a r e f o r t r a n s f e r s w i t h i n t h e h o s p i t a l as w e l l as v i s i t s Christmas.  t o t h e i r homes over  The e x c i t e m e n t o f t h e season, t h e i r home l e a v e s ,  and t h e two hour group s e s s i o n f a c i l i t a t e d  termination of t h i s  -99 meeting.  There was no p r e p a r a t i o n o f t h e i n d i v i d u a l s f o r t h e  d i s b a n d i n g o f t h e group.  Considering the emotional investment  of t h e members and t h e r o l e o f t h e worker i n f o s t e r i n g  relation-  s h i p w i t h them, as w e l l as between them, s u c h a b r u p t t e r m i n a t i o n may have s e r i o u s consequences f o r t h e members. ROLE o f WORKER i n GROUP T2 The worker i n group T2 ( c h r o n i c s c h i z o p h r e n i c s ) i n d i c a t e d -extreme a n x i e t y i n h i s f i r s t m e e t i n g w i t h t h e g r o u p .  He s t a t e d :  "My p e r s o n a l r e a c t i o n t o t h e group was one o f a n x i e t y and d i s comfort.  I smoked t o o much and was e x t r e m e l y n e r v o u s . "  The  caseworker i n d i c a t e s t h e e x t e n t o f h i s d i s c o m f o r t i n t h e f o l l o w ing  statement:  "The group s i t u a t i o n was s i m p l y overwhelming.  For  t h i s r e a s o n I t e r m i n a t e d t h e meeting a f t e r twenty m i n u t e s . "  T h i s was t h e caseworkers f i r s t e x p e r i e n c e i n t r e a t i n g  clients  t h r o u g h t h e use o f t h e group and i t p r o v e d v e r y t h r e a t e n i n g . The members had been i n s t r u c t e d t o r e p o r t t o t h e meeting room f o l l o w i n g a casework i n t e r v i e w .  When t h e p a t i e n t s a r r i v e d  t h e y q u i e t l y took s e a t s i n d i f f e r e n t p o s i t i o n s a l l oyer t h e room.  The caseworker d i d n o t attempt t o e x p l a i n t h e purpose  of t h e meeting o r a c t i v e l y i n t e r p r e t what t h e meeting was i n t e n d e d t o a c c o m p l i s h . I t was s t a t e d : the  rriedical s t a f f .  " T h i s had been done by  They knew t h e y were here t o d i s c u s s problems."  The caseworker by a v e r y s h o r t i n t r o d u c t i o n t r i e d t o i n i t i a t e the  i n t e r a c t i o n s o f t h e members.  F o l l o w i n g t h i s he s a t back  and w a i t e d f o r t h e members t o comment.  S i l e n c e r e s u l t e d and .  - 100  -  l a s t e d the e n t i r e l e n g t h of t h e meeting.  The t e n s i o n i n t h e  room was e v i d e n t f r o m t h e heavy b r e a t h i n g o f t h e c l i e n t s sat  s t a r i n g a t the f l o o r .  who  The a c t i v e r o l e t h a t i s e x p e c t e d o f  the s o c i a l worker i n i n i t i a t i n g and c o n t i n u i n g a d i s c u s s i o n i n treatment  groups, was n o t e v i d e n t .  to help the c l i e n t s p a r t i c i p a t e .  The caseworker d i d n o t t r y T h i s was c o m p l i c a t e d by t h e  f a c t t h a t t h e p a t i e n t s i n t h i s group were so withdrawn.  The  caseworkers p a s s i v e r o l e l i m i t e d t h e h e l p he c o u l d o f f e r t h e members i n l e a r n i n g how t o i n t e r a c t and i n v o l v i n g them i n t h e group. I n t e r a c t i o n s by t h e m i d d l e m e e t i n g were s t i l l v e r y ed and o n l y about h a l f o f t h e group was p a r t i c i p a t i n g .  limit-  The  members were s c a t t e r e d randomly around t h e room b u t t h e caseworker d i d not encourage them t o s i t a t t h e t a b l e p r o v i d e d f o r them.  The r e a s o n g i v e n f o r t h i s was:  t o e n t e r t h e group a t t h e i r own speed.  "The members were a l l o w e d There were not h u r r i e d . "  To overcome t h i s r e s i s t a n c e and t o f a c i l i t a t e t h e i n t e r a c t i o n s of t h e group, t h e worker began t a k i n g two members on an o u t i n g i n t o town each week. follows:  H i s reasons f o r t h i s were s t a t e d as  " I d i d t h i s t o p a r t l y r e d u c e my own a n x i e t y .  o u t i n g s h e l p e d g i v e t h e members something t o d i s c u s s . "  The This  was an approach t h a t a l l o w e d t h e caseworker t o meet w i t h t h e c l i e n t s i n t h e s m a l l e r more i n t i m a t e p a i r group s e t t i n g w h i c h was l e s s t h r e a t e n i n g t o t h e w o r k e r . I n t h e m i d d l e and f i n a l meetings of t h e group t h e r o l e o f the worker was more a c t i v e .  S i n c e t h e group was b e g i n n i n g t o  d i s c u s s v a r i o u s s u b j e c t s , t h e worker h e l p e d them e x p l o r e and  - 101 -  f o c u s t h e t o p i c s , as w e l l as i n t e r p r e t e d and c l a r i f i e d f o r the group.  issues  I t was n o t e d however,, t h a t u n l e s s t h e members  i n i t i a t e d t h e s u b j e c t o f t h e d i s c u s s i o n , t h e worker remained silent.  T h i s was a l s o t r u e i f t h e members stopped t a l k i n g .  The w o r k e r remained q u i e t l y w a i t i n g f o r t h e group t o resume t h e discussion.  I n s u c h a withdrawn group o f p e o p l e t h e a n x i e t y o f  s i t t i n g q u i e t l y i n a group was p r o b a b l y  very threatening.  The  caseworker d i d n o t a d e q u a t e l y u n d e r s t a n d t h a t h i s r o l e i n a t r e a t ment group was expected t o i n v o l v e a c t i v e p a r t i c i p a t i o n .  His  r e l i a n c e on t h i s group o f withdrawn c l i e n t s t o m a i n t a i n t h e d i s c u s s i o n , does n o t seem r e a l i s t i c . The o v e r - a l l r o l e o f t h e caseworker i n t h e group s e t t i n g was d e s c r i b e d as f o l l o w s : " I gave a s h o r t summary o f t h e p u r p o s e . . . I s a t back q u i e t l y t r y i n g n o t t o show my a n x i e t y . I n l a t e r meetings I was more comfortable... I i n t e r p r e t e d the reason the group was i n h o s p i t a l and t r i e d t o h e l p them d i s c u s s t h e i r f e e l i n g s . " A more d e t a i l e d p i c t u r e o f worker r o l e i n t h e f i r s t meeting o f t h e group emerges i n t h e f o l l o w i n g e x p l a n a t i o n : t r e a t m e n t team has recommended t h i s group f o r e v e n t u a l  "The  dis-  charge.  The group meetings w i l l be h e l d once weekly u n t i l you  leave."  T h i s i n t r o d u c t i o n c o u l d have been v e r y t h r e a t e n i n g t o  the members, s i n c e many o f them had been i n h o s p i t a l f o r f i v e years.  The thought o f r e t u r n i n g t o t h e community would have  been v e r y a n x i e t y p r o d u c i n g .  This could p a r t i a l l y e x p l a i n the  s i l e n t reaction that r e s u l t e d . The m i d d l e meeting was i n i t i a t e d by t h e worker  again  - 102 -  d i s c u s s i n g t h e e v e n t u a l i t y o f t h e members r e t u r n i n g t o t h e community. saying:  One i n d i v i d u a l responded t o t h i s opening remark b y  " I am r e a d y . "  the m e e t i n g .  He f e l l s i l e n t a g a i n f o r t h e r e s t o f  T h i s r e a c t i o n t o t h e workers opening l e a d i n d i c a t e d  t h a t t h e members were b e g i n n i n g t o i n t e r a c t . f e e l i n g however was s t i l l v e r y d e f e n s i v e  The e x p r e s s i o n  of  as e v i d e n c e d by t h e  s i l e n c e o f t h e p a t i e n t f o l l o w i n g h i s remark. The w o r k e r ^ p a s s i v e n o n - v e r b a l r e a c t i o n f o l l o w i n g h i s i n t r o d u c t i o n i n the i n i t i a l upon.  m e e t i n g , has a l r e a d y been  elaborated  I n t h e m i d d l e meeting t h e worker was more a c t i v e and  f o l l o w i n g the i n t r o d u c t i o n o f h i s t o p i c a t t e m p t e d t o i n v o l v e the group i n t h e d i s c u s s i o n . t o go home.  S e v e r a l members s a i d t h e y wanted  The worker then asked:  t h a t you a r e r e a d y f o r d i s c h a r g e ? " ment was u s u a l l y s i l e n c e .  "Can you prove t o t h e group The r e a c t i o n t o t h i s s t a t e -  The worker i n p o s i n g t h i s  i m p l i e d t h a t t h e member was n o t ready f o r d i s c h a r g e .  question To a s k t h e  i n d i v i d u a l t o prove h i s r e a d i n e s s  i n f r o n t of other p a t i e n t s ,  would l i k e l y be v e r y t h r e a t e n i n g .  The l o n g pauses throughout  t h i s s e s s i o n may be e x p l a i n e d , question  i n p a r t , by t h e t h r e a t e n i n g  posed by t h e w o r k e r .  S i n c e t h e members were so i n s e c u r e a c t , the problem of t e r m i n a t i o n  and r e l u c t a n t t o i n t e r -  d i d n o t loom l a r g e .  The group  did  n o t become e m o t i o n a l l y  i n v o l v e d u n t i l the f i n a l meeting.  The  e x t e n t o f i n v o l v e m e n t even a t t h i s p o i n t was l i m i t e d as  judged by t h e amount o f i n t e r a c t i o n t h a t was e x h i b i t e d . terminating was up.  t h e f i r s t m e e t i n g t h e worker s i m p l y  In  s t a t e d that time  The r e l i e f t h a t was e x p e r i e n c e d a t t h i s p o i n t was  - 103 -  i l l u s t r a t e d by t h e worker:  "The members s t o o d up l o o k i n g r e -  l i e v e d and s l o w l y f i l e d o u t .  Since schizophrenics r a r e l y  a n y t h i n g t h e y c e r t a i n l y showed no r e s i s t a n c e h e r e . " was a g a i n e v i d e n t i n t h e m i d d l e m e e t i n g o f t h e group.  resist  This reaction The  worker c a l l e d t h e meeting t o an end and t h e members w o r d l e s s l y f i l e d out o f t h e room.  The p a t h o l o g y o f t h e group seemed t o  i n t e r f e r e w i t h t h e development o f any c o h e s i v e bonds between the  members. Involvement o f t h e members and a g r o w i n g dependence  the  upon  group was i n d i c a t e d i n t h e f i n a l s e s s i o n f o r t h e w o r k e r .  The  caseworker was l e a v i n g t h e agency and t r a n s f e r r e d t h e group t o a n o t h e r member o f t h e s t a f f .  T h i s change had n o t been d i s c u s s e d  w i t h t h e group u n t i l t h e f i n a l s e s s i o n . the  r e a c t i o n as f o l l o w s :  were v e r y f e a r f u l . worker.  The worker d e s c r i b e d  "When I t o l d them I was l e a v i n g t h e y  They asked many q u e s t i o n s about t h e new  Comments such a s ; 'What do we do now?' were common."  The caseworker a t t e m p t e d t o i n t e r p r e t t h e r e a s o n f o r t h e change and reduce t h e a n x i e t y o f t h e members.  S i n c e t h e group  was so withdrawn and d e f e n s i v e , any changes would r e s u l t i n intense anxiety. the  The group may have been b e t t e r p r e p a r e d f o r  change o f worker i f i t had been d i s c u s s e d i n advance and i f  i t would have been p o s s i b l e t o i n t r o d u c e t h e new worker w h i l e the  o u t g o i n g one was s t i l l  present.  ROLE o f WORKER i n GROUP T3 T h i s caseworker worked w i t h a group o f p r e - d i s c h a r g e p a t i e n t s from a m e n t a l h o s p i t a l .  The group had been i n o p e r a t i o n  - 104 -  f o r two y e a r s under t h e g u i d a n c e o f t h e caseworker, and he was v e r y r e l a x e d and c a s u a l i n h i s approach t o t h e members. T h i s i n f o r m a l i t y o f t h e worker h e l p e d t h e members r e l a x and f e e l a t ease i n t h e group.  S i n c e t h i s was an open-ended  group, t h e membership was c o n s t a n t l y changing and i t was nece s s a r y t o e x p l a i n t h e purpose o f t h e meetings t o t h e new members. The worker's i n f o r m a l i t y was i l l u s t r a t e d i n t h e way t h i s was accomplished.  " I guess you a r e wondering what i n h e l l you w i l l  get out o f t h i s .  We d i s c u s s problems h e r e , y o u r problems."  The worker attempted t o show t h e group t h a t he was an i n d i v i d u a l , i n t e r e s t e d i n h e l p i n g them u n d e r s t a n d t h e i r p e r s o n a l  difficulties.  The warmth o f t h e group meetings a l l o w e d t h e worker t o be v e r y a b r u p t w i t h t h e members i n b r i n g i n g out p e r s o n a l problems. i s i l l u s t r a t e d by t h e statement:  This  " F e l l o w s let's n o t h e s i t a t e .  We a r e here t o d i s c u s s problems, l e t ' s g e t down t o i t . "  This  was o f t e n f o l l o w e d by a c h u c k l e f r o m t h e group and t h e i n t e n s i v e d i s c u s s i o n would b e g i n .  The worker a t t e m p t e d t o p u t t h e r e l a t i o n -  s h i p on a "man t o man" b a s i s . The worker s t r e s s e d importance upon t h e p a r t i c i p a t i o n o f t h e i n d i v i d u a l members i n each m e e t i n g .  One p e r s o n f o r example  had n o t been i n t e r a c t i n g so t h e caseworker a s k e d him t o r e a d a s h o r t a r t i c l e on m a t u r i t y , w h i c h was p e r t i n e n t t o t h e needs o f t h e group.  The member needed encouragement  to. undertake t h i s  t a s k b u t w i t h t h e s u p p o r t o f t h e members and worker t o g e t h e r , he p r e s e n t e d t h e t o p i c .  The caseworker s a i d :  but g o t a l o t out o f r e a d i n g t h i s a r t i c l e .  "He was nervous  They a l l welcomed  - 105 -  down-to-earth m a t t e r s and responded p o s i t i v e l y t o t h i s approach." T h i s t e c h n i q u e c o u l d a g a i n be t h r e a t e n i n g t o t h e i n d i v i d u a l concerned.  D i s c r e t i o n i s needed i n u s i n g t h i s method o f  o b t a i n i n g i n t e r a c t i o n and i t s a p p l i c a t i o n would depend upon t h e worker's e v a l u a t i o n o f t h e memberfe s t r e n g t h s . In  each m e e t i n g , t h e c e n t r a l f o c u s of t h e worker's r o l e  was t o h e l p t h e members see t h e r e c i p r o c a l r e l a t i o n s h i p between themselves and t h e community.  The weaknesses  and s t r e n g t h s t h e  members e x p r e s s e d were d i s c u s s e d i n r e g a r d s t o t h e i r l i v e s o u t side the i n s t i t u t i o n .  The h e l p i n g f o r c e s i n t h e community were  e x p l a i n e d and what t h e members may e x p e c t as w e l l a s c o n t r i b u t e to  t h e s e s e r v i c e s , were c e n t r a l themes i n t h e d i s c u s s i o n .  