Running head: GROUP THERAPY TECHNIQUES FOR ADOLESCENTS 1

Group Therapy Techniques for Adolescents

Shawn Marie Edgington

COUN 501

November 12, 2010

Liberty University
GROUP THERAPY TECHNIQUES FOR ADOLESCENTS 2

Abstract

Group therapy is very beneficial to adolescents because they are naturally very social creatures

and tend to do things in groups. Adolescents participate and interact in their own social groups

and trust their peers. This is why group therapy is a great choice for the counseling needs of

adolescents. Those who suffer from ADD, ADHD, Social disorders, PTSD, sexual abuse and

many other disorders benefit from group therapy by interacting with others who are going

through the same issues as they are. Adolescents in school that benefit from group therapies are

those who suffer from educational disabilities, learning disabilities, high potential for drop out,

children of divorce, and those with drug addictions. Adolescents can learn from others while

observing their peers who have gone through the same issues. With the added benefits of

Christian Therapy, adolescents are offered peace, triumph, and victory, which only can happen

through a relationship with Jesus Christ.

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Group Therapy Techniques for Adolescents

From the beginning of time, God conditioned humanity to live and work in groups.

Human beings are very social creatures and they enjoy interacting with those around them.

There are numerous mentions of groups in the Bible. The intimate nature of small groups assists

individuals to obtain enhanced attention. God often worked and ministered through families or

other forms of groups throughout the Old and New Testament. The greatest example in the

Bible of how small groups work was the ministry of Jesus while He was here on Earth. Jesus

chose to devote himself to smaller groups and not the masses. During the smaller, more intimate

groups that Jesus was able to teach in greater detail. For example when ministering to crowds

He spoke in parables, but in smaller group settings, like with his disciples, he explained

everything in greater detail.

Psychology provides different types of therapy that can be used to treat adolescents.

Group therapy is very beneficial to adolescents because they are naturally very social creatures

and tend congregate in groups. Adolescents participate and interact in their own social groups

and trust their peers. This is why group therapy is a great choice for the counseling needs of

adolescents. Group therapy has proven to be very beneficial to adolescents who struggle with a

variety of different disorders. Group therapy helps adolescents realize they are not the only ones

going through problems in their lives. In a group therapy setting they realize there are others

going through the same thing. An adolescent who is troubled, experiences relief when they

realize they are not alone in their struggles. This is one of the principal benefits that group

therapy provides. As an adolescent matures they are struggling with their personal identity and

how they fit into the world around them. Adolescents between the ages of 12 and 20 naturally

struggle to identify who they are. Adolescents search for their identity: through family
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relationships, status symbols, through grown-up behavior, through rebellion, and through others’

opinions. When individuals who share similar issues are brought together, this unifies them and

brings cohesiveness to the group. They can relate to one another and provide support to those

around them (Clinton & Ohlschlager, 2002).

Adolescents do well in groups of their own peers because they will take advice from their

peers before they will an adult. They will be less defensive if the advice they are receiving

comes from their peers who have already dealt with the same types of problems. In a group

setting, group members tend to take on the same roles they play in their families (Sosin, Lecture

D, 2010). If a group member does not actively participate in the group, he or she can still learn

by observing the behaviors and interactions of the other group members. If the adolescent

continues to attend therapy, then maybe they will begin to feel comfortable and share in group.

Members in a group must be able to function in a group setting, have common goals, and

have the desire to change. If a client’s goals are not compatible with the group’s goals, there is

not a compatible link to integrate the person into the group. Personality conflicts can be a

hindrance to how the group works and could tear down the group dynamics. This can prevent

any member of the group from making progress.

Cognitive-Behavioral Therapy (CBT) is a type of therapy that consists of a variety of

different approaches. A few examples are Schema Focused Therapy, Cognitive Therapy,

Rational Behavior Therapy and Rational Emotive Behavior therapy. Albert Ellis disliked the in-

efficient and in-directive nature of Psychoanalysis. It was from this that he developed Rational

Emotive therapy. He is one of the original developers of cognitive-behavioral therapy (National

Association of Cognitive-Behavioral Therapists, 2008).

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CBT is a therapy method for identifying and changing negative core beliefs and negative

automatic thoughts. CBT believes that our thoughts are what our feelings and behaviors are

based upon and that they are not influenced by external stimuli such as people, environment, and

events. This can be beneficial because if a client changes their thought processes on how he or

she feels and acts, then he or she will feel better even if the circumstances in their life does not

change (Edelman & Redman, 2005).

Cognitive therapy has benefits and strengths that a Christian counselor can employ.

