Fostering the group therapeutic process

“Foster the group therapeutic process” (NBCC, 2027 task 4.5)

Group counseling uses the interactions among members as a powerful source of change. The counselor's job is to create safety, build cohesion, manage conflict and help members learn from the here and now. The exam tests group stages, therapeutic factors and leader skills such as linking and blocking.

Key points

Yalom described therapeutic factors including instillation of hope, universality, imparting information, altruism, corrective recapitulation of the primary family group, development of socializing techniques, imitative behavior, interpersonal learning, group cohesiveness, catharsis and existential factors.
Tuckman's stages are forming, storming, norming, performing and adjourning; other models describe initial, transition, working and final stages.
Linking connects members' common themes; blocking stops harmful behavior, such as attacking, gossiping or breaking confidentiality; drawing out invites quiet members.
Focusing on the here and now (what is happening among members in the room) deepens interpersonal learning.
Conflict in the transition stage is normal; the leader helps members address it openly rather than suppressing it.
Screening and preparation before the group starts improve fit and reduce dropout.
The ASGW (Association for Specialists in Group Work) publishes best practice and training standards for group workers.

In practice

In a group for adults with social anxiety, a member says she always feels everyone is judging her. The leader links her comment to two others who described similar fears, and the members notice they are not alone.

A group member repeatedly interrupts others with advice. The leader gently blocks him, asks him to let the speaker finish, and later invites him to say what it is like for him to hear others struggle.

Check yourself

What is universality in group counseling?

Members' recognition that others share similar problems, which reduces isolation.

What is the purpose of blocking?

To stop behavior that harms members or the group, such as attacking, interrupting or breaching confidentiality.

What typically happens in the storming stage?

Conflict, resistance and testing of the leader and of norms, which the leader helps members address openly.

NBCC's knowledge and skills for Domain 4

Knowledge of: Substance use disorder interventions; Core conditions; Client suitability; Multicultural and Social Justice Counseling Competencies; Core Counselor/Counseling attributes; Formative and summative feedback; Counseling theories and strategies; Counseling modalities.

Skill in: Addressing inappropriate client behavior during the session; Reading nonverbal cues; Active listening; Open-ended questioning; Reflecting skills; Summarizing; Reframing; Paraphrasing; Closed-ended questioning; Establishing therapeutic alliance/rapport; Broaching; Tailoring culturally responsive interventions; Self-disclosure; Immediacy; Applying theories appropriately; Providing psychoeducation; Perspective taking; Use of confrontation; Use of silence; Giving feedback; Crisis intervention; Repairing and resolving client rupture; Establish and maintain professional boundaries; Session management (time management); Communicating with clients; Maintaining confidentiality; Linking; Blocking; Facilitating here and now awareness; Modeling; Core counselor attributes (Empathy; Unconditional positive regard; Authenticity; Genuineness; Congruence).

A study guide written by ExamDragon from NBCC's published task; not NBCC material and not part of the exam.