the local mental health services agency or contact-
ing the primary care provider is another way for a
client to check a therapist’s credentials and ethical
practices.
Groups
A group is a number of persons in a face-to-face set-
ting to accomplish tasks that require cooperation,
collaboration, or working together. Each person in
a group is in a position to influence and to be influ-
enced by other group members. Group content refers
to what is said in the context of the group including
educational material, feelings, and emotions, or dis-
cussions of the project to be completed. Group process
refers to the behavior of the group and its individual
members including seating arrangements, tone of
voice, who speaks to whom, who is quiet, and so forth.
Content and process occur continuously throughout
the life of the group.
STAGES OF GROUP DEVELOPMENT
A group may be established to serve a particular pur-
pose in a specified period such as a work group to
complete an assigned project or a therapy group that
meets with the same members to explore ways to deal
with depression. These groups develop in observable
stages. In the pre-group stages, members are selected,
the purpose or work of the group is identified, and
group structure is addressed. Group structure includes
where and how often the group will meet, identifica-
tion of a group leader, and the rules of the group—for
example, can members join the group after it begins,
how to handle absences, and expectations for group
members.
The beginning stage of group development, or the
initial stage, commences as soon as the group begins
to meet. Members introduce themselves, a leader can
be selected (if not done previously), the group purpose
is discussed, and rules and expectations for group
participation are reviewed. Group members begin to
“check out” one another and the leader as they deter-
mine their levels of comfort in the group setting.
The working stage of group development begins
as members begin to focus their attention on the pur-
pose or task the group is trying to accomplish. This
may happen relatively quickly in a work group with
a specific assigned project, but may take two or three
sessions in a therapy group because members must
develop some level of trust before sharing personal
feelings or difficult situations. During this phase,
several group characteristics may be seen. Group co-
hesiveness is the degree to which members work to-
gether cooperatively to accomplish the purpose. Co-
hesiveness is a desirable group characteristic and is
associated with positive group outcomes. Cohesive-
ness is evidenced when members value one another’s
contributions to the group; members think of them-
selves as “we” and share responsibility for the work
of the group. When a group is cohesive, members feel
free to express all opinions, either positive or nega-
tive with little fear of rejection or retribution. If
a group is “overly cohesive” in that uniformity and
agreement become the group’s implicit goal, there
may be a negative effect on the group outcome. In
a therapy group, members do not give one another
needed feedback if the group is overly cohesive. In a
work group, critical thinking and creative problem-
solving are unlikely, which may make the work of the
group less meaningful.
Some groups exhibit competition, or rivalry
among group members. This may positively affect the
outcome of the group if the competition leads to com-
promise, improved group performance, and growth
for individual members. Many times, however, com-
petition can be destructive for the group; when con-
flicts aren’t resolved, members become hostile; or the
group’s energy is diverted from accomplishment of
their purpose to bickering and power struggles.
The final stage or termination of the group oc-
curs before the group disbands. The work of the group
is reviewed with the focus on group accomplishments,
growth of group members, or both depending on the
purpose of the group.
Observing the stages of group development in
groups that are ongoing is difficult with members
joining and leaving the group at various times.
Rather, the group involvement of new members as
they join the group evolves as they feel accepted by
the group, take a more active role, and join in the
work of the group. An example of this type of group
would be Alcoholics Anonymous (AA), a self-help group
with stated purposes; members may attend AA meet-
ings as often or infrequently as they choose. Group
cohesiveness or competition can still be observed in
ongoing groups.GROUP LEADERSHIP
Groups often have an identified or formal leader—
someone designated to lead the group. In therapy
groups and education groups, a formal leader is usu-
ally identified based on his or her education, qualifi-
cations, and experience. Some work groups have for-
mal leaders appointed in advance, while other work
groups select a leader at the initial meeting. Support
groups and self-help groups usually do not have iden-3 PSYCHOSOCIALTHEORIES ANDTHERAPY 63