Chapter 10
Small Group and Individual Interventions
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Chapter Aims After reading this chapter you will
be able to answer the following questions about small group and individual interventions:
(a) What are they and why they are important? (b) What is their value-base?
(c) How do they promote well-being and liberation? (d) What is the role of
community psychologists in promoting them? and (e)
What are some of the limitations and dilemmas they pose for community
psychologists? |
Is it fair to expect community members wounded by interpersonal and social oppression to change society while they are hurting? At what point do we expect people who have been damaged emotionally and socially to turn their attention to the plight of others? If we expect them to do so too soon they may not be ready, or it may not even be fair. After all, they may need some time and space to nurse their wounds and recover, spiritually and psychologically, from experiences of subjugation and minimization. On the other hand, if we don’t connect their plight to the plight of others, in some form of solidarity, we may end up isolating them and their source of discomfort even further. There seems to be a unique paradox at play here. Without some kind of individual attention and space, individuals may not process their own sources of suffering and alienation; but with too much space and individual attention they may not connect their own suffering to the suffering of others, nor would they join hands with others to overcome the forces pressing them down. The paradox may be resolvable if we time individual and small group interventions right, and if we connect them to larger efforts at social transformation.
It is entirely
possible that citizens experiencing psychosocial emergencies may be depleted
and unable to turn their attention to the psychopolitical
sources of personal, relational, and collective suffering. Some of them may
justifiably want to focus on the pain of abuse, depression, or eviction. Some
of them want food and school supplies for their children now. They cannot wait
until a radical social transformation takes place. And they are right. So we,
community psychologists and community workers of all stripes, rally behind
their cause to demand psychosocial emergency now. But our political awareness
tells us that something must be done to stop these tragedies from happening in
the first place. Something tells us that it’s not fair that some live in
opulence and others in destitution. But the unceasing demand for services and
emergency supplies barely leaves time for transformative work. So we, community
psychologists and community workers of all stripes, face a serious dilemma:
When do we stop looking at the individual emergencies to put out the fire that
is causing so many burns in the first place? It may seem out of place to worry
about politics when children cannot eat now. It may seem utopian to think of a
better society when homeless families are on the streets now. But if we fail to
dream and we fail to put out the fire, more and more casualties will continue
to require our immediate attention, and nobody will have the foresight to think
about neither the future, nor the other children who will become homeless and
hungry if we don’t act now.
In the context of this dilemma
we explore the role of individual and small group interventions. Our premise is
that individual and small group interventions must be connected to the large
socio-economic spheres that dictate so much of what transpires at the local and
micro levels of experience and analysis. Hence, we are in favour of providing
psychosocial emergency service, provided they are accompanied and paralleled by
efforts at social transformation. Otherwise, however well intentioned they
might be, individual and small group interventions solidify the status quo by
giving the message that what ought to change is primarily psychological and not
sociological. By the same token, we oppose societal interventions that neglect
the psychological needs of individual members and force social changes without
community consultation (Community Mental Health Project, 1998; Lewis, Lewis,
Daniels, & D’Andrea, 2003).
Think of yourself as a practicing community psychologist. You are under pressure to look after psychosocial emergencies while you know that you cannot expend all your energies treating the casualties of social decay. If you do, you’ll have no time or stamina to prevent them in the first place. Well, most of us community psychologists feel that way. In this chapter we review the benefits of individual and small group interventions but we caution against glorification of their virtues, lest we forget that psychosocial emergency treatments have their limitations. Not surprisingly, their usefulness is a question of timing, balance, and context.
If citizens are hurting so much that they cannot attend to others, timing is not right for them to engage in solidarity work. If the focus remains on the individual for too long, balance is offset. If the context violates individual rights and forces conformity, we turn our attention to personal needs. In the case of services for children, Levine and Levine (1992) documented how dominant ideologies created imbalances in attention to either personal or social issues. The lesson for us is to be alert to historical trends so that we may restore balance when necessary.
Hitherto we have turned our attention to interventions with people who require some form of help. But this is only one way of using individual and small group interventions. These strategies may also be used with people who do not necessarily hurt but can, and want, to fight injustice. The foci may change, but some of the tools are the same. In both instances we need to be good listeners, good communicators, and good challengers of the status quo. Hence, in this chapter we present individual and small group interventions as means of coping with adversity and as means of promoting social transformation (Vera & Speight, in press). In many cases, our work with one group or one person may encompass both aims: coping and transformation. Sometimes it will be a matter of what comes first. In others we may be able to work on both simultaneously. We have to remember that people are neither victims nor selfless activists all the time. Many of us fluctuate between feeling hurt and garnering our strengths in support of social change. People who require help in coping with adversity can also support others. They are not permanently in “client” mode. They also have a sense of agency that needs to be nurtured and validated, for their own sake and for the sake of others (Freedman & Combs, 1996; Morgan, 2000; White, 1988/9; 2000)
This preamble alerts us to the many uses of individual and group interventions. They can be used in supporting the unwell, but also in channelling the transformational energies of the well-enough. Let’s see how we can do this in our work and personal lives.
WHAT ARE SMALL GROUP AND INDIVIDUAL INTERVENTIONS?
