Perspectives on Social Group Work Practice

Albert S. Alissi

• Publisher: Free Press
• Year: 2008
• Print ISBN: 9780029004807
• eBook ISBN: 9781439119648
• Topic: Social Sciences
• Subtopic: Sociology
• Index: Social Sciences

Not simply another "how-to" book, this provocative collection of readings does not advance a single viewpoint or approach to group work. Instead, the 25 selections present the full spectrum of classic and current perspectives, providing student and practitioner alike with a sound basis for evaluating contemporary practice and for formulating a personal approach to social group work. The historical and conceptual roots of modern social group work methods are examined in Part I, "Conceptual Foundations" which contains some of the classic statements in the field. Part II, "Current Perspectives", explores the most widely influential contemporary models of group work, "social goals" perspectives, "remedial" perspectives, and "mediative" perspectives. The two-part section that concludes the volume focuses on applications: group work is first discussed in relation to family and community casework and administration; then, self-help groups and other techniques used in the fields of medicine, counseling, and psychology are surveyed in light of their implications for social workers. To encourage the reader's active participation in the development of an individual philosophy and approach to social group work, Dr. Alissi concludes each chapter with probing study questions. These open-ended questions stimulate comparisons among the methods presented and urge the reader to relate new ideas to his or her own experience in the field. Introductions to each part and chapter also stress comparative aspects. An annotated list of articles and books on the subject of each chapter allows the reader to explore it in greater depth. A stimulating and systematic exposure to the most important ideas in social group work today, "Perspectives on Social Group Work Practice" expands the repertoire of working concepts vital to contemporary practice.

24 Comparative Group Methods

Albert S. Alissi

Whatever else happens, the rapid expansion of radically different methods of working with groups is forcing us to re-examine our views regarding the significance of the small group experience to assess anew what is acceptable practice in the helping professions. It would appear that those long-fought-for principles and cherished values which have guided our work so much in the past must now somehow seek reaccreditation in a climate of vigorous methodological and ideological competition.

The current emphasis on emotional display, mutual touch, physical acting-out, and exhibition represents a greatly altered set of expectations of what people are encouraged to do in some groups. For example, the very need to lay down a rule that there be no physical fighting or breaking of furniture seems strange indeed when the group is composed of perfectly “healthy” adults. In one type of group (Ellis, 1970), a participant may be invited to have a “love experience” with another member of choice within the group. The two may also have five minutes of privacy to continue the experience on the condition they describe their activity in detail upon returning to the group. “Let it all hang out” seems to be the order of the day.

The customary role of the leader or therapist is also changing rapidly as leader-member distinctions are increasingly blurred. Gibb’s TORI groups (Gibb and Gibb, 1970), for example, highlight the dysfunctional nature of role behavior in groups and insist that the leader should be free of any role demands, role obligations, role prescriptions, and role expectations. And in one Marathon group, a male and female co-therapist give testimony to genuine involvement and authenticity as they escalate their personal differences in the group to the point where a physical fight erupts between them— presumably to the therapeutic advantage of the group’s members as onlookers (Fagan, Smith, and Timms, 1968).

Although progress has been uneven, generally the use of groups as a method of choice in working with people has achieved a new form of acceptance and respectability. This is evident in the bids for credit and competing claims for recognition that characterize the literature. In the field of medicine, for example, the initial uncertain acceptance of the work of such group therapists as Joseph Pratt, J. L. Moreno, E. W. Lazell, L. Cody Marsh, and Trigant Burrow has changed drastically within recent years. Moreover, current authors have somewhat belatedly sought to trace the contributions of the traditional therapies of Adler, Homey, Sullivan, and others to the development of group methods of treatment.

To be sure, the evidence is not always convincing. Kanzer (1971), for example, in his review of the minutes of the Vienna Psychoanalytic Society, seems to be stretching a point with his claim that Freud’s leadership of the society of early Viennesian analysis made him the “first psychoanalytic group leader.” And Moreno (1969), who has been described as “a visionary of no less than cosmic dimensions,” doubtless has been most influential through the years, although some will probably react with surprise to his claim that the encounter movement, existentialism, group dynamics, and sensitivity grew out of the Austrian encounter experience he himself described as far back as 1914. On the other hand, Dreikurs (1971, p. 21), who practiced “collective therapy” in Vienna in the 1920s, claims that Moreno’s work there “had nothing to do with group psychotherapy as we understand it today.” There are of course those who hold no such positive views regarding groups and who make no such claims. Hence Jung, true to the end, stated, “When a hundred clever heads join a group one big nincompoop is the result because every individual is trammeled by the otherness of the others” (Illing, 1963, p. 134).

