Group Counseling with AdolescentsAmerican Society for Adolescent Psychiatry Pre-Conference

March 28, 2014Crystal L. Barksdale, Ph.D.

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Group Counseling with Adolescents1

•Group work can facilitate transition

•Groups can serve several socioemotional and developmental functions for adolescents

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Types of Groups for Adolescents1

•Two main types of groups to which adolescents may belong:

▫Developmental or psychoeducational group, which is primarily voluntary and self-focused.

▫Counseling or psychotherapy group, which can be voluntary or non-voluntary and focuses on either oneself or oneself with others.

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Advantages and Disadvantages of Group Counseling with Adolescents1

• Advantages

▫ Groups are a “natural” environment in which adolescents can learn

▫ Life skills may be taught to adolescents in groups through modeling, role playing, group discussions, and brief lectures

▫ A sense of belonging is also created in groups

▫ Groups provide for multiple feedback that can help adolescents

• Disadvantages

▫ The pressure that some adolescents may feel to conform to behaviors in which they do not believe

▫ The group may not have enough appeal to motivate the participants

▫ Individuals in groups may not be given enough attention

▫ Group leaders almost always have to obtain parental consent (working with minors) and they must get the consent of the adolescent as well

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Developmental and Cultural Context of Adolescence2

• Adolescent development is multifaceted and multi-contextual

• All aspects of development occur within a larger cultural context that must be understood

▫ Physical development

▫ Cognitive development

▫ Emotional development

▫ Social development

▫ Behavioral development

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Developmental Considerations3

•Differences in understanding, recognizing, and communicating distress

•Role of adult “gatekeepers”

•Agreeing to treatment

•Understanding and delivering developmentally guided interventions

•Acknowledgement of limited ability to change environment

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Cultural Considerations3

• We must consider and incorporate culture into all treatment practices because:

▫ It helps us provide more relevant, higher quality treatment

▫ It helps us better understand our clients and better conceptualize their presenting problems

▫ It helps us reduce mental health disparities

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Relational-Cultural Theory (RCT)4-6

•Emphasizes relational competencies and connectedness as foundation to survival and wellness

•Focus on experiences of social mistreatment that occur in the context of marginalization and inequity

•Complements and expands upon theory of social justice

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Core Principles of RCT7

1. People grow through and toward relationship throughout lifespan

2. Movement toward mutuality, rather than separation, characterizes mature functioning

3. Relational differentiation and elaboration characterize growth

4. Mutual empathy and mutual empowerment are core of growth-fostering relationships

5. In growth-fostering relationships, all people contribute and benefit

6. Therapy relationships are characterized by special kind of mutuality

7. Mutual empathy is vehicle for change in therapy

8. Real engagement and therapeutic authenticity are necessary for development of mutual empathy

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RCT Approach in Counseling5,6

•Focus on supporting clients in building and sustaining growth fostering relationships

•Counselor’s “quality of presence” is key

•Aim is to improve clients’ empowerment to avoid detrimental relationships

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RCT Approach in Group Counseling4,8

•Goal of RCT groups is to help participants understand, explore, and achieve need for connectedness

•Group Counseling and RCT

▫Universality

▫Development of socializing techniques (e.g., relational competence)

▫Instillation of hope

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An Illustrative Example: Adolescent Mothers9-11

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Trends Among Adolescent Mothers9

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Predictors of Adolescent Mothers’ Well-Being12-13

•Education

•Employment

•Social Relationships

•Parenting

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Evidence-Based Prevention Programs Focus On…12,14

•Knowledge, perceptions, and attitudes about sexual issues

•Personal values about sex and abstinence

•Perception of peer norms and behavior about sex

•Intentions and behaviors related to sex

•Communication about sex with others

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Outcomes of Successful Interventions for Adolescent Mothers12,14

•Improve birth outcomes (low birth weight)

•Reduce subsequent childbearing

•Better childrearing environment

•Improve maternal life course outcomes (education, economics)

•Improve child outcomes

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Functions of Promising Interventions for Adolescent Mothers12

•Increase social support

•Improve mastery of life tasks needed for motherhood

•Improve problem solving

•Facilitate active coping

•Enhance parenting skills

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Group Counseling for Adolescent Mothers12,14

•Provide the setting to achieve many essential functions

•Provide the relational opportunities necessary to improve social support

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Key Points – Group Counseling for Any Adolescent1

•Remember the cultural and developmental context of the adolescent population (or subpopulation)

•Understand and respect resistance•Involve parents in group work with

adolescents•Consider co-leadership models, which

may be very useful

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References1. Corey, M.S., Corey, G., & Corey, C. (2010). Groups: Process and practice (8th ed.). Belmont, CA: Brooks/Cole—

Cengage Learning. 2. American Psychological Association. (2002). Developing adolescents: A reference for professionals . Washington,

DC: Author.3. Mance, G.A., Mendelson, T., Byrd, B., Jones, J., & Tandon, D. (2010). Utilizing community-based participatory

research to adapt a mental health intervention for African American emerging adults. Progress in Community Health Partnerships, 4, 131-140.

4. Cannon, K.B., Hammer, T.R., Reicherzer, S., & Gilliam, B.J. (2012). Relational-cultural theory: A framework for relational competencies and movement in group work with female adolescents. Journal of Creativity in Mental Health, 7, 2-16.

5. Duffey, T., & Somody, C. (2011). The role of relational-cultural theory in mental health counseling. Journal of Mental Health Counseling, 33, 223-242.

6. Comstock, D.L., Hammer, T.R., Strentzsch, J., Cannon, K., Parsons, J., & Salazar, G. (2008). Relational-cultural theory: A framework for bridging relational, multicultural, and social justice competencies. Journal of Counseling & Development, 86, 279-287.

7. Jordan, J.V. (2000). The role of mutual empathy in relational-cultural therapy. In Session: Psychotherapy in Practice, 55, 1005-1016.

8. Comstock, D.L., Duffey, T., & St. George, H. (2002). The relational-cultural model: A framework for group process. The Journal for Specialists in Group Work, 27, 254-272.

9. Hamilton, B.E., Martin, J.A., & Ventura, S.J. (2012). Births: Preliminary data for 2011. National Vital Statistics Reports. 2012;61(5).

10. Perper, K., Peterson, K., & Manlove, J. (2010). Diploma attainment among teen mothers. Child Trends, Fact Sheet Publication #2010-01: Washington, DC: Child Trends.

11. Hoffman, S.D. (2008). Kids Having Kids: Economic Costs and Social Consequences of Teen Pregnancy. Washington, DC: The Urban Institute Press.

12. Harris, M.B., & Franklin, C.G. (2003) . Effects of a cognitive-behavioral, school-based, group intervention with Mexican American pregnant and parenting adolescents. Social Work Research, 27, 71-83.

13. Letourneau, N.L., Stewart, M.J., & Barnfather, A.K. (2004). Adolescent mothers: Support needs, resources, and support-education interventions. Journal of Adolescent Health, 35, 509-525,

14. Seitz, V., & Apfel, N.H. (1999). Effective interventions for adolescent mothers. Clinical Psychology Practice, 6, 50-66.