Cognitive therapy helps identify thoughts and behaviors perceived to be negative and

problematic. Dysfunction originates with faulty beliefs. CBT addresses the issue that negative

thoughts lead to negative consequences. Christians also address the negative thought process and

beliefs but unlike secular counseling, the Bible clearly defines the beliefs and behaviors to avoid

(Jenkins, 2008). Cognitive therapy holds individuals accountable and responsible for their

actions, beliefs and distortions. In a group therapy session, the group members can assist with

this by holding their fellow group members accountable also. The Christian counselor also needs

to allow his or her clients the freedom to make their own choices and help them evaluate the

ramifications of those distorted thoughts and choices. Cognitive behavior therapy is also very

goal oriented which works well within the context of group therapy. The therapist helps the

group identify their goals and then by listening, teaching, and encouraging, helps the clients

achieve those goals. In the group therapy sessions the group leader should not be telling the

client how to solve the problem but giving the client the tools and ability to solve the problems

themselves. A group member needs to use the group sessions in order to model and try out the

new behavior in a safe environment. When a person hears, sees, and applies the new behavior he

or she is more likely to remember it and use it in the future. CBT can be beneficial to a wide-
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range of people. The therapy’s philosophy teaches clients to change negative beliefs. CBT is

useful in treating depression, anxiety, phobias, intra-personal relationships, obsessive-

compulsive disorders, eating disorders, attention deficit disorders, and aggression issues. It can

even be used to treat victims of physical and sexual abuse (Avinger & Jones, 2007).

Trauma-focused cognitive-behavior therapy has been developed to help victims

overcome PTSD, anxiety, depression, feelings of self-blame, lack of trust, and the feeling of

being unsafe in their environment (Jenkins, 2008). There have also recent studies that show that

cognitive behavioral treatment groups (CBTG) are being established for children with Learning

Disabilities (LD) (Shechtman & Katz, 2007). The research on CBTG for LD provided a task

oriented environment and helped the individuals expand their academic and social skills. The

structured process focused on cognitive processing, training and guidance (Shechtman & Pastor,

2005).

A tool that can be used with a client to help reduce negative thoughts and help increase

more balanced thoughts is a technique developed by Greenberger and Padesky called the Seven

column technique. It helps the clients explore the data to either substantiate or refute the key

maladaptive cognitions. This technique incorporates the use of Scripture to help contradict

negative beliefs of the client (Garzon, 2005).

A Social Skills Group helps people to acquire the necessary skills through learning and

experience. People learn personal social skills and their self-esteem by models such as parents,

teachers, and peers. Acquiring and learning social skills is a lifelong learning process. Some

individuals have a more difficult time in responding to social situations and learning how to

apply the correct skills. Individuals who are shy or have a social disorder may misinterpret

social cues that lead to rejection. Some individuals lack social awareness and cannot interact
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with those around them. Children who have suffered trauma, neglect, abuse, or have

developmental problems are unsure how to interact or cope. Individuals, who fear rejection,

develop an anxiety around these situations. For fear of this rejection, individuals would rather

avoid social situations than cope with it. Individuals may show signs of withdrawal, aggression,

anxiety, depression, or deviance (Wanlass & Thomson, 2006).

By joining others in a therapeutic group environment, individuals can begin overcome the

desperation they feel in social situations. In a group environment, the members can shed the fear

of social rejection and share their experiences with others going through similar situations. This

results in a sense of bonding through positive inter-personal relationships.

By providing a therapeutic learning environment with a group setting for social anxiety,

provides the members an opportunity to use what they are learning. It provides them with an

opportunity to test a new social skill. Interactive learning can be done in a group setting with

less stress or anxiety than if done in a real-world setting. Group therapy also rewards individuals

and helps build self-esteem from helping other members resolve their own problems. Group

members can benefit from sharing helpful information, similar life experiences, and give

encouragement to other members to improve. Children who are Autistic benefit from social

skills groups. Social skills group therapy is beneficial for a wide range of personality types. It

can help adolescents with social anxiety, aggression management, impulse control, depression.

This technique can be used for a broad range of personality disorders and developmental

disabilities.

Research has shown that adolescents with Learning Disabilities (LD) have problems with

social interactions with their peers. Children with LD are often rejected socially because of

social blunder they make (Shechtman & Katz, 2007). Children who suffer from ADD/ADHD
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also suffer from antisocial behaviors. This can manifest in impulsive, aggressive, and hostile

behaviors. The article by Schechtman concluded that “expressive-supportive groups are effective

in producing gains in social competence with a population of adolescents with LD” (Shechtman

& Katz, 2007). During the research they incorporated positive interactions, group support, and a

safe environment in which to explore how to interact with their peers. This allowed them to gain

confidence in themselves and they could function despite the complications involved with their

LD. The research did show that positive relationships between the group members were very

important to the success of the study.

