Categories
Brief Articles

Barriers to Group Psychotherapy

Martyn Whittingham, Ph.D., CGP
Martyn Whittingham, Ph.D., CGP

Barriers to Group Psychotherapy for African-Americans, Latino/a’s and White, non-Latino/a University Students :  A Systematic Research Program to compare and contrast cultural differences and similarities. 

This program will explore how three studies (Harris, 2012; Stoyell, 2013; Suri 2015) explored barriers to group psychotherapy for three different groups – African-Americans; Latino/a’s and White, non-Latino university students.  Sample sizes ranged from 81 to 108, with a total N for all studies of 272.  The studies utilized one set of survey questions (with occasional minor cultural variations and modifications) to allow for between and within group comparisons.  The clusters of questions related to variables including 1) Coping styles 2) Expectations of group leaders 3) Expectations of group members 4) expectations of multicultural issues.  Each study utilized chi-square analysis; mean scores and rank order, with factor analysis also utilized to determine the clustering of variables.

This presentation will explore which items were significant within group and between groups.  Differences within group will be used to explore how relative rankings and absolute scores reflect the importance and non-importance of variables related to expectations of group psychotherapy.  Between group differences in terms of ranking and mean scores will be explored to highlight the relative importance of variables to each group.  Particular attention will be drawn to within and between group differences in coping style; the expectation of leaders’ ability to manage conflict and differing expectations among groups around expectation of discussing racism and discrimination.  Suggestions for the training of group leaders and provision of group therapy services will be made based on these findings. Each researcher will present their findings and the between group comparisons will then be presented by the discussant.

Categories
Brief Articles

Diversity Committee Report

Jeanne Steffen, Ph.D.
Jeanne Steffen, Ph.D.

Activities since the July 2015 report have included:

Dr. Chun-Chung Choi received the 2014-15 Diversity Award.

The Diversity Committee encouraged student involvement in a symposium at APA. Our program, entitled Multicultural Skill Development in Group Psychotherapy, was selected by the program committee. Three students co-presented along with Eric Chen, Jeanne Steffen, and Joe Miles.

Joe Miles, Eric Chen, Jeanne Steffen and Robert Gleave were present for a committee meeting and discussed goals related to increasing student involvement for 2016.

Items Needing to be Discussed:

Recruiting new members to the committee for 2016; prioritizing goals for 2016

Items Needing Action:

Jeanne will contact members of the committee in October to establish new members, summarize suggestions for goals from our last meeting, and ask for votes regarding which goals to priorotize for 2016.

Recommendations, if any:

None currently.

Members of Committee:

Eric Chen

Maria Riva

Cheri Marmarosh

Joe Miles

Lee Gillis

Brittany White

Joel Miller

Jennilee Fuertes

Categories
Brief Articles

Prevention Corner: Is Homework Helpful?

Elaine Clanton Harpine, Ph.D.
Elaine Clanton Harpine, Ph.D.

As the school year progresses, the number of letters that we have received concerning school problems has multiplied tremendously. The letter chosen today highlights a problem that has been an issue of concern between parents and schools for many years: Is homework actually helpful? How much is too much? In the past several years, the question of homework has also become a topic of study by many researchers as well. Researchers are asking: Is homework harmful?

Editorial Question Posed

Dear Prevention Corner: 

I’m at my wits end. My teenager has been up every night past midnight doing homework. The school says that homework will help raise test scores and help my son prepare for college. He’s worn-out, and says, “That if this is what college is like, he doesn’t want to go.” I think the school is pushing too hard. What should I as a parent do? Am I wrong? Is four hours of homework a night normal?

In Need of Help

Response

Dear In Need Of Help:

As a parent of three grown children, I certainly understand your problem and your concerns. This subject of homework is being discussed by more than just parents and schools. Many researchers are stepping forward to say that there is no correlation between homework and classroom improvement in academics for elementary age children (Cooper, 2006). Only a tiny bit of improvement has been shown from homework in middle school. While research has supported benefits from homework in high school, researchers also caution that too much homework can backfire and create more problems than benefits (Cooper & Valentine, 2001; Cooper, Robertson, & Patall, 2006). So, why do schools still insist on more homework? It’s been estimated that the homework load has increased about 40% for students (Cooper, 2006). As you indicated in your letter, some students are being assigned as much as four hours of homework a night. Still other schools are totally banishing homework. Some schools are suggesting that web-based applications for online teaching opportunities actually benefit students more than paper and pencil homework.

One of the age old problems with homework is that if a student does not know how to work a math problem correctly, practicing the problem incorrectly for homework, will not teach the student the correct procedure for working the problem. Practicing a mistake does not make the mistake go away. Research shows that math scores do not necessarily improve with homework. On the other hand, if online teaching was incorporated, then the student could learn and practice the problem correctly.

Trying to improve test scores by loading on additional homework has also not proven to be successful. Excessive homework and the results of incomplete homework have even been listed as one of the reasons that some students give for dropping out of school before graduation. Homework is supposed to help students learn, improve study skills and organization of time, and teach responsibility. Unfortunately, researchers are finding that too much homework actually reduces its effectiveness and that when students consider homework simply “busy work,” such homework discourages learning (Kalish & Bennett, 2006).

We have worked for years from the premise that “homework is good.” New research is showing that too much homework actually has negative effects on well-being and behavior. If a student sacrifices sleep to study for a test or complete homework assignments, they are going to have more trouble the next day in school and miss out on new material being discussed in class (Gillen-O’Neal, Huynh, & Fuligni, 2013). Students who consume energy drinks in order to stay awake at night also increase their risk of becoming too reliant upon stimulants and other drugs. Excessive homework (over 2 hours a night in high school) can lead to sleep deprivation, headaches, exhaustion, stomach problems, weight loss, and even depression (Galloway, Conner, & Pope, 2013).

When students are assigned too much homework, such homework assignments create stress (Pressman et al., 2015). High levels of stress can lead to physical as well as mental health problems. Homework needs to have a purpose that benefits the student’s overall education and well-being. In a recent survey, 90% of the students surveyed said that homework created stress in their daily life.

Since homework has not necessarily led to better grades or higher test scores and has been found to be a major source of stress for many students, what should a parent do?

  1. Talk with the teacher. See if you can reach a compromise on the amount of homework being assigned.
  2. If your child is exhibiting signs of stress, talk with a school counselor.
  3. If you’re still unable to negotiate a “healthy” homework level, talk with your school principal and/or a member of the school board.

Nancy Kalish and Sara Bennett (2006) state in their book, The Case Against Homework: How Homework is Hurting Our Children and What We Can do About It, that we need to find new educational alternatives to homework. We also need to remember that quality is more important than quantity.

I do not have simple or easy answers for you, but going to the school and intervening on behalf of your child may be the best prevention that you can provide to alleviate problems in the future. No one is saying that your child should just sit around and watch TV or play computer games, but sometimes a student may need a more individualized approach to homework and learning in the classroom. You definitely want to make the teacher and school aware of stress and other concerns. Never be afraid to be your child’s advocate.

Let me know if I can be of further assistance, and watch for our next column when we will turn to some educational policy experts to see if they can offer some suggestions for how to change the schools.

If you would like to join this discussion, let us hear from you. We welcome your participation. We invite psychologists, counselors, prevention programmers, graduate students, teachers, administrators, parents, and other mental health practitioners working with groups to network together, share ideas, problems, and become more involved. Please send comments, questions, and group prevention concerns to Elaine Clanton Harpine at clantonharpine@hotmail.com

References

Bennett, S., & Kalish, N. (2006). The case against homework: How homework is hurting our children and what we can do about it. New York: Harmony Books.

Cooper, H. (2006). The battle over homework: Common ground for administrators, teachers, and parents, 3rd ed. Thousand Oaks, CA: Corwin press.

Cooper, H., Robinson, J. C., & Patall, E. A. (2006). Does homework improve academic achievement? A synthesis of research, 1987–2003. Review of Educational Research, 76, 1–6.

Cooper, H., & Valentine, J. C. (2001). Using research to answer practical questions about homework. Educational Psychologist, 36, 143–153.

Galloway, G., Conner, J., & Pope, D. (2013). Nonacademic effects of homework in pivileged, high-performing high schools, The Journal of Experimental Education, 81, 490-510. doi: 10.1080/00220973.2012.745469

Gillen-O’Neal, C., Huynh, V., & Fuligni, A. J. (2013). To study or to sleep? The academic cost of extra studying at the expense of sleep. Child Development, 84, 133-142.   doi: 10.1111/j.1467-8624.2012.01834x

Pressman, R. M., Sugarman, D. B., Nemon, M. L., Desjarlais, J., Owens, J. A., & Schettini-Evans, A. (2015). Homework and family Stress: With consideration of parents’ self-confidence, educational level, and cultural background, The American Journal of Family Therapy, 43, 297-313. doi: 10.1080/01926187.2015.1061407

Categories
Brief Articles

Group Training Opportunities in Graduate Psychology Programs

Abstract

Erin Crozier BS, and Samuel Collier BA

This paper elaborates on a brief report about survey data collected by Division 49 leadership. The purpose was to obtain an overview of group training opportunities in APA-accredited clinical and counseling psychology programs in the United States and to determine if opportunities are different across types of program. The sample was 55 directors of clinical training. A majority (64%) reported that their school offers a group course, but over a third have no group course available and only three reported offering an advanced group course. Most of the open responses received stated that group experience is available at affiliated practicum sites, and 67% stated that students in their program have opportunities for involvement in group research. Most respondents indicated that group therapy has a moderate to high level of value in their program. Directors of counseling psychology programs gave a higher rating for the value of group therapy in their programs and were more likely to report offering a group class than were directors of clinical psychology programs. Based on these data, group training is available to many students, but opportunities are inconsistent, leaving the possibility that many will enter the profession with little or no group training.

Introduction

            An oft-discussed concern among group psychotherapists is the growing demand for group work in the field (Fuhriman & Burlingame, 2001; Taylor et al., 2001), without a corresponding increase in group training provided to students in psychology and other mental health professions (Barlow, 2008; Conyne & Bemak, 2004; Kovach, Dubin, & Combs, 2014). For many emerging practitioners of group psychotherapy, much of their group-specific training is gained on the job, or they are never formally trained at all. In such a case, it could benefit both clinicians and clients if these practitioners were able to gain a more extensive background in group therapy in their masters or doctoral programs. Indeed, several recent studies have demonstrated that trainees in social work (Goodman, Knight, & Khudododov, 2014), psychiatry (Kovach et al., 2014), and counseling (Ohrt, Ener, Porter, & Young, 2014) desire more group work training in their years of formal education.

