Discuss the multitude of intense feelings that children associate with the abuse as well as the changes that they have encountered.

circumstances might it be beneficial to design a group in which both children and their parents would participate? What special issues might arise in such a group, and how would you manage them?
7DL2PQ2Review the group proposal for children who have been abused, described on pages 313-319 in the textbook. If you were screening children for such a group, what would be some signs that this group would be contraindicated for a particular child? How would you strive to obtain consent from parents or legal guardians, and how would you want to involve them? How might you orient children to this kind of group? Group Work with Children and Adolescents
Notes Introduction
The effects of child abuse are pervasive
and often multifaceted. Aside from the
obvious physical injury sustained by any
number of abusive violations, children
who are abused often experience a range
of feelings and thoughts related to anger
and hostility, fear and anxiety, vulnerability
and powerlessness, sadness and loss,
shame, and guilt. The detrimental outcome
of child abuse often presents itself
in children who struggle with trust issues,
self-blame, depression, isolation, poor selfimage,
and many other interpersonal relationship
issues. The literature and research
have addressed the mental health services
needed, but counselors continually yearn
for new ideas about how to work with children
affected by abuse. Many experts contend
that effective interventions focus on
the appropriate expression of emotions, a
positive self-image, interpersonal relationship
skills, and rebuilding trust in a variety
of social situations. Therefore, interventions
that explore interpersonal and social
relationships can be highly effective with
those who suffer from abuse. In particular,
group counseling provides a nonjudgmental
and safe climate in which children
are encouraged to address a multitude of
issues and in which they have the opportunity
to establish relationships with their
peers who have similar experiences. After
several years of experience, I have found
group counseling to be very helpful for
children affected by abuse. The model that
follows has emerged from my experiences
as an individual, group, and family counselor
with children affected by varying
forms of abuse.
Group Goals
The main goal of this group is to foster a therapeutic
relationship in which children who
have been abused feel safe enough to risk
trusting other children and another adult.
Therefore this group is designed to establish
a safe environment, empower children, and
enhance their sense of self. This group is also
structured to assist children in discovering
that they are not alone in their experiences
and feelings and that others understand
and care, which is accomplished by providing
an environment in which children have
an opportunity to express diffi cult and complex
emotions and act out the intrusive and
abusive experiences. By assisting children to
express the full range of mixed and confusing
emotions felt toward the perpetrator, children
experience a sense of control and mastery,
which is another goal of this group. By the end
of the group, it is hoped that all children have
learned to express their feelings appropriately,
acknowledge their personal strengths,
and develop skills about how to have healthy
interpersonal interactions and relationships.
Setting Up the Group
Screening is crucial when counseling children
who have been abused, and timing is
essential when determining when children
are ready for group. Most of all, children
must be ready and willing to interact with
other children in a therapeutic setting as
evidenced by their desire to play games,
talk, and generally spend time with peers.
A Group for Children Who Have Been Abused
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All rights reserved. No distribution allowed without express authorization
314 PART 3 Application of Group Process to Specific Groups
All children in my groups have completed or
are concurrently involved in individual and
family counseling, and I utilize case notes and
clinical impressions to assist in the screening
process. When I believe children are ready, I
invite them to participate in group counseling.
I emphasize that they can decline, thus
empowering them to make choices.
Group counseling is contraindicated if
(1) the abuse happened recently, (2) the
abuse is still highly traumatizing to the
child, (3) the child has experienced serious
psychological disturbances such as suicidal
behavior, self-mutilation, severe mood
swings, or thought disturbances (hallucinations
or delusions), or (4) the child was
abused by more than one person at a time.
The functioning and climate of the group
are dependent on the behavioral patterns
of prospective members. Accordingly, it is
essential to balance the group with members
similar in age, physical size, and gender. Likewise,
the type and severity of the abuse must
be considered when composing the group so
that children are not re-traumatized by other
children’s stories. Once children are deemed
appropriate for group counseling, consent
from the legal guardian must be obtained.