To establish an effective School-based group therapy (SBGT) program requires the

facilitator to be knowledgeable of how groups work. Middle school and high school are difficult

periods of transition for adolescents. Adolescents are searching for their own identity. They do

this through family relationships, status symbols, grown-up behaviors, rebellion, other’s

opinions, idols, and cliquish exclusion, (Clinton & Ohlschlager, 2002). Research has shown

some success with using SBGT in regard to working with adolescents who are at-risk and

possess academic and behavioral problems (Paone, Maddux, & Rothman, 2008).

Group talk therapy is not a specific form of therapy but is integrated into various types of

group settings. Group talk therapy can be used to help individuals deal with pain, loss,

depression, anxiety, self-esteem, support, and moral dilemmas. There are hardly any limitations

to the topics that can be covered in group talk therapy. For example, the facilitator introduces a

moral dilemma to the group members, such as pre-marital sex. Afterwards the facilitator asked

open-ended questions to help the group explore the moral dilemma that was presented to them.

A Christian group therapist can provide Biblical Scriptures to help support the idea of abstinence
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and help guide the conversation to deal with the moral dilemmas and peer pressure that

adolescents are dealing with.

The use of group talk therapy helps cultivate interactive learning by permitting each

member to observe different outlooks, perspectives, other coping skills, and alternative answers

to everyday problems. Schools use group talk therapy to help adolescents talk out issues in a

safe environment (Paone, Maddux, & Rothman, 2008). In the group setting they can talk with

their peers about similar experiences and events in their lives. The schools are developing more

groups to help the students deal with loss, divorce, drug addictions, self-esteem, peer pressure,

and transitional problems (Shechtman & Katz, 2007).

Group experiences can help an individual learn to express himself, explore his inner self,

and grow as a person. Group talk therapy is used with students in school as part of the guidance

program to discuss topics such as family issues, academic success, and social issues (Paone,

Maddux, & Rothman, 2008). If a person does not communicate in the group, attend on a regular

basis or his or her only interaction is negative and disrespectful, it can hinder the group’s ability

to grow and connect.

Group activity therapy is can be used with adolescents in middle school and high school.

GAT is similar to child-centered play therapy but developmentally appropriate for most

adolescents in middle school and high school. By providing the group members with structured

group activities that provide a safe environment for the group members they can express

themselves through arts and play. Adolescents whom participate in groups can see how the other

group members solve problems and interact with others (Paone, Maddux, & Rothman, 2008).

Group Activity therapy is made up of three distinctive will consist of three parts.

Therapy will consist of a beginning activity that is structured, free or self-directed play, and
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group discussion. GAT uses structured activities to help provide a safe guided environment for

the members to express themselves. Using expressive art activities helps clients share their

experiences and feelings without feeling threatened (Paone, Maddux, & Rothman, 2008).

Adolescents often need more inventive ways to explore how they feel. Group talk

therapy can be useful in certain situations but group art therapy has proven an ideal way for

adolescents to express themselves. It provides a way for them to communicate difficult feelings

and thoughts through artistic expression. Group art therapy can be beneficial in helping

adolescents solve problems, increase self-esteem, build social skills, and learn behavior

management.   Art therapy is usually an “open” group versus a “closed” group. This allows

members to work at their own pace because the group revolves. This allows the group members

to participate at their own speed and level without fear of falling behind the other members. In

group art therapy, the facilitator will have a planned activity that involves a common theme. The

themes can range from “painting your depression” or “creating a personal portrait with string.” 

Group leaders provide a structured environment for members to create and express their feelings.

Adolescents, although maturing, still thrive in a structured and supportive environment.

One example of a technique to be used in group art therapy is creating masks. The mask making

project asked the members to create two masks, one that represents how society sees them and

the other represents how one views themself. The discussion can lead to what they believe about

themselves, why they choose to wear a different mask in society, and are they being true to

themselves if they act differently in another mask (Vivo, 2009). Sometimes it is hard for

adolescents to share their feelings and GAT provides a venue for individuals to share and express

themselves in a creative way.

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Play therapy is a therapeutic technique than enables a child to express himself through

play. It is a therapeutic method that allows a child to cope with emotional stress or trauma.

