The theory behind teen therapeutic social groups

Therapeutic Social Groups for Teens are based on Group Theory principles mostly drawn from the group therapy modality Psychodrama, and adapted to the developmental needs of teenagers in general and the individual developmental needs of the members of a group at any one time. These therapeutic interventions are guided by the principles of:

1) Sociometric theory:  the measurement of quality and quantity of social relationships and interventions to promote social safety, connectedness and cohesion.

2) Role theory: how people develop and function in progressive, coping and fragmenting ways ie roles. Enable interventions to reorganise roles that cause fragmentation in the identity and in the sociometry.

3) Spontaneity theory: the understanding of how the developmental of greater flexibility, adequacy, originality, creativity and vitality can be achieved and strengthened in the role system of the client.

Adolescent developmental theory and teen groups

Adolescent developmental theory indicates that teens need the opportunities to explore, test and master their own experiences and maturational challenges to find their own authentic identity from which they can experience self-confidence, relational success and social belonging.

Considering the multiple developmental challenges characterising adolescence participants have often found themselves floundering and can’t achieve these without the support of a group of peers where they experience belonging.

Teens need peers to launch themselves away from the dependency of their parents/protective adults/ to interdependency and greater autonomy. They need to test that they are okay themselves, not just okay in the eyes of their parents, but connected to others who dont have that parental aregard for them; who they are accepted by and connected with for themselves.

The group offers a dignified way to be supported to develop social/emotional/relational autonomy and connectedness though participants typically present with a loss of confidence in their capacity to feel connectedness and autonomy.

Adolescent developmental theory infroms an understanding of the conditions, strengths and concerns that young people who are distressed about their social isolation, present with. These are integrated into the delicate balance of group interventions.

Young people who attend the group present with any of a range of reasons for experiencing social isolation including neurodevelopmental or other developmental disorders such as autism, sensory/functional deficits, mutism; temperament difficulties such as shyness, mood disorders including anxiety and depression -eg about going to school; a history of traumatic experiences particularly with peers (eg bullying, exclusion) but can be more accidental such as the fright of being in an MVA and loss of confidence; parent/child conflict and oppositionality eg to school attendance, that can all impact on the teens social confidence, skills, connectedness and belonging.

Teen group structure and goals

Group treatment typically occurs in small groups from 2-5 young people of similar age and mixed gender. Young people are met with before the group to ascertain their suitability, to ascertain their willingness to do the work required, to develop and be engaged with it and to clarify goals and objectives for doing the group.

Typical and appropriate goals as articulated by young people are to become more socially confident and connected. The therapist suggests relevant, achievable and palatable goals to work on, as well as ways to achieve those goals, such as aiming to relax socially (therefore counteracting social anxieties) and making it clearer that the young person is friendly towards others by asking questions, responding to and commenting on others stories and their friendliness; by expressing themselves openly, and disclosing their concerns in their own time so that they do not feel pressured and oppositionality, withdrawal is not incited.

Clarity about goals and how to achieve them is usually refined over time in 3 monthly or “as indicated” reviews. At these times the young person is more confident and safe in the group and for example their overuse of avoidance of intense affects can be approached without causing re-traumatisation.

Within the group space there are constant opportunities to explore and develop social/emotional/relational and developmentally appropriate roles through discussions of teen relevant topics, clarification of group culture and norms, creative and structured activities, games, dramatic self-presentation and role plays.

As the group members feel more safe in the group they are encouraged to take responsibility for initiating discussion topics relevant to them and the group’s purpose, for generating mutually engaging and meaningful activities and enactments.

They are given the space to explore and test out different expressions of their emotions, interests and concerns, to develop trust, mutuality, reciprocity, negotiation, help seeking skills via functional expressions of their unique identity.

The role of the group therapist

This is in relationship to and consideration of the other group members wellbeing and within the scaffolding guidance of the group therapist. The group therapist is in the privileged position of holding all the group members private stories, their goals and role systems and deploying interventions to enable a productive group culture and individualised growth without disclosing sensitive matters.

In the “normalised” stages of a group process, after group safety and connectedness have been established, a group would typically look like four young people sitting together talking about their current interests and concerns while doing socially oriented art, music or drama activities. Simultaneously they are being gently guided to develop how they socialise, emote and relate in this quasi-naturalistic context. Topics of discussion typically cover social experiences, pastimes (sport, electronics, art, music), developmental challenges, family experiences, school issues, spirituality, sexuality, morality and vocational aspirations etc.

The group leader strikes a balance between holding the group boundaries, promoting exploration of difficulties promoting progressive role development ennabling a growthful space and activities of shared interest in the service of individual goals and group cohesion.

Group outcomes

In the course of these groups young people typically come to realise that their concerns, anxieties, difficulties are normative, their anxieties about social isolation are diminished, their experiences of acceptance and belonging are bolstered, their “natural” identity, they can shape identity more confidently, their self awareness and awareness of others grows, their social skills develop; they see their own value better and their experience of being of value to others is clearer. These developments are contribute dynamically to all aspects of their ongoing and everyday wellbeing.

Group members typically stay in the group for 6 to 18 months though the length of involvement depends on the individual. Teens “graduate” by their own initiative/preference, in discussion with the group therapist, parents and the group. Parents typically report that their teen is organised to come to the group, happy and generally positive about attendance. Drop out numbers are low. Indeed some young people have their individual therapy schedule coupled with the groups to improve their adherence to other treatments as they are more motivated to come to the groups.

Parents report their teens energy improves (vitality) eg they get up and go to school more easily; they persist with difficult social situations and are more resilient (flexibility and creativity), their mood improves (roles related to self esteem and self confidence strengthen), they are happier; their social engagement improves (more originality and adequacy in their interactions), they make friends more confidently and have the headspace to focus better on their school work and academic goals, extracurricular interests, dreams and vocational pathways.

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