Despite this inconsistency of group training in graduate programs, some scholars in psychology have expressed hope that pre-doctoral internships provide solid training in group psychotherapy that makes up for inconsistent training in doctoral programs. However, this appears to be a false hope, as group training in internship programs has been found to be inconsistent as well (Markus & King, 2003). Currently, there are multiple options for obtaining specialty training and certifications in group psychotherapy (Barlow, 2008, 2013; Stone, 2010) at the pre- and post-doctoral level. However, the current reality is that many providers of group therapy do not have the time, inclination, or administrative support to seek out such credentials and therefore must rely solely on the training that they received in their doctoral education. Given this reality, it is important to understand precisely what training opportunities exist in doctoral training programs in psychology.

A few previous studies have sought to directly assess available training opportunities; however, these studies are now either outdated (Fuhriman & Burlingame, 2001) or limited by only surveying student experiences in a single training program (Goodman et al., 2014). The present study, therefore, aimed to provide a current overview of the training opportunities available in APA-accredited clinical and counseling psychology graduate training programs. This article elaborates on a brief survey report by Lee Gillis (2014). These survey data were gathered by Division 49 leadership, including Lee Gillis, Sean Woodland, Rosamond Smith, and Leann Diederich.

In addition to obtaining a general overview of current training opportunities in clinical and counseling psychology programs, this study sought to reassess some previous findings. Fuhriman and Burlingame (2001) found that clinical psychology programs reported fewer required courses in small group experience, supervised clinical experience, and group theory than did counseling psychology programs, and that directors of counseling programs reported valuing group therapy more than did directors of clinical programs. Thus, this study sought to discover whether these differences still exist in the current training landscape, as well as to determine the overall availability of group psychotherapy training opportunities in graduate training programs in the United States.

Methods

Participants

Surveys were sent via email to directors of 57 Council of Counseling Psychology Training Programs (CCPTP), 31 directors from National Council of Schools and Programs of Professional Psychology (NCSPP; identified from webpages), and to the listserv of the Council of University Directors of Clinical Training (CUDCP; approximately 80 members). From each of these requests, 24, 8, and 21 responses were received, respectively. In addition, 3 board members of Division 49 responded to a pilot study with usable data about their programs. Of these 56 responses, 1 respondent declined to participate, leaving a total N of 55. The full response rate (56 of approximately 168) was about 33%. Note that 2 additional responses were received since the original brief survey report (Gillis, 2014).

In addition to the 1 respondent who declined to participate, 8 provided incomplete data. Their responses were included in the analyses for the items to which they provided a response. Of the 47 respondents who provided complete data, 26 (55%) were directors of clinical psychology programs and 21 (45%) were from counseling psychology programs. A total of 37 respondents (79%) were from Ph.D. programs, while 10 respondents (21%) were from Psy.D. programs. Six of the respondents (5 Ph.D. and 1 Psy.D.) reported that students from their programs also receive a master’s degree.

Materials and Procedure

After providing consent to participate, participants responded to a questionnaire created specifically for this study. The questionnaire included five multiple choice and seven open response questions about group training opportunities available in the respondents’ training programs, as well as one scaled question (0-10) asking participants to rank the perceived value of individual, couple, family, and group therapy in their training program. Additionally, participants answered brief demographic questions about their program and were asked if they would like their program’s information to be shared by name on the Division 49 webpage. Information from this component of the survey will be published online at a later date. Respondents were free to skip questions as desired.

Analysis

            The open response data were sorted qualitatively by grouping data from each question into categories of similar responses, with one author first working independently and then the other checking all work and regrouping responses when appropriate. The full dataset was referenced to clarify responses when needed.

To determine whether any group differences existed between responses of clinical and counseling psychology program directors, simple t-tests were conducted. Paired samples t-tests were also used to examine the differences in the perceived value of individual, couple, family, and group therapy in the full sample.

Results

Of the total survey respondents (N = 55), a majority (n = 35; 64%), indicated that their school offers some form of group psychotherapy course. Of the 29 respondents who provided additional qualitative descriptions of their courses, almost all offer a basic, semester-long course. Only 3 respondents indicated that their program offers an advanced group therapy course. Although only 8 respondents identified specifically that their group course was required, the actual number of programs requiring students to take a course in group work may be much higher because our survey did not ask directly about the presence of a required course.

Of those respondents who said their program provides a group course, 78% (n = 25) indicated the presence of an experiential component. In addition, half of those with group classes reported that their class includes peer leadership opportunities (n = 16; 50%) and a similar number of courses include rotating leadership (n = 17; 53%). Of the 23 respondents who described the experiential component of the class, 17 (74%) described the use of some form of group process simulation. Additionally, 34% of the 50 respondents who provided data on this item (n = 17) reported that group training is included in other coursework within the program, such as within practicum class, multicultural or diverse populations classes, and intervention or technique classes, among others.

In terms of group psychotherapy experiences available during practicum, 37 of 39 open responses reported that group psychotherapy was currently being administered by students at one or more affiliated practicum sites. However, none of the programs indicated the presence of any group-specific practicum opportunity.

In regards to research opportunities, 31 of 46 valid responses (67%) indicated that group-focused research opportunities are available to students within their program. According to the 28 respondents who described these opportunities in an open response question, types of research vary broadly and include student dissertations, special projects, and faculty-driven research.

When asked to rate the value placed on each of four psychotherapy modalities on a scale of 0 to 10, individual therapy was consistently ranked the highest with an average rating of 9.68 and a standard deviation of only 0.66. Not one of the 47 respondents to this question ranked individual therapy lower than a score of 8. Within the value ratings for group therapy (M = 6.15; SD = 2.21), most scores (n = 32) fell between 5 and 8, indicating that group therapy is consistently of a moderate-high importance level in the majority of programs. Examination of the scores for couples therapy (M = 5.19, SD = 2.52) and family therapy (M = 5.87, SD = 2.76) reveals that group therapy is consistently valued as much as or more than these modalities. In fact, results from paired samples t-tests indicate that our sample placed a higher value on group therapy than on couples therapy (t = -2.28, df = 46, p < .05) and that scores for the value of family therapy and group therapy were not significantly different from one another (t = -.58, df = 46, p = .56).

Lastly, while the slight majority of respondents to the survey identified as clinical psychology programs, 100% of counseling psychology programs indicated presence of a group psychotherapy class in their program, while only 35% of clinical programs reported the presence of such a class. Even when accounting for the unequal variance between these two segments of our sample, the difference in the presence of a group class between clinical and counseling programs is clearly significant (t = -6.87, df = 25, p < .001). Additionally, in the aforementioned value ratings of different therapy modalities, respondents from clinical psychology programs gave lower ratings for the value of group therapy than did those from counseling psychology programs (t = -2.35, df = 45, p < .05).

Discussion

The results of this study have provided an assessment of the current availability of group psychotherapy training for clinical and counseling psychology doctoral students. Despite a few limitations, several conclusions may be drawn, and further research into the sufficiency of group therapy training is warranted.

Although the majority of our sample reported offering at least one course in group psychotherapy, over one third of the responding programs offer no such course. This is even more striking in clinical psychology programs, where just over one third reported offering a class in group. Additionally, only three programs in our sample reported that they offer an advanced group therapy course. In advocating for the importance of group training in today’s professional landscape, several authors have argued that even a one-semester course is wholly insufficient (Barlow, 2008; Ohrt et al., 2014; Stockton et al., 2014). Based on the results of this research, additional opportunities for group training in graduate programs are warranted to meet the demands in the industry.

While almost all of the respondents who answered our open response question about practicum training reported that there are opportunities for their students to provide group therapy at affiliated practicum sites, it is unclear if those who did not respond to this question simply skipped the open response for time or convenience, or if they did so because they do not offer any opportunities for group training at practicum sites. Additionally, regardless of whether students are afforded opportunities for group practice at practicum sites, those who were not offered a group class in their academic curriculum may still be left at a disadvantage due to lack of exposure to the theoretical foundations of group process, group leadership, and other topics essential to developing competency in group psychotherapy. Essentially, more must be done to ensure both proper training and practical experience are offered to practitioners to ensure basic competence in group therapy before entering the field.

It is encouraging that most training directors in our sample placed a moderate to high level of value on group therapy. However, it appears that sufficient training opportunities in group therapy may be falling second to the emphasis placed on other modalities and the varied coursework necessary in training future psychologists. As members of Division 49, we sincerely hope that group will continue to be an increasingly strong presence in those competencies viewed as necessary, but much work is still needed in this area.   Perhaps this argument can be strengthened by authors like Counselman (2008), who argued that training in group modalities provides a profound impact on all clinical work, including individual psychotherapy and other aspects of one’s professional identity. The authors of this paper agree with Counselman that an increase in group training within programs across the board will bring a variety of benefits whether or not practitioners in training ever choose to pursue group therapy interventions.

Several limitations within this study are also of note, and some of these could be overcome in future research. First, the study is limited by a relatively small initial sample size and several incomplete responses, resulting in a final sample of only 47 responses. Although the response rate was certainly respectable for online survey-based research, a larger sample would strengthen the implications that could be drawn from the results. This may be helped by targeting group training faculty, sending email reminders after the initial survey distribution, or rephrasing some questions from open response to multiple, although the latter may result in the loss of some rich qualitative data.

Second, response bias may have skewed the sample towards graduate programs more interested in group training. Of the 168 program directors who were contacted, it is possible that those who were most interested in the subject matter of the survey were more likely to complete it. If this is the case, the results may show only a skewed view of the actual status of group training across all programs.

Third, there were some limitations in the phrasing of survey questions, which could be modified or added in order to gain additional information. For example, as Gillis (2014) pointed out in the initial brief synopsis of the survey, the survey asked “Does your program provide a group-specific class or classes?” instead of asking whether such a class is required, which would determine whether group training is mandatory in each program.   Additional questions such as “Approximately what percentage of affiliated practicum sites administer group psychotherapy at your school?” could also provide valuable information.   Questions qualifying the respondents’ role in the program and expertise in the field of group psychotherapy may also be important in determining whether follow-up could be conducted by a more qualified member of the faculty, as well as allow for the assessment of potential response bias.