The main focus here will be on describing the different methods of working with groups that are commonly employed in the field of medicine, counseling, psychology, and social work. Although the descriptions will help to compare and contrast alternative ways of working with groups, the basic intent is not to assess and evaluate their respective merits, but rather to highlight their prominent features. The necessity of a critical review cannot be denied, but there is a more immediate need to better understand the full range of group methods, for few if any writers have chosen to deal with the subject in a comprehensive manner.

For the group methodologist intent on conceptual clarity and organization, there are the usual frustrating problems of overlapping approaches, elusive assumptions, confusing terminologies, and inconsistent practices and techniques. Clearly, these problems will not be resolved here. First, no one has ever been able to capture the full essence of any human experience and formulate it into a model that serves as an exact replica of real life. There are perhaps as many if not more unrecognized forces at work that are overlooked as practice experiences are translated and systematized. Second, no approach is methodologically pure, for in human relations one can never separate the influences of the leader’s personal style from the dictates of the method. Third, our tendency to treat alternative methods as though they were unstable entities is unreal, for techniques and methods are not only changing but are also shared and borrowed, often blurring distinctions between the approaches.

Although group methods may of course be categorized in different ways, the usefulness of the distinctions in the final analysis will depend on how closely they resemble reality. The decision to organize them according to disciplines, as was done here, merely forces us to recognize that the point of departure for the vast majority of group leaders will more than likely stem from their professional identifications.

MEDICAL CLINICAL APPROACHES

The group procedures that have characterized the medical-clinical field, in contrast to the usual accepted standards of the profession, have lacked specificity and standardization. No classification has as yet been developed that clearly explicates group methods and techniques in dealing with and “curing” medically recognized problems and symptom categories. Whereas a range of practitioners with varying kinds of training engage in group treatment in medical settings, it would appear that it is more often the conceptualizations and terminologies that are carefully guarded rather than the actual practice techniques that distinguish group psychotherapy from the others. On the advice that psychiatrists might think it presumptuous for lay therapists to describe their activities using medical terminology, Slavson some time ago avoided the use of the term “group psychotherapy,” substituting the more broadly diffused term “group therapy” to describe his work (Spotnitz, 1961). Yet Slavson, perhaps more than anyone else, is responsible for the fact that in the United States group psychotherapy functioned as a brand of applied psychoanalysis (Anthony, 1971). In any case, in the field of group practice, one seldom hears any one accused of “practicing medicine without a license.”

The varied medical approaches that characterize today’s practice can be traced to the efforts of a relatively few pioneering group therapists (Corsini, 1957; Moreno, et al., 1966; J. L. Moreno and Z. T. Moreno, 1959; Lieberman, 1977).

Dr. Joseph Pratt (1907), a Boston internist, is generally acknowledge as the first to utilize group psychotherapy, although it was not clear that he was always aware of the potential curative powers residing in groups. In 1907 he conducted “thought control” classes of tuberculosis patients. These consisted of group sessions where patients received group recognition for individual progress towards health. Sessions were spotted with periods of relaxation and short inspirational lectures. Later his approach was extended to psychosomatic patients (Pratt, 1953). There was some criticism from the medical profession of Pratt’s earlier work, which was sometimes confused with the Emmanuel Church Movement because Reverend Worcester-who had himself successfully helped people in groupsprovided funds to help Pratt launch his “experiments” (Pinny, 1978).

Lazell (1921, 1930) used lectures, inspirational talks, selected readings, and analysis of psychoanalytic and popular literature with Dementia Pracox patients at St. Elizabeth Hospital in the 1920s. Similarly, L. Cody Marsh (1931) gave a series of thirty lectures dealing with hospital adjustment, growth, and development to psychotics at Kings Park Hospital. In the 1930s he used group singing, arts, and crafts and included similar methods with hospital personnel, relatives, and other members of the communities (1933). J. W. Klapman (1946) used a “didactic” group psychotherapy and developed a textbook of his lectures to be read by patients in conjunction with outside reading assignments. Anonymous case histories and autobiographies written by patients were also discussed.

The more psychoanalytically orientated approaches were advanced by such therapists as Trigant Burrow, Louis Wender, and Paul Schilder. Burrow (1927) introduced the term “group analysis” and later “phyloanalysis” to describe his early method, which stressed the importance of the “here-and-now,” spontaneity, and immediacy and sought to bridge the gap between feelings and verbalization among his patients. Wender (1940) was perhaps the first to conduct psychoanalytically oriented groups in hospital settings during the 1930s. Combining individual and group therapies, he started seeing small single-sex groups of patients two or three times a week and worked intensively with group feelings, which were seen to be representative of family conflicts. Around the same time, Paul Schilder (1936) utilized psychoanalytic techniques in groups at Bellevue. He was among the first to share and justify his own personal ideology with the group and was in this sense very much a part of the group process. The technique, however, has never really caught on in group psychotherapy.

