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Women in Leadership

STEPPING UP TO THE PLATE: Opportunities and Challenges for Women in Leadership

Susan H. McDaniel, Ph.D., ABPP and Nadine Kaslow, Ph.D., ABPP

 “As we look ahead into the next century, leaders will be those who empower others.” Bill Gates

The two of us have traveled similar paths, having met in Houston when Susan was a postdoc in family therapy and Nadine was a practicum student in child psychology.  Since then, we’ve both:  taken on leadership roles in academic health centers (Susan as a Division Chief in Psychiatry and an Associate Chair of Family Medicine, Nadine as Vice Chair of Psychiatry and Behavioral Sciences and Chief Psychologist at Grady Hospital).  We both did national leadership training:  Nadine following Susan in the HHS Primary Care Policy Fellowship, and Susan following Nadine in the Executive Leadership program for women in Academic Medicine (ELAM).  We have both been active for years in APA governance:  Nadine is now the President of APA, Susan is on the Board of Directors and running for President.  Susan has built a career developing primary care psychology, Nadine has focused on suicide and family violence research, psychology education and training, and family psychology.  Both are experienced journal editors. Both have much experience with the internal and external barriers to women in leadership roles of all kinds.

Answering the phone:

“This is Dr. McDaniel.”

“Can I leave a message for Dr. McDaniel?”

“No, this is SHE.  How can I help you?”

How many of us have had this experience? When we started working in our respective academic health centers in the 80s, there were few women, and we were almost always assumed to be secretaries.  How do we move from there to here—an era when many women want to “lean in,” step up to the plate, and provide leadership to their organizations?

Women often have good interpersonal skills and high emotional intelligence.  That’s how we were raised.  These are VERY helpful in leadership roles.  However, there are plenty of other skills we must learn to be good leaders.  Many women can come to the work world expecting that, like in their childhood, they will be rewarded for being good girls and not causing trouble.  Unfortunately, at least in academic health centers, this behavior often results in taking the woman’s skills for granted rather than developing her abilities and maximizing her contributions.

We will address some of these challenges in this article, starting with assessing the alignment of the system with the woman’s goals, then reviewing issues of power and dependency in leadership, and concluding with conflict management skills.  This treatment is only an appetizer in a very rich meal; we hope you will consider some of the references for more in-depth treatment of these subjects.

Alignment  

Opportunities for leadership can arise in planful or unexpected ways.  One key consideration is the alignment of the mission, values, and culture of the institution with your own.  We find it very useful, as a first task, to write a personal mission statement.  Most of us have participated in writing mission statements for our department or organization.  Spend 20-30 minutes writing one for yourself.  Whenever we’re making difficult decisions about priorities, we return to our personal mission statements and ask what is most important in achieving our personal goals.  Not who will we please, or will we be good for the job, but is it in line with what we care about most?  Is it how we want to spend our energy, our precious time?  Personal mission statements are also useful to read just before going into a difficult meeting.  They ground us in our commitments, and help to quell the reactivity so common to our species.  They also evolve over time, and are worthy of rewriting annually.

After writing a personal mission statement, the next step is to assess the psychological health of the organization for which you may become a leader (McDaniel, Bogdewic, Holloway, & Hepworth, 2008).  Does it have a clear mission and identified goals?  How do these match with your own?

More generally, do its leaders communicate clear expectations for its workers?  Does it have a mentoring system and foster career success?  Are its resources aligned with its stated priorities?  Does it conduct formative reviews?  Does it acknowledge employee value and contributions?  Do leaders have strategies to help individuals having difficulty?  Does it afford latitude for employees with changing life events?  Does it have fair and systematic mechanisms for dealing with disruptive behavior?

Power and Dependency

Leadership, by definition, means confronting issues of power and dependency.  The American Heritage Dictionary lists four definitions of power, the first being  “the ability or capacity to act or perform effectively.” Not until the 4th definition do we get to “the ability or official capacity to exercise control or authority.”  It is this definition that implies domination, and can be problematic for clinicians in relation to patients and other team members.  The antidote to power as domination is shared power, or caring.  Caring consists of being present, listening, demonstrating a willingness to help, and an ability to understand–people talking with each other rather than to each other, interactions based on a foundation of respect and empowerment (McDaniel & Hepworth, 2003).  Sometimes that means finding out the behaviors that the other person experiences as respectful or empowering, or reporting on behaviors we appreciate.