The  meetings brought out and c e n t e r e d on t h e r e a l i s t i c problems t h e y would f a c e i n r e t u r n i n g home. The o v e r - a l l r o l e o f t h e worker, as d e s c r i b e d i n t h e i n t e r • v i e w i s summarized  as f o l l o w s :  "The worker began t h e d i s c u s s i o n . . . on a r e a l i s t i c b a s i s t o g i v e them i n s i g h t i n t o h a n d l i n g l i f e s i t u a t i o n s and m a r i t a l problems... I f o c u s t h e group on s i m i l a r i t i e s between t h e group s i t u a t i o n and t h e community... I i n t e r p r e t ed t o t h e s e f e l l o w s t h e i r s t r e n g t h s and what t o watch out f o r . We a r e on a man t o man l e v e l and t h e member i s more like a friend." The caseworker i n group T3 i n i t i a t e d t h e d i s c u s s i o n as would be expected f r o m t h e d e s c r i p t i o n o f h i s a c t i v e r o l e . the  f i r s t meeting f o r any new members t h e caseworker s t a t e d :  "They a r e u s u a l l y t h i r s t y f o r r e a l i s t i c d i s c u s s i o n . r i g h t where t h e y need h e l p t h e most." to  In  I start  By e n c o u r a g i n g t h e group  d i s c u s s p e r s o n a l f e e l i n g s , t h e members began t o i n t e r a c t .  - 106 -  The  p r a c t i c a l l e v e l a t w h i c h t h e d i s c u s s i o n was c e n t e r e d , f a c -  i l i t a t e d t h e b e g i n n i n g i n v o l v e m e n t o f t h e members.  The o l d e r  p a r t i c i p a n t s were u s e f u l as a means o f h e l p i n g t h e new members u n d e r s t a n d t h e type o f problems t h a t were t o be d i s c u s s e d . o l d e r members i n i t i a l l y c a r r i e d t h e c o n v e r s a t i o n  The  u n t i l t h e new  i n d i v i d u a l s f e l t s e c u r e enough t o b e g i n communicating.  The  open-ended group was u s e f u l i n h e l p i n g t h e worker promote i n v o l v e ment and overcome t h e i n i t i a l  communication b a r r i e r .  The m i d d l e m e e t i n g was s t a r t e d by t h e worker one member t o r e a d an a r t i c l e . The  requesting  T h i s has a l r e a d y been  discussed.  use o f t h i s t y p e o f communication a i d i s more common i n  education groups.  I t was n o t e d however t h a t t h e m a t e r i a l was  r e l a t e d t o t r e a t m e n t i n t h a t t h e caseworker compared t h e s o c i a l f u n c t i o n i n g o f t h e members t o t h e a r t i c l e and p o i n t e d out s i m i l a r i t i e s and d i f f e r e n c e s . The  group was a c t i v e i n c o n t i n u i n g t h e d i s c u s s i o n once  i t was i n i t i a t e d by t h e w o r k e r . statement:  "Once away and t h e y were f i n e .  t o s t a t e a p o i n t o r two. necessary. The  T h i s was i l l u s t r a t e d by t h e  Generally  I would i n t e r r u p t  I o n l y i n t e r p r e t e d where  Asking the o c c a s i o n a l question  a l s o f o c u s e d them."  worker has s t a t e d t h a t t h e d i s c u s s i o n s were o r i e n t e d and  r e l a t e d t o problems i n t h e community.  S i n c e t h i s i s such an  i m p o r t a n t problem t o t h e members t h e y j o i n e d i n w i t h o u t culty.  diffi-  The use o f i n t e r p r e t a t i o n , c l a r i f i c a t i o n and f o c u s i n g  the d i s c u s s i o n a l l a i d e d i n t h e p r o c e s s o f d e l i b e r a t i o n .  This  - 107 -  f o c u s was p r e s e n t i n b o t h t h e i n i t i a l and m i d d l e meetings o f t h e group. Many of "the members i n t h i s p r e - r e l e a s e group had been very i l l .  T h i s r e s u l t e d i n t h e worker b e i n g f o r c e d t o handle  an I n d i v i d u a l r e a c t i o n w h i c h d e v e l o p e d from the f e a r of t h e member,: p r e p a r i n g t o l e a v e t h e h o s p i t a l . follows:  T h i s was d e s c r i b e d as  " I n h i s f i r s t meeting t h e member h i d b e h i n d a c u b i c l e  and d i d not come i n t o the room or s i t down.  Later i n h i s t h i r d  meeting t h e member moved i n t o t h e opening o f the room but d i d not  interact."  The worker a l l o w e d t h e p a t i e n t t o e n t e r t h e  group a t h i s own pace and r e a l i z e d how t h r e a t e n i n g t h e s i t u a t i o n was f o r him.  By the t h i r d meeting t h i s a c c e p t i n g r o l e of the  worker h e l p e d t h e member move i n t o a m a r g i n a l p o s i t i o n i n the group. The a d v i s a b i l i t y o f i n c l u d i n g such a withdrawn p e r s o n i n the c o m p o s i t i o n o f a d i s c u s s i o n group, d e s i g n e d t o p r e p a r e p a t i e n t s to  l i v e out i n t h e community,is q u e s t i o n a b l e but a g r e a t d e a l  more would have t o be known about t h i s p a t i e n t b e f o r e a d e f i n i t e statement c o u l d be g i v e n . S i n c e t h e i n t e r a c t i o n s of the members p l a y such an imp o r t a n t p a r t of any t r e a t m e n t group, how the meetings a r e ended w i l l be v e r y s i g n i f i c a n t t o t h e members. e a r l i e r i n the p a p e r .  T h i s was  discussed  I n T3, the i n t e r a c t i o n s of t h e group  t e r m i n a t e d f o l l o w i n g a knock on t h e door announcing t h a t i t was lunch time.  The caseworker d i d not attempt t o summarize t h e  d i s c u s s i o n i n the f i r s t meeting.  I t was s t a t e d :  members were p l e a s e d w i t h t h e m e e t i n g .  "The  new  They were l o o k i n g f o r w a r d  - 108 -  t o n e x t week."  There d i d n o t appear t o be any r e s i s t a n c e t o  t h i s p r o c e s s and a l l t h e members l e f t t h e meeting t o go t o l u n c h . T h i s seemed t o be t h e p a t t e r n o f t h e m i d d l e m e e t i n g .  The group  q u i e t l y l e f t t h e room and t h e r e was no attempt t o p r o l o n g t h e session.  S i n c e l u n c h f o l l o w e d t h e m e e t i n g , t h i s change o f  a c t i v i t i e s c o u l d w e l l have been a f a c t o r which c o n t r i b u t e d t o the ease w i t h which t h e meetings t e r m i n a t e d .  The abrupt ending  t o t h e i n t e r a c t i o n s however c o u l d have i n t e r r u p t e d any meaningf u l d i s c u s s i o n t h a t was i n p r o c e s s .  I t i s suggested t h a t t h i s  type o f t e r m i n a t i o n does n o t a l l o w t h e s o c i a l worker s u f f i c i e n t time, t o b r i n g the d i s c u s s i o n t o a h a l t or c l a r i f y e n i n g i s s u e s t h a t may have been i n p r o c e s s . important i n t h i s  any t h r e a t -  T i m i n g would be  situation.  In the f i n a l  s e s s i o n o f t h e group, f o r t h o s e members who  were l e a v i n g , t h e r e was c o n s i d e r a b l e group a t t a c h m e n t s .  The worker s t a t e d :  out o f t h e s e m e e t i n g s . t h e y were g r a d u a t i n g  reluctance t o sever the "They had g o t t e n a l o t  They were s o r r y t o go.  I indicated that  and t h e r e was no t u r n i n g back."  The worker  spent t h e l a s t m e e t i n g h e l p i n g t h e members u n d e r s t a n d t h e i r strengths end  and weaknesses i n r e t u r n i n g t o t h e community.  At the  o f t h e s e s s i o n , t h e s e members r e m a i n i n g i n h o s p i t a l wished  the o t h e r people f a r e w e l l . the d e p a r t i n g group:  The worker s t a y e d b e h i n d and s a i d t o  "You know where I am, i f you want me j u s t  c a l l and make an appointment."  S i n c e t h e members knew s e v e r a l  weeks ahead o f time t h a t t h e y were l e a v i n g , t h e i r r e s i s t a n c e t o t e r m i n a t i o n was m i n i m i z e d .  They had been p r e p a r e d f o r t h i s  break and t h e group was s p e c i f i c a l l y d e s i g n e d t o h e l p them make this  transition.  - 109 -  SUMMARY o f SOCIAL GROUP TREATMENT The s o c i a l t r e a t m e n t group i s used t o h e l p t h e members a d j u s t more a d e q u a t e l y t o t h e environment i n w h i c h t h e y f u n c t i o n . I t has been shown t h a t t o e f f e c t t h e s e changes t h e s o c i a l worker uses i n f o r m a t i o n f a s h i o n e d from t h e p e r s o n a l e x p e r i e n c e s o f t h e members.  To f a c i l i t a t e t h e f l o w o f d i s c u s s i o n i n t h e s e s e n s i t i v e  areas, t h e purposeful use of s e l f a i d s i n t h e establishment of relationship. the  The r a p p o r t t h a t d e v e l o p s between t h e members and  worker i s used t o overcome r e s i s t a n c e s and t o encourage t h e  members t o d i s c u s s f e e l i n g s about t h e c o n t e n t .  The worker  a t t e m p t s t o r e l a t e t h e b e h a v i o u r p a t t e r n o f t h e members i n t h e group t o o t h e r a r e a s o f l i v i n g ; i . e . t h e ward, t h e h o s p i t a l , the  community.  T h i s w i l l h e l p t o i n c r e a s e t h e awareness o f t h e  i n d i v i d u a l members and develop i n s i g h t i n t o t h e problems experienced i n t h e i r adjustment. The o v e r - a l l r o l e o f t h e worker i n two o f t h e t h r e e groups s t u d i e d i n t h i s c l a s s i f i c a t i o n appeared t o be a c t i v e i n h e l p i n g the  members u n d e r s t a n d t h e i r p r o b l e m s .  To a c c o m p l i s h t h i s t h e  worker was t h e d i s c u s s i o n l e a d e r and a c t i v e l y f o s t e r e d group bonds.  I n group T2 however, t h e caseworker p l a y e d a p a s s i v e  r o l e throughout t h e l i f e o f t h e group.  I t was n o t e d i n t h e  f i r s t meeting t h a t a p a r t f r o m a s h o r t opening s t a t e m e n t , t h e worker d i d n o t communicate a g a i n w i t h t h e members.  The s c h i z o -  p h r e n i c p a t i e n t s were e x t r e m e l y withdrawn and t h e e n t i r e group . remained s i l e n t i n t h e s e s s i o n .  The r o l e o f t h e worker became  more a c t i v e i n l a t e r s e s s i o n s b u t t h e members were expected t o  - 110 -  be r e s p o n s i b l e f o r i n i t i a t i n g and c a r r y i n g t h e d i s c u s s i o n . a c t i v e development  The  o f t h e t o p i c t h r o u g h t h e worker's s u p p o r t ,  q u e s t i o n s o r a t t e m p t s t o i n v o l v e t h e members was n o t e v i d e n t . A l l t h r e e workers i n t h e s o c i a l t r e a t m e n t groups attempted to i n i t i a t e the d i s c u s s i o n .  V a r i o u s t e c h n i q u e s were n o t e d how-  e v e r i n t h e approaches used by t h e w o r k e r s .  I n group T2, t h e  worker would make a s h o r t statement and t h e members were r e s p o n s i b l e t o d i s c u s s t h e s u b j e c t r a i s e d w i t h t h e minimum amount o f guidance o f f e r e d by t h e caseworker.  The d i s c u s s i o n i n group T l  on t h e o t h e r hand was i n i t i a t e d by a summary statement o f t h a t w h i c h was c o n s i d e r e d a t t h e p r e v i o u s meeting and i n c l u d e d t h e problem t h a t was t o be c o n s i d e r e d t h i s t i m e .  This active  approach was a l s o e v i d e n t i n T3 b u t t h e worker a l l o w e d t h e members t o b e g i n where t h e y f e l t i t n e c e s s a r y .  The caseworker's  a t t i t u d e encouraged t h e members t o p r e s e n t t h e i r problems f o r d i s c u s s i o n and, i n i t i a t i n g t h e i n t e r a c t i o n s . The case workers i n groups T l and T3 used s i m i l a r t e c h n i q u e s i n c o n t i n u i n g t h e d e l i b e r a t i o n s o f t h e group once t h e y were s t a r t e d .  These i n c l u d e d t h e use o f d i s c u s s i o n t e c h n i q u e s  i n f o c u s i n g , i n t e r p r e t i n g and d e v e l o p i n g t h e c o n t e n t o f t h e meeting.  The t e c h n i q u e used i n T2 was t o a l l o w t h e members t o  c a r r y t h e d i s c u s s i o n and where n e c e s s a r y , t h e caseworker would i n t e r p r e t or c l a r i f y i s s u e s .  I f t h e members stopped t a l k i n g  however, t h e worker would remain s i l e n t the  u n t i l i t was resumed by  group. I n a l l t h r e e groups t h e caseworker t e r m i n a t e d t h e m e e t i n g .  T h i s was a c c o m p l i s h e d t h r o u g h t h e use o f a summary i n group T l . C o n s i d e r a b l e r e s i s t a n c e t o t h i s p r o c e s s was n o t e d and t h e members  - I l l -  a t t e m p t e d t o p r o l o n g t h e s e s s i o n by b r i n g i n g up new t o p i c s f o r d i s c u s s i o n a t t h e end o f t h e m e e t i n g .  The worker was f i r m about  c l o s i n g and t h i s was done i n o r d e r t o h e l p t h e members l e a r n t o maintain a routine. the  I n t h e o t h e r two groups t h e worker brought  s e s s i o n t o an end and t h e members l e f t .  There was no  r e s i s t a n c e noted i n t h i s process. The worker i n group T2 was l e a v i n g t h e agency and t r a n s f e r r e d t h e members t o a new s t a f f member. not  The new l e a d e r was  i n t r o d u c e d t o t h e group by t h e o u t g o i n g worker and reonsider-  a b l e a n x i e t y was e x p r e s s e d around t h e change.  The members were  t h r e a t e n e d by t h i s t r a n s i t i o n o f l e a d e r s h i p and r e s i s t a n c e was very evident. the  The worker a t t e m p t e d t o reduce t h e a n x i e t y o f  members by i n t e r p r e t i n g why t h i s change was n e c e s s a r y . The t e r m i n a t i o n o f group T l o c c u r e d v e r y a b r u p t l y .  F o l l o w i n g t h e C h r i s t m a s break t h e group d i d n o t reconvene and the  members had n o t been p r e p a r e d f o r t e r m i n a t i o n i n any way.. In  t h e f i n a l s e s s i o n o f group T3 t h e members who were  l e a v i n g were g i v e n s p e c i a l a t t e n t i o n .  The m e e t i n g f o c u s e d on  t h e i r s t r e n g t h s and weaknesses i n making t h e t r a n s i t i o n back t o the  community.  A t t h e end o f t h e m e e t i n g t h e i n d i v i d u a l s who  were r e m a i n i n g i n t h e h o s p i t a l s a i d good-bye t o t h e o u t g o i n g members.  The worker d e s c r i b e d t h e s e s s i o n as a r e a l i t y  oriented  f a r e w e l l meeting. I t i s i n t e r e s t i n g t o note t h e d i f f e r e n c e s between t h e e d u c a t i o n t y p e group d i s c u s s e d i n t h e f i r s t  s e c t i o n and t h e groups  b e i n g d i s c u s s e d h e r e , when i t came t o t h e t e r m i n a t i o n o f t h e  - 112 -  meetings.  I n t h e f o r m e r t h e r e a p p e a r s t o be l i t t l e  resistance while  i n the l a t t e r  the very  member a n d member-member r e l a t i o n s h i p , which expresses  itself  o r no  i n t e n s i t y o f workercreates a  i n t h e need t o p r o l o n g  dependency  the sessions.  - 113  -  GROUP PSYCHOTHERAPY psychotherapy groups a r e designed t o help the members undergo p e r s o n a l i t y changes i n an e f f o r t t o i n c r e a s e t h e i r f u n c t i o n i n g and adjustment. gaining i n s i g h t i n t o personal adaptive  patterns  social  The treatment emphasis centers on problems, and t o r e s t r u c t u r e f a u l t y  of b e h a v i o u r .  