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Chapter 10. Group Facilitation and Counseling. Key Terms. Brainstorm – technique to generate as many ideas as possible for consideration Emotion-Based – feelings and emotional benefits that drive the behavior change approach

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Group Facilitation and Counseling

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key terms
Key Terms
  • Brainstorm – technique to generate as many ideas as possible for consideration
  • Emotion-Based – feelings and emotional benefits that drive the behavior change approach
  • Facilitator – uses group processes to keep members focused on content and guide the flow of a meeting
  • Ground Rules – set of guidelines for group members
  • Group Counseling – using group support to find solutions for lifestyle problems
  • Group counseling has been found to work effectively and efficiently either as a stand-alone program or in combination with personal counseling
  • 2 categories of group work:
    • Facilitating groups – focuses on leading a number of people with a particular goal in mind
    • Group counseling – provides guidance for working with groups where the objective is behavior change
communication styles
Communication Styles
  • 3 types of communication styles:
    • Submissive
    • Aggressive
    • Assertive – the most effective style for leading a group
using questions in a group
Using Questions in a Group
  • Whether you are facilitating a group towards a common goal, or conducting a group counseling intervention, having an arsenal of questions and knowing when to use them is essential
  • Appropriately used questions can help keep a group on task and moving toward desired goal
  • Types of questions will depend on objective
using questions in a group1
Using Questions in a Group
  • Questions help to encourage participation
  • Facilitator uses group processes to keep members focused on content and guide the flow of a meeting; designated leader of the group, team or committee
    • Must evaluate what types of questions are needed to move the discussion forward
    • Avoid questions that put individuals “on the spot”
facilitating groups
Facilitating Groups
  • Role of the facilitator is to use knowledge of group processes to provide structure allowing the group to remain focused on content and work effectively to bring about results
    • Processes include creating open and inclusive environment using methods that allow group members to interact productively with each other
    • Content addresses issues under discussion needed to reach the ultimate goals of the group
facilitating groups1
Facilitating Groups
  • Groups meet for various reasons:
    • Talk about a concern
    • Exchange information
    • Identify issues
    • Complete a task
    • Build consensus
    • Develop plans
    • Make a decision
    • Solve problems
facilitating groups2
Facilitating Groups
  • Desirable characteristics of a group facilitator:
    • Actively listens and observes
    • Shows respect and empathy
    • Appears honest and fair
    • Accessible
    • Asks probing questions
    • Thinks quickly
    • Assertive
    • Flexible
    • Uses humor
    • Knows a variety of techniques
    • Energizes the group
  • Who? When? Where? Why?
  • Goals are specific, concrete, positive, realistic, practical, defined
  • Agenda developed and sent to participants before meeting
  • Need to consider:
    • Equipment and supplies
    • How to solicit input of participants
    • Identifying support roles
    • Organization and flow of meeting
  • Methods for facilitating the meeting:
    • Pair-Share
    • Corners
    • ORID
    • Consensus
pair share
  • Process:
    • Facilitator supplies 1-3 questions for discussion
    • Participants work with a partner to discuss/answer
    • Participants share their ideas with the group
  • Advantages:
    • Works well with a large group
    • Provides an opportunity for all participants to discuss their thoughts and feelings
    • Comments likely to be more concise and coherent
  • Process:
    • Post the name of each task in a corner of a room
    • Participants move to the corner of the task that interests them most
    • Each corner has specific questions to address
    • Speaker from each corner reports to whole group
  • Advantages:
    • Works well when there are distinct tasks that need to be addressed
    • Participants are given choice of task
  • Process: questions should flow naturally from one stage to the next)
    • Objective Discussion – focus on getting the facts
    • Reflective Discussion – focus on emotions/feelings
    • Interpretive Discussion – focus on values, meaning, purpose and significance to group
    • Decisional Discussion – focus on making a group decision or personal response to the experience
  • Advantages:
    • Useful for reflecting on experiences
    • Invites a variety of perspectives in non-confrontational manner
  • Method for making group decisions by encouraging members to share their thoughts, feelings, and suggestions
  • Group facilitator needs to lead group through 4 stages:
    • Gathering diverse points of view
    • Building a shared framework of understanding
    • Developing inclusive solutions
    • Reaching closure
  • Process:
    • Explain purpose of discussion
    • Review values important for good group discussion
    • Explain that goal is to reach acceptable agreement in a defined time frame
    • Repeat purpose of discussion
    • Ask someone to start discussion
      • “Who would like to begin?”
    • Group comes to consensus and agrees on course of action
group management beginning a group meeting
Group Management: Beginning a Group Meeting
  • Use an “icebreaker”
    • Helps participants to get to know each other
    • Dispels anxiety
    • Find areas of commonality
    • Ex/ treasure hunt, tell interesting story, open-ended questions, humor, interview each other
  • Set ground rules and review agenda
  • Always start on time and show respect to those who were on time
group management guiding the flow of a group meeting
Group Management: Guiding the Flow of a Group Meeting
  • Facilitator needs to guide the flow in order to have an effective meeting
  • Implement specific technique or strategy after the introduction phase
  • Silence
    • Facilitator may feel pressure to fill silence
    • Silence may indicate to group that facilatator does not intend to dominate the discussion
    • Normally if silence is long enough, someone will take initiative for beginning a discussion
group management closing the meeting
Group Management:Closing the Meeting
  • End may occur at a preset time or after a goal has been achieved
  • General guidelines for closing a meeting:
    • Summarize – provide synopsis of what occurred during meeting and highlight challenges and successes
    • What’s next? – review plans for the future and time/date of next meeting
    • Thank you – to participants; and congratulate on accomplishments
group management follow up
Group Management:Follow-Up
  • Follow-up activities may include:
    • Maintain contact with members through websites, email, etc.