The sociology of superordinates tells us that there are predictable feelings and behaviors experienced by those higher in the hierarchy, as well as by those perceived as lower (Goode, 1980).  In particular, those higher tend to experience their position in terms of feeling burdened and responsible rather than powerful, blessed or lucky.  Those lower can feel that their talents or accomplishments go unrecognized. They can be vulnerable to feeling invisible, unappreciated, disrespected, and eventually, resentful.  Understanding these dynamics can help to provide appropriate support to leaders or followers, and move the culture towards one of collaborative respect.

Conflict Management

Effectively managed conflict promotes cooperation and builds healthier and more positive relationships (Coleman, Deutsch, & Marcus, 2014). Conflict management refers to using strategies that moves the conflict toward resolution without escalation or destruction of relationships.  A strong overall approach to conflict management includes an appreciation that conflicts are complex and thus require differential tactics of management based upon the people involved, the situation, and the style of the parties. It entails thoughtful consideration of the myriad sources of conflict (e.g., misunderstandings and miscommunications, fear, failure to establish boundaries, negligence, need to be right, mishandling differences in the past, hidden agendas, and the intention to harm or retaliate). Conflict management efforts must involve a detailed analysis (i.e., scientific approach) of the facts of the situation and attention to the feelings and perceptions of the parties.

The first step to managing a conflict is identifying the critical issues related to the situation, as well as associated organizational, personal, and cultural factors. Encourage each party to ask him/herself a series of questions, such as “how does my behavior contribute to the dynamics? What elements of the situation am I able and willing to change? What matters most to me/to the other party in the situation?”. If you are a party to the conflict ask yourself these questions.

Finally, take a clear and direct, but respectful and caring approach to addressing a conflict. It is critical that you define the situation in terms of a problem that calls for a solution (Fisher, Ury, & Patton, 2011).  All parties must acknowledge their feelings and acknowledge the feelings of the other(s).  Then ask for specific behavior change and hear the behavior change requests of the other party(ies).  This involves being  clear about the outcome you want, accepting what you can get, giving up on having to be right, and demonstrating your willingness to hear the other party’s perspective and to work collaboratively. Following this, share what you are willing to do to improve the situation and strive to do your best to make these changes.

In conclusion, women bring many talents to leadership.  Like other important decisions in life, it takes courage to “step up to the plate” but it is also a rewarding opportunity to serve.  We all need ongoing coaching and feedback regarding challenges related to defining our personal mission; ensuring its alignment with the institution, agency or organization; and managing issues of power, dependency, and conflict.  We need your talents in this time of transition!

References

Coleman,P.T.,  Deutsch, M., & Marcus, E.C. (2014). The handbook of conflict resolution: Theory and practice (3rd edition). San Francisco: Jossey-Bass

Fisher, R., Ury, W.L., & Patton, B. (2011). Getting to yes: Negotiating agreement without giving in. New York: Penguin Books.

Goode W.T. (1980). Why men resist.  Dissent27(2), 287-310.

McDaniel, S.H., Bogdewic, S., Holloway, R., & Hepworth, J. (2008). Architecture of Alignment: Leadership and the Psychological Health of Faculty. In: T.R. Cole, T.J. Goodrich, and E.R. Gritz (Eds.) Academic Medicine in Sickness and in Health: Scientists, Physicians, and the Pressures of Success.  Humana Press, pp 55-72.

McDaniel, S.H. & Hepworth, J. ( 2003). Family psychology in primary care: Managing issues of power and dependency through collaboration.  In: R. Frank, S.H. McDaniel. J. Bray, M. Heldring (Eds.), Primary Care Psychology.  Washington, DC: American Psychological Association Publications

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Experiential and Didactic Group Therapy Program: The Sad Lady’s Group

John Breeskin, Ph.D.
John Breeskin, Ph.D.

Somatization Disorder is a condition that is both hard to diagnose and hard to treat. For many years, I was Chief Psychologist of a thousand-bed hospital outpatient mental health clinic. While I mean absolutely no disrespect by this comment, I would classify many of the clients referred to as “sad ladies.” These were women with multiple medical folders with each thicker than the next. Their bodies were cross-hatched with medical and surgical interventions, all of which were ultimately futile. In a fit of irritation and despair, the most recent in a long line of defeated physicians would disclaim, “Get thee hence to the Outpatient Mental Health Clinic!” As a result, these dear ladies would show up in my office, rejected yet another time. Often, they were “empty nesters,” low in self-esteem and self-image, and cemented into maintenance type marriages. It became apparent to me that their numerous outpatient visits symbolically represented a deep need to be touched intimately by a caring human being.