T h i s i s accomplished through  the i n t e r a c t i o n o f t h e members i n a group s e t t i n g . Psychotherapy groups u s u a l l y pass through s e v e r a l The f i r s t  stages.  has been termed t h e " t h e r a p e u t i c honeymoon," i n which  the members r e l e g a t e tremendous p e r s o n a l  status to the t h e r a p i s t .  They b e l i e v e t h a t he i s a b l e t o s o l v e a l l t h e i r problems and the members a t t h i s p o i n t a r e very dependent on him. ever i s u s u a l l y p a s s i v e and any questions p i s t from the members a r e r e t u r n e d  His r o l e how-  directed to the thera-  t o t h e group.  Long s i l e n c e s  may be evident d u r i n g t h i s phase and t h e i n a c t i v e p a r t i c i p a t i o n of t h e t h e r a p i s t c r e a t e s a n x i e t y .  E v e n t u a l l y , the members be-  g i n t o i n t e r a c t between themselves, which marks t h e entrance o f the group i n t o t h e second stage o f t h e r a p y . Dependence on the group r a t h e r than t h e t h e r a p i s t develops. The members b e g i n t o p o i n t out v a r i o u s problems and symtoms t h a t they r e c o g n i z e d  i n each other,.. T h i s f u r t h e r i n c r e a s e s the a n x i e t y  of the members and t h i s second stage o f development becomes c h a r a c t e r i z e d by h o s t i l i t y and t h e f o r m a t i o n The  of sub-groups.  i n t e n s i t y of i n d i v i d u a l r e a c t i o n s develops as t h e emotional  involvement o f each member i n c r e a s e s . The t h i r d stage i n v o l v e s p a r t i c i p a t i o n by the t h e r a p i s t i n t h e d e l i b e r a t i o n s of t h e group.  He a c t i v e l y i n t e r p r e t s t h e  meaning of behaviour and begins t o move t h e members toward  - 114 -  termination.  S i n c e t h e p a r t i c i p a n t s a r e so e m o t i o n a l l y i n v o l v e d  and dependent on t h e group t h e y a c t i v e l y r e s i s t t h i s  process.  T e r m i n a t i o n i s t h e r e f o r e v e r y d i f f i c u l t i n t h e psychotherapy groups. The- p e r s o n a l e x p e r i e n c e s  o f t h e members a r e d i s c u s s e d i n  an e f f o r t t o d e l v e i n t o t h e deeper u n c o n s c i o u s behaviour.  motivations of  The use o f f r e e a s s o c i a t i o n i n t h e group c o n t e x t ,  i s used t o a c h i e v e t h i s p u r p o s e .  The members a r e a l l o w e d t o  b e g i n t h e d i s c u s s i o n on any t o p i c and t h e y develop t h i s s u b j e c t i n a d i r e c t i o n a p p r o p r i a t e t o t h e i r needs.  The u n c o n s c i o u s  needs  o f t h e member w i l l be r e v e a l e d i n t h e s e d e l i b e r a t i o n s . The t h e r a p i s t i n t h i s t y p e o f group w i l l a t an a p p r o p r i a t e time i n t e r p r e t t h e b e h a v i o u r p a t t e r n s o f t h e members.  I n areas  where r e s i s t a n c e s a r e e v i d e n t t h e t h e r a p i s t w i l l examine t h e s e barriers for possible psychological significance. a n a l y s i s i n t o t h e unconscious  T h i s type o f  m o t i v a t i o n s o f t h e group p l a c e s  the s o c i a l worker beyond t h e l i m i t s o f h i s p r o f e s s i o n a l d i s c i p l i n e * T h i s i s an a r e a o f knowledge f o r t h e p s y c h i a t r i s t o r t r a i n e d psychologist.  The s o c i a l worker i n t h i s t y p e o f s e t t i n g would  t h e r e f o r e a c t p r i m a r i l y as a secondary change agent i n t h e g r o u p , working  i n conjunction with the t h e r a p i s t . Many psychotherapy  groups attempt t o s i m u l a t e t h e f a m i l y  s e t t i n g and t h e r e f o r e employ b o t h a male and female t h e r a p i s t to a c t as p a r e n t f i g u r e s .  The i n t e r p r e t a t i o n and p s y c h o l o g i c a l  s i g n i f i c a n c e o f t h e s e mechanisms however would be l e f t f o r t h e p s y c h i a t r i s t t o communicate t o t h e group i f he f o u n d i t n e c e s s a r y .  - 115 -  The r o l e of the s o c i a l worker i n such a group i s secondary t o t h a t o f the t h e r a p i s t .  These elements a r e o u t l i n e d by  K l e i n i n d e s c r i b i n g the expected a c t i v i t y of s o c i a l worker i n psychotherapy groups.  She S t a t e s :  "In these groups the l e a d e r uses m a t e r i a l d e r i v e d from p e r s o n a l e x p e r i e n c e s o f t h e members, encourages c o n s i d e r a b l e v e n t i l a t i o n o f f e e l i n g and i s a c t i v e i n the e x p l o r a t i o n o f r e s i s t a n c e s and d e f e n s e s e x p e c i a l l y when these b l o c k group movement. He f o s t e r s i d e n t i f i c a t i o n w i t h h i m s e l f and p l a c e s emphasis on t r a n s f e r ence and counter t r a n s f e r e n c e elements. He a c t i v e l y promotes group i n t e r a c t i o n s , set few l i m i t s and f o c u s e s only i n a minimal way."2 The ROLE o f WORKER i n GROUP PI M i n d f u l of t h e a p p r o p r i a t e use o f s o c i a l workers i n t h i s type o f group,and w i t h the K l e i n d e f i n i t i o n o f the l e a d e r s it  role,  i s p o s s i b l e to t u r n t o an examination of the t h r e e groups  in this classification.  Group PI (adolescent p a t i e n t s ) was  formed t o help teen-age members w i t h problems i n s o c i a l a d j u s t ment.  There were two t h e r a p i s t s i n t h i s group.  The male was a  p s y c h i a t r i s t and the female was a s o c i a l worker. stated:  "We wanted t o c r e a t e a f a m i l y group.  The caseworker  Both the mother  and f a t h e r image was p r e s e n t i n the two t h e r a p i s t s . "  The  worker attempted to use her p o s i t i o n i n the group as a t r a n s f e r agent and f o s t e r e d the i d e n t i f i c a t i o n of h e r s e l f as a mother image.  T h i s was i l l u s t r a t e d as f o l l o w s :  "I would suggest t h a t  maybe we don't have f a m i l i e s , but we do have each o t h e r .  At  2 K l e i n , J.G., A d u l t E d u c a t i o n and Treatment Groups i n S o c i a l A g e n c i e s . A D i s s e r t a t i o n . The C a t h o l i c U n i v e r s i t y of America P r e s s . Wash. D.C., I960, p.90  - 116  one point they suggested t h i s new for  what t h e y had  -  f a m i l y would h e l p t o make up  lost."  To a c h i e v e i n t e r a c t i o n among the members, the worker i n i t i a l l y a c t i v e i n the group.  She f a c i l i t a t e d t h e f l o w of  d i s c u s s i o n by e n c o u r a g i n g t h e members t o communicate the experiences  familiarity.  I t was  "We  For  wanted t o g a i n t h e i r t r u s t  and  explained that i n d i v i d u a l experiences  the job and a t s c h o o l s h o u l d be d i s c u s s e d h e r e . " to  personal  and problems t h e y f a c e d i n t h e i r d a i l y l i v e s .  example, t h e worker s a i d :  was  This  on  helped  c r e a t e a common frame o f r e f e r e n c e from w h i c h t h e group i n t e r -  a c t i o n s c o u l d b e g i n more e a s i l y . B o t h t h e r a p i s t s attempted t o s t r u c t u r e the f i r s t meeting by u s i n g an agenda.  I t was  stated:  something t o hang on t o i n t h i s new of n e u t r a l i z i n g t h e i r f e a r . "  "We  wanted t o g i v e them  association.  I t was  a  The t h e r a p i s t , w i t h the h e l p  way of  the w o r k e r , a i d e d the group i n a p o i n t by p o i n t coverage of t h e l i s t e d d i s c u s s i o n t o p i c s , on the agenda. a p p r o a c h was  Implicit in this  the i n t e n t i o n of t h e t h e r a p i s t s t o h e l p the group  f e e l a t ease.  The use of f r e e a s s o c i a t i o n and the l o o s e  s t r u c t u r e d p s y c h o t h e r a p y s e t t i n g t h a t would be e x p e c t e d  unwas  not e v i d e n t i n t h i s m e e t i n g . I n the m i d d l e s e s s i o n the worker became., more p a s s i v e . The  t h e r a p i s t s a l l o w e d t h e group t o b e g i n d i s c u s s i o n on  t o p i c t h a t was role said: I was  important  " I was  t o them.  any  The w o r k e r i n d e s c r i b i n g h e r  q u i e t f o r the most p a r t and d i d not comment.  g e n e r a l l y p a s s i v e e x c e p t f o r the odd e x p l a n a t i o n t h a t  was  - 117  given."  -  The worker c o n f i n e d her statements  areas concerned  t o the group i n  w i t h s o c i a l f u n c t i o n i n g . I t was  i n t e r v i e w t h a t the t h e r a p i s t was the middle meeting.  noted i n the  more a c t i v e than the worker i n  The s o c i a l worker seemed t o be u s i n g her  p o s i t i o n i n the group to supplement the work of the p s y c h i a t r i s t . H o s t i l i t y becomes e v i d e n t i n the middle meeting and group d i r e c t s t h e i r anger a t the t h e r a p i s t s .  Following t h i s  outburst the members seemed t o draw more c l o s e l y t o g e t h e r the d i s c u s s i o n purposely circumvented was.!  the t h e r a p i s t s .  i l l u s t r a t e d i n the f o l l o w i n g statement:  "One  theme as though we  and  This  member d i r e c t -  ed her h o s t i l i t y a t the v a l u e of s i t t i n g t a l k i n g i n a group, w i t h people t a k i n g n o t e s .  the  silly  They continued along t h i s  were not t h e r e . "  Group bonds were evident  at t h i s p o i n t and the f r u s t r a t i o n of t h e members w i t h the p a s s i v e r o l e of t h e t h e r a p i s t s were vented i n t h e i r remarks.  The attempt  hostile  t o i g n o r e the t h e r a p i s t s a t t h i s p o i n t ,  seem t o be a f u r t h e r i n d i c a t i o n of the group's h o s t i l i t y . The r o l e of the caseworker and the p s y c h i a t r i s t became more a c t i v e as the group approached t e r m i n a t i o n . the worker was  The focus of  aimed a t h e l p i n g the group accept t h i s  process  by m a i n t a i n i n g a p o s i t i o n t h a t c o n s t a n t l y r e i n f o r c e d t h i s The worker s t a t e d :  "I accepted t h e i r anger d i r e c t e d at myself  as the mother i n the group. understand accept i t . "  fact.  t h a t the group was T h i s was  I attempted  t o help the members  t e r m i n a t i n g and t h a t they had t o  a v e r y d i f f i c u l t p e r i o d f o r the  two  t h e r a p i s t s and t h e y assumed the a c t i v e r o l e which i s expected i n  - 118 -  terminating a psychotherapy The  caseworker's  the f o l l o w i n g  group.  r o l e was d e s c r i b e d i n t h e i n t e r v i e w i n  manner:  - "We were v e r y v e r b a l i n t h e f i r s t s e s s i o n . . . We e x p l a i n e d t h a t i n d i v i d u a l e x p e r i e n c e s a n d g r o u p e x p e r i e n c e s on t h e j o b a n d a t s c h o o l s h o u l d be d i s c u s s e d h e r e . . . I n t h e m i d d l e m e e t i n g we were q u i t e p a s s i v e b u t where n e c e s s a r y we f o c u s e d t h e d i s c u s s i o n . . . We d i d o c c a s i o n a l l y s u p p o r t them a r o u n d m a k i n g t h e b r i d g e between f a n t a s y a n d reality... I n t h e f i n a l m e e t i n g we were a g a i n a c t i v e and k e p t t h e f o c u s on t h e t e r m i n a t i o n no m a t t e r what t h e d i s c u s s i o n . . . " (a)'  I N I T I A T I N G THE A C T I V I T Y In  psychotherapy  ible f o rinitiating open t h e m e e t i n g cern, cult  areas.'  T h i s a l l o w s the group t o  areas that  a r e c a u s i n g them  the f i r s t  them i n l a t e r  speaking. later  o r caseworker  tries  diffi-  not t o i n t e r f e r e  s e s s i o n o f group P I t h e t h e r a p i s t s  the discussion through  was u s e d  discussion,  to orient sessions.  t h e u s e o f an a g e n d a .  the c l i e n t s  t o what w o u l d be  many o f t h e members w o u l d a s k i f t h e y The w o r k e r r e p l i e d :  will  "We  This type that  them.  easily  t h e use o f t h e agenda.  expected under continue  are here mainly t o observe  n o t be p a r t i c i p a t i n g . "  The d i s c u s s i o n d e v e l o p e d  should  activeThe  F o r example, when a p o i n t was  t h e members r e a l i z e - t h e r e s p o n s i b i l i t y  by  con-  process.  initiated  meeting  and  on a n y p r o b l e m  The t h e r a p i s t  During  of  the discussion.  respons-  o r b y t h e u s e o f f r e e a s s o c i a t i o n t o move i n t o t h e s e  with this  ly  g r o u p s t h e members a r e p r i m a r i l y  fairly  o f remark  helped  was e x p e c t e d o f a n d was  facilitated  - 119 -  In the middle meeting t h e d i s c u s s i o n was i n i t i a t e d by a member who s t a t e d t h a t by devious means he had d i s c o v e r e d h i s medical d i a g n o s i s .  The worker s t a t e d :  the group p i c k e d up on the t o p i c . "  " T h i s was f a n t a s y but  Anger was expressed a t the  t h e r a p i s t s f o r a l l o w i n g t h i s t o happen.  I t would seem t h a t  this  s u b j e c t f u l f i l l e d the need of the group t o v e n t i l a t e t h e i r f r u s t r a t i o n s a t t h e two t h e r a p i s t s . however and i t was s t a t e d : not  comment.  They.; were met by s i l e n c e  "We accepted t h e i r anger but d i d  We both remained s i l e n t . "  T h i s allowed the group  to develop the s u b j e c t without d i r e c t i o n or guidance from t h e two  therapists. In t h e f i n a l meeting, t h e t h e r a p i s t s were again a c t i v e i n  i n i t i a t i n g t h e s u b j e c t which was focused accept t e r m i n a t i o n .  on having the members  S i n c e t h e group was a c t i v e l y r e s i s t i n g i t  was necessary f o r the t h e r a p i s t s t o guide and develop the meeting i n considering t h i s t o p i c . (b)  CONTINUING THE DISCUSSION The  d i s c u s s i o n t e c h n i q u e s which p l a y e d  p a r t of t h e workers r o l e i n education  such an important  and s o c i a l treatment groups,  have only a l i m i t e d use i n psychotherapy groups.  The r o l e of the  s o c i a l worker i n r e l a t i o n t o the d i s c u s s i o n s o f the group w i l l mainly be concerned w i t h c l a r i f y i n g and i n t e r p r e t i n g i n f o r m a t i o n to the members.  The t e c h n i q u e s f o r i n v o l v i n g i n d i v i d u a l s i n the  d i s c u s s i o n w i l l not be a p p l i c a b l e s i n c e t h i s r e s p o n s i b i l i t y l i e s ' w i t h t h e members. In t h e f i r s t meeting o f group PI the caseworker and t h e r a p i s t  - 120 -  were r e s p o n s i b l e f o r developing  and g u i d i n g the d i s c u s s i o n .  