Situations requiring small group and
individual interventions are as diverse as the sources of oppression and
suffering. Our holistic notions of health and well-being require that we
intervene at the personal, relational, and collective levels. Problems of
abuse, homelessness, and discrimination have multiple sources and multiple
manifestations. While the problems go beyond what any one individual can
probably do, the repercussions are often felt deeply at the personal level (McWhirter, 1994). To help individuals cope with problems in
living and to strengthen their personal resources we devise individual and
small group interventions. These interventions identify people’s assets and
build on their resilience. But these strategies are not meant exclusively for
people experiencing psychosocial challenges, for they can also be used to
generate social change with people who are fortunate enough not to experience
severe challenges.
For us, then, individual and small group
interventions are paths and strategies towards coping and social transformation
at the same time. Interventions of this kind may occur in mental health
centres, community centres, adult education programs, schools, as part of a
prevention program, or as a component of mutual help projects. Furthermore,
these interventions may be directed by community, clinical, school or
organizational psychologists, natural helpers, mentors, lay people, or
community workers. The crucial component for us is that people working with
individuals and small groups follow the values and principles of community
psychology articulated in earlier chapters. That means constant attention to
the balance among values for personal, relational, and collective well-being.
This type of work requires the skilful combination of compassion and empathy
with the ability to challenge preconceived notions of community members. All of
it in such a way that trust may be built among the
helper and the community member (Corey & Corey, 2003).
We want to be clear though that some mental
health problems require the specialized treatment of clinical psychologists or
counsellors. Still, there are many issues in life that may be addressed with
the help of natural helpers in the community such as youth leaders, pastors,
mentors, friends, teachers, and relatives. Hence, personal and small group work
happens in parenting groups, counselling sessions, mutual help associations and
others (Levy, 2000).
Chapter two outlined the two main goals of
community psychology: well-being and liberation. Driven by these goals and by
the values expressed in Chapter three, the task is to develop skills that can
put these visions into action. The remainder of the chapter deals with that
challenge.
WHAT ARE THE VALUES SUPPORTING THE WORK WITH SMALL GROUPS AND
INDIVIDUALS?
While all the values articulated in Chapters
two and three play a role in well-being and liberation, the need for some
values may be more pressing for some people than for others. People’s needs, in
turn, are greatly determined by the context of their lives. Hence, we cannot
predetermine what combination of values will help Susan the most before we know
Susan’s situation. Victims of abuse, during a certain phase of their recovery,
may need more compassion than assertiveness and self-determination. They may
not have the emotional wherewithal to deal with the abuser or with the system
that often re-victimizes them. But after a certain period of mourning, or
reflection, or participation in self-help groups, victims may be ready to fight
the system and help others who have been equally victimized. As discussed in
Chapter 5, empowerment is closely linked to mentoring relationships and
participation in action groups. Connecting with others in similar situations is
a source of support and growth; it’s comforting and energizing at the same time
(Kieffer, 1984; Lord & Hutchinson, 1993; Nelson,
Lord, & Ochocka, 2001).
The question we have to ask ourselves is what
does this person need right now? As we progress in our work, we have to ask
ourselves how her needs have changed over the course of our relationship. These
are questions we cannot answer for ourselves. Our partners in the helping
relationship have a big say in what they need. We accompany them in their
journey, but we don’t necessarily tell them where to travel, even if at times
we may suggest a different course of action (Ivey & Ivey, 2003; Morgan,
2000; White & Epston, 1990).
It is possible that in our work with
privileged people we may foreground the value of accountability (Goodman,
2001). There is much wisdom in the saying “may the troubled be comforted and
may the comfortable be troubled.” A call to accountability may trouble the
privileged, for it requires self-examination and personal scrutiny. Most of
all, it requires change and perhaps even a degree of depowerment.
But however uncomfortable this may make us, and them, it’s one of the only ways
we have to restore justice and equality: Demanding accountability and a measure
of self-depowerment (see Chapter 16 for an
elaboration of this concept).
[Insert table 10.1 about here]
WHY ARE SMALL GROUP AND INDIVIDUAL INTERVENTIONS IMPORTANT?
This question has a three-part
answer. They are important because they enhance (a) personal, (b) relational,
and (c) collective well-being. As may be seen in Table 10.1, the effects of
individual and small group interventions may be felt at all these levels.
Whereas some individual interventions may concentrate on the emotional
well-being of the person in front of us, others can target relational or
societal domains such as norms of aggression or social capital (Lewis, Lewis,
Daniels, & D’Andrea, 2003).
At the personal level, research has
documented some of the beneficial effects of counselling and therapy. Positive
outcomes include better coping, higher sense of control, improved life
satisfaction, renewed appreciation for one’s voice, enhanced self-concept, and
other positive effects (Perez, DeBord,
& Bieschke, 2000; Seligman, 1995). These positive outcomes concern primarily a person’s
well-being. Equally beneficial outcomes include the liberation from oppressive
psychological, social, or political forces (Prochaska,
Norcorss, & DiClemente,
1994). Emancipatory outcomes at the personal level
include overcoming internalized oppression, personal de-blaming, empowerment,
and making the connection between personal suffering and political
circumstances. Personal well-being is closely tied to political well-being (McWhirter, 1994; Moane, 1999; Prilleltensky & Nelson, 2002).
