Spring 2025 SOWK 487w Week 10 - Treatment Groups - Examples of CBGW, DBT, and Psychoeducational

Spring 2025 SOWK 487w Week 10 - Treatment Groups - Examples of CBGW, DBT, and Psychoeducational

title: Spring 2025 SOWK 487w Week 10 - Treatment Groups - Examples of CBGW, DBT, and Psychoeducational

date: 2025-03-26 11:32:38

location: Heritage University

tags:

• Heritage University
• BASW Program
• SOWK 487w

presentation_video: > “”

description: >

In week 10, we start looking at treatment groups. To look at this, we will use the example of three types of groups. The week’s readings are around these topics. I also want to share some example curricula that you can see and review to get a picture of what this looks like. All of the readings for this week are good information, and I think they will help give you some perspective. Dialectical behavioral therapy is a frequently used group format, and Rizvi et al. (2013) provide a helpful overview of what it looks like. Next, Rose (2004) gives the example of cognitive-behavioral group work (CBGW). Even though most curricula don’t explicitly describe themselves as being founded in CBGW, I could argue that they are. Finally, Roffman (2004) reviews psychoeducational groups.

The agenda for week 10 is as follows:

• Group Intervention Pitch
• Psychoeducational group skills
• Curriculum used with psychoeducational or CBGW
• Phases of the group process for CBGW
• Information about DBT
• Planning and implementation group

Agenda: The Plan for Week 10

• Group Intervention Pitch
• Psychoeducational group skills
• Curriculum used with psychoeducational or CBGW
• Phases of the group process for CBGW
• Information about DBT
• Planning and implementation group

Mindfulness minute

[Whole Class Activity] Have the class go through and walk them through breathing activity.

Midcourse Feedback

Thank you. I had 10 people who completed their midterm feedback.

Going Well:

• Organized and clear
• Class topics
• Activities and how interactive is

Challenges:

• Readings (hard to understand)
• Long lectures and challenging concepts

“long lectures, lots of information too quickly, hard to grasp concepts.”

While Rate My Professor isn’t a way that we officially receive feedback, I had some student share with me there were negative reviews from this semester

They talked about feeling like I show favoritism, being long and boring, and not implementing accommodations. What I will say is these (other than maybe being boring and long) are not things that I have personal insight into doing. If you feel like I am being unfair or inequitable or not following reasonable accommodations awarded based on disability, these are serious accusations. I am open to talking through why you feel like or if you feel unable to approach me I’d encourage you to follow up with our Department co-chair Ruby Aguilar (Aguilar_R@heritage.edu)

Context:

Both posted same time:

Lectures are long and boring, with no in between breaks, as he literally takes the entire class. Shows extreme favoritism, and it’s painfully obvious when he dislikes you for whatever reason. Not very accommodating towards disabled students, snarky when concerns are brought forth about grades, and you’re not one of the ‘social kids in class.’

and

He could have been better. He shows clear favoritism towards certain students, and it will be painfully obvious if he dislikes you. He takes the entire class period going through his premade slides, which can get rather boring and uninteresting. Not very accommodating towards disabled students.

Assignment 04a: Group Intervention Pitch

Each group will make a short informal pitch for the group they plan to facilitate. As a group, students will share with their classmates their plan to implement their group (i.e., when and where) and the content they will do for their groups. These presentations should not be longer than five minutes.

[Whole Group Activity] Have each group complete a their pitch.

Teaching and Delivering Information

Psychoeducational groups necessarily place social workers in the role of a teacher. This role, and by extension the delivery of information, should not be imagined as one-way relationship.

• Selecting optimum methods for delivering information based on participant factors (e.g., age, previous learning, motivation)
• Demonstrating the meaningfulness of material among group members
• Creating opportunities for group members to integrate new information with existing knowledge and skills;
• Encouraging retention of new information by doing

Abilities in Facilitators

Engaging in group work practice requires familiarity with leadership styles conducive to facilitating psychoeducational groups.

• Education on preparing and delivering: Education and/or training on organizing and providing psychoeducational groups
• Knowledge of Group Process: Knowledge of group processes, including typical stages of group development
• Supervision: Purposeful and targeted supervision related to group practices
• Interpersonal practice skills
• Capacity to self-reflect and challenge personal axes of privilege, power, and oppression
• Normalizing without essentializing
• Connection of group content to the anticipated stage of group development

Structured versus Response Based

We can think of two basic types of psychoeducational groups. Those that are manualized and those that are responsive.

The current trend is towards integration of both types (i.e., manualized curricula with flexibility to and awareness of group processes)

Example Group Curricula

It might be helpful to see some examples of group curriculum. While I would say that all of these curricula fall within the Cognitive Behavioral Framework, they aren’t necessarily 100% Cognitive-behavioral group work.