The  caseworker was p a r t i c u l a r i l y a c t i v e i n h e l p i n g the members v e r b a l i z e t h e i r f e e l i n g s around t h e t o p i c s on t h e agenda. i n d i c a t e d t h i s i n her statement: on t h e agenda. members.  "We both o u t l i n e d t h e t o p i c s  I t was more a p p r o p r i a t e  f o r me t o i n v o l v e t h e  The p s y c h i a t r i s t would be handling  l a t e r on."  She  the deeper m a t e r i a l  The s o c i a l worker i n t h i s s i t u a t i o n , i n d i c a t e d t h a t  the r o l e o f c o - t h e r a p i s t was c l e a r l y understood i n working with the p s y c h i a t r i s t . In the middle meeting o f the group, the therapy f o c u s very  clear.  The s e s s i o n was opened by t h e group d i s p l a y i n g  h o s t i l i t y to the t h e r a p i s t s . istic  anger was very  The worker s t a t e d :  significant.  "This  unreal-  The group was d i s c u s s i n g t h e i r  r e a c t i o n t o the b e g i n n i n g o f the meeting. fantasy  was  The emphasis on  i n d i c a t e s the need of t h i s defense f o r them."  By a l l o w -  i n g the member to develop the s u b j e c t they i n i t i a t e d , the t h e r a p i s t and caseworker recognized  an important need f o r the  group as a whole. In t h e f i n a l meeting o f t h e group the t h e r a p i s t and caseworker again became a c t i v e i n developing  the d i s c u s s i o n .  f o c a l p o i n t d u r i n g the l a s t t h r e e weeks o f the group was on t e r m i n a t i o n . as f o l l o w s :  The worker s t a t e d her r o l e i n t h e s e  The centered  sessions  " I helped the t h e r a p i s t keep t h e i d e a o f termina-  t i o n before t h e group."  T h i s process was a c t i v e l y r e s i s t e d .  The members p r e f e r r e d not t o d i s c u s s the problem and avoided i t wherever p o s s i b l e .  The two t h e r a p i s t s however helped t h e group  - 121 .-  a c c e p t t h e i d e a by r e l a t i n g  any problem under  discussion to this  eventuality. In  group  P I an i n t e r e s t i n g  One member i d e n t i f i e d meeting. said:  "They o p e n l y r i d i c u l e d  w o r k e r d i d n o t comment group  of purpose.  reaction the  s h e was t h e w o r k e r ' s  i n this  developed.  i n the middle caseworker  t h e member a n d t h r o u g h  facial  favorite."  The  s i t u a t i o n but the t h e r a p i s t  what was s p e c i f i c a l l y  statement thoughts  that  reaction  o f t h e group  I n d e s c r i b i n g t h e group's  expressions indicated  the  the purpose  scape-goat  annoying about  T h i s h e l p e d t h e group  asked  t h e member's  clarify  their  and d e v e l o p awareness o f t h e r e a s o n s f o r t h e i r  annoy-  ance .  (c)  TERMINATION The  individual reactions  t o t h e group  as t h e t r e a t m e n t p r o c e s s b e g i n s t o a f f e c t group  form  The  meeting  i s very evident.  i s very great, This  i s true of  o f P I was ended by t h e c a s e w o r k e r  the content of t h e d i s c u s s i o n .  summed up t h e m e e t i n g .  to f e e l  reaction  resisted.  Cohesive  meeting. initial  summarizing generally  o f t h e members  of termination i s adtively  ending each  while  t h e members.  bonds d e v e l o p a n d d e p e n d e n c e upon t h e g r o u p  Since the emotional involvement any  become more i n t e n s e  relaxed.  The g r o u p  "We  I suggested i t would take a left  to termination of the f i r s t  T h i s was p a r t l y due t o t h e u n f a m i l i a r any p e r s o n a l i n v o l v e m e n t  She s t a t e d :  without  meeting  comment."  was s i l e n t  The consent.  s e t t i n g and t h e l a c k o f  i n t h e meeting.  - 122 -  In the  m i d d l e m e e t i n g however t h e  able  r e s i s t a n c e t o ending the  "The  t h e r a p i s t ended the  members p r o l o n g e d t h e When t h e  two  this  members o u t  session  session  chatting point  of the  was  room v e r y  the  ending of the  This  process i s very  usually  view the  ing  to mental h e a l t h .  personal  opportunity  problems.  The  therapist personal  The  implied  members i n g r o u p P I , The  Another t r i e d that  he  word i n . "  r o l e of  to  the  the  This  firm,  members a c c e p t  as  i s even more  i n d i v i d u a l meetings. group.  The  members  group a s s o c i a t i o n  and  their  return-  resource  in  g r o u p , means e n d a n g e r i n g  of the  anxieties  severed  and  slowly  factors involved  by  in  Termination i s u s u a l l y members p r e p a r e  their  the  their  discussed  emotionally  for  group.  t i m e b-f t e r m i n a t i o n . anxiety.  last  group i t s e l f  d e p e n d e n c y attachment's a r e  ending of the  Two  " I herded, t h e  of freedom from n e u r o t i c  the  up.  pleasantly."  to the  Ending the  o v e r s e v e r a l weeks, t o h e l p this  the  sessions  behaviour adaptations.  stated:  easily.  threatening  through explanations  consider-  group tended  The  follows:  ending of the  psychotherapy  the  the  groups.  have become d e p e n d e n t upon t h e  may  caseworker t i m e was  leave,  seemed t o h e l p  problem of t e r m i n a t i n g of the  saying  f i r m l y but  m e e t i n g more  than that  The  t r y i n g to get  s t a t e d as  understanding approach,  difficult  by  i n smaller  yet  The  by  t h e r a p i s t s prepared to  remain together worker at  session.  group i n d i c a t e d  indicated intense  worker s t a t e s :  t o make t h e  "One  anxiety  at  the  member v e r b a l i z e d  therapist feel  would t a k e over t h a t r o l e h i m s e l f . "  guilty A  and  very  -  immature member and  -  i n t h e g r o u p was v e r y  t h e w o r k e r was c o n c e r n e d  of t h e worker i n t h i s p r o c e s s responded with firmness, reiterated  123  depressed  f o r h i s personal safety. was s t a t e d a s f o l l o w s :  especially  meeting The r o l e  "I  as the female t h e r a p i s t .  I  t h a t t h i s was t h e e n d o f t h e g r o u p a n d t h e r e was no  way t o e x t e n d  it."  In handling  the individual  arose  during t h i s  taken  a n d c a s e w o r k s e s s i o n s were a r r a n g e d .  s e s s i o n t h e worker i n d i c a t e d  of t h e group by t h e t h e r a p i s t terminate  inthis  i s a focus  problems t h a t t h a t notes were  This active  ending  a n d t h e r e l u c t a n c e o f members t o  t h a t i s common t o p s y c h o t h e r a p y  groups.  ROLE o f WORKER i n GROUP P2 The  role  o f t h e c a s e w o r k e r i n g r o u p P2 (young a d u l t s )  was e n t i r e l y n o n - v e r b a l activity  d u r i n g the meetings o f the group.  i n each s e s s i o n , p r i m a r i l y  centered  r e a c t i o n s f o r the use of the t h e r a p i s t . d i d n o t open my mouth a t a n y t i m e . taking notes." three  T h i s was t h e r o l e  on r e c o r d i n g g r o u p  The w o r k e r s t a t e d :  "I  I was b u s y o b s e r v i n g a n d the worker maintained  in a l l  meetings. As  a result  of this  non-participant role  came a n n o y e d a t t h e w o r k e r . the f i r s t  success.  caseworker f r u s t r a t e d questions.  "Considerable  evident i n  guidance  They t u r n e d f o r h e l p t o t h e t h e r a p i s t  caseworker without  to t h e i r  t h e members b e -  T h i s was p a r t i c u l a r l y  s e s s i o n when t h e members were s e e k i n g  deliberations.  the  Her  and t h e  S i n c e h e r r o l e was e n t i r e l y  passive  t h e g r o u p even f u r t h e r b y n o t r e p l y i n g  T h i s was i l l u s t r a t e d  hostility  i n their  was d i r e c t e d  b y t h e f o l l o w i n g remark:  t o w a r d t h e w o r k e r due t o my  - 124 -  position.  They were very h o s t i l e . a t me f o r not t a l k i n g . "  The  p o s i t i o n of t h e caseworker i n t h i s group d i f f e r s from the exp e c t e d model t h a t was o u t l i n e d  earlier.  I n the middle meeting o f t h e group, t h e worker began t o communicate n o n - v e r b a l l y w i t h t h e members.  The caseworker s a i d :  "I was responding e m o t i o n a l l y t o t h e members.  The kinds of  f e e l i n g s I t r i e d t o m a n i f e s t were s u p p o r t i v e , by l o o k i n g up, watching, showing i n t e r e s t , but not e x p r e s s i n g i t v e r b a l l y . " " The worker f e l t t h a t her attempt t o communicate i n t h i s way helpeduthe group f e e l more secure. The primary purpose o f the caseworker i n t h i s group was to help create a f a m i l y s e t t i n g i n which she was the mother I t was s t a t e d :  "The member saw me as the mother image.  image.  The  remarks t o t h i s e f f e c t were always done o b l i q u e l y but were very e v i d e n t i n . t h e l a t e r meetings."  The caseworker was aware of the  t r a n s f e r e n c e p r o c e s s t a k i n g p l a c e i n the group, but she was l i m i t e d i n any attempt t o f o s t e r t h i s i d e n t i f i c a t i o n . all  The over-  r o l e of the worker was i l l u s t r a t e d i n the f o l l o w i n g statement: "I was making no v e r b a l responses. I n the l a t e r meetings I t r i e d t o communi c a t e on a non-verbal l e v e l . This aided my i d e n t i f i c a t i o n as a mother t o the members, which was why I was i n t h e group. I n the f i n a l meeting I was s t i l l e n t i r e l y passive."  (A)  INITIATING  THE DISCUSSION  The v e r b a l r o l e was c a r r i e d s o l e l y by the t h e r a p i s t .  In •  the f i r s t meeting, t h e p s y c h i a t r i s t o u t l i n e d - what was expected of the members and commented t h a t they c o u l d be observed on a  - 125 -  one-way screen and microphone.  He encouraged e x p r e s s i o n  t h i s problem and one member s a i d : f i s h bowl."  Following  " I t was l i k e being  about  i n a gold  t h i s , the t h e r a p i s t s a t back and waited  f o r t h e group t o decide what they were going t o d i s c u s s .  This  p a r t of the meeting was l e f t t o t h e members and the t h e r a p i s t d i d not o f f e r any encouragement or guidance. In the middle meeting of the group t h e members had assumed the r e s p o n s i b i l i t y f o r i n i t i a t i n g t h e t o p i c o f d e l i b e r a t i o n . worker s t a t e d :  "They would s t a r t on some s u p e r f i c i a l s u b j e c t but  l e a r n e d t o ask why they were a v o i d i n g The  The  the i n t e n s i v e m a t e r i a l . "  psychotherapy approach was c l e a r l y i l l u s t r a t e d i n t h i s  s e s s i o n , as t h e members i n i t i a t e d and were r e s p o n s i b l e f o r d i r e c t i n g the d i s c u s s i o n . In t h e f i n a l meeting however the t h e r a p i s t was f o c u s e d on termination. (B)  The t h e r a p i s t i n i t i a t e d t h i s  discussion.  CONTINUING THE DISCUSSION The  f i r s t meeting was c h a r a c t e r i z e d by a n x i e t y  of the members and they c o n t i n u o u s l y group l e a d e r s i n t o the d i s c u s s i o n .  attempted t o draw the two I t was s t a t e d :  "Anxiety and  f r u s t r a t i o n were d i r e c t e d a t the t h e r a p i s t s f o r t h e i r roles.  Any questions  on the p a r t  passive  d i r e c t e d to e i t h e r o f us were r e t u r n e d t o  the group by the t h e r a p i s t . "  When the members f i n a l l y r e a l i z e d  that the t h e r a p i s t would n o t i n t e r a c t they c a r r i e d the d i s c u s s i o n without h i s h e l p . In the middle meeting, t h e t h e r a p i s t only and  commented  twice  h i s remarks c l a r i f i e d misconceptions the members h e l d about  mental i l l n e s s .  Apart from t h i s i n f o r m a t i o n ,  the e n t i r e d i s -  - 126 -  c u s s i o n was c a r r i e d by the group without help from the two leaders.  The worker s a i d :  "During t h i s meeting  formed which opposed each o t h e r . the  sub-groups  M a i n l y i t was the men a g a i n s t  women and the remarks were v e r y p e r s o n a l . "  The n o n - i n t e r v e n -  t i o n o f the t h e r a p i s t and caseworker i n the group helped the members c r e a t e t h i s type of c l i m a t e . I t has been seen t h a t i n d i v i d u a l r e a c t i o n s i n e x p r e s s i n g h o s t i l i t y a r e common t o psychotherapy groups.  To handle these  r e a c t i o n s the r e s p o n s i b i l i t y r e s t s mainly w i t h the members. the  In  middle meeting a v e r y h o s t i l e member was a l o o f and d i s i n t e r -  ested.  Whenever she was spoken t o she would sneer and t u r n her  back on the o t h e r members.  The worker s t a t e d :  "We d i d not t r y  to b r i n g her i n t o t h i s group but allowed her t o m a i n t a i n t h i s hostile role.  E v e n t u a l l y one member s a i d t h a t she was too  frightened to i n t e r a c t .  T h i s was p r o b a b l y t r u e . "  The group  allowed t h i s member t o remain i s o l a t e d f o r s e v e r a l meetings but were aware of her d e f e n s i v e p a t t e r n s which they c l a r i f i e d f o r her.  T h i s aspect o f psychotherapy helps the i n d i v i d u a l become  i n v o l v e d in. the group and therapy becomes more a c c e p t a b l e . (C)  TERMINATION S i n c e the treatment aspect of psychotherapy i s the c e n t r a l  purpose o f the group and i n t e n s i v e bonds develop due t o the i n t e r a c t i o n s o f the members the problem o f t e r m i n a t i n g each meeting  w i l l be very d i f f i c u l t .  the  members l e f t immediately a t the c l o s e of the s e s s i o n without  any comment.  I n t h e f i r s t group meeting of P2  By the middle s e s s i o n however t h e group has become  - 127 -  cohesive  and  terminating "One  the  a new  to get  the  subject."  last  moved t h e  by  the  way  members out  In  ending the  increases.  The  s o b b e d she  she of  the  on."  In  these  help  the  therapist.  a parting g i f t  group p r e s e n t e d the  stated: me  f o r not  passive  could  i n d i c a t e d the  participating."  r o l e of the and  ROLE OF  WORKER IN  THE  Group P3 months.  The  irritation  co-therapist,  a g e n c y and' t h e  her  place.  The  initially  quite  t o overcome t h e  member was  was  i n tears  two  'Sick,  Sick,  the  worker  members  scotch Sick.'  final  the  or  the  and  they  She  members f e l t  been a c o n s t a n t to the  and  therapists  It-would appear t h a t  up  termination  s i t u a t i o n s the  to the  had  toward  entirely  source  of  meeting.  