Working with individuals or small
groups can also have positive effects at the relational domain. They can
improve relationships, balance power dynamics, increase participation in
decisions affecting one’s life, and others. The benefits of individual and
small group work can radiate outwards and create positive ripple effects. If I
learn in a group how to identify my own biases and how to communicate with
others better, those who surround me at work and at home will benefit from my
participation in such group (Barrera, 2000; Berkman,
1995; Cohen, Underwood, & Gottlieb, 2000; Ornish,
1998).
At the collective level, this kind
of work can strengthen social capital, reduce the prevalence of mental health
problems, improve community safety, and can even generate social action to
challenge oppressive norms (Putnam, 2000). We are reminded of Margaret Mead’s
“never doubt that a small group of people can change the world. Indeed, it is
the only thing that ever has.” Research demonstrates that empowerment is a very
relational construct. Few are the people who empower themselves without joining
groups or getting support from others (Kieffer, 1984;
Lord & Hutchinson, 1993).
In addition to these beneficial
outcomes, let’s not forget that all our work in organizations, communities, and
social movements reviewed in earlier chapters relies heavily our ability to
work with people. There is, in fact, a great deal of correlation between our
ability to listen empathically and to be a small group facilitator and our
ability to be effective in any kind of organization. As Goleman
(1995, 1998) noted, there is a core set of emotional intelligence skills that
are transferable from setting to setting.
[Insert Table 10.2 about Here]
HOW DO SMALL GROUP AND
INDIVIDUAL INTERVENTIONS PROMOTE WELL-BEING AND LIBERATION?
Individual and
small group interventions can, and often do, go together. A common intervention
in community psychological work is home visiting. In many early intervention
programs, parents work with a nurse, a psychologist, a community worker or a
volunteer. Mothers are often given advice on how to stimulate their infants and
what to expect from them at different developmental phases. Often these mothers
also attend parenting groups where they share experiences and learn from each
other.
[Insert
The “I Have a
Future Program” in
People who are effective changers go through identifiable stages. We introduced in Chapter nine the stages of change. Prochaska and colleagues observed that people move through different phases as they get ready to make changes in their lives (Prochaska, Norcross, & DiClemente, 1994). In this chapter we apply these phases to individual and small group work. Our dual emphasis is on how people work to (a) alter circumstances oppressing them, and (b) create changes to give up some of their power and privilege. Whereas the former concentrates on forms of empowerment, the latter deals with forms of de-powerment (see Chapter 16). In this section we deal with both kinds of change.
[Insert Table 10.2 about Here]
During the various phases of change there are certain jobs that need to get done. In this section we describe the tasks community members embark on. In the next section we focus on what we, as community psychologists, need to do to enable community members to be effective change agents.
Helping
encounters come in many forms. In some instances service providers and service
recipients are paired because of a third party order. Such is the case when
court mandates a youth to see a probation officer or when a school principal
sends a kid to a counsellor. In other cases help is voluntarily sought from a
social worker or a psychologist. Yet in others, it just happens that the
community psychologist is part of a project and people trust her and come to
her with their personal issues.
During pre-contemplation
people are usually exploring what is bothering them. Some may feel uneasy
or unhappy but may be unable to articulate the source of oppression or concern.
A milestone is achieved when they can verbalize what is bothering them and what
may be the source of the problem. Whereas some people may be the subject of
oppressive relationships or discriminatory practices, others may be exerting
too much power over others, causing themselves and others pain and suffering.
But being the complex beings that we are, most of us are somewhere in between
these two poles of oppressed or oppressors. In fact, most of us experience some
of both (Goodman, 2001). In some realms of our lives we suffer some form of
minimization and exclusion; in others we do the same to other people. This
requires that we, as helpers, view our clients and ourselves as potentially
inflicting pain on others, directly or indirectly, wittingly or unwittingly,
consciously or unconsciously. This interpretation rejects simple
categorizations of people as either oppressors or oppressed. In pursuing well-being
and liberation, we think that lasting changes come about when individuals
reflect on their dual roles in life as contributors to well-being and possible
oppression at the same time.
It is easier to recognize the victim rather than the
aggressor within ourselves. We surely don’t want to impugn our clients with
crimes they have not committed, but nor do we want to create false dichotomies
such as victim or oppressor. With this realization, it is possible that some of
our clients, community partners, or peers may wish to work on giving up some of
their power. This process can take place in individual or small group work. In
either case, the intervention can assist those of us who need to change
something about ourselves in order to make more space for others.
In group work, the beginning stages also require that the
group review its origins and aims (Dimock, 1987;
Johnson & Johnson, 2000). In cases where the group is mandated, as in
patients in psychiatric hospitals or youth in court-ordered treatment, there
may be animosity towards the leader or other members of the group. Hence, we
think it’s important to spend some time clarifying feelings and legitimizing
the group’s existence, if such can be accomplished
Whether it is in individual or small group work, we
recommend that people spend some time during the contemplation phase defining the problem. It is all too possible
and frequent to jump to actions prior to knowing what the problem is.
