Open-Ended and Open-Door Treatment Groups for Young People with Mental Illness

The concept of open-ended groups is expanded to include an open-door model (OEOD) wherein members with severe mental illnesses, including schizophrenia disorders and bipolar, can join, leave, and reenter groups as their life circumstances dictate their availability and willingness for treatment. This model is grounded on the work of Schopler and Galinsky's (1984/2006 Schopler, J. H. and Galinsky, M. J. 2006. Meeting practice needs: Conceptualizing the open-ended group. Social Work with Groups, 28(3): 49–68. (Original work published 1984) [Google Scholar]) and Galinsky and Schopler's (1989 Galinsky, M. and Schopler, J. 1989. Developmental patterns in open-ended groups. Social Work with Groups, 12(2): 99–114. [Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) theses on the value and processes of open-ended groups and includes perspectives on mutual aid and group development. Groupwork with the OEOD format is illustrated with examples taken from a group of 79 participants diagnosed with first-episode schizophrenia/schizoaffective disorders, 40 of whom had cooccurring substance abuse. Of the 79 participants in the OEOD group program, 70 (89%) remained in treatment for the maximum of 3 years. The overall value of group treatment for this population is reviewed along with the small number of available publications on open-ended and open-door type groups.     

Examining the Structure and Dynamics of Kinship Care Groups

ABSTRACT

In the fall of 2006, a self-administered Internet survey was made available to all kinship care group facilitators listed in the 2006 New York State Office for the Aging's directory for kinship care providers. The survey sought facilitators' views on the purpose and structural aspects of the groups and to understand whether and how mutual aid processes were occurring. A purposive sample of 16 participants (53% response rate) completed the online quantitative survey that included space for qualitative comments. Findings revealed that 75% of participants facilitated a kinship care group in the past 5 years, and they believed their group purposes primarily included support and growth. Additionally, participants reported that all mutual aid principles occurred in their groups, with the supportive mutual aid interventions occurring more frequently than the challenging ones. Finally, themes from open-ended responses included 1) an enhanced sense of solidarity developed among group members, 2) the importance of facilitators' show of compassion for group members, and 3) facilitators' need to have a working knowledge of and ability to maximize available resources. Implications for serving the needs of kinship care providers through groups and other practices are addressed.     

Further Evidence of Racial Disparities in Drug Court Outcomes: Enhancing Service-Delivery to Reduce Criminal Recidivism Rates for Non-White Participants

Abstract

The first drug court began in 1989, and since their inception, they have expanded to over 3,000 in the United States and United States territories. The long-term goal of drug courts is to reduce criminal recidivism rates for nonviolent offenders who have substance use disorders. This study adds to the literature by using secondary data to compare criminal recidivism rates between drug court participants (n?=?163) and probationers who had diagnosed substance use disorders and arrests that were eligible for drug court but they did probation instead (n?=?185). Criminal recidivism was measured up to 36?months post drug court/probation discharge, which provides a more accurate assessment of the long-term effectiveness of drug court. Furthermore, this study identified which drug court participants were most likely to recidivate. Drug court participants were less likely to recidivate than the probation group. However, differences between the two groups may have contributed to the difference in criminal recidivism rates and also suggest that screening criteria may exclude some non-White participants from drug court. Non-white participants were more likely to recidivate than their White counterparts. Implications for future research and drug court practice are discussed, focusing on enhancing the service-delivery of education and employment opportunities to non-White drug court participants.     

Domestic abuse treatment perspective that builds client voice and skills in a court-ordered environment

Building client voice in men who abuse to reduce dropout and improve outcomes in domestic abuse treatment continues to challenge. This mixed-method study examined the implementation of the Outcome Rating Scale (ORS), a client feedback tool, as a component of an open-ended group domestic abuse program (N = 25). Additionally, the Social Empathy Index (SEI) was administered during pre- and posttreatment individual interviews. Further information about the treatment experience was gleaned from interviews of three treatment completers. More than three fourths of the participants (21 or 84%) completed the minimum of 18 weeks, more than one third (8 or 38%) of completers showed reliable or clinically significant change on the ORS, with a statistically significant increase on the SEI reflecting increases in empathy concurrent with their view of making progress in treatment. Building awareness of self and others’ points of view and applying relationship enhancement skills were key themes expressed during interviews.     