been i n p r o g r e s s f o r  working i n t h i s  caseworker s t u d i e d  r o l e was  mother image f o r t h e  This  P3  (epilepsy)  the  problem of  o f f e r e i t h e r the  hostility  w o r k e r had  frustration  wanted  caseworker  therapist.  t h e r a p i s t with a b o t t l e of  c a s e w o r k e r a book c a l l e d "This  the  "One  l i m i t e d i n the As  she  stated:  room.  group i t s e l f ,  go  I t was  remained.seated w h i l e the p s y c h i a t r i s t  worker s t a t e d :  couldn't  a result  word i n w h i l e a n o t h e r  r o l e of the  was  gave t h e  As  I n t h e s e s i t u a t i o n s the  unable t o supplement the  illustrated  strong.  m e e t i n g becomes more d i f f i c u l t .  member t r i e d  to discuss was  t h e member,.; bonds a r e v e r y  designed to  group.  The  anxious w i t h her i n s e c u r i t y and  g r o u p had  in this create  several left  p a p e r was  a family  group.  t o become o r i e n t e d  taking  setting  c a s e w o r k e r i n g r o u p P3 r o l e i n the  . r.a  was  I n an  to the  and  effort  group  - 128 -  s e t t i n g t h e worker  s t a r t e d out as a r e c o r d e r .  the  g r o u p was  evident  was  replacing a co-therapist,  worker  also  stated:  fortable.  "This  worker  who  session had l e f t  since  the  t h e new  anxiety  worker  l e v e l was  very  i n the group."  high  initially  The f o r m e r s o c i a l w o r k e r  assumed, h e l p e d  t h e i n i t i a l m e e t i n g o f P3  the caseworker  It  stated:  "Whenever I commented i t was  situations pertaining to s o c i a l  and w e l f a r e . " difficulties  I n problems of the c l i e n t ,  responsibility. remained  The  in  well this  defined type of  In worker  that  this  psychological  s t a t e d as I simply  caseworker i n d i c a t e d t h a t  i n t h e s e a r e a s a n d was  environ-  employment  the p s y c h i a t r i s t took the  r o l e o f t h e w o r k e r was  The  remained  major follows: had t o  the r o l e  was  reluctant to p a r t i c i p a t e  discussion.  t h e m i d d l e m e e t i n g t h e p s y c h i a t r i s t was  absent.  attempted t o c o n t i n u e the group meeting i n the u s u a l  was  dependent and my  passive  u s u a l l y on  dealt with the  a n d assumed t h e r o l e o f t h e r a p i s t . "This  had  discipline.  assistance,  q u i e t l y i n the background unless  become i n v o l v e d . " not  the  to create  t h e bounds o f knowledge o f t h e s o c i a l work  "I  uncom-  and t h e y t a l k e d  within  mental  The  i n t h e members. In  was  caseworker  the agency.  b e e n a c t i v e e a c h m e e t i n g and i t i s s u g g e s t e d t h a t role,  of  change made t h e members s t r a i n e d and  Their anxiety  a b o u t t h e new  in this  The a n x i e t y  a way  of ensuring  that  on t h e p s y c h i a t r i s t .  first  The  caseworker  t h e group  way  stated:  d i d n o t become t o o  I remained r e l a t i v e l y  comment came h a l f way  The  through t h e group."  passive The  -  worker i n d i c a t e d a n x i e t y  1  2  9  -  i n t h i s meeting.  T h i s suggests t h a t  the worker was beyond her p r o f e s s i o n a l c a p a c i t y and the i n s e c u r i t y could p o s s i b l y have been t h e r e s u l t o f t h i s s i t u a t i o n . It  was s t a t e d e a r l i e r t h a t psychotherapy groups a r e u s u a l l y  small cohesive  u n i t s t h a t o f t e n simulate  family settings.  This  group however was open-ended and new members were c o n s t a n t l y admitted.  Since the treatment aim of psychotherapy i s t o g a i n  i n s i g h t and understanding i n t o a n ' i n d i v i d u a l ' s behaviour t o e f f e c t p e r s o n a l i t y changes i t appears t h a t t h i s group would f i n d d i f f i c u l t y i n accomplishing  t h i s purpose.  Defenses would be  e s t a b l i s h e d w i t h the entrance of each new member. of the p a r t i c i p a n t s being ment w o u l d l a l s o  i n v o l v e d i n d i f f e r e n t stages of t r e a t -  be e v i d e n t .  T h i s would tend t o c r e a t e  i n moving i n t o i n t i m a t e areas of p e r s o n a l The  The d i f f i c u l t y  resistance  discussion.  o v e r - a l l r o l e o f t h e caseworker was d e s c r i b e d  i n the  i n t e r v i e w as f o l l o w s : "I p l a y e d a p r e t t y p a s s i v e r o l e i n the f i r s t meetings. My responses were mainly i n r e p l y i n g t o t h e l e a d of the p s y c h i a t r i s t . I n the middle meeting I was s t i l l r e l a t i v e l y p a s s i v e but I assumed the r o l e of the t h e r a p i s t . -COccasionally I would step i n and i n t e r p r e t something." In d e s c r i b i n g how the i n i t i a l said:  s e s s i o n was s t a r t e d the worker  "Some people were h e s i t a n t i n s t a r t i n g .  The p s y c h i a t r i s t  asked them what they thought about the new worker." was a p p r o p r i a t e worker.  The t o p i c  s i n c e the group was anxious about the. change o f  T h i s gave the members o p p o r t u n i t y  t o vent t h e i r  ings b e f o r e moving i n t o a more i n t e n s i v e d i s c u s s i o n .  feel-  130  -  In  the middle meeting the worker  began t h e s e s s i o n . effort  to start  therapist. own  I t was  said:  the d i s c u s s i o n  T h i s was  problems.  allowed  -  "The  d i d not  that  or  comment a t t h i s  the  i n t h e s e g r o u p s would  develop the meeting. first  group,  m e e t i n g was  the t h e r a p i s t  of the  one member d i s c u s s i n g h i s  T h i s has been  point  and  T h i s was  s i s t e n t w i t h the p s y c h o t h e r a p e u t i c approach t o worker  valiant  the absence  t h e g r o u p t o b e g i n where t h e y w i s h e d . "  The  t h e members  members made a  and i g n o r e d  a c c o m p l i s h e d by  The w o r k e r  stated  con-  groups.  n o t be  expected to guide  outlined  earlier.  Since  used t o i n t r o d u c e the caseworker t o the d e v e l o p e d t h e theme o f t h e m e e t i n g .  brought out i n d i v i d u a l  feelings  a b o u t t h e new  worker  and  He encouraged  them t o i n d i c a t e what t h e y e x p e c t e d o f t h e c o - t h e r a p i s t . stated:  "Each person o u t l i n e d  Many o f them were p l e a s a n t O n l y one p e r s o n was It  d i s c u s s i o n o f h i s own stated:  s t o p p e d and worker trist. the  what t h e y t h o u g h t I s h o u l d do.  and t r i e d  described  developed.!!;  asked a question r e l a t i n g The  subject.  group The  to begin a  how  p e r s o n a l problems  "This a c t i v i t y  silence  relationship.  one member b e g a n a i n the middle  continued u n t i l  After  meeting.  t h e member  an awkward p a u s e  to the absence  of the  spent the remainder of the meeting worker u s e d h e r awareness  a n x i e t y a n d by f o c u s i n g t h e d i s c u s s i o n the  was  hostile."  has a l r e a d y b e e n  The w o r k e r  It  of the  on t h i s  the psychia-  discussing  group's  point  facilitated  flow. An  individual  r e a c t i o n was  evident  i n the middle  meeting  - 131 -  as a r e s u l t of the t h e r a p i s t ' s absence. follows:  I t was d e s c r i b e d as  "A very anxious member t r i e d t o handle h i s f e e l i n g s  around the absent t h e r a p i s t by d i s c u s s i n g them. s e t t i n g f o r t h e whole group."  The caseworker a l l o w e d t h i s member  to continue t a l k i n g without i n t e r f e r e n c e . c h a l l e n g e d by another member i n the group. continued i n the f o l l o w i n g way: ing.  T h i s was up-  F i n a l l y he was This discussion  " E v e n t u a l l y they stopped f i g h t -  One of them commented t h a t he wished the t h e r a p i s t was at  the meeting.  A l l the group agreed they missed him." The case-  worker s t a t e d t h a t as soon as the group became aware o f t h e importance of t h e therapistfe absence the group r e l a x e d and the d i s c u s s i o n was l e s s t e n s e . The bonds between the members have been somewhat neutr a l i z e d i n t h i s group due to the open-ended membership. seemed t o f a c i l i t a t e the t e r m i n a t i o n of the meetings.  This The worker  i n both t h e i n i t i a l and middle meetings i n d i c a t e d t h a t t h e r e was no r e s i s t a n c e evident i n c l o s i n g the meeting. "The t h e r a p i s t s a i d time was up. granted and l e a v e . "  I t was s t a t e d :  A l l o f them take t h i s f o r  T h i s process was unusual as compared t o  the d i f f i c u l t i e s g e n e r a l l y encountered i n t e r m i n a t i n g t h i s type of group.  S i n c e P3 has not been disbanded i t i s not p o s s i b l e  to study the t e r m i n a t i o n procedure used by the t h e r a p i s t and caseworker. SUMMARY OF PSYCHOTHERAPY GROUPS The s o c i a l worker,  i n psychotherapy groups, uses t h e group  d i s c u s s i o n s t o help the members g a i n i n s i g h t i n t o problems and  - 132  -  d i f f i c u l t i e s they express i n t h e i r s o c i a l f u n c t i o n i n g . of  The r o l e  the worker \±s t h e r e f o r e a secondary change agent i n the  group and her f u n c t i o n w i l l be to i n t e r p r e t knowledge bounds of the s o c i a l work d i s c i p l i n e .  w i t h i n the  I n t e r a c t i o n s w i t h the  group tend t o be p a s s i v e s i n c e the members are p r i m a r i l y responsible for initiating,  d e v e l o p i n g and c o n t i n u i n g the meeting.  The  use of two t h e r a p i s t s , male and female i s meant t o simulate the f a m i l y s i t u a t i o n , w i t h both the " f a t h e r and mother  present."  The o v e r - a l l r o l e of the s o c i a l worker i n the t h r e e psychotherapy groups s t u d i e d i n t h i s c l a s s i f i c a t i o n showed c o n s i d e r a b l e variation.  The worker i n group PI was a c t i v e i n the i n i t i a l and  f i n a l meetings of the group. i n t e r a c t i n g i n the f i r s t p r o c e s s o f the group. the  T h i s helped the members to b e g i n  s e s s i o n and aided the t e r m i n a t i o n  The middle meeting however i n d i c a t e d t h a t  worker had assumed a r e l a t i v e l y p a s s i v e In  the f i r s t meeting of group P3,  t h a t of r e c o r d e r .  role.  the worker's r o l e  was  I t was noted however, t h a t she would comment  on matters d e a l i n g w i t h the welfare of the members, where appropriate. of for  In the middle s e s s i o n the caseworker took over the r o l e  therapist.  One may wonder about the v a l i d i t y o f t h i s  the s o c i a l  worker.  The r o l e of the worker i n group P2 was There wasn't  role  entirely  passive.  any v e r b a l i n t e r a c t i o n between t h i s person and the  members a t any t i m e .  T h i s seemed t o l i m i t her a c t i v i t y i n a l l  areas of the group. The d i s c u s s i o n was u s u a l l y i n i t i a t e d by the members i n these meetings.  During the f i r s t  s e s s i o n of a l l the groups  - 133 -  however, h e l p was  g i v e n t h e members i n g e t t i n g s t a r t e d .  P I u s e d an  agenda t o f o c u s  therapists  i n the  on  o t h e r two  a series  of t o p i c s ,  groups o u t l i n e d the  Group  while  the  subject f o r  the  meeting. Once t h e  t o p i c f o r d i s c u s s i o n was  became r e s p o n s i b l e f o r t h e made by  either  interpret  the  issues to the  group.  the  groups i n the middle  therapist  accepted and  P2  this  who  noted  "that in  he  i n PI  The that the  P2.  initial  together  The  T h i s was  m e e t i n g was  true  was  up  and  resistance.  the  outstanding  T h i s was  of of  members  I n group  s l o w l y moving out  helped  the  the  has  not been  group."  therapist  the worker observed  The  or  terminated  members were t e a r f u l a n d  PI  room.  itself  one  stated:  caseworker the  without  group,  verballly  terminated. i n a l l t h r e e groups i s  to f u l f i l l  w o r k e r s a l s o had  The  and  of the  terminate  the process  characteristic  caseworker-was i n t e n d e d  observing.  intensity  i n s m a l l i n f o r m a l groups  c a r r y on w i t h o u t  Group P I  mother f i g u r e .  comments  m e e t i n g however, t h e members were r e l u c t a n t  f i r m and  i n g r o u p P2  interacting.  Any  r e s i s t a n c e t o t e r m i n a t i n g the group  and  c o u l d not  g r o u p P I was  while  members  meeting.  t o p r o l o n g t h e m e e t i n g by  Considerable was  d i r e c t i o n and  i n d i c a t i n g any  They g a t h e r e d  attempted  The  announced t h a t time  without  i n the middle  to leave.  subject.  d e p e n d e d upon t h e members.  I n a l l t h r e e groups the by  the  the  t h e w o r k e r s o r t h e r a p i s t were u s e d t o c l a r i f y  the d e l i b e r a t i o n all  developing  initiated  the  s e e n as a s e c o n d a r y  the r o l e  of  the  task of r e c o r d i n g function.  and  CHAPTER  SUMMARY AND  4  FINDINGS  IMPLICATIONS FOR  The  focus of t h i s  working w i t h groups.  s t u d y was  I t would  workers i n terms o f s o c i a l  model.  felt  that  On  and t h e r o l e  t h e l a t t e r would  several occasions,  system f o r the  of the groups' purposes  reference  i s made i n t h e s t u d y t o  encounter d i f f i c u l t i e s  the e s t i m a t i o n of the r e s e a r c h e r s , might c a s e w o r k e r s had had  social  g r o u p work.  some b a s i c  knowledge  However, i t must be  social with  i t i s important to consider  g r o u p work p r a c t i c e  which,  have b e e n a v o i d e d i f and t r a i n i n g i n  stressed that  c a s e w o r k e r s were n o t a t t e m p t i n g t o do s o c i a l theless,  be a more u s e f u l  of the caseworkers.  i n s t a n c e s where w o r k e r s a p p a r e n t l y  the  of the  s t u d y on c a s e w o r k e r s w o r k i n g  I t a l s o p e r m i t t e d an a n a l y s i s  and g o a l s ,  of caseworkers  have b e e n p o s s i b l e t o j u d g e t h e s e  The model p r o v i d e d a c l a s s i f i c a t i o n  groups.  in  an a n a l y s i s  g r o u p method, b u t b e c a u s e  existence of Dr. Joyce K l e i n ' s w i t h g r o u p s i t was  PRACTICE  these  g r o u p work.  some c o n t r i b u t i o n s  Neverwhich  m i g h t make t o c a s e w o r k e r s w o r k i n g  groups.  CLASSIFICATION It  was  deemed e s s e n t i a l t o c l a s s i f y  before attempting to analyse the r o l e c o n s i d e r e d i m p o r t a n t b e c a u s e i t was  the t e n groups  of the workers.  