In response to this obvious human need, I quickly designed an intensive six-week group therapy program composed of both experiential and didactic components. We covered such topics as communication skills, assertiveness training, and trust-building.

I remember clearly our very first meeting. The ladies introduced themselves one at a time, and each would outdo the next in terms of the doleful, painful details of her journey. I was astonished! I pointed out that they were competing for “Victim of the Day” awards, and, for now at least, I was less interested in what was wrong than what was right with them. I told them that they did not need to compete for my attention. I was aware that they were problematic individuals in pain and all were well worthy of my concern. After we got that initial dynamic out of the way, we launched into team-building, trust, self-disclosure, and interpersonal bonding. The ladies grasped these principles quickly and firmly, and it changed their lives. One group, because the chemistry was so great, made me an honorary woman at the end of the six weeks, an honor that I will always carry with me.

Another group that I remember with great fondness, at the end of our six weeks together, decided to carry on the group by themselves. They proceeded to hire an attorney, a financial planner, a personal trainer, and, of all things, a psychologist to provide them with ongoing therapy. The psychologist called me in great bewilderment indicating that the ladies had called him and were interviewing him to see if he met their criteria. He called me to ask if this was on the level. I told him it was and that he would be normously enriched if he passed the evaluation. When I left the base two years later, the group had started an investment club and had accomplished several humanitarian tasks. Their manifold visits to the hospital clinics had dramatically diminished.

This model can be replicated easily in many different settings. Once these powerful healing forces are energized and released, much positive change can occur. It is important to take this model very seriously. On the surface it looks very simple, but it is not at all. The twin concepts of intentional kinship and reciprocity are central components of my theoretical model, together with the ever-present mystery of agape.

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Increasing Multicultural Competency in Group Psychology: Balancing Etic and Emic Approaches

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

As Chair of the Diversity Committee for Division 49, I wanted to focus my columns on building multicultural competency in group therapy practices with an emphasis on providing something useful to the practitioner. To set the stage, I’d like to review a bit of theory related to a particular debate in the late 1990s regarding the importance of emic (culturally specific) versus etic (culturally universal) factors related to multicultural competency. This debate was lively because around the same time mental health professionals were discovering that the medical model (treatment specific approach) did not do an adequate job of identifying what accounted for client change in psychotherapy. This was around the same time that Common Factors theory became quite popular. Common Factors theory research found that the factors that accounted for the greatest amount of client change in psychotherapy were actually those that were common or universal to the therapeutic relationship: client, therapist, and relational variables.

This finding probably did not surprise group therapists, particularly those who facilitated process oriented groups. It is the group interpersonal process, after all, that provides the curative factors resulting in the positive outcome of the individual. However, like physicists concluded when debating the wave versus the particle theory of light, and like biologists concluded when debating nature versus nurture, mental health researchers found that both emic and etic factors are important in client change or healing. I point this out because I think that we as group therapists may get a bit too comfortable with the etic side of the debate because, unless you are facilitating a culturally specific group such as “Estamos Unidas” (an outreach group for Chicana/Latina students offered by UC Irvine this Spring), you are likely to have a mix of folks with differing cultural backgrounds and beliefs, not to mention genders (the “a” on the end of Chicana/Latina indicates the group is for females), ethnicities, races, abilities, sexual orientations/gender identities, religious identities, ages, and socioeconomic/class statuses to name a few emic groupings. Although both types of groups would likely experience those 11 Therapeutic Factors identified by Irvin Yalom (Universality, Altruism, Instillation of Hope, Imparting Information, Developing Socializing Techniques, Interpersonal Learning, Cohesiveness, Catharsis, Existential Factors, Imitative Behavior, Self-Understanding, and the Corrective Recapitulation of the Primary Family Experience), it might be less clear in the mixed group how your emic skill-set might be useful.