This study has provided a snapshot of the current state of group psychotherapy training within clinical and counseling psychology doctoral programs. Future research should continue to assess demand in the field in order to determine whether group training in programs is adequate for the demand placed on emerging practitioners. Because group therapy is performed by professionals from many different disciplines, additional research on group training in training programs in social work, psychiatry, and counseling may also be valuable. If demand is not being met, this research will also set the stage for how programs can be further enhanced.   For example, an increasing demand at clinical sites may warrant the creation of advanced level group training courses. This study provides one small piece of a complex puzzle as we continue to pursue the development of high quality group therapy competencies in our emerging practitioners.

References

Barlow, S. H. (2008). Group psychotherapy specialty practice. Professional Psychology: Research and Practice, 39(2), 240–244. http://doi.org/10.1037/0735-7028.39.2.240

Barlow, S. H. (2013). Specialty competencies in group psychology. New York, NY: Oxford University Press, USA.

Conyne, R. K., & Bemak, F. (2004). Preface. The Journal for Specialists in Group Work, 29(1), 3–5. http://doi.org/10.1080/01933920490275295

Counselman, E. F. (2008). Why study group therapy? International Journal of Group Psychotherapy, 58(2), 265–272. http://doi.org/10.1521/ijgp.2008.58.2.265

Fuhriman, A., & Burlingame, G. M. (2001). Group psychotherapy training and effectiveness. International Journal of Group Psychotherapy, 51(3), 399–416. http://doi.org/10.1521/ijgp.51.3.399.49889

Gillis, L. (2014). Group training survey: May 2014. The Group Psychologist, 24(3). Retrieved from http://div49tgp.com/2014/10/30/group-training-survey-may-2014/

Goodman, H., Knight, C., & Khudododov, K. (2014). Graduate social work students’ experiences with group work in the field and the classroom. Journal of Teaching in Social Work, 34(1), 60–78. http://doi.org/10.1080/08841233.2013.866615

Kovach, J. G., Dubin, W. R., & Combs, C. J. (2014). Psychotherapy training: Residents’ perceptions and experiences. Academic Psychiatry. http://doi.org/10.1007/s40596-014-0187-7

Markus, H. E., & King, D. A. (2003). A survey of group psychotherapy training during predoctoral psychology internship. Professional Psychology: Research and Practice, 34(2), 203–209. http://doi.org/10.1037/0735-7028.34.2.203

Ohrt, J. H., Ener, E., Porter, J., & Young, T. L. (2014). Group leader reflections on their training and experience: Implications for group counselor educators and supervisors. The Journal for Specialists in Group Work, 39(2), 95–124. http://doi.org/10.1080/01933922.2014.883004

Stockton, R., Morran, K., & Chang, S.-H. (2014). An overview of current research and best practices for training beginning group leaders. In J. L. DeLucia-Waack, C. R. Kalodner, & M. Riva (Eds.), Handbook of Group Counseling and Psychotherapy (2nd ed., pp. 133–145). Los Angeles, CA: SAGE Publications.

Stone, W. (2010). Introduction to the special issue on training in group psychotherapy. Group, 34(4), 277–281.

Taylor, N. T., Burlingame, G. M., Kristensen, K. B., Fuhriman, A., Johansen, J., & Dahl, D. (2001). A survey of mental health care provider’s and managed care organization attitudes toward, familiarity with, and use of group interventions. International Journal of Group Psychotherapy, 51(2), 243–263. http://doi.org/10.1521/ijgp.51.2.243.49848

 

Categories
Brief Articles

Prevention Corner: Age Old Problems

Elaine Clanton Harpine, PhD
Elaine Clanton Harpine, Ph.D.

With the end of the school year, age old problems and questions re-arise, particularly the question: Why are so many children failing in reading? We have discussed reading prevention programs before, but a question comes to our attention that brings reading failure to the forefront of prevention programming once again. Prevention efforts in reading are relevant to our group prevention focus because the majority of childrens’ prevention programs take place at school. Also, the National Reading Panel (2000) stated that groups are one of the most effective ways to teach reading. Therefore, let’s take another look.

EDITORIAL QUESTION POSED:

Dear Prevention Corner:

I am a school psychologist, and I attended your 2nd Annual School-Based Mental Health Group Interventions Conference where both you and Dr. Keith Herman stated that “children can definitely be taught to read.” We just finished reviewing this year’s scores where 60% of our students are failing in reading. These are students below the fourth-grade level. What can we do? I returned from your conference with exciting ideas, but my school only allows teachers to use the curriculum and methods that they endorse. Obviously, school methods are not working. How do you make the school change?

Signed,

Desperate for Help

RESPONSE

Dear Desperate for Help:

It is wonderful to hear from you again, and I’m glad that you remembered my invitation to keep in touch.

I am sorry to hear that you are still having trouble. It is neither helpful nor comforting to say that you are not alone. According to the Nation’s Report Card (2013), only about 40% of 4th graders are able to read at grade level. Such reading scores are dismal and have not significantly improved over the past 14 years. Reading failure is a nationwide problem that has not been corrected, nor is it showing any signs of significant progress.

I do still stand by my statement that “children can definitely be taught to read.” My work is mostly in community-based settings, and that may be an option that you may want to consider. I just tested a 2nd grade student this year from our after-school Reading Orienteering Club (Clanton Harpine, 2013b) program who started the year in September reading at the pre-primer level (below kindergarten). The student ended the year in May reading at the 4th grade reading level. No, not every student makes that much progress in one year’s time. Each child has distinct needs and learns in a different way. Yet, for the past six years in our after-school program, we have been taking students who are failing in school, teaching them to read, and sending them back to the classroom to be successful. How? Phonemic awareness and phonological decoding are essential if you want children to learn to read (Fleming et al. 2004; Foorman & Torgesen, 2001; Hoeft et al., 2007; Lyon, 1998; Rayner et al., 2001; Shaywitz, 2003).

So, to answer your first question, yes, we know how to teach children to read. Unfortunately, so far as a society, we refuse to accept the research findings and change the way we teach children to read. I have included an extensive list of references so that you may read the research.

To answer your second question on how to make the schools change, I am sorry but I do not have an answer for you. I do plan to pass your letter on to others who work more directly with the schools to see if they can offer suggestions.

The reason that I suggested a community-based organization or setting is that you often have more flexibility in community-based organizations than you do in a public school. The teaching method being used in most public schools is being cited as one of the primary reasons for reading failure (Chessman et al., 2009; Foorman et al., 2003; Keller & Just, 2009; Lyon, 2002; Meyler et al., 2008; Shaywitz and Shaywitz, 2007Torgesen et al., 2001).

Many schools offer an after-school program for at-risk readers, but these use the same teaching strategies under which the child failed to learn to read in the classroom. Some after-school programs are successful. Many programs are not. Children who struggle in school need programs that emphasize step-by-step instructions, intrinsic motivation (no reward or incentive programs), active hands-on learning, structured skill-building, social skills, and group process with emphasis on interaction and cohesion.

So, try something new. Do not simply repeat methods and curriculum that has failed in the classroom. What is needed is an after-school prevention program that uses a totally different approach to learning.

If you decide that you would like to develop a community-based program, help is available. Robert Conyne (2010) offers a detailed account for developing psychoeducational prevention programs. If you want specific help on developing an after-school program, my After-School Prevention Programs for At-Risk Students: Promoting Engagement and Academic Success (Clanton Harpine, 2013a) gives a step-by-step plan for developing a successful after-school program using a group-centered approach.

In the June 2015 Monitor on Psychology, in an article entitled: Grabbing Students– Researchers have identified easy ways to boost student success by increasing their engagement and learning, several ideas are specified for making school programs more successful. The researchers highlighted in the article state that education in the classroom should include: (1) engagement that includes application, importance, and enjoyment (with the students being actively involved—not just sitting and listening to a teacher talk), (2) being intrinsically motivated (being interested and seeing the value or relevance in what is being taught—not working for rewards or prizes), (3) rebuilding self-efficacy (helping the student believe that they can succeed—based on skills learned), (4) art enrichment hands-on activities related to the subject or topic being taught, (5) relationship building activities, (6) reducing the emphasis on testing and striving for mastering a learning task rather than striving for a grade, (7) measuring growth on an individual level rather than comparing to other students, and (8) finding ways to personalize learning– possibly even using forms of technology. The article ends by explaining that researchers and educators must work together, but the article does not give any advice on how to make this happen. Again, they do not offer suggestions for how to change the schools.

Keller and Just (2009) showed conclusively through their neuroimaging studies with at-risk readers that phonological decoding skills and enhanced phonemic awareness can teach a student how to read. Regrettably, these are not the methods being used in most public schools.

Let me know if I can be of further assistance, and watch for our next column when we will turn to some educational policy experts to see if they can offer some suggestions for how to change the schools.

If you would like to join this discussion, let us hear from you. We welcome your participation. We invite psychologists, counselors, prevention programmers, graduate students, teachers, administrators, and other mental health practitioners working with groups to network together, share ideas, problems, and become more involved. Please send comments, questions, and group prevention concerns to Elaine Clanton Harpine at clantonharpine@hotmail.com

References

Chessman, E. A., McGuire, J. M., Shankweiler, D., & Coyne, M. (2009). First-year teacher knowledge of phonemic awareness and its instruction. Teacher Education and Special Education: The Journal of the Teacher Education Division of the Council for Exceptional Children, 32, 270-289. doi: 10.1177/0888406409339685

Clanton Harpine, E. (2013a). After-school prevention programs for at-risk students: Promoting engagement and academic success. New York: Springer.

Clanton Harpine, E. (2013b). Erasing failure in the classroom, vol. 3: The Reading Orienteering Club, using vowel clustering in an after-school program. North Augusta, SC: Group-Centered Learning.

Collier, Lorna, (2015, June). Grabbing students: Researchers have identified easy ways to boost student success by increasing their engagement and learning. Monitor on psychology, 46(6), 58-63.

Conyne, R. K. (2010). Prevention program development and evaluation: An incident reduction, culturally relevant approach. Thousand Oaks, CA: Sage.

Fleming, C. B., Harachi, T. W., Cortes, R. C., Abbott, R. D., & Catalano, R. F. (2004). Level and change in reading scores and attention problems during elementary school as predictors of problem behavior in middle school. Journal of Emotional and Behavioral Disorders, 12, 130-144.

Foorman, B. R., Breier, J. I., & Fletcher, J. M. (2003). Interventions aimed at improving reading success: An evidence-based approach. Developmental Neuropsychology, 24, 613-639.

Foorman, B. R., & Torgesen, J. K. (2001). Critical elements of classroom and small-group instruction promote reading success in all children. Learning Disabilities Research and Practice, 16, 202-211.