Parent/Legal Guardian Consent
In most cases, I converse with parents/legal
guardians in person, but sometimes I send a
letter of consent. The letter outlines issues of
confi dentiality, therapeutic factors, topics to
Dear Parent/Legal Guardian:
As you are well aware, the detrimental outcome of child abuse often
presents itself in children who struggle with trust issues, self-blame,
depression, isolation, poor self-image, and many other interpersonal
relationship issues. While such problems are currently or have been
addressed with your child in individual and/or family counseling, I
believe that group counseling is yet another opportunity that can be
highly therapeutic and benefi cial to your childʼs mental well-being.
Throughout my experience as a counselor and play therapist, I have
found that many children affected by abuse struggle with relationships,
namely peer relationships. Research has indicated and I fi rmly believe
that group counseling can assist many children in (a) learning how to
trust others, (b) understanding that they arenʼt alone in their experiences,
(c) developing healthy interpersonal relationship skills, and
(d) increasing their sense of control and mastery when in social situations.
By interacting with others who have similar feelings, experiences,
and concerns, children learn how to accept and cope with their emotions
and thoughts more effectively.
Based on clinical observations and my professional judgment, I
believe that your child is ready and prepared for a group counseling
experience. Accordingly, I am requesting that you grant permission for
___________________________ (childʼs name) to take part in a 10-week
group that will be made up of approximately fi ve to seven other children
who have similar concerns and are compatible in terms of age, size, and
Group sessions will include an array of structured and nonstructured
conversations and activities related to abuse and other mental health
issues. All children and parents will be informed about confi dentiality,
but I cannot control what children say or do outside of the session. However,
I will make every effort to enforce confi dentiality and ensure the
physical and emotional safety of your child. Should you have any questions
or concerns about the group, please contact me at ____________.
By signing this form, you acknowledge and support your childʼs
participation in this group counseling experience and hereby provide
written consent.
________________________________ ___________________
Parentʼs/Guardianʼs Signature Date
________________________________ ___________________
Witnessʼs Signature Date
________________________________ ___________________
Teresa M. Christensen, PhD Date
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CHAPTER 9 Groups for Children 315
be discussed in the group, and a description
of the process, which provides a rational for
group counseling with children affected by
abuse (see letter). I emphasize that group
does not take the place of individual or family
counseling, but that it is a supplement to
the current treatment plan.
Written consent is obtained from legal
guardians prior to informing the child about
the group. (It is important to attain proof of
legal guardianship, particularly when children
don’t reside with their biological parents.)
Legal guardians may include foster
or adoptive parents, grandparents, or other
members of the extended family.
Group Composition and Characteristics
This type of group works most effi ciently
with children of similar ages (only 1 to 2 years
apart) who have suffered the same type of
abuse. Adolescents can also benefi t from
such a group, but the activities described
here pertain to a group for children ages 7 to
12 who have been sexually abused. Because
developmental and gender issues need to be
considered, each group is structured a bit
differently depending on the specifi c needs
of the members. Due to factors such as
trust, power and control, group cohesion,
and boundary issues, this is a closed group.
The group consists of fi ve to seven members
who meet for 45 to 60 minutes once a week
for 10 consecutive sessions.
Because of my experience as a play therapist,
I prefer to facilitate groups with children ages
4 to 12 in the playroom. This space allows for
a variety of structured activities that incorporate
both nondirective and directive play
(therapeutic toys and games, art supplies,
sand, and other creative materials).
Group Format
I use a combination of directive and nondirective
techniques, and development and
process issues are addressed by dividing
each group session into three basic segments
(warm-up, work, wrap-up). The structure
and topic for each session varies depending
on the issues and needs of the individual
members and the group as a whole. Therefore,
aside from the initial session (Orientation)
and the last session (Celebration),
weekly sessions alternate between structured
and nonstructured activities. Sessions 1–4,
6, 8, and 10 are highly structured through
one or more activities focused on topics
related to abuse. I use a variety of activities
and games in the structured sessions that
are derived from my clinical experience and
other resources. Sessions 5, 7, and 9 are
process oriented and begin with nonstructured
time in the playroom or a space with
a variety of games, toys, art supplies, and
activities that group members are free to
choose from. All sessions begin with 5 to 10
minutes for warm-up, which includes (a) a
check-in with each member about how he
or she is feeling today, (b) time to refl ect on
and talk about what happened in the last
session, and (c) discussion about what the
group session will be like. The next 25 to
35 minutes of the group, the work phase,
includes either a structured activity or free
play. The fi nal 10 to 15 minutes of each
session is reserved for wrap-up, also known
as T&T (Treat and Talk Time). During
T&T group members are offered a healthy
snack and encouraged to take turns sharing
their reactions to the session. Discussions
focus on what members learned in
the session and on how these experiences
might be generalized to their life outside of
the group. The following outline includes
examples of topics and activities for each
of the sessions.
