1. Chapter 5: The Efficacy of Group Work Introduction to Group Work, 5th Edition Edited by David Capuzzi, Douglas R. Gross, and Mark D. Stauffer

2. Introduction to Group Work, 5th Edition Edited by: David Capuzzi, Douglas R. Gross, and Mark. D. Stauffer What Is Efficacy ? Efficacy = The degree to which desired goals or outcomes are achieved

3. Introduction to Group Work, 5th Edition Edited by: David Capuzzi, Douglas R. Gross, and Mark. D. Stauffer Why are efficacy questions important? Ethics: Nonmaleficence — Do not impose interventions that risk harm. Ethics: Beneficence — Apply interventions that research proves efficacious. Professionalism: Base actions upon scientific knowledge and not on personal preference. Economics: Managed care makes counselors responsible for demonstrating the cost effectiveness of their methods.

4. Introduction to Group Work, 5th Edition Edited by: David Capuzzi, Douglas R. Gross, and Mark. D. Stauffer Quantitative Methods to Measure Efficacy Methods = correlational, causal–comparative, true experimental, quasi-experimental, action research Statistical analysis of numerical data for targeted behaviors Includes behavioral, role, or process phenomenon that can be defined and counted Focus on client and group characteristics that can vary (independent and dependent variables) Controls for the influence of factors other than the independent variable on the dependent variable

5. Introduction to Group Work, 5th Edition Edited by: David Capuzzi, Douglas R. Gross, and Mark. D. Stauffer Qualitative Methods to Measure Efficacy Based on interpretable data generated through “thick” description of client phenomena Thick description is built through narratives, surveys, interviews, and observations Outcome data can include assessments of change in such things as worldview or personal idiosyncrasy

6. Introduction to Group Work, 5th Edition Edited by: David Capuzzi, Douglas R. Gross, and Mark. D. Stauffer Outcome Measurement Outcome Measurement: Will the tools used to study the behaviors of interest obtain a measurement that is complete and accurate? Reliability Qualitative: Is there a match between what is observed as happening and the data that is recorded? Quantitative: Is consistency found across the different observations? Validity Qualitative: Does the assessment process have credibility? Do the constructed realities of the participants match the constructed reality of the researcher? Quantitative: Does a particular assessment tool measure what it claims to measure?

7. Introduction to Group Work, 5th Edition Edited by: David Capuzzi, Douglas R. Gross, and Mark. D. Stauffer Effective Counselor Practices in Group Work Specific Factors and Outcomes Specific factors = the counselor’s acts that are unique to a particular theory of counseling Lack of structure = can create cognitive distortion, interpersonal fear, subjective distress, and premature termination Providing alternatives and instruction = will prevent client reactance and produces more client involvement

8. Introduction to Group Work, 5th Edition Edited by: David Capuzzi, Douglas R. Gross, and Mark. D. Stauffer Effective Counselor Practices in Group Work Nonspecific Factors and Outcomes Nonspecific factors = change-producing elements present in counseling regardless of the theoretical orientation Working alliance = the best predictor of outcomes and has three components: goal, task, and bond Curative factors = Yalom’s 12 curative factors (e.g., universality, instillation of hope, etc.)

9. Introduction to Group Work, 5th Edition Edited by: David Capuzzi, Douglas R. Gross, and Mark. D. Stauffer Effective Counselor Practices in Group Work Nonspecific Factors and Outcomes Group development = knowledge of the group stages (e.g., forming, storming, norming, performing, adjourning, etc.) Leadership = providing a sense of hope, matching leadership style with client personality, and having personal characteristics which include being positive and emotionally supportive

10. Introduction to Group Work, 5th Edition Edited by: David Capuzzi, Douglas R. Gross, and Mark. D. Stauffer Group Counseling Modes and Outcomes Task/work mode (TASK): Focus on identification and completion of specific goals Psychoeducational mode (EDUC): Purpose is to prevent psychological maladjustment Counseling mode (COUN): Focus is on interpersonal growth and problem solving Psychotherapy mode (THRP): For clients who may be experiencing severe and/or chronic maladjustment

11. Introduction to Group Work, 5th Edition Edited by: David Capuzzi, Douglas R. Gross, and Mark. D. Stauffer Effective Interventions for Internalizing Disorders Internalizing disorders: When a client’s aggression is turned inward Depression: Most efficacious group counseling blends skill training, cognitive restructuring, and a supportive group process. Cognitive–behavioral group therapy is found to be the most efficacious. Eating disorders: Cognitive, cognitive– behavioral, or interpersonal counseling prove most efficacious.

12. Introduction to Group Work, 5th Edition Edited by: David Capuzzi, Douglas R. Gross, and Mark. D. Stauffer Effective Interventions for Externalizing Disorders Externalizing disorders: When a client’s aggression is turned outward toward others Spouse battering: Cognitive approach is shown to have a 53% – 85% success rate. Most successful therapies include cognitive techniques, profeminist components, and highly structured group process. Disruptive behavior disorders and delinquency: Therapies found effective are cognitive, nondirective group therapy interventions, and eclectic behavioral interventions.

13. Introduction to Group Work, 5th Edition Edited by: David Capuzzi, Douglas R. Gross, and Mark. D. Stauffer Effective Interventions for Physical Health Problems Geriatric cognitive dysfunction: Resocialization groups have been found effective. Insomnia: Cognitive and behavioral approaches have been successful. Other psychical health problems: Group counseling has been found efficacious for clients with cancer, respiratory diseases, and chronic headaches, among other ailments.

14. Introduction to Group Work, 5th Edition Edited by: David Capuzzi, Douglas R. Gross, and Mark. D. Stauffer Crossing Boundaries Group counseling is also efficacious for the following: Personal growth Career development and work performance Interpersonal relations Multicultural understanding Diversity is a critical factor affecting outcomes. Methods addressing culture, identity, and socialization positively influence efficacy.

15. Introduction to Group Work, 5th Edition Edited by: David Capuzzi, Douglas R. Gross, and Mark. D. Stauffer Ineffective Interventions Large group guidance (LG-EDUC) in the schools has not been shown to be efficacious with the exception of career development and Second Step (groups designed to lessen school violence).

16. Introduction to Group Work, 5th Edition Edited by: David Capuzzi, Douglas R. Gross, and Mark. D. Stauffer Harmful Interventions Poor pre-group screening (counselors must have knowledge of contraindication issues) Contraindication types Barriers (e.g., lack of clients with similar issues, scheduling problems, lack of qualified counselors) Client treatment needs (e.g., clients in crisis or suicidal, clients who need more attention than the group can provide) Client personality factors (e.g., paranoid or psychotic, extreme interpersonal sensitivity) Counselor actions Training/skills issues (e.g., knowledge or skills deficits, employing techniques with little training) Counselor personality issues (e.g., traits such as coldness, obsessiveness, seductiveness, pessimism, unconscious hostility)

17. Introduction to Group Work, 5th Edition Edited by: David Capuzzi, Douglas R. Gross, and Mark. D. Stauffer Unanswered Issues Regarding Group Counseling Effectiveness The research on group counseling causalities has focused exclusively on counseling and psychotherapy groups. Researchers have not addressed psychoeducational groups. There are still questions regarding the best way to compose a group — homogeneously or heterogeneously — with respect to diagnosis. There is not sufficient research on group counseling interventions with children and adolescents.