Hoeft, F., Ueno, T., Reiss, A. L., Meyler, A., Whitfield-Gabrieli, S., Glover, G. H., Keller, T. A., Kobayashi, N., Mazaika, P., Jo, B., Just, M. A., & Gabrieli, J. D. E. (2007). Prediction of children’s reading skills using behavioral, functional, and structural neuroimaging measures. Behavioral Neuroscience, 121, 602-613.  doi: 10.1037/0735-7044.121.3.602

Keller, T., A., & Just, M. A. (2009). Altering cortical connectivity: Remediation-induced changes in the white matter of poor readers. Neuron 64, 624-631. doi: 10.1016/j.neuron.2009.10.018

Lyon, G. R. (April 28, 1998). Overview of reading and literacy initiatives. Testimony before the Committee on Labor and Human Resources, Senate Dirkson Building. Retrieved November 27, 2006, from http://www.cdl.org/resourcelibrary/pdf/lyon_testimonies.pdf

Lyon, G. R. (2002). Reading development, reading difficulties, and reading instruction educational and public health issues. Journal of School Psychology, 40, 3-6.

Meyler, A., Keller, T. A., Cherkassky, V. L., Gabrieli, J. D., & Just, M. A. (2008). Modifying the brain activation of poor readers during sentence comprehension with extended remedial instruction: A longitudinal study of neuroplasticity. Neuropsychologia, 46, 2580-2592.

National Assessment of Educational Progress. (2013). Nation’s Report Card: Reading 2013. Retrieved from http://nces.ed.gov/nations report card/pdf/main2013/2010458.pdf

National Reading Panel, (2000). Teaching children to read: An evidence-based assessment of the scientific research literature on reading and its implications for reading instruction (NIH Publication No. 00-4754). Washington, DC: National Institute for Literacy.

Rayner, K., Foorman, B. R., Perfetti, C. A., Pesetsky, D., & Seidenberg, M. S. (2001). How should reading be taught? Scientific American, 286, 84-91.

Shaywitz, S. (2003). Overcoming Dyslexia: A new and complete science-based program for reading problems at any level. New York: Knopf.

Shaywitz, S. , & Shaywitz, B. (2007). Special topic: What neuroscience really tells us about reading instruction: A response to Judy Willis. Educational Leadership: Improving instruction for students with learning needs, 64(5) 74-76.

Torgesen, J. K., Alexander, A. W., Wagner, R. K., Rashotte, C. A., Voeller, K. S., & Conway, T. (2001). Intensive remedial instruction for children with severe reading disabilities: Immediate and long-term outcomes from two instructional approaches. Journal of Learning disabilities, 34, 133-158. doi: 10.1177/002221940103400104

Categories
Brief Articles

Career Paths: Group Psychology and Group Psychotherapy

Lee Gillis, PhD
Lee Gillis, Ph.D.

It is difficult to imagine you will embark on a career path after completing your undergraduate degree in psychology that will not require you to work with a group. Clinical, counseling, social, industrial-organizational, addiction, child and adolescent, military and sport psychologists, among others, all work with groups. We may take different academic paths in graduate school, but we all share a belief in the power of the group. If you have an interest in groups you may wish to consider joining us and becoming a group psychologist or group psychotherapist.

What We Do

Group psychologists specialize in social, industrial-organizational, addiction, child and adolescent, military and sport psychology. We are interested in such issues as researching group factors that help an organization function more efficiently, enable addicts to reduce destructive behaviors, keep youth from bullying one another, lessen the impact of PTSD and allow individuals to perform at peak levels — and that’s just scratching the surface.

Group psychologists are also interested in leadership. For example, we research whether there are natural born leaders. We explore leadership traits that can help transform a group into a high-performing team.

Clinical and counseling psychologists conduct individual, couples, family and group psychotherapy. Research demonstrates that group psychotherapy is as effective as individual psychotherapy (Burlingame, Strauss, & Joyce, 2013), and it costs less. When clinical and counseling psychologists practice in independent practice, community mental health clinics, university counseling centers, veterans’ hospitals, recovery centers or geriatric facilities, to name a few places of employment, they are often asked to conduct group psychotherapy. Groups are efficient; groups are effective.

Group psychotherapy offers its members therapeutic benefits that cannot be as easily obtained in individual therapy. For instance a group member can experience universality — when they realize that at least one other person in their group feels similarly to them, when before, they felt they were the only person in the world who had ever had such feelings. Group psychotherapy can instill hope as group members develop insight and learn social skills while receiving feedback from others.

Why You Should Pursue This Career

If what is projected about your work environment in the future is true, most of you reading this article will be part of a group or team in your work world. The recently revised APA Guidelines for the Undergraduate Psychology Major (PDF, 447KB) places emphasis on enhanced teamwork capacity (Goal 5.4) and specifically states that those with a baccalaureate degree in psychology should be able to, among other things, “collaborate successfully on complex group projects,” “assess basic strengths and weaknesses of team performance on complex projects” and “work effectively with diverse populations.”

According to the Bureau of Labor Statistics, there will be an increase in the need for industrial-organizational psychologists at a rate much greater than in other fields of employment. In addition, as mental health care gains parity with physical health care under the Affordable Care Act, demand for psychological services may increase. There is no doubt that psychologists will increasingly work in collaborative teams with medical doctors, social workers and other health care professionals to help provide more interdisciplinary, effective and efficient treatment. As a psychologist who understands both group dynamics and group psychotherapy, you will be a double asset to the teams in which you belong.

How To Get Involved

After graduating with an undergraduate degree in psychology, most group psychologists and group psychotherapists pursue a graduate degree at the master’s or doctoral level. Research psychologists pursue careers in academia or industry. Clinical and counseling psychologists who specialize in group psychotherapy attend doctoral programs accredited by APA, and many pursue a license to practice psychology.

Group psychologists and group psychotherapists may both belong to Div. 49 (the Society of Group Psychology and Group Psychotherapy). The division welcomes all psychologists who believe in the power of group. You can become a student affiliate member of Div. 49 or join us on Facebook, Google+ or LinkedIn. You are also invited to attend our division’s activities at the annual APA convention. We would love to connect with you.

References 

Bureau of Labor Statistics, U.S. Department of Labor (n.d.). Occupational outlook handbook, 2014-15 edition, Psychologists.

Burlingame, G. M., Strauss, B., & Joyce, A. S. (2013). Change mechanisms and effectiveness of small group treatments. In M. J. Lambert (Ed.), Bergin and Garfield’s handbook of psychotherapy and behavior change (6th ed.; pp. 640-689).

This article first appeared in the Psychology Student Network (January 2015).

Categories
Brief Articles

Preventation Corner

Elaine Harpine, Ph.D.
Elaine Harpine, Ph.D.

This is our third column in our series on developing training programs for prevention groups. We sought advice from two experts in the field of group prevention, Robert K. Conyne, Ph.D. and Arthur M. Horne, Ph.D. who gave us excellent suggestions on designing training programs. We were also reminded in our last column that prevention program training is needed at both the university level for professionals planning to specialize and work with prevention groups and at the community or prevention group level with volunteers, health practitioners, teachers, or others who may be leading or working with prevention groups. Effective training is essential if your prevention group is to be successful.

Training seems to be on the mind of many practitioners as evidenced by the number responses that we received to our last column. The letter chosen for today highlights another problem facing prevention groups and those training prevention group practitioners.

EDITORIAL QUESTION POSED:

Dear Prevention Corner:

I’ve been following the discussion on training, and I’d like to know– which training approach works best.

Signed,

Just Wondering

RESPONSE

Dear Just Wondering,

You are not the only person seeking an answer to the question: Which training approach works best? There are basically seven different training techniques being used with prevention groups. The basic training methods are: (1) a written training manual, (2) instructor-led training or lecture, (3) interactive group sessions, (4) hands-on training through apprenticeships and internships, (5) computer-based training, (6) online or web-based training, and (7) blended training approaches (using one or more methods together). Let’s take a moment to look at each method individually.

A Written Training Manual

A written training manual is probably one of the most frequently used methods for training, but a written training manual is only as effective as the person writing the manual and the person reading and interpreting the material contained in the manual. A written training manual does not answer questions from confused readers nor does it allow for interaction between the trainer and the trainee. A written training manual does not ensure clarity, and it also does not ensure that the trainee will use the material as instructed. This is a particular problem with prevention group programs. School, community-based, and federally funded organizations are frequently mandated to buy and use evidence-based programs. This sounds good. Yet, there is no way to ensure that those who purchase such evidence-based programs and read the training manuals accompanying these programs actually follow the instructions given in the manual or use the evidence-based program as intended. In such cases, the evidence-based program and those participating in the program end up with less than a satisfactory experience. A written training manual is simply not enough.

Instructor-led Training or Lecture

Most training programs utilize some form of instructor-led training. The most common approach is lecture with or without PowerPoint. The problem with instructor-led training is that it does not include interaction. Questions and answers are not classified as being effective interaction. Anyone who has ever conducted an instructor-led lecture can also testify to the number of participants who have slept through such training sessions. With today’s handheld technology, a training lecture must also compete with easy access to Internet sites and people’s ability to occupy their mind and time with something other than listening to a training lecture. Even with a very dynamic speaker, audiences absorb approximately only one-third of what is said. Clearly, relying on instructor-led training is not adequate.

Interactive Training

Interactive training involves using some form of small group discussion, case studies, or possibly a demonstration. The idea is to get the audience involved and engaged as participants in the training process from beginning to end. Interactive training can be very effective, but it is also time consuming and may restrict its use to only small groups. If you’re facing a room full of 100 people, interactive training will be very complicated.

Hands-on Training

Hands on training may involve a class that goes out and applies and evaluates what they learn, an apprenticeship where a trainee works and learns alongside an established group worker, and an internship which may include classroom instruction as well as working alongside an established group worker. Internships and apprenticeships are sometimes paid training positions as well, which may allow for longer and more in-depth training. Each of these methods of training can be very effective, but they are time-consuming and limit the number of people who can be trained at a time.

Computer-based Training

The newest trend in training is computer-based. Such training may be text only, multimedia (including videos), or virtual reality with an interactive simulation (such as a flight simulator). The most effective computer-based training programs are interactive. Interactive computer-based programs show a greater degree of comprehension of skills by trainees. Cost may be a factor, especially if your program uses interactive simulation and requires special equipment.