Group Work with First Episode Schizophrenia Clients

ABSTRACT

Group work with first episode schizophrenia clients is an effective way of improving ego functioning, building adaptive coping skills, and addressing the painful feelings associated with learning of this diagnosis. First episode schizophrenia clients are typically in their late teens to late twenties, and confront the cognitive disability, the stigma and the loss of social roles and statuses at a developmentally difficult stage of emotional growth. The dynamic processes by which cohesive groups reduce isolation, build self-esteem, and provide peer support are illustrated with case material. The group work consists of integrating psychoeducation with clients' concerns in order to provide optimal adjustment to the disease. The groups described in this article are structured within a continuing care team treatment model in a medical facility, but the group work discussed may be utilized in a variety of settings.     

The Power of Learning and Men’s Stories in Engaging Abusive Men in the Change Process: Qualitative Study Across Programs

This study draws upon input from facilitators (n = 8) and a sample of men who committed acts of domestic abuse (n = 14) from two urban programs. A key finding of the research was that “learning things and motivation to learn” was an important factor keeping men engaged in treatment. Men also reported that hearing other mens’ stories was a motivator for change. These findings validated the importance of open-ended groups with an educational format. They also suggest that men already in treatment can be of value to others just beginning the treatment process by sharing their stories of change.     

The relationship between lack of control and illusory pattern perception among at-risk gamblers and at-risk cannabis users

The link between lack of control and illusory pattern perception in gambling and cannabis use disorders is important to understand because the role of cognitive distortions as etiological risk factors in the development and maintenance of these disorders remains unclear. In this study, undergraduate students are categorized into five severity groups based on gambling and cannabis problem severity and illusory pattern perception variables are assessed following random assignment to two experimental groups: a lack-of-control and baseline group. In the lack-of-control group, a sense of lack of control is experimentally induced, whereas the baseline group serves as a neutral comparison. The results reveal no differences in illusory pattern perception among the severity groups and only partially and weakly replicate the findings of Whitson and Galinsky (2008), whereby relative to the baseline group, participants in the lack-of-control group perceive more illusory patterns in only one of two illusory pattern perception tasks. As an extension of Whitson and Galinsky, we also find that participants in the lack-of-control group detect more real patterns compared to participants in the baseline group in one of two illusory pattern perception tasks. No differences between severity groups are observed in terms of accuracy for identifying both non-real and real patterns.     

Characteristics of female perpetrators of domestic violence in group therapy

This report is based on a set of clinical observations that identified unique characteristics of 12 female perpetrators of domestic violence in court ordered 52‐week group treatment. The observations are primarily based on the experiences of two therapists who treated a group of 12 female participants, concurrent with two male groups, each of which consisted of 10 participants. A number of comparative clinical observations are made in relation to the treatment of these male and female perpetrators. The group leaders identified three characteristics specific to female perpetrators of domestic violence: compulsive and premature disclosure by more than half the participants in the woman's group, versus minimal or deferred disclosure in the men's groups; perception of self as perpetrator and ambivalent perception of self as victim in the women's group, versus perception of self as either victim or perpetrator in the men's groups; and devaluation of self in the women's group, versus devaluation of the partner in the men's groups. The group leaders also observed that the perceptions and attitudes of the younger, poorer, less well‐educated participants often conflicted with those of their more affluent counterparts.

Therapists who treat mandated perpetrators of domestic violence in groups must contend with direct expressions of hostility. They must also help clients recognize and understand reasons for their dysfunctional partnerships and begin to think about how they can develop healthier relationships. The clinical observations from this group strongly suggest that psychological and socio‐economic factors interact to significantly influence treatment process and outcomes.     

Culturally Based Intervention Development: The Case of Latino Families Dealing With Schizophrenia

OBJECTIVES: This article describes the process of developing a culturally based family intervention for Spanish-speaking Latino families with a relative diagnosed with schizophrenia. METHOD: Our iterative intervention development process was guided by a cultural exchange framework and based on findings from an ethnographic study. We piloted this multifamily group 16-session intervention with 59 Latino families in a randomized control trial. Data were collected on family- and client-level outcomes, and poststudy focus groups were conducted with intervention participants. RESULTS: Preliminary evidence indicates that the intervention is effective by increasing illness knowledge and reducing family burden. CONCLUSIONS: This work can provide a model for how to integrate cultural factors into psychosocial services and enhance interventions in real-world settings for culturally diverse populations.     