Ideological influences are such in our society that people can seriously
misjudge the source of their suffering. A common misattribution is to impute to
oneself blame for things beyond one’s control. Unemployed people blame
themselves for losing their jobs and victims of spouse abuse blame themselves
for not doing the right things. Advice programs, widely prevalent in
Group work also requires some contemplation with respect
to values and working principles. Do we have a leader? Do we make decisions by
consensus? Do we rotate in our roles? Nothing worst than starting a process
with only an implicit understanding of how it “should” work. People come to the
table with varied experiences and expectations. The sooner we clarify them in
the open the better off we are. It is at this stage that misgivings and
hesitations need to be aired. Otherwise, they can fester like wounds, create
resistance, and undermine ownership (Nelson, Prilleltensky,
& MacGillivary, 2001).
The preparation phase
is all too important. Eager clinicians send their clients to do something
different, only to find out later that they were not ready for it. After all,
change is hard and there is no reason why people should jump for it. Habitual
modes of relating to others and thinking about ourselves are profoundly
engrained in our individual and collective psyche. Imagery, visualization,
concrete plans and achievable goals can all help in moving forward.
Action then is
only one more element in the equation, albeit an important one. People need a
great deal of support to experiment with new ways of being and relating to the
world.
[Insert
Groups can
act as powerful resources in introducing new behaviours in their members or
getting rid of undesirable ones (Johnson & Johnson, 2000). The literature
on mutual help and organizing confirms that empowerment often grows out of
social support and solidarity (Levy, 2000; Speer & Hughey,
1995; Speer, Hughey, Gensheimer,
& Adams-Leavitt, 1995). But groups can be powerful in multiple ways, and
not all of them positive. Norms of conformity can suppress creativity and power
dynamics can further oppress vulnerable members. Hence, attention to process is
crucial throughout the life of the group (Johnson & Johnson, 2000).
If you have ever tried to change something, you know how
difficult it can be to sustain the new behaviour. If you tried to stop smoking
or to lose weight, you probably know that starting is not as hard as keeping it
up. This is why the stage of maintenance
is so crucial (Prochaska, Norcross, & DiClemente, 1994). Planning for change without planning for
maintenance is a recipe for failure. Imagine you made a decision to start
exercising every other day for 30 minutes. You made a plan that read like
“exercise for 30 minutes Monday, Wednesday and Friday” but you did not plan
exactly what time, what to do if somebody invites you to go out for a drink, or
if you just have too much to study. You may have had a good beginning, but you
did not have a contingency plan or a maintenance plan. Groups can be powerful
in creating norms of accountability. Alcoholic anonymous create pacts among
their members that serve to maintain the gains newly acquired. Attending the
meetings and sharing the personal odyssey towards sobriety helps people with
addictions to keep the risk at bay.
Evaluation should
not be relegated to the end of the change process. Nothing more disappointing
for group members or facilitators than to realize at the end that you missed
the ball from the beginning, that you didn’t notice some people were
disengaged, that therapy wasn’t working, that there wasn’t ownership of the
process. To prevent that, it’s important to build in reflective practice: structured
moments where people can express their feelings about how things are going,
either in group or individual quests for change (Patterson & Welfel, 2000). This requires the creation of a truly safe
space where discontent may be expressed and achievements may be celebrated.
Role modeling is crucial for formative evaluations to work. The message from
the facilitator of change ought to be that mistakes happen, that things can go
wrong, and that it is better to express our discomfort as we feel it. A skilled
facilitator balances opportunities for process reflections with concrete
actions and achievements.
Part of maintenance and evaluation is follow up. Setting dates for reviewing
new practices, assigning roles for championing new procedures, animating processes
that keep an innovation alive are all parts of follow up. Institutionalizing
innovations is the culmination of change.
[Insert
Table 10.3 about Here]
WHAT IS THE ROLE OF COMMUNITY PSYCHOLOGISTS
WORKING IN SMALL GROUPS AND INDIVIDUAL INTERVENTIONS?
In a nutshell, the role is to enable the progression from
pre-contemplation to maintenance and follow up. But for this to occur, certain
skills have to be developed. Table 10.3 describes seven roles that must be
present every step of the way. While the discrete learning of these roles is
vital, it is their integration that is crucial for success in facilitating
change in individuals and small groups (Ivey & Ivey, 2003). What is
expected of a skilled facilitator is to invoke the most appropriate role at the
most opportune time.
The role of inclusive host calls for the creation
of a welcoming atmosphere. In such a climate people feel safe to explore
sources of oppression, avenues for empowerment, vulnerabilities, as well as
personal and social privilege. An inclusive host makes space for all guests to
feel at home. In a non-judgmental atmosphere people begin to consider aspects
of their lives they didn’t feel comfortable to explore before. This is the case
in individual and small group interventions alike, although it is somewhat
harder to achieve in the latter because of the gaze of multiple spectators.
An inclusive
host strives to make all members of the group as accepting as possible. This
requires a “reading” of where people are at during the conversation. Skilful
facilitators have a hand on the pulse of the group all the time. This is quite
a sophisticated ability, as it requires identification of people’s moods as
individuals and as a group. Some of the questions inclusive hosts ask
themselves are:
1.
Is everyone feeling comfortable?
2.
Is someone dominating the discussion
in the group?
3.
Are there some people who feel afraid
to speak?
4.
Have I made an effort to hear from
all people in the group?
5.
Are people leaving the meeting
enthusiastic or disappointed?
