The Art and Science of Group Counseling
Rex Stockton Indiana University
This article is based on the keynote address given by Dr. Stockton at the Association for Specialists in Group Work (ASGW) Luncheon at the ASGW Biennial Conference in New Orleans, LA, on February 19, 2010.
I am pleased that my talk and the conference theme focus on both the art and the science of group counseling because these two domains truly go together. ASGW members will know that there are various classifications of group work; for my talk today I am going to highlight only one of them, that is group counseling. There are many useful definitions of the term. Today, I want to use Bob Conyne’s (in press) definition as a ‘‘therapeutic and educational method . . . to facilitate interpersonal problem solving processes among members, as they learn how to resolve difficult, but manageable problems of living, and how to apply gains in the future.’’
When I started in this field in the 1960s there was a great deal of enthusiasm and an explosion of group leadership activity, without much knowledge of what works best. In other words, there was much enthusiasm but generally speaking practice was not informed by a knowledge base. Happily, over the years, the field has developed exponentially. One important development has been the growth of counseling in both individual and group work as a worldwide phenom- enon. Individual countries have adapted our profession to their unique cultural identities and needs, retaining elements that are universal.
Throughout my career, I have been impressed with the talent of the people active in its development as well as with the increasing sophisti- cation of what we know about group counseling and how we practice it. Ours is a multi-disciplinary field in which other helping areas such as social work, psychiatry, and psychology also have good claim.
Rex Stockton, Ed.D., is the Chancellor’s Professor at Indiana University, Bloomington. Correspondence concerning this article should be addressed to Rex Stockton, 201 N. Rose Ave #4056, Bloomington, IN 47405. E-mail: firstname.lastname@example.org
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# 2010 ASGW
From the beginning, I have been concerned with the education that we provide group leaders, as well as the efficacy of the procedures that we use in our group work. For many years, I was privileged to teach an advanced group counseling course. My students at Indiana University were doing graduate work, and in our program they had learned a great deal about group leadership theory as well as the research base underlining our practice. However, almost inevitably when they began leading a group, they experienced difficulty. While they understood the underlying group dynamics fairly well and could tell me what kind of intervention might work in specific situations, often they could not perform a specific intervention with proficiency. In other words, they had not developed the art of group leadership.
In 1980, I authored a review in The Journal for Specialists in Group Work entitled, ‘‘The Education of Group Leaders: A Review of the Literature With Suggestions for the Future.’’ I noted that group leadership training at that time was approximately at the same place that training for individual counseling had been 10 years earlier; that is, there were competing training models without much evidence of their efficacy.
The reports in the literature were generally descriptive with little or no data-based results. Yet, they did constitute a beginning. Happily, quite a lot has happened in the intervening years.
Through a variety of individual studies as well as several meta- analyses, we know that counseling in general is efficacious (McRoberts, Burlingame, & Hoag, 1998). For our work, it is also good to know that research has demonstrated that group counseling can be regarded as effective as individual counseling. As Barlow, Fuhriman, and Burlingame (2000) have noted, ‘‘The efficacy of group psycho- therapy has been undeniably established in the research literature.’’ Having said that, it is also true that practitioners very often do not make use of the research knowledge base. This is because they do not feel that it is relevant.
When criticizing group research for its lack of practical relevance, it would be easy to focus solely on single studies, any one of which will necessarily have limitations. However, it is not useful to view research as a series of isolated and independent studies. As my colleague, Keith Morran, and I have recommended, those who want to conduct research should plan to develop an ongoing program of study that will evolve and can be modified to provide increasingly relevant data. This is important because an evolving program also offers the advantage that each round of data collection serves as a pilot study for the next. Data collection can be expanded to include promising outcomes and the elimination or reduction of areas that show little promise. Thus, such programmatic studies, as they evolve, can become increasingly focused
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on the real world concerns of group practitioners. This is especially true when group clinicians are included as members of the research team. Lau, Ogrodniczuk, Joyce, and Sochting (2010) have provided an example of research with heavy clinician input in a study of depressed Chinese clients in a mental health outpatient service in Canada. The mental health practitioners were able to provide valuable input into the need for the creation of both a Cantonese and Mandarin group treatment program.
Of course these recommendations do not solve all the problems of the disjunction between research and practice. In an ideal world, theory informs research, which then systematically examines the theory to see if it is possible to be validated or discredited. Valid results can then be placed into practice. As mentioned earlier, we all know that in the real world research findings are often not integrated into clinical practice.
Perhaps the most damning reason given for the lack of integration is the constraints of experimental research. These include the need to control for extraneous variables. This necessarily limits the immediate usefulness of the findings to a real world context. In essence, studies may be internally valid but limited in terms of practical value. Thus, the need in our applied field for studiesthat are directly relevant to practice.
This type of research can be thought of as:
(a) practical and aimed at meeting group members’ and leaders’ present needs,
(b) realistic and not intended to make sweeping global claims, and (c) adaptable and not rigidly forced to fit into a prearranged research
design (Stockton & Toth, 1997).
It should be noted that, while the results of such studies are usually limited in their generalizability, they may still provide important findings that can be applied to other group settings with appropriate caution.
Now, I would like to focus on a few studies that will illustrate the value of research findings—and how they can impact practice. Let us begin with the Lieberman, Yalom, and Miles (1973) study of the 1970s. This seminal effort resulted in the classic book, Encounter Groups: First Facts (1973), which informed us of the kind of group leadership approaches that worked best with specific populations. We also learned that certain types of leadership can have negative as well as positive results. Later, Bednar and his colleagues (1974, 1977, & 1978) conducted a series of studies that taught us a great deal about the usefulness of an optimal amount of structure in group work.