Some of the current clinical approaches will be described briefly under the following headings: Freudian Group Psychotherapy, NeoFreudian Approaches, Activity Group Therapy, Tavistock, Group Psychotherapy, Adaptive Approaches, Psychodrama, Reality Therapy, Transactional Analysis, Behavioral Therapy in Groups, Existential Group Psychotherapy, Bio-energetic Therapy, Primal Scream, Therapeutic Social Clubs and Communities, and Repressive- Inspirational Groups.

Freudian Group Psychotherapy

In the psychoanalytic tradition, groups of about eight to ten patients ranging from eighteen to sixty in age sit facing each other in a circle interacting primarily through discussion for the purpose of exploring and interpreting unconscious processes. Groups are usually self-perpetuating, with patients entering and leaving the group as they are deemed to be ready. The groups serve as a “control” on free association as resistances are interpreted by group members as well as the therapists. Members are encouraged to air past experiences as well as to focus on current disturbances in their relationships. Although therapists vary in their directiveness, the role of “doctor” is clearly understood.

Alexander Wolf ranks among the better known psychoanalysts to directly apply the principles of individual psychoanalysis to the group (Wolf and Schwartz, 1962, 1971). Antagonistic to the use of group dynamic concepts, he maintained that the group itself cannot be used as a means for resolving intrapsychic problems and at one time at least referred to his method as psychoanalysis of groups rather than psychoanalysis in groups. Wolf introduced the technique of “going around,” which is a procedure where each member in turn free associates about the next member. He also introduced the “alternative session,” whereby the group meets on occasion without the therapist present to continue psychotherapy relatively uninfluenced by the therapist. In contrast to Wolf, S. H. Foulkes (1948, 1957; Foulkes and Anthony, 1965), the noted British psychoanalyst, utilizes a method he calls “Group Analytic Psychotherapy,” in which he incorporates field theory and group dynamic concepts. In his approach, the “doctor must be group oriented as well as individually oriented.” The therapist is likened to a “conductor” functioning as a participant-observer unobtrusively directing, encouraging, and withdrawing from the group.

Neo-Freudian Approaches

Included within the analytic approaches are a variety of “schools” based on the traditional theories of Adler, Horney, Sullivan, and others that have resulted in currently recognized distinctive group therapies. Rudolf Dreikurs (1957), an Adlerian, has advanced a group method that recognizes the social nature of man’s conflict and sees the group as ideally suited to highlight and reveal these conflicts and offer corrective influences. Inferiority feelings are most effectively counteracted as attitudes and values are directly affected within the group. The Group Analysis of Bohdan Wassell (1966) is perhaps the most explicit approach based on the theories of Karen Homey, where the goal of analysis is to mobilize and organize the patient’s striving toward self-realization and full development as a human being. The therapist is a “conductor-participant,” supporting and encouraging the group members’ movement toward spontaneous self-expression and self-growth. Sidney Rose (1957) incorporates Homey’s concept of the here-and-now and concentrates on the basic health strivings, which can be freed to develop into constructive integrating patterns as neurotic adaptations are worked through. George Goldman (1957) has applied Harry Stack Sullivan’s theories to group psychotherapy. The therapist is a participant-observer of the human interaction who seeks to acquaint patients with the various processes and techniques they employ to minimize and avoid anxiety.

These distinctions seem to lose meaning in practice. Hyman Spotnitz (1961) indicated, for example, that he heard himself described as a follower of Freud, Alder, Sullivan, Rank, Stekel, T. Reik, W. Reich, and others, and that he was referred to as a follower of Carl Rogers before he had any knowledge of Rogers’s concepts or procedures.

Activity Group Therapy

S. R. Slavson (1945) has contributed a form of group therapy based on psychoanalytic concepts, which he used primarily with disturbed children ranging from age seven to fifteen. Group members are carefully selected on the basis of their mutual therapeutic influences. The children are encouraged to utilize nonverbal forms of expression, participating at their own pace in a variety of activities: arts and crafts, cooking, going on trips, and so on. An extremely permissive group atmosphere is created, where children “act out their impulses, hostilities, and fantasies, even to the point of committing aggressive acts directed against the person of the therapist.’” The therapist has no particular role but seeks to meet the patient’s conscious and unconscious needs in an unobtrusive manner. Latent aspects of children’s behavior are interpreted in terms of psychoanalytic concepts. More recently, Slavson and Schiffer (1975) have pulled together theories and practices of group psychotherapy with children where activity group therapy is seen as one of a variety of methods including activity-interviews, group psychotherapy, play group therapy, and therapeutic play groups.