Online or E-Training

Web-based training is another form of computer-based training. It may consist of web-based training modules, tele-or-video conferencing (primarily uses lectures or demonstrations), audio conferencing (sound only), web meetings or webinars where trainees dial in to receive audio and/or visual instruction, online college and university classes (distance-learning), collaborative document preparation training (trainer and trainee must be linked on the same network), and email for follow-up questions and reminders. While online training can be very convenient and serve a large population, it limits the actual contact with the trainer. It also requires skills and knowledge of computer-based systems from trainees.

A Blended Training Approach

Blended training uses more than one training method. It may combine instructor led with computer-based training or interactive with hands-on training. The idea is to blend together two training methods that best meet the needs of your group. Research has shown a blended training approach to be more effective with improved training outcomes and to be more cost-efficient financially and in terms of time commitment.

The answer to your question: Which is best? A training program that involves interaction with trainees and engages the trainees in the training process is best. The method that you choose may be influenced by financial constraints, the number of trainees being trained at one time, and the time allotted for training. There is no one simple answer. The true test of training effectiveness comes when your trainees begin to work in your group prevention program. If your training program does not actually train workers to work effectively in a prevention group, it cannot be labeled a success, especially if your purpose is to train prevention group workers. Therefore, do not hesitate to take time and put forth effort in designing your group prevention training program.

We would like to continue this discussion and invite your comments and responses. Our next column will be devoted to the responses that we receive. Let us hear from you. We welcome your participation. We invite psychologists, counselors, prevention programmers, graduate students, teachers, administrators, and other mental health practitioners working with groups to network together, share ideas, problems, and become more involved. Please send comments, questions, and group prevention concerns to Elaine Clanton Harpine at clantonharpine@hotmail.com

 

Categories
Brief Articles

University-Community Group-Centered Prevention Project with At-Risk Students: Four Year Study

Anna Thompson, M.A.
Anna Thompson, M.A.

Anna Thompson, M.A.

University of South Carolina Aiken

Abstract

The Reading Orienteering Club (ROC) is a university-community collaborative group-centered prevention after-school project that focuses on the reading ability and comprehension of what children are reading. This program’s concentration is on 1st, 2nd, and 3rd graders primarily from a southern small town, population 29,884 with an ever increasing low socio-economic community base. Reading is a vital skill necessary in order to survive and thrive in all aspects of life including school and future jobs. The students who participated in this case study experienced academic problems in reading, spelling, or comprehension. The ROC program, recorded the level of reading, spelling and sight words using a pretest and post-test. Children were evaluated as to their improvement by age: 5 to 7-years-old, 8-years-old, and 9 to 11-years-old. Participation was open, free, and self-selected by the parents, teachers, and other community after-school groups who are affiliated with the students. The 1st hypothesis was: children who begin the program at younger ages will improve more than children who begin when they are older. The 2nd hypothesis was: children who attend the program for more than one year will show greater increases from pre to post test. Overall, the three groups of children showed similar improvements in all literacy areas. Outcomes of the program were positive and provided evidence of significant improvements from pretest to post-test. Results showed that there were no significant main effects or interactions with age group. The 2nd hypothesis was not supported.

Keywords: group-centered prevention, prevention groups, after-school programs, reading failure

This study describes the outcomes of the ROC, “a year-long group-centered after-school community-based prevention program that emphasizes phonological awareness, reading and writing, spelling, and intensive hands-on instruction” (Clanton Harpine, 2013, p. ix). The ROC uses vowel clustering, the 4-step method, and group-centered prevention interventions to improve the literacy scores and behavior of the children, primarily 1st, 2nd, and 3rd graders, of Aiken County in South Carolina. The 4-step method involves having the children: (a) capture tricky words, words they do not know, (b) write the word correctly, (c) look up the words in the dictionary to find the definition, (d) and write sentences using these words (Clanton Harpine, 2013). This lets the children correct themselves, learn a new word, and get a better comprehension of the word. The main goals of this program are for the children to practice “reading, writing, spelling, focusing their attention, comprehension, following step-by-step instruction, learning new words, and practicing a specific vowel cluster for the day” (Clanton Harpine, 2013, xi).

Torgesen believes “the ultimate goal of reading instruction is to help children acquire the knowledge and skills necessary to comprehend printed material at a level that is consistent with their general verbal ability or language comprehension skills” (2002, p. 10). At the ROC, a goal is to bring a child from reading below the appropriate reading level to reading at or above their reading level (grade). One study conducted used children from 14 elementary schools (Hatcher et al., 2006). The children were split into two groups. One group received the small group intervention for 20 weeks and the other received the intervention for only the second 10 weeks. During the first 10 weeks of the full 20 week program, students who participated in the intervention improved more than the other children who did not receive the first half of the program (Hatcher et al., 2006). On the other hand the second group who only received the small group intervention during the second set of 10 weeks, caught up to the first group. This may mean it does not matter how long the small group intervention is, but just that the children participate in the intervention. The current study looks at the amount of time spent in the program in order to see if more time spent in the program translates into more improvement. It also looks at whether or not early intervention helps improve test scores. Targeted skills include taking turns and sharing, building self-efficacy, working together, and motivation (Clanton Harpine, 2013). A child’s self-efficacy is their belief that they can succeed.

Motivation Component

Motivation is defined as the inner power that makes people do what they do” (Clanton Harpine, 2013). The key to motivation is that it is something that cannot be forced onto a person, particularly a child. Motivation comes from different experiences and the affect that each experience has on the internal mindset of the child. There are both intrinsic and extrinsic motivations. Extrinsic motivation comes from quick automatic rewards such as ice cream after completing homework or a particular amount of money for every A on a report card. The ROC does not reward students by using extrinsic motivation, but focuses instead on intrinsic motivation. Intrinsic motivation is motivation that does not come from receiving a prize after completion but the motivation to complete the task because of the enjoyment and interest in the task at hand. “Intrinsic motivation can help children rebuild their self-efficacy, change their approach to learning, and consequently, change their behavior” (Clanton Harpine, 2008, p. 20).

The creator of the ROC has discovered several items that help a group-centered program like the ROC, build children’s motivation, particularly intrinsic motivation. These according to Ryan and Deci, include: “positive self-efficacy, efficacy expectations, outcome expectations, choice, competence-affirming feedback, and self-determination” (Clanton Harpine, 2013, p. 56). Children are encouraged to continue learning when not only the parents see improvement and give praise, but also when the children themselves see an improvement in the struggling area. The ROC is a program that allows children of different ages to work together as a team and not be judged based on their lower reading skills. Each child has areas that may need improvement. They are able to receive the extra encouragement, helping to increase their intrinsic motivation.

A study conducted by Gottfried, Fleming, & Gottfried (1994) discovered, using a longitudinal study of 9 and 10 year-olds, that the intrinsic motivation practices of the group of 9 year-olds influenced an increase in academic level when they turned 10. The study looked at verbal and math skills. The predications of the experimenters were “children’s academic intrinsic motivation … [would be] positively related to encouragement of task endogeny and negatively related to provision of task-extrinsic consequences” (Gottfried, Fleming, & Gottfried, 1994, p. 104). The results of this study supported these predications in showing the importance of internal motivation in academic success.

The current study looked at the impact of the amount of time spent in the ROC program and the compared literacy scores of 46 children. These 46 children were grouped by age: 5 to 7-year-olds, 8-year-olds, and 9 to 11-year-olds. The hypothesis was that the longer children continued in the ROC program, the more their literacy scores would increase. Another hypothesis of this study was, the early starting ages of children completing the ROC program would result in an increase of later scores. In this study, Literacy includes reading, spelling, and comprehension. Literacy is important especially as a child due to the influence it has on later life experiences including jobs, secondary education, and day to day activities. All of these experiences involve literacy. Spelling is the skill of putting letter sounds together correctly to form a word and reading is the skill of decoding these letter sounds to read written or printed material aloud (Clanton Harpine, 2013). Comprehension is the ability to understand what is being read and use what is read to: elaborate on material, continue with stories, apply it to today’s world, and complete activities based on reading material (Clanton Harpine, 2013).

This study tested the hypothesis that the early starting ages of children completing the ROC program would result in an increase of later scores. This hypothesis was created due to Lyon’s idea that “if children are not provided early and consistent experiences that are explicitly designed to foster vocabulary development, background knowledge, the ability to detect and comprehend relationships among verbal concepts, and the ability to actively employ strategies to ensure understanding and retention of material, reading failure will occur no matter how robust word recognition skills are” (1998, p. 10). Keller & Just showed that the white matter of the brain can change over time, even though it takes more time and is harder with age (Keller & Just, 2009). They tested 62 children with ages ranging from 8-years-old to 12-years-old. Attitude, motivation, and stigmatization of failure play a major role in change with these older children which can cause for change to be more difficult. The second alternative hypothesis of this study was, the longer children continue in the ROC program, the more their literacy scores would increase.

Method

Participants

The participants of this study included 46 children who received no compensation or coercion in participating. There were 25 male participants and 21 female participants. Eighteen participants were ages 5 to 7-years-old. Eleven of the participants were 8-years-old. Seventeen of the participants’ ages ranged from 9-years-old to 11-years-old. All the participants were enrolled in the Aiken County school system. Starting ages ranged from 5 years old to 11 years old. Sixteen participants were Caucasian, 28 participants were African American and three were of mixed descent.

Materials and Procedure

In order to correctly test the reading level of each child, the children all completed the same test. The skills were assessed using the Howard Street Tutoring Manual, 2nd ed. (2005) by Darrell Morris. The test data on reliability and validity of test was also completed by Morris (Morris, Shaw, & Perney, 1990; Morris, Tyner, & Perney, 2000). The 46 children were first tested before the program begins in the fall to get a starting level. Then the children were tested using the same test in the winter as a mid-point test to see any improvement made and any areas that may need more help. Lastly, the 46 children were tested in the spring at the completion of the program for that year to see how far they improved. Fourteen of the children who completed the ROC program continued for an additional year and were tested before the start of the school new year and again for mid-point testing. Two of the children continued for an additional third year and received the same testing. Testing effects have been evaluated previously in order that the children are not scoring better on the later tests just because they have already completed the test. There was no testing effect discovered.

Each child was given the same test during the beginning, middle, and end of the ROC program. The test consisted of reading, spelling, comprehension, and sight word sections. Each section was then split into three more sections, which corresponded to 1st grade, 2nd grade, and 3rd grade levels. Scores were organized by reading level and the amount missed, spelling level and the amount missed, sight word level and the amount missed, and the comprehension scores which consisted of the amount missed by the participants. Levels 1, 2, 3 represents before 1st grade. Level 4 represents 1st grade, 5 represents 2nd grade, 6 represents 3rd grade, and 7 represents 4th grade.

