1. Coping with Family Trauma A therapeutic process group treatment for college students Jack Mack, Ph.D. Buffalo State College Counseling Center

2. Outline Basic structure Group agreements and norms Screening and construction Process vs. support group Mindfulness Common themes, challenges, interventions Why this group works, client feedback Q & A

3. Basic Structure Theme / Purpose – 66% of college students reported Criterion A trauma – 9% met criteria for PTSD Description of group – Length/Frequency – What we do each week – Our stance Short term (1 semester w/ option to continue) Recruitment (what we tell our colleagues) Leader(s) – ideally male/female coleaders Read, J.P., Ouimette, P., White, J., Colder, C., & Farrow, S. (2011). Rates of DSM-IV-TR trauma exposure and posttraumatic stress disorder among newly matriculated college students. Psychological Trauma: Theory, Research Practice, and Policy, 3(2), 148-156.

4. Basic Structure Mindfulness exercise Check-in – How are you feeling right now? (Feelings Wheel) – Any updates on family contact since last group? – Any specific topic/issue to address today? Group process (based on above) Check-out – How are you feeling right now? – What is something from group you connected with? – What is a small goal you could work on before next group?

5. Group Screening & Construction Hand out screening form What goes into group construction? – Demographics (gender, age, grad or undergrad) – Matching vs. Diversity – What types of traumas fit in group? – Heterogeneity vs. homogeneity (Yalom, 1985) – Potential problems (leaders, wallflowers, attendance, boundary issues, talking too much or too little, etc.) Rule-out criteria

6. Group agreement and norms Confidentiality, limits of confidentiality No contact outside group, subgrouping Attendance Commitment (at least 3 sessions) No physical contact I-statements Asking members for what they want to add, put it in their own words

7. Process Group vs. Support Group vs. Structured Group We don’t have an agenda, but we have themes/skills that we cover Some structure (check-in, check-out) open process part is sandwiched in the middle Process—present oriented, coping oriented Activities based on group topics/interest Emphasis is not processing trauma, more helping to cope w/ trauma in the present

8. Mindfulness Exercise We begin and end with a mindfulness and/or relaxation exercise. Demonstrate difference techniques over the semester. – Breathing – Movement – PMR – Guided meditation – Apps

9. Common Themes Anxiety, depression, PTSD Triggers Balance, self-care “Overcontrolled” vs. “Undercontrolled” reactions to trauma Boundaries with family, friends, partners Emotional intelligence/processing Loneliness, stigma Replicating family patterns – Substance use/abuse – Chaotic relationships Trust, acceptance, and/or forgiveness Siblings, roles in family Reasonable goals/expectations for self/family

10. Common Challenges Attendance (group and individual) Current traumas vs. past traumas Disorganization Trust Subgrouping (age, gender, type of trauma) Crisis management Clients acting in therapist/helper role Termination, saying goodbye healthily

11. Common Interventions Present/coping-focused Setting reasonable/attainable goals Skill building – mindfulness, self-validation, seeking social support and safety Psychoeducation Understanding/improving communication – I statements – Speaking the unspoken – Ask for/give direct feedback when it feels safe “Genograms” – What does your family look like? What is each person’s role? Has this changed? How would you change it?

12. Why this group works Universality, reduced isolation Validation Emotional processing Problem solving Interpersonal feedback/learning/practice Altruism, pride, resilience Reinforcing strengths Installation of hope Yalom, I.D. (1995). The theory and practice of group psychotherapy (4 th ed.). New York: Basic Books.

13. Anonymous client feedback (used with permission) “I got a lot of good feedback from people who understood where I was coming from and I think that really helped.” “I never thought that being in this group would be as hard as it was and I didn’t think it would have such a profound effect.” “It really helped me to cope with my depression.” “I didn’t expect that I would have such a positive impact on other group members. It was amazing to hear feedback from peers, pointing to strengths they see in me, especially when I feel so broken.” “It definitely pushed me to take risks in a healthy, unintimidating way, and it helped me seek and give support to others.” “I am not alone.”

14. Questions?