Tavistock

W. R. Bion (1959), the noted British psychoanalyst associated with the Tavistock Clinic, developed the theory that groups could best be described in terms of their prevailing emotional states or “basic assumption cultures.” Individuals were seen to be functioning in terms of “valences,” such as pairing, expressing a need for dependency, and “fight-flight.” Group movement was seen as shifts from one emotional culture to another. In this method the therapist “establishes no rules or procedures and puts forth no agenda.” He makes it clear from the start that he is not the group leader but is a participant observer more interested in observing and studying group tensions. The reactions created by his refusal to be drawn into active leadership provides the material for interpretation. Such groups are sometimes referred to as study groups or “S” groups, because the therapist or consultant is essentially concerned with alerting participants to ongoing group process to study and explore their experiences as members of a social unit. Interpretations are made concerning emotional states observed and are based on group rather than individual behavior.

Henry Ezriel (1950, 1952), a contemporary of Bion, also used an ahistorical approach and is in fact credited with having coined the expression “here-and-now,” which so permeates the literature. In his view, patients will express themselves through three kinds of patienttherapist fantasized relationships: that which is required, that which is to be avoided, and that which is calamitous. Collectively, these eventuate in a common group tension, which emerges into a common group structure. In the usual format, the therapist identifies the common group structure, which is interpreted to the whole group, followed by individual interpretations of various avoided and anticipated calamitous relationships. The therapist, according to Ezriel, is “nothing but a passive projection screen except for his one active step of interpretation.” For example,

In one group, in which the majority of members remained in therapy for nine years and three for eleven years, the members at the end of therapy discussed the changes that had occurred in each person; they all agreed that, aside from being a decade older, Dr. Ezriel had not changed whatsoever. “That,” states Dr. Ezriel, “is a good technique” [Yalom, 1970, p. 138].

Bion’s basic assumptions, Ezriel’s common group themes, and Whitaker and Lieberman’s group focal conflicts are leading examples of “holistic” approaches insofar as they rely on assumptions about the unity of group themes. Leonard Horwitz (1977) offers a contrasting “group-centered” approach that does not pass over individuals in deducing group themes but inductively works through individual contributions as a step in a process that eventually leads to a focus on group themes.

Group Psychotherapy

Drawing from research studies and experiences of patients as well as group therapists, Irvin Yalom (1970) was able to identify different “curative factors,” which represent the successful components of group therapy and assume varying importance depending upon group purposes, composition, stages of treatment, and so forth. The curative factors divide into ten categories: imparting information, instillation of hope, universality, altruism, the corrective recapitulation of the primary family group, development of socializing techniques, imitative behavior, interpersonal learning, group cohesiveness, and catharsis. The overall function of the therapist is to create and maintain a therapeutic atmosphere, which depends largely on the development of therapeutic resources in the group to facilitate the application of the curative factors. Utilizing specialized knowledge and techniques, the therapist functions both as a “technical expert” in creating and maintaining a therapeutic atmosphere and as a model-setting participant in influencing group norms and culture building. In keeping with the view that the patient’s behavior in the group is an accurate representation of interpersonal behavior outside the group, Yalom emphasizes the ahistoric here-and-now approach.

Adaptive Approaches

Unlike the analytic approaches, James Johnson (1963), has advanced a form of group therapy that does not ...

Table of contents

• Cover Page
• Title Page
• Contents
• Conceptual Foundations
• Social Group Work Commitments and Perspectives
• Some Basic Assumptions About Social Group Work
• The Social Group Work Process
• Frame of Reference for Social Group Work
• Group Work and Democracy—A Philosophical Note
• Education for Social Action
• Play as a Means of Social Adjustment
• Regulatory Principles
• Current Perspectives
• Social Group Work Models Possession and Heritage
• Models of Group Development Implications for Social Group Work Practice
• Social Group Work A Model for Goal Formulation
• The Social Group Work Method
• What Is Group Work Skill
• Group Work Revisited A Statement of Position
• A Humanistic View of Social Group Work Worker and Member on a Common Human Level
• The Generic and the Specific in Group Work Practice in the Psychiatric Setting
• The Essential Components of Social Group Work Practice
• On the Use of Groups in Social Work Practice
• The Mechanics of the Model
• Social Group Work An Intersystemic Frame of Reference
• Related Applications
• A Group Work Approach to Family Group Treatment
• Instructed Advocacy and Community Group Work
• Administration as a Group Process Philosophy and Concepts
• Comparative Group Methods
• Self Help Groups and the Professional Community
• Index