Session 1: Orientation
The initial session includes discussions about
confi dentiality, the purpose and structure of
the group, and rules (policies). I usually begin
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All rights reserved. No distribution allowed without express authorization
316 PART 3 Application of Group Process to Specific Groups
by thanking members for choosing to be a
part of this group. I also state that everyone
in the group has been abused but that this is
not the only reason members were selected
for this experience. I indicate that this group
is about getting to know others, learning how
to express feelings appropriately, and learning
how to make positive choices. To assist children
in getting acquainted with one another,
I facilitate an icebreaker in which children
take turns stating their name and something
about themselves (favorite color, animal, or
time of day). This type of go-around continues
for approximately 15 to 20 minutes.
During the last half of the session, I use
the term “group policies” to discuss rules
and enlist the help of group members in
making a list of rules for this group. This
sets the tone for empowering the children to
co-construct the group experience. I record
this information on a poster titled our
“Group Declaration Banner” and provide
a variety of art materials and encourage
children to sign their names and decorate
the Group Banner, which will be displayed
during each group session and referred to
whenever necessary to set limits. I closely
monitor what policies members choose to
adopt and make certain that we include
rules to protect physical and emotional
safety. I make certain that our declaration
gives children the freedom to remain silent
or pass on go-around activities, and I also
emphasize boundary issues such as confi –
dentiality and physical touch. In most cases,
group members come up with policies that
far surpass the rules or limits that I would
enforce. Accordingly, I monitor the group to
make certain that they don’t make too many
policies, or that the policies aren’t too rigid.
This group session ends with a fi nal wrapup
T&T go-around.
Session 2: Awareness Activity
Session 2 includes a relationship-building
activity intended to promote member interaction.
Each member of the group creates
an “identity collage,” choosing four or fi ve
magazine images, phrases, or words that
describe how the member sees her- or himself.
Therapists are encouraged to select a
wide range of magazines that support diversity
and are developmentally appropriate.
Once members have had the opportunity to
share their collages, they are encouraged to
refl ect on how they have changed since the
abuse. Group members are then encouraged
to select at least one more item, word, or
phrase that represents how they believe they
have changed as a result of the abuse and
how they feel about this change. These items
are used to alter the existing collage, and
group members are again given the opportunity
to share their revised collages.
This activity gives group members an
opportunity to self-refl ect and engage in selfexploration
regarding how the abuse has
affected them. When processing this activity,
it is important to discuss the multitude of
intense feelings that children associate with
the abuse as well as the changes that they
have encountered. For example, the following
remarks were shared in groups I facilitated
with children who had been molested:
“I am sad that I don’t live with my mom
and dad anymore.” “I hate being a boy! My
body does strange and dirty things.” “I don’t
know if I will ever fi nd a husband, because
no boy will want me after they learn about
what happened with my dad.”
Session 3: Secrets and Touches
This session includes an activity specifi c
to inappropriate and appropriate touching
and safe and unsafe secrets. Because this
activity is intended to help children learn
how to both establish and adhere to appropriate
physical boundaries and distinguish
between safe and unsafe secrets, it is important
to fi rst defi ne these concepts in developmentally
appropriate terms to children. For
example, I would explain: “A safe secret is
9781133664970, Groups: Process and Practice, Marianne Schneider Corey – © Cengage Learning.
