Counseling
Center
University
of Maryland
College
Park, Maryland
A Model
for Determining Group Counseling Outcomes
Susan S.
Gerson, William E. Sedlacek, and
Robert
W. Freeman
Research
Report # 1-91
Computer
time for this study was furnished by the Computer
Science
Center, University of Maryland at College Park.
Counseling
Center
College
Park, Maryland
A Model
for Determining Group Counseling outcomes
Susan S.
Gerson, William E. Sedlacek, and Robert W. Freeman
Research
Report # 1-91
Summary
The goal of this article is to address areas of concern,
raised by previous research, in order to provide a model for measuring outcomes
of group interventions in school settings.
The researchers utilized objective measures of behavior
change, experimental and control groups, and carefully documented procedures so
that they might easily be reproduced. This model is intended to encourage
counselors to measure group outcomes so that they may have tangible information
about what group interventions work most effectively.
Since their inception in the 1940's group therapies have
grown in popularity and frequency. The variety of interventions that fit the
label "group counseling" as well as the frequency of their use has
caused group interventions to be integral to the field of psychological
counseling (Yalom, 1985).
Small group guidance and counseling is one of the primary
activities of school counselors in elementary, middle/junior, and senior high
schools (Bowman, 1987). However, a variety of problems plague counselors
leading these groups. Resistance from teachers or parents and lack of
confidence in their group skills lead many counselors to be unsure about the
future of counseling groups. In addition, counselors often do not determine
whether their groups are an effective or just an efficient method of working
with students. Systematic methods of measuring outcomes are not typically used
by school counselors.
The majority of research on interventions with children
has been done in a school setting (Riester & Dies, 1986). The school is the
primary environment for school-aged children (other than the home) and is
therefore a comfortable and familiar place for the intervention to occur.
Additionally, the students often do not need to be transported for
intervention, and therefore minimal disruption to their lifestyle will occur.
The most common approaches to measuring student change
have included self-report measures, teacher's observations, and to a
lesser extent, independent observations (Riester & Dies, 1986). The
problems with these approaches are that some important
perspectives are missed (most notably that of the
parents). Additionally, the behavior has often been rated with poorly developed
measures or by only one source. LaGreca (1983) points out the importance of
using several people in the child's environment to do assessments. Barret,
Hampe, and Miller (1978) also support this position.
Another area of concern is that much research relies on
the counselor's own perception of change because there are no comparison groups
present. Freeman, Anderson, Kairey, and Hunt, 1982; DuPlessis and Lochner,
1981; and McKibbin and King, 1983; like numerous others have found behavior
change in children but due to the lack of control groups, were not able to know
if the change was due to a given treatment.
It is clear that a variety of problems have plagued the
study of the effectiveness of group interventions with children (Riester &
Dies, 1986). The greatest concerns have been a lack of objective measures being
used, failure to employ non-treatment control groups, and a lack of
reproducible research projects. The goal of this article is to address each of
these areas of concern in order to provide a model for measuring outcomes of
group interventions in school settings.
In order to be able to effectively attribute treatment effects
to the intervention, this study utilized both an experimental group and a
control group. The control group engaged in an alternate activity for the same
period of time as the experimental
group in order to control for the Hawthorne effect (the
tendency f or any form of attention paid to the students to off ect results) .
The Behavior Rating Profile (BRP) was used because it is a
well researched and reliable measure for gaining information about a child's
behavior at home, school, and with peers. Test-retest results for
emotionally disturbed and learning disabled elementary aged students ranged
from .76 - .97, with the teacher's ratings being the most reliable (.95 -
.97), (Brown & Hammill, 1983). It is a measure which has met the standards
set by Public Law 94-142 for testing special education students. The
greatest concerns raised about using behavior checklists are the subjectivity
of the rater and the necessity of a basal reading level of the rater (Barkley,
1987). While the BRP's reliability indicates that subjectivity is not a
problem, reading level could have been a problem for some of these students or
parents.
Three points were specified in this research to enhance
reproducibility: a clear definition of the sample, a description of the
therapists, and a description of the group activity.
The participants (18 experimental, 18 control) had one or
more of the following disabilities: mental retardation, "serious emotional
disturbance", or learning disability. All of the students were recommended
by their teachers for the program. Students ranged in age from 8-12 years
old. Parents' permission was required to participate.
Groups were conducted over 2 years with 8 students in each
group during year 1, and and 10 in each group during year 2. A PhD psychologist
as well as two graduate students in counseling and psychology worked with the
experimental groups on Friday mornings for 2 hours. Concurrently, the control
group went bowling with classroom teachers or were involved in a special
activity program.