Issues that can be dealt within play therapy are family matters (divorce, sibling issues),

aggressive or cruel, social underdeveloped, or victims of child abuse. During the play therapy

session children can explore their feelings and bring these hidden emotions to the surface so that

the therapist can help the clients cope with their emotions. In a study done on a group of African

American Elementary boys, child-centered group play therapy is an innovative strategy that

fosters positive growth in African American boys’ racial cultural identity (Baggerly, 2005). The

article focuses on culturally sensitive group counseling interventions necessary for African

American boys in elementary school. Honoring the African worldview and building self-

confidence are two significant factors for group counseling for this ethnic group. Another

research was done on a group of African American elementary school-aged children with

oppositional defiant disorder (Tiggs, 2010). Play therapy techniques were proven to help

decrease dysfunctional behaviors and decreased impulsive behaviors. Play therapy helps a child

gain mastery over every day dilemmas and traumatic experiences.

Game therapy has evolved over the past few decades. Game play during therapy helps

create an environment that allows individuals to experience new social behaviors in a safe

setting. Social learning theory and cognitive behavioral play therapy supports the integration of

games into therapy sessions. The therapist can choose games that focus on expression of

feelings and identification. Types of games that could be used are tag for gross motor skills and

darts for fine motor skills. Strategy games help teach social skills and promote problem-solving

skills. This allows the individuals to create awareness of their situation and choices, evaluate the

outcome, and accept the consequences for their actions.

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The last genre of games is games of chance. One example of a game of chance that helps

clients deal with their emotions is “Emotion Bingo,” the game uses emotions instead of numbers.

When a player hits “bingo” they discuss a particular situation that evokes those emotions. The

game also provides participants with new vocabulary to help express their emotions (Swank,

2008). Another area that can be used is video games. There is little research regarding using

video games in the therapeutic relationship but future studies are recommended to evaluate the

benefits to psychotherapy. Using video games to help build social skills, patience, self-control,

and anger management can be beneficial to adolescents (Ceranoglu, 2010).

The group leader is one of the most important pieces in a group therapy setting. They are

the mediator, counselor, director, teacher, empathetic ear, traffic-director, and caretaker for the

group. A group leader will help members formulate and work on the designated goals and help

the group discover other links to help build a bond within the group.

A group leader has to assess each individual to see if he or she meets the criteria for the

group. The group leader needs to be an advocate for all the members and make sure that

everyone has a voice in the group. The leader also needs to be guiding the group instead of

“teaching.” Groups are about self-discovery and interactions with the entire group.

Group leaders have to be aware of ethical issues unique to groups. A group therapist

approaches the issue of confidentiality among the group’s members in the beginning session and

at the beginning of each meeting. The only person ethically responsible for confidentiality is the

therapist. If confidentiality is broken within the group, the facilitator needs to decide on how to

address the issue. Options are talking with the client in private and addressing the issue or

having the group talk through the issue. If a member of the group speaks outside of group, it

could affect the group dynamics and cause conflict and tension. The group leader will have to
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step in and help the group work through the issue and help build back the relationships and trust

in the group (Sosin, Lecture D, 2010).

A Christian counselor needs to apply implicit and explicit integration in the therapy

sessions with their clients. Praying for the client, for the session, for personal inner healing, and

for God to guide the counselor in the sessions is a way that a Christian counselor can include

prayer for the client without intruding on his or her moral and religious beliefs. More explicit

integration would be to incorporate the Scripture and prayer into the sessions with the informed

consent of the client (Garzon, 2005). A variety of methods can be used such as:

psychoeducational, applying Biblical scriptures to help a client understand his or her emotions;

behavioral, using relaxation techniques such as reading or quoting scripture when they feel

stressed; cognitive, using REBT (Rational and Emotive Therapy Styles), to help change core

irrational beliefs . In the counseling field, all practitioners share a common goal. That goal is to

help our clients overcome their problems and be able to become well-adjusted and happy

individuals. The counselor will use tools and skills from the secular field but in the end a

Christian counselor acknowledges that God is the final truth (Jenkins, 2008). Christian

counselors use the wisdom in the Bible to help guide their clients carefully into the discovery of

God’s healing words and the source of His truth. “All Scripture is God-breathed, rebuking,

correcting, and training in righteousness, so that the man of God may be thoroughly equipped for

every good work” (2 Timothy 3:16-17).