Once people
feel comfortable and ready to do some individual or group work, it is important
to help them to envision a better yet realistic state of affairs. When people
grow up in violent homes sometimes they come to believe that this is the way
things are supposed to be. Their world of possibilities may be constrained by
multiple factors including socialization, family experiences, community
narratives and deprecating messages about one’s group or personal abilities. It
is the role of the visionary to (a)
expand the realm of possibilities, and (b) establish values and principles to
guide the work. Hence, in our role as visionaries we fulfil the dual task of
aspiring towards a better state of affairs and creating norms that will help us
work together at the same time. In short, we envision the ends and the means to
achieve it. But we don’t envision it by ourselves. We most definitely include
the group and our associates in making the decision.
In individual
work there are only two people making decisions about personal growth, coping
strategies, or social activism. In group situations the process of crafting a
vision and choosing values that guide the collaboration can be fairly involved.
Some questions a visionary can ask him or herself at this stage include:
1.
Have all people expressed their
aspirations?
2.
Are we able to think of alternative
ways of being?
3.
Have we established a process that is
democratic and inclusive?
4.
Have we had time to think about the
norms that we all want to follow?
5.
Is there collective ownership for the
values and vision we have created?
As an asset seeker it is our job to identify
sources of resilience, strength, and ingenuity in the people we work with (Ivey
& Ivey, 2003). In individual encounters it is important to validate what
the person in front of us is already doing well to cope with a problem or to
fight injustice. Disenfranchised community members are used to hearing about
their deficits, when in fact many of them have remarkable talent in coping
under adverse circumstances. Within group settings it is vital not to leave
anyone behind in our search for assets and strengths. People have experiential
or academic knowledge they wish to have validated. To make sure we are
effective in our search for assets we can ask the following questions:
1.
Have I asked people how they cope
with this difficult situation?
2.
Have we discussed what each of us can
contribute to the process?
3.
Are we able to combine our strengths
in a synergistic way?
4.
Have I offered my input as an equal
member of the group?
5.
Have we explored different types of
knowledge and wisdom that can help us in our collaborative work?
As a listener conceptualizer
the main job is to attend carefully to what people are telling us about their
lives, challenges, struggles, and aspirations. We cannot emphasize enough the
importance of letting people speak and explain on their own terms what they are
experiencing and hoping and feeling. It is not uncommon for eager helpers to
rush and give advice before they have listened carefully. Each of us brings to
the table multiple assumptions that can lead to unwarranted conclusions about
other people’s lives. It is best not to presume anything about people’s lives
or views before we check it out with them (James & Prilleltensky,
2002).
Once we have
a good grasp of the issues and challenges ahead, we begin to conceptualize the
problem and isolate the main factors causing and perpetuating suffering,
injustice and oppression in personal, communal, and social lives. As community
psychologists we always have our antenna up for signals of oppression and
exclusion. Power differentials and inequality figure prominently in the lives
of people we work with (Community Mental Health Project, 1998; Lewis, Lewis,
Daniels, & D’Andrea, 2003; Vera & Speight, in
press). Unlike other professionals in the helping fields, we do not necessarily
concentrate on intrapsychic dynamics, although they
may be an important part of the puzzle. For us, internal psychological
processes are just one more element to consider. Ecologically speaking, we
conceptualize problems in terms of micro, meso, and
macro spheres. As noted in Chapter two, holism is the perfect antidote against
reductionism in the formulation of problems.
As we derive
our own conclusions about a problem in living or a challenge to work on, we
have to recognize that our views may differ from the group or the individual
(James & Prilleltensky, 2002). We have to
consider the possibility that our conceptualization may be wrong, or that it
may take more dialogue for people to reach consensus on causes and possible
solutions. Conflict is expected and unavoidable. The very way we deal with that
may be therapeutic and growth enhancing.
To remind
ourselves of the various tasks involved in being a good listener conceptualizer, we can use the following prompts:
1.
Have I listened without interruptions
to what people have to say about their issues?
2.
Have I thought about it in ecological
terms?
3.
Have I expressed disagreement or
alternative conceptualizations in a respectful way?
4.
Have I thought about the influence of
power inequality in this person’s life?
5.
Has the group agreed on the
definition of the problem and possible solutions?
As we cycle
through the steps, we come close to enact the role of pragmatic partner. Problem definition is crucial, but action is
what gets changes under way. When the group or the individual are ready to take
action, we have to contribute our academic, professional and personal knowledge
to the process of change. If a group wishes to use a confrontational technique
with a school board, and you know that this strategy will alienate potential
allies, as a pragmatic partner you want to discuss the merits of other options.
If a victim of spousal abuse wishes to return to the marriage, and you know
from her past experience and other research that this will likely not work out,
as a pragmatic partner you want to raise the possibility that this may not be
the best way to proceed. In either case, our alternatives have to be bought by
the people we work with. No point in forcing our views upon others who are not
ready to listen.
As a
pragmatic partner, your job is to listen, conceptualize, formulate actions and
collaborate with your partners in carrying them out. This is an essential part
of our jobs in working with individuals, small groups, organizations and
communities: Our ability to identify transformational actions while keeping
everyone engaged and being effective at the same time. We discussed in the
previous chapter the set of emotional intelligence skills that can help us not
only in ameliorative, but in transformational work as well (see Table 9.3).
These competencies come in handy when working with individuals and small
groups. Questions that sharpen our skills as pragmatic partners include:
1.
