Facilitating Open-Ended Groups

Facilitating
Open-Ended Groups
Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC
Executive Director: AllCEUs Counselor Education
Host: Counselor Toolbox Podcast
Objectives
~ Define closed, open and single-session groups
~ Explore the benefits and challenges for each
~ Identify the developmental phases for open groups
~ Discuss necessary skills for managing open-ended groups

Definitions
~ Closed groups are those which begin with a group of people and do not add anyone else (i.e. a 12 week anxiety management group)
~ Single session groups are stand-alone groups in which participants are not expected to return (i.e. A 4 hour grief workshop)
~ Open groups are those which do not have a set number of sessions and participants regularly rotate in and out.
Closed Group
Benefits
~ Participants all begin at the same time and learn the same material
~ When all begin together, the developmental process occurs in a predictable way: Forming, storming, norming and performing (Tuckman 1965)
~ Participants form more intimate bonds

Drawbacks
~ As people leave, there is no replacement
~ There is often a waiting period for people to get into groups which is not ideal for emergent issues.
~ When people drop out, they usually cannot return

Single Session Group
Benefits
~ Uses a brief intervention model during a longer session.
~ Available like a “menu”
~ Does not require the participant to return another day

Drawbacks
~ Requires the full development of the group in one session
~ Does not typically help participants translate knowledge into practice
~ Typically more psychoeducational in nature
Open Ended Groups
Benefits
~ Available on-demand for emergent concerns
~ Meets the guidelines for co-occurring disorder treatment of episodic care
~ Provides a gentle transition back into care
Drawbacks
~ A certain amount of forming and norming happens each time a new member arrives or rejoins
~ It is harder to develop a deep level of trust with client rotations
~ Requires clinicians to be highly structured, able to foster cohesion between old and new members and
~ Facilitators must be able to develop a clear and specific purpose
~ Facilitators must thoroughly research expected needs to be able to facilitate “on the fly”
Forming in an Open Ended Group
~ Facilitator Planning
~ Divide the topic into stand-alone groups
~ Someone who was not there last week should still be able to benefit this week.
~ Consider a cyclic rotation (every 8-16 sessions w/new information )

Forming in an Open Ended Group
~ Pre-group orientation
~ Explain the expectations and the rules for group
~ Attendance and how to withdraw
~ Participation
~ Reasons for discharge
~ Review what will be covered in group (weekly schedule)
~ Provide introductory information (handouts, videos)
~ Develop personal goals for group
~ Before group starts
~ Buddy up the new member with an existing member
Forming in An Open Ended Group
~ The first (or only) session
~ Goals: Create cohesion, provide a useful nugget
~ New people introduce themselves and identify what they hope to get out of group (5-10 minutes)
~ Have current members share if they have similar goals
~ Tom: I am just so tired of being tired and depressed all the time. I want to find a way to get some pleasure back.
~ Jim Responds: I hear you. When I joined the group life almost didn’t seem worth living, but each week I learn more about the reasons I feel this way and small changes that have made a big difference.
~ Go around the group and have members share how they are doing, one way they dealt with their [issue] since the last group and one challenge they have experienced (if any) (10 minutes)
Storming in An Open Ended Group
~ Existing members typically take a facilitative lead to help empower new members to take full advantage in the group
~ Facilitators need to ensure one person does not dominate the group
Norming in An Open Ended Group
~ The first (or only) session
~ Present the topic for the day and link it to people’s tools and challenges
~ Challenges: Anhedonia, hypersomnia, no motivation
~ Group Topic: Distress Tolerance (10 minutes)
~ Review how dopamine, serotonin and norepinephrine are impacted by stress and can impact ability to feel pleasure, libido, sleep, appetite and motivation (ad lib)

Performing in An Open Ended Group
~ The first (or only) session
~ Group Topic: Distress Tolerance
~ Provide handouts on distress tolerance techniques
~ Teach each technique using multisensory approaches (20 minutes)
~ Have participants discuss (30 minutes)
~ How the new technique or information could have helped them address their challenge from the past week (anhedonia, motivation, hypersomnia)
~ How they can foresee remembering and using it in the upcoming week
~ How it will help them achieve their overall goal for group
Other Ways of Organizing Groups
~ By Symptoms
~ By Book Chapters (usu. self-help books)
~ Toxic Parents
~ Surviving the Borderline Parent
~ Self-Esteem
~ Grieving: A Beginners Guide
~ By Current Events
~ Other…

Sample Grief Group
~ The Impact of Grief and Trauma: What to Expect and How It Makes Sense (Behavioral, Emotional, Physical, Interpersonal, Cognitive, Spiritual)
~ Getting Support (LUV) from Others and Yourself: Listening, Understanding & Validating
~ Highlighting Resilience
~ Making Meaning
~ Transforming Crisis Into Opportunity
~ Managing Emotions: Promoting Feelings of Resolve and Competence
~ Envisioning Possibilities: Creative Coping
~ Taking Action
Based in part on Crisis Intervention: Promoting Resilience and Resolution in Troubled Times by Lennis Echterling et. Al.

Multisensory Techniques
Visual

~ Whiteboard
~ Graphs/ Drawings
~ Handouts
~ Worksheets
~ Analogy examples
~ Art therapy
~ Note taking
Other Adult Learning Tips
~ Ensure participants see how the group benefits them
~ Make it relevant to their lives
~ Use culturally appropriate examples
~ Take 2-3 minute thinking breaks every 10-15 minutes
Summary
~ Open-ended groups are the norm in most agencies
~ The biggest challenges with open ended groups are:
~ Structuring sessions so prior knowledge is not necessary participants have access to all the information.
~ Facilitating progression beyond superficial awareness
~ Developing cohesion among members
~ Tying participants’ current challenges to the planned topic
~ The biggest benefits are:
~ Episodic flexibility
~ Rapid admission
~ New perspectives