This  a n t i c i p a t e d that the  was  role  - 135 -  of the worker would be i n f l u e n c e d , i f not i n f a c t d i c t a t e d , by the purpose and type of group.  By c l a s s i f y i n g the groups, the  t h e s i s team hoped t o evolve a more s y s t e m a t i c , c o n c i s e , and u s e f u l a n a l y s i s of the worker's  role.  I f i t were, indeed, p o s s i b l e t o c l a s s i f y groups as t o t h e i r purpose and g o a l , then t h i s might be f o l l o w e d by a c l e a r er d e f i n i t i o n of the r o l e of a worker i n a group. t h i s would have on p r a c t i c e i s s i g n i f i c a n t :  The importance  t r a i n i n g and  p r a c t i c e c o u l d become more p r e c i s e and e f f e c t i v e ; and  criteria  could be e s t a b l i s h e d t o evaluate the r o l e of the worker.  With  t h i s i n mind, the r e s e a r c h e r s t e s t e d the t e n groups a g a i n s t the model to a p p r a i s e the v a l i d i t y and s u i t a b i l i t y of K l e i n ' s c l a s s i f i c a t i o n system f o r groups operated by caseworkers. The study r e v e a l e d t h a t each of the groups could be p l a c e d i n one or other of K l e i n ' s t h r e e c a t e g o r i e s :  group  education, s o c i a l group treatment, or group psychotherapy. Four groups f i t t e d the model of t h e group education i c a t i o n as d e f i n e d by K l e i n . impart knowledge. treatment model.  classif-  T h e i r purpose was p r i m a r i l y to  Three groups conformed to the s o c i a l group They were e s t a b l i s h e d t o p r o v i d e treatment  to reduce s o c i a l and emotional p r e s s u r e s and to i n c r e a s e the c l i e n t ' s capacity f o r s a t i s f a c t o r y s o c i a l functioning.  The  remaining three groups corresponded t o the group psychotherapy model.  This c l a s s i f i c a t i o n c o n s i s t s of groups w i t h treatment  aimed a t p e r s o n a l i t y r e o r g a n i z a t i o n i n an i n d i v i d u a l conducted under p s y c h i a t r i c  supervision.  I t i s evident from the p r e v i o u s chapters t h a t i n some  - 136 -  g r o u p s t h e r e was standing  examples  c h i l d r e n ) and In the f i r s t group's  a lack of c l a r i t y  Two  out-  a r e f o u n d i n Group E l ( p a r e n t s o f d e a f  Group E2  (relatives  instance  of p s y c h i a t r i c  ( E l ) the worker's  purpose d i f f e r e d  the group  about purpose.  of r e l a t i v e s  from that  patients).  perception of the  o f t h e members'.  of p s y c h i a t r i c  patients  the  While i n emphasis  s h i f t e d b a c k w a r d s and f o r w a r d s between e d u c a t i o n and t r e a t m e n t , a l t h o u g h the group's  stated  these deviations the K l e i n classification  o f groups  p u r p o s e was  education.  t y p o l o g y appears v a l i d  i n which  caseworkers  Despite  f o r the  work.  PURPOSE All  t e n groups  r e s p e c t i v e models: reorganization.  had b a s i c p u r p o s e s  education, s o c i a l  I t was  consistent with  adjustment,  discovered that  i n practice  some o v e r l a p p i n g o f e l e m e n t s o f e d u c a t i o n a n d ten groups. overlapping group.  T h i s would  standing  there  was  treatment i n a l l  e x p e c t e d i n any g r o u p .  i n fact,  supplement  o v e r l a p p i n g m i g h t be  Klein  personality  However,  such  s h o u l d not d e t r a c t from t h e main purpose o f t h e  I t may,  Perhaps,  be  or  their  and  support the purpose.  d e s c r i b e d as a " f r i n g e  benefit".  discusses the importance of having a c l e a r  of purpose.  She  p o i n t s out the c o n f u s i o n t h a t  a r i s e when t h e r e i s o v e r l a p p i n g .  She  states:  E d u c a t i o n , c o u n s e l i n g , and g r o u p t h e r a p y a r e c o n f u s e d when t h e p u r p o s e o f t h e .group i s n o t c l e a r . The r e s u l t i s t h a t t h e w o r k e r becomes m u l t i - s e l v e d a n d c a n n o t i d e n t i f y c l o s e l y w i t h h e r own  undermay  - 137 -  profession.  Role c o n f l i c t a p p e a r s .  1  T h i s makes i t imperative t h a t an adequate c l a s s i f i c a t i o n be a v a i l a b l e and t h a t a worker endeavours t o f o l l o w i t . The study suggests t h a t c o n f u s i o n of purpose can be a t t r i b u t a b l e to e i t h e r the worker o r the agency. ly  i n e x p e r i e n c e i s the b a s i c cause.  Most  frequent-  I n regards t o the worker,  being a caseworker attempting f o r the f i r s t a group i s o f t e n t h e crux of the problem.  time t o work w i t h F o r example, t h e  worker i n E l (parents o f deaf c h i l d r e n ) , because of her i n e x p e r i e n c e was unable t o r e c o n c i l e the dichotomy o f purpose which e x i s t e d between her and the members. L i k e w i s e , an agency experimenting f o r the f i r s t  time  w i t h groups, might w e l l have d i f f i c u l t y i n f o r m u l a t i n g a c l e a r and c o n s i s t e n t purpose.  F r e q u e n t l y , the a g e n c y s purpose f o r 1  e s t a b l i s h i n g a group i s ambiguous.  T h i s occurs when the agency  sees a group as a "time saver" or "money saver."  Group S3  ( b l i n d c h i l d r e n ' s p a r e n t s ) , a l t h o u g h not a new group, does i l l u s t r a t e confusion o f purpose stemming d i r e c t l y from b e i n g e s t a b l i s h e d as a "time s a v e r . " to  -The i n t e n t of the agency was  r e p l a c e i n d i v i d u a l casework s e r v i c e s w i t h group  services.  Although c l a s s i f i e d as an education group, a c o n s i d e r a b l e p o r t i o n of time was devoted t o i n d i v i d u a l c o u n s e l l i n g i n the group  sessions. The c o n f u s i o n of purpose i s a c c e n t u a t e d when an i n e x -  p e r i e n c e d worker i s engaged t o work w i t h a group i n an agency  1 K l e i n , A d u l t E d u c a t i o n and Treatment Groups i n S o c i a l Agencies, p. 95*  - 138 -  experimenting w i t h groups and  c a s e w o r k e r s would  or a s i m i l a r social  f o rthe f i r s t  be w e l l a d v i s e d  classification  time.  Both agencies  to consider using  as a g u i d e and s e c u r i n g  g r o u p work k n o w l e d g e a n d t r a i n i n g  Klein's  some b a s i c  b e f o r e embarking  on  work w i t h g r o u p s . The p s y c h o t h e r a p y g r o u p s  revealed v i v i d l y  having a w r i t t e n purpose f o r the group. groups  The two p s y c h o t h e r a p y  ( P I a n d P2) w h i c h had w r i t t e n p u r p o s e s d e m o n s t r a t e d a  c l e a r n e s s of purpose, r e s u l t i n g performance purpose. tion  of the workers.  Even  assumed c o m p l e t e l e a d e r s h i p  i n eonsistent  Group P3  However, t h e w o r k e r  o f the purpose.  having a clear  a n d members.  o f the group.  T h e r e may have  role at this  can s t i l l  However, t h e w o r k e r  Without  vacillated  like  worker  encountered s i m i l a r The  even w i t h a  i n this  case,  between remained  t h e members a c c e p t e d ( a n d t h i s may  t h e worker  may  have  have  E l ( p a r e n t s o f d e a f c h i l d r e n ) when s h e  resistence.  two-groups  l e d by p s y c h i a t r i s t s Group E4  that  a clear perception of her role,  b e e n a i d e d by h a v i n g a w r i t t e n p u r p o s e )  been  point.  be c o n f u s i o n o f p u r p o s e  c o n s i s t e n t w i t h t h e p u r p o s e and e v e n t u a l l y it.  percep-  so, i n t h e m i d d l e meeting t h e worker  Group P2 (young a d u l t s ) i l l u s t r a t e s w r i t t e n purpose t h e r e  g o a l and r o l e  ( e p i l e p s y ) had no w r i t t e n  intimated  some q u e s t i o n a b o u t the- w o r k e r ' s  worker  the value of  with a written  s t a t e m e n t o f p u r p o s e were  and t h e s t a t e m e n t s were p r e p a r e d b y them.  (adoptive parents) prepared a brochure o u t l i n i n g the  group's purpose.  The s u c c e s s o f t h e a d o p t i v e p a r e n t s ' g r o u p ,  a l o n g w i t h t h e e x p e r i e n c e s o f t h e two p s y c h o t h e r a p y g r o u p s ,  - 139  suggests that a l l workers a i d e d by a w r i t t e n of  -  w o r k i n g w i t h g r o u p s would  greatly  statement of purpose p r i o r t o the f o r m a t i o n  a group. The  study r e v e a l e d  t h a t a a group  composed o f members  h a v i n g t h e same common p r o b l e m f a c i l i t a t e s the  be  purpose.  similar  The members' p e r c e p t i o n  to the worker's.  the acceptance of  of t h i s  I n an open-ended  clarifying prevent  continues  and i n t e r p r e t i n g  this  forgotten;  indefinitely.  The w o r k e r ,  t h e p u r p o s e t o e a c h new  o c c u r r i n g t o some  be  group, t h e r e i s a  d a n g e r f o r t h e p u r p o s e t o become c o n f u s e d a n d e x p e c i a l l y i f the group  p u r p o s e must  member,  by can  extent.  GOALS One  d i f f e r e n c e between an i n t u i t i v e  p r o f e s s i o n a l worker  w o r k e r and  i s that the professional  a  deliberately  plans  a n d has p r e p a r e d a c o n s c i o u s g o a l f o r e a c h m e e t i n g he has w i t h the  client  specific not  or group.  Most  g o a l s f o r e a c h casework  be t a k e n f o r g r a n t e d t h a t  o v e r t o work w i t h g r o u p s . the  goals  interview.  they would  Therefore,  m i d d l e , and f i n a l  p l a n n e d a g o a l f o r e a c h t i m e he met  practice studied  of the group.  These  o f the group.  the worker  This  consciously  with his clients.  And,  t o compare t h e g o a l o f t h e i n d i v i d u a l m e e t i n g s w i t h t h e  o v e r - a l l purpose of the group.  I n t h i s way,  d i s c o v e r i f t h e s h o r t - r a n g e g o a l was range  carry this  meetings  have  However, i t s h o u l d  the researchers  done i n o r d e r t o a s c e r t a i n w h e t h e r  also,  caseworkers would  set at three p o i n t s i n the l i f e  were t h e f i r s t , was  professional  purpose.  i t was  hoped  consistent with the  to long-  - 140 -  N i n e g r o u p s had g o a l s the model. It  consistent with  O n l y group E l ( p a r e n t s  was f o u n d , however, t h a t  t h e purpose and  o f deaf c h i l d r e n ) d i d n o t .  on o c c a s i o n s  no s p e c i f i c  goal  was  e s t a b l i s h e d by t h e w o r k e r s .  T h i s was i n t e n t i o n a l i n t h e meet-  ings  the psychotherapy groups  studies.  goals  For instance,  i n order  problem areas  t o permit  terminating  s e t by t h e workers  i n discussing  i n their f i r s t  m e e t i n g were g i v e n  this  study.  able  among s t r a n g e r s  goal,  flexibility  or c o n f l i c t s .  The g o a l s their  f o r greater  s e t no  In the f i r s t  special  meeting and  consideration i n  m e e t i n g t h e members may f e e l  o r anxious about t h e group.  The w o r k e r ' s  t h e r e f o r e , must be t o i n t e r p r e t a n d c l a r i f y  o f t h e g r o u p a n d s t i m u l a t e a warm, f r i e n d l y ,  uncomfort-  t h e purpose  and a c c e p t i n g  atmosphere. In realize to  the f i r s t  t h e n e c e s s i t y f o r e x p l a i n i n g the'purpose o f the group  t h e members.  The i n f o r m a t i o n  consciously tried "feel  a t home."  first  meeting The  that  to relieve  i n d i c a t e s t h a t most  t h e members' a n x i e t y  A l l t e n workers  consistent with  them i n m a k i n g  m e e t i n g stems  group i s d i s b a n d i n g of g u i l t  and t h e group.  the separation.  a t t a c h e d and support  An i n t e r p r e t a t i o n o f why t h e  may be n e c e s s a r y  o r t h e agency.  from the f a c t  The w o r k e r must  i n order  among t h e members o r a n e x p r e s s i o n  worker  f o r their  good p r a c t i c e .  importance of the f i n a l  on t h e w o r k e r  workers  a n d make them  e s t a b l i s h e d goals  some o f t h e members may have become v e r y  dependent  the  meeting, a l l t e n workers appeared t o  t o d i s p e l a sense  of hostility  towards  - 141 -  In the study, therefore,  d i d n o t have a f i n a l m e e t i n g .  the  s i x remaining  for  the t e r m i n a t i o n  (relatives specific ing  f o u r o f t h e g r o u p s were open-ended  g r o u p s a p p e a r e d t o have of the group.  of p s y c h i a t r i c  goal  Workers  and,  in five  of  a c l e a r g o a l i n mind  The w o r k e r  i n group,  E2  p a t i e n t s ) , d i d n o t a p p e a r t o have  c o n s i s t e n t with the requirements  of the  a  terminat-  situation.  ROLE K l e i n ' s model p r o v i d e d the  worker's  fore,  role  necessary  too general  i n any o f h e r c l a s s i f i c a t i o n s .  t o i n c l u d e some c o n c r e t e  g a i n a b e t t e r a p p r a i s a l o f the worker's the  education  groups the r e s e a r c h e r s  consider  specific  make u s e  o f them t o i n i t i a t e  role  passiveness, questions, analyse  d i d the worker  and  expanded  I t was  scapegoating,  role  found  some d i f f i c u l t y  and  d i d the  i n this  f o r example?  material,  t o one  questions  hostility,  These,  and  similar  t h e K l e i n model t o group.  role  o r more o f t h e f o l l o w i n g :  there  i n the group.  r e s e a r c h e r s b e l i e v e t h a t most o f t h e c a u s e s f o r t h i s attributed  of the  critical  t h a t on t h e p a r t o f most w o r k e r s confusion i n t h e i r  worker  t o pose  h a n d l e dependency,  were u s e d i n c o n j u n c t i o n w i t h  was  on t h e model t o  necessary  the r o l e of the caseworker i n the It  How  to  For instance, i n  K l e i n makes no m e n t i o n  i n termination.  How  role.  there-  i n order  discussion, interpret  t o c o n s t r u c t the a p p r o p r i a t e worker situation.  I t was,  questions  discussion techniques.  or encourage p a r t i c i p a t i o n ? worker's  a d e s c r i p t i o n of  (1)  could  l a c k of  was The be  - 142  clarity  of purpose;  knowledge (5)  o f group p r o c e s s ;  of c l a r i t y (4)  confusion i n professional Difficulty  of  (2) l a c k  p u r p o s e was  in role  -  lack  of goals;  (3)  lack  of necessary s k i l l s ;  of and  identity.  performance  o b s e r v e d i n E2  c a u s e d by l a c k  (relatives  of  clarity  of p s y c h i a t r i c  patients).  The w o r k e r  g r a d u a l l y moved f r o m an e d u c a t i o n a l t o a t r e a t m e n t  focus.  e n c o u r a g e d t h e members t o i n i t i a t e  a  He  role  the  g e n e r a l l y a c c e p t e d as b e i n g t h e p r e r o g a t i v e Also,  discussion: of a  in  an e d u c a t i o n group.  