Have I considered with the group the
risks and benefits of every course of action?
2.
Have I consulted colleagues and the
literature on the merits of various alternatives?
3.
Is our work balancing attention to
process with attention to outcomes?
4.
Is the preferred action in accord
with our values?
5.
Do we have a contingency plan in case
this strategy doesn’t work?
Learning is
truly a lifelong journey. This is not just a cliché. Although we are able to
extrapolate from one situation to another, more often than not new situations
require a new lesson in how to solve problems. We have to be open to challenges
and unexpected turns in our work. Therefore, we want to promote the role of research partner. This is not research
in the narrow sense of experimental designs, but rather in the broad sense of
exploring and evaluating how we’re doing, what’s working well, how people are
feeling, and what am I doing wrong?
Table 10.3
identifies the various domains that need to be evaluated during our work with
individuals and groups. Many of us are used to “getting the job done.” While
this quality may be a great asset, we have to be careful that in our rush to
accomplish things we don’t forget how we’re accomplishing them. Evaluation is
not a solitary activity but rather a collaborative one. Our partners in change
have to be able to express their views on the process of our work together.
Some questions we find useful at this stage are:
1.
Have we created a space to reflect on
how we’re feeling about our work together?
2.
What have we done to evaluate our
intervention?
3.
Are people feeling safe enough to
express disapproval?
4.
Am I open to challenges and
criticism?
5.
Have we practiced how to give
feedback in respectful and useful ways?
Perhaps the
toughest part of the job is to make changes last, both in our personal and
institutional lives. This is why we have to pay particular attention to our
role as trend setters. To achieve a
change is admirable, but to make it into a new trend is even more remarkable
(Mayer & Davidson, 2000; Prochaska, Norcorss, & DiClemente,
1994). This role supports maintenance and follow-up as described in Table 10.2.
When starting new programs in the community so much effort goes into project
development, recruitment and evaluation that sustainability is often not a priority.
By the time funding runs out in one, two or three years, as the case might be,
there are rarely plans for the continuation of the initiative.
Long term
planning applies to individual, group, or community change alike. The first
priority is to institutionalize the innovation at the personal and local
levels. Once that has been accomplished, it’s important to take the message to
other communities and groups (Mayer & Davidson, 2000). In Chapter sixteen
we can see how indigenous groups in
What can be
done to make trend setting a priority? Some questions community psychologists
can ask include:
1.
What have we done to make sure that
the changes we plan for persist?
2.
How do we change the system, not just
perceptions, in order to institutionalize innovations?
3.
What group norms can we establish to
help members sustain new behaviours?
4.
How can we disseminate knowledge gained
in one setting to others?
5.
What do we know from the literature
about institutionalizing innovations?
While trend
setting is very challenging, it is also very exciting. Community members like
being part of something new and transformative. Motivation increases when
people realize that their contributions may transcend the local level. When you
think of environmental trends like recycling and composting, you can appreciate
how rare they were twenty or thirty years ago, and how much more common they
are today. At first environmentalists encountered much more opposition than
they face today when trying to institute earth-friendly policies and practices.
The same may be said of civil rights activists who fought an uphill battle to
obtain basic human rights. While their struggle is far from over, new trends
such as affirmative action and disability rights legislation make it easier for
people of colour and people with disabilities to participate in society.
WHAT ARE THE STRENGTHS AND LIMITATIONS OF SMALL GROUP AND INDIVIDUAL INTERVENTIONS?
We started this chapter
with the concept of psychosocial emergencies. These are wounds that require
urgent treatment. Abuse, neglect, violence, addictions, depression,
homelessness; they all require immediate attention. And when properly given and
carefully applied, sensitive one-on-one and small group interventions can help.
People recover hope, feel empowered, join others in fighting inequality, and
enjoy the benefits of mutual support.
Research demonstrates that
individual and small group interventions can help at the universal, selective,
and indicated levels (if you need a refresher on these concepts see Chapter
four). At the universal level, schools that smooth the transition from
elementary to high school by grouping children in small clusters and
restructuring the school environment deliver positive outcomes. In the School
Transition Environment Project (STEP) the school was reorganized
so that grade 9 students remained with the same group of students in the same
part of the building for most of the day; they had a small group of teachers;
and the home room teachers handled many of the guidance-related issues for
these students. Effectively this intervention created a smaller, more
supportive environment within the context of a larger, more impersonal school.
Compared with students in a control group, the students who participated in
this new arrangement reported more positive attitudes towards school, had fewer
absences, and had better marks (Felner & Adan, 1988). This is a universal intervention in that all
school children participate in the program. They all receive individual
guidance and they all work in small groups. Such a program has proven effective
in enhancing academic performance and satisfaction with school overall.
At the selective level,
families at risk for abuse or neglect or children at risk for educational
underachievement benefit from individual and small group interventions with
parents and children alike. Geoff Nelson and colleagues conducted two
meta-analyses to find out whether programs such as home visitation and family
preservation achieve reductions in abuse, and whether early intervention
programs have lasting effects in children’s educational well-being (MacLeod
& Nelson, 2000; Nelson, Westhues, & MacLeod,
2002). In both instances Nelson and colleagues found that individual and small
group interventions work. Some work better than others and some achieve longer
lasting results than others, but in general these analyses support the
implementation of individual interventions with parents to prevent abuse, and
with children to enhance educational outcomes. Parents feel better about their
children, obtain better employment, and improve rearing knowledge and techniques.