In order to provide more clarity and, I admit, more encouragement to the practitioner to develop more multicultural awareness, knowledge, and skill about culturally specific issues, it might help to pose the following question: if the therapeutic effectiveness of group process comes from existential factors, which are those that are universal to all human experience, why apprise ourselves of human specific knowledge because how would this be useful? The answer actually lies within the question, which is: one of the existential challenges we all face is that we are “alone”, that is, that we are all individuals who are different. So while it is helpful for someone to learn “I’m not alone—all of us suffer at one point or another (‘I’m okay’)”, it is also helpful for someone to learn “I’m different so no wonder people respond to me in these ways/contexts—it’s not my imagination/I’m not crazy (‘I’m okay’)”. Therefore, I think group is a treatment where it’s important to emphasize both attachment/universality as well as separation/individuality because they are both an existential reality.

My goal in this column, as I noted earlier, is to provide something useful to the practitioner. Therefore, I encourage you to try a new intervention in one of your groups, the intent of which is to plant the seed and give permission for more multicultural discussions during the group process. That is, at the beginning of your group announce that you may be posing more cultural questions to the group so that members think more about how individual differences may play a role in their current experiences. Then ask both questions during the process: How are these struggles universal to all of you? How are these struggles specific to your particular cultural experience? These questions work in both heterogeneous and homogenous groups. If you don’t already ask these types of questions, I hope the answers you get increase your multicultural awareness and intrigue you enough to seek out more multicultural knowledge. It doesn’t have to be fancy, a simple intervention such as the one mentioned can really add to your multicultural skill set. By the way, if you haven’t already, check out the APA site regarding multicultural guidelines at: http://www.apa.org/pi/oema/resources/policy/multicultural-guidelines.aspx?item=7. As always, I welcome questions, concerns and ideas for future columns. Please email me at: jsteffen2013@gmail.com

References

Fischer, A.R., Jome, L.M., & Atkinson, D.R. (1998). Reconceptualizing Multicultural Counseling: Universal Healing Conditions in a Culturally Specific Context. The Counseling Psychologist, 26, 525-588.

University of California, Irvine Counseling Center (n.d.). Groups at UC Irvine Counseling Center [www page]. URL http:// www.counseling.uci.edu/Students/groups.aspx

Yalom, I., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York: Basic Books.

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Research Column: Why Measurement Matters: A Systematic Inquiry of Group Therapy Outcome Studies

Sean Woodland, Marie Ricks, Griffith Jones, & Kyle Lindsay
Brigham Young University

Conclusions regarding treatment efficacy are best justified when ascertained with a high level of measurement precision, rigorous methods, and inferences accurately reflecting the research question (Cook & Campbell, 1979; Bednar, Burlingame, & Masters, 1988). Measurement precision is a foundational piece that, when ignored, can negatively affect the ability to assert therapy effectiveness. Several proposed frameworks for better understanding outcome measures illustrate that the level of rigor applied is directly related to the strength of the study’s inferences (Bednar, Burlingame, & Masters, 1988; Burlingame et al. 2005; Erbes et al. 2004; Lambert, Ogles, & Masters, 1992). Unfortunately, the psychometric properties of outcome measures often go unreported, which leads to unneeded diversity in measures used, and either chaos or apathy in measurement selection (Lambert, Ogles, & Masters, 1992).  The aim of our study was to ascertain whether these issues hold true in studies of group psychotherapy.

Group therapy outcome studies (n=89) were obtained through extensive literature searches. To be included samples needed to have at least 12 participants, with a minimum two-thirds primarily diagnosable with either schizophrenia or borderline personality disorder. Outcome measures (n=197) were extracted from these studies and reviewed for listing of normative and local psychometrics (i.e., reporting of reliability and/or validity). Outcome domains included depression, anxiety, general mental health, quality of life, and disorder-specific symptoms.  Measures were excluded from the study if articles cited as seminal were unobtainable.  All literature searches were completed twice to insure accuracy.

Of the measures analyzed 31 (15.8%) were “investigator-generated” measures created specifically for the outcome study without prior use or citation.  Each study used an average of 4.68 measures (SD=2.81).  The average number of validities reported within each outcome study was 1.09 (SD=2.56), making up 19% of sample of measures.  The average reliability reported was 1.63 (SD=2.84), representing 45.1% of the average number of measures used per study. Evidence of previous internal consistency was reported 64 times. The average validities found per measure were 1.57 (SD=1.60). For measures used at least three times, the average number of validities increased to 3.20 (SD=1.39).  The most common validity was criterion-related, followed by construct-validity, discriminant, convergent, factorial, and content-validity.