Group therapy with adolescents is very close to my heart because I have worked in group

homes for the past 12 years with adolescents. The pain and suffering these individuals have

gone through in their short lives is devastating. By doing the research for the paper I could

understand and begin to see why things work the way they do and why sometimes things do not
GROUP THERAPY TECHNIQUES FOR ADOLESCENTS 14

work. A therapist has a great deal of responsibility when it concerns working with a group of

clients. They need to assess the situations, guide the discussions, and mediate without imposing

their personal opinions on the group. As a parent and Christian there are many times when you

want to tell others how to solve his problems by giving him the “right solution” but this is not

beneficial to the client. As a Christian counselor we need to be sensitive to this and give the

client the necessary personal tools to understand the healing process that God provides for us in

the Bible.

Conclusion

Adolescents are at a very critical and delicate stage of their development. They are

seeking to find who they are and where they belong in the world. As a counselor, if I impose my

opinions and beliefs on the individual, this may hinder them finding their on self-identity.

Teaching a client how to find the answers for herself by seeking God’s wisdom and advice is

very crucial for them becoming happy and healthy individuals, mentally, spiritually, and

physically.

Belonging to a group is very natural to adolescents. From early on they are separated

into groups to play sports, go to school, or just simply hang out with their friends. This makes

group therapy ideal for adolescents. It provides a safe environment for adolescents to share and

talk. The group setting provides a safe place where the adolescent can work on social skills,

cooperation, sharing, and anger management. Adolescents can learn from others while

observing their peers who have gone through the same issues. With the added benefits of

Christian Therapy, adolescents are offered peace, triumph, and victory, which can only happen

through a relationship with Jesus Christ.

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References

Avinger, K. A., & Jones, R. (2007). Group Treatment of Sexually Abused girls: A Review of

Outcome Studies. The American Journal of Family Therapy, 35(1), 315-326.

Baggerly, J. (2005). Child-Centered Group Play Therapy with African American Boys at the

Elementary School Level. Journal of Counseling & Development, 83(4), 387-296.

Clinton, T., & Ohlschlager, G. (2002). Competent Christian Counseling. Colorado Springs, CO:

Waterbrook Press.

Cohen, J. A., Deblinger, E., & Mannarino, A. (2004). Trauma-Focused Cognitive-Behavioral

Therapy for Sexually Abuse Chlidren. Retrieved from

http:www.psychiatrictimes.com/display/article/10168/54571

Edelman, S., & Remond, L. (2005). Group Cognitive Behavior Therapy Program with Troubled

Adolescents: A Learning Experience. Child and Family Behavior Therapy, 27(3), 47-59.

Garzon, F. (2005). Interventions that Apply Scripture In Psychotherapy. Journal of Psychology

and Theology, 33(2), 113-121.

Jenkins, D. M. (2008, January 11). Cognitive Therapy - A Brief Christian Review. Retrieved

from

http://www.associatedcontent.com/article/528195/cognitive_therapy_a_brief_christian_p

g2.htm.?cat=72

National Association of Cognitive-Behavioral Therapists. (2008). History of Cognitive Behavior

Therapy. Retrieved from http://www.nacbt.org/historyofcbt.htm

Paone, T. R., Maddux, C., & Rothman, T. (2008). A school-based group activity therapy

intervention with at-risk high school students as it relates to moral reasoning..

International Journal Play Therapy, 17(2), 122-137.

GROUP THERAPY TECHNIQUES FOR ADOLESCENTS 16

Shechtman, Z., & Katz, E. (2007). Therapeutic Bonding in Group as an Explanatory Variable of

Progress in the Social Competence of Students with learning Disabilities. Group

Dynamics: Theory, Research, and Practice, 11(2), 117-128.

Shechtman, Z., & Pastor, R. (2005). Cognitive-Behavioral and Humanistic Group Treatment for

Children with Learning Disabilitie: A Comparison of Outcomes and Process. Journal of

Counseling Psychology, 52(3), 322-336.

Sosin, L. (2010 D). [Group Counseling]. Retrieved from Liberty University

Tiggs, P. (2010). Play therapy techniques for African American elementary school-aged

children diagnosed with oppositional defiant disorder (Doctoral Dissertation). Retrieved

from http://proquest.umi.com/pqdweb?

did=2049060981&sid=1&Fmt=2&clientld=2606&RQT=309&VName=PQD

Vivo, M. (2009). Breaking Down Barriers: Using Art Therapy to Reach Troubled Teens.

Retrieved from http://www.alternativesummercamps.com/ASC/using-art-therapy-to-

reach-troubled-teens.htm

Wanlass, J & Thomson, H.M. (2006, December). Group Therapy for Abused and Neglected

Youth: Therapeutic and Child Advocacy Challenges. Journal for Specialists in Group

Work, 31(4), 311-326.