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In the 1980s, someone named Stockton and his close colleague, Keith Morran, along with a research team of graduate students com- pleted a programmatic effort on interpersonal feedback in counseling groups. At the time, it was known that feedback was an important fac- tor in inducing change; however, there was not a solid research base. Our team examined factors that influence both positive and negative feedback in a systematic way. Utilizing the results of this effort, we were able to suggest guidelines for maximizing both positive and corrective feedback that have been widely adopted. A good reference here would be the article, ‘‘Facilitating Feedback Exchange in Groups: Leader Interventions’’ (Morran, Stockton, Cline, & Teed, 1998).
More recently, Dennis Kivlighan and his colleagues (Kivlighan & Shaughnessy, 1995) have shed light on important therapeutic pro- cesses in group work, especially therapeutic factors (Kivlighan, Jr., & Holmes, S. E., 2004). These are but a few of the programmatic efforts that have greatly influenced our current practice. Today is not a time to go into technical details. However I can tell you that each set of studies utilizes a more sophisticated research design, and increased methodological rigor. The list could be expanded to many other studies, but I want to illustrate both the usefulness of a research base as well as the increasing sophistication that has characterized the study of group counseling over the years. This is true, even though the procedures are so well accepted now that we forget that they had to be established at an earlier time.
I also want to note that I was quite pleased when I received an email notice regarding the preconference research workshop that has now taken place. This is another sign of our field’s increasing maturity, and recognition of the importance of research as well as the need for research training. While I strongly believe in the need for our work to be informed by solid research, at its heart, group coun- seling that is not done artfully is not apt to be effective. Time and again, those of us who lead groups or supervise group leaders are able to see the positive results of our efforts.
As groups cohere and individuals can share their hopes, fears and frustrations, there is a sense of relief as well as an opportunity to gain support and useful feedback. I’m quite sure that everyone here would be able to share an example of group counseling that made a differ- ence. However, since I’m doing the talk, I’ll give you an example that made a big impression on me.
Last summer, I had the opportunity to participate in a workshop in Botswana. The purpose of the workshop was to train school counselors in group procedures. Part of the workshop included testimony from a group of blind, adolescent, young women who had undergone a semester-long group experience at their residential school. We felt
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that it was important for the adult workshop participants to see how effective group work can be. The girls’ group leaders were students of our own Amy Nitza, who is part of an overall project with the name of International Counseling, Advocacy, Research and Education (I-CARE) which I coordinate. The I-CARE website is: http://site.educ. indiana.edu/Default.aspx?alias=site.educ.indiana.edu/i-care.
The project relates to Counselor Training and Research in Africa with emphasis on Botswana. We have been active for several years. Currently the volunteer staff includes U.S.-based university faculty and students along with colleagues in Botswana. As part of her overall assignment, Amy taught a group counseling class during her year as a Fulbright Scholar in Botswana. The rest of her assignment was at the HIV=AIDS Centre at the University of Botswana. Along with receiving didactic instructions, Amy’s students conducted groups under her supervision. (These included the adolescent girls’ group.)
It is important to know that in Botswana, as well as many other countries, women definitely have second class status. On top of that, to be blind and an adolescent has its own extra burden. Thus, it is not surprising, that these young women were frequently sexually and in other ways harassed. Sadly some of them are already HIV posi- tive. In their testimonies, they describe how alone and powerless they had felt. As a result of the group experience, it was heartening to hear how these young women had found a voice. They gave some testimo- nials to tell us how much they learned and were now much more able to turn down unwanted sexual advances and to stand up for each other. Words do not adequately describe the sense of optimism, confi- dence, enhanced self, unity, and hope that they portrayed. I deeply regret not being able to video-tape the testimony, so I could more fully share this joyful experience with you.
Through our project, we have trained many counselors in Botswana but nothing has given me more satisfaction than to see the fruits of this group training. For these young women, the group experience was life changing. I have no doubt that those who are here today could add many vignettes of your own which could illustrate how useful group work can be. The important thing to acknowledge is that our work can make a huge difference in the lives of others, and that this is accomplished through artful practice informed by science.
You are a sophisticated audience, so I don’t think that I need to go into efficacious leadership procedures. In addition to university classes, there are many excellent training opportunities. These include workshops and conferences, books, training tapes and research reviews from which it is possible to develop both a solid knowledge base and effective group leadership techniques. I think that we would all agree
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that appropriate knowledge and informed practice are the keys to successful leadership resulting in meaningful group change.
By ‘‘informed practice,’’ I am really thinking of Ericsson (1993, 1994) and his use of the term to mean sustained practice informed by appropriate feedback and reflection. Ericsson and his colleagues have studied expert performance in a variety of fields; his findings can be generalized to any field of expertise including our own. He and his colleagues have demonstrated that sustained practice coupled with feedback and reflection is the pathway towards competence. Practice without feedback and reflection on the feedback does not assist neophytes as they strive to become proficient. This concept has guided my own work in training others as well as trying to improve my own supervisory as well as group leadership skill level.
So far, I have tried to present a sense of how our knowledge base and practice have changed for the better in the last 50 years—which by the way coincides fairly closely with my own professional lifetime. If I had more time, I would focus on the current scene and what might be in store for us in the future. I have certainly given it a fair amount of thought lately. But that will have to wait for another day.
My work in Africa has made me painfully aware of the many ways that individuals can be harmed. Of course, all helping professionals are exposed to dysfunctionality, loss, pain, and suffering. It’s impor- tant to remember, however, that there can also be joy and fulfillment. Group work is not just work with extremely distressed individuals. In all its uses it can provide a way for individuals to learn more about themselves, solve problems, and live a fuller, more meaningful life. Being a skilled group work provider is an excellent way for each of us to have a meaningful career.
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