All rights reserved. No distribution allowed without express authorization
CHAPTER 9 Groups for Children 317
not telling about something that won’t harm
anyone else, like keeping a surprise birthday
party a secret. Whereas an unsafe secret
is when something hurtful or dangerous is
happening to you or someone else and you
keep it a secret by not telling anyone.” As
a group activity, members are then encouraged
to come up with lists of appropriate
and inappropriate forms of touching and
safe and unsafe secrets. This activity ends
with members developing a plan about how
to handle touching and secrets in a healthy
manner in the future.
Session 4: Trust Activity
Session 4 focuses on activities pertaining
to trust such as a trust walk. The walk
involves some members being blindfolded
while other members serve as guides as
they both proceed through a maze or series
of directions. This activity facilitates issues
pertaining to trust, vulnerability, powerlessness,
risk-taking, facing anxiety, and relying
on others for support. Once members have
processed their reactions to the trust walk
experience, they are instructed to create a
list of people whom they can trust in their
lives and to indicate why. Members are given
the option of sharing their list with the rest
of the group.
Session 5: Process Oriented
Similar to other sessions, Session 5 begins
with a check-in process. Then members
are encouraged to make their own choices
about what they would like to do during
this session. As the leader, I become a keen
observer in the ways children choose or do
not choose to engage with other members.
I offer verbal and nonverbal encouragers
and refl ections as members make their own
choices about what to do in the session.
Children often choose to play games or
build sandtrays together. Some children
use the time to explore the playroom or to
create a drawing or painting on their own.
The session ends with the traditional treat
and talk time when children are offered an
opportunity to refl ect on their experiences
in the group.
Session 6: Interpersonal Interaction Activity
At this point in the process, I believe it is
important to help members address relationship
issues, and we cover a variety of topics
related to communication: using “I” messages,
how to show respect for emotional
and physical boundaries, how to ask for what
one needs, and ways to appropriately express
feelings. A number of games and structured
activities that are specifi cally designed to
address these topics including The “talking,
feeling, doing” game, role-plays, puppet
shows, family drawings, blowing bubbles (to
represent physical boundaries), and the telephone
game. We also might read from books
that address issues related to abuse.
At the end of this session I remind members
that we only have three more sessions
until our last meeting, and I ask members
to begin to think about how other groups
in their lives have ended. I give examples of
endings by talking about what it might be
like when clubs or teams don’t meet anymore
or the end of the school year. In particular,
we discuss how members have learned to
say good-bye to others, we talk about “goodbye
rituals” that members have experienced
in their families and communities, and we
begin to prepare for the end of our group.
Session 7: Process Oriented
During this session children typically read
books, play with puppets, or utilize the art
material to create a picture or journal for
Session 8: Resilience Activity
The goal of this session is to assist members
in developing a positive self-image.
The focus is on helping children identify
personal strengths and learn how to use
9781133664970, Groups: Process and Practice, Marianne Schneider Corey – © Cengage Learning.
All rights reserved. No distribution allowed without express authorization
318 PART 3 Application of Group Process to Specific Groups
their strengths to make healthy choices in
the future. At the beginning of the session,
I clarify what strengths are and encourage
members to take a few moments to construct
a list of at least four strengths they
recognize in themselves. Examples have
included: “I am a good listener.” “I am a
good friend.” “I have learned how to show
my anger without hitting someone or something.”
“I know how to say NO.” Because
self-esteem can be damaged by child
abuse, the group counselor’s assistance is
especially important here. As a group we
decide what we can do to creatively exhibit
our strengths. Any number of activities and
games can be used to accomplish this task,
and I encourage members to create something.
Sometimes they use art and construction
materials to build kites, personal or
family shields, personalized license plates,
or T-shirts. Then members list their wants
and needs in life, and we brainstorm ideas
about how they can use their strengths to
get their needs met and satisfy their desires
in a healthy manner. I emphasize that they
still have a choice about many aspects of
their lives regardless of what people have
said or done to them in the past. We talk
about how their strengths can help them
make healthy choices, about how to get
their needs met in the future, and how to
express their feelings and thoughts.