While fairly simple, the results are notable. The studies in our sample reported instrument reliability less than 30% of the time and validity was reported less than 25% of the time; this indicates chronic underreporting of both normative and local psychometrics. Also notable was the fact that 16% of the measures were “investigator-generated.” Combined with the result that less than half of the 197 measures were used more than once, this implies an overabundance of instruments measuring similar constructs, and raises questions about creating new measures rather than relying on those previously validated. It is recommended that previously validated instruments be favored in future studies to better insure measurement precision. Further, we suggest that group researchers increase inclusion of psychometric data in their methods sections to decrease doubt about the rigor associated with measures they implement in outcome studies.

References

Bednar, R. L., Burlingame, G. M., & Masters, K. S. (1988). Systems of family treatment: Substance or semantics? Annual Review of Psychology39(1), 401-434.

Burlingame, G. M., Dunn, T. W., Chen, S., Lehman, A., Axman, R., Earnshaw, D., & Rees, F. M. (2005). Special section on the GAF: Selection of outcome assessment instruments for in patients with severe and persistent mental illness. Psychiatric Services56(4), 444-451.

Cook, T. D., & Campbell, D. T. (1979). Quasi-experimentation: Design and analysis for field setting. MA: Houghton Mifflin.

Erbes, C., Polusny, M. A., Billig, J., Mylan, M., McGuire, K., Isenhart, C., & Olson, D. (2004). Developing and Applying a Systematic Process for Evaluation of Clinical Outcome Assessment Instruments. Psychological Services1(1), 31.

Lambert, M. J., Ogles, B. M., & Masters, K. S. (1992). Choosing outcome assessment devices: An organizational and conceptual scheme. Journal of Counseling & Development70(4), 527-532.

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Group Psychotherapy Column: What Do You Say After You Say “Hello”?

John Breeskin, PhD
John Breeskin, PhD

John Breeskin, PhD

This set of guidelines closely follows a chapter from my book titled, “Sparky Says Hello” and should be read in connection with this article.

My illustration will consist of the questions that I feel need to be asked in this first interview. I understand that the format for an interview is very much idiosyncratic so my comments are no more than suggestions.

These suggestions are generic in nature and can be used for crisis intervention, pre-therapy interviews, for forensic interviews, for group placement evaluations and the like.

Hello, my name is Sarah Smith and I comfortable being called Sarah if that is alright with you. Our job is to interview each other so that you and I can get to know one another and, as a result, we can plan together as to our next step to help you deal with specific nature of the reasons that brings you here today and, additionally, and so we can get a sense of the historical events that contribute to the present situation. In sense, this interview can act as a preview to introduce the main feature which can be called “a part of your life’s journey.”

The first question you are probably asking yourself is, “Can Sarah be trusted?” That particular question is quite appropriate and I hope you can give me the chance to prove that I am trust worthy. I hope that you understand that I am not asking you to trust me just because I am sitting on this side of the desk. I expect to be given your trust in an n old fashioned way: I expect to earn it and I will try to be very clear as attempt to accomplish this goal of earning your trust.

What I will need form you, in this context, is periodic information as to how well or how poorly I am establishing this goal from your point of view.

As the first step, and the most important of all, I hope you will see me as non-judgmental. I do not have any idea as to what is best for you. Only you know that but I promise that I will listen and keep track of where you want to go without any sense of good or bad or any sense of guilt, shame or blame.

The reason that I can be non-judgmental is because you and I are sisters (or brother or a brother and a sister): not biological sisters but I hope you will quickly see that the two of us have shared the same journey and, while the details are different, the overall theme may probably be the same.

From a specific point, of view, with respect to the structure of your participation in this therapy program, I will do an intake evaluation, and, if we decide together it is appropriate, I will present you with a series of options for you to consider.

If you and I succeed in establishing a comfortable style of speaking to one another, the danger is that you might feel abandoned if I pass you on to another person. I would probably feel the same way myself. My wish is that you will take whatever we accomplish together and bring it to the next step of your journey. As a temporary bridge, you can keep me posted as to your decision.

