1. PROBLEM BEHAVIORS IN GROUPS Reference: Cole, Ch.2

2. What We Already Know Individual roles: Use group to serve individual needs Use group to serve individual needs Interfere with group productivity and cohesiveness Interfere with group productivity and cohesiveness

3. Individual Roles Aggressor – Disapproves of others, attacks group or group task Aggressor – Disapproves of others, attacks group or group task Blocker – Negative, resistant, side-tracks group with irrelevant issues Blocker – Negative, resistant, side-tracks group with irrelevant issues Recognition seeker – Looks for constant attention Recognition seeker – Looks for constant attention Self-confessor – Uses group as audience Self-confessor – Uses group as audience Playboy – Jokes, displays lack of caring Playboy – Jokes, displays lack of caring

4. Individual Roles, cont. Dominator – Monopolizes, interrupts, sees every discussion in terms of self Dominator – Monopolizes, interrupts, sees every discussion in terms of self Help-seeker – Looks for sympathy, unreasonably insecure, help-rejecting complainer Help-seeker – Looks for sympathy, unreasonably insecure, help-rejecting complainer Special interest pleader – Uses group to sell his/her ideology (political, religious, or social agenda) Special interest pleader – Uses group to sell his/her ideology (political, religious, or social agenda)

5. When problem is occurring, Ask yourself: When is it a problem? When is it a problem? To whom is it a problem? To whom is it a problem? Why is the problem occurring? Why is the problem occurring?

6. Why Individual Behaviors Occur Members have inadequate group skills Members have inadequate group skills Members don’t understand how groups should work in therapy Members don’t understand how groups should work in therapy Members have low morale Members have low morale Leader does not set therapeutic norms Leader does not set therapeutic norms Group has low level of maturity Group has low level of maturity Group task is inappropriate Group task is inappropriate Members have personality disorders Members have personality disorders

7. Strategies for the Group Therapist Develop an understanding of the member with the problem behavior Develop an understanding of the member with the problem behavior Ask yourself, “What does this person really need?” Ask yourself, “What does this person really need?” Ask yourself, “What does the group need?” Ask yourself, “What does the group need?” Take measures to preserve the group integrity Take measures to preserve the group integrity

8. Problem Behaviors The silent member The silent member The dominating member The dominating member The angry or distressed member The angry or distressed member Disruptive or bizarre behavior Disruptive or bizarre behavior The silent group The silent group The apathetic group The apathetic group A group in conflict A group in conflict

9. Example: Monopolist Harry came into the group angry. He refused to listen to the purpose of the group or to participate in the activity. “I’m not going to draw like I’m in kindergarten. Excuse me, but you girls don’t know anything about alcohol abuse. When I was in county hospital, they had me doing paintings & sculptures and what-all. It never did anything for me…” Five other members listened to this outburst in silence. They had heard Harry’s routine before Harry came into the group angry. He refused to listen to the purpose of the group or to participate in the activity. “I’m not going to draw like I’m in kindergarten. Excuse me, but you girls don’t know anything about alcohol abuse. When I was in county hospital, they had me doing paintings & sculptures and what-all. It never did anything for me…” Five other members listened to this outburst in silence. They had heard Harry’s routine before

10. Monopolist: What to Do? What does Harry need? What does Harry need? Control the group Control the group Maintain leader/group attention Maintain leader/group attention Avoid his own hurtful issues Avoid his own hurtful issues Gain respect Gain respect What does the group need? What does the group need? Get Harry to be quiet Get Harry to be quiet Let Harry continue, so that they won’t have to reveal or discuss their own hurtful issues Let Harry continue, so that they won’t have to reveal or discuss their own hurtful issues How can leader intervene to avoid establishing a non-therapeutic norm? How can leader intervene to avoid establishing a non-therapeutic norm?

11. Monopolist, What to Do, cont. Harry is playing the role of an aggressor, devaluing the group and its leaders Harry is playing the role of an aggressor, devaluing the group and its leaders Best strategy: Ask group “Why are you allowing Harry to monopolize your group?” Best strategy: Ask group “Why are you allowing Harry to monopolize your group?” Ask specific members, “Why are you silent? What are you thinking?” Ask specific members, “Why are you silent? What are you thinking?” Encourage members to give Harry feedback by completing the sentence, “When you speak like that it makes me feel ____________” Encourage members to give Harry feedback by completing the sentence, “When you speak like that it makes me feel ____________” If the group can be helped to express its frustration with Harry, then Harry might learn to control the behaviors that elicit negative feelings from others If the group can be helped to express its frustration with Harry, then Harry might learn to control the behaviors that elicit negative feelings from others

12. Problem Behaviors Monopolist Monopolist The silent member The silent member The boring member The boring member Help-Rejecting Complainer Help-Rejecting Complainer The Self Righteous Moralist (SRM) The Self Righteous Moralist (SRM) Psychotic member Psychotic member Characterologically difficult members Characterologically difficult members Schizoid Schizoid Narcissistic Narcissistic Borderline Borderline From Cole, M. Group dynamics in occupational therapy instructor's manual. Online document, http://www.efacultylounge.com, based on Cole, M. (2004). Group dynamics in occupational therapy, Third edition. Thorofare, NJ: SLACK Incorporated.