At the end of this session, we discuss the
upcoming celebration session. We brainstorm
ideas about what they want to do
(activities, games, art, talk, sing, or dance).
I inform group members that I will provide
some sort of drink (usually juice) and at
least one treat (usually fruit or popcorn)
and tell members that they are welcome
to bring something but are not required
to do so. This takes pressure off children
who are anxious about bringing something
or whose parents/guardians don’t have the
resources or aren’t actively involved in this
Session 9: Process Oriented
Due to the power of group development and
enhanced trust, members typically choose
activities in which they verbally interact
more during Session 9. For example, children
often play board games and draw and
share their pictures.
Session 10: Celebration
The last session is a celebration and a time
to reminisce about the group experience,
which includes members talking about
what they have learned about themselves
and others. The intent of this session is
to achieve some sense of closure, and
because group members have a hand in
planning this session, the structure often
varies. Final sessions have included, but
are not limited, to the following. Younger
children may want to create good-bye pictures
that everyone in the group signs, create
and act out a skit or role play, or play a
game together. Older children and adolescents
are more likely to appreciate a nondirective
session in which group members
have free time to reminisce about previous
sessions and talk about their experiences
in the group. On many occasions, older
children and adolescents have brought
refreshments to the last session and created
personal journals out of art materials,
which were then autographed or decorated
by every member in the group as
a memory of this experience. Regardless
of the format, I request that all members
share the following information: (a) what
they have learned about their individual
strengths and talents, (b) how they plan
to continue making positive choices and
building healthy relationships outside of
group, and (c) their individual plans about
how to take care of themselves.
Expected Group Outcomes
Children who have been abused deserve
opportunities to express their thoughts,
9781133664970, Groups: Process and Practice, Marianne Schneider Corey – © Cengage Learning.
All rights reserved. No distribution allowed without express authorization
CHAPTER 9 Groups for Children 319
feelings and overall reactions with others
in a safe and constructive environment.
Over 14 years of experience facilitating
groups with children affected by abuse I
have come to believe that group counseling
provides an ideal environment for teaching
children how to establish a trusting and
healthy relationship with other children,
and with adults as well. Participating in a
group allows children to break down the
barriers of isolation, express their innermost
struggles, clarify misplaced blame,
and feel more comfortable about interacting
with others. In my view, the group
atmosphere provides a deeper level of healing
for children who have been affected by
abuse. Enhanced interpersonal relationship
skills, increased confi dence and independence,
and self-assurance are but a few
of the outcomes exhibited by children who
participate in these groups. The struggle
to assist children in healing from abusive
experiences can be complex and challenging.
Thus, I encourage group counselors to
pursue unique and creative ways to incorporate
the therapeutic factors of group
work in their interventions with children
affected by abuse.
Resources that I found useful in designing
this group include Carman (2004),
Corder (2000); Hindman (1993), Kleven
(1997), Lowenstein (1999, 2002), and
Spinal-Robinson and Wickham (1992a,
1992b, 1993).
Here are some key points in designing and conducting a group for children:
Points to Remember
Groups for Children
â–  As a prerequisite to the effective facilitation
of groups for children, it is essential to
acquire a working knowledge of the developmental
needs of children.
â–  In designing a group in schools or agencies,
strive to develop collaborative relationships
with agency directors, principals, and colleagues.
â–  It is essential to understand the laws of your
state regarding children and the policies of
the agency where you work.
â–  It is a good practice to obtain written
permission of parents or guardians for
group members who are under the age
of 18.
â–  Confi dentiality is particularly important in
groups with children. Communicate with
children about the importance of keeping
confi dences.
â–  Remember that ethical practice demands
that you have the training and supervision
required to facilitate a group with
â–  Not all children are ready for group participation.
You need to have clear criteria
regarding who can benefi t from involvement
in a group. DeLucia-Waack (2006c) outlines
how to develop screening and selection
criteria based on group goals and member
â–  Having some structure is particularly important
in groups with children.
â–  If you practice group work with children, give
thought to helpful methods of evaluating the
outcomes of your groups. DeLucia-Waack
and Bridbord (2004) review reliable and valid
measures to assess group content and

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