Interpersonal group work 1
Last updated on 21st March 2010
Here are a set of handouts and questionnaires that I often use when I'm running interpersonal process groups. As the "Group therapy background information" leaflet (see below) comments: "Group therapy simply means that therapeutic work is done in groups rather than one-to-one. Many different types of therapy have been tried in group format. Rather than construct a long list of such therapies, it may be more helpful to divide the many types of therapy group into two general categories - structured groups and process groups. Structured group therapy often involves the transfer of skills and knowledge. It may feel a bit like a classroom situation. Frequently, structured groups are used as a cost-effective way of delivering similar forms of therapy to individual one-to-one work. Process groups, however, use groups not just for cost effectiveness but also to focus on forms of learning that are specific to the group format itself. Process groups acknowledge that the developing relationships between group members are also a major therapeutic resource." In actual practice this structured-group/process-group distinction isn't so cut and dried. See the post on "Training in group facilitation" for more on this. Many participants in, for example, structured stress management groups will comment how they have benefited from listening to the experiences and comments of other group members. Similarly, facilitators of structured groups will knowingly or unknowingly have interpersonal group processes contributing to the effectiveness or ineffectiveness of the groups they run. However the handouts listed below are those I am more likely to use in groups that acknowledge interpersonal process as a major learning resource. It's likely that most people would benefit from participation in groups of one type or another e.g. group education, group activities, group support, group therapy, and so on. This variety is illustrated by the blog post "Different kinds of group, different kinds of friendship". These interpersonal groups however, that focus on how we relate with others, are primarily for those who are robust enough and psychologically minded enough to engage with this fascinating and rich opportunity to share, learn, and develop deeper, more open, more compassionate ways of being with other people.
Group therapy, background information - this brief overview of group therapy aims to provide some initial orientation for would-be participants.
Course publicity leaflet - the kinds of interpersonal process groups I run have evolved over the years. This publicity leaflet illustrates the current "Opening Up" (relationships & emotional intelligence) format that I'm working with. Everyone who joins these groups will have also had some individual one-to-one sessions with me. Facilitators no doubt vary a lot in how they use the mix of group and one-to-one therapy. There are advantages and disadvantages to running them side by side. I personally find it very useful to at least see group participants for one-to-one orientating and reviewing sessions.
Confidentiality agreement - people coming to these interpersonal groups are likely to be challenged by the degree of honesty and self-disclosure involved. It's important to minimise reasons why participants might feel inhibited about opening up. I make it explicit verbally in initial one-to-one orientation, at the first session of the group, and via this "Confidentiality agreement" that any personal information shared by members of the group is to be treated as confidential and is not to be discussed with non-group members.
Inventory of interpersonal problems (IIP-48) - there are many before-and-after assessment measures that are potentially relevant to the kind of work focused on in these interpersonal process groups. I routinely ask participants to fill in this 48 item version of the "Inventory of Interpersonal Problems". Scores on the six subscales can be added up and noted on the "IIP-48 Scoring Chart". I then typically join these six subscale points to make what is likely to be an irregular star shape. The more the spikes of the star are distant from the "no-problem" centre, the more difficulty the person is likely to be experiencing in interpersonal relationships. I both pay particular attention to any large spikes on the scoring chart and also any "3" or "4" answers on the IIP questionnaire itself. I chart change both by adding further - hopefully reduced in size - stars to the person's diagram as they later retake the IIP-48, and also by simply monitoring reduction in the IIP-48 total score which is simply the sum of the six subscale scores.
Personal community map - this is another assessment exercise that I ask would-be course participants to complete when considering whether to come to the group. It is a helpful way of encouraging people to begin describing their relationships. It may take an hour or so to fill in properly, but it can then provide a major focus for subsequent therapy. When handing out this chart, I also give the instructions and questions sheets (see below)
Personal community map instructions - these instructions go with the "Personal community map" (above), explaining how to fill the chart in, and giving background information.
Personal community map questions - I ask people to answer these questions as they fill in, and after they've filled in, their personal community map (see above). Their answers help to clarify what they probably need to do to continue building personal relationships that promote health, stress resilience, and wellbeing. Sheldon Cohen's work, for example, highlights the value of building high scores on intimacy (question 2) and integration (question 4), while maintaining low scores on - at least chronic - conflict (question 5). There will almost certainly be times in our lives when scores on these questions won't be good, but an awareness of this gives us challenges to work on - for example, deepening our relationships with some people on the map so they come in closer to the centre, developing a cluster of close relationships so we don't have "too many eggs in one basket", having a wide variety of acquaintances/less close friends so our personal community map is more "mountain shaped" (cluster of close relationships at the top/in the centre, broad range of acquaintances/less-close friends further down the mountain/further away from the centre) rather than "pole shaped" (some close relationships at the top/centre but only a smallish number of acquaintances/less-close friends further down/further out). "Pole shaped" personal communities seem too vulnerable to illnesses, friends/family moving away, changes in job, and so on. It seems important too, to maintain the ability to make new friends over our lives, so as we age we don't simply see a progressive attrition and shrinkage of our early life personal community. Healthy gardens have a mix of plants in them!
Maladaptive schema assessment - this is a fairly quick/straightforward way, from Young's work, of getting a sense of internal beliefs/feeling structures that may sabotage making good, close relationships. These "schema" are likely themselves to be largely caused by experiences in relationships earlier in our lives.
I tend to pretty routinely use these three questionnaires - the "IIP-48", the "Personal Community Map" and the "Maladaptive Schema Assessment" - for all group participants. I ask them to answer the questionnaires for the last month or some other time period that represents how they usually function. We may well use a model like the one described in the blog post "Our life stories: needs, beliefs & behaviours" to help organise emerging patterns. Depending on what is most important for each individual, we may also use other questionnaires from those listed on the "Relationships in general", "Relationships, families, couples & psychosexual", "Wellbeing, time management & self-determination" and other pages.
Initial difficulties severity scale - this scale attempts to distil the picture that has emerged from the other assessment questionnaires and from one-to-one discussion to give a key area(s) that each participant currently wants to work on in the interpersonal group.
For further relevant handouts, see "Interpersonal group work 2".