The interview information that we will be looking at are the details of your current situation and your past history. At this point you may ask yourself the reasonable question, “what does my past history have to do with my current situation?” I hope that as a result of our interaction, you will see that the two points in time are connected and that past behavior can guide us to making sense of our current behavior. It will also give us a road map in terms of how to free ourselves form the danger of repeating past problematic behavior and allow you to experiences, perhaps for the first time, a powerful sense of freedom.

In terms of obvious but very important information, the fact that you came in today and that you came to talk to me is an optimistic sign that you want your life to be better. That is a significantly positive step and I want you to know that you being in my office right now strongly suggest that your reward for taking that first step is that your journey will be better and earn my deep respect.

I am looking forward for the two of us getting to know each other better. Please feel free to ask me questions which, I hope, will include questions about myself as another traveler on the road since there can be safety in interacting with other human beings. Of course there is also potential danger as well but you and I must work together through that aspect of human connection.

I hope that you do not see me as talking about myself as trying to compete with you in any way. I see our discussion as an enhancement model and not a scarcity model. I am looking forward to continuing our discussion next week; good bye for now.

I think it is overly optimistic to pack all this information into one session. These ideas probably need to be spread out over at least two or three sessions so these comments can be used as general guidelines. I am quite aware that my style is uniquely my own. Please feel free to modify in terms of your own degree of comfort.

 

 

 

 

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Diversity Column: Committee Activities at the 2013 Annual APA Convention

Jeanne Bulgin Steffen, PhD
Jeanne Bulgin Steffen, PhD

Jeanne Bulgin Steffen, PhD

The Diversity Committee, founded as a subcommittee under the Society of Group Psychology and Group Psychotherapy in 2007, was created with the overarching goal of promoting the inclusion and visibility of underrepresented populations in the Division. This year, Dr. Eric Chen completed his third year term as Chair of the Diversity Committee in December 2013, and yours truly was asked to serve as new Chair of the Diversity Committee for January 2014-December 2016. I want to take this opportunity to thank Dr. Chen for his commitment and work throughout the past three years and express how excited and honored I am to continue to work with him and the rest of the committee to advance our goals in 2014 and in the coming years. In this column, I would like to focus on summarizing our major activities for 2013 related to our overarching goal mentioned previously.

One of the major activities related to our overarching goal is to formally honor those individuals who make significant contributions to group psychology practice, research, service, and/or mentoring, with a focus on promoting understanding and respect for diversity. Each year we encourage nominations from the Division for the Group Psychology and Group Psychotherapy Diversity Award, which is presented at the Annual APA Convention. Dr. Clayton P. Alderfer was recognized as the 2013 recipient of this award at the business meeting of Division 49 in Honolulu, Hawaii in August. Dr. Alderfer has had a prolific career in organizational psychology, producing more than 100 published articles and four books over the years, of which more than half pertain to intergroup relations. His empirical work addresses intergroup relations among intersecting identities (e.g., race, gender, ethnicity, generation) using a number of methodology. Dr. Alderfer has provided interventions to change race relations within various organizations through the use of race and gender based consulting teams, and has also provided service and mentoring through his academic positions at Yale University and Rutgers University. The Committee concluded that Dr. Alderfer is highly deserving of the Diversity Award from Division 49 as he has made outstanding contributions within the overall field of group psychology and especially in promoting understanding and respect for diversity. Congratulations, Dr. Alderfer, and thank you for your contributions to the field!

At the 2013 APA convention, the Diversity Committee engaged in another important activity related to our overarching goal, that of providing education and encouraging diversity related conversations among our colleagues and ourselves in order to increase awareness, knowledge and skills related to multicultural competence. In this case, the educational activity was a symposium, which was contextually related to Hawaii, where the 2013 APA convention was held, and closely aligned with Division 49’s conference theme of “Group Psychology and Group Psychotherapy Around the World: Research and Practice.” It consisted of four paper presentations aimed to highlight the complex process of “border crossing,” giving special attention to the interplay of multicultural competence and social justice within the context of group counseling. Topics included: (a) “Themes on Multiculturalism and Social Justice in Group Counseling Research” by Jill D. Paquin and Joseph R. Miles; (b) “Multicultural Groups and Social Justice Issues with Transgender Native Hawaiians” by Rick Trammel and Patrick K. Kamakawiwo‘ole; (c) “Ethical and Legal Considerations in Group Counseling for Undocumented Immigrants” by Allyson Regis, Kourtney Bennett and Eric C. Chen; and (d) “Group Counseling with Undocumented College Students: Supports and Barriers” by Gary Dillon, Jill Huang, and Eric C. Chen. Although this activity was held on an early Saturday morning, more than 30 individuals participated in the symposium.

