Читать книгу Group Work for Men In Sexual Recovery: A Strategic Model for Sex Addicts - Carol Juergensen Sheets aka Carol the Coach - Страница 5

+ Week 1: Form Stage +

Developing Group Cohesion

The primary goals of Week 1 are as follows and will be elaborated on individually:

•Identify group member's views of themselves.

•Stress accountability and confidentiality, which is essential in the development of trust.

•Assist men in the formulation a goal statement.

In this manual, the term "we" will refer to having one or two facilitators involved in the group process, fully recognizing that you may be the only facilitator in your group.

In Week 1, the focus is forming a cohesive group from individual men with specific clinical needs and issues. Often men enter therapy and/or group with an extremely distorted view of themselves, which dominates their interactions with others. It is imperative that you find safe and non-threatening exercises that will enable the men to get to know each other but will establish healthy boundaries and the safe container necessary to do good work. The "What Is a Recovering Addict?" exercise creates this process. It utilizes an introduction exercise which allows them to articulate how they see themselves.

This activity serves as a non-threatening way to self-disclose in the first group. It also helps men formulate a goal formation statement as an anchoring piece throughout the group series. It is imperative that you find safe and non-threatening exercises that will enable the men to get to know each other, but will establish healthy boundaries and the safe container necessary to do good work. The "What Is an Addict?" exercise creates this process.

Exercise: "What is a Recovering Addict?"

In this activity, you ask the men to generate adjectives (not nouns or roles) that describe a recovering addict. They are then asked to list what an addict is. Typically the words start out negative and depict the deep shame that has resulted from years of secrecy and deceit.

You then compile the list on a dry erase board, and when the men have exhausted the list, you ask them to depict what a man is, and later ask them to write down adjectives that describe their father, brothers, or any male that may have been a role model or a pivotal person in their lives.

You will easily have 50-75 words written on the board or on newsprint. The men then are given a sheet of paper and asked to privately complete the following statements by using an adjective from the list or another that has come to their mind. Limit their choice of adjectives to only one word. This population is overwhelmed with shame and grief and, typically, they do not feel they have the right to see themselves in a positive light.

This exercise is meant to highlight the positive and negative attributes of each man.

•As a recovering addict, I am __________

•As a recovering addict, I am not __________

•As a recovering addict, I want to be __________

Once completed, the men are asked to share these safe and non-threatening self-disclosure statements in group.

National statistics identify that one in ten men have reported experiencing childhood sexual abuse. For that reason, group disclosure can be very threatening. It is your responsibility as a facilitator to create non-threatening ways to self-disclose in Weeks 1, 2 and 3.

The "What is a Recovering Addict?" activity does just that. It is also helpful to encourage men not to divulge too much personal information in the group before trust is developed. Some men have scared themselves or others out of group by sharing too much too soon. In establishing this expectation, you will be role-modeling healthy boundaries for group members from the onset.

As indicated, this exercise assists the client in developing a goal formation statement. Men are often unclear about why their therapist has referred them to group. Additionally, they are unsure as to what goals to work on. The final statement in the "What is a Recovering Addict?" activity allows men to unconsciously create a goal formation statement.

The following example illustrates this point:

•As a recovering addict, I am scared and ambivalent.

•As a recovering addict, I am not confident.

•As a recovering addict, I want to be strong.

Unknowingly, he is articulating a goal of assertiveness. By raising this to his conscious awareness, you can actively assist him by clinically creating the techniques to address this need throughout the 15-week series. You may need to help some men clarify their adjectives, especially in "As a recovering addict, I want to be __________." You can do this by demonstrating how his life might have been different if the addiction were not in his life. Sometimes it has been helpful to ask him to complete the statement: "As a man, I want to be __________." Since this is a goal formation statement, the adjective he chooses must be one in which he can operationalize and make progress.

This exercise will be used as an anchoring piece throughout group series. Neuro-Linguistic programming has been found to be very effective in evoking change. The above-mentioned goal statement, whether it is "As a man…" or "As a recovering addict….." becomes the anchoring piece throughout the remaining group sessions. Each piece will be reiterated each time he participates in a therapeutic process. Therapeutically, opportunities are given and created for this man to push beyond his shame and self-blame and replace it with a new self-awareness of wisdom and strength.

Therapeutically, many opportunities are given and created for this man to push beyond his shame and self-blame and replace it with a new self-awareness of wisdom and strength.

Stress accountability and confidentiality

After the self-disclosure, it becomes apparent which men have more childhood or present-day trauma in their lives. This typically results in a comparison to other group members regarding their level of dysfunction. It is important to tell the men that invariably some of the members will be leaving the first session thinking to themselves "I am the sickest man in the group and I don't belong here," or "I am not nearly as sick as the rest of the group and I don't belong here." Remind them that they have committed to the group process and are there for the 15 weeks and that they will find great camaraderie and unity in the group. This is an accountability piece that needs to be stressed, especially when you have more new men attending group for the first time.

We encourage the men to acknowledge their feelings and points of view, and tell them that these thoughts and feelings are normal and necessary.

Formal rules and expectations are addressed in Week 2; however, we end the first group with a firm confidentiality statement: "What is said in here, what is heard in here and who you see in here, stays here!" This is stressed heavily because confidentiality lays the groundwork for developing trust and rapport. It is also shared that I am clinically bound to break confidentiality as it relates to current allegations of abuse, suicide and duty to warn. It is important to know your state laws in regard to reporting child pornography usage so that you adhere to state regulations. The men are informed that their treatment progress is documented in their chart notes and we consult with their therapist/doctor to keep him/her apprised of their progress.

After you have completed the non-threatening goal formulation statement, you describe the structure that the group will be following, and you normalize how easy it is for an addict to move in and out of denial depending on their circumstances.

Although each member will be in different stages of recovery, they find it helpful to assess their present level of denial and functioning. When a man has been in several series, they typically describe old ways of behavior, which of course gives them gratitude for their progress.

It is imperative to predict to the men that they will likely be leaving the group feeling one of two ways, either: "My problems are more extreme than the other men, and no one will understand or respect me!" or "I don't have nearly as many problems as the other men, and I don't belong here!"