    • Review the accomplishments and concerns of the meeting with colleagues
    • Write thank you notes
    • Provide minutes to participants
    • Provide information about the meeting to people who were absent
group counseling
Group Counseling
  • Intended to elicit behavior change r/t nutrition issues
  • Facilitator needs to provide a group atmosphere that encourages curious exploration and consideration of behavior modification alternatives
  • AND review of the evidence regarding facilitating health and food behavior change identified 3 studies showing group counseling to be more effective than individual counseling
  • Weight loss study by Renjilian et al. showed group counseling sessions produced more weight loss than individual treatment
  • Advantages of combining group counseling and one-on-one
group counseling advantages
Group Counseling: Advantages
  • Emotional support – clients feel as though they are not alone; feel accepted and special
  • Group problem solving – motivate each other to change through coping strategies and problem-solving together; “two heads are better than one”
  • Modeling effect – clients learn by observing accomplishments of others
  • Attitudinal and belief examples – group members may re-evaluate their own belief systems as they observe others
group counseling disadvantages
Group Counseling: Disadvantages
  • Individual responsiveness – some people do not easily share in a group setting
  • Group member personalities – dynamics are influenced by individual personalities; some members may dominate or monopolize
  • Possibility of poor role models – can create additional burdens for counselor to counteract
  • Meeting the needs of all group members – needs may vary widely; age, gender, ethnic background differences, health problems can be challenging
group process
Group Process
  • First session is crucial
    • Group personality evolves early on
    • Plan interactive and fun activities
  • Principal objective is to address participants’ concern of feeling accepted and being acknowledged as worthy
  • Composition of groups can be:
    • Open groups
    • Closed groups
group process1
Group Process
  • Open groups
    • Support groups
    • Participants encouraged to participate
    • No commitment to a set number of sessions
    • Participants generate the topics and share their own experiences
    • Leader’s role is to facilitate the process
    • Works well in WIC, diabetes clinics, dialysis units
group process2
Group Process
  • Closed groups
    • Do not accept new members after the first or second session
    • Allow for greater bonding
    • More suitable environment for behavior change to take place
    • Members feel a sense of belonging and acceptance
    • Counselor guides group on a “journey of self-discovery and shared problem solving”
group process3
Group Process
  • 6 steps for development of cohesive, well-functioning groups:
    • Establish an open, warm environment and productive leader-participant relationships
    • Balance facilitator-generated and group-generated information
    • Design problem-solving strategies
    • Provide the opportunity for group members to practice new skills
    • Use positive role models and pacing to keep the group motivated
    • Ask for evaluation and feedback
1 establish an open warm environment productive leader participant relationships
1) Establish an open, warm environment & productive leader-participant relationships
  • Facilitators need to:
    • Show empathy
    • Appear warm/genuine
    • Use effective body language
    • Use relationship-building responses
    • Show attentive behavior
    • Radiate positive energy
    • Stay focused on group members
    • Establish ground rules (can be formal or informal)
2 balance facilitator generated and group generated information
2) Balance facilitator-generated and group-generated information
  • Facilitators have a list of tasks identified as essential for clients to understand, but this will fall on deaf ears if group members have their own concerns on their minds
  • Facilitator may want to ask participants in the 1st session to identify their pressing needs
  • Ex/ a person with diabetes may be concerned about amputations d/t complications and may have trouble focusing on other issues such as glucose monitoring
3 design problem solving strategies
3) Design problem-solving strategies
  • Counselor should provide many opportunities for group problem-solving, rather than tell the group what to do
  • Likability of advice giver affects acceptance of advice
  • Group counseling provides ideal setting for self disclosure coupled with group problem-solving
4 provide the opportunity for group members to practice new skills
4) Provide the opportunity for group members to practice new skills
  • Divide members into small groups to rehearse new skill developed from previous step
  • The new skill should be something the members can use before the next group session so members can report back on their experience
  • Ex/ modify a recipe, measuring portion sizes, interpreting a food label, analyzing blood glucose records
5 use positive role models and pacing to keep the group motivated
5) Use positive role models and pacing to keep the group motivated
  • Spend time reviewing successes of group members to provide model for other members
  • Successful members inspire other members
  • However, members may exhibit counterproductive or disruptive behaviors
    • Scapegoating, personal attacks, side jokes, unrelated stories, gossiping
  • Counselor needs to block these members from disrupting the group process
    • Focus on blocking the behavior, not on the person
6 ask for evaluation and feedback
6) Ask for evaluation and feedback
  • Facilitator should elicit feedback from group throughout the counseling process or after trying new activities or strategies
  • Ex/ “Since we began meeting, what did you find particularly useful?”
  • Bring closure to the session
  • Provide a summary
  • Encourage the power of group support to have a continuing effect
  • Ask members to think about the journey of change and address the next chapter of the journey
  • Summarize evolution of group and ask participants to share their stories
practical considerations for successful groups
Practical Considerations for Successful Groups
  • Allow adequate time for organization
  • Plan for adequate meeting time
  • Select a comfortable meeting room and location
  • Ideal group size for closed groups is 8-12
  • Contemplate collecting fees or refundable deposits before the 1st meeting
  • Appraise target group needs for selecting a meeting time
practical considerations for successful groups cont d
Practical Considerations for Successful Groups (cont’d)
  • Consider composition issues of the potential group
  • Interview prospective group members
  • Group leaders should remain the same
  • Be responsible
  • Plan sessions carefully
  • Consider refreshments
  • Call members who miss meetings
evaluation of group interactions
Evaluation of Group Interactions
  • Facilitating group meetings can be rewarding and challenging
  • Mentor is beneficial; can sit in and provide feedback
  • Written evaluations from members can supply useful information