Design

This study is a quasi-experimental study. The dependent variable is the scores for each of the literacy areas. The two independent variables for hypothesis 1 are ages of the children and the time of measurement. The independent variable for hypothesis 2 is the amount of time in the program. This study has a mixed design with the independent variable of, time of measurement, and the age and gender of the between-subject variable. Three different age groups include: 5 to 7-year-olds, 8-year-olds, and 9 to 11-year-olds. The 46 children who completed the Reading Orienteering Club (ROC) fall under one of these categories of ages. Eighteen of these children started at the age of 5 to 7-years-old, 11 of these children were 8-years-old, and 17 of these children started at the ages of 9 to 11-years-old.

Results

The first hypothesis was tested using a repeated measures ANOVA. It was 3 (Ages) x 3 (pre, mid, post) using mixed design. Overall, the three groups of children; aged 5 to 7-year-olds, 8-year-olds, and 9 to 11-year-olds showed similar improvements in all literacy areas. The results showed boys and girls improved from pretest to midtests, but not much improvement from mid-test to posttest, no matter their ages, for the level of spelling. Thirty-five percent of the variations in spelling scores were explained by the ages of the participants. There was a significant main effect for age based on spelling, F(2, 4) = 6.93, p = .002. There was also a significant main effect for age based on reading, F(2, 4) = 19.87, p = .000. Overall from midpoint testing to post testing all participants improved; from pretest to posttest, the younger age groups improved. This supports the hypothesis for younger children improving more than the older children, due to a main effect for time based on the age groups, F(4,4), p = .033. Looking at the data generally, everyone still improved. A significant main effect was sight words, F(2, 4) = 9.06, p = .000. From the mid-tests to post-test, the younger children showed improvement. This also supports the hypothesis: the early starting ages of children completing the ROC program would result in an increase of later scores. The last significant main effect was found for comprehension, F(2, 4) = .64, p = .000. From pretest to post-test, all groups improved. The stigmatization of failure, mentioned earlier, may also be part of the reason for not receiving stronger change with the older students.

A second aspect of this study also involved the 46 children. These 46 children represent three years of participation. Thirty children finished the ROC program in one year. Fourteen children took 2 years to complete the program and two of the participants took 3 years to complete. Participants who took 2 years and 3 years to complete the program were put into one group, which was compared to the children who were able to complete the program in 1 year. There was a significant main effect for the amount of time spent in the program based on spelling, F(2, 2) = 5.96, p = .004. Participants improved as much the second years, as they did the first year. Unfortunately, there was not a significant main effect for reading, F(2, 2) = 2.07, p = .133. Everyone did show signs of improvement. A significant main effect was found for comprehension comparing time and years, F(2, 2) = 0.17, p = .007. The children who completed the ROC program in 1 year improved more from midpoint test to post-test. Overall, children who completed the program in 1 year did better than children who took a longer period of time. Lastly there was not a significant main effect was sight words, F(2, 2) = 1.73, p = .184. Participants did still improve overall.

Discussion

There was not much support for the hypothesis that staying in the program for a longer length of time, increased test scores. The only set of scores that showed significance for this hypothesis was the reading comprehension scores that showed one group improving more from mid-test to post-test. In this instance the group of children who showed significant improvement above the rest was the participants who completed the program in one year.

There are many reasons for the hypothesis to not be supported. One reason for the hypothesis to not be supported involves the nature of the second and third year children. The case may be that the children who have to continue on for another year or 2 have more serious learning problems, which would take more work and time, than the children who finished the program in one year. The analysis itself may also cause for no significance to be reported. Age was reported as a covariate which is a statistical way to look at a comparison group that is not reported. This compares the current data to an above and beyond natural group. The data was briefly analyzed without using age as a covariate, but was not used due to the lack of a real comparison group. Overall, the ROC program has shown improving scores of participants. The concept behind the ROC program is to help all children learn how to read in order to better their lives now and in the future.

References

Clanton Harpine, E. (2008). Group Interventions in Schools: Promoting Mental Health for At-Risk Children and Youth. New York: Springer. doi: 10.1007/978-0-387-77317-9

Clanton Harpine, E. (2013). After-School Prevention Programs for At-Risk Students: Promoting Engagement and Academic Success. New York: Springer. doi: 10.1007/978-1-4614-7416-6

Common Core State Standards Initiative. (2014). Retrieved from http://www.corestandards.org/

Gottfried, A., Fleming, J. S., & Gottfried, A. W. (1994). Role of parental motivational practices in children’s academic intrinsic motivation and achievement. Journal of Educational Psychology, 86(1), 104-113. doi:10.1037/0022-0663.86.1.104

Hatcher, P. J., Hulme, C., Miles, J. V., Carroll, J. M., Hatcher, J., Gibbs, S., & … Snowling, M. J. (2006). Efficacy of small group reading intervention for beginning readers with reading-delay: A randomized controlled trial. Journal of Clinical Psychology and Psychiatry, 47(8), 820-827. doi: 10.1111/j.1469-7610.2005.01559.x

Keller, T. A., & Just, M. A. (2009). Altering cortical connectivity: Remediation-induced changes in the white matter of poor readers. Neuron, 64, 624-631. doi:10.1016/j.neuron.2009.10.018

Lyon, G. R. (1998, April 28). Overview of reading and literacy initiatives. Retrieved July 14, 2014, from http://www.nrrf.org/learning/overview-of-nichd-reading-and-literacy-initiatives/

Morris, D., Shaw, B., & Perney, J. (1990). Helping low readers in grades 2 and 3: An after-school volunteer tutoring program. The Elementary School Journal, 91(2), 133-150. doi:10.1086/461642

Morris, D., Tyner, B., & Perney, J. (2000). Early Steps: Replicating the effects of a first-grade reading intervention program. Journal of Educational Psychology, 92(4), 681-693. doi:10.1037/0022-0663.92.4.681

South Carolina State Department of Education. (2014). Retrieved from https://ed.sc.gov

Torgesen, J. K. (2002). The prevention of reading difficulties. Journal of School Psychology, 40(1), 7–26.

Categories
Brief Articles

Prevention Corner

Elaine Harpine, Ph.D.
Elaine Harpine, Ph.D.

This is our second column on our series on developing training programs in group prevention. In our last column, two experts in the field of group prevention, Robert K. Conyne, Ph.D. and Arthur M. Horne, Ph. D., presented two perspectives on training prevention groups: (1) the American Psychological Association Guidelines for Prevention in Psychology (APA, 2013) and (2) training with an awareness toward social justice. We received a response to that column and continue the discussion.

EDITORIAL QUESTION POSED:

Dear Prevention Corner:

I read the column each time, and I know that you are talking about training programs at the college level—course work training. My question though is: what is the best way to train workers for a community or school program? I attended your APA convention workshop a couple of years ago on developing and designing group prevention programs. I came home excited and overflowing with ideas. I followed the workbook that you gave us, set up my program, held a training session, but then I ran into a brick wall. I work in a school where half of our students drop out before graduation because they cannot read. I want to keep students in school by helping them learn to read. The other teachers who volunteered to work in the program wouldn’t listen; they went back to teaching reading using the same way they have for years. My program failed. How can I train people to use these new prevention ideas?

Signed,

In Need of Help.

RESPONSE:

Dear In Need of Help:

I want to thank you for bringing to the discussion a very important point that we have failed thus far to emphasize: training in group prevention must include (1) training at the university level for professionals planning to specialize and work with prevention groups and (2) training in the community or at the prevention group level with volunteers, health practitioners, teachers, or others who may be leading or working with prevention groups. While it is essential that we increase course work and training at the university level, it is just as essential that we provide effective training programs for volunteers or others who use the group prevention format.

Universities do not always see the necessity for adding new courses in group prevention, and community and school prevention groups do not always see the need for extensive training in prevention techniques and interventions. Change is often hard to accept.

Introducing a change or new group prevention approach for solving an old established long-standing problem is even more difficult. I truly understand your frustration, and trust me, you are not alone. I just spoke this past week with a nurse working with obesity prevention groups. She was also complaining that her prevention group leaders would not change and try new prevention techniques. Her nursing staff was accustomed to lecturing to obesity patients and therefore saw no need to change to a more interactive format.

In reading, change is twice as hard. You are not only trying to train workers to use new group prevention techniques (such as cohesion and interaction); you are also trying to train workers to use a totally new and different approach to teaching reading.

According to the Nation’s Report Card, approximately 40% of students across the nation are unable to read at grade level (Nation’s Report Card, 2013). This is not a new statistic, and the problem did not occur yesterday. The problem has been compounding without any sign of significant improvement for the past 12 years. With such a staggering history of failure, you would think that we would be eager to engage in a new approach. Such is not the case. Even after Congress commissioned the National Reading Panel (2000) to ascertain the most successful method for teaching reading and the panel stated that phonemic awareness (the teaching of sounds and decoding of sounds) was the best method for teaching students to read, the whole- language fight goes on.

The National Reading Panel (2000) stated emphatically that phonemic awareness worked better than “old style” phonics and better than whole-language—even blended methods. Yet, the majority of schools across the nation today still handout sight word strips for students to memorize each week (whole-language); even though, such methods have been proven ineffective (Blaunstein & Lyon, 2006; Fleming et al., 2004; Foorman et al., 2003; Keller & Just, 2009; McGuinness, 1997; National Reading Panel, 2000; Pullen Paige & Lane, 2014; Vaughn, Denton, & Fletcher, 2010). Phonemic awareness is not the same as old-style phonics or the new blended method. Shaywitz and Shaywitz (2007), Co-directors for the Yale Center for the Study of Learning, state it best: In order for a child to learn to read, the child must learn that (1) each and every word is composed of individual sounds (phonemes), (2) these sounds are represented by alphabetic letters, (3) some letters represent several sounds, and that (4) children or any struggling reader (Shaywitz, 2003) must learn how to pull words apart into their elemental phonemes and then put the letter sounds back together into words that have meaning.

Research has solidly proven that phonemic awareness (sounds) and the phonological understanding of those sounds and how they work together to form a word is by far the best way to teach children to read. Yet, there are still universities teaching new prospective teachers the whole-language method for teaching reading. Just this past week, a parent complained that her Kindergartener was failing because she could not memorize her sight word list each week (a whole-language technique). A college professor spoke to me recently and explained that all children need is more exposure to books. “If someone would just read to them, then the children could learn how to read.” Reading is a skill that must be taught; you cannot simply learn how to read by listening to someone else. Community groups are organizing to purchase and distribute new books in order to teach children to read, but simply handing a child a book, even a new book, will not teach the child how to read.