c o n t r a r y t o p u r p o s e and  he  e n c o u r a g e d one woman t o d i s c u s s a p e r s o n a l p r o b l e m .  p r o c e e d e d t o p r o v i d e h e l p i n a manner s i m i l a r social  same g r o u p  r o l e performance  ( E 2 ) p r o v i d e s a good  c a u s e d by l a c k  have been t h e r e s u l t  He  t o a worker  of c l a r i t y  example  g r o u p was  o f poor agency p l a n n i n g .  disbanding.  w o u l d meet a g a i n a f t e r reason,  t h e g r o u p was  The w o r k e r  then in a  his vacation.  t h e g r o u p was  be assumed t h a t f o r some.imembers t h i s great  deal of anguish.  fostered  The f a c t  This  In the  may  final  aware t h a t  the they  F o r some u n e x p l a i n e d  not r e - e s t a b l i s h e d .  to explain that  faulty  i n f o r m e d t h e group t h a t  The w o r k e r  himself i n the p o s i t i o n of having to contact individually  of  of goals.  m e e t i n g n e i t h e r t h e members n o r t h e w o r k e r was  ately  practice,  group t r e a t m e n t g r o u p . The  a  worker  found  e a c h member  terminated.  It  abrupt ending would  that  the worker  s t r o n g g r o u p bonds r e s u l t e d  had  i n the group  may cause  delibermeaning  more t o t h e members t h a n w o u l d be t h e c a s e i n a n e d u c a t i o n  group.  - 143 -  An  example  of l a c k  c a p p i n g a w o r k e r was Klein in  emphasizes  o f knowledge  found i n s o c i a l  the worker's r o l e  t r e a t m e n t groups, worker  relied not  almost e n t i r e l y  surprising,  one-to-one  relationship  technique into ularly  in affecting  on a o n e - t o - o n e  and  c o u l d be  displayed.  tion  relationship.  this  Group E4  i n the  this partic-  inexperienced.  examples  of problems  aris-  ( a d o p t i v e p a t e n t s ) seemed t o  i s the core s k i l l  techniques  requiz^ed f o r e d u c a team  that  workers  have t r a i n i n g  in this  Psychotherapy  s u g g e s t s some c o n f u s i o n i n p r o f e s s i o n a l  identity.  The w o r k e r  complete l e a d e r s h i p it  This i s  T h i s w o u l d be  g r o u p s i t seems e s s e n t i a l t o t h e t h e s i s  should  role  As  process  schizophrenics)  be t h e o n l y g r o u p where e f f e c t i v e u s e o f d i s c u s s i o n was  Although  expected t o carry  t h e i r work w i t h g r o u p s .  of s k i l l .  handi-  caseworkers are t r a i n e d  e d u c a t i o n groups p r o v i d e  from l a c k  group  (chronic  t r u e where t h e w o r k e r was. a n x i o u s o r The  ing  group t r e a t m e n t .  i n g r o u p T2  considering that  of group p r o c e s s  area.  i n P3  (epilepsy) actually  o f .the g r o u p .  i s w i t h i n t h e competency  assumed  I t i s questionable  of a s o c i a l worker  whether  t o assume a  which i s p r o p e r l y  the j u r i s d i c t i o n  studying the r o l e  of the workers i n the f i r s t  it  the workers a t t a c h e d t o the psychotherapy  was  found that  g r o u p s assumed t h e r o l e  a s s i g n e d them b y t h e  T h e s e were c o n s i s t e n t w i t h t h e The  role  of a p s y c h i a t r i s t . and f i n a l  role  In meetings  psychiatrist.  model.  o f t h e workers i n t h e e d u c a t i o n and t r e a t m e n t  g r o u p s were c o n s i s t e n t w i t h t h e g o a l s f o r t h e f i r s t As w o u l d be e x p e c t e d , a l l s e v e n w o r k e r s assumed a  meeting.  major  - 144 -  responsibility  f o r starting  purpose of the group.  t h e meeting and i n t e r p r e t i n g t h e  Four of t h e f i v e  work w i t h g r o u p s f o r t h e f i r s t is  El  inexperience.  cases i t i n t e r f e r e d w i t h t h e worker's  role.  t h e group members b e c a u s e o f i t .  schizophrenics) found the s i t u a t i o n the  meeting a f t e r  adequately  coped w i t h t h e i r  suggest t h a t work c o u l d initial  The w o r k e r i n  some b a s i c  eliminate  The w o r k e r  i n T2  so t h r e a t e n i n g  (chronic  that  he c l o s e d  The r e m a i n i n g two w o r k e r s  insecurity.  training  t h e purpose  The r e s e a r c h e r s  and knowledge i n s o c i a l  some o f t h e a n x i e t y w o r k e r s  feel  group  i n their  group e x p e r i e n c e . In  four  twenty minutes.  This  However, i n  ( p a r e n t s o f d e a f c h i l d r e n ) was u n a b l e t o c l a r i f y  for  the f i n a l  meeting, the r o l e  o f t h e workers i n t h e  c l o s e d groups i n t h e e d u c a t i o n and treatment  displayed for  engaging i n  time e x p e r i e n c e d a n x i e t y .  a common phenomenon a c c o m p a n y i n g  two  workers  some marked c o n t r a s t s .  illustration.  Group E4  T h r e e examples  categories a r e chosen  ( a d o p t i v e p a r e n t s ) was an e x c e l l e n t  example o f a p p r o p r i a t e r o l e p e r f o r m a n c e i n an e d u c a t i o n  group.  The w o r k e r u s e d t h e m e e t i n g t o p r e s e n t a summary o f t h e v a r i o u s ideas  discussed  i n a l l the previous meetings.  She c i r c u m v e n t e d  r e s i s t a n c e t o t e r m i n a t i o n t h r o u g h i n f o r m i n g t h e members i n advance having the  that  i t was t o be t h e f i n a l  e n c o u r a g e d g r o u p bonds,  group.  Also,  facilitated  by n o t  the c l o s i n g of  Group E l ( p a r e n t s o f d e a f c h i l d r e n ) p r o v i d e s a n  example o f f a u l t y no  this  meeting.  r o l e performance.  consideration to possible  The w o r k e r  resistance  apparently  t o t e r m i n a t i o n f o r she  gave no p r i o r w a r n i n g t o t h e members t h a t t h e g r o u p was banding.  gave  No a t t e m p t was made t o summarize t h e g r o u p ' s  disdiscussions.  - 145  Group  T2  worker's r o l e  (chronic  schizophrenics)  i n s u p p o r t i n g v e r y d e p e n d e n t members  t r a n s f e r e n c e t o a new w o r k e r . could not a l l e v i a t e members  i n this  responsibility  must  to accept  o f t h e worker d i s p l a y e d by t h e  The c a s e d e p i c t s  t h e immense  t h e r e i s on a w o r k e r t o c o n s c i o u s l y p l a n h i s meeting and t o f a s h i o n  a role  consistent  goal.  A number o f i n t e r e s t i n g open-ended  A l l the s k i l l  t h e a n x i e t y and h o s t i l i t y  situation.  goal f o r the f i n a l with this  i l l u s t r a t e s the  findings  g r o u p s were u n c o v e r e d .  consciously help  pertinent  to roles i n  I t i s o b v i o u s t h e worker  e a c h new member f i n d  h i s place i n the  group.  T h i s i n c l u d e s an i n t e r p r e t a t i o n  o f the purpose o f the  group.  The i n t e r p r e t a t i o n a l s o a s s i s t s  i n keeping the group  and t h e w o r k e r f o c u s e d on t h e p u r p o s e .  T h i s i s extremely im-  p o r t a n t because t h e r e i s danger o f d e v i a t i o n and  consequently from r o l e ,  indefinitely. dependent  When t h i s  from purpose,  i n e d u c a t i o n g r o u p s w h i c h meet  happens,  t h e members may become  upon t h e g r o u p a n d t h e w o r k e r .  Where t h i s  does  overly occur  t h e onus i s on t h e w o r k e r t o h e l p e a c h member move o u t o f t h e g r o u p more  easily.  Group striking  E2  (relatives  example  of p s y c h i a t r i c  o f the problems i n h e r e n t  group r u n n i n g i n d e f i n i t e l y .  The b a s i c  switched t o include treatment. from educator t o t h e r a p i s t . their  own needs  worker.  patients) i s a i n an  open-ended  purpose of education  The w o r k e r ' s r o l e  vacillated  The members u s e d t h e g r o u p f o r  a n d became a t t a c h e d t o t h e g r o u p a n d t h e  Then, a b r u p t l y t h e g r o u p d i s b a n d e d .  The w o r k e r  was  - 146 -  unable t o g i v e adequate event.  s u p p o r t t o t h e members t o a c c e p t t h i s  I f t h e g r o u p had r e m a i n e d t r u e t o i t s p u r p o s e t h e a b r u p t  t e r m i n a t i o n m i g h t have b e e n a v o i d e d .  Group  E3,(blind  children's  p a r e n t s ) shows t h e a c t i v e r o l e t h e w o r k e r must p l a y i n a s s i s t i n g e a c h member make t h e t r a n s i t i o n f r o m one g r o u p t o a n o t h e r . The i m p l i c a t i o n s  are of p a r t i c u l a r  workers i n treatment groups.  In t h i s  significance  setting  encouraged t o use t h e group f o r s u p p o r t .  to  t h e members a r e  When t h e t i m e comes  f o r the i n d i v i d u a l  t o l e a v e the group the r o l e  o f the worker i s  crucial.  (pre-discharge) i l l u s t r a t e s  t h e emphasis  Group  T3  w o r k e r must p l a c e on h e l p i n g a member s e p a r a t e f r o m t h e  the  security  and s u p p o r t o f t h e group. CORRELATION BETWEEN PURPOSE, GOALS, AND The  ROLE  study p o i n t s out c o n c l u s i v e l y the important  correla-  t i o n between p u r p o s e o f t h e g r o u p and t h e g o a l s e s t a b l i s h e d f o r the group m e e t i n g s .  Likewise,  worker w i t h i n t h e group w i l l g r o u p and  goals  study c l e a r l y  of the worker.  the r o l e  illustrates  the  difficulties  o f group  t h e s t a t e m e n t o f g o a l s and a s s i s t s  Group example  purpose  A t t h e same t i m e , t h e s t u d y shows  a c l e a r p e r c e p t i o n o f the group's purpose d i r e c t l y  appropriately  of the  established f o r achiev-  ensue when t h e r e i s l a c k o f c l a r i t y  on t h e p a r t that  The  found that  be d e t e r m i n e d by t h e p u r p o s e o f t h e  consequently the s p e c i f i c  i n g that purpose. w h i c h may  i t was  the worker  i n using  affects himself  i n the group. E l ( p a r e n t s of deaf c h i l d r e n ) ,  p r o v i d e s an  excellent  o f what c a n happen when t h e r e i s f a u l t y p e r c e p t i o n o f t h e  - 147 -  group's purpose.  In this  g r o u p t h e r e was a d i s p a r i t y  p u r p o s e a s p e r c e i v e d by t h e members a n d t h e w o r k e r . course o f t h e group's meetings t h e worker h e r i d e a s t o t h o s e o f t h e members'. for  the meetings being i n c o n s i s t e n t .  t h e group-was e v e n t u a l l y appeared t o l o o s e al  sight  ignored. of the fact  i n f o c u s and assumed a r o l e  The w o r k e r  Through t h e  gradually  This resulted The o r i g i n a l  accommodated i n the goals purpose f o r  In the confusion, that  i nthe  t h e worker  t h e g r o u p was  incongruent with the purpose.  played a passive r o l e providing very l i t t l e  and l e a v i n g t h e i n t e r p r e t a t i o n  education-  of material  guidance  t o t h e members them-  selves . Group E4 ( a d o p t i v e p a r e n t s ) ,  e x e m p l i f i e s what c a n be  a c c o m p l i s h e d when t h e r e i s a c l e a r a n d c o n c i s e p u r p o s e l a t e d f o r the group.  T h i s g r o u p most  closely  models i n a l l t h r e e a r e a s o f purpose, g o a l , g o a l s i n e a c h m e e t i n g were c o n s i s t e n t role  o f t h e w o r k e r was c l e a r l y  imated  the r o l e  o u t l i n e d by K l e i n .  and r o l e .  and most c l o s e l y  The The approx-  Although the researchers  d i d n o t a t t e m p t t o measure t h e e f f e c t i v e n e s s would  resembled the  with the purpose.  defined  formu-  of t h e groups, i t  a p p e a r a s t h o u g h Group E4 came v e r y n e a r t o r e a c h i n g t h e  d e s i r e d p u r p o s e f o r w h i c h t h e g r o u p was  IMPLICATIONS FOR The  formed.  PRACTICE  study e s t a b l i s h e d that l a c k o f c l a r i t y  inexperience?  a r e two o f t h e m a i n s h o r t c o m i n g s h a n d i c a p p i n g c a s e -  workers working w i t h groups. i e n c e d workers  o f p u r p o s e and  -should be g i v e n  The f i n d i n g s some b a s i c  suggest that  inexper-  knowledge a n d t r a i n i n g  - 148  -  i n s o c i a l group work before embarking on work w i t h groups. In a d d i t i o n , agencies  should c o n s i d e r p r o v i d i n g a w r i t t e n s t a t e -  ment of purpose f o r the p r o s p e c t i v e group. might be found u s e f u l and  convenient  K l e i n ' s typology-  as i t was  d i s c o v e r e d to be  a v a l i d model f o r the c l a s s i f i c a t i o n of the ten groups s t u d i e d in this  thesis. The  c o r r e l a t i o n of purpose, g o a l , and r o l e p o i n t s out  the importance of m a i n t a i n i n g goals c o n s i s t e n t w i t h the purpose. To do so, the worker must accept p r o f e s s i o n a l r e s p o n s i b i l i t y f o r c o n s c i o u s l y p l a n n i n g and meeting.  s e t t i n g a p p r o p r i a t e goals f o r each  Some c o n s i d e r a t i o n might be given to how  recording  can be i n s t i t u t e d to a s s i s t i n t h i s matter. Agencies and workers should c o n s i d e r the f i n d i n g s d i s c o v e r ed i n r e l a t i o n to ppen-ended groups.  The l o n g e r a group i s i n .  o p e r a t i o n the g r e a t e r i s the danger of the members becoming overdependent on the group and the worker.  In such cases,  care must be shown by the worker i n h e l p i n g the separate from the group.  Having a d e s i g n a t e d  extreme  individual  date f o r c o n c l u s -  i o n might w e l l o f f s e t many of the d i f f i c u l t i e s found  in self-  p e r p e t u a t i n g groups and i n t e r m i n a t i o n . In psychotherapy groups i t was  found  that unless there  i s a c l e a r d e f i n i t i o n of purpose and a p r e c i s e s e p a r a t i o n of r o l e s , there i s a r e a l danger of a s o c i a l worker assuming an inappropriate function. and understanding employ t h e i r own  Only w i t h a c l e a r statement of purpose  of r o l e can the s o c i a l worker and the t h e r a p i s t unique p r o f e s s i o n a l s k i l l s i n d e a l i n g w i t h the  members' problems.  Danger of c o n f u s i o n i n p r o f e s s i o n a l i d e n t i t y  - 149 -  i s i n h e r e n t i n the psychotherapy  s i t u a t i o n and must be guarded  a g a i n s t by the workers. The  study undertaken by K e r r and Kirkham, and a l s o the  D i s s e r t a t i o n by Dr. Joyce K l e i n , p o i n t out t h a t caseworkers a r e moving i n t o the area of working w i t h groups more;, e x t e n s i v e l y . There i s no reason t o presume t h a t t h i s t r e n d w i l l d i m i n i s h i n the f o r e s e e a b l e f u t u r e . s o c i a l group treatment  The t h r e e workers attached t o the  groups, d i s c u s s e d i n t h i s t h e s i s , s t a t e d  t h a t they were extremely  p l e a s e d with the r e s u l t s they had had  i n t h e i r experience i n working w i t h groups o f c l i e n t s .  