[Whole Class Activity] Discuss each curriculum and provide an overview.

[Whole Class Activity] Have the class break up into three groups. Each group will have an opportunity to read through the curriculum from the three sources:

• Guiding Good Choices Curriculum
• Dragon Slayers’ Curriculum
• Why Try Curriculum
• Aggression Replacement Training Curriculum

Consider discussion regarding the following:

• What stands out to you about the curriculum
• How are they the same or different
• How facilitated in each of the different curriculum

[Whole Class Activity] Discuss what they saw in the curriculum, what stood out… etc.

• Print out 01 copy of Why Try Curriculum
• Bring a copy of the Dragon Slayers’ Curriculum
• Bring a copy of the curriculum for the Guiding Good Choices Curriculum
• Bring a copy of the Aggression Replacement Training Curriculum

Cognitive Behavioral Therapy (Individualized)

(Rector, 2010)

To start our conversation about Cognitive-Behavioral Group Work, I thought that it would be helpful to discuss what is Cognitive behavioral therapy– CBT. This therapeutic approach can help people with a wide range of mental health problems.

CBT is based on the idea that how we think (cognition), how we feel (emotion), and how we act (behavior) all interact together. Precisely, our thoughts determine our feelings and our behavior. This is sometimes referred to as the cognitive triangle.

• Bring awareness to negative interpretations of thoughts
• Review patterns of behavior that reinforce distorted thinking
• Develop alternate ways of thinking

Therapeutic Procedures

(Tolman & LeCroy, 2017)

Some therapeutic procedures are either unavailable or less efficient for individual treatment and are often implemented when performing CBGW.

• The Buddy System: having a partner to learn new skills
• Group Exercises: Think about curriculum
• Multiple Modeling: ART as an example and multiple role plays
• Group Feedback: getting feedback from peers is sometimes more powerful than getting input from a professional. Think about Drug and Alcohol groups and people’s BS detectors.
• Group Brainstorming: Both to solve individual and group problems.
• Mutual Reinforcement: The mutual aid model has similar benefits.

Some of the therapeutic procedures that are implemented in doing individual CBT can also be used in CBGW.

Phases of Cognitive-Behavioral Group Work

The phases identified for CBGW are as follows:

• Beginning the Group
• Motivational Enhancement Phase
• Assessment Phase
• Intervention Phase
• Generalization Phase

Beginning the Group

All groups have a beginning of the group phase. At the beginning of the group phase for CBGW, there are a couple of tasks that we think about in this phase.

• Orientation - How can we provide an orientation for clients in a group?
• Cohesion - the mutual liking of members for each other and the group worker and their attraction to the program of the group.

Motivational Enhancement Phase (1 of 2)

Generally, in a CBGW, there will be time that the worker focuses on increasing the participants’ motivation. This might mean addressing ambivalent or hostile views of the group. These can look like…

[Whole Class Activity] Talk about possible strategies and ways of addressing these as a reflective exercise.

• Reluctance to speak
• Anger about being in treatment
• Denial of any serious problems
• Setting themselves apart
• Speaking only to the group worker
• Unwilling to provide self-disclosure

Motivational Enhancement Phase (2 of 2)

Some standard processes in enhancing motivation include…

• Normalizing ambivalence
• Contrasting costs and benefits of changing or resolving problems
• Eliciting and reinforcing self-motivational statements
• Removing barriers to treatment
• Supporting self-efficacy
• Avoiding argumentation and early confrontation
• Providing clear advice
• Delivering continued feedback

Assessment Phase

The assessment phase might occur before the group or in the orientation phase and throughout the group process. In this phase, the worker is:

• Gathering background information: Before, at the beginning or during
• Using assessment tools: think screeners
• Doing goal setting: both individual and common treatment goals.

Grounding Techniques

I want to share a tool I have often taught clients with all of you. Grounding is a set of simple strategies to detach from emotional pain. To be grounding, it should fall under the following guidelines…

Frame using chart of ambivalence to extreme emotions.

• Accessibility: do it at any time, place, anywhere, and no one has to know.
• Broad: put a healthy distance between you and negative feelings (useful for when faced with a trigger, enraged, dissociating, or having a substance craving).
• Present Focused: keep your eyes open, scan the room, and turn the lights on to stay in touch with the present. Do not focus on the past or the future.
• Scaling: scale your emotions when using grounding. Rate your emotion (craving, impulse… etc.) on a scale from 0-10 before beginning grounding. After implementing your grounding technique, rate your emotion again.
• Focus Outward: Do not talk, think, or journal about your feelings. The purpose of grounding is to distract from negative feelings, not get in touch with them.
• Stay Neutral: avoid judgments of good and bad.
• Not Relaxation Training: note that grounding is not the same as relaxation training. Grounding is more active, focuses on distraction strategies, and is intended to help extreme negative feelings.