The newest trend is excitement. Pep rallies, costume characters, book collection drives, and free gifts are the latest fad in teaching children how to read. No, excitement is not the answer. Such an approach would be like giving someone a book in French. If they had not learned French, the book would be worthless because someone not schooled in reading French would not be able to read the book. Don’t get me wrong. I think that giving a child or teenager a book (new or used) is the best gift that you can ever give, but simply handing a child a book will not teach a child to read (even if the book is distributed through a very exciting program by a costumed character). You must teach the child to read first, and then give the child a book.

If you want to develop a group prevention program to teach children and teens to read, you must first combat this age old unwillingness to change from whole-language teaching techniques to phonemic awareness and phonological teaching techniques. Therefore, in your group prevention training program, you are not only teaching that prevention groups must be interactive (Conyne & Clanton Harpine, 2010); you must also prove that there is a need for a change and that prevention groups will offer the best means of change for your students. No, this will not be easy because you are combating years and years of denial. The challenge will be to change the ideology of your group leaders in respect to reading. You may not be able to accomplish this within the schools. If you encounter too much resistance to change, you might try establishing an after-school program through a community organization. After-school community-based programs can offer you more freedom and the opportunity to try new prevention ideas.

You may also find that you want to set up skill-building training sessions for your workers or volunteers so that they can learn how to work in a group setting. A prevention group is more than just a discussion, and it is certainly not the time for a lecture. Your training sessions may need to incorporate interaction and cohesion so that your workers can see how to use interaction and how to help group members build a cohesive group atmosphere. I find the best way to do this is by using group prevention techniques and interventions in my training sessions. Instead of the age old tradition of standing in front of your workers and explaining to them what you want them to do or lecturing to them about how the program will be conducted, set up training sessions that use a group prevention format. For example, I use group-centered prevention workstations for my program and my training sessions. In this way, workers and volunteers get to experience prevention techniques during the training program instead of just listening to me talk about interaction, cohesion, and working together as a group.

My answer to your question, how can you best teach people to use new prevention techniques, is to show your workers and volunteers how group prevention works during your training program. Let them experience group prevention in action.

We would like to continue this discussion and invite your comments and responses. Our next column will be devoted to the responses that we receive. Let us hear from you. We welcome your participation. We invite psychologists, counselors, prevention programmers, graduate students, teachers, administrators, and other mental health practitioners working with groups to network together, share ideas, problems, and become more involved. Please send comments, questions, and group prevention concerns to Elaine Clanton Harpine at clantonharpine@hotmail.com

References

Blaunstein, P., & Lyon, R. (2006). Why kids can’t read: Challenging the status quo in education. Lanham, Maryland: Rowman and Littlefield Education.

Conyne, R. K., & Clanton Harpine, E. (2010). Prevention groups: The shape of things to come. Group Dynamics: Theory, Research, and Practice, 14, 193-198. doi:10.1037/a0020446

Fleming, C. B., Harachi, T. W., Cortes, R. C., Abbott, R. D., & Catalano, R. F. (2004). Level and change in reading scores and attention problems during elementary school as predictors of problem behavior in middle school. Journal of Emotional and Behavioral Disorders, 12, 130-144.

Foorman, B. R., Breier, J. I., & Fletcher, J. M. (2003). Interventions aimed at improving reading success: An evidence-based approach. Developmental Neuropsychology, 24, 613-639.

Keller, T., A., & Just, M. A. (2009). Altering cortical connectivity: Remediation-induced changes in the white matter of poor readers. Neuron, 64, 624-631. doi: 10.1016/j.neuron.2009.10.018

McGuinness, D. (1997). Why our children can’t read and what we can do about it: A scientific revolution in reading. New York: The Free Press.

National Center for Education Statistics. (2013). The nation’s report card: Reading 2013 (NCES 2012-457). National Center for educational statistics, Institute of education sciences, US Department of Education, Washington DC.

National Reading Panel, (2000). Teaching children to read: An evidence-based assessment of the scientific research literature on reading and its implications for reading instruction (NIH Publication No. 00-4754). Washington, DC: National Institute for Literacy.

Pullen Paige, C., & Lane, H. B. (2014). Teacher-directed decoding practice with manipulative letters and word reading skill development of struggling first grade students. Exceptionality, 22, 1.

Shaywitz, S. (2003). Overcoming Dyslexia: A new and complete science-based program for reading problems at any level. New York: Knopf.

Shaywitz, S. , & Shaywitz, B. (2007). Special topic: What neuroscience really tells us about reading instruction: A response to Judy Willis. Educational Leadership: Improving instruction for students with learning needs, 64(5), 74-76.

Vaughn, S., Denton, C. A., & Fletcher, J. M. (2010). Why intensive interactions are necessary for students with severe reading difficulties, Psychology in the Schools, 47, 432-444.

Categories
Brief Articles

Concurrent Group Therapy with Parents: An Exploratory Study – Part II

Elisabeth Counselman Carpenter, LCSW
Elisabeth Counselman Carpenter, LCSW

Note. This is ‘Part II’ of an article included in the previous issue of The Group Psychologist. Click here to read Part I, which provided background information on concurrent group therapy and prior research on the topic. Part II below details the author’s pilot study.

Exploratory Study of Concurrent Group Therapy for Parents

This exploratory survey looks at the occurrence of concurrent group therapy for parents whose children are being treated in group therapy. The research questions explore the reported incidence of concurrent group therapy by members of the Association for Play Therapy (APT) listserv. Of the APT members surveyed, it was asked how many practice settings have groups, which group modalities are used, and if any groups are concurrent parents’ groups. The study questions concluded with respondents’ feedback identifying potential barriers to treatment of using concurrent group therapy as a treatment modality.

Methodology
A quantitative survey with open and close-ended questions was created by the author to gather data for the study. The research protocol was approved by the Adelphi University Institutional Review Board for research with human participants. Survey questions were developed by the author and managed through SurveyMonkey software. Questions were presented in both a multiple choice and Likert Scale format. Open ended questions with dialogue boxes were included in order to facilitate more comprehensive data collection.

Sample
The sample was taken from the general listserv of the Association for Play Therapy, an international play therapy professional organization founded in 1982. The APT general listserv was chosen for the sample due to the high number of practitioners working with children who may also have contact with or work in a treatment context with the parents of the children in treatment. This author is a member of the Association for Play Therapy.

The invited respondents were participants in the General Community Listserv, an online email discussion group for international play therapists, although most participants are from North America and all are identified as being in good standing with APT. All participants had a valid email address and voluntarily participated in the study. The members of the APT listserv are diverse, both professionally and geographically and includes social workers, psychologists, psychiatrists, licensed professional counselors, licensed marriage and family therapists, licensed mental health professionals, interns and students, both undergraduate and graduate-level. Currently, as reported in November 2010 by the Association for Play Therapy head office, there are 523 professionals that subscribe to the General Community Listserv.

Recruitment for the survey took place in two phases. All members currently enrolled in the listserv received an email with a paragraph explaining the purpose of the survey and a link to the informed consent form and the online survey, which was created through SurveyMonkey software. Ten days later, an additional email with the survey link was sent as a follow-up asking those whom had not yet participated to respond. Due to the anonymous construction of the listserv, it was not possible to only include non-respondents in the follow-up email. Participants did not receive any compensation or incentives for participation.

Results

Profiles of Respondents and their Practices

Demographics. Seventy-three of 523 (14%) members of the listserv consented to participate in the study and answered at least some of the survey questions. Sixty-three of the 73 overall respondents shared their demographic information. Practitioners had a diverse orientation and some held multiple degrees or designations in the mental health field. Twenty-three respondents hold designations of LPC (Licensed Professional Counselors), 19 hold designations of MSW/LCSW (Masters of Social Work or Licensed Clinical Social Worker), 6 hold doctoral degrees such as a Ph.D., EdD. or Psy.D., 3 are LMHC/MHC interns (Mental Health Counselors), and two respondents hold international degrees.

The respondents also varied geographically. Of the 62 respondents that shared their geographic information, the majority were from the United States. Two respondents are international practitioners from the United Kingdom and France. The majority of respondents came from the South (24), with Texas as the highest represented state with six respondents. Fourteen respondents practice in the Northeast while 13 practice in the Midwest and 10 from the West.

Practice. All respondents identified themselves as practitioners working with children between the ages of 0-17. The type of settings in which the respondents practice significantly favored private practice. Forty respondents (62.5%) listed private practice as their primary service setting. Eleven respondents (17.2 %) ranked second as family service agency practitioners. Eight respondents (12.5%) practice in a mental health clinic while another nine respondents (12.5%) practice in school setting. Four responders practice in a Child Advocacy Center. The following settings were only identified by one respondent each: residential treatment facility, outpatient cancer center, inpatient psychiatric hospital, hospital community health center, consultant role and a university clinic for developmental disabilities.

Groupwork. Of the 73 study participants, only 22 respondents (30.1%) have at least one child-age client who participates in some form of groupwork. Of these 22 respondents, all but two respondents reported that 50% or less of their caseload of child-age clients actually participate in groupwork.

The majority of children participating in groupwork were identified as participating in social skills groupwork. In addition to the modalities listed on the survey, other forms of groupwork which respondents facilitate were identified as short-term brief group therapy, trauma-related sexual abuse groups, child-centered play therapy groups, bereavement/grief groups, and Parent Child Interaction Therapy (PCIT), a specific form of treatment for young children diagnosed with conduct disorder (http://pcit.phhp.ufl.edu, retrieved on December 5, 2010).

Parent participation. The majority of respondents (69 of 73) answered questions about parents participating in treatment. Sixty-one respondents (88.4%) reported that parents/guardians could also receive treatment at their place of service. However, of these 61 respondents, very few reported that parents participate in groupwork. Of the 58 who shared their estimation of the percentage of parents who receive any treatment at the place of service, 32 (55.1%) stated that none of the parents participate in group treatment. Another 15 respondents (25.9%) reported that less than 10% of parents who participate in treatment engage in groupwork. Only 5.2% reported that 50% of the parents participate in group work, and no one reported a higher rate than fifty percent.

Orientation of group therapy. Of the modalities listed, parents who participate in groups appear to most frequently participate in cognitive behavioral groups (33%) and/or substance abuse groups (25%). In addition to the group modalities listed on the survey, respondents were asked to identify other types of group therapy in which the parents participate. The following types of groups were also identified: non-offending parent/caregiver groups related to sexual abuse, CPRT (Child Parent Relational Training), Filial Therapy groups, family therapy groups, parenting groups, PCIT groups, support groups, psychoeducational groups, groups specifically relating to cancer, anger management groups, mandated domestic violence groups, humanistic/object relations groups, ‘transparenting’ groups, parent coaching, marital counseling groups, sex offender groups, and bereavement/grief groups.