Talking with like-minded people—Equality and efficacy in enclave deliberation

Enclaves of like-minded people are often seen as problematic from a democratic point of view, as they have been found to lead to both group polarization and an amplification of cognitive errors. Nevertheless, enclaves can also act as protected spaces have the opportunity to discuss politics with their peers. As a result, people who are less well-endowed to face political disagreement can find it easier to engage in politics. In order to study the ‘empowering’ potential of enclave deliberation, we use data from a population-based experiment (n = 207). The participants were randomly allocated to two treatments. Some participants deliberated in groups consisting of people with similar baseline views on immigration (like-minded treatment), whereas others deliberated in groups where both restrictive and permissive participants were present (mixed treatment). We hypothesize that (1) discussion in like-minded groups is more equal than in mixed opinion groups and that (2) participants with lower resources feel politically more efficacious after deliberation in like-minded than in mixed groups. Our results suggest that people with higher resources tend to be more active regardless of treatment. Nevertheless, we also find that among those with lower resources deliberation in like-minded groups generates a higher sense of equality than discussion in mixed opinion groups.     

The Melanoma Patient Exchange: Insights from a Supportive Group Intervention for Melanoma Patients and their Caregivers

Melanoma is one of the fastest growing cancers worldwide, and the psychosocial impact of its diagnosis and treatment can be substantial. The authors implemented a support group for melanoma patients and caregivers to address a gap in support services. The authors describe insights from the first year of the program, including group format and dynamics, participant feedback, and satisfaction. Feedback was collected using the Group Session Rating Scale and two open-ended questions. Sixty-six members participated and responses demonstrated high satisfaction with the group (Mean = 38.7/40.0). Similar organizations may utilize these strategies to provide a support group option for their population of interest.     

A Comparison of Two Types of Pregroup Preparation for Men Who Batter

This article describes a comparison of the efficacy of two pregroup preparation formats for reducing drop-outs from groups for men who batter their female partners. Eighty men attending a weekly, four-session preparation group were compared with 103 men attending an intensive eight hour workshop format prior to joining open-ended, ongoing groups. The quasi-experimental comparison revealed that the intensive workshop format resulted in significantly fewer drop-outs from the ongoing group prior to completion of four sessions.     

Valuing Diversity and Interest in Intergroup Contact

The present research examines ways in which valuing diversity relates to interest in intergroup contact among members of minority and majority status groups. Using open-ended responses, Study 1 reveals that ethnic minority group members are less likely to perceive that diversity is valued than ethnic majority group members, yet those who perceive that diversity is valued tend to express greater interest in intergroup contact. Surveys of Black and White respondents (Study 2) and ethnic minority and majority respondents (Study 3) indicate similar trends. Moreover, these studies consistently show that valuing diversity uniquely predicts interest in intergroup contact among majority group members, whereas perceiving that outgroup members value diversity predicts interest in intergroup contact among minority group members. Implications of these findings for understanding the role of diversity in intergroup relations, and reformulating aspects of intergroup contact theory, are discussed.     

Identifying Themes Regarding the Benefits and Limitations of Caregiver Support Group Conversations

Support groups continue to be one of the most needed and desired forms of help for family caregivers to persons with dementia. Though the effects of caregiver support group participation have been examined, the benefits and limitations of the dynamics of support group conversations have been neglected. This study focuses on the perceived consequences of group dynamics. Three themes—balance, sameness, and individuality—emerged through analysis of open-ended interviews with support group members following observations of their meetings. The consequences of these themes are illustrated with a case study and the implications of these themes for practitioners are discussed.     

A Support Group for Caregivers of Children with Craniofacial Differences

ABSTRACT

Caregivers of children with craniofacial differences (CFD) experience psychosocial stressors; however, few groups are described for this population. The authors outline an eight-session group and qualitative analysis of caregivers’ experiences. The majority of participants (n = 100) were mothers (76%) of children who were female (75%) and identified as Latino (79%). Children’s mean age was 10.6 (SD = 2.8) years, and they were born with cleft lip/palate (56%) along with other CFD diagnoses. Themes included: group appreciation (21%), mutual acceptance (18%), coping (18%), parenting skills (17%), learning (9%), resiliency (7%), empathy (4%), diagnosis information (3%), and self-care (3%). Caregivers’ reported experiences largely corresponded with group goals.