[Whole Class Activity] Review the sheet. Practice some of the skills / discuss them. Talk about how it can be implemented in a group format (in part or whole)

• Print 16 copies of Using Grounding To Detach From Emotional Pain handout

Intervention Phase - Systematic Problem Solving

CBGW encompasses many different types of interventions that can be implemented. One of these is…

Systematic Problem Solving is where concerns brought to the group and discussed with the group usually includes:

• Orient to systematic problem solving
• Identifying and defining the problem and resources
• Generating alternative solutions
• Evaluating and selecting the best set of solutions
• Preparing for implementation and evaluating outcomes

Intervention Phase - Modeling Methods

Modeling Methods is the use of role-plays (simulated demonstrations)

Can be with…

• Group members
• Group worker
• Special guests

[Whole Class Activity] How look in ART, Debbie’s classroom (social skills school), OSCE (for SW Students)

Intervention Phase - Cognitive Change Methods

Cognitive Change Methods is the bulk of types of interventions used in CBGW. The focus is on correcting distorted cognitions and replacing them with coping thoughts. This is oftentimes done through the techniques of cognitive restructuring. In ART, the following are the thought distortions they teach:

Self-centered Thinking: Thinking about only your needs or interests, not caring about others. One example is saying, “If I lie to people, it is nobody’s business but mine.” Assuming the Worst: Acting as if the worst outcome in a situation is the only possible outcome. Thinking people are out to get you. One example is saying, “I might as well lie. People won’t believe me if I tell the truth.” Blaming Others: Not accepting responsibility for your choices and consequences. Making it seem like someone forced you to act how you did. Saying someone else is responsible. One example is saying, “People make me lie when they ask too many questions.” Minimizing/mislabeling: Trying to make something ‘okay’ by making it less than or different from what it is. One example is saying, “Everybody lies; it’s no big deal.”

Intervention Phase - Community Interventions

Community Interventions is getting members involved in outside processes such as organizations, volunteering, etc.

-> Think empowerment theory.

Intervention Phase - Other

Some other interventions include…

• Guided Group Exposure: Similar to exposure therapy
• Relaxation Methods: Teaching clients to deal directly with strong emotions such as anxiety, stress, pain, or anger. Might be like
• Operant Methods: Offering positive and negative reinforcement and positive and negative punishments, with the idea of the group reinforcing the self as well.
• Relationship Enhancement Methods: Appropriate self-disclosure, humor/personality, effective listening, etc.
• Small-Group Practice Procedures: Broad group participation, role-playing, subgrouping, and group exercises.

Generalization Phase

The preparation for the transfer of skills to the world.

Often throughout the whole process.

Dialectical Theory

I want to spend a little bit of time talking about DBT as another example of the book. To understand DBT, your reading described

Dialectical theory states that reality is interrelated and connected, made of opposing forces, and always changing. In DBT, dialectics take the form of both a fundamental worldview as well as a method of persuasion (i.e., a set of communication strategies that the therapist uses to elicit change).

They go on to say… My experience with DBT (workbook, practicum placement and “Changing Behavior Thoughtfully”)

In DBT, the therapist may use dialectics when therapy comes to an impasse. In this case, the therapist will take a dialectical stance by holding the opposing viewpoints simultaneously and looking for the truth in both positions.

(Rizvi et al., 2013, p. 76)

Dialectical Behavior Therapy Skills

There are four areas that we think about teaching skills related to in doing DBT.

• Distress tolerance will help you cope better with painful events by building up your resiliency and giving you new ways to soften the effects of upsetting circumstances.
• Mindfulness will help you experience more fully the present moment while focusing less on painful experiences from the past or frightening possibilities in the future. Mindfulness will also give you tools to overcome habitual, negative judgments about yourself and others.
• Emotion regulation skills help you to recognize more clearly what you feel and then to observe each emotion without getting overwhelmed by it. The goal is to modulate your feelings without behaving in reactive, destructive ways.
• Interpersonal effectiveness gives you new tools to express your beliefs and needs, set limits, and negotiate solutions to problems—all while protecting your relationships and treating others with respect.

(McKay et al., 2007)

Developing Your Own Curriculum

What would a group curriculum look like if you were to create one for a therapeutic group?

[Whole Class Activity] Discuss what a group curriculum might look like.

• Objectives
• Planned content
• Tasks or roles

[Activity] Work with groups of four. Pick a topic for a group. Spend time thinking about what type of curriculum you would do, what parts you would include, and what some of the information you would do. Plan one of the sessions.

Practice Facilitating a Group

[Activity] Divide up into four groups. Pick one of the group sessions that you previously designed. In shifts of 15 minutes each, rotate through each getting an opportunity to facilitate from where the previous group leader left off.