Familiarity and use of Concurrent Group Therapy. Respondents were asked to share their familiarity with the modality of concurrent parent group therapy. Sixty-two respondents provided information on their familiarity with concurrent group therapy as a modality. Of these respondents, 21% reported they were completely unfamiliar with the modality, 30.6% reported they were mostly unfamiliar, 32.3% reported that they were somewhat familiar, and 16.1% reported that they were very familiar with concurrent group therapy.

Of the 62 respondents who answered this question about familiarity with concurrent group therapy, 31 (50%) offered detailed and diverse explanations in their answers to this open-ended question. One respondent stated “never heard the term” and another stated “not familiar”, while many reported vague familiarity, such as “have attended conferences where it was presented in detail” and “…have heard of some in the past” or “heard of it, never done it.” In contrast, many respondents reported familiarity with running parent groups, but not in conjunction with their children’s group treatment. One respondent stated, “I only know of parent support groups, not therapy group for parents, and have no knowledge of any providers doing group therapy in my area.” Other respondents stated they were familiar with blended parent-child groups such as those offered through filial therapy, conjoint therapy, and multi-family group therapy. Only three respondents (5%) answered with having direct contact or knowledge of concurrent parent therapy groupwork: one of whom uses this model at their agency; one of whom had experience with it at a prior agency; and one whose school district offered concurrent parent group therapy as a model.

The overwhelming majority of respondents do not offer concurrent parent group therapy as a treatment modality at their place of service. In fact, only 8 (12.9%) respondents work at a service site where concurrent parent group therapy is offered as a treatment option. Of these eight respondents, their experience with parents participating in concurrent group therapy varies considerably. Two respondents state that 100% of groups at their service sites are run concurrently, while the other 6 reported that they either “don’t know” the percentage of parents participating or their answers ranged from 0-20% as the reported participation rates. The types of concurrent parent group therapy were identified as social skills groups, task-oriented, cognitive-behavioral, substance abuse, and art/expressive therapy in addition to trauma-related, domestic-violence related, PCIT and NOPS (the author was unable to identify this type of group treatment), sexual abuse groups, and groups for parents who abuse their children. One respondent stated they did not know what type of concurrent group therapy was offered. In regards to the type of attendance, of these eight respondents, one stated that group attendance was mandatory, six stated it was voluntary, and one did not respond.

For parents who do not participate in concurrent group therapy, the majority of respondents (81%), stated that parents do not participate in group therapy because it is not offered at their place of service. Eight (12.7%) stated that parents chose not to participate in concurrent parent group therapy. Two respondents identified scheduling conflicts as the reason for not participating and two reported that they did not know the reason.

Respondents identified varied reasons for service locations not providing concurrent group therapy as a treatment option. However, the responses could be divided into various categories. Twelve respondents stated that their setting made offering the modality a challenge due to the fact that they were in a small private practice or small agency, worked in a school, or saw clients at their homes. Another common answer was that many of the respondents work in private practice as solo practitioners. One respondent stated “I run a private practice, not an agency. Group treatment is not part of our contracts with ‘referrants’.” Another primary reason cited was space limitations. Of the forty-six respondents who answered, seven respondents listed staffing as an issue, while six respondents cited space as the primary issue. Six respondents stated they had not considered using concurrent group therapy as a treatment modality. Five respondents listed that concurrent group therapy was not used due to unfamiliarity with the modality, and five stated that concurrent group therapy was not offered due to parent resistance, although it was not made clear if the parents were resistant to treatment overall or group treatment in particular. Billing issues were also mentioned. Three respondents stated that it was due to not being a reimbursable modality or was unfunded. Two respondents stated that time and scheduling were issues in offering this modality.

Respondents were asked choose their identified top three barriers to providing concurrent parent group therapy from a provided list. Sixty-two (62) respondents answered the question and the answers were ranked as the following listed in Table 1:

Table 1 – Ranking of identified barriers to treatment (respondents listed their top 3)

Staffing issues – 31
Child Care issues – 28
Time/Day of the group – 26
Space Constraints – 24
Billing Issues/Reimbursement for services – 20
Lack of client interest – 14
Practitioner’s lack of familiarity with the modality – 13
Other – 8

Of those that answered other, parental transportation issues was the number one answer. Additional “other” responses included: reimbursement issues; lack of interest both on behalf of the clients and of the practitioner; not enough homogeneity among parents; and it was unethical in their practice to use such a modality. One respondent also mentioned that the parents in their population believed it was the child who needs help and not the parent.

Respondents were given the opportunity to elaborate on their answers to identified barriers to treatment with an open-ended question. Thirty-five respondents chose to share their opinions as to why concurrent group therapy with parents was not used as a modality in their work. Most respondents shared reasons why any type of group therapy with parents is a challenge and/or may not be used in treatment. Resistance to treatment appeared to be one significant and underlying issue, both on the part of the parents and the therapists. For example, one respondent stated “…doing groups has its challenges in terms of billing, space, scheduling, so therapists tend not to pursue it, even though it may be a good offering for parents.” Child care of siblings, the second highest ranking identified barrier, also appears to be a significant issue in terms of staffing, affordability, and the space to offer it at the site of service. For those who identified staffing issues as a barrier, they stated that there was just not enough staff or that their practice was too small to offer group therapy as a viable option. Finally, a larger scale issue appears to be the type of service setting and how it relates to group therapy as a form of treatment. One respondent said, “…the contract with the agency mandates individual or family treatment. Group therapy is not an option.” Another said, “our agency only serves children” indicating that treatment for parents was not even an option.

Discussion

Given the dearth of information discussing and showing the benefit of concurrent group therapy, it was anticipated that few practitioners would be incorporating this treatment modality into their practice. As previously discussed, this appears to be the case. An unexpected finding coupled with this was the percentage of therapists who admitted being unfamiliar with any group work, in addition to being unfamiliar with concurrent group therapy. While this may relate to the sample and diversity of the practitioners in the APT regarding the types of training curriculums of the various designations under which respondents practice, the unfamiliarity of group work practice with members of the Association for Play Therapy would be another facet to explore in future studies of group work with children and their parents. One final unanticipated finding that the frequency with which the role of identified patient may play in parents participating in group work. These results indicate the need to explore the meaning of the role of identified patient in family group work and how this factors into parental resistance and family services.

There were several reasons respondents identified as to why concurrent group therapy is not offered at their site. Less respondents than expected identified and discussed billing as a treatment barrier to providing concurrent group therapy as a treatment modality. Instead, other resource deficiencies presented much higher on the list of identified treatment barriers regarding space, time and the number of therapists able to provide services. Another unexpected result was the frequency with which transportation issues were identified in providing treatment services to families. Although it is mentioned only sporadically throughout the articles discussed in the literature review, the possible significance of the role of transportation difficulties in receiving services indicates a larger policy concern in service provision for families participating in treatment.

Another issue that highlights the need for further research is the high rate of responses that identify the significance of role of child care issues in working with families. Exploring successful models of agencies or other service sites that either provide some form of child care or reimbursement for child care while the parents participate in treatment would lead to a better understanding of how to address this issue.

Limitations
This exploratory study had several methodological limitations. The first is that the data were collected through an online survey which often results in low response rates and can result in non-respondent bias (Monette, Sullivan & DeJong, 2008). Due to the nature of gathering online data, it is difficult to compare the respondent group to a subsample of non-respondents to manage the potential of non-respondent bias. Also, the online format of the survey requires a working knowledge and understanding of the English language, which may have excluded some international participants. Another issue with this data collection instrument and the anonymous response format is that there is no way of clarifying or elaborating on the answers given, particularly for the open-ended questions after the survey is submitted by the respondent.

Another limitation of the study is the sample population which contained a limited amount of respondents who work with parents and children participating in group therapy. A different purposive sample of group practitioners more familiar with group work modalities may provide alternative information regarding the incidence of concurrent group therapy for parents.

Conclusion
Based on the responses gathered, a complex picture of the needs of parents of children participating in group work emerges. While prior research clearly demonstrates that groups for parents and children are an effective way of providing services, concurrent group therapy appears to be an unfamiliar and under-utilized modality for most play therapists, despite their treatment population being primarily comprised of families who would potentially benefit from this holistic modality. The lack of familiarity with concurrent group therapy demonstrated by those surveyed sheds light on a potential gap in group curricula and trainings available. Further research into why this modality is not taught and/or how it can be incorporated into current group therapy curricula would provide further information.

The respondents also provided important implications for practice. Most private practitioners who responded stated that they were constrained by staff availability and space limitations for group work in general, let alone concurrent group therapy. Exploring the lack of presence of group therapy in play therapy private practice and how this can be addressed is another important piece of discovering ways of providing the most comprehensive services possible to families in treatment.

While this exploratory study successfully identified barriers to treatment regarding concurrent group therapy for parents whose children are participating in treatment, it is clear that more in-depth research is necessary. For those who present research on successful concurrent groupwork models, understanding the researcher’s or agency’s rationale for choosing it as a model would be helpful in developing more detailed data to analyze, would build upon the limited studies currently available, and would provide a rich addition to the knowledge base of group social work for children and their families. Focus groups for group work practitioners and in-depth qualitative interviews with family practitioners, both those who offer and do not offer concurrent group therapy treatment, would provide a richer understanding of how and why the modality is (or is not) used.

Concurrent group therapy continues to remain an under-recognized and under-utilized form of groupwork. However, the limited research published shows some promising results both in terms of successful implementation and the achievement of multiple treatment goals. In addition, this study’s respondents, many of them direct practitioners who work with families, appear to be curious about why and how concurrent groupwork might be implemented to complement the current and diverse forms of groupwork already in place. This study’s results present an opportunity for growth and development of this potentially rich and valuable addition to the other, more widely practiced groupwork modalities.

References

Association for Play Therapy (2010).About APT, Mission and Scope. Retrieved from http://www.a4pt.org/ps.aboutapt.cfm.

CHP Parent-Child Interactional Training (PCIT) (n.d.). What is it? Retrieved from http://pcit.phhp.ufl.edu.

Monette, D.R., Sullivan, T.J., DeJong, C.R. (2008). Applied Social Research: a tool for the human services, 7th edition. Belmont, CA: Brooks/Cole Publishing.