The experimental group time included an indoor art
project, an outdoor group game and a snack time. These active periods were the
times used for meaningful group interaction. Due to the high energy levels of
most group emembers, just sitting and talking was not a strategy that would be
conducive to the group process. During the project time group members were
encouraged to work diligently on their projects and to keep on task. Positive
verbal reinforcemnt was utilized to encourage these behaviors and negative
behaviors were ignored. During the outside games, organized group sports
ensued. Group members were encouraged to take turns, cooperate, and to be
"good sports." Snack time was utilized as a "wind down"
period before their departure back to the classroom and a time of discussion of
the day's activities.
Groups met once a week for ten weeks. Experimental groups
met during the fall term only. Their behavior was measured in September (pre),
January (post) and June (post). Control groups engaged in the non-treatment
activity in the fall term and then engaged in the treatment during the spring
semester. Their behavior was measured in September (pre), January (non-treatment
post) and June (treatment post). A comparison was made
between experimental and control group means over time.
Year 1: Group means were examined on 5 different areas:
parent rating of home behavior, teacher rating of school behavior, child's
rating of home behavior, child's rating of school behavior, and child's rating
of peer relations. Both control and experimental groups showed slight group
changes over time from pre to post tests. While the experimental group had
slightly higher means than the control group, both groups' scores increased
slightly from pre to post test on all dimensions. The changes from pre to post
test for experimental and control groups were not statistically significant
(.05 level).
Year 2: Group means were examined on teacher rating of
school behavior, child's rating of home behavior, child's rating of school
behavior, and child's rating of peer relations. This change was made because
many parents experienced difficulty in understanding the questionnaire items
during Year 1. Both control and experimental groups showed slight group changes
over time from pre to post tests, but the differences were not statistically
significant (.05 level).
Therefore, it is possible that the treatment did not
result in any change in the experimental group members' behavior. However,
there are a variety of concerns in the data collection that indicate other
issues that may have affected the outcome of the study.
Three primary concerns may be raised about the results
found, indicating needed changes for future research. The first concern is in
the use of the BRP. Several parents as well as students were unable to
understand the language used in the questions. The authors of the BRP indicate
that it is an appropriate measure for this population, however, our experience
indicates that this measure was beyond the comprehension of several students
and their parents. Caution should be used in future work with this measure for
special populations.
Second, it is possible that the goal of this research was
too comprehensive. To observe overall behavior improvements in children whose
primary difficulty is with their behavior is a large goal. Many of these
children spend years in special placements in order to improve their behavior.
Perhaps, a more attainable goal for ten weeks work could have been chosen.
Future researchers might measure willingness to share, ability to wait one's
turn or a variety of other discrete behaviors to determine the success of group
therapy with behaviorally disordered children.
This research did successfully meet many of the previous
concerns of researchers of groups treatments for children. Control comparison
groups, multiple behavior ratings, clearly defined intervention, and
credentialed group leaders were achieved.
However, some new concerns were raised: size of sample,
using measures appropriate for the sample, and devising goals appropriate to
the abilities of the students. Future research in this area is
still promising given that these areas of difficulty are
improved.
The counseling needs of children are growing every day.
School counselors will be using groups with greater frequency in order to meet
the increasing needs of school children. It is therefore necessary to continue
to research improved methods of measuring outcomes of groups, in order to
determine under what conditions children most benefit from group interventions.
Barkley, R. A. (1987). The assessment of attention deficit
hyperactivity disorder. Behavioral Assessment, 9,
207-233.
Barret, C. L., Hampe, I. E., & Miller, L. C. (1978).
Research on child psychotherapy. In: Handbook of
psychotherapy and behavior
change: An empirical analysis, ed. S.L. Garfield & A.E.
Bergin. New York:
Wiley, pp.411-435.
Brown, L. L., & Hammill, D. D. (1983). Behavior
rating profile-. Austin, TX: Pro-ed.
DuPlessis, J. M., and Lochner, L. M. (1981). The effects
of group psychotherapy on the adjustment of four
12-year-old boys
with learning and behavior problems. Journal of Learning Disabilities,
14, 209-212.
Freeman, R. W., Anderson, C., Kairey, I., & Hunt, P.
F. (1982). Evaluation of Camp Tortuga, a two week
children's therapeutic day camp
via goal attainment scaling and locus of control. Children's Youth Service
Review, 4, 375-388.
LaGreca, A. M. (1983). Interviewing and behavioral
observations. In: Handbook of clinical child psychology,
eds. C. E. Walker & M. C.
Roberts. New York: Wiley, pp.109-131.
McKibbin, E., and King, J. (1983). Activity group counseling for learning disabled children with
behavior
problems. American Journal of
Occupational Therapy, 37, 617-623.
Riester, A. E., &
Dies, R. R. (1986). Research on child group
therapy. In: Child group
psychotherapy: Future tense, eds.
A. E. Riester
& I. A. Kraft. Madison, CT: International
Universities
Press, pp. 173-220
Yalom, I. D. (1985). The theory and practice of group
psychotherapy.
New York: Basic Books.