Children, in turn, become better learners and experience higher family and
social well-being.
Sensitive home visitors
help parents to remove blame and feelings of inadequacy. Trained group
facilitators also help children of divorce to remove blame and feelings of
inadequacy. Social support groups help people with addictions, mental health
problems, physical disabilities and other afflictions overcome exclusion,
marginality, and depression (Levy, 2000).
At the indicated level,
individual and small group interventions are also effective in coping with
adversities such as ill-health and serious mental health problems. In Chapter
21 we can see how people with psychiatric conditions benefit from mutual help
and empowering approaches.
At all levels, through a
process of personal affirmation and safe exploration, individuals and groups
achieve higher levels of well-being. In the best possible world, the newly
gained confidence and psychological health would be invested in helping others
achieve higher levels of well-being and collective liberation. But often this
is not the case. Self-actualization can easily turn into selfish actualization,
a trend that has been inadvertently supported by traditional therapeutic
approaches that reinforce individualism (Prilleltensky,
1994).
At present, most preventive interventions are
person-centred or small-group centred. This flies in the face of ecological
formulations of problems. If problems reside in systems as much as in
individuals, how come most of our psychological interventions put the onus of
change on the victim and not on the system? Furthermore, most interventions
wish to fix the person damaged and not the powerful ones inflicting the damage.
These are inherent risks of individual and small group interventions. On one
hand they are helpful, but on the other hand they divert attention from meso and macro sources of conflict.
A final caveat to keep in mind: The vast majority of individual and small
group interventions are ameliorative in nature. They soothe wounds and react to
pain, but do not confront their origins. In a sense, they follow the medical
model of “wait and they shall show up in your clinic” (Albee,
1990, 1996; Pilgrim, 1992; Vera & Speight, in press).
WHAT ARE SOME OF THE DILEMMAS FACED BY COMMUNITY PSYCHOLOGISTS WORKING WITH SMALL GROUPS AND INDIVIDUALS?
What right do we have to convince people to work for
social change, to oppose convention, to rebel? If we are clear and honest about
our values, we are bound to share them with the people we work with. If we have
an agenda for change, we shall want to propagate it. Who is to say that our
values will not seep in the work we do with individuals and small groups. That
would not be a dilemma if people invited and allowed us to work for social change,
but what about groups who think we can help them with addictions and we end up
talking about how corporations exploit children and poor people? Aren’t we
politicising the helping process? The answer is we most definitely are. The
dilemma lies not in pretending we are apolitical when in fact we are, but in
introducing agendas community partners may not be ready for or interested in.
After all, community psychologists are well-known for working on health and
welfare related issues and not on radical transformation.
In our view, the ethical way to proceed is to share
our convictions, our analyses, and our strategies with people we work with. It
is up to the partners to decide whether health can be isolated from corporate
greed or not, and whether they see any connection between eating disorders and
the fashion industry. If our partners refuse to make the connections, or if
they oppose our agenda, which is entirely possible, the collaboration may not
be possible, in which case we gracefully exit the scene. We cannot be all
things to all people.
We should not psychologize everything and think that
people who exploit others are simply misguided or psychologically unhealthy.
That may very well be true. But we must keep in mind that certain groups may
expressly reject our values and wish us away. How wonderful it would be if we
could easily tell who is misguided and who is a genuine despot. Until there is
a quick procedure for such diagnosis, we are stuck with disclosing our values
and seeing how far we can go with them.
SUMMARY
This chapter merely touched upon
ways of working with individuals and groups. Due to space considerations we
could not expand on specific interviewing skills or group facilitation.
Fortunately, there are excellent resources for learning the craft of interview
and group processes (see resources section below). In this chapter we chose to
discuss the more likely roles of community psychologists and the likely stages
people go through in their efforts to make personal or social change.
Prochaska’s
stages of change remind us that effective self-changers go through discernable
steps, from pre-contemplation to maintenance and follow up (Prochaska,
Norcross, & DiClemente, 1994). There is merit in
following their wisdom. Each phase builds on previous ones, and skipping may
cause unnecessary regressions. Action without contemplation may be misguided
and contemplation without action may be frustrating. These phases are enabled
by a set of skills and roles.
We recommended the use of seven
roles, introduced in earlier chapters and applicable to work with individuals
and small groups as well: Inclusive host, visionary, listener conceptualizer, asset seeker, pragmatic partner, research
partner and trend setter. Mastery of individual skills is important, but more
vital is their integration and activation at appropriate times.
The dilemmas we posed at the
beginning and the end of the chapter are not easily resolvable. How do we
allocate our time between psychosocial emergencies and preventive measures? How
can we tell if people who reject our values are simply misguided or genuinely
disinterested in the well-being and liberation of others? For how long do we
try to persuade others before we decide they need to be disempowered instead of
empowered? When do we tell ourselves we have too much power and we need to find
ways of giving it up? Answers will perpetually vary across contexts. But until
all contexts look the same and before we can safely tell friend from foe, there
is one simple answer: We struggle with each and every one of these dilemmas. At
best, we shall find colleagues to help us resolve them. At worst, we shall
pretend they don’t exist.
Class Exercise For us to change, and for us to help others to change, we need to
understand how social influences prevent us from transforming our attitudes
and behaviour. In particular, we need to
understand our relationship to our own power and privilege. Many theories
claim that society influences us. We claim that society does not just
influence us; society is in us.
It is not just a matter of society shaping our ways; we embody society within ourselves. Therefore, it is
very hard to be critical of society when we are it, and it is very hard to
be critical of ourselves when society doesn’t want us to be critical of the
status quo. We are part of the status quo; we are the very society we wish
to criticize. To explore our blind spots then, consider the following group
exercise:
Resources
Universal Small
Group and Individual Interventions
Resources
1. For skills in working with individuals consult in particular the following authors listed in the reference section: Ivey and Ivey (2003), Corey and Corey (2003), McWhirter (1994), and Morgan (2000).
2. For skills in working with groups, please consult the following authors listed in the reference section: Dimock (1987), and Johnson and Johnson (2000).
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Potential Contributions of Small Group and Individual Interventions
|
Concerns |
Domains |
||
|
|
Collective |
Relational |
Personal |
|
Well-being |
Enhanced social capital Higher
educational outcomes Reduced
prevalence of mental health problems Economic
productivity Sense of
community Improved
safety |
Supportive relationships Caring and compassion Participation in decisions affecting one’s life Respect for diversity in relationships Better parenting |
Effective coping Resilience Better quality of life Voice and Choice Dignity and self-respect Respect Sense of control |
|
Liberation from oppressive forces |
Group
action against patriarchy and other forms of domination Links with
other solidarity groups More
leaders in social movements Citizens
with political consciousness Education
about sources of injustice |
Support
people to leave abusive relationships Prevent
emotional abuse in family, school and work Join with
others in struggle for liberation Accountability
in relationships Relationships
based on “power with” instead of “power over” |
Overcome
internalised oppression Personal
de-blaming Personal
empowerment Expression
of anger Protest
against personal and social injustice Clear
connections between personal and social injustice |
Table 10.2
|
Steps |
Work with Individuals |
Work with Small Groups |
|
Pre-contemplation |
- Explore sources of oppression and suffering - Explore need for accountability |
- Review reasons for coming together - Legitimize group’s existence |
|
Contemplation |
- Refine and define areas of work - Think about personal, relational, and collective changes |
- Refine and define areas of work - Establish principles for working together - Validate misgivings and hesitations |
|
Preparation |
- Choose specific goals and areas of change - Warm up to idea of doing things differently |
- Devise plan for achieving personal and group goals - Have timelines for preparation phase |
|
Action |
- Experiment with actions to overcome oppression - In cases of over-empowerment, explore ways of sharing power and increasing accountability |
- Balance attention to participatory processes with concrete actions - Decide ahead of time on schedule but remain open to changes as group evolves |
|
Maintenance |
- Put in place systems of sustainability that will reinforce personal empowerment or de-powerment, as the case might be |
- Develop norms and procedures to sustain and institutionalise change either in people’s behaviours or in social changes pursued |
|
Evaluation |
- Evaluate process and outcomes of change, not only at the end of a trial period but throughout work phase as well |
- Group conducts formative and summative evaluations of the work |
|
Follow up |
- Procedures are in place for individual to check in with self and others to see if changes are maintained |
- Institutionalise procedures to help group members to remain accountable to each other |
Table 10.3
“I
Have A Future” Combines Individual And Group-Based
Work To Prevent Teenage Pregnancy
Individual and Group Work Can be Used to
Increase Resilience
According to Rutter (1987), there are four
central mechanisms that can help people cope with adversity and develop
positive mental health: (1) reducing risk impact, (2) interrupting
unhealthy chain reactions stemming from stressful life events, (3)
enhancing self-esteem and self-efficacy, and (4) creating opportunities for
personal growth. Risk impact may be reduced either by altering the risk or
by altering exposure to the risk. Altering the risk means changing it in
some way to minimize effects. For instance, for young children to face a
separation or new situation without preparation constitutes a risk. The
risk for children who need hospitalization can be altered by taking them to
visit the hospital before admission and by “practice separations” from
parents in secure circumstances. Altering exposure means keeping the person
away from the risky situation, or reducing involvement in its riskier
aspects. For example, Rutter (1987) found that in
high-risk communities, strict parental supervision of children’s activities
outside the home can reduce the risk for delinquent behaviour. Placing
limits on what children can do and how long they can stay out minimizes
exposure to the risky environment. The mechanism of breaking a potentially
damaging chain reaction can be seen in a study of parental loss: ensuring
sustained, adequate care breaks the chain of harmful consequences. A
nurturing environment can protect children from the consequences of loss,
separation, and other risks. Self-efficacy can be fostered in children by
offering age-appropriate tasks and sufficient rewarding experiences of
control. Finally, opportunities for personal development may be created by
teaching youth social skills they can apply in various settings, and by
preventing school dropout. This last mechanism may be conceptualized as
promoting beneficial chain reactions. A good education can lead to
attractive jobs, a higher income, and the like. Similarly, adequate social
skills can lead to friendships, which translate into social supports that
have the effect of buffering stress. All of these mechanisms can be put in
place through individual and/or group work enhancing self-esteem,
preventing exposure to risks, and opening up opportunities.