One of  them s a i d t h a t he plans on i n c r e a s i n g h i s e f f o r t s i n the group area and d i s c o n t i n u e some of h i s i n d i v i d u a l casework because he found the group technique more e f f e c t i v e w i t h h i s c l i e n t s .  This  t r e n d r a i s e s c e r t a i n i m p l i c a t i o n s f o r the p r o f e s s i o n of s o c i a l work and schools of s o c i a l work. The r e s e a r c h e r s f e e l there i s an o b l i g a t i o n on the p r o f e s s i o n t o a i d the workers and agencies enunciating p r a c t i c e i n t h i s f i e l d .  C o n s i d e r a t i o n should be  g i v e n to d i s c o v e r i n g what requirements competence i n the p r a c t i c e .  i n c l a r i f y i n g and  a r e necessary  to assure  A l s o , some c r i t e r i a should be  formulated by which workers and agencies  c o u l d measure the  a p p r o p r i a t e n e s s of t h e method f o r t h e i r needs, and the e f f e c t i v e ness o f t h e i r  service.  There would appear a l s o t o be some i m p l i c a t i o n s f o r schools of s o c i a l work.  W i t h i n the. c u r r i c u l u m t h e r e should be  more emphasis p l a c e d on s k i l l s and knowledge e s s e n t i a l f o r worki n g w i t h groups.  T h i s should be geared  s p e c i f i c a l l y t o the types  - 150 -  of  groups which caseworkers might;• be c a l l e d upon to s e r v e .  SUGGESTIONS FOR FURTHER STUDY The p o s s i b i l i t i e s f o r f u r t h e r r e s e a r c h i n the a r e a of caseworkers working w i t h groups i s e v i d e n t .  The t e n workers  who were so generous w i t h t h e i r time and so w i l l i n g to p a r t i c i pate i n the present study, are a l l e x c e l l e n t sources from which to  draw f u r t h e r m a t e r i a l . One important i n v e s t i g a t i o n suggests i t s e l f immediately,  namely the need t o measure the degree t o which the groups met the  needs of the members.  T h i s would i n v o l v e r e a c h i n g out to  a sample group of c l i e n t s i n each of the groups. The present study d i d not undertake r e s e a r c h i n t o the way  i n which caseworkers r e c o r d e d the group s e s s i o n s .  Nor  was  there any attempt to i n v e s t i g a t e the use t o which such r e c o r d s were put.  The l a t t e r might prove t o be an important area t o  pursue. There i s need f o r f u r t h e r i n v e s t i g a t i o n i n t o the methods and t e c h n i q u e s employed  by caseworkers working w i t h groups.  appears important t o determine f i r s t , whether merely an e x t e n t i o n of casework.  It  the p r a c t i c e i s  Or, a t l e a s t , to a s c e r t a i n  what casework methods and techniques are a p p l i c a b l e , i n t h i s situation.  As caseworkers are i n v o l v e d i t seems most p e r t i n e n t  and v a l u a b l e , that wherever p o s s i b l e , they make use o f the s k i l l s a l r e a d y a v a i l a b l e t o them. L i k e w i s e , an i n v e s t i g a t i o n should be made of s o c i a l group work methods and techniques employed.  The f i n d i n g s from  - 151 -  t h e s e two  studies  might  show w h e t h e r  the p r a c t i c e  ation  o f t h e two  would  be p a r t i c u l a r l y v a l u a b l e f o r t r a i n i n g p u r p o s e s . The  methods o r an e n t i r e l y new  is a  investigation  consideration  and r e s e a r c h i n t o  therapy groups.  I t was  more d e f i n i t i v e and workers  engaged  to appropriate The  points  evident  clearer  These  the r o l e o f the worker i n t h e groups  studied  i n psychothat  a  assist  their  function  s o c i a l work s p h e r e s .  f o r t h i s phase  of the workers.  of p r a c t i c e  i s another  investigation.  a r e but a few  o f t h e many s u b j e c t s w h i c h of research.  The  might  ever-expanding  o f c a s e w o r k e r s w o r k i n g w i t h g r o u p s deem i t e s s e n t i a l  additional full  information  special  d e m a r c a t i o n o f r o l e would  p r o f i t a b l y be p u t t o t h e t e s t  the  o u t a n e e d f o r some  study d i d not c o n s i d e r the s u p e r v i s i o n  area requiring  that  The  i n group p s y c h o t h e r a p y t o c o n t a i n  However, t h e i m p l i c a t i o n s  practice  one.  combin-  s t u d y be u n d e r t a k e n i n t h i s f i e l d .  potential  of t h i s practice  may  n e v e r be  Otherwise,  realized.  APPENDIX A  - 152 -  INTERVIEW SCHEDULE  CASEWORKERS WORKING WITH GROUPS  I  What was t h e p u r p o s e o f t h e g r o u p ?  II  First 1.  Meeting  In the f i r s t  m e e t i n g , what was i n i t i a l  reaction of:  (a) t h e group - as - a - whole? (b) t h e i n d i v i d u a l members? Please i l l u s t r a t e . How d i d t h e w o r k e r r e s p o n d t o t h i s r e a c t i o n ? Please i l l u s t r a t e . How d i d t h e member r e s p o n d t o t h e w o r k e r ? Please i l l u s t r a t e . 2.  Was t h e r e a n y r e s i s t a n c e d i s p l a y e d by t h e members t o being present i n t h i s f i r s t meeting? Please i l l u s t r a t e . I f s o , how d i d t h e w o r k e r h a n d l e t h i s r e s i s t a n c e ? What t e c h n i q u e s were u s e d i n h a n d l i n g t h i s r e s i s t a n c e ? Please i l l u s t r a t e .  3.  D i d t h e worker f i n d i t n e c e s s a r y t o e x p l a i n t o t h e g r o u p t h e r e a s o n why t h e members were t h e r e ? Why was t h i s e x p l a n a t i o n n e c e s s a r y ? Please i l l u s t r a t e . What was t h e e x p l a n a t i o n g i v e n t o t h e members? How d i d t h e members o r members r e s p o n d ? How d i d t h e w o r k e r h a n d l e t h i s r e s p o n s e ?  4.  D i d t h e w o r k e r e x p l a i n t o t h e g r o u p what t h e y were g o i n g t o do i n t h e f i r s t m e e t i n g ? What was t h e e x a c t e x p l a n a t i o n g i v e n ? How d i d t h e members r e s p o n d t o t h i s e x p l a n a t i o n ? How d i d t h e w o r k e r h a n d l e t h i s r e a c t i o n ? D i d t h e w o r k e r t e l l t h e group what t h e y were g o i n g t o do i n t h e f o l l o w i n g m e e t i n g s ? What was t h e e x a c t e x p l a n a t i o n g i v e n ? How d i d t h e members r e s p o n d t o t h i s e x p l a n a t i o n ? How d i d t h e w o r k e r h a n d l e t h i s r e a c t i o n ? D i d t h e w o r k e r d i s c u s s w i t h t h e members 'the l e n g t h o f t i m e t h e g r o u p w o u l d be o p e r a t i n g ? How d i d t h e members r e s p o n d ? Please i l l u s t r a t e .  - 153  -  -2-  Ill  5.  D i d the members ask questions about the worker's r o l e i n the group? What s p e c i f i c questions were asked? How d i d the worker respond t o the Members' questions? How d i d the members respond t o t h e worker's e x p l a n a t i o n s ? How d i d the worker handle t h i s response? Please i l l u s t r a t e .  6.  Describe how the group's a c t i v i t y f o r the f i r s t - m e e t i n g got s t a r t e d ? Was the a c t i v i t y i n i t i a t e d by: (a) worker (b) member (c) both How d i d the members respond t o t h i s a c t i v i t y ? How d i d the worker handle t h i s response?  7.  What d i d the worker want t o a c c o m p l i s h most i n the f i r s t meeting with the group? What a c t i v i t y d i d the worker choose t o accomplish t h i s ? Was t h i s by: (a) d i s c u s s i o n (b) c r a f t s (c) speaker (d) other How d i d the worker use t h i s a c t i v i t y ? Please i l l u s t r a t e . How d i d the members respond t o t h e a c t i v i t y ? Please i l l u s t r a t e . How d i d the worker respond t o the behaviour of the members? Please i l l u s t r a t e .  8.  How was t h i s meeting terminated? Did the worker and/or member terminate the meeting? How was t h i s accomplished? What s p e c i f i c a l l y d i d t h e worker do? Please i l l u s t r a t e . What was the member r e a c t i o n t o t h i s ? How d i d the worker handle t h i s r e a c t i o n ?  Describe a second meeting - one which i s p r e f e r a b l y way through the group s e s s i o n s . 1.  half-  What d i d the worker want t o accomplish most i n t h i s meeting? Please i l l u s t r a t e , . D e s c r i b e how the worker planned t o accomplish t h i s ?  - 154 -3-  IV  2.  E e s c r i b e how t h e g r o u p ' s a c t i v i t y f o r t h e m e e t i n g was started? Was t h i s i n i t i a t e d by: (a) w o r k e r (b) members (c) b o t h D e s c r i b e how t h e members r e s p o n d e d t o t h i s a c t i v i t y ? W o r k e r ' s r e p o n s e t o member's r e a c t i o n .  3.  D i d t h i s a c t i v i t y continue? I f s o , what f a c t o r s i n c o n t i n u i n g t h i s a c t i v i t y were i n f l u e n c e d ? (a) by t h e w o r k e r (b) by t h e members I f n o t , d e s c r i b e t h e changes i n t h e a c t i v i t y . Who i n i t i a t e d t h e change? (a) w o r k e r (b) members (c) o t h e r Members' r e s p o n s e t o t h e c h a n g e . Worker's response t o the change.  4.  How was t h i s m e e t i n g t e r m i n a t e d ? D i d t h e w o r k e r a n d / o r member t e r m i n a t e - t h e m e e t i n g ? How was t h i s a c c o m p l i s h e d ? What s p e c i f i c a l l y d i d t h e w o r k e r do? What was t h e member r e a c t i o n t o t h i s ? How d i d t h e w o r k e r h a n d l e t h i s r e a c t i o n ?  Describe the f i n a l  meeting.  1.  What d i d t h e w o r k e r want t o a c c o m p l i s h most i n t h i s meeting? Please i l l u s t r a t e . D e s c r i b e how t h e w o r k e r p l a n n e d t o a c c o m p l i s h t h i s .  2.  D e s c r i b e how t h e g r o u p ' s a c t i v i t y f o r t h e m e e t i n g was started? Was t h i s i n i t i a t e d b y : (a) w o r k e r (b) members (c) b o t h D e s c r i b e how t h e members r e s p o n d e d t o t h i s a c t i v i t y ? W o r k e r ' s r e s p o n s e t o member's r e a c t i o n .  3.  D i d t h i s a c t i v i t y continue? I f s o , what f a c t o r s i n c o n t i n u i n g t h i s a c t i v i t y was i n f l u e n c e d by: (a) t h e w o r k e r (b) t h e members I f n o t , d e s c r i b e t h e changes i n t h e a c t i v i t y . Who i n i t i a t e d t h e change?  -  155  -  -4(a) w o r k e r (b) members (c) o t h e r Members' r e s p o n s e t o t h e c h a n g e . Worker's r e s p o n s e t o t h e change. 4.  How was t h i s m e e t i n g t e r m i n a t e d ? D i d t h e w o r k e r a n d / o r member t e r m i n a t e t h e m e e t i n g ? How was t h i s a c c o m p l i s h e d ? What s p e c i f i c a l l y d i d t h e w o r k e r do? What was t h e member r e a c t i o n t o t h i s ? How d i d t h e w o r k e r h a n d l e t h i s r e a c t i o n ?  - 156 -  BIBLIOGRAPHY  GEEERAL REFERENCES Barnwell, John E.- "Group Treatment of O l d e r Adolescent Boys i n a Family Agency." S o c i a l Casework, V o l . XLI,  No. £, May I960, pp. 250-253.  Clemenger, F., et a l . "The Role of the S o c i a l Worker i n the Helping P r o c e s s . " C e r t i f i c a t e Program i n the S o c i a l S e r v i c e s Residence Seminar, School of S o c i a l Welfare, U n i v e r s i t y of C a l i f o r n i a , Berkeley, June 9-21, 1958. Conrad, Gertrude J . "Development of a Group C o u n s e l l i n g Program i n a Family S e r v i c e Agency." S o c i a l Casework, V o l . XXXIX, No.10, December 1958, pp.560-573. F a l c k , Hans S. "The Use of Groups i n the P r a c t i c e of S o c i a l Work." S o c i a l Casework, V o l . XLIV, No. 2, February  1963, pp. 63-67.  G o l l e r , Gertrude. "Use of t h e Small D i s c u s s i o n Groups i n Parent E d u c a t i o n . " '-Journal o f the S o c i a l Work, N a t i o n a l A s s o c i a t i o n of S o c i a l Workers, Vol.2, No.2, A p r i l 1957, pp.47-50. Kramer, Sidney, et a l . "Some P r i n c i p l e s and Techniques I d e n t i f i e d i n the Records of the Eager V a l l e y Mothers' Group." Residence Seminar Culminating the C e r t i f i c a t e i n the S o c i a l S e r v i c e s S o c i a l Welfare Extension, School of S o c i a l Welfare, U n i v e r s i t y of C a l i f o r n i a , Berkeley, June 13-25, I960. P f e i f f e r , E l i z a b e t h , et a l . " S o c i a l Work With I n d i v i d u a l s and Groups." F i n d i n g s ; C e r t i f i c a t e Program i n the S o c i a l S e r v i c e s Residence Seminar, School o f S o c i a l Welfare, U n i v e r s i t y of C a l i f o r n i a , Berkeley, June  9-21,  Phillips,  1958.  Helen U. E s s e n t i a l s of S o c i a l Group Work S k i l l . A s s o c i a t i o n Press, Nev; York, 1957.  Rosenbaum, Max and Berger, M i l t o n , ed. Group Psychotherapy and Group F u n c t i o n . B a s i c Books, Inc., New York,  T96T:  -  157  -  Saloshin,  E t t a H. D e v e l o p m e n t o f a n I n s t r u m e n t f o r t h e A n a l y s i s o f t h e S o c i a l Group Work M e t h o d i n T h e r a p e u t i c S e t t i n g s . Ph.D. T h e s i s , U n i v e r s i t y o f M i n n e s o t a , M i n n e a p o l i s , March 1954.  Schwartz,  William. "The S o c i a l W o r k e r i n t h e G r o u p . " P r o c e e d i n g s N a t i o n a l C o n f e r e n c e o f S o c i a l Work 1961, pp.146177.  Wilson,  Gertrude. "The S o c i a l W o r k e r ' s F u n c t i o n a n d R o l e s i n Groups." F i n d i n g s , C e r t i f i c a t e Program i n t h e S o c i a l S e r v i c e s R e s i d e n c e Seminar, S c h o o l o f S o c i a l W e l f a r e , U n i v e r s i t y o f C a l i f o r n i a , B e r k e l e y ^ J u n e 9-21, 1958.  Wilson,  G e r t r u d e and R y l a n d , G l a d y s . S o c i a l Group Work Houghton M i f f l i n Co., B o s t o n , 1949.  Practice.  W i l s o n , M a r g a r e t , e t a l . "Some Common E l e m e n t s o f t h e H e l p i n g P r o c e s s i n S e l e c t e d P r o f e s s i o n s . " C e r t i f i c a t e Program i n t h e S o c i a l S e r v i c e s Residence Seminar, S c h o o l o f S o c i a l Welfare, U n i v e r s i t y of C a l i f o r n i a , Berkeley, June 4-16, 1956.  S P E C I F I C REFERENCES K e r r , Ann M. a n d K i r k h a m , E l i n o r M. Caseworkers Working With G r o u p s . M a s t e r s o f S o c i a l Work T h e s i s , U n i v e r s i t y o f B r i t i s h Columbia, 1963. Klein,  J o y c e G. A d u l t E d u c a t i o n and T r e a t m e n t Groups i n S o c i a l A g e n c i e s , A. D i s s e r t a t i o n . Catholic University of A m e r i c a P r e s s , W a s h i n g t o n , D.C., I 9 6 0 .  Konopka, G i s e l a . Social Prentice-Hall,  Group Work: A H e l p i n g P r o c e s s . I n c . , E n g l e w o o d C l i f f s , N . J . , 1963.  

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