As the chair of the Diversity Committee, I also have a special opportunity to provide education and encourage conversations to increase multicultural competency and spark interest in diversity related topics through this column. I hope I can engage my fellow group psychologists and psychotherapists on path to increase their competence and confidence by providing intriguing topics and talking points over the next few years. After all, as group psychologists we are especially poised for multicultural competence since we, in essence, work within the multicultural social microcosms of our own psychotherapy groups and thus have the opportunity to be exposed to and to participate in various interplays of intersecting identities—hopefully with the outcome of improving intrapersonal and interpersonal health and the overall health of our family, community, nation and international systems. I welcome comments, concerns and requests for various topics. In addition, if you are interested in participating in the Diversity Committee, we are currently welcoming new members. Please contact me at jsteffen2013@gmail.com.

 

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Prevention Corner

Elaine Clanton Harpine, PhD
Elaine Clanton Harpine, PhD

Elaine Clanton Harpine, PhD

The subject of training in group prevention is a frequently discussed topic at conferences and conventions these days. Through the Prevention Corner, we have also received numerous questions about how to receive training and exactly what type of training is needed in order to be effective in group prevention. We turn to two experts in prevention groups to give us some guidance. Before addressing our editorial question directly though, let us turn to a definition of prevention groups presented in the 2010 Special Issue on Group Prevention in Group Dynamics: Theory, Research, and Practice to remind readers of the depth and nature of prevention groups.

Prevention groups utilize group process to the fullest extent: interaction, cohesion, group process and change. The purpose of prevention groups is to enhance members’ strengths and competencies, while providing members with knowledge and skills to avoid harmful situations or mental health problems. Prevention groups occur as a stand-alone intervention or as a key part of a comprehensive prevention program. Prevention encompasses both wellness and risk reduction. Preventive groups may focus on the reduction in the occurrence of new cases of a problem, the duration and severity of incipient problems, or they may promote strengths and optimal human functioning. Prevention groups encompass many formats. They may function within a small group format or work with a classroom of thirty or forty. Prevention may also be community-wide with multiple group settings. Prevention groups use various group approaches. Psychoeducational groups are popular and, while some prevention psychologist work within a traditional counseling group, others use a group-centered intervention approach. Two key ingredients for all prevention groups are that they be directed toward averting problems and promoting positive mental health and well-being and that they highlight and harness group processes (Conyne & Clanton Harpine, 2010, p. 194).

References

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

EDITORIAL QUESTION POSED:

Dear Prevention Corner:

What type of training is needed for people working in a prevention group? What should you include in a training program?

Signed,
Confused

RESPONSE #1

Suggestions for Training in Prevention Groups

Robert K. Conyne, PhD
Robert K. Conyne, PhD

Robert K. Conyne, PhD
William M. Allen Boeing Endowed Chair & Distinguished Professor,  Seattle University (2013-14)
Professor Emeritus, University of Cincinnati

Training in prevention group leadership needs to help learners to become informed about and develop competencies in:  (a) prevention knowledge, skills, attitudes, and values as they relate to mental health; (b) group leadership best practices grounded in evidence bases, ranging across the domains of planning, performing, and processing and emphasizing psychoeducation and active interaction; and (c) how to integrate and apply these two elements (Conyne & Horne, 2013; Conyne, 2014). Each of these elements is briefly expanded below.

Prevention principles and processes:  Particular attention should be placed on a systemic, ecological vantage point;  on collaboration, group processes and consultation;  on personal attributes sensitive to prevention (e.g., persistence, social justice, and a long-range view);  and on cultivating adoption of a primary prevention perspective emphasizing incidence reduction and a proactive, before-the-fact orientation  (Conyne, Horne, & Raczynski, 2013). Prevention applications should be informed by the American Psychological Association Guidelines for Prevention in Psychology (APA, 2013).