13. Monopolist, characteristics Anxious with silence Anxious with silence Responds to everyone’s comments Responds to everyone’s comments Decreased ability to empathize with others Decreased ability to empathize with others Unaware of impact on others Unaware of impact on others Discusses tangential issues in irrelevant detail Discusses tangential issues in irrelevant detail May assume the role of interrogator May assume the role of interrogator May tearfully describe his or her own crisis May tearfully describe his or her own crisis

14. The Silent Member Dreads self-disclosure Dreads self-disclosure Perfectionistic Perfectionistic Fears failure Fears failure Dreads being center of attention Dreads being center of attention May be conflicted about aggression May be conflicted about aggression Maintains control thru silence Maintains control thru silence May be avoiding display of feelings May be avoiding display of feelings May feel incapable of expressing self in ways other group members have done May feel incapable of expressing self in ways other group members have done What are your reasons for being silent? What are your reasons for being silent?

15. Silent Member: Therapeutic Interventions Comment on non-verbal behaviors Comment on non-verbal behaviors Ask process questions like: “What is the ideal question that I could ask you today to get you involved in therapy?” Ask process questions like: “What is the ideal question that I could ask you today to get you involved in therapy?” Help member learn about self thru his or her behaviors Help member learn about self thru his or her behaviors Get member to explain why it is so hard for him or her to speak in group Get member to explain why it is so hard for him or her to speak in group

16. The Boring Member Massively inhibited Massively inhibited Lacks spontaneity Lacks spontaneity “Safe” – Does not take risks “Safe” – Does not take risks Agrees with majority Agrees with majority Could be dependent, silent (not aware of feelings) Could be dependent, silent (not aware of feelings) May have a core dependent self and dread rejection/abandonment May have a core dependent self and dread rejection/abandonment

17. Therapeutic Interventions If you as leader are bored by this person, so is the group If you as leader are bored by this person, so is the group Group tolerates this behavior better than other problem behaviors, because it seldom disrupts the group Group tolerates this behavior better than other problem behaviors, because it seldom disrupts the group Use self as data to give member feedback Use self as data to give member feedback Replace boredom with curiosity Replace boredom with curiosity Ask “How can I find the real, dynamic person behind this boring shell?” Ask “How can I find the real, dynamic person behind this boring shell?” Inquire gradually over several sessions, encourage other members to do the same Inquire gradually over several sessions, encourage other members to do the same

18. Help-Rejecting Complainer Variant of the monopolist Variant of the monopolist Seeks therapist attention Seeks therapist attention Implicitly or explicitly asks for help, then rejects it Implicitly or explicitly asks for help, then rejects it Problems sound impossible to solve and takes pride in this Problems sound impossible to solve and takes pride in this May belittle problems of others May belittle problems of others Usually blames others for own problems Usually blames others for own problems Highly conflicted about dependency Highly conflicted about dependency Mistrusts authority Mistrusts authority

19. HRC: Vicious Cycle

20. HRC: Therapeutic Interventions Do not express your anger and frustration. Why? Do not express your anger and frustration. Why? Use empathy and self disclosure about hopelessness of situation Use empathy and self disclosure about hopelessness of situation Do not continue to offer help Do not continue to offer help Give support for HRC to choose to accept or reject help Give support for HRC to choose to accept or reject help Use feedback only when trust is established Use feedback only when trust is established

21. Self Righteous Moralist (SRM) Invokes guilt and blame Invokes guilt and blame Blames and judges other members Blames and judges other members Doesn’t care about being liked Doesn’t care about being liked Usually appears self assured and calm Usually appears self assured and calm Will not admit to being wrong Will not admit to being wrong Feels shame on deeper level Feels shame on deeper level Creates maladaptive cycle, similar to HRC Creates maladaptive cycle, similar to HRC

22. SRM: Therapeutic Interventions Get group to give SRM feedback on how behavior makes them feel Get group to give SRM feedback on how behavior makes them feel Discuss consequences of behavior on relationships with others Discuss consequences of behavior on relationships with others Use empathy to develop trust Use empathy to develop trust Look at pattern of behavior outside group and consequences for SRM Look at pattern of behavior outside group and consequences for SRM Don’t tell him he’s right. Why? Don’t tell him he’s right. Why?

23. Psychotic Member Persons who are psychotic should not be included in a group Persons who are psychotic should not be included in a group If member becomes psychotic, he or she is unable to benefit from group treatment, according to Yalom If member becomes psychotic, he or she is unable to benefit from group treatment, according to Yalom Irrational and illogical members take up vast amounts of group energy, and may bring group process to a stop Irrational and illogical members take up vast amounts of group energy, and may bring group process to a stop Such members should be removed from the group until their psychosis comes under control Such members should be removed from the group until their psychosis comes under control

24. Summary Use interpersonal learning as guide Use interpersonal learning as guide Therapist judgment as to how much feedback members are ready to accept Therapist judgment as to how much feedback members are ready to accept Use group feedback to facilitate self understanding Use group feedback to facilitate self understanding Always protect integrity of group first Always protect integrity of group first