Five Heads are Better Than
Two
Using Group Principles to Help Ourselves, Our Clients,
and Our Profession
To be a professional social worker in today’s challenging health care
climate requires that we are steadfast in setting standards of care and ensuring
clinical excellence. As we move toward a less gentle and caring world, where
imposing conditions threaten our job security and the very integrity of our
profession, many have understandably become demoralized, frightened, and rageful.
As an outlet for professional concerns, supervision has always been a major
source of support for the social worker. As things now stand, most supervision
is cut to the bone.
Workers are not the only ones feeling powerless.Supervisors and administrators
are pressured by cost and the need to produce more with less. Ultimately, there
is a tendency to cut back on non-income producing activities such as training
and supervision. While on paper there may be a cost/benefit ratio to less social
work training, the money gained in the short run is often lost in the long run,
with lost clients, failed appointments, staff retention issues and staff burnout.
Attempting to produce more with less usually ends up producing nothing but frustration
and despair.
While all of us have always been mindful of cost and time factors, this more
recent managed care emphasis has catapulted us into a strategic planning process
that has resulted in major changes. We mourned our more comfortable, traditional
operating modes. I am painfully aware that while we needed to cut costs, both
our management and staff required more training to meet the challenges of managed
care. This resulted in a focus on time-effective treatment with individuals,
couples and families and a profusion of group courses in our training.
The advent of the “Managed Care System” has forced the profession
to focus more sharply on the time factor, and to engage clients in that concern:
How long should treatment take? At what intervals should treatment take place?
And perhaps most important, what do clients want to accomplish in that time?
These are vital decisions that clients and worker-social workers now need to
make together, in as concrete a way as possible.
Difficult as these decisions may be, social workers must accept that hostility
and resistance to change are not solutions. Our professional history attests
to our ability to address continuing changes – in social crisis, economic
and social conditions, the practice of environment, as well as shifts in mental
health and social welfare philosophy, policy, and popularity. We are resilient
and willing to face challenges, and today’s problems will require all
of our mettle.
I would love to hearken back to a time when a client was not a patient and was
understood to have a wide context of supports in family, job, and community.
The “Whole Person” concept was a rule of thumb. But now we need
to look for other resources to help us, worker and client, to accomplish our
goals. We are none of us alone, and we0 can all acknowledge our need to seek
assistance from outside our immediate surroundings.
The context for contemporary social work practice today requires that supervisors
have new methods of providing support and instilling hope for their workers
and workers need to do the same for their clients. Today’s supervisors
face tough issues:
• How to provide adequate supervision for workers.
• How to help workers obtain more job satisfaction and avoid burnout.
• How to provide services for a greater number of clients without compromising
quality of care.
• How to address diversity issues with clients and staff.
What is Group Supervision?
The aim of group supervision is to use the basic principles of group psychotherapy
to supervise and support staff members in a group setting. One of the primary
tasks of the group supervisor is to be mindful of the boundaries between supervision
and therapy.
Who should run the group?
Ideally, the supervisor should be someone other than the person administratively
responsible for the workers.
How do Group Treatment Principles work in group supervision?
In the Theory and Practice of Group Psychotherapy, Irvin Yalom develops an empirically
based, 11-factor inventory of the therapeutic mechanisms operating in group
psychotherapy. I would like to relate some of this model to group supervision
of staff.
Installation of Hope
• Workers feel hopeless, disappointed with the field, frustrated with
their jobs, and inept impostors professionally. New social workers are often
under the impression that they are alone in being unable to run a group, that
their group was the only one that fell apart, etc. It is helpful for them to
receive reason to hope from seasoned social workers in the field.
• The supervisor will nurture workers as they learn from each other.
• Workers are presented with a significant potential for conflict of interest
between their new fiduciary responsibilities and quality of treatment. Group
supervision can create a sense of safety which allows workers to have an avenue
for expressing their struggles.
Universality
• Workers will see commonalities between their peers and themselves, i.e.,
fear of failure, feelings of isolation.
• A sense of camaraderie leads to greater staff morale and higher rate
of staff retention.
Imparting of Information
• “Best Practice” protocol
• Networking—workers will feel more comfortable with co-workers
and provide them with referrals.
• Greater potential for research and data analyzation, resulting in clinically
sound and economically responsible services.
• Additional creative treatment modalities through collaboration.
Altruism
• Workers’ confidence will benefit from generous feelings.
Imitative Behavior
• Workers will learn to model the group leader and to be better able to
handle conflicts within their groups.
• Workers will learn the importance of honesty in their group.
Group Cohesiveness
• Workers experience the power of collectivity and shared feelings.
Interpersonal Learning
• Workers feel less inept as they learn to understand the power of the
group.
• A diverse staff group helps social workers be more knowledgeable about
the clients they serve. Workers learn to understand diverse backgrounds and
experiences as well as their own bias and the effect of the bias on others.
• New workers learn from mature workers and vise versa.
• Workers can learn creative solutions to administrative issues.
Helping ourselves, helping our clients
We can use therapeutically derived group principles to help ourselves, our staff,
and thus our profession. The more familiar a social worker becomes with the
power of group, the more groups a social worker will be willing to run and the
more successful at running these groups he/she will be.
Present day social workers need to be versatile in order to survive. It is no
longer possible to deal only with a particular population or to be involved
only with individual therapy. Group forces workers to stretch themselves professionally.
When we are forced to engage clients sooner (in time-limited therapy), it is
in our best interest to be as comfortable as possible with diverse clients.
This ultimately benefits the treatment.
Because change is hard work and requires such fortitude, we must do everything
we can to encourage and support our workers—both new professionals and
experienced social workers. Today we are fighting to preserve the integrity
of the social work profession. We have experienced an erosion of our sense of
professionalism, in our quality of service, in the extent of continuing education,
supervision, and support of professionals themselves. Even as we help others
we need to pay attention to our own well-being, and the continued mentoring
of new social workers. Groups can indeed help us to do more with less. Therefore,
we need a new dedication to training for social work with groups to help us
to achieve this mission.r