Group leadership best practices:  Special focus needs to be given to best practice guidelines (e.g., Association for Specialists in Group Work, 2007). These include planning and designing groups collaboratively with representatives of the designated population, respecting their unique ecological context (Conyne & Diederich, 2014, Rapin & Crowell, 2014);  performing/delivering  groups and group activities that accentuate member connection and interaction while providing clear opportunities for intentional skill development and feedback (Clanton Harpine, 2010; Marmarosh & Dunton, 2014); and assisting members to process their learning to engender meaning and to increase the likelihood of current and future application (Ward & Ward, 2014).

Integration Trainees need opportunities to conduct prevention groups under supervision.  Practica and internships afford the best places for this watchful practice to occur.  They need coursework in program development and evaluation to assist their abilities to design prevention group programs that include the components I’ve mentioned.  They need group training in basic and advanced leadership knowledge and skills.  Learners need seminars that allow them to evolve the all-important primary prevention perspective, which allows them to apply traditional and basic competencies to promote and prevent, as well as to remediate.

References

APA (2013).  Guidelines for prevention in psychology. http://www.apa.org/about/policy/prevention.pdf

ASGW (2007). Best practice guidelines 2007 editionhttp://asgw.org/pdf/Best_Practices.pdf).

Clanton Harpine, E. (2013).  Prevention groups. Thousand Oaks, CA:  Sage.

Conyne, R.  (2014).  (Ed.).  Group work practice kit.  Thousand Oaks, CA:  Sage.

Conyne, R., & Horne, A. (2013) (Eds.).  Prevention practice kit.  Thousand Oaks, CA:  Sage.

Conyne, R., Horne, A., & Raczynski, K. (2013).  Prevention in psychology:  An introduction to the Prevention Practice Kit.  Thousand Oaks, CA:  Sage.

Marmarosh, C., & Dunton, E.  (2014). Groups:  Fostering a culture of change.  Thousand Oaks, CA:  Sage.

Rapin, L., & Crowell, J. (2014).  How to form a group.  Thousand Oaks, CA:  Sage.

Ward, D., & Ward, C.  (2014).  How to help leaders and members learn from their group experience.  Thousand Oaks, CA:  Sage.

RESPONSE #2

Arthur M. Horne, PhD
Arthur M. Horne, PhD

Arthur M. Horne, PhD
Dean Emeritus and Distinguished Research Professor
University of Georgia

 “What type of training is needed for people working in a prevention group?”

For persons learning to be effective leaders with prevention groups the most important training issue is awareness. Awareness has two parts:

  1. 1. Awareness of why prevention is critical. That, as Albee (1982) has said, “We must recognize the fact that no mass disorder affecting large numbers of human beings has ever been controlled or eliminated by attempts at treating each affected individual or by training enough professionals as interventionists” (p. 1045). Developing an understanding of the importance of a preventative approach is critical to being an effective prevention group facilitator.
  2. Steps necessary to migrate from a life saver to a swim coach; from a mechanic to a gardener. Letting go of addressing the crises of the moment and moving back to developing the skills to recognize, identify, evaluate, and engage problems that are systemic, and preventable, rather than first order, and thus focus energy on stopping the problem from happening rather than treating it after it has occurred.

“What should you include in a training program?”

Much of the effort to change orientation from problem focused crises to solution focused prevention efforts takes a reorientation to problems. This will include a values clarification process which challenges participants to understand: what values are driving you? If immediate engagement and problem solving is a driving force, then treatment through solving problems in the here and now should be respected, honored, and allowed. If, on the other hand, participants are interested in developing long-term solutions to problems, to preventing the conflicts from ever occurring, it will be necessary to honor the values of prevention work and let go of the guilt of not being available for the crises while time is spent on long-term prevention engagement. In family therapy terms, the leader will need to understand the importance of letting go of first order behavior change and, instead, focus on second order change.

It is critical that we address hunger in America, and taking steps to provide support for the hungry of our streets is a worthwhile and noble act. But feeding the hungry is a first order change. On the other hand, hunger in America exists because we have a gross misdistribution of resources; we have sufficient food for all in our nation, but with the jobless rate, the homeless rate, and the poor economic circumstances, hunger becomes a byproduct. A second order change would be to address the issues that allow for homelessness, joblessness, and hunger to exist in the first place. But that is a much bigger challenge and one that takes enormous effort. The first step is for the facilitator of prevention groups to begin thinking differently.

References

Albee, G. W. (1982). Preventing psychopathology and promoting human potential. American Psychologist, 37, 1043-1050.

What do you think is needed